bluuebunny/crossref_metadata_2025 huggingface dataset:
Generating Community Engaged Learning in Gerontology Courses During the COVID-19 Pandemic
Authors: Felsted Katarina , Whitehead Samantha
Published: December 2021

This presentation describes the core traits of a community-engaged learning (CEL course), how one gerontology program incorporated a theoretical framework to continue to provide students opportunities during the COVID-19 pandemic, and how generalizable this is across gerontology programs. Caregiving and Aging Families, a gerontology course enrolling both undergraduate and graduate students, champions community-engaged learning in two critical ways: students attend caregiver support groups in the community, and students form a partnership with a caregiver mentor in the community. This partnership allows students an intimate look at the caregiver's role and burden while enlisting the student to prepare a service care plan and compendium of resources for the caregiver. Ensuring the safety of older adults during the COVID-19 pandemic placed restrictive parameters on these experiences. While students typically attend support groups and identify and partner with a caregiver mentor in person, this needed modification during the pandemic. This was created through the application of Baltes' Theory of Selection, Optimization, and Compensation (SOC model), aided by a CEL teaching assistant, funded through the campus Community Service Center. This allowed for identifying, coordinating, and communicating with community partners throughout the semester and provided ongoing communication, technical assistance, and problem-solving for both partners and students. Caregiver groups with a robust online, synchronous presence were identified and approached. The gerontology program communities of interest disseminated a call for community caregivers with basic technological familiarity. The caregiver mentor-student partnerships were founded and maintained, with additional benefits stemming from a shared pandemic experience.
Fraudulent Data Detection and Prevention Within the National Caregiver Survey
Authors: Jackson Jada , Lipchin Jessica , Zhang Rachel , Robinson-Lane Sheria
Published: December 2021

The National Caregiver Survey is an online, incentivized survey that aims to gather information about the health and coping strategies used by Black family caregivers of persons with dementia. The survey data will help elucidate the relationships between coping, health, and adaptation to family caregiving and facilitate the development of culturally responsive caregiver support programming. Virtually distributing this survey made it cost-effective, easily accessible, and quick to produce usable data. The online format also helped the team reach caregivers from across the nation, as well as keep participants safe during the COVID-19 pandemic. Unfortunately, because online surveys are advertised and administered digitally, they become targets for hacking, especially when the surveys are incentivized. The hacking attempts are executed through digital survey bots and threaten the integrity of the collected data. These corrupt responses also increase study costs by falsely rewarding the hackers for their survey responses and research team time in the investigation, detection, and removal of fraudulent responses. To detect potential bots, a reCAPTCHA bot system was incorporated into the survey, and survey questions were formatted specifically to thwart hacking attempts. Finally, data were cleaned to remove illogical, inconsistent, and duplicative surveys. Findings from this work may help researchers improve online survey design and data collection methods to provide greater confidence in conclusions drawn from virtually surveyed data.
Support Needs as Perceived by Grandparent-Caregivers: A Qualitative Systematic Review
Authors: Matovu Schola , Whitley Deborah , Young Heather
Published: December 2021

Caregiving can have adverse mental and physical health outcomes. Older grandparents who are primary caregivers for their grandchildren report multiple health conditions such as depression, anxiety, hypertension, cardiac disease and chronic fatigue, which are caused by or otherwise exacerbated by the caregiving demands. We conducted this qualitative systematic review to identify support needs that contribute to such poor health outcomes and as perceived by grandparent-caregivers for minor grandchildren. We searched relevant databases (PubMed, PyschINFO, CINAHL, and Social Work Abstracts) using terms such as: child rearing, parenting, child custody, grandparents, support needs, and caregiving. Studies were included for review if they were written in the English language; used only qualitative methods; and were published from January 1990 to January 2020. Included studies were critically appraised using the Critical Appraisal Skills Programme checklist. Data were extracted from these studies and synthesized using meta-ethnography. Of the 2828 studies identified, 58 studies from 12 countries met all inclusion criteria for review. Three main themes emerged from the review: 1) grandparent-caregivers’ personal needs, and 2) grandchildren needs. Both themes were further divided into subthemes of health (mental & physical), financial, social (interpersonal, cultural and environmental factors and services). Findings from this review have potential to: 1) inform design of comprehensive interventions and screening needed to address perceived support needs; and 2) identify gaps in and barriers to available support resources for older grandparent-caregivers. Further research is needed on comprehensive assessment of support needs and risk for poor health outcomes among grandparent-caregivers.
Utilization of social media peer support groups among family caregivers of patients with dementia
Authors: Ramos Mary Dioise
Published: December 2021

Caring for a family member with dementia is particularly challenging. Unpaid family caregivers provide a significant amount of the care for aging relatives, and they provide the vast majority of long-term care. Family caregiving often results in negative effects, which compromises the caregiver’s physical and psychosocial health. Social media support groups are an increasingly common venue for family caregivers supporting patients with dementia to exchange emotional, informational, and instrumental support. This study examined the utilization of social media support groups among family caregivers of patients with dementia during the pandemic. Using deductive thematic analysis, the use of social media support groups of family caregivers provide link to social interaction as a means when social distancing is enforced due to the pandemic. Family caregivers use social media support groups to share their personal experience, express their mood and feelings, offer prayers and positive quotes, keep up with the current events, gather information, and share feedback about dementia care services. Awareness of the potential advantages that social media support groups offer, healthcare providers can encourage family caregivers to use social media support groups as an empowering and practical platform. Further research is required about the long term benefit from social media support groups and the reliability and validity of the information that the family caregivers can get from the group.
Intergenerational Communication as Intervention: Social Isolation in Older Adults During COVID-19
Authors: Kirk Laura , Kessler Penny , Gingerich Stephanie , McGill Sharon , Pryor Hanna
Published: December 2021

Social isolation and loneliness are prevalent and impactful in the lives of older adult across care settings, and the emergence of a deadly global pandemic requiring social distancing and quarantining exacerbated these experiences significantly in 2020. A semester-long communication-focused clinical project was developed and piloted for sophomore bachelor of nursing science (BSN) students during fall 2020. Affording preclinical nursing students the opportunity to develop communication skills early in their program of study holds potential, and learning the story of older adults appears to be mutually beneficial; older adults serve as mentors and share their story, and preclinical nursing students have an opportunity to learn about their mentor’s life, challenging some prevalent stereotypes about aging. A pre- post-clinical survey of student attitudes toward older adults suggests a dramatic positive shift in perspective, and unsolicited, anecdotal comments in student reflections support this finding: “...it helped me feel much more open to working with older adults in the future”; “This conversation taught me that my assumptions about the older generation are not always correct”. Of older adult participants, 96% reported the experience enriched and enhanced their social connectedness, with 88% requesting to participate in the program again. Narrative comments from residents indicated that their involvement enabled them to feel engaged and purposeful: “I was a mentor”; “Conversations were so alive. Connections with curious young people fill my heart and soul.” Intergenerational sharing of life stories has the potential for both healing and growth and may provide an antidote to ageism.
Hope, active coping and well-being in stroke-survivors and caregivers: An actor–partner model analysis
Authors: Chow Esther , Fung Sai-fu
Published: December 2021

Purpose: Stroke is a medical condition cause of suffering for both patients and their caregivers within the family. This paper aimed to assess the influence of the psychological construct of hope and active coping on hedonic wellbeing in patient with stroke and caregiver dyads by determining the dyadic patterns. Methods: A baseline study including 200 stroke-survivor (Age 73.63; SD=7.22) and caregiver (62.49; SD=14.44) dyads with actor–partner interdependence model (APIM) estimated by structural equation modelling with maximum likelihood estimation. Herth Hope Index (HHI), Proactive Coping Inventory (PCI) and Personal Wellbeing Index (PWI) were used to measure hope, proactive coping and wellbeing, respectively. Results: The APIM analysis revealed that both stroke patients and caregivers demonstrated double actor-only pattern. As such, stroke-survivors’ hope and active coping excreted an actor effect on their own wellbeing with beta = 0.48 (p < 0.01) and 0.16 (p < 0.01), respectively. Similarly, the caregiver also reported an actor effect between hope and wellbeing (beta = 0.84, p < 0.01) as well as active coping with wellbeing (beta = 0.37, p < 0.01). The overall SEM model also fulfilled the criteria for good model fit (χ2 (5.87), p = > 0.05, CFI = 0.98, TLI = 0.96 and RMSEA = 0.07). Conclusions: The results suggest that both stroke patients and caregivers’ hedonic wellbeing are holding actor-oriented pattern with the hope and active coping. The implications for clinical practitioners, research and theoretical development are discussed.
Psychosocial Interventions for People With Dementia and Their Caregivers in Primary Care
Authors: Frankenstein Lou , Jahn Georg
Published: December 2021

Psychosocial interventions, such as occupational and behavioral therapy are effective opportunities to support people with dementia and their caregivers in adapting to the cognitive and behavioral changes and the resulting challenges in everyday life they are facing. However, psychosocial interventions do not seem to have found their way into routine care yet. We wanted to get an insight into the knowledge and attitudes general practitioners have about occupational and behavioral therapy. In an online survey we asked medical students about the relevance of dementia, occupational therapy, and behavioral therapy during their studies. In another online survey we asked practitioners what they had learned about these topics and to what extent they are making use of psychosocial interventions. Then semi-structured interviews were carried out with general practitioners all over Germany, exploring their experiences with dementia and psychosocial interventions in primary care as well as their expectations regarding interdisciplinary cooperation. It became obvious that psychosocial interventions are not conveyed sufficiently within medical school. A lack of occupational therapy prescriptions for people with dementia seemed to result from uncertainties regarding the content of the approach and the budgeting of the prescriptions. Barriers for prescriptions of behavioral treatment were a lack of therapy places and the perceived inadequacy of the approach for this target group. General retentions to invest in people with dementia were expressed. These obstacles need to be overcome in order to provide optimal care for people with dementia and their family caregivers.
Qualitative Study of an mHealth Mindfulness intervention with Caregivers of Older Adults with MCI or Dementia
Authors: Llaneza Danielle , Dong XinQi , Duberstein Paul , Kozlov Elissa
Published: December 2021

Caregivers of patients with dementia experience high levels of emotional distress. mHealth interventions have the potential to feasibly address some needs of caregivers and reduce stress. This qualitative research study of (n = 15) caregivers of patients with dementia explored caregivers’ experience using a mindfulness meditation mobile application. The qualitative interviews were guided and structured to allow participants to share their perceived benefits, drawbacks, likes, and dislikes of using mHealth strategies to manage stress and anxiety. We asked about the caregivers' experience with mindfulness before the study, use of the app, their positive/helpful and negative/unhelpful app experiences, the perceived value of the app, and potential enhancements of the app. Caregivers reported that the app was easy to use, engaging and that there were many perceived benefits. They also noted multiple barriers to using the app including time constraints and implementation of mindfulness techniques outside of direct app use. Most of the caregivers recommended using the app to increase knowledge of mindfulness and to reduce stress. Our findings support the growing body of literature on the practical use of mHealth strategies for caregivers. Future work should address the perceived barriers caregivers encounter when using mHealth strategies.
Association of Frailty Index with Clinical BPH Progression and Serious Adverse Events: the MTOPS Trial
Authors: Bauer Scott , Ensrud Kristine , Walter Louise C , Suskind Anne M , Ricke William A , Liu Teresa T , McVary Kevin T , Covinsky Kenneth
Published: December 2021

Lower urinary tract symptoms due to suspected benign prostatic hyperplasia (BPH) are increasingly treated with medications targeting obstruction among older men, but frailty may represent a novel risk factor for this condition. Our objective was to assess the associations between frailty and clinical BPH progression or serious adverse events (SAE) among 3047 men, age 50-89 years, enrolled in the Medical Therapy of Prostatic Symptoms Study, a placebo-controlled RCT of doxazosin, finasteride, or combination therapy on clinical BPH progression. We created a frailty index using 69 items collected at baseline and categorized men as fit (0-0.1), less fit (0.1-<0.25), or frail (0.25-1.0). The primary outcomes were time to 1) first composite event of clinical BPH progression, and 2) SAE requiring hospitalization. Cox proportional hazards models were adjusted for demographics, intervention, BPH surrogates, and comorbidities. At baseline, 28% men were fit, 58% were less fit, and 14% were frail. During follow-up (mean 4.5 years), the incidence rate of clinical BPH progression was 2.2/100p-y among fit, 3.0/100p-y among less fit (HR =1.28, 95% CI 0.98, 1.67), and 4.1/100p-y among frail men (HR=1.60, 95% CI 1.13, 2.26). Among men randomized to combination therapy, the SAE incidence rate was 3.4/100p-y for fit men versus 12.7/100p-y for frail men (HR=5.98, 95% CI 3.76, 9.52). In conclusion, frailty is independently associated with greater risk of both clinical BPH progression and SAE. The decision to initiate medical therapy for BPH among frail men should therefore include a discussion of both benefits and risks via shared decision making.
Body Mass Index and Frailty Among Older Mexican Americans: Findings From an 18-year of Follow-up
Authors: Rutherford Megan , Downer Brian , Li Chih-Ying , Snih Soham Al
Published: December 2021

The objective of this study was to examine body mass index (BMI) as predictor of frailty among non-frail Mexican American older adults at baseline. Data are from an 18-year prospective cohort of 1,647 non-institutionalized Mexican American aged ≥ 67 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/1996-2012/13). BMI (Kg/m2) was grouped according to the National Institutes of Health obesity standards (<18.5=underweight, 18.5–24.9=normal weight, 25.0–29.9=overweight, 30.0–34.9=obesity category I and ≥ 35=obesity category II and extreme obesity). Frailty was defined as meeting three or more of the following: unintentional weight loss of >10 pounds, weakness, self-reported exhaustion, low physical activity, and slow walking speed. Covariates included socio-demographics, comorbidities, cognitive function, depressive symptoms, and limitations in activities of daily living (ADL). General Estimating Equations were performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of frailty as a function of BMI categories. All variables were analyzed as time varying except for gender and education. Participants in the underweight or obesity type II / morbidity obesity category had increased OR of frailty over time than those in the normal weight category (2.68, 95% CI=1.46-4.9 vs.1.55, 95% CI=1.02-2.35, respectively) after controlling for all covariates. Those who reported arthritis, hip fracture, depressive symptoms, or ADL disability had increased odds of frailty over time. This study showed a U-shaped relationship between BMI and frailty over an 18-year period of follow-up which has implications for maintaining a healthy weight to prevent frailty in this population.
Malnutrition-Sarcopenia Syndrome and its Associated Factors Among Older Adults
Authors: Taani Murad
Published: December 2021

Malnutrition and sarcopenia are present in parallel in older adults and characterized by a combination of inadequate nutrient intake and decreased muscle mass, strength, and/or function. The presence of both conditions has been termed Malnutrition-Sarcopenia Syndrome (MSS) and is associated with negative health outcomes. The objective of this correlational study was to identify the prevalence and factors associated with the malnutrition-sarcopenia syndrome among older adults living in continuing care retirement communities. A convenience sample of 104 older adults living in CCRCs participated in this study. Muscle mass, strength, and function were measured using bioimpedance analysis, Jamar digital hand dynamometer, and the Short Physical Performance Battery test, respectively. Physical activity, sedentary time, and nutritional status were measured using ActiGraph GT3X and Mini Nutritional Assessment, respectively. Questionnaires were used to measure self-efficacy for exercise and goal congruence for physical activity and protein intake. Of the 104 participants, 37 (35.2%) had sarcopenia, 19 (18.1%) had malnutrition, and 14 (13.5 %) had MSS. Compared with those without MSS, older adults with MSS were more than two times more likely to have a sedentary lifestyle (Odd ratio, 2.028; 95% confidence interval, 2.012–2.044). Findings showed that sarcopenia, malnutrition, and MSS are prevalent in older adults living in continuing care retirement communities. Older adults should be screened and assessed for both malnutrition and sarcopenia. The results also suggest that decreasing the sedentary time could help in preventing MSS among older adults living in continuing care retirement communities.
Risk factors associated with cognitive frailty among community-dwelling older adults: A scoping review
Authors: Lee Sumi , Lee JuHee
Published: December 2021

Objectives: This study aimed to explore the risk factors associated with cognitive frailty(CF) among community-dwelling older adults, and to provide the impact of CF on health-related outcomes. Methods: PubMed, EMBASE, Cochrane, PsycINFO, CINAHL, RISS, DBpia, NDSL, and KoreaMed databases were searched to retrieve studies. Two reviewers independently screened titles, abstracts and articles. The inclusion criteria are peer-reviewed articles written in English or Korean for community-dwelling older adults with both physical frailty and cognitive impairment present at the same time. Results: A total of 3,513 were searched, and the final 33 were extracted according to the inclusion criteria. Physical factors affecting CF were the number of chronic disease, cardiovascular disease, activity of daily living(ADL), making telephone calls and shopping during instrumental ADL, and a Mini Nutrition Assessment–Short Form score. Psychological factor was depressive symptoms. Significant behavioral factors included self-reported physical activity, low vitamin D, smoking, frequent insomnia, and sedentary lifestyle. In social factors, social participation such as volunteering was identified as a protective factor. Mortality, followed by dementia was health related outcomes on CF, including ADL dependence, poor quality of life, and hospitalization. However, the CF-related fall was inconsistent. Conclusion: A wide variety of factors have been presented in studies related to CF. In order to understand CF and improve health-related outcomes, older adults in CF should be screened as high-risk group. When the risk factors and protective factors of CF managed, better health-related outcomes will lead to successful aging of community-dwelling older adults.
The Effect of Low-Dose Aspirin on Frailty in Older Adults in the Aspirin in Reducing Events in the Elderly Study
Authors: Espinoza Sara , Ekram A R M Saifuddin , Woods Robyn , Ernst Michael , Polekhina Galina , McNeil John , Murray Anne , Ryan Joanne
Published: December 2021

There are no widely accepted pharmacologic treatments for frailty prevention. Since frailty is associated with inflammation, aspirin has the potential to reduce frailty. We investigated whether low-dose aspirin reduces incident frailty in participants of the ASPirin in Reducing Events in the Elderly (ASPREE) trial. In the U.S and Australia, 19,114 healthy community-dwelling individuals aged ≥70 years (U.S. minorities ≥65 years) were enrolled in ASPREE, a double-blind, placebo-controlled trial of 100mg daily low-dose aspirin vs. placebo. Frailty was defined according to a modified Fried frailty definition, and a frailty index which used a deficit accumulation model. Competing risk Cox proportional hazards models were used to compare time to incident frailty for aspirin vs. placebo. At baseline, 2.2% and 8.1% met criteria for frailty by Fried and frailty index criteria, respectively. Over a median of 4.7 years of follow-up, 2252 participants developed incident frailty according to Fried classification, and 4376 according to the frailty deficit accumulation index. There was no difference in the risk of incident frailty between individuals randomized to aspirin versus placebo according to either criteria (Fried frailty HR: 1.03, 95% CI 0.97-1.09, p=0.41; frailty index HR: 1.03, 95% CI 0.97-1.10, p=0.29). Change in frailty over time was not different between the aspirin and placebo treatment arms. The results were consistent across a series of sub-groups, including baseline frailty status. Based on these results, aspirin use in healthy older adults does not reduce incident frailty.
Pre-Operative Physical Function Predicts Post-Operative Skeletal Muscle Gene Expression in Old Mice
Authors: Asche-Godin Samantha , Harlow Lauren , Graham Zachary , Huang Weihua , Mobbs Charles , Cardozo Christopher , Ko Fred
Published: December 2021

In older adults, pre-operative physical function predicts post-operative outcomes. The biological mechanisms underlying vulnerability to physical decline remain poorly understood. Using a mouse model of laparotomy, we sought to identify biological correlates of post-operative function. 24-month-old male C57BL/6N mice were categorized as high functioning (HF) or low functioning (LF) based on pre-operative performance on the accelerating rotarod. On post-operative days (POD) 2 and 4, LF mice had lower rotarod latency to fall times than HF mice did. Forelimb grip strength was reduced after laparotomy in both HF and LF groups on POD 1 and 3 and did not differ significantly between these groups. Whole transcriptome sequencing analysis (RNAseq) of soleus muscles collected on POD 5 showed 224 and 228 differentially expressed genes (DEGs) for HF and LF, respectively, compared to their respective controls. Only 21 DEGs were observed in both groups, including Pparα, Fst and Pla2g15. Such changes may be hallmarks of the post-surgical response in aging. Pathway analysis of DEGs using Ingenuity Pathway Analysis software (Qiagen) revealed one pathway common to HF and LF (osteoarthritis) whereas activation of GP6 signaling and apoptosis signaling was observed in HF and inhibition of PPARα/RXR activation and PPARα signaling was noted in LF. We conclude that pre-operative performance on the accelerating rotarod correlates with differences in skeletal muscle gene expression, which may contribute to the differences in functional outcomes post-operatively in HF and LF mice. Further studies are needed to delineate the roles of these signaling pathways in physical resilience to surgery.
The Role of Obesity in Frailty Incidence: The San Antonio Longitudinal Study of Aging
Authors: Cortes Tiffany , Wang Chen-pin , Hazuda Helen , Espinoza Sara
Published: December 2021

Background: Although initially conceptualized as a wasting syndrome, obesity has been associated with frailty in prior studies. The goal of this study was to examine the associations of obesity and waist circumference with frailty and determine whether they predict incident frailty in an ethnically diverse population of older Mexican Americans (MAs) and European Americans (EAs). Methods: 749 MA and EA community-dwelling older adults (65+) participated in the baseline examination of the San Antonio Longitudinal Study of Aging (SALSA), and 474 participants completed the first follow up approximately 6 years later. Frailty was classified using Fried criteria. Baseline characteristics, including body mass index (BMI) and waist circumference (WC) were summarized by frailty category (non-frail, pre-frail, frail) using ANOVA. The odds of becoming frail at follow-up by baseline BMI and WC were estimated using separate logistic regression models, adjusting for age, sex, ethnicity, diabetes, comorbidity (presence of ≥2 chronic diseases not including diabetes), baseline frailty score, and follow-up time. Results: At baseline, participants were 69 ±3 years old, 61% female, and 50% MA. BMI and WC increased with increasing frailty category (p <0.01 for both). BMI was a significant predictor of incident frailty (OR=1.08, 95% confidence interval [CI]: 1.02-1.14, p=0.011). WC also predicted frailty (OR=1.03, 95% CI: 1.01-1.05, p =0.017). Conclusion: These results demonstrate that BMI and WC are significant predictors of frailty. Interventions which target obesity may reduce the incidence of frailty; however, more research in this area is needed.
Comparison of Catastrophic Out-of-Pocket Medical Expenditures in the US and South Korea
Authors: Kim Narae , Jacobson Mireille
Published: December 2021

To date, relatively few studies have examined catastrophic out-of-pocket medical spending in the United States, especially in comparison to other high-income countries. We compared catastrophic out-of-pocket medical spending among adults age 65 and older in the United States versus South Korea, a high-income country with national health insurance that is often overlooked in cross-country comparisons. We defined catastrophic medical spending as health care expenditure for the past two years that exceeds 50% of one’s annual household income. Using data from the 2016 Health and Retirement Study (HRS) and Korean Longitudinal Study of Aging (KLoSA), we performed a logistic regression to examine the factors affecting catastrophic out-of-pocket medical spending for older adults in both countries. We also performed a Blinder-Oaxaca decomposition to compare the contribution of demographics factors versus health system-level factors to catastrophic out-of-pocket medical spending. The proportion of respondents with catastrophic out-of-pocket medical expenditure was higher in the US; the proportion was 5.8% and 3.0% in the US and South Korea, respectively. Both in the US and South Korea, respondents who were in the lower-income quartiles, who had experienced a stroke or had diabetes, and who rated their health as poor had higher odds of catastrophic out-of-pocket medical expenditure. The Blinder-Oaxaca non-linear decomposition showed that the significant difference in the rate of catastrophic out-of-pocket medical spending between the two countries was attributable to unobservable system-level factors, not observed differences in the sociodemographic characteristics between the two countries.
Non-Response to Population Aging in Sub-Saharan Africa: A Survey of Gerontology Scholars
Authors: Adamek Margaret , Kotecho Messay , Chane Samson , Gebeyaw Getachew
Published: December 2021

Life expectancy is increasing globally, with the biggest gains expected in sub-Saharan Africa. In fact, most of the population growth globally in the next few decades will occur in sub-Saharan Africa. Using an online survey we investigated the perspectives of gerontology scholars on the challenges of aging in sub-Saharan Africa as well as the assets of elders. Respondents (n=72) from 17 countries, primarily in Africa, and representing 16 disciplines, identified the top issues facing African elders as: poverty, lack of trained professionals, food insecurity, disability/health issues, and long-term care. Older adults’ unique strengths were noted as indigenous knowledge systems, being holders of cultural heritage, and their contributions to development. Respondents’ biggest concerns about older adults in sub-Saharan Africa were the lack of government attention to aging issues (63%) and a lack of social services targeted to elders’ needs (57%). Government funding (77.8%) and international partnerships (38.9%) were noted as resources needed to support aging research in sub-Saharan Africa. The response or non-response of governments in sub-Saharan Africa will determine whether the growing number of older adults will increasingly experience unmet needs and whether their assets will be considered in development efforts. Establishing professional networks of gerontology scholars in the region will help to document the challenges faced by elders, to plan for the coming demographic shift, and to empower elders to thrive as valued community members.
Predictors of Custodial Grandparents’ Perceived Barriers to the Use of Services
Authors: Montoro-Rodriguez Julian , Jr Bert Hayslip , Ramsey Jennifer
Published: December 2021

Getting timely access to help, information, and a variety of services is paramount among the challenges of raising a grandchild, and grandparents face a variety of internal and external barriers in getting such help. The present pilot exploratory study focused on caregiving-related and personal resource variables best predicting grandparent caregivers’ perceptions of barriers to receiving services. Fifty-two grandparents (M age = 59.1) raising their grandchildren completed measures assessing caregiver strain, social support, resilience, self-care, psychosocial adequacy, health, depression, and grandchild relationship quality. They also completed measures of the extent to which they faced personal and caregiving-related difficulties giving rise to the need for services (e.g. health, grandchild well-being, support from others) as well as the extent to which they had experienced barriers to service (health/financial limitations, isolation, transportation, respite care, lack of knowledge of services) in the past 3 months. Correlations (p < .05) suggested that psychosocial adequacy (r = -.32), depression (r = .27), caregiver strain (r = .42) and difficulties (r = .48) were all related to greater perceived barriers. Regression analyses (F7, 40 = 2.81, p < .02) indicated that caregiver strain (Beta = .33, p < .05) and difficulties giving rise to the need for services (Beta = .32, p < .04) emerged as most salient in predicting barriers. These findings underscore the fact that personal, caregiving-related, and interpersonal factors exacerbate the barriers associated with grandparents’ accessing needed services and reinforce such factors’ impact on grandparents as targets for overcoming impediments to accessing services among them.
Assessing SSDoH in Alzheimer's Research: Core Measures and Those in Sexual and Gender Minority Populations
Authors: Stites Shana , Midgett Sharnita
Published: December 2021

Social and structural determinants of health (SSDoH) are conditions that can impact on Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD) outcomes. We will describe theoretical underpinnings of core SSDoH constructs and their measure, empirical evidence for their importance, and their potential for elucidating disease and prevention mechanisms. We focus on a core set of SSDoH measures that are important across a broad range of socially and culturally heterogeneous populations. We outline a rationale for universal implementation of a set of SSDoH measures and juxtapose the approach with alternatives, such as investigator-initiated grants, aimed at collecting SSDoH data. We also speak very briefly about the evidence supporting assessing SSDoH with respect to sex, gender, and sexual orientation and considerations in doing this.
Psychological Inflexibility and Geriatric Primary Care: Transforming Peri-Urban and Rural Aging
Authors: Jacobs Lindsey , Allen Rebecca , Ly Timothy , Bell John , Carroll Dana , Halli-Tierney Anne
Published: December 2021

Based on the acceptance and commitment therapy (ACT) framework, human suffering is thought to be caused by psychological inflexibility. Psychological inflexibility is characterized by rigid avoidance of unpleasant experiences, fusion with unhelpful thoughts, lack of contact with the present moment, fusion with a narrow self-narrative, and lack of clarity and contact with one’s core values in life. Psychological inflexibility captures the unhelpful or unworkable ways in which individuals respond to emotional discomfort. Research using samples of adults under age 65 indicate that psychological inflexibility is associated with poorer quality of life and mental well-being; however, the literature on psychological inflexibility in older adults is limited. Patients (N=129) ages 65 and older presenting to a Geriatric Primary Care clinic in the Deep South completed measures of depression, anxiety, subjective health literacy, and psychological inflexibility. Our team used the Acceptance and Action Questionnaire-II (AAQ-II), which is the most commonly used measure of psychological inflexibility. Anxiety (r = 0.66, p < .001) and depression (r = 0.70, p < .001) were moderately correlated with psychological inflexibility, which is consistent with the existing literature on psychological inflexibility in adults under the age of 65. Subjective health literacy significantly predicted psychological inflexibility, b = –.058, t(127) = -4.07, p < .001. This finding provides additional support for the importance of increasing health literacy among older adults in the Deep South, as it has implications in level of psychological flexibility and, thus, quality of life and mental well-being.
Self-Reported Utilization of Nutrition-Related Resources in Veterans Compared to Non-Veterans
Authors: Serra Monica , Robbins Ronna , Addison Odessa
Published: December 2021

As they age, Veterans are at elevated risk for developing nutrition-associated chronic diseases compared to their Non-Veteran counterparts. This is despite Veterans often being eligible for a variety of nutrition-related resources. This project compared self-reported utilization of community and government nutrition-related resources in male Veterans compared to Non-Veterans participating in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys. Veterans (mean: age: 59 years; BMI: 29 kg/m2; N=135) self-reported “yes” and Non-Veterans (age: 61 years; BMI: 30 kg/m2; N=230) self-reported “no to “ever having served on active duty in the U.S. Armed Forces.” A similar percentage of Veterans (3%) and Non-Veterans (4%) reported utilizing meal delivery programs (i.e., “Meals on Wheels) and eating at community or senior centers (both 7%) in the past year. Veterans were less likely than Non-Veterans to report receiving emergency food (i.e. from church or food bank) in the past year (7% vs. 12%; P<0.01) and tended to be less likely to report ever having received benefits from a nutrition assistance program (NAP; i.e., Food Stamps) (27% vs. 32%; P=0.08). Veteran also reported their household receiving more financial assistance the last time they received support from a NAP ($281 vs. $188; P=0.02). These data suggest that Veterans have less reliance on NAP than Non-Veterans; however, when they do receive assistance, Veterans appear to receive greater financial support. Future studies are needed to identifying ways to improve access to nutrition-related resources in those at risk for food insecurity.
Older Nonmedical and Medical Cannabis Users: Health Characteristics, Cannabis Use Patterns, and Cannabis Sources
Authors: Choi Namkee , DiNitto Diana
Published: December 2021

Despite rapidly growing number of older medical cannabis users, research on them is scant. In this study, we examined medical and nonmedical cannabis users aged 50+ on health-related characteristics and cannabis use patterns and sources. Hypotheses were that compared to nonmedical users, medical users are more likely to have physical and mental health problems, use healthcare services, discuss their drug use with a healthcare professional, use cannabis more frequently, and purchase cannabis from a medical dispensary and other sources rather than obtain it as a gift, share someone else’s, or use other means. We used the 2018 and 2019 National Survey on Drug Use and Health data (N=17,685 aged 50+; male=8,030; female=9,655) and multivariable logistic regression analysis to test hypotheses. Of the sample, 8.9% reported past-year cannabis use. Of past-year users, 18.5% reported any medical use. Of medical users, 70.9% reported exclusive medical use and 29.1% reported using medically and nonmedically. A large proportion obtained cannabis from private/informal sources. Any medical use, compared to nonmedical use, was associated with lower odds of alcohol use disorder but higher odds of discussing drug use with a healthcare professional (AOR=4.18, 95% CI=2.53-6.89), more days of use (AOR=2.56, 95% CI=1.35-4.86 for 200-365 days), and purchase at a medical cannabis dispensary (AOR=4.38, 95% CI=2.47-7.76). Medical and nonmedical users did not differ on physical health, and both had high behavioral health problem rates. However, only a small portion discussed their drug use with a healthcare professional. More healthcare professional attention to older cannabis users is needed.
Food Insecurity in Older Adults: Gerontology Students and RSVP a Partnership that Works
Authors: Greenberg Phyllis , VanderWerf Jessica
Published: December 2021

A gerontology course related to policies /programs each year researches, develops and designs a service-learning project related to an issue/concern for older adults and their quality of life. Students wanted to work with vulnerable older adults and after research and discussion decided on tackling the issue of food insecurity in older adults. Food insecurity is a growing issue for older adults which has been exasperated by COVID-19. According to Meals on Wheels America (2020) there has been a 22% increase in the number of older adults needing food assistance. In addition, while the need for food banks has increased donations have declined (Next Avenue, 2020). Students partnered with RSVP, which had previously conducted a food donation project.. Students took on the responsibility for advertising, soliciting grocery stores to allow us to set up and engage shoppers in purchasing items for the project. In addition, they reached out to the university community and set up food donation stations. RSVP sent out emails to their constituents to encourage them to volunteer and do their shopping on the date of the project. Students were paired with RSVP volunteers at two stores and provided shopping lists and information about food insecurity in older adults to shoppers. Students collected 566 pounds of food. The food was distributed equally between Catholic Charities, which has a senior shopping program and the Somali Elder Community. Students sorted the food by categories and removed any foods with pork/gelatin products for the Somali Community.
Geriatric Oral Health for dental and non-dental primary care providers
Authors: Tabrizi Maryam
Published: December 2021

Age-Friendly Health System is the innovation that provides care to older adults within 4Ms structure comprehensively. The 4Ms structure is the clinicians' guideline for providing treatments for each individual based on what matters most which is the first M. The 4Ms structure creates a person focus approach for the health of the elderly on every visit, as what matters most may change over time based on other health conditions of life situation. We must consider our patients come from all kinds of life walks, based on his/ her lifestyle, health beliefs, and cultural background. Consequently, older adults may define health and wellness differently and they might have different needs, oral health is no exception. However, evaluating both primary care office workflow and hospital workflow is missing the health element of oral care. The current health flow designed by the Institute of Health Improvement (IHI) in a collaborative effort with John A. Hartford may create a larger gap between oral health and overall health. In the light of integrating oral health to the overall health, the best place and most feasible in both primary care and hospital workflow is at the time of Check history for a baseline on 4Ms. This poster will clearly illustrate how oral health can integrate to overall health leading by the non-dental profession who usually take history for a baseline. As oral health is an integrated factor in the health of the geriatric population in the Age-Friendly Health System.
Global Unbiased Determination Of Comorbidity (GUDC) In U.S. Older Adults
Authors: Hogans Beth , Siaton Bernadette , Kheirbek Raya , Katzel Leslie , Sorkin John
Published: December 2021

With age, many adults develop multiple comorbid conditions; and resulting clinical complexity increases markedly so that identifying how specific conditions effect others remains important. Here, our primary objective was rapid unbiased appraisal of pair-wise condition-specific comorbidity; our second objective was identification of common conditions with highest and lowest rates of such comorbidity. In 2016, utilization of ICD-10 codes became mandatory for providers rendering care to Medicare beneficiaries. Universal adoption of ICD-10 coding ensued and concomitantly, all patients had ICD-9 codes replaced with new codes, so that 2017 data represent an opportunity to examine massive amounts of ‘freshly’ coded patient claims data. Evaluating ICD-10 coding data at individual and population levels, we appraised how often two codes were utilized together, i.e. estimated pair-specific comorbidity. Expanding this computationally, we determined the extent to which any given condition was co-coded with all other utilized diagnostic codes, i.e., estimated global, unbiased pair-wise comorbidity. We term this metric the global unbiased dyadic comorbidity (GUDC) value. Based on 40 million claims for a representative sample of 1.5 million older adults across the U.S., GUDC values varied with age and gender but were highly stable across varying comorbid condition prevalence, e.g., common (>1%) vs. less common (1/1000-1/100) prevalence. GUDC values for HIV in older adults were modest, compared to high values for ARDS, we infer substantive progress in HIV management among older adults. We discuss the interpretation and potential applications of GUDC and conclude that access to comorbidity appraisals may advance geriatric care, more study is needed.
Aging, Social Determinants of Health in the Case of Persons With Disabilities and Refugees
Authors: Trani Jean-Francois
Published: December 2021

Structural and social determinants of health differentially impact on social groups. Among those particularly disadvantaged during the life course are both persons with disabilities and refugees. Because of the way society treats these two populations, both persons with disabilities and refugees may face physical, social, economic and environmental barriers that impede them from benefiting from the same opportunities accessible to other social groups. As a result, these populations have less access to education, higher unemployment, are more likely to be deprived and excluded from social benefits. In other words, public stigma —prejudice and discrimination voiced and practiced by the general population— translates to a life course characterized by daily stressors that result in a higher likelihood of cognitive disorders and dementia. Measuring and analyzing SSDoH inclusive of disability and refugee experiences are essential to efforts aimed at recruitment and retention and knowledge generation in ADRD research.
Research with Older Asian American Family Caregivers Pre- and During the Pandemic: Challenges and Lessons Learned
Authors: Lee Jung-Ah , Nguyen Hannah
Published: December 2021

Research with hard-to-reach, monolingual adults from ethnic minority communities can present a multitude of challenges throughout the research process. This presentation will highlight challenges and lessons learned from two pilot studies with Vietnamese-, Cambodian-, and Korean-American family caregivers aged 50 and older. The first study (n=9) implemented a one-on-one, telephone-based psychosocial intervention before the COVID-19 pandemic; the second is an ongoing study (n=12) consisting of a group-based intervention via Zoom. Throughout recruitment, the following challenges arose: addressing the lack of familiarity with research among caregivers, earning the trust of caregivers, and identifying creative ways to recruit caregivers to participate. During study implementation, common challenges included: caregivers’ unpredictable daily schedule that made it difficult to participate in the scheduled classes, caregivers feeling apprehensive about technology and Zoom, access to reliable internet, and facilitating participation and engaging the voices of caregivers over the phone or via Zoom. Strategies were identified to address these barriers: engaging the support and collaboration of trusted, bilingual and bicultural community-based providers, building culturally-responsive rapport with caregivers, and seeking continuous feedback from caregivers to improve the appeal of the project implementation. The COVID-19 pandemic added an additional layer of difficulty to the research, requiring creativity and flexibility in implementation that took into consideration caregivers’ heightened anxiety, distress, lack of participation due to around-the-clock care, and loss and grief. The challenges and lessons learned from these studies could guide the development of future research efforts and strategies to effectively engage older hard-to-reach, monolingual Asian American caregivers.