bluuebunny/crossref_metadata_2025 huggingface dataset:
Remote Assessment Preferences of NIA Alzheimer’s Disease Research Center Participants During COVID-19 Pandemic
Authors: Nunnerley Michael , Mattek Nora , Beattie Zachary , Kaye Jeffrey
Published: December 2021

Background: In a progressively technology-infused world, older adults are becoming accustomed to the digitization of research participation. During the COVID-19 pandemic, it became necessary to conduct remote study visits typically carried out over the telephone or using video calling programs (e.g. Zoom). Methods: The National Alzheimer’s Coordinating Center developed a COVID-19 Technology Accessibility Survey to determine preferred types of study visits for study participants and to understand how this older population accesses the internet. Results: Seven Alzheimer Disease Research Centers collected 1282 survey responses (mean age: ±71.8 years, mean education: 16.5±2.5 years, race/ethnicity: 86% White/non-Hispanic). In respondents aged 65-80, internet access was endorsed by 73% regarding smartphones, 61% for laptops, and 46% for tablets. Interest in wearable devices was expressed by 21% of respondents and interest in smart homes by 6%. Study visit preference among this age group was 42% in favor of in-person, 25% via phone, and 33% via video. In respondents aged >80 internet access was endorsed by 47% regarding smartphones, 47% for laptops, and 34% for tablets. Interest in wearable devices was expressed by 9% of respondents and interest in smart homes by 3%. Study visit preference among this age group was 38% in favor of in-person, 34% via phone, and 28% via video. Discussion: In light of the COVID-19 pandemic, the survey suggests many study participants are interested in remote visits. Significant age group differences are present regarding internet access. Further studies are required to increase the understanding of the efficacy of this research visit format.
Staying Connected during the COVID-19 Pandemic: Experiences of Older People in Mexico and Scotland
Authors: Curreri Nereide , de Oca Verónica Montes , McCabe Louise , Vivaldo Marissa , Dawson Alison , Rivera Miguel , Arroyo Maria , Douglas Elaine
Published: December 2021

During the pandemic older people saw transformations in their social connections due to lockdowns and other restrictions. Technology provided one mechanism for them to stay connected with others, but technology may not be accessible or desirable for everyone. Gender, socioeconomic status, ethnicity, age and other factors enhance or limit engagement with technology. This project explored experiences of older people in Mexico and Scotland during the pandemic and examined the potential of everyday technology to help maintain social connectedness. A mixed methods approach included secondary analysis of large-scale datasets alongside primary data. Online semi-structured interviews and focus groups were carried out with 36 older people in Mexico and 23 older people in Scotland. Sampling was purposeful creating a diverse sample across age, gender, ethnicity and socioeconomic status. The findings demonstrate that advantages and disadvantages accumulated in the life course determine how older people select, optimize and compensate for new ways of staying socially connected during the pandemic in both countries. The use of technologies among older people is further mediated by structural inequalities with differences found between Mexico and Scotland in specific patterns identified. Further, stereotypes about older age and technology use are obstacles to the use of technology, as they affect the perception of self-efficacy by older people. Despite the obstacles, this study has shown that older people have a broad range of resources that have enabled them to cope with the pandemic and utilise technology to maintain social connections. The project offers recommendations to support older people’s human rights.
The influence of cognitive function on adherence to breast cancer screening among older American women
Authors: Li Chien-Ching , Flores Fritzi , Matthews Alicia K , James Bryan , Shah Raj
Published: December 2021

Cognitive decline and impairment among older adults have become an important public health issue. Previous research shows older women have a greater prevalence of Alzheimer's disease than Men. Among women, breast cancer is one of the most common types of cancer. Over half of breast cancer deaths occur in women aged 65 and older. Therefore, early detection of breast cancer through mammogram screening is important among older women. This study aimed to examine the influence of cognitive function on adherence to mammogram breast cancer screening among older American women aged 65 and older. Data from the Health and Retirement Study (2012-2016) was obtained and analyzed. The independent variable of the study was cognitive function (normal, not normal). Adherence to mammogram (low, moderate, high) was the dependent variable. Multinomial regression was performed to examine the association between cognitive function and adherence to mammogram after controlling for demographic covariates. In the study, 33.3% of respondents had impaired cognitive function and 21.7% showed low adherence to mammogram screening. Regression results found that older women with impaired cognitive function were more likely to be in low adherence group (OR=1.30, p=0.01) or moderate adherence group (OR=1.47, p<0.001) relatively to be in high adherence group compared to older women with normal cognitive function. The development and implementation of interventions are needed for reducing barriers to accessing cancer screening services in high-risk vulnerable populations. This submission is considered late-breaking research because study findings were obtained from a recently completed student's master's project.
Transnational Caregiving for Older Adults and Caregivers’ Wellness in Japanese Americans during the Pandemic
Authors: Hoshino Kazumi , Tseng Winston , Kamide Kei
Published: December 2021

Global migration has greatly affected intergenerational family support beyond national borders, in particular adult children’s transnational family caregiving for elderly parents. Specifically, the COVID-19 pandemic has largely influenced transnational caregiving due to the travel restrictions. Transnational caregiving for older adults includes adult children’s periodical returning to their home country and/or adult children’s caregiving for their parents in their settled country. The goal of this study was to identify trajectories between adult children’s transnational caregiving for their parents and caregivers’ wellness in Japanese Americans before and during the pandemic. We conducted semi-structured interviews with Japanese Americans 40 to 59 years of age (N=20) in California before the lockdown and during the increasing number of patients infected with the Delta variant. The qualitative data analysis showed some Japanese Americans periodically returned to Japan to provide caregiving for their parents before the pandemic, while others didn’t. However, the former group currently relied on their families in their home country more than before. The limitations led to not only distress over uncertainty but also release from a strong sense of reciprocity and filial responsibility, by changing from physical support to emotional and financial support via online. They also enhanced cultural identity as Japanese Americans, by thriving from discrimination against Asian Americans. Thus, our findings demonstrate important factors that impacted on transnational caregiving and caregivers' wellness, including cultural identity, family norms, beliefs and practices of intergenerational support, social and historical contexts, financial remittance, ICT use, and healthcare policies among the underrepresented populations across the Pacific.
“For me, it's connection”: Older Adults Experience with Technology during COVID-19
Authors: Miller Vivian , Lee HeeSoon , Roark Erin
Published: December 2021

As a result of COVID-19, older adults have experienced isolation, lost social contacts, and a decrease in connections. A recent study found that “approximately one-quarter of community-dwelling older adults are considered to be socially isolated, and 43% of them report feeling lonely.” Various innovative interventions have emerged, including technology-based interventions as a means to reduce social isolation in older adults, particularly as information communication technology (ICT) use is on the rise among this population. However, it remains to be known how these connections are faring for older adults in the pandemic and whether these ICT connections lead to greater or lesser feelings of social connectedness. Thirty-nine (N=39) in-depth semi-structured interviews were conducted to explore the lived experiences of technology use among older adults during COVID-19. Participants experiences with ICT ranged from illiterate to savvy. Most participants indicated Zoom was the primary means to stay socially connected to family and friends. Participants emphasized that ICT may be a possible solution to deal with loneliness for those older adults who are especially isolated due to COVID-19 restrictions. Barriers and challenges to ICT use included taking too much time to use and needing help to fix any problems that arose. Finally, participants shared essential aspects of ICT use, revealing that it was ‘technology or nothing.’ Findings from this study indicate a need for a simple ICT for the older adult population. Moreover, findings suggest opportunities for peer-support ICT training programs for older adults.
Can Remote Monitoring Measure Life Activity and Caregiver Experience? Early Results of Multi-modal Assessments
Authors: Dawson Walter , Lindauer Allison , Gothard Sarah , Tran Leslie , Beattie Zachary , Kaye Jeffrey
Published: December 2021

Subjective assessments of dementia caregiver burden are vulnerable to recall and recency biases. Objective continuous home assessment using passive technologies (e.g., bed mats, actigraphy watches) can provide ecologically valid detail on caregiver stress and family function. We tested the utility of objective assessment of activity before, during and after the behavioral intervention of STELLA (Support via Technology: Living and Learning with Advancing AD) which facilitates effective online management of behavioral symptoms of dementia. We present preliminary data on objective measures of sleep and step counts, and subjective measures of burden. We captured data from three caregivers caring for a family member with dementia. Each family lives in home with unobtrusive monitoring devices that recorded data on sleep (Emfit sleep mat) and daily steps (Withings watch). Self-report assessments of burden, depression and grief were collected prior to and after the 2-month intervention. Objective data was collected continuously. Pre/post subjective assessments suggest that the STELLA intervention has the potential to reduce behavioral symptom frequency and caregiver reactivity to symptoms (pre-STELLA behavior frequency=44.9, post=39.2; pre-STELLA reactivity=50.5; post=38.5). Step count ranged from 775 steps/day to 5065, with each participant trending fewer steps during the intervention. Mean sleep time ranged from 6.3 to 8.6 hours and didn’t change during the intervention. The small sample size limits interpretation but provides evidence that it is feasible to collect continuous objective life-activity data during caregiver interventions. This digital data has the potential to inform the validity of subjective findings by limiting recall and recency biases.
Racial Differences in the Erosion of Psychological Resilience Following COVID-19 Related Financial Hardship
Authors: Taylor Miles , Carr Dawn , Jason Kendra
Published: December 2021

Objectives: Research on the impact of COVID-19 among older adults has primarily focused on virus outcomes, but it is also possible the pandemic’s hardships have eroded the adaptive capacity of older adults. It is also likely these impacts vary by race and ethnicity. We examine changes in psychological resilience (PR) among older adults pre and post-pandemic to determine whether financial and social hardships have altered this resource for White, Black, and Hispanic older adults. Method: Using the COVID module recently released by the HRS (n=735), we examined changes in PR between 2016 and 2020 related to specific COVID experiences. We tested interactions to determine whether the effects of these experiences were conditioned by race and ethnicity. Results: Consistent with previous literature, resilience was relatively stable during this time on average. Financial hardship due to COVID-19 diminished resilience, but this effect was concentrated primarily among White Americans. PR was unchanged related to financial hardship among Black Americans. Discussion: The results suggest that PR is a relatively stable resource in later life, even during a pandemic. However, this resource may be impacted in the face of specific and especially new challenges in later life. Policies and interventions related to job loss and financial hardship during the pandemic should be seen as supporting the capacity for older adults to adapt to current as well as future challenges.
Developing Behavioral Markers of Social Function in Aging: A Methodology Using Pitch Mimicry
Authors: Williams Christine , Tognoli Emmanuelle , Wead Alice , Beetle Christopher , McKinley Joseph
Published: December 2021

The Covid pandemic brought to the forefront the crucial role of social interactions for society at large and in gerontological practice. Social interactions play a paramount role in preserving cognitive reserve in older adults. They rely on neurobehavioral processes that are complex (engage large parts of the brain and demand integrity of multiple perceptuomotor, attentional, cognitive and memory functions). Pitch mimicry is a well-known and spontaneously arising social phenomenon that requires the integrity of numerous processes of the brain, and we hypothesize that it constitutes a potentially sensitive behavioral marker of neurodegeneration in Alzheimer’s Disease and Related Dementias (ADRD). We developed and validated a series of algorithms to parse verbal exchanges between people and quantify the level of mimicry that each exhibit with their partners. Those algorithms are based on silence thresholding, carefully parametrized CEPSTRAL algorithms for automatic pitch estimation and Synchrosqueezing Transform for validation. We introduce a theoretical model to compare our estimates of pitch mimicry with model’s expectations based on the null hypothesis that its neurobehavioral pathways retain their integrity. Our method will allow researchers to study the evolution of pitch mimicry in aging individuals and its sensitivity to diverse social contexts, including those preserving lasting social engagement. Our method will also allow us to test the hypothesis that Pitch Mimicry is a sensitive behavioral marker of dementia, a condition characterized by a breakdown in social relatedness.
Developmental Analysis of Prospective Effects of Problem Drinking and Health Problems in Three-Age Groups
Authors: Kwan Thomas , Bowlby Douglas , Lee Matthew
Published: December 2021

Past research has clearly demonstrated interrelations between drinking and health. However, little research has investigated this from a lifespan-development perspective, which is the objective of the current study. Our hypotheses predicted results consistent with the familiar “J-shaped curve” of drinking effects on health, including that health problems would be (1) lower in moderate drinkers than abstainers and (2) higher in excessive drinkers than moderate drinkers. We also hypothesized that these protective effects of moderate drinking would increase with age across the lifespan. The current study used two waves of data from a large U.S.-representative sample. Analyses used 3*3 between-persons ANCOVAs that tested a three-level Wave-1 drinking-group factor and a three-level Wave-1 age-group factor. Of particular importance were the drinking-group-by-age interactions. Various Wave-2 health outcomes were predicted in different ANCOVAs, and each ANCOVA controlled for Wave-1 levels of the Wave-2 health outcome. Across nearly all health outcomes, young adults did not show significant differences between abstainers and moderate drinkers, whereas midlife and older adults consistently showed better health for moderate drinking versus abstainers. This suggests that protective effects of moderate drinking apply more-so to midlife and older adults than young adults. Surprisingly, excessive drinkers generally did not show poorer health than moderate drinkers, except for mixed evidence for such effects only among older adults. Thus, only older adults showed patterns entirely consistent with our hypothesized “J-shaped curve.” A next analytic step we will conduct in advance of this poster presentation will assess if alternative excessive-drinking operationalizations more consistently signal health problems.
Examining the Impact of Individual and Shared Biological Risks on Health among Older Married Couples
Authors: Su Tai-Te , Meija Shannon , Gonzalez Richard
Published: December 2021

Relationship research has suggested that health among spouses is interdependent and should be considered jointly. Using data from the 2008/2010 and 2016/2018 waves of the Health and Retirement Study (3858 qualified couples; age=67.0±9.6), we investigated the joint influence of married partners’ individual and shared cumulative biological risk on future health outcomes. Two risk indicators were constructed to indicate biological health in different domains. Individual grip strength, walk speed, lung function, and cystatin-C were biomarkers selected to construct frailty risk whereas blood pressure, pulse, waist circumference, C-reactive protein, glycohemoglobin, high-density lipoprotein cholesterol, and total cholesterol were biomarkers used to construct cardiometabolic risk. Shared risk was calculated as the number of risks the partners shared. We employed multilevel Poisson regression models to nest partners within couples and examine the effects of individual and shared cumulative risks on future functional limitations. Heckman correction was performed to correct potential selection bias. Our unadjusted models showed individual (frailty: b=0.22, p<.001; cardiometabolic: b=0.10, p<.001) and shared (frailty: b=0.17, p<.001; cardiometabolic: b=0.08, p<.01) risks are associated with greater future functional limitations. Further, shared cardiometabolic risk moderated the effect of individual risk (b=-0.01, p<.05). In the adjusted models, the direct associations between shared risks and future functional limitations were explained by indicators of partner selection and shared experiences. In the fully adjusted model, the cross-level interaction for frailty risk became statistically significant. The unique set of dynamics shown in our study offered new insights into understanding how couples influence one another in the context of multisystem biological health.
Hospital, Emergency Department, and Home Health Use in Older Adults with Sensory Impairment
Authors: Wallace Laura , Hirschman Karen , Naylor Mary , Huang Liming , Cacchione Pamela
Published: December 2021

Hearing, vision, and dual (combined hearing and vision) sensory impairments (HI, VI, and DSI) are common in older adults and associated with adverse health outcomes. However, it is not clear how sensory impairments impact healthcare utilization in older adults. This study aims to examine hospital, emergency department (ED), and home health care use amongst adults 65 and older diagnosed with HI, VI, and DSI in an urban academic health system. This secondary analysis (N=45,000) used a limited data subset of older adult primary care patients’ EHR data from a parent study examining medical complexity, healthcare use, and social vulnerability. Using logistic regression and controlling for participant demographics and comorbidities, results show HI, VI, and DSI increase the likelihood of having an ED visit (OR 1.29, p<.0001; OR 1.28, p=0.0011; OR 1.50, p=.0328, respectively) and a home health episode (hearing OR 1.41, p<.0001; vision OR 1.42, p=.0002) compared to those without sensory impairment (SI). No significant difference was found in hospital use and home health use for DSI. This is the first known study to examine ED use for older adults with VI and DSI, and home health use for older adults with SI in the US. Findings suggest older adults with SI have greater utilization and dependence on healthcare services. Older adults with SI may benefit from outpatient assessments and interventions to mitigate risks of ED use. Findings also support research into the drivers of healthcare use amongst this population, financial implications, and intervention development to prevent avoidable healthcare use.
Impact of Restricted Contact between Grandparents and Grandchildren during the COVID-19 Pandemic
Authors: Klusmann Verena , Cengiz Sara , Materna Carina , Spreckels Christian
Published: December 2021

To combat the COVID-19 pandemic strict contact restrictions have been imposed on institutions for both older and younger people, social structures have been locked down, families have been urged to reduce contact with older relatives, and people over 65 have been temporarily banned from their workplaces and from attending events, both in public and private spaces. These measures are assumed to have a number of psychosocial consequences. For this questionnaire study, 268 pupils (7-to-10 years-old) of nine different schools in Hamburg, Germany, with different social index were asked about how they experienced, perceived, and behaved during the COVID-19 pandemic. 75% of the children reported on restricted contact to their grandparents: While 41% did not meet their grandparents at least for a certain time at the beginning of the pandemic, 34% did not meet their grandparents during the whole first year of the pandemic. Of those who met their grandparents, 25% kept physical distance to them. These contact restrictions were significantly higher in schools with a lower social index, chi2(8)=15.49, p=.05. Those children who never met their grandparents also reported on higher perceived stress, t(220)=-2.37, p=.019, d=-.33, tended to have lower subjective well-being, t(223)=-1.73, p=.09, d=-.24, and had higher risk perceptions concerning COVID-19 infections, t(223)=-2.18, p=.03, d=-.31. Hence social isolation and loneliness is not only an issue for older people themselves, but contact restrictions also potentially increase the stress load and impair the well-being of children who have to do without support and care of their grandparents in sensitive developmental phases.
In-home Online Music Therapy for Psychological Health among Caregivers of Persons with Dementia: A Pilot Study
Authors: Kim Hyejin , Engström Gabriella , Theorell Töres , Emami Azita
Published: December 2021

Family caregivers who provide care to persons with dementia (PWD) in a home setting may feel greater stress, depressive symptoms, or struggle to deal with issues in their lives. Indeed, PWD often require 24-hour care that includes ensuring safety, providing emotional support, and assistance with activities of daily living and multiple instrumental activities of daily living. This study examined the short-term effects of an online music intervention on stress, coping, and depression among caregivers of PWD. We included 35 caregivers (n=24 [intervention group], n=11 [comparison group]) living at home with their family member with dementia. Mann-Whitney U test and Wilcoxon signed-ranked test were performed to examine between- and within-group differences from baseline to eight weeks after the intervention. The coping subscale yielded a significant difference between the groups at post-test (U=76.50, Z= -1.978, p=0.048), indicating the intervention group had better coping than the comparison group at post-test. Significant within-group differences in overall stress (Z= -2.200, p= 0.028) and coping subscale (Z= -1.997, p=0.046) in the comparison group at post-test suggest that overall stress and coping were maintained from baseline to post-test in the intervention group, whereas the comparison group had significantly higher overall stress and lower coping at post-test. This home-based online music program showed potential benefits for caregivers of PWD by taking into account participants’ musical preferences and ease of access to the program. A randomized controlled trial with a larger sample size and objective measurements of stress and depressive symptoms (e.g., biomarkers) should be conducted in the future.
The Effect of a Virtual Reality Delivered Physical Activity Intervention on the Physical Function of Older Adults
Authors: Kershner Kyle , Fanning Jason , Furlipa Joy , Brubaker Peter , Brooks Amber , Page Lindsey , Ehlers Diane
Published: December 2021

COVID-19 public health recommendations have prohibited many older adults from attending in-person physical activity (PA) programs that improve physical function and promote functional independence. Most PA programs have shifted towards a video conference (VC) format, but this modality has been noted to “flatten” the social experience which is fundamental for lasting behavior change. Virtual reality (VR) is now designed for immersion and place-presence and may be better suited for instilling a feeling of social connection, which will likely improve physical function. The purpose of this study was to evaluate differences in physical function after a 4-week in-home VR or VC based PA intervention. Low-active adults (66.8±4.8 years) were randomized to VR (n=5) or VC (n=4) based PA counselling and instructed to find activities that were intrinsically motivating. VR participants were asked to select pre-approved available active games in addition to enjoyable real-world activities. ANCOVA models were used to explore group differences in six-minute walk distances across time. Results are reported using η^2 effect sizes based on the small sample size. After controlling for baseline values, the ANCOVA models revealed a moderate-to-large magnitude effect for distance traveled during the six-minute walk test (η^2=.10). Additionally, the VR group participants walked 42.63 meters further, which approaches a clinically meaningful difference. These promising early findings suggest there is value to exploring the impact of VR-delivered, group-mediated activity promotion on physical functioning in older adults. Future research should investigate aspects of VR that promote increased social connection and physical function in the older adult population.
The Impact of Age on Mobile Technology Use During the COVID-19 Pandemic
Authors: Lin Yi , Rowles Graham
Published: December 2021

The COVID-19 pandemic led to quarantines and mandatory spatial distancing; people of all ages were encouraged to use technologies instead of actual human contact as part of COVID-19 prevention. The promotion of mobile applications (apps) during the pandemic influenced mobile technology use behavior. This study explored age differences in mobile technology use during the COVID-19 pandemic. A pilot-tested survey was distributed using online survey software. Persons surveyed were 35 years of age or older, currently living in the United States of America with experience using mobile technology. Survey questions pertained to mobile technology use frequency and factors influencing the decision to use mobile technology. The nationwide response included 1212 individuals. The average age of participants is 56.12±12.26 years old (female: male = 1.24:1). Responses were categorized participants into three age groups, 35 to 49, 50 to 64, and 65 or older. Daily mobile technology use frequency increased significantly (p<0.01) for all groups during the COVID-19 pandemic, with participants 35 to 49 having a significantly higher (p<0.01) use frequency than other groups. Regarding factors influencing the decision to use mobile technology, 64.1% of respondents aged 50 to 64 identified the necessity of using this technology during the pandemic as a significant factor, and 64.0% of participants in age 65 or older reported that the availability of functions on mobile devices is critical. Overall, the COVID-19 pandemic led to a significant increase in mobile technology use with people in different age groups differentially valuing the factors that affected their user behavior.
A Qualitative Study of the Impact of COVID-19 on Hospice and Home-Based Palliative Care in Taiwan
Authors: Wang YuHsuan (Olivia) , Enguidanos Susan
Published: December 2021

COVID-19 has had a tremendous impact on individuals and health care, particularly among those with serious illnesses. Although Taiwan initially reported low rates of COVID-19 (20.7 cases per million in 2020), by early 2021 the Alpha variant began spreading in Taiwan, which went into a soft lockdown from May to July. This study aimed to investigate the impact of COVID-19 on Hospice and Home-Based Palliative Care (HBPC) patients, family, and medical team member in Taiwan during different COVID-related time points. From November 2020 to May 2021, we conducted semi-structured interviews with 2 patient, 5 caregivers, and 8 medical team members in the hospice and HBPC setting to elicit their views about the impact of COVID-19 on care. Content analysis was used to guide the analysis of themes. Two researchers independently coded transcripts and met to reconcile codes. Results showed varying impact across the time points. In 2020, patients, caregivers, medical team members felt little impact of COVID-19. However, in 2021, HBPC caregivers reduced the frequency of HBPC visits to lower the household COVID-19 infection risk. Hospice and HBPC team members reported that more caregivers selected HBPC over hospice. They also observed an increase in complicated grief among family survivors following the soft lockdown. The impact of the pandemic on homecare provision increased as prevalence of COVID-19 increased, impacting care and quality of hospice and HBPC. Further research is needed to better understand the impact of the pandemic on the quality of hospice /HBPC and grief experiences.
Exploring the Ecology of Third Age Informal Language Learner Groups
Authors: Barnes Gareth
Published: December 2021

This research explores the factors involved in the emergence of an independently organized Third Age informal language learner group in a community centre in Japan. The methodology applies PPCT (Process-Person-Context-Time) from Bronfenbrenner’s bioecological approach to provide a detailed perspective of the people, the environment and settings over time to show how these factors interact to construct an emergent learner group. The analysis looks at how and why this specific learner ecology emerges and ultimately, how it can benefit the Third Age and inform healthy ageing policy. The findings show that by engaging in second language learning, the participants find meaningful and active involvement in the group by creating a setting that welcomes self-expression, while balancing limiting and facilitating factors of resilience and reciprocal support, self-management, sage-ing, interest, agency, and responsibility. The result is the creation of a multilingual, multicultural, and multigenerational place of inclusion within the community. The study highlights the heterogeneity of the 3rd Age and illustrates the interplay of contexts outside of the learner group from micro to macro, individual and group resources, and the influence of the specific social time period. It also shows the social importance of creating opportunities for autonomous informal language learning settings in the community while highlighting the impact of Third Age agency.
Home Care Physical Therapists’ Views on Inter-Professional Shared Decision Making
Authors: Moore Cindy
Published: December 2021

Shared decision making (SDM) has been associated with increased patient satisfaction and engagement and improved process and care outcomes. However, SDM use by physical therapists (PTs) working with older adults in the home care setting is not known. Understanding home care PTs’ views about and experiences with SDM, including inter-professional SDM, can inform SDM research and strategies for increasing its use. This presentation highlights inter-professional aspects of SDM described by home care PTs in the qualitative arm of a mixed methods, implementation science frameworks-informed study exploring PTs’ perspectives on SDM in home care. Semi-structured interview data from twenty PTs (80% female; mean age = 50.6, SD=12.7, range 28-73) representing all geographic regions of the continental United States and having varied levels of geriatric (mean 24.2 years, SD=11.6, range 3-40) and home care (mean 15.7, SD=11.5, range 2-40) experience were analyzed using thematic content analysis. A trustworthiness plan guided data collection and analysis, and reflexive journaling, memo, audit trail, peer debriefing, data triangulation, and member checking were used to support study rigor. Three inter-professional SDM-related themes were identified: team members facilitating SDM for all disciplines; within-team sharing of and competition for patient care resources; and limited patient/caregiver participation in team treatment planning decisions. Findings support the need for including inter-professional issues in home care SDM implementation and measurement research and suggest topics to include in future studies.
Prediction of COVID-19 Stress among Community Dwelling Older Adults: The Role of Anxiety and Resiliency
Authors: Francois Geffre Jean , Carr Dawn , Sachs-Ericsson Natalie
Published: December 2021

Worldwide, the COVID-19 pandemic has been an unparalleled source of stress. Older adults with anxiety are vulnerable to higher levels of stress during the pandemic. However not all older adults with anxiety will experience severe stress; resiliency may decrease such negative outcomes. There have been few, if any, longitudinal studies that followed older adults before and during the pandemic. Our data of community dwelling older adults (aged 60-92) is unique in that it allowed for an investigation of psychological variables that increase and decrease negative outcomes during the pandemic. Our longitudinal study examined the influence of pre-pandemic anxiety and resiliency on the severity of COVID related stress. Methods: The pre-pandemic data was obtained in September 2018, and the pandemic data was collected in June 2020. In the baseline survey we obtained measures of anxiety and resiliency. During the pandemic we measured the severity of COVID related stressors. We hypothesized that anxiety would predict higher level of COVID-stress, whereas resiliency would be associated with decreased severity of COVID-stress. Further we predicted that resiliency would attenuate the association between anxiety and COVID-stress. Results: Using OLS regression, we found that anxiety predicted higher COVID-stress, whereas resiliency predicted lower COVID-stress. However, resiliency did not moderate the association between anxiety and COVID-stress. Conclusion: Older adults are subject to many unavoidable negative life events, such as death of family members and chronic health problems. Resiliency may help buffer against such adversities. Development of intervention programs to enhance resiliency may increase psychological resources and foster healthy aging.
Leveraging the Intersection between Age-friendly Universities and Age-Friendly Communities
Authors: Black Kathy
Published: December 2021

Age-friendly Universities represent a growing contribution to the worldwide age-friendly movement. For universities, the international effort aims to highlight the role higher education plays in responding to the opportunities associated with an aging population. The initiative outlines ten principles to engage older adults via collegiate mission pertaining to research, education and service. Shared practices suggest diverse and unique application of the guiding tenets across participating colleges and universities. However Age-friendly Universities are also part of a broader ecosystem, situated in geographic locales reflecting actual or prospective age-friendly community status. The global Age-friendly Community movement is a decade-old effort to improve the environments in which we age via a cyclical process. This paper identifies the intersection between Age-friendly University principles and Age-Friendly Community processes and discusses reciprocal considerations for mutual advancement of the broader movement.
Four Approaches for Implementing Interprofessional Education
Authors: Mendez Jennifer , Mendez Jennifer
Published: December 2021

Using Microsoft Teams, the students from Psychology and marketing at Upper Iowa University, create a marketing plan focused on proposing a product or service targeting older adults. The Michigan LEND program, engages a minimum of 4 disciplines in practice online simulation approaches to respond to a case study. At Wayne State University and University of Detroit Mercy, during a zoom visit with community dwelling 50+ old adults, students from 9 disciplines collaborate on recommendations, referrals, and resources to improve health and/or quality of life. Marquette University students from 10 health professions participate in a series of four half-day workshops, designed in alignment with the Interprofessional Education Collaborative (IPEC) core competencies.
Adult Day Services as an Essential Service and Support
Authors: Gaugler Joseph , Marx Katherine , Dabelko-Schoeny Holly , Parker Lauren , Anderson Keith , Albers Elizabeth , Gitlin Laura
Published: December 2021

Throughout the COVID-19 pandemic, the significant challenges and gaps related to the care of older people in the U.S. were made distressingly apparent. This summary presentation will consider the effects of COVID-19 and associated shutdowns on older persons who use ADS programs, their family caregivers, and programs/staff themselves. Among recommendations to consider are the classification of adult day services and similar community-based long-term care providers as essential (and clarifying their difference from senior centers). In addition, considering new financing approaches and utilizing ADS or similar community-based programs as incubators of evidence-based innovation are options to consider to better align ADS with optimal dementia care.
Medicare Costs by Disability and Community-Dwelling Status
Authors: Ankuda Claire , Ornstein Katherine
Published: December 2021

Understanding population-level Medicare expenditure patterns for older adults with functional disability is critical to focus supports to reduce costly and potentially burdensome health care use. We used the National Health and Aging Trends Study (NHATS) to assess quarterly Medicare expenditures over the 12 months following NHATS interview. We examine Medicare expenditure patterns for older adults in nursing homes (N=386), in the community and without disability (N=20,103), with disability and dementia (N=2,008), and with disability but not dementia (N=2,945). One-year mortality ranged from 2.0% for those without disability in the community to 25.9% for those residing in nursing homes. Among those surviving 1 year, Medicare expenditures the first quarter after NHATS survey ranged from $1,794 (95% CI $1,690-$1,898) for those with no disability to $5,177 (95% CI $4,535-$5,818) for those with disability and dementia. We assess trends over the following two years, and find that trajectories vary by clinical grouping.
Providing Specialty Telehealth Care to Older, Rural Patients: Voices From Field
Authors: Dryden Eileen , Moo Lauren
Published: December 2021

Older, rural adults have limited access to quality geriatric specialty care for several reasons including relatively few geriatric specialists in rural areas and lack of transportation options or patient ability to travel to more urban centers. GRECC Connect is a promising telehealth-hub and spoke model that provides rural patients access to teams of multidisciplinary geriatric specialists in more urban medical centers primarily by video connection with affiliated community-based outpatient clinics (CBOCs). This model provides a viable option for increasing access to geriatric specialty care for rural patients but is not used to the extent it could be. To date, much of our understanding of this model has come from the experts at the hub medical centers. To learn more about the experience of this model from the field we interviewed CBOC staff and providers as well as Veterans and their caregivers about geriatric specialty telehealth services. In this symposium we will discuss facilitators and barriers to implementing this model from the perspective of the field and then explore more deeply both the context of the CBOC environment and the older patient population served by rural CBOCs to further understand the challenges that are faced in attempting to connect older patients with telehealth services. Finally, we will share the perceived value of the service and alignment with local needs. This deeper understanding of the experience of the ‘spoke’ may help enhance access to much needed geriatric specialty care for rural veterans.
There Is No Community Here: Living Alone, Place, and Older Peoples' Risk of Social Isolation
Authors: Weldrick Rachel
Published: December 2021

Existing research has identified significant risk factors for experiencing social isolation in later life including chronic health conditions, mobility impairments, and living alone among others. Although many older people who live alone maintain active social lives, living alone remains a top predictor of social isolation. Less is known about other types of risk factors, such as place-based risks and social exclusion. Despite calls to examine the role of place and social exclusion in social isolation risk, few studies have investigated the links. Models of isolation risk have often omitted place-based factors and social exclusion and focused largely on individual-level risks. In order to address these gaps, this paper presents the findings of 17 in-depth, qualitative interviews with community-dwelling older people who live alone (aged 65-93). Participants were recruited using a theoretical sampling strategy to ensure that a diverse range of neighbourhood types were represented among the participants (e.g., walkable vs. car-dependent neighbourhoods). Interview transcripts were analyzed using a constructivist grounded approach resulting in several major themes. Participants described aspects of their local environments as shaping their risk of isolation including infrastructure and amenities delivered in place, and neighbourhood makeup, among others. These themes are further examined through the lens of place-based exclusion and used to conceptualize how dimensions of both place and social exclusion fit into the model of known isolation risk factors. An adapted model of risk is presented to guide future research and intervention planning.
Reflections on Applying Anti-Racist Pedagogy to Teaching About Aging
Authors: Karasik Rona , Kishimoto Kyoko
Published: December 2021

Racial disparities are well documented in all facets of aging (e.g., health, housing, retirement). Helping gerontology students to recognize racial inequity, however, is only the first step toward effecting change. Empowering students to investigate root causes of these disparities (e.g., power relations) is essential in order to begin to identify ways to dismantle institutional racism and create systems that are more equitable. With its attention to historical/political context and fostering skills for critical analyses and social change, anti-racist pedagogy offers educators a framework from which to introduce and explore these issues (Karasik & Kishimoto, 2020). This session will consider how anti-racist pedagogy may be applied within the gerontological curriculum using examples of teaching about (1) retirement and (2) housing for older adults. Associated challenges such as finding and preparing appropriate material, as well as engaging students and faculty in work they are unfamiliar and/or uncomfortable with will also be discussed.
Project VITAL: A Statewide Initiative Using Technology to Impact Social Isolation
Authors: Fazio Sam
Published: December 2021

Project VITAL leverages customized technology to enhance connection, engagement, education and support to individuals with dementia and their caregivers. The goal was to positively impact social isolation, stress, and well-being and help mitigate the effects of isolation experienced during the pandemic and beyond. Phase One included three components designed to impact connection, engagement, education and support. It’s Never Too Late provided 300 customized tablets to 150 care communities to facilitate connections to family members and increase individualized, person-centered engagement. Project ECHO, a video-based learning platform, educated and supported care community staff. Virtual education and support were offered to family caregivers at home. Phase Two provided the program to an additional 150 care communities and added online professional training/certification. Phase Three focuses on 150 family caregivers and individuals with dementia living at home. In addition to connection and individualized engagement, family caregivers now had direct access to virtual programs and services.
The Impact of COVID Restrictions Among Rates of Falling in Assisted Living Residents
Authors: Danilovich Margaret , Fong Melanie , Hester Kamil
Published: December 2021

As a result of the COVID-19 pandemic, assisted living group activities and congregate dining stopped and residents were confined to their rooms. While this may have kept residents safer from contracting the virus, it also reduced their physical activity levels. The aim of this study was to investigate if rates of falls in one assisted living community varied as a result of COVID-19 restrictions. We analyzed fall incident reports from n=155 residents from October 2019 to October 2020. Results showed a total of n=802 falls in the year-long period (range of 1-30 falls per resident; mean = 5.17; SD=5.6 in the 12 month period). The majority (65%) of falls occurred in resident rooms. 55% of falls occurred between 6am and 6pm. The primary cause of these falls was loss of balance (30%). Comparing falls that occurred 5 months pre-restriction (Oct 2019-Feb 2020) with 5 months post-restriction (April 2020-August 2021) showed non-significant differences between time periods (p=.59). However, analyzing rates of falls by month showed a range of 46 - 88 falls by month with the lowest number occurring in winter months and the peak number of falls occurring in both Oct 2019 and 2020. Despite the majority of falls occurring in resident rooms, Covid restrictions of room confinement did not appear to impact the prevalence of falls in this sample. However, the seasonal variation warrants further research and those in assisted living should consider seasonal variations and proactively implement policies to prevent falls during these times.