bluuebunny/crossref_metadata_2025 huggingface dataset:
To Fall or Not to Fall – Falls and Perceptions of Control and Meaning of the Home
Authors: Slaug Björn , Iwarsson Susanne , Schmidt Steven
Published: December 2021

Falls are a major public health problem among older people. Even if the outcome of a fall is not fatal, it may be a traumatic experience with both physical and psychological consequences. However, there is a lack of studies examining how falls in the home may impact the perception of the home. To compare perceptions of the home between those who had fallen and those who had not, we utilized data from the Swedish SNAC-GÅS study (N=371; mean age=68; 43% men). Perceptions of control and meaning of the home were captured by established psychological instruments. Excluding falls in other environments than the home (n=99), those who fell in the home the previous year (n=34) scored notably higher on housing control by “powerful others” (p=0.053) and notably lower on perceived “behavioral home bonding” (p=0.056) compared to non-fallers (n=238). These results warrant further research into the impact of falls on perceived housing.
Reasoning About Life Transitions in Relation to Perceived Housing: In-Depth Data From Germany
Authors: Wanka Anna , Wazinski Karla , Oswald Frank
Published: December 2021

Partially different to the Swedish contribution, this paper analyses the relationships between perceived housing, life course transitions and wellbeing among community-dwelling older adults in Germany. Based on 15 qualitative interviews with persons aged 60-75 years, the contribution focuses on the experience of interrelationships between different life course transitions and perceived housing, and how they contribute to wellbeing in later life. First findings indicate a concourse of different transitions around the retirement age (e.g. illnesses, changes in partnerships) and a temporal as well as causal relationship between the two transitions relocation and retirement (for example, relocation becomes possible only after retiring or people relocate with the retirement phase in mind). The entanglement of life course transitions, in turn, shapes the person-place-relationships and perceived housing in different ways, which will be exemplified and interpreted in the presentation. However, further research is needed to consider the effects of social inequalities in these processes.
A Transitional Care Model for Veterans With Complex Needs During COVID: The Behavioral Recovery Outreach (BRO) Team
Authors: Matthews Kathleen , Vinson Latrice
Published: December 2021

The Veterans Health Administration’s Care for Patients with Complex Problems (CP)2 Program developed a national infrastructure to disseminate promising practice models to improve care for Veterans with complex medical, mental health, and/or neurocognitive conditions, who may also have behaviors disruptive to care. A strategic priority is improving safe and effective transitions to community care for Veterans with complex care needs, many of whom have historically been limited to VA settings as a result of behavioral concerns. The Behavioral Recovery Outreach (BRO) Team was the first model identified for national dissemination and evaluation at partner sites. Developed at VA Central Iowa, BRO is an interdisciplinary team model that identifies Veterans in long-term VA care settings with complex care needs to engage in individualized behavioral programing to manage/stabilize behaviors and safely transition them to more appropriate and less costly community settings. This symposium will describe the BRO team model, highlight the facilitators and barriers to nationally disseminating the BRO model with VA partner facilities, discuss adaptations in continuing community transitions following the COVID-19 pandemic, and describe program outcomes. The first speaker will discuss development of the BRO model and outcomes of a regional dissemination. The second speaker will present results from the program evaluation of the national dissemination. The final speaker will describe BRO Team expansion and lessons learned from the perspective of a VA partner facility. The (CP)2 Program Director will integrate findings and highlight implications for scaling and evaluating promising models for national dissemination for policy, practice, and future research.
Daily Physical Activity Patterns: A Window on Cognitive Decline in the Baltimore Longitudinal Study of Aging (BLSA)
Authors: Wanigatunga Amal , Liu Fangyu , Wang Hang , Urbanek Jacek , An Yang , Simonsick Eleanor , Resnick Susan , Schrack Jennifer
Published: December 2021

Gradual disengagement from essential daily physical activity (PA) necessary for independent living could signal present or emerging mild cognitive impairment (MCI) or Alzheimer’s disease (AD). We used BLSA data to examine whether PA patterns including: 1) total activity counts/day, 2) minutes/day spent active, and 3) activity fragmentation (reciprocal of the mean active bout length) differs between participants with adjudicated normal cognition (n=498) and MCI/AD diagnoses (n=32). Linear models were used and adjusted for demographics, APOE-e4 status, morbidity, and gait speed. Compared to those with normal cognition, those with MCI/AD had 3.0% higher activity fragmentation (SE=1.1%, p=0.006) but similar mean total activity counts/day (p=0.08) and minutes/day spent active (p=0.19). Results suggest that activity fragmentation may arise as a compensatory strategy in the absence of reduced activity in MCI and early AD and that activity monitoring may be potentially useful for detecting MCI and AD at an earlier stage.
Stability and Variability of Indoor Room Transitions and Mild Cognitive Impairment in Older Adults
Authors: Wu Chao-Yi , Reynolds Christina , Barnes Lisa , Silbert Lisa , Dodge Hiroko , Kaye Jeffrey , Beattie Zachary
Published: December 2021

Indoor room transition is an underexplored real-world activity outcome. We estimated the stability and variability of indoor room transitions and their associations with mild cognitive impairment (MCI) in older adults. Older adults living-alone (n=159, age=78.3±8.8 years, 14% MCI) from the Oregon Center for Aging & Technology (ORCATECH) and the Minority Aging Research Study (MARS) were included. Room transitions were detected using passive infrared motion sensors in bathroom, bedroom, kitchen, and living room. The hourly number of room transitions was used to calculate the interdaily stability and intradaily variability of room transitions. MCI was operationalized by the Clinical Dementia Rating equaled 0.5. Generalized estimating equations models adjusted for demographics, health, and environmental factors revealed that older adults with MCI had a lower interdaily stability of room transitions than cognitive healthy peers (z=-2.06,p=0.03). A pervasive-sensing system deployed in homes can obtrusively measure room transition activities to inform cognitive health in older adults.
Metformin Inhibits Mitochondrial Complex I To Promote Health
Authors: Chandel Navdeep
Published: December 2021

The major function of mitochondria in cellular homeostasis has been the generation of ATP through oxidative phosphorylation. However, we have previously demonstrated that mitochondria can serve as signaling organelles by releasing low levels of reactive oxygen species (ROS) and TCA cycle metabolites that are essential for hypoxic activation of HIF, antigen activation of T cells, cellular differentiation and proliferation of cancer cells. The anti-diabetic drug metformin has been proposed to inhibit mitochondrial complex I. We will present data indicating that metformin inhibits mitochondrial complex I to exert it’s biological effects through controlling ROS, ATP, and NAD+.
Delaying Health Care Due to the COVID-19 Pandemic: Associations With Physical and Mental Health and Preventive Care
Authors: Wheaton Felicia , Scatliffe Terika , Johnson Matilda
Published: December 2021

Health care is important for maintaining optimal physical and mental health. However, due to the COVID-19 pandemic, many older adults have delayed or postponed care. Data from the special midterm release of the 2020 Health and Retirement Study (HRS) were used to examine the relationship between chronic conditions and delayed care, as well as between delayed care and mental health outcomes and preventative care among Americans aged 50+ (N=3,266). Approximately 30% of respondents said yes when asked “Since March 2020, was there any time when you needed medical or dental care, but delayed getting or did not get it at all?” Of those, 55% said their provider cancelled, closed or suggested rescheduling, 28.5% decided it could wait, and 20.8% were afraid to go. Results from OLS and logistic regression, controlling for sociodemographic characteristics, indicate that those with lung disease and those with a heart condition had significantly higher odds of delaying care. Delaying care was associated with significantly higher odds of poor self-rated health and feeling depressed, as well as significantly higher average hopelessness, loneliness and negative affect and significantly lower average positive affect. Surprisingly, delaying care was not associated with receiving a flu shot, cholesterol test, colonoscopy, mammogram or prostate exam in the previous two years. It is likely that the full effects of delaying health care during the pandemic have yet to be felt and there is a need to study the implications of such delays.
Lung Function in Old Age and Physical Activity From Midlife to Old Age: Longitudinal Study With 24-30 Years' Follow-Up
Authors: Kåreholt Ingemar , Mehmedi Liberta , Nilsen Charlotta
Published: December 2021

The study investigated the role of physical activity, from midlife to older age, in relation to lung function in older age. In order to increase the understanding of the relationship between physical activity and lung function, the relationship between physical activity in midlife and physical activity in older age was also studied. Two Swedish studies based on nationally representative samples were used in this study, the Level of Living Survey, LNU, and the Swedish Panel Study of Living Conditions of the Oldest Old, SWEOLD. The participants were interviewed on three occasions; at the mean ages of 53 years, 61 years, and 81 years. The average follow-up time from the last to the first interview was 24-30 years. The results show that more physical activity in late midlife (mean age of 61 years) was associated with better lung function in older age. The association persists but attenuates when physical activity in older age was included in the analyses. There was also a strong association between physical activity in older age and better lung function in older age. Physical activity in late midlife had a positive association with physical activity in older age. This study shows the importance of physical activity in late midlife and in older ages to maintain good lung function in older ages. To invest in preventive actions in the form of physical activity are vital to be able to promote healthy aging, and should include the oldest old (76+).
Changes in Physical Fitness of Older People During the COVID-19 Pandemic in Germany: Objective Training Data
Authors: Koschate Jessica , Hackbarth Michel , Lau Sandra , Zieschang Tania
Published: December 2021

The purpose of this study was to analyze objective training data on changes in leg muscle training before and after the COVID-19 lockdown during spring 2020 in Germany. Overall, the training data of 4435 individuals in the age group (AG) 45-64 years (55±5 years, 66% ♀) and of 2853 in the AG 65-95 years (72±6 years, 54% ♀) were exported from chip-controlled exercise circuits. Training weight and number of repetitions performed on the leg extensor were used to calculate a leg score (LS), considering the last three training sessions before the lockdown (baseline) and the first ten individual sessions as well as the averaged sessions for August, September and October after individual training resumption. Based on the baseline LS, three training intensity groups (TG_low, medium, high) were defined, and analyzed for differences (ANOVA). The LS in TG_low remained stable after the lockdown, but increased compared to baseline in both AGs after the first ten sessions (p<0.05). In TG_medium, LS was reduced at the first post training session (p<0.05) and returned to baseline levels at training session eight in the younger and session two in the older adults. In both AGs, LS was reduced in the TG_high (p<0.001), and did not reach baseline levels by October. Hence, the LS of TG_high was identified as being particularly affected by the training interruption, irrespective of age. More individually tailored training recommendations should be made for these individuals to be able to regain their initial training levels and avoid long-term adverse health effects.
Impact of the COVID-19 Stay-at-Home Order on Diet and Health in Community-Dwelling Older Adults With Obesity
Authors: Starr Kathryn Porter , Borack Michael , Miller Marshall , Hutchins-Wiese Heather , King Alyssa , Young Kenlyn , Bales Connie
Published: December 2021

Profound restrictions were placed on previously free-living older adults due to mandatory stay-at-home orders for Covid-19. Recognizing the potential for worsening health and heightened risk of Covid-19 complications with older age and obesity, we conducted a survey to assess the impact of stay-at-home requirements on diet, health/social behaviors, and food security in 58 older adults (age=70.8±6.2, 55% Black, 93% female) who had participated in past obesity-reduction trials. A 71-item questionnaire was administered by phone and included demographics, health, lifestyle and dietary habits, food attitudes, and food security questions. Results showed indicators of heightened health risk, including health care appointments either delayed/cancelled (69%) and self-reported weight gain (62%). Of those with weight gain, 22% reported a gain of >10 pounds (33% gained 5-10 pounds and 7% < 5 pounds). Increased food intake was reported by 67% and 45% felt their eating patterns were less healthy due to increased snacking (71%) and consumption of sweets (41%). Food access and isolation were also an issue, as 51% were concerned about leaving the house for food and 81% reported eating alone. While some positive behaviors were reported (new ways to access food and health information, more reported cooking at home), the majority of findings indicated increased risk of obesity and its complications. The findings emphasize the need for effective lifestyle interventions that can be delivered remotely to high-risk older adults; this would benefit those presently self-restricted for Covid-19 concerns as well as other isolated older adults who need better access to individualized interventions.
Prior Physical Performance Impacts Social Contact and Social Participation of U.S. Older People During COVID-19
Authors: Zhang Yun , Hou Wei , Clouston Sean
Published: December 2021

Objective: To assess what roles the prior physical and cognitive performances of US older people played in changes of social contact and social participation due to the COVID-19 pandemic. Methods: We used the 2020 National Health and Aging Trends Study (NHATS) COVID-19 questionnaire (n=3,188, response rate=80.5%), linked to demographic information from the 2019 NHATS wave. We excluded participants who reported COVID-19 diagnosis and/or symptoms (n=288), and those represented by a proxy (n=414). We compared older people’s social contact with family and friends, social contact with health care providers, and social participation, prior to and during the COVID-19. We used paired t-test for the summed scores, Wilcoxon signed-rank for paired categorical variables, and McNamara test for paired binary variables. We further used weighted linear and logistic regressions adjusted for multiple covariates to investigate the effects of prior physical and cognitive performances on social contact and social participation, prior to, during, and changes in the COVID-19. Results: The sample included 2,486 participants that were predominantly females (56.20%) and non-Hispanic whites (88.43%), with participants averaging 78.24 years old. The COVID-19 pandemic resulted in significantly increased social contact with family and friends but decreased social participation of the US older people. Better prior physical performance was associated with significantly increased video calls and volunteering work during the COVID-19, while prior cognitive ability was not a significant risk factor. Conclusion: Prior physical performance, rather than prior cognitive ability, significantly affected the social way old people responded to a pandemic crisis.
Loneliness at Older Ages in Japan: Variation in Lonely Life Expectancy and the Role of Social Isolation
Authors: Furuya Shiro , Raymo James
Published: December 2021

Despite growing media, policy, and research attention to loneliness, it remains an understudied dimension of inequality in demography. Additionally, research on loneliness often fails, both methodologically and conceptually, to distinguish loneliness from social isolation. This is an important limitation given the positive correlation between measures of these two distinct concepts, a relationship that may be particularly relevant in collectivistic societies. This study focuses on Japan, describing the synthetic cohort duration of exposure to loneliness at older ages, with and without adjusting for the correlation between loneliness and social isolation. Combining life tables from the Human Mortality Database with individual data from the National Survey of Japanese Elderly, we calculated isolation-adjusted lonely life expectancies. We also evaluated regional and educational differences in isolation-adjusted lonely life expectancies. Results showed significant differences in lonely life expectancy before and after adjusting for social isolation; however, the attention to social isolation did little to alter our general understandings of trends and differentials in lonely life expectancy. In contrast to public perceptions of growing loneliness, we find that lonely life expectancy is short among older Japanese and has not increased over time. Additionally, we found no clear regional nor educational differences in isolation-adjusted lonely life expectancy.
Going Into a Community, We Need to Start From Where They’re At: Caregiver and Advocate Perspectives
Authors: Baker Zachary
Published: December 2021

We recorded and inductively coded an open-ended discussion of jargon surrounding “dementia” with the “Supporting Dementia Caregivers After Death” community advisory board (CAB). CAB-members included current and former caregivers of PLWD due to early- and normal-onset Alzheimer’s, Lewy body, and Parkinson’s, a co-president of the Alzheimer’s Association (ALZ) Young Champions, a dementia trainer/consultant and member of a Catholic church that preserves American Indian spiritual traditions, a senior program manager at ALZ who was entrusted by American Indian reservation elders to provide dementia education, a care partner support group leader, and an Alzheimer’s Ambassador chosen by multiple US senators. Themes identified included differential inclusiveness of terms like “memory loss” versus “dementia”, misuse and misunderstanding of “dementia” versus “Alzheimer’s,” and the difficulty of translating “dementia” into the American Indian Ojibwe (i.e., Anishinaabemowin) language where suggested translations directly translated to “slow memory loss”, “brain deterioration”, “absent mindedness”, or even “craziness”.
From DemenTia to DemenCia: Way More Than a Single Letter
Authors: Britton Maggie
Published: December 2021

Hispanic or Latino/a/x/e (H/L) individuals are at 1.5x risk for Alzheimer’s Disease and Related Dementias (ADRD) compared to non-H/L White individuals. Although H/L individuals make up roughly 18% of the U.S. population, they are vastly underrepresented in ADRD research. For example, less than 9% of individuals in the National Alzheimer's Coordinating Center (NACC) data set are H/L. Collaborative efforts like the ECHAR Network are working to increase the representation of H/L individuals in ADRD research across the U.S. A non-exhaustive list of barriers to H/L participation include limited health literacy, perspectives on aging, and preferences for family-centered care that aligns with H/L cultural values (e.g., familismo). For example, H/L individuals are less likely to have a medical conceptualization of the Spanish translation for dementia. The cognate “demencia” is more likely to be conflated with alternative meanings like insanity, which may create barriers when developing community-facing recruitment and study materials.
Either Sent by God or Used by God: Impact of COVID-19 on the Religious Lives of Black Families With Dementia
Authors: Epps Fayron , Ge Yiran , Sainz Mayra , Gore Janelle
Published: December 2021

The COVID-19 pandemic has underscored systemic disparities and laid its effects on the Black community. Often overlooked is how health disparities heighten stress and affect the emotional well-being of Black American caregivers. The purpose of this study is to explore the impact of COVID-19 on church engagement for Black families affected by dementia. A qualitative design was employed to collect data from current caregivers, faith/church leaders, and persons with cognitive impairment. Participants (n = 17) were predominantly female, all identified as Black. During semi-structured interviews, participants were asked how COVID-19 has impacted their participation in faith practices. The following themes emerged: (a) ability to continue faith practices, (b) increased church engagement, (c) new normal, (d) importance of fellowship, and (e) role of technology. Participants believed COVID-19 did not impact their faith practice partly due to the ability to continue with faith traditions in a virtual format. Online worship services enabled more families affected by dementia to participate. Many church leaders expressed the intent of continuing to provide online worship services post-pandemic. Families highlighted their need to have fellowship with other parishioners. Technology was perceived as a double-edged sword that serves as both a motivator and a barrier to religious engagement. These findings will support faith leaders and churches in understanding the needs of their congregation during the COVID-19 pandemic, specifically, it will allow families living with dementia to continue engaging in religious activity and living in meaningful ways.
Development of a Staff Informant Measure of Lucidity
Authors: Teresi Jeanne , Luchsinger José , Ramirez Mildred , Silver Stephanie , Devanand Davangere , Ellis Julie , Boratgis Gabriel , Gonzalez-Lopez Paloma
Published: December 2021

Lucidity Measure Development: An existing questionnaire measuring lucidity length, degree, content, coinciding circumstances, and time from lucid episode to death was expanded to include time of day, expressive and receptive communication and speech the month prior to and during the lucid event. Pilot Study: 33 interviews with staff were conducted; 73% reported ever witnessing paradoxical lucidity. Among 29 events reported, 31% lasted several days, 20.7%, 1 day, and 24.1% less. In 78.6% the patient engaged in unexpected activity. 20% died within 3 days and 17% within 3 months after the event. Qualitative Analyses: To refine the measure, 10 family caregivers and 20 LTSS staff caregivers completed a web-based focus-group type exercise using QualtricsXM. A content-thematic analysis with an inductive approach was applied to make qualitative inferences by analyzing the meaning and semantic relationship of words, phrases, and concepts. Using the reduction method of selection, conceptual content categories will be developed.
Rural-Urban Differences in Availability of Telemedicine Services Among Medicare Beneficiaries During COVID-19
Authors: Jonk Yvonne Catharina , Ziller Erika , O'Connor Heidi
Published: December 2021

The COVID-19 pandemic has created substantial disruptions to all aspects of rural and urban U.S. life. At the same time, it has provided opportunities for shifts in health service delivery, including policy innovations to increase telehealth availability and use for diagnosis and treatment of health concerns. However, it is unclear whether rural residents, particularly older adults, have the same access to telehealth services as their urban counterparts. Rural providers may face unique barriers to delivering telehealth services, and rural patients may have more difficulty accessing those services from their homes. This study used the Fall and Summer 2020 Medicare Current Beneficiary Survey COVID-19 Supplement Public Use Files to examine rural-urban differences in the telemedicine services available to Medicare beneficiaries from their primary care providers, as well as their ability to access those services. Preliminary findings suggest that rural beneficiaries are less likely to have access to telehealth services during the pandemic, they were more likely to exhibit hesitancy towards receiving the COVID-19 vaccine, they were less likely to engage in preventive behaviors such as hand washing and sterilizing surfaces, and more likely to have missed diagnostic or medical screening tests (37%) compared to urban (27%) beneficiaries. Finally, rural beneficiaries were less likely to have a smartphone, computer, or tablet at home and less likely to have access to the internet (78% rural; 84% urban). Policy implications include the need for outreach efforts to better inform the provider community, and efforts to improve rural health system infrastructure available to support telehealth.
Telehealth: A Resource for Vulnerable Populations to Access Oral Healthcare During the COVID-19 Pandemic
Authors: Raveis Victoria , Glotzer David , Ritter Andre
Published: December 2021

Dental care and adherence to daily oral hygiene practices are particularly important for healthy aging. For socially disadvantaged or impoverished, older community residents, populations who are at risk for long-standing oral disease, public dental clinics are safety nets. In March 2020, when COVID-19 cases surged in the New York metropolitan area, a months-long suspension of the area’s community dental services occurred, including clinical operations at the NYU College of Dentistry. To ameliorate the impact of this widespread service suspension, NYU Dentistry implemented an interim Dental Telehealth Service, open to the community, with telehealth consultations delivered by NYU faculty. This consultative service served a diverse population, adhering to guidelines the American Dental Association (ADA) issued on “urgent” and “emergency” care, with the goal of treating with a minimally invasive approach, to relieve the burden on hospital emergency rooms. Older adults, experiencing dental issues and fearing they were particularly vulnerable to the virus, called into this service, as they desperately wanted to avoid the overwhelmed public hospital ERs. A range of significant dental issues, i.e. pain, swelling, tooth fractures, were addressed. Implementing this community resource was a creative strategy to address a serious health services gap during this public health crisis. It also yielded important insights regarding the feasibility, acceptability and utility of telehealth, as a routine component of dental practice, when treating older adults, who often have serious co-morbidities and limited mobility. Certainly, the conversational nature of telehealth is a less stressful and anxiety-provoking clinical encounter.
Predictors of Classes of Well-Being Among Aging Women
Authors: Woods Nancy , Rillamas-Sun Eileen , Cochrane Barbara , Pike Kenneth
Published: December 2021

Our aim was to examine the relationship of predictors of well-being from prior studies to the well-being profile developed from data from aging WHI participants. Class 1 included women with both low hedonic and eudaemonic well-being scores, class 4 with the highest scores. Classes 2 and 3 had moderate scores, with class 2 having higher hedonic and lower eudaemonic scores and class 3 having lower hedonic and higher eudaemonic scores. We examined associations between predictors and well-being classes. Youngest women were in Class 4 (mean=60.2 years) and oldest in Class 3 (mean=63.2). African American women had higher proportions in in Classes 2 and 3, Latinas in Classes 1 and 3, and Asian/Pacific Islanders in Class 3. College graduates, married women and those with household incomes >$50,000 were most likely in Class 4. Associations with age, race/ethnicity, education, marital status and income were consistent with prior analyses incorporating individual well-being indicators.
Recruiting Diverse Dementia Family Caregivers: What Works for Which Groups?
Authors: Mendez Kyra , Cotter Valerie , Han Hae-Ra
Published: December 2021

The purpose of this presentation is to compare success of recruitment methods by race/ethnicity, age, and kinship of dementia family caregivers. We conducted a cross-sectional study and recruited a convenience sample of dementia family caregivers using community-based and online methods. Recruitment success was tracked through survey questions, direct referrals, and community event sign-ups. Using chi-squared statistics, we examined the success of each method by caregiver race/ethnicity, age, and relationship to person with dementia (kinship). There were significant differences in recruitment source based on race/ethnicity, age, and kinship (P<.001). Specifically, referrals and newspaper advertisements were most successful for recruiting older (54 years+), White, non-Hispanic, and spousal or child caregivers; community events and reputable websites for recruiting older, minority, child caregivers; ResearchMatch for recruiting younger, minority, child/grandchild caregivers; and social media for recruiting younger, White, non-Hispanic, and child caregivers. Findings support the importance of implementing tailored methods to reach diverse dementia caregivers.
Targeting Biological Aging: A New Paradigm for 21st Century Medicine
Authors: Kaeberleien Matt
Published: December 2021

Biological age is the greatest risk factor for nearly every major cause of death and disability, including COVID-19. Yet, traditional biomedical research and clinical approaches have focused on waiting until people are sick and treating individual diseases one at a time. Attempts to “cure” age-related diseases have proven unsuccessful, and the impact of “disease-first” approaches continue to be incremental. Recent advances in understanding them mechanisms linking biological aging to disease, or geroscience, have identified interventions that directly target the molecular hallmarks of aging. Unlike disease-specific approaches, such interventions have the potential to prevent multiple diseases of aging simultaneously, thereby greatly enhancing healthspan and lifespan for most individuals. Here I will provide an overview of translational geroscience, which I believe will become the paradigm for the practice of medicine in the 21st century. I will also discuss recent work with one such intervention, the drug rapamycin, and our efforts to eventually delay or reverse biological aging in companion dogs and people.
Dementia and Living Arrangements Among Mexicans and Mexican Americans
Authors: Cantu Phillip , Kim Jiwon , Rote Sunshine , Mejia-Arango Silvia , López-Ortega Mariana , Angel Jacqueline
Published: December 2021

This study compares the living arrangements of adults 85 and older in Mexican-origin adults in Mexico and the United States. The study uses 475 Mexican-Americans in five southwestern states (Hispanic Established Population for the Epidemiologic Studies of the Elderly, H-EPESE) and 1,710 Mexicans from 32 states in Mexico (Mexican Health and Aging Study, MHAS) to examine living alone vs living with others based on the presence of dementia controlling for demographic, health, and financial correlates. In both countries, more than 20% of respondents living alone have dementia. Dementia is associated with household extension in both countries. Homeownership increases household extension in Mexico but not the U.S. The findings show that individuals with dementia are more likely to live alone in the U.S. than in Mexico. Older individuals with dementia may be at elevated risk of isolation in later life if families or formal organizations cannot provide on-going assistance.
Examining the Gender Disparities in Health Service Utilization Among Older Adults Managing Cognitive Impairments
Authors: McKenzie Camille , Findley Patricia
Published: December 2021

Comorbid conditions can complicate healthcare access, yet little is known about the impact of cognition on accessing those services. This study aims to examine the effect of gender on health service utilization among the aging population. Data from the National Health Interview (2019) Survey (n=3,058) were utilized to assess the impact of gender on the use of physician and dental services among older adults managing cognitive impairments. We estimated logistic regression models controlling for demographic, health/physical functioning, and psychological predictors. Findings indicated older male respondents managing cognitive impairments were less inclined to utilize both physician (p<.05) and dental (p<.01) health services on a yearly basis as compared to their female counterparts. Household income (aOR = 0.62 [-0.91, -0.06]; aOR = 0.34 [-1.25, -0.90]) and health insurance coverage (aOR = 0.18 [-2.31, -1.13]; aOR = 0.32 [-1.68, -0.62]) respectively were the strongest structural factors limiting access to both physician and dental services, with lower levels of educational attainment (aOR = 0.46 [-1.00, -0.55]) being an additional barrier for dental service utilization. Respondents with low self-rated health were inclined to utilize physician more than dental services (aOR = 2.31 [0.38, 1.29]; aOR = 0.73 [-0.50, -0.14]). It is imperative geriatric practitioners adopt a more integrative approach to health, especially among the aging population managing chronic disabilities, where additional community supports are warranted to promote and maintain physical and oral health.
Discrimination and Mental Health During the Black Lives Matter Movement and the COVID-19 Pandemic
Authors: Lu Peiyi , Kong Dexia , Shelley Mack
Published: December 2021

Discrimination has been more prevalent since the pandemic. Black Lives Matter (BLM) movement flourished in the summer of 2020 as protests against police brutality and racial injustice. However, the extent to which individuals’ discrimination experiences and associated mental health outcomes change amid a global pandemic and a dramatic societal movement in American society remains unknown. This study examines the dynamic relationship of racism and/or Covid-19-related discrimination with changes in mental health in the context of BLM and Covid-19. Data were from U.S. adults (age ≥18) who completed the online Understanding Coronavirus in America survey in June and September of 2020 (n=3,502). Respondents were asked to attribute their discrimination experience to 8 main reasons: (1) Covid-19; (2) national origin/race/skin color; (3) gender/sexual orientation; (4) age; (5) physical feature; (6) education/income; (7) health condition; and (8) religion/other. Quasi-Poisson regression models examined the associations between discrimination and anxiety/depression/stress. Results indicated about 33% of respondents reported discrimination in June compared to 21% in September. Racism was significantly associated with more anxiety/depression/stress in June, but not in September or in the longitudinal trend. Covid-19-related discrimination was associated with elevated levels of anxiety/depression/stress in September and in the longitudinal trend, but not in June 2020. We concluded that individuals’ discrimination experiences are shaped by societal contexts. Specifically, racism was the dominant discrimination attribution in June 2020 when BLM was at its peak. However, Covid-19 discrimination overtook racism as the primary attribution and showed a significant relationship with poorer mental health over time.
Effects of Isolation Among Older Adults Due to Coronavirus Restrictions
Authors: Thomas Cynthia
Published: December 2021

Semi-structured interviews were conducted with 35 residents in a Maryland condominium, four to six months after the presence of the epidemic in the US was recognized in mid-March. The objective was to determine to what extent the restrictions resulting from the presence of a new disease was affecting older adults in their daily lives, and in their plans for the future. All respondents were over the age of 60 and half were more than 80 years old. Two-thirds lived by themselves; most others lived with a husband or wife. Respondents for the most part were following guidelines to wear masks, practice social distancing and avoid close contact with persons outside their homes, including other family members. Over half had already made dramatic changes in their daily activities. Some found an opportunity to develop new skills, had connected with people from the past, or had become more introspective. Others, while exhibiting some of the same characteristics, were more focused on the restrictions they faced, and were more aware than ever of the limited amount of time left in their lives. Differences between respondents in the emphasis of their perspectives are explored, by age, gender, and other characteristics.
Influence of Social Determinants on Self-Rated Health in Three Countries of East Asia
Authors: Cho Jinmyoung , Nakagawa Takeshi , Yeung Dannii
Published: December 2021

This study aims to compare five domains of social determinants and their associations with self-rated health (SRH) among older adults in China, Japan, and Korea, where they share some cultural values but the development and conditions of economic status, health care system, and education system vary. A total of 10,111 participants aged 65 years and older were included from three harmonized datasets at baseline CHARLS, KLoSA, and JSTAR. Guided by the Healthy People 2020 Framework, five domains of social determinants were included: education levels, economic stability (total income, working for pay), social and community context (social engagement, living with children), health care access (medical center utilization), and neighborhood (rural vs. urban). Regression models showed that working for pay, social engagement, and medical center utilization were significant predictors for SRH in three countries. However, unique predictors have also been observed in China and Korea, which will be discussed in the presentation.
The African Immigrant Dementia Education Project: A Community-University Partnership
Authors: Nkimbeng Manka , Russell Wynfred , Gaugler Joseph
Published: December 2021

The African Immigrant Dementia Education project is a community-university partnership with the goal of developing a culturally tailored dementia education program with African immigrants in Minnesota. In collaboration with our community partner (African Career, Education & Resource, Inc.), a project advisory board that features professionals and family members from the African immigrant community was assembled and its first meeting was held in February 2021. Preliminary discussions about content, mode of delivery and cultural considerations of an eventual dementia education intervention have begun. This presentation will offer details on the process of working with an advisory board and community partner to identify and culturally tailor an evidenced-based dementia education curriculum for a unique cultural group. Also, we will present challenges encountered during this process and offer suggestions and strategies to promote successful researcher-community partnerships.
Exploring Factors Contribute to Adhering in Computerized Cognitive Training Among Healthy Older Adults in China
Authors: Liu Yu , Lv Siman , Ni Cuiping
Published: December 2021

Computerized cognitive intervention has the potential to enhance cognition among healthy older adults. However, little is known of the factors associated with adherence in computerized cognitive training among healthy older adults in China. This study was designed to explore these factors utilizing a descriptive qualitative method. A semi-structured interview was used to interview 13 informants. The analysis suggested that factors associated with adherence to the computerized cognitive intervention, included 3 core themes:(1) individual characteristics, with three subthemes of “having free time”, “emotion”, and “persistence characteristics”; (2) encouragement, with three subthemes of “peer group support”, “support from healthcare professional”, and “supervision from facilitators”; and (3) self-recognized improvement related to training, with two subthemes of “better brain function” and “emotion improved”. The results revealed multi-factors promote adherence including personal and social aspects.
A Comprehensive Cognitive Health Management Model for Community-Dwelling Older Adults in Shanghai
Authors: Qiu Jiayuan , Nie Jing , Fang Yuan , Li Xia
Published: December 2021

To investigate whether a comprehensive cognitive health management model improves cognitive function among community-dwelling older adults in Shanghai, China. The comprehensive cognitive health management model included brain health screening, individualized brain health consultation and referrals, and annual follow-up monitoring. We compared 161 older adults (43 with MCI, 118 with normal aging) who received the health management model, to an equal size of control group who did not receive the model on their cognition and emotion using Montreal Cognitive Assessment Scale (MoCA) and Geriatric Depression Scale (GDS). Over one-year, participants with MCI in the intervention group showed a significant increase of MoCA score than their MCI counterparts in the control group. Participants with normal aging in the intervention group showed no differences in MoCA and GDS with those in the control group. The individualized cognitive health management model is promising to assist community-dwelling older adults with MCI to maintain brain health.
Active Aging and the Mattheus Effect
Authors: Jensen Per
Published: December 2021

While active ageing has been discursivized in international organizations and among researchers as a major means to combat the challenges of demographic ageing, this study aims to make a critical-theoretical and empirical assessment of the active ageing concept. It falls into three parts, the first showing how the conceptual framework of active ageing is undertheorized, lacks conceptual and analytical clarity, and that the theoretical framework does not hold clear ideas regarding the factors conditioning active ageing. The second part investigates the main patterns and structuring mechanisms of active ageing in an outcome perspective using Danish data subject to a correspondence analysis. Here, a Matthew Effect of accumulated advantage is found; that is, older adults who are blessed in one sphere of life are also blessed in others, and such inequalities in old age are the outcomes of social life biographies (i.e., cumulative advantages/disadvantages over the life course). Although nursed by the political system, EU ideas about active ageing are only weakly translated into policies and programs. Part three discusses some of the reasons for this, one obviously being that active ageing is elusive and lacks well-defined cause-and-effect descriptions. Another reason is that the concept has been developed in global elite networks that are quite distant from policymakers; at least in a decentralized political system like the Danish welfare state.
Review of Research Into Employer Approaches to Younger Onset Dementia and Mild Cognitive Impairment in the Workplace
Authors: Carino James , Taylor Philip , Morgan Damian
Published: December 2021

Younger Onset Dementia (YOD) and Mild Cognitive Impairment (MCI) are relatively prevalent conditions globally which can affect the job performance of individuals in their working lives. This presentation considers the existing research documenting actual, stated or intended approaches taken by employers to managing and supporting employees with these conditions. Nine relevant research projects were identified based on an extensive exploration of the peer reviewed literature. These show that employers have some knowledge of dementia, but do not recognise this as a possible explanation when performance changes occur in the workplace. Employees typically leave or are removed from the workplace before a formal diagnosis or soon after. The literature shows both supportive and unsupportive behaviours toward employees. Drawing from this literature recommendations for increasing the quality of support provided to employees are offered: awareness training to foster earlier detection, clarification of these conditions as a disability, and application of methods to support employees to continue to contribute to the workplace while this is feasible and desirable from both the employer and the employee’s perspective.
Eliminating Disparities and Achieving Health Equity Using Implementation Science
Authors: Prusaczyk Beth , Baumann Ana
Published: December 2021

Eliminating health disparities and achieving equity are central to aging services, programs, and research, as we work to ensure older adults are treated equitably compared to their younger counterparts. Additionally, aging services, programs, and research are not immune from the structural racism and other inequities that plague all facets of our lives, and we must work to eliminate disparities within them as well. This presentation will discuss how Implementation science can be used to advance both of these fronts. Implementation science frameworks can be used to ensure multiple levels of context are considered, which is critical when working against something as pervasive and structural as racism. Implementation science can also guide the adaptation of evidence-based interventions for different populations, including for older adults or for different racial or ethnic groups. Furthermore, there are important ways health equity research can improve implementation science that advance the shared goal of eliminating disparities.
The Elderhood Mystique
Authors: de Medeiros Kate
Published: December 2021

While elderhood recognizes untapped potential and continued growth and creativity in later life, it also risks becoming a dismissive label that positions older people as different, otherworldly, and mysterious. By analyzing the concept of elderhood and similar movements (e.g., sageing, croning, eldering) in popular and academic literature, paying close attention to how elderhood is defined and framed, I found that elderhood has a role in some religious and cultural practices. However, newer approaches to elderhood have emerged from middle aged writers who imagine an idealized role in later life – the elderhood mystique. Often grounded in introspective passivity and selflessness, elderhood parallels Kathleen Woodward’s depiction of wisdom as a disempowering label that discourages activism and resistance by older people. Subsequently, elderhood and wisdom risk becoming new forms of othering or exclusion. Overall, findings underscore the importance of critical analysis of age-related terms, regardless of how positive they seem.