bluuebunny/crossref_metadata_2025 huggingface dataset:
UNDERSTANDING OLDER ADULTS’ ATTITUDES TOWARD MOBILE AND WEARABLE TECHNOLOGIES TO SUPPORT HEALTH AND COGNITION
Authors: Fowe Ibukun , Boot Walter
Published: December 2022

Technologies that facilitate remote patient monitoring, virtual care, and telehealth are becoming increasingly prevalent, accelerated due to the challenges providing healthcare during the COVID-19 pandemic and the need for more efficient and effective methods to care for the expanding older adult population. Despite the potential benefits of these technologies, their promise can be hampered by low rates of acceptance and adoption among older adults. We assessed older adults’ (N = 92) attitudes towards the use of wearable and mobile technologies for 1) predicting cognitive decline, 2) assisting with adherence to health activities, and 3) collection of self-report data to understand current health status and predict future problems. Participants generally rated hypothetical technology solutions as useful (M = 4.2, SD = 0.70, 1 = Strongly Disagree, 5 = Strongly Agree), were interested in learning more about these technologies (M = 3.81, SD = 0.86), and indicated willingness to adopt these technologies themselves (M = 3.83, SD = 0.93); however, participants did indicate some privacy concerns (M = 2.92, SD = 1.02. General technology attitudes and previous experience using mobile devices were the best predictors of acceptance and willingness to adopt these technologies (r =0.50, p < .001; r =0.22, p < .05, respectively). These findings suggest generally positive attitudes and highlight potential targets for intervention to increase the uptake of these technologies, maximizing their benefits.
MOTIVATIONAL INTERVIEWING TO MODIFY SORTING AND DISCARDING BEHAVIORS IN HOARDING DISORDER
Authors: Nix Caitlyn , Dozier Mary
Published: December 2022

The act of sorting and discarding possessions is the fundamental health behavior that underlies clutter, a core symptom and signifier of hoarding disorder. In older adults, excessive clutter can cause hazardous conditions in the home that increase the risk of being unable to age in place safely. Current evidence-based treatments for hoarding require lengthy treatment dosages and primarily target fears surrounding sorting/discarding. Because not all older adults with hoarding disorder experience a fear-response when sorting/discarding, other targets for hoarding treatment must be evaluated in this population, including directly targeting motivation for behavior change. The current pilot study investigated motivation to sort and discard items as a treatment target for hoarding disorder in older adults. The rationale for this treatment study was that targeting motivation to engage in regular sorting/discarding of household clutter would result in decreased hoarding severity by creating a sustainable change in behavior. Fifteen participants (age 50 and up, M = 62) engaged in six in-home sessions of a novel intervention that combined intensive motivational interviewing with sorting practice (i.e., spending time engaging in the target behavior of sorting and discarding items in the home). This presentation will discuss the applications of motivational interviewing for hoarding disorder in older adults, including skills related to engaging, focusing, evoking, and planning. Our initial treatment outcomes suggest that motivation is a worthwhile treatment target for hoarding disorder.
TRENDS IN MENTAL ILLNESS ACROSS ASSISTED LIVING SETTINGS: RESIDENT AND COMMUNITY FACTORS
Authors: Carlson Bryant , Dys Sarah , Tunalilar Ozcan , Carder Paula
Published: December 2022

Although rates of serious mental illness (SMI), depression, and anxiety are becoming more common among assisted living (AL) and residential care (RC) residents, few studies have investigated resident and community-level factors to ensure that the settings and resources are adequate to meet residents’ mental health needs. Using a representative sample of Oregon AL/RC residents (n = 1,013), this study uses descriptive cross-sectional analysis to examine intrastate variation in the prevalence of SMI, depression, and anxiety related to: (1) resident-level characteristics (e.g., mental illness comorbidity, psychotropic medication use, and Medicaid status); (2) community-level characteristics (e.g., facility type and urban/rural geographic designation); and (3) health services utilization (e.g., emergency room visits and hospital admission). Results indicate that 12% of AL/RC residents had an SMI diagnosis, nearly half of whom also had depression and anxiety, and 80% were Medicaid eligible. One in six residents with SMI received at least three psychotropic medications in the last week. Residents with SMI were also more likely to live in RC facilities than AL facilities, in facilities with Medicaid contracts, and in urban rather than rural settings. Compared to residents without SMI, a larger share of residents with SMI utilized hospital emergency rooms (32% vs. 18%) and were admitted to the hospital overnight (15% vs. 9%). Findings underscore characteristics associated with potentially higher needs among AL/RC residents with SMI compared to their counterparts, with implications for the high quality provision of mental health services and quality of life and care in these settings.
LOVE OR OBLIGATION TO “SEE THEM THROUGH:” BURDENS AND GAINS IN CAREGIVING FOR CENTENARIANS
Authors: Shum Eric Ngai Yin , Lau Bobo Hi Po , Martin Peter , Siu Joey Chung Yue , Cheung Karen Siu Lan , Chan Cecilia Lai Wan , Chan Grace Man Yee , Luk James Ka Hay
Published: December 2022

In Hong Kong, the population of centenarians increased from about 3,000 in 2011 to over 10,000 in 2021. The growth of this population has led to challenges concerning how far family caregivers, who are usually older adults themselves, could care for their spouse or parents. In 2021, we launched the 2nd Hong Kong Centenarian Study and included the voices of family caregivers. Notwithstanding the increased difficulties of caregiving during COVID outbreaks, our interviews with 120 caregivers revealed low to moderate scores of caregiving burden and gains (measured by 4-items from the Zarit Burden Scale and 5-items from the Positive Aspects of Caregiving Scale). Female and older (aged 70 or above) caregivers reported more emotional distress, burden, and poorer self-rated health, while younger caregivers (less than 70 years old) sustained a wider social network. Financial stress was related to smaller social network size and more emotional distress. When being asked what sustained their motivation to care for their spouse or for their parents, “filial obligation to see them through” and “repaying for love” were answered as key motivators. Caregivers also derived pride and satisfaction from contributing to the remarkable longevity of their loved ones or from witnessing their loved ones recovering from life-threatening traumas (e.g., falls, hospitalization), but felt helpless when faced with escalating care needs due to their own deteriorating physical health and capacities. “Double-old caregiving” will become more common, and society will need to overhaul the care system to support these motivated families who have escalated care needs.
IT’S A FAMILY AFFAIR: COMMUNITY-BASED RESEARCH PARTNERSHIP TO CREATE A FAMILY-CENTERED DEMENTIA CAREGIVER PROGRAM
Authors: O’Conor Rachel , Oladejo Dianne , Filec Sarah , Knox Janice , Griffin Angel , Chapman Joyce , Roberson Tonya
Published: December 2022

People in the Black community are two times more likely to develop dementia than white people. This racial disparity is due to both social and structural factors which shape access to power, resources and exposure to health-damaging conditions by race. Due to the significant cognitive changes that occur, Black families assume substantial caregiving responsibilities to support family members, yet few caregiving programs offer culturally tailored support and training to the preferences and familial care norms of Black caregivers. In response, individuals from two community-based organizations (CBOs) and an academic medical center partnered to develop a culturally tailored, community-based, family-centered dementia caregiving research program for individuals living in far south Chicago. A team of stakeholders identified by the CBOs convened in the Fall 2021 to discuss the need for the proposed program, and together a key informant interview guide was designed. We have conducted 16 of 30 interviews and preliminary analyses of the interviews has revealed that caregivers are largely caring for parents or grandparents and are sharing caregiving responsibilities with other family members. Caregivers endorsed a need for the program; preferred a hybrid format and the need to include content related to 1) education on dementia, 2) emotional coping, and 3) linkage to medical and community-based resources. Anticipated barriers to participation included, time, location, and care for their family member while they participated. Our stakeholder team will continue to conduct key informant interviews, review and interpret data findings, and collectively develop a community-based family-centered caregiving program.
THE DETERMINANTS OF LIFE SATISFACTION AMONG MONGOLIAN OLDER ADULTS
Authors: Otgon Saranchuluun , Lkhagvasuren Khorolsuren , Mukhtar Yerkebulan , Baatar Anujin , Fabio Casati , Czajka Agnieszka , Myagmarjav Sugarmaa
Published: December 2022

Background

As the average life expectancy and the proportion of the elderly population increases, approaches that limit their policies, programs, and activities to health issues are changing worldwide. International organizations, such as the WHO, United Nations, have pledged their member countries to update their policies on the elderly population and increase their psychological and social participation over the next 20 years. We determined social demographic factors of life satisfaction among Mongolian older adults.

Methods

A cross-sectional study recruited three hundred four older adults recruited by geriatric doctors and seniors’ association units in urban and rural areas of Mongolia. The questionnaire included life satisfaction, social network, loneliness, social participation, self-rated health, and demographics. We used multiple linear regression analyses. Result: Life Satisfaction of the older adults living in urban is higher than those living in rural area (β = 0.954, p = 0.001). Good self-rate of health (β = 1.013 p = 0.001), voluntary work (β = 0.847 p = 0.001), and employment increase life satisfaction levels. Life satisfaction scores increased by 0.3 points for male older adults with a 1-point increase in education, 0.9 points for women living in cities (β = 0.929 p = 0.002), and 0.8 points for volunteering (β=0.790 p=0.006) respectively. However, when the loneliness score increases by one, the satisfaction score decreases by 0.3 points (β = -0.353 p = 0.013). Conclusions: The level of satisfaction of the Mongolian older adults is associated with self-rate of health, education level, loneliness, social activities, and living areas.
REFRAMING STUDENT EXPERIENCES AND ATTITUDES TOWARDS WORKING WITH OLDER ADULTS
Authors: Martinez Iveris
Published: December 2022

We are experiencing a shortage of trained health and social service providers to meet the needs of an aging society. However, few students have positive opportunities to work with older adults in their training. If they interact with older adults it is usually in end-of-life and nursing home care settings. We therefore need to find creative ways to motivate students in these fields to choose to work with older adults. We recruited students from health and social services programs to implement four health promotion projects at an older adult low-income residential community. We asked students (Nf22) to reflect on their experiences, and analyzed responses using a grounded theory approach. Myths regarding working with older adults included that they were mean, difficult, not technologically savvy, nor physically active. Initially nervous and uncertain about working with older adult prior to their experience, students gained confidence and had fun. They reported rewarding experiences, built relationships, and learned the benefits of prevention programs for older adults, and reconsidering their career trajectories to focus on working with older adults. Encouraging positive student experiences working with older adults can help prepare to develop the health and human services workforce for an aging society.
YOU DON’T KNOW WHAT YOU DON’T KNOW: BLACK/LATINX CANCER SURVIVORS’ KNOWLEDGE AND USE OF SURVIVORSHIP CARE PLAN
Authors: Nwakasi Candidus , Romero Cristy , Sinkler Kateri , Pawlowicz Abigail
Published: December 2022

Compared to Whites, Black and Latinx cancer survivors and their families experience disproportionate adverse effects of cancer and cancer therapy. This is due to extreme psychosocial, physical, emotional, and financial challenges they experience, thus, highlighting racial/ethnic disparity in cancer survivorship. A cancer survivorship care plan (SCP) is important for improving cancer health and quality of life, but the effectiveness of SCP as a tool to address the disproportionately persistent poor health and quality of life of Blacks/Latinx compared to Whites deserve critical attention. This study is part of a larger study on evaluating cancer survivorship in Rhode Island. We explored knowledge and use of SCP among Blacks and Latinx cancer survivors in Rhode Island. The study employed a qualitative descriptive method. Semi-structured interviews in English and Spanish were conducted with a purposive sample of 12 cancer survivors, 8 Latinx and 3 Blacks (Mage = 62 years). Their responses were transcribed and analyzed for themes. The 3 major themes identified were: 1) invisibility of survivors; 2) understanding the needs of cancer survivors; and 3) issues of empowerment. Our findings draw attention to the need for tailored interventions targeting Black/Latinx cancer survivors. One of such interventions include designing programs to increase the accessibility of SCP to help improve quality of life of cancer survivors from disadvantaged population groups.
MEASURING AGE-FRIENDLINESS OF TRANSPORTATION, MOBILITY COMMUNITY CHARACTERISTICS: A SCOPING REVIEW
Authors: Hansmann Kellia , Deemer David , McAndrews Carolyn , Robert Stephanie
Published: December 2022

Age-friendly community initiatives seek to identify and develop infrastructure and services that promote active aging. Inclusive characteristics of transportation and outdoor spaces can improve everyone’s mobility around their communities but are particularly important to adults who are transitioning to non-driving. In this study, we aimed to identify and describe age-friendly community indicators that evaluate characteristics most associated with community-level mobility, specifically transportation and outdoor spaces. We conducted a scoping review of peer-reviewed and gray literature to find records describing the development of age-friendly community indicators and then to identify indices with measures of transportation and outdoor spaces resources. We searched PubMed, Scopus, Ebsco, and Web of Science in August 2022 for literature published since 2005. Our search resulted in 1,012 unique records; screening for relevance by title and abstract resulted in 33 records that received full text reviews. We identified 9 final indicators for inclusion and reviewed records to describe the source of the indices, development methodology, and specific indicators used to measure transportation and outdoor spaces. Included indicators were sponsored by governmental or non-profit public health organizations (n=4) and academic researchers (n=5), including one academic partnership with a for-profit insurance company. Most indices (n=6) described measures drawn from subjective data collected during community assessments. Age-friendly indicators were not developed specifically for investigating older adults’ transition to non-driving, a missing focus that represents a significant gap. Aligning indicators with this common life transition will facilitate research into the interventions promoting mobility at the community level for all.
SUPPORTING DEMENTIA CAREGIVERS: THE PUBLIC HEALTH CENTER OF EXCELLENCE ON DEMENTIA CAREGIVING
Authors: Gaugler Joseph
Published: December 2022

The Public Health Center of Excellence on Dementia Caregiving has established a robust, national network of 17 organizations to jointly develop and disseminate information, tools, and resources to support families, friends, and other unpaid caregivers of people living with dementia. The Center is establishing partnerships with local, state, tribal, and other public health organizations throughout the United States to provide technical assistance on the sustainability of dementia caregiving support programs as well as the cultural adaptation of messaging and tools to best meet the needs of diverse communities The Center also has a robust stakeholder engagement process so that the voices of caregivers and public health providers are incorporated in all Center efforts. The Center also collaborates with the Public Health Centers of Excellence on Risk Reduction and Early Detection to develop and refine cross-cutting resources and tools to further meet the complex public health challenges of dementia.
THE EFFECTS OF NEIGHBORHOOD DEPRIVATION AND PERCEIVED NEIGHBORHOOD PROBLEMS ON DEPRESSIVE SYMPTOMS
Authors: Choi Jean , Muñoz Elizabeth , Corley Robin , Wadsworth Sally , Reynolds Chandra
Published: December 2022

The progression of detrimental mental health outcomes may begin before old age, and investigating correlates earlier in the lifespan may provide insights into prevention efforts. Neighborhoods have been linked with mental health in adulthood, but there is variation in measurement across studies. Studies have examined the independent associations between either of objective or subjective measures of neighborhoods, but few to none have examined both of these in one study. We assessed the effects of both objective (Area Deprivation Index; ADI) and subjective, or perceived, neighborhood characteristics on depressive symptoms among early midlife adults, using data from the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (Nf1166, Mage=33.51 (5.07)). Participants completed self-report assessments of perceptions of their neighborhoods (e.g., perceived safety, disorder). Addresses were geocoded and linked with 2010 Census data, and we created a standardized ADI composite. To account for subject non-independence, we fitted multilevel linear regressions, controlling for relevant confounding variables. Results showed that higher ADI was linked with greater depressive symptoms (d = .04), but the effect of ADI was no longer significant and was reduced by about 30% after accounting for subjective neighborhood domains. Perceived neighborhood disorder had the largest effect (d = .19) and remained the sole predictor of depressive symptoms when all perceived domains were included in one model. Findings suggest that residents’ subjective interpretations of their neighborhood surroundings may be shaped by the broader structural contexts in which they live in, revealing a potential pathway through which objective neighborhoods affect depression.
SUBSIDIZED SENIOR HOUSINGS (SSH) FOR LOW-INCOME OLDER ADULTS IN THE U.S.: A SCOPING REVIEW
Authors: Park Sojung , Park Soobin , Amano Takashi , Baek Jihye , Kim BoRin , Ryu Byeongju
Published: December 2022

Subsidized senior housing (SSH) has been advocated as a key component of a community-based, long-term care policy for low-income older adults that links housing with health and social services to support aging-in-place (AIP). Relative to the accumulating evidence on for-profit housing models, SSH remained understudied. Guided by the Person-Environmental fit perspective, this scoping review described and synthesized existing literature on SSH to identify strengths and gaps in the literature. With a five-step scoping review method, we focused on the empirical studies published from 2010 in the U.S using four electronic databases and additional manual searching. Sixty-six articles met the inclusion criteria. Study participants were predominantly non-Hispanic White and female; most studies were quantitative surveys with a cross-sectional design. Five areas of outcomes emerged: (1) Health and well-being (45%), (2) Healthcare use and health behavior (24%), (3) Social Relations (11%), (4) Housing Relocation (12%), and (5) Technology (8%). In examining the study outcomes, the existing articles primarily focus on the personal (29%) and environmental (71%) dimensions, including 9% of the articles investigating both dimensions. For each dimension, the majority of the research tends to highlight residents’ health conditions and characteristics of supports and service programs in the housing. The largest proportion of the literature studied the relationship between residents’ health and the outcomes related to health and well-being. Future research needs to examine subpopulations of older residents in SSH (e.g., racial/ethnic minority, LGBTQIA, and others) as well as the current and future role of technology in SSH and community partnership.
AI-ASSISTED METHODS FOR ASSESSING AFFECT AND BEHAVIORAL SYMPTOMS IN DEMENTIA: A SYSTEMATIC REVIEW
Authors: Jao Ying-Ling , Liao Yo-Jen , Yuan Fengpei , Liu Ziming , Zhao Xiaopeng , Liu Wen , Berish Diane , Wang James
Published: December 2022

Negative affect and neurobehavioral symptoms occur in most people with dementia and significantly impact their health outcomes and sense of wellbeing. Detecting these symptoms in this population is challenging due to associated cognitive impairment and communication difficulties. Innovative technology and artificial intelligence (AI)-assisted tools are emerging for assessing affect and neurobehavioral symptoms in individuals with dementia. This review synthesizes research evidence to identify existing AI-assisted measurement tools and evaluate their accuracy in assessing affect and symptoms in people with mild cognitive impairment and dementia. PubMed, CINAHL, Scopus, and Web of Science databases were searched. Eight articles were identified. Multiple machine learning (ML) models were developed to assess affect, apathy, anxiety, depression, agitation, and wandering. One ML model detected positive and negative affect via facial expression with an overall accuracy of 86%. One ML model detected apathy based on speech and achieved an area under curve (AUC) accuracy of 0.77–0.88. Another speech-based ML model, based on paralinguistic markers, predicted apathy, anxiety, and depression by ≥0.3 points. Another model detected wandering based on activity monitoring data and showed 98% sensitivity and specificity. Furthermore, multiple ML models were developed to detect agitation using multi-modal sensors with AUC ranging from 0.50–0.82. Findings suggest that AI-assisted tools are a promising approach to detecting affect and neurobehavioral symptoms, yet the evidence is limited. More research is needed to develop comprehensive, accurate models to detect neurobehavior symptoms. The results have significant implications for supporting research and clinical practice to promote quality of care for people with dementia.
WHAT MOTIVATES PARTICIPATION IN ALZHEIMER’S PREVENTION RESEARCH: A MIXED-METHODS STUDY
Authors: Murillo Lizbeth Vera , Meulen Maria Vander , Villamor Monique , Collie Angel , Cline Sarah , Nicholson Jody , Edwards Jerri
Published: December 2022

6.5 million Americans aged 65 and older are currently living with Alzheimer’s disease or related dementias (ADRD; Alzheimer’s Association, 2022). By 2060, it is estimated that this number will increase to 13.9 million (Matthews et al., 2018). Therefore, it is imperative to gain insight into participants’ personal motivations and expectations of research to advance community participation. The Preventing Alzheimer’s with Cognitive Training (PACT) study is a National Institute of Health, National Institute on Aging-funded, multi-site clinical trial examining the prevention of mild cognitive impairment and ADRD through computer-based cognitive training. Across 5 locations, data were collected from 2,360 cognitively normal participants (M=73.03 years, range=65–97, SD=5.04). The current project explores individuals’ motivations and expectations of cognitive training (CT) utilizing a mixed-method approach by coding qualitative open-ended questions about motivation to participate and comparing how motivational themes aligned with expectations about CT from the Expectations Assessment Scale (EAS; Rabipour et al., 2018). Six themes for participant motivation emerged: direct experience with the disease (26.9%), concern about brain health and aging (23.9%), general personal interest (17.9%), general interest in research (20.1%), referral to the study (5.8%), and altruism (5.4%). After completing the initial training session, motivation themes did not differentiate satisfaction with (p=.06) or perceived success of (p=.11) the CT program. Understanding participants’ motivations can further expand and optimize recruitment and retention strategies in AD prevention research. Future research will focus on how these themes influence adherence and retention and relate to participant demographic characteristics (i.e., education, gender, race, and ethnicity).
THE RELATIONSHIP BETWEEN SOCIOECONOMIC DISADVANTAGE AND DEMENTIA CAREGIVER BURDEN
Authors: Beverly Alexis , Baucco Christina , Park Seho , Schroeder Matthew , Johns Shelley , Judge Katherine , Fowler Nicole
Published: December 2022

More than 16 million people provide unpaid care to someone with Alzheimer’s disease or a related dementia (ADRD) in the United States. These caregivers frequently report experiencing psychological and physical burden. Prior research shows that socioeconomic disadvantaged neighborhoods have higher rates of ADRD, but little is known about caregiver burden. We hypothesized more socioeconomic disadvantage is associated with higher caregiver burden. We performed a secondary analysis using baseline data on dementia caregivers (n=132) enrolled in the Indiana University Telephone Acceptance and Commitment Therapy for Caregivers (TACTICs) pilot trials. Mean (SD) caregiver age was 61.6 (11.6) years; 83.3% women; 78.8% white; 19.7% black. Seventy-two percent of the caregivers lived with the care recipient and 50.8% reported moderate dementia severity. A linear regression model examined the relationship between caregiver’s national Area Deprivation Index (ADI) score (ranging from 1–100 with higher scores indicating greater socioeconomic disadvantage) and caregiver burden. The following covariates were included: age, sex, race, education, shared residence with care-recipient, health status, anxiety, depression, and dementia severity of care recipient. Higher ADI was associated with lower caregiver burden (β=-0.222, p < 0.001). Caregiver burden has a significant negative relationship with ADI and dementia severity (p<-.001 and 0.046, respectively) and positive relationship with anxiety (p=0.014) controlling other covariates in the model. Although we found no support for the hypothesis, further research should examine these factors with how caregiver’s ADI may impact other psychosocial wellbeing outcomes. Discussion will highlight the need for caregivers to have access to resources that can aid them through their experience.
THE EFFICACY OF MUSIC AND DEMENTIA EDUCATION PROJECT ON HEALTH CARE PROFESSIONAL STUDENTS: PRELIMINARY OUTCOMES
Authors: Shi Jiaming , Sun Fei , Hirsch Jen , Cohen Dan , Kim Ha-Neul
Published: December 2022

This study aims to improve dementia literacy and competence to use music in practice with people with dementia among students in health professional fields. The eight-week curriculum was developed by a gerontology social worker and a subject matter expert on personalized music use for people with dementia. Two focus groups were completed in Spring of 2022 with people living with dementia and care partners to refine the curriculum and include information that those with lived experience felt was important for future health care professionals to know. The study used 2 single group designed cohorts of students who received the 8-week educational intervention over Zoom. Each cohort included 2 persons living with dementia (PWD) as co-trainers. Pre- and post- surveys included a modified Alzheimer’s Disease Knowledge Scale and Dementia Attitude Scale. Participants (n=17) included Social Work = 8, Nursing = 2, Psychology =3, and Others =4. Total of 11 student participants completed both pre-test and post-test surveys. Paired t-tests were used to compare pre-post differences. At post-test, participants reported increased dementia knowledge (M=2.45, p=.0027); increased dementia attitudes (M=13.18, p=.0057); and improved competency on using music with PWD (M=.97, p=.0045)compared to the baseline scores. The 8-week intervention showed a statistically positive impact on dementia attitudes and competency of music use. The findings of this study laid the groundwork for future studies on training current service professionals and comparing their practice after the training to non-trained professionals to measure the impact of the training in intervention.
ROBOTS IN SENIOR-LIVING FACILITIES: A SYSTEMATIC LITERATURE REVIEW
Authors: Trainum Katie , Hauser Elliott , Xie Bo
Published: December 2022

Robots are promising technologies for improving both the care of older adults living in facilities and the job satisfaction of caregivers, but concerns about their efficacy, ethics, and best practices remain. To inform this ongoing debate, we examined the literature on robots utilized in senior-living facilities. Three rounds of searching and screening were conducted in February 2022, following PRISMA guidelines. Keyword searches produced 666 non-duplicate articles from 5 relevant databases. We screened titles and abstracts against inclusion/exclusion criteria, resulting in 127 articles. Full-text screening resulted in 78 articles for analysis, published between 2002-2022 and represent 17 countries. Most studies demonstrated promising effects of robots, however there was a lack of high-quality studies, overrepresentation of female participants, and focus on companion robots over service robots. Few studies addressed the effects of robots on caregivers or controlled for novelty effects. Research addressing these gaps should combine robotic and gerontological expertise.
PRIMARY CARE PROVIDER PERSPECTIVES ON LANGUAGE AND COMMUNICATION BARRIERS IN DEMENTIA DIAGNOSIS AND CARE
Authors: de Jesus Alma Hernandez , Ma Melissa , Dohan Daniel , Alagappan Cecilia , Rankin Katherine , Sideman Alissa
Published: December 2022

Dementia diagnosis and care relies on extensive communication between a doctor, patient, and oftentimes a family caregiver. Communication is important for recognizing when there is a cognitive concern, gaining an understanding of the patient’s history of cognitive decline, engaging in cognitive testing, and providing quality care post-diagnosis. We conducted a qualitative study of 35 primary care clinicians and primary care nurse practitioners working in safety net settings in California to understand facilitators and barriers to dementia diagnosis and care. Using thematic analysis, we identified similar themes to those that have been explored extensively related to language and communication in doctor-patient relationship. Topics ranging from challenges that emerge when there is language discordance, difficulties finding and using interpreters, and challenges related to communicating medical topics in a patient’s native language. Specifically related to dementia, we found that language challenges emerge due to inadequate translation or availability of cognitive testing and post-diagnostic resources in multiple languages. However, we also identified unique challenges related to communication, including hearing loss, communicating about trauma during the diagnostic history interview, navigating the logistics of care, including communicating with specialists, building trust and rapport when there is language discordance, and cultural miscommunication even when the spoken language is the same. These issues affect historically marginalized individuals and communities, especially when dementia and cognitive impairment are present. We suggest new approaches and policies to enhance communication and better ways of working with patients who are hard of hearing.
INCORPORATING SPIRITUALITY INTO COGNITIVE STIMULATION THERAPY GROUPS FOR PERSONS WITH DEMENTIA
Authors: Nketsiah Ebow , Zubatsky Max , Berg-Weger Marla
Published: December 2022

With the rise in Dementia-Related Disorders globally, few non-pharmacological approaches have been developed to effectively target cognitive impairment and memory loss. Cognitive Stimulation Therapy (CST) has shown effectiveness in improving cognition and quality of life of older adults with dementia. To date, no studies have incorporated spirituality into CST for improving the cognition and quality of life of older adults with dementia. This study’s aim is to evaluate the effectiveness of CST with a spirituality component compared to the traditional CST group intervention. Our team grouped participants (Nf34) into either spiritual or traditional groups based on their location of residence and level of cognition. Preliminary results showed that spiritual-themed groups improved in mental health status, mobility, and depression. The spiritual groups had a mean difference of 1.85-points improvement on mental status exam as compared to 0.2-point reduction for the traditional groups. In addition, the spiritual groups had a mean difference of 4.80-points improvement in mobility and 0.6-point improvement on depression as compared to a 5.25-points reduction in mobility and a 2.13-points reduction on depression of the traditional groups respectively. Compared to the traditional CST group, there were no significant differences noted regarding cognition and memory recall. Incorporating spirtiuality and other faith-based themes in groups may provide additional benefit for individuals with memory loss. Both healthcare and long-term care facilities may benefit from incorporating group interventions such as CST into their routine care with older adults.
CROSS-CULTURAL COMPARISON OF A LATENT DEMENTIA INDEX IN MEXICO AND THE UNITED STATES
Authors: Saenz Joseph , Beam Christopher
Published: December 2022

Latent variable models have recently been used to extract latent dementia index scores using cognitive and functional ability data. Yet, no cross-cultural comparisons have been conducted. This analysis tests metric measurement invariance of a latent dementia indicator (LDI) among older adults in Mexico and the US using different statistical criteria. We then test whether demographic risk factors relate with the LDI similarly depending on criteria used to test measurement invariance. Data included the MexCog (Mexico, n=2,265) and Harmonized Cognitive Assessment Protocol (US HCAP, n=3,347). The LDI is a latent variable measured using 13 cognitive and 10 functional common items. Measurement invariance was tested in multiple group confirmatory factor analyses using both nested chi-square difference tests and comparisons of comparative fit indices (CFI). Covariances between demographic risk factors (age and education) and the LDI were compared across models achieved using different measurement invariance criteria. Full metric invariance of the LDI was achieved using CFI comparisons but not with chi-square comparisons, which required nine loadings to be freely estimated across studies to achieve partial metric invariance. Regardless of criteria used to test measurement invariance, age and education correlated with the LDI in both studies in expected directions with similar parameter estimates regardless of approach used to test measurement invariance. The LDI may be a valid tool to compare associations between risk factors and dementia in the HCAP and MexCog. The LDI related with demographic factors in expected ways and findings were robust to statistical approach used for measurement invariance testing.
EXAMINING THE IMPACT OF HEART DISEASE AND DIABETES ON THE MENTAL HEALTH OF OLDER MINORITY ADULTS
Authors: Saroj Sree , Panchagnula Sainath
Published: December 2022

As the world’s population ages and healthcare costs associated with the care of the elderly rise, it is pertinent to address these concerns. This study examines how older adults’ mental health is affected by chronic medical illnesses. It is hypothesized that minority older adults, on average, have worse mental and physical health outcomes than their majority counterparts. A secondary data analysis of the National Health and Aging Trends Study, revealed that older minority adults experience higher rates of depression than non-minority older adults, as measured by the Patient Health Questionnaire – 2 (PHQ-2). European-Americans significantly differ from African Americans (AA) and Hispanics regarding their level of anxiety, as measured by the Generalized Anxiety Disorder – 2 (GAD-2) measure. AA and Hispanics are significantly more likely to exhibit anxiety than their European-American counterparts. Minority older adults with a higher rate of surgeries are not substantially more likely to be depressed, according to the PHQ-2. Minority older adults who reported having a difficult time falling asleep are considerably more depressed than older minority adults who did not endorse depressive symptomatology on the PHQ-2. Minority older adults who had two or more social supports in their lives have lower levels of anxiety compared to older minority adults who have less than two social supports in their lives. The findings from this study serves as groundwork to promote equity between majority and minority older adults, which will improve their abilities to perform independent activities of daily living successfully.
SOCIAL DETERMINANTS OF ORAL HEALTH AMONG OLDER ADULTS: RURALITY MATTERS
Authors: Ballard Aimee , Wetherbee Maya , Bernstein Laura , Patrick Julie Hicks
Published: December 2022

Oral health is often viewed as a predictor of emotional well-being. Older age and any tobacco use are among the strongest predictors of poor oral health. We sought to examine the roles of age, tobacco use, and dental health in relation to emotional well-being. Moreover, we identified unique predictors of oral health. Data were provided by 197,786 adults completing the 2020 BRFSS (mean age = 54.3 yrs; 46% men; 80% white; 15% rural; 41% had ever regularly used tobacco). Although 53.6% reported no loss of natural teeth, 29.5% reported losing between 1 and 5 teeth and 17% reported having lost 6 or more natural teeth. Hierarchical linear regression analyses revealed that younger adults, smokers, urban-dwellers, and those with more tooth loss experienced more poor mental health days, F (4, 359016) = 4307.6, p < .001, R^2= .05. Tooth loss uniquely contributed to the variance explained, above and beyond the other predictors (Step 2: F (1, 359016) = 3722.01, p, .001). We also conducted a multinomial logistic regression to test whether age, tobacco use, and rurality could differentiate among levels of tooth loss. These equations were significant, with odds ratios showing that rurality was the strongest predictor of tooth loss. Our results suggest that rurality is a strong predictor of oral health, even beyond the influence of age and tobacco use. Future interventions used to improve the oral health of people, including older adults, must consider the greater needs present to rural-dwelling Americans
USING MDS TO MEASURE TRANSFER TRAUMA IN NURSING HOME RESIDENTS
Authors: Montoya Ana , Park Pil , Chang Chiang-Hua , Bynum Julie
Published: December 2022

Transferring long-term nursing home residents between facilities has been shown to compromise their quality of life. The negative consequences associated with transfers have been termed transfer trauma and its spectrum spans from functional, cognitive, and emotional decline to hospitalizations, and even death. The objective of this study was to develop a composite measure of transfer trauma after a nursing home-to-nursing home transfer using clinically relevant events and sub-measures covering functional, cognitive, behavioral, and emotional domains based on validated scales available in the Minimum Data Set (MDS) assessments. MDS Data were used to identify long-stay nursing home residents and obtain information on transfers, clinical assessments, and facilities. This study is a cross-sectional cohort analysis of long-stay nursing home residents in the state of Michigan who had a nursing home-to-nursing home transfer during our study period (March 1, 2018-October 31, 2018). We developed a measure of transfer trauma as a composite from 5 previously validated measures: 1) Activity of Daily Living (ADL) Self-Performance Scale; 2) Cognitive Function Scale (CFS); 3) Patient Health Questionnaire-9 (PHQ-9/PHQ-9-OV); 4) Agitated Reactive Behavior Scale (ARBS); 5) falls. The distribution and frequency of each sub-measure were analyzed to assess scaling of the composite measure. Of a total of 817 residents who transferred in our study period, 549 had complete composite measures, and from those 242 (44%) met criteria for transfer trauma. These findings demonstrate the need for further research to identify underlying transfer trauma and develop interventions to ameliorate the negative effects of transfers on this vulnerable population.
STAFFING DIFFERENCES IN NURSING HOME SPECIAL FOCUS FACILITIES AND SPECIAL FOCUS FACILITY CANDIDATES
Authors: Rhodes Annie , Zanjani Faika , Caprio Thomas , Gendron Tracey , Waters Leland
Published: December 2022

Introduction

Centers for Medicare and Medicaid Services designates “Special Focus Facilities” (SFF), which are nursing homes receiving special oversight for persistent quality problems. “Special Focus Facility Candidates” (SFFc) are nursing homes with quality problems that are designated as candidates to be future SFFs. Recent academic literature has not examined if SFF and SFFc have significant differences in staffing hours per resident day (HPRD).

Methods

Nursing homes that were SFF or SFFc in 2020 were matched to 5-star nursing homes. Monthly staffing averages were aggregated, and two-way ANOVAs with Tukey Post Hoc were conducted to detect level differences in HPRD across the three facility groups. Gross and Case-Mix staffing HPRD were analyzed, along with daily resident census.

Results

The final sample was n=197 SFFc, and n= 50 SFF, which were matched with n=247 5-star nursing homes for a total sample of Nf494. Over 2020, daily census for 5-star nursing homes was lower (M=72.36, SD=52.5) than SFFc (M=93.77, SD=68.34) or SFFs (M=97.88, SD=44.06). There was a significant difference between SFF and SFFc HPRD in Case-Mix Aide F(2, 5748)=187.6, p= < .005, and Registered Nurse (RN), F(2,5748)=323,p=.003 care. There were no significant differences between SFF and SFFc in HPRD Aide F(2,5748)=380,p=.63, Practical Nurse F(2,5748)=1.1, p=.211, Case-Mix Practical Nurse F(2,5748)=19.57,p=.39, Case-Mix RN F(2,5748)=9.51,p=.91 or Total HPRD F(2,5748)=472.6,p=.16, care. Discussion: There is only a significant difference in staffing levels observed between SFF and SFFc for Aide staffing and RN staffing. This information supports researchers and policymakers in delineating the differences and similarities between SFF and SFFcs.
INFORMATION TO BE COLLECTED IN THE ASSESSMENT FOR PARENTS AND CHILDREN WITH “8050 PROBLEMS” IN JAPAN
Authors: Ayabe Takako , Takemoto Yoshito , Okada Shinichi , Fukui Sadaaki
Published: December 2022

In Japan, the “8050 problems” have become a social issue, where parents and children are parents in their 80s and children in their 50s and live together. In the case of parents and children with “8050 problems,” the parents are older, but the children are often dependent, withdrawn, and have financial problems. Recently, the number of such cases has increased in care management. The previous studies indicated that it was important to know what information was gathered in the assessment in such cases. The research was conducted from February to March of 2022 by self-administered questionnaires. The survey was mailed to all 1,410 care management centers in Osaka City. The response rate was 11.8%. The statistical analysis was an exploratory factor analysis. Six factors in the significant information in the assessment were extracted by the factor analysis: Physical, mental and living conditions of children; Parents’ physical and mental conditions; Parents’ perspectives on their lives; Parents and children’s financial situations; Living environment; and Relationships between the informal and formal supports and the parents and children. The Cronbach’s alpha for internal consistency was greater than 0.8 for each factor. In addition, the four factors were strongly associated among the six factors. In conclusions, the present study found that information about the physical and mental status, living conditions, community relations, and financial situations of the parents and children with “8050 problems” was important in the assessment of the parents and children, and that the information is closely related to each other.
LEVERAGING TECHNOLOGY TO OPTIMIZE THE ENGAGEMENT OF VIRTUAL PARTICIPANTS IN A NATIONAL CONSENSUS CONFERENCE
Authors: Falzarano Francesca , Brody Lilla
Published: December 2022

The COVID-19 pandemic has accelerated the uptake and use of technology in hosting virtual and hybrid (combining virtual and in-person) meetings and events. In this presentation, Dr. Falzarano will describe the ways in which the 2021 Conference on Engaging Family and Other Unpaid Caregivers of Persons with Dementia in Healthcare Delivery leveraged videoconferencing systems (e.g., Zoom) and other web-based platforms (e.g., Qualtrics) to enact a hybrid event. Specifically, she will discuss the various components involved in the event’s planning and execution, including the appointment of a virtual liaison and audiovisual technicians to enable seamless integration and participation of both in-person and virtual attendees. She will also discuss how videoconferencing technology was used to facilitate the delivery of virtual panel presentations; strategies for immersing virtual attendees in both large group discussions and small group breakout sessions; and the process by which virtual attendees participated in the priority vote.
OLDER VETERANS’ PREFERENCES FOR FORMAT AND DESIGN OF EDUCATIONAL MENTAL HEALTH BROCHURES
Authors: Cui Ruifeng , Rotondi Armando , Shalaby Alaa , Callan Judith
Published: December 2022

Older Veterans may have lower mental health literacy and education than younger Veterans. The Veterans Affairs Healthcare System (VA) has created many educational brochures on mental health to facilitate service utilization by Veterans, however few studies have solicited Veteran stakeholder feedback pertaining to their design and effectiveness. The present qualitative pilot study aimed to develop a brief general mental health educational brochure for older Veterans seen in VA medical settings. The brochure aims to provide information on mental health symptoms and VA mental health resources. Participants (Nf5, mean age=67.2) were older adult White male Veterans. An iterative design process was used to develop and refine the educational brochure which consisted of qualitative interviews with Veteran stakeholders on their mental health needs and their feedback on the brochure. The brochure was then modified based on prior Veteran feedback before being tested with subsequent Veteran participants. The brochure received high ratings on clarity (8.8/10), conciseness (8.6/10), and importance (8.6/10). Qualitative interviews revealed that Veterans appreciated the simplistic presentation of the content (“It’s very informative for being so simple, it caught my attention”), the generality of the content (“it is encouraging because it is a broad approach to a spectrum of mental health concerns”), and contact number content (“Direct lines, that’s really nice”). These findings support the use of user-centered design methods to develop educational materials. The findings indicated that a brief educational mental health print brochure was an acceptable method to promote mental health literacy and use of VA mental health services.