bluuebunny/crossref_metadata_2025 huggingface dataset:
THE INTERACTIVE EFFECTS OF EDUCATION AND SOCIAL SUPPORT ON COGNITION IN AFRICAN AMERICANS
Authors: Byrd DeAnnah , Jiang Yanping , Zilioli Samuele , Lichtenberg Peter , Thorpe, Jr. Roland J , Whitfield Keith
Published: December 2022

This study examines whether the effects of receiving or providing social support on cognition differ by education. Data from 602 African American adults (48-95 years) enrolled in the Baltimore Study of Black Aging—Patterns of Cognitive Aging were analyzed using multiple linear regression. We found no main effects of receiving or providing social support on global cognition. However, a significant moderation effect was observed for memory, such that received social support was more strongly associated with higher working memory among less-educated individuals than those with high levels of education, adjusting for age, sex, marital status, chronic health conditions, and depressive symptoms. Study findings demonstrate that social support and education have joint effects on memory outcomes, highlighting the importance of considering psychosocial protective factors that might alleviate, reduce, or even eliminate cognitive health disparities in African Americans.
DEMENTIA CAREGIVER PERCEPTIONS OF TELE-DEMENTIA CARE FOR VETERANS DURING THE COVID-19 PANDEMIC
Authors: Iyer Sowmya , Ngo Victoria , Humber Marika , Brodrick Marisa , Gould Christine , Trivedi Ranak
Published: December 2022

The estimated 5 million persons living with dementia in the United States have been greatly impacted by the medical and psychosocial impacts of the COVID-19 pandemic, respite program closures, social isolation, and Veterans seen within the Veterans Health Administration system are particularly vulnerable. Telemedicine provides needed specialty dementia care to these patients with complex needs in their homes, and its uptake has increased during the pandemic. This qualitative, observational study explored informal caregivers’ perceptions of tele-dementia care for Veterans seen at 2 sites, Palo Alto and Cleveland, via semi-structured interviews. Twenty-five caregivers (Mean age = 67y, SD=12y, 88% women) were interviewed over telephone following a tele-dementia visit. Themes that emerged from the interviews were that tele-dementia visits: (1) saved caregivers 2.6h±1.5h (Range: 0.5 to 6h) of travel time, (2) required limited preparation compared to in-person visits, (3) mitigated COVID-19 risk and avoided needs for masking and social distancing, (4) avoided behavioral challenges during appointments, and (5) allowed participation from home with minimal disruption of routine. Caregivers described significant physical challenges that made leaving the home for appointments difficult including balance issues, incontinence, and difficulties getting into vehicle. Caregivers plan to continue using tele-dementia services beyond the pandemic due to the convenience. Taken together, these findings indicate that caregivers find tele-dementia care convenient, comfortable, helpful, and timesaving and highly satisfactory. A combination of both in-person and virtual visits would be an ideal future state. This study illustrates how caregivers experience virtual visits for dementia care and will shape future intervention design.
RESOURCES AND EXPERIENCES AMONG DIVERSE DEMENTIA CAREGIVERS BY GEOGRAPHIC CONTEXT
Authors: Yoshikawa Aya , Bouldin Erin , López-Anuarbe Mónika , Kindratt Tiffany , Sylvers Dominique , Webster Noah
Published: December 2022

Rural caregivers are often underserved by caregiving services, yet little is known about how the intersectionality of geographic context and race/ethnicity relates to caregiving resources among dementia caregivers. We examined whether 1) caregiving resources and experiences differ across metro and non-metro areas; and 2) the use of caregiving resources is associated with geographic context by race/ethnicity, controlling for age, gender, and education. We analyzed a sample of caregivers of care recipients aged 65 years or older with ‘probable’ dementia (n= 808) in the 2017 National Health and Aging Trends Study (NHATS) and the associated National Study of Caregiving (NSOC). We defined geographic context by the recipient’s residence in metro (urban) or non-metro (rural) counties and grouped formal (respite care, support groups, caregiving training) and informal (family or friend help) resources. Among minority caregivers, 47% of those living in metro and 36% in non-metro areas used a formal service, and 83% and 72%, respectively, used informal resources. Among White caregivers, estimates were 44%, 48%, 76%, and 66%, respectively. Multivariate regression analyses revealed that non-metro White dementia caregivers had 2.04 times higher odds (95% CI=1.10-3.78) of using formal resources than metro White dementia caregivers. This pattern was not observed among minority dementia caregivers. The use of informal resources did not differ across geographic contexts by race/ethnicity. Findings suggest the influence of geographic context on the use of formal caregiving resources varies by race/ethnicity. With higher rates of dementia in non-metro areas, formal caregiving resources among non-metro minority dementia caregivers need more attention.
DEVELOPING A RESOURCE FOR LEVERAGING POPULATION DATA SETS TO ADVANCE CAREGIVING SCIENCE
Authors: Goodwin Rebecca , Ornstein Katherine , Elmore Catherine , Utz Rebecca , Tay Djin , Ellington Lee , Smith Ken , Stephens Caroline
Published: December 2022

Older adults often rely on other people to help care for them as they age. Caregiving has predominantly been studied through a primary caregiver lens with few studies focusing on the wider caregiving network. However, it is challenging to collect new data about family caregivers, particularly in contexts of serious illness and end of life. Selection and attrition effects, underrepresentation of marginalized or minoritized racial and ethnic groups, and low response rates can bias findings in prospective clinical research. Analyzing existing datasets, particularly population-based data (e.g., registries with linked administrative, health, and vital records) may hold promise to advance our understanding of the role families play throughout the caregiving and bereavement continuum to optimize the health and well-being of older adults. Little is known, however, about existing population-based datasets available for research on family caregiving. We conducted a scoping review of published literature and data repositories to identify datasets relevant for family caregiving research, explore the research reuse of these datasets, and describe potential validity and reliability concerns. Synthesized findings reveal: 1) methodological approaches for identifying the presence and type of caregivers and their level of engagement; 2) inclusion and measurement of key outcome variables; and 3) sampling and study design issues. We describe and compare a selection of high-value existing datasets relevant to family caregiving research. This new research information resource will advance research use of population datasets to improve care for older adults and their family caregivers across the lifespan.
A PHENOMENOLOGICAL STUDY ON THE PERCEPTION OF FRAIL ELDERLY IN SUBJECTIVE HEALTH AWARENESS AND SUCCESSFUL AGING
Authors: Seo Jisu , Song Rhayun , Park Moonkyoung , Ryu Ahyun
Published: December 2022

BackgroundFrailty is a multi-dimensional concept including physical, functional, and psychological aspects. The frail elderly have been assessed by various instruments, yet the classification of being frail is not often consistent with the perception of individuals. PurposeThis study aimed to explore the perception of frail older adults in subjective health awareness and successful aging. Methods9 participants who met the following inclusion criteria: older than 70 years, defined as frail status screened by frailty index, and signed the consent form. Data was collected through in-depth interview with recording, and evaluated by phenomenological approach of Colazzi. Results The content analysis on the perception of 9 participants on subjective health awareness yielded 7 theme-clusters and 3 categories: (a)Recognize frailty, (b)Vague and endless emotions, (c)Reflecting on the past and thinking about death. The participants described ‘recognizing frailty through senility’ as a subjective health awareness. The perception of participants on successful aging was structured 6 theme-clusters and 4 categories: (a)Sustainable health, (b)The goal of successful goodbye, (c)Responsibility for parenting, (d) The best wisdom that aging gives life. The participants described ‘living in the present and successfully parting with it’ as a successful aging. ConclusionThe participants who were categorized as frail status did not perceive themselves as frail. Many participants perceive being frail as natural process of aging, and their successful aging as sustainable health and successful goodbye. It is pertinent to understand the meaning of successful aging and subjective health awareness of frail older adults to provide effective intervention to help them.
ASSOCIATION OF LOWER URINARY TRACT SYMPTOMS WITH INCIDENT FRAILTY AND MORTALITY AMONG OLDER COMMUNITY-DWELLING MEN
Authors: Cawthon Peggy , Bauer Scott , McCulloch Charles E , Ensrud Kristine , Lu Kaiwei , Scherzer Rebecca , Covinsky Kenneth , Marshall Lynn M
Published: December 2022

Lower urinary tract symptoms (LUTS) are associated with increased risk of new mobility and functional limitations among older men. Our objective was to evaluate the longitudinal relationship between baseline LUTS severity and incident frailty or all-cause mortality among 3667 community-dwelling non-frail men age >70 years from the Osteoporotic Fractures in Men (MrOS) study. LUTS severity at analytic baseline was defined using the American Urologic Association Symptom Index (AUASI). Phenotypic frailty was defined at baseline and 2-year follow-up visits using modified Fried criteria and classified as robust (0), intermediate stage (1-2), or frail (3-5); men classified as frail at analytic baseline were excluded. Vital status was assessed every 4 months. Since the proportional odds assumption was not met, we used multivariable multinomial logistic regression to estimate odds ratios (OR) for the association between baseline LUTS severity and incident frailty or death at follow-up compared to robust. OR were adjusted for demographics, health-behaviors, comorbidities, and cognition. After a mean follow-up of 2.3 years, 37% of men were categorized as robust, 46% were intermediate stage, 9.2% developed incident frailty, and 7.9% had died. Per 4 point higher AUASI, the adjusted odds incident frailty versus robust was 1.23 (95% CI 1.12, 1.34). Odds of death versus robust was not statistically significant (OR=1.05, 95% CI 0.94, 1.18). In conclusion, non-frail men with greater LUTS severity at baseline have slightly greater odds of incident frailty within 2 years. Clinicians should be aware that LUTS severity is a prognostic marker for developing frailty in older men.
INTERVENTIONS TO PREVENT THE FRAILTY IN OLDER WOMEN WITH FRAILTY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Jeong Ha Na , Chang Sun Ju , Kim Joo Ri , Choi Gi Won
Published: December 2022

Background

Frailty is a health challenge related to adverse health outcomes in older adults. Older women are more likely to be frail than older men. However, few studies have reviewed the effectiveness of interventions for older women with frailty is scant. Objective: This systematic review aimed to explore the properties of interventions and to investigate their effectiveness in preventing the progression of frailty in older women with pre-frailty or frailty.

Methods

Narrative synthesis was conducted to identify the contents, outcome variables, and findings of the interventions. Then, a meta-analysis was performed to evaluate the effectiveness of exercise interventions on grip strength, sit-and-reach, sit-to-stand, and timed up and go tests.

Results

Twenty-six studies were selected, including 14 randomized controlled trials and 12 quasi-experimental studies. These studies implemented exercise (96.2%), nutrition (15.4%), hormone replacement (7.7%), toileting strategies (3.8%), and laughter interventions (3.8%). The selected studies assessed physical, psychological (11.5%), and cognitive health (11.5%), as well as quality of life (19.2%). The meta-analysis found significant effects of aerobic and resistance exercise interventions on the sit-to-stand (SMD = 1.30, 95% CI [0.70, 1.90], p < 0.001) and timed up and go scores (SMD = -0.56, 95% CI [-0.93, -0.19], p = 0.003).

Conclusion

Exercise interventions are essential to improve physical health, in particular mobility, in older women with pre-frailty or frailty. Future studies should consider theoretical frameworks and evaluate psychological and cognitive health as well as quality of life to develop and provide effective interventions to prevent the progression of frailty in older women.
VULNERABILITY TO ANTICHOLINERGIC MEDICATION ASSOCIATED FRAILTY IN LOW-INCOME MINORITY OLDER ADULTS
Authors: Sargent Lana , Barrett Matthew , Nawaz Huma , Mackiewicz Marissa , Roman Youssef , Slattum Patricia , Hobgood Sarah , Price Elvin
Published: December 2022

Low-income minority older adults are highly susceptible to drug adverse effects of medications due to aging, comorbidities, and polypharmacy. Several studies have demonstrated anticholinergic medication is associated with frailty, supporting the hypothesis for mechanistic peripheral nervous system effects. The goal of this cohort study is to determine peripheral nervous system effects of anticholinergic medication exposure with frailty by conducting a sensitivity analysis using multiple anticholinergic tools. Spearman correlation matrix and intraclass correlation coefficients (ICC) are used to determine the function of five clinical Anticholinergic Burden Scales (ACBS): Anticholinergic Burden Scale (ACB), Anticholinergic Drug Scale (ADS), total standardized daily doses (TSDD), and Cumulative Anticholinergic Burden scale (CAB). Ordinal logistic regression and area under the curve (AUC) are used to evaluate anticholinergic burden-associated frailty models. The cohort included 80 individuals (mean age = 69 years; 55.7% female, 71% African American). Among individuals prescribed anticholinergics, 33% are robust, 44% pre-frail, and 23% frail. All scales are highly correlated with each other (p < 0.001), ICC3 = 0.66 (p < 0.001, CI 95% 0.53-0.73). All five of the scales predicted pre-frail and frail status (p < 0.05) with low misclassification rates for frail individuals (AUC = 0.70 – 0.80). Considering ACBS are highly correlated and all predict frailty; all of the scales can be used in future frailty research; however, the CAB and TSDD consider both potency and dose. Additional research is necessary to understand the peripheral nervous system effects of anticholinergic drug exposure and if deprescribing can improve frailty status.
RISK FACTORS OF DISABILITY AMONG COMMUNITY-DWELLING OLDER ADULTS WITH HYPERTENSION IN THAILAND: THE HART STUDY
Authors: Wongsin Utoomporn , Chen Tuo-Yu
Published: December 2022

About 60% of the older adults in Thailand experience hypertension, a condition that increases the risks of disability. However, little to no study has investigated modifiable risk factors to prevent disability in this segment of population in Thailand. Therefore, this study aims to investigate factors associated with disability among community-dwelling older adults aged 60 years or above with hypertension in Thailand. Longitudinal data (wave-1 [2015] and wave-2 [2017]) were from the Health, Aging, and Retirement in Thailand (HART) survey. Descriptive analysis and logistic regression analysis were employed to analyze the data. Outcome variables were difficulty with activity of daily living, hearing-related disability, vision-related disability, and pain-related disability in wave-2. Sociodemographic information, health behaviors/health status, mental illness, chronic diseases, and disability at baseline were independent variables. The results showed that older age significantly predicted difficulty with activity of daily living and hearing-related disability among community-dwelling older adults with hypertension in Thailand. Drinking alcohol significantly predicted vision-related disability. No factors were found to be a significant factor for pain-related disability. Our analysis provided useful information for the prevention of disability among older adults with hypertension in Thailand.
EVERYTHING HAS CHANGED FOR THE WORSE: EXPERIENCES OF ELDERS DISPLACED BY ARMED CONFLICT IN ETHIOPIA
Authors: Gebeyaw Getachew , Dessale Shambel , Kasseye Eyayu , Adamek Margaret
Published: December 2022

In November 2020 an outbreak of ethnically and politically motivated armed conflict started in Tigray, Ethiopia and expanded to the Amhara and Afar regions, bringing a devastating impact upon civilians and disadvantaged groups. Persons living in those areas, including elders, were forced to flee and seek refuge at internal displacement centers. The purpose of this study was to investigate the challenges faced by older individuals fleeing the war zone and settling in internal displacement centers during Ethiopia's armed conflict. A qualitative descriptive case study was used in this cross-sectional investigation. Purposive sampling was used to identify 13 displaced older adults. Data from the in-depth interviews with elders were supplemented with key informant interviews and observations. Narrative data was analyzed using thematic analysis. Findings revealed that the older adults faced a variety of challenges in the war zone while escaping their homes and in the displacement center, all of which negatively impacted their physical and psychosocial well-being. Elders fled on foot and walked for three days without food to reach the internal displacement center. In addition to food shortage, other themes included loss of significant others, family disintegration, and lack of care and support. The findings call attention to the need for practical access to social and economic integration of elders in the aftermath of war as well as ongoing psychosocial intervention. In Ethiopia and in other war-affected areas, displaced older people need tailored support.
LIFE ON THE STREETS IS HORRIBLE: OLDER RURAL-URBAN MIGRANTS COPE WITH HOMELESSNESS IN ETHIOPIA
Authors: Gebeyaw Getachew , Kotecho Messay , Adamek Margaret
Published: December 2022

The prevalence of homelessness among older adults in Ethiopia is growing. While prior studies examined the push factors and challenges of homeless elders, little is known about how older people in Sub Saharan Africa cope with homelessness. This study explored the coping strategies of homeless older people in Kobo Town, Ethiopia. Purposive sampling was used to identify 10 homeless older people and four key informants. Study participants were homeless for a year or longer. Thematic analysis was used to analyze the data collected through in-depth interviews. To cope with the challenges faced on the street, homeless older people used various strategies including begging, holy water, drying leftover food, using river water for hygiene and sanitation, sleeping in church compounds, and creating their own social networks. Despite their efforts, the coping strategies used by elders were not sufficient. In the absence of family and government support, study participants relied heavily on begging to meet their survival needs. The findings call attention to the need for a national income support program and other supportive services for older adults. Homelessness is the product of a failing support system. Despite Ethiopia having a Plan of Action for Older Persons and Social Protection Policy for Vulnerable Groups, these policies have not been effectively implemented leaving older adults with no safety net. This study calls for the development of new policies to empower older people in Ethiopia and prevent them from turning to begging as their only recourse.
MEASURING A GOOD DEATH: AN ASSESSMENT ACROSS FOUR COUNTRIES
Authors: Clem Sarah
Published: December 2022

A good death is often viewed as a common goal in end-of-life care, yet our understanding of what qualifies as a good death is still under development. Previous studies have attempted to conceptualize our understanding of a good death and have highlighted the need to improve our measurement of this construct. The present study examines a measure of a good death across four countries. Data for this study were derived from the Four-Country Survey on Aging and End-of-Life Medical Care (2017), in which participants were sampled using a random digit dial method. The study relies on a sample of 4,239 participants from the US, Italy, Japan, and Brazil. Confirmatory Factor Analysis (CFA) was employed to fit a measurement model to the full sample for a measure of the importance of a good death. Once model fit was deemed sufficient, a multi-group CFA was used to assess invariance across the four countries. Model fit was adequate at the configural and metric levels, highlighting that across the four countries importance of a good death was measured and understood the same. However, the model failed at the scalar level of invariance, implying that indicators for the importance of a good death are valued differently across the four countries. Further developing our understanding of a good death and how it is measured is essential for improving quality end-of-life care. This study identifies a quality measure of good death while simultaneously highlighting the limitations in using such a measure in a transnational context.
THINGS LEFT UNDONE: RELATION OF GRIEF TO SENSE OF PURPOSE IN BEREAVED OLDER ADULTS
Authors: Sharma Shubam , Mroz Emily , Bluck Susan
Published: December 2022

Sense of purpose is grounded in life experiences (Ko et al., 2019) and can be threatened by the loss of a loved one. The death of a spouse in late life can be particularly disruptive when the bereaved struggle with perceptions of unfinished business with the deceased. This mentality may also derail their sense of life purpose. This study examined the association between persistent grief symptomatology (Prigerson et al.,1995) and sense of purpose (Ryff, 1989) in conjugally-bereaved older adults (N = 53; Mage = 81.59). Unfinished business constructs (i.e., unfulfilled wishes, unresolved conflict; Holland et al., 2018) were tested as mediating grief-purpose relations. Older adults who reported greater grief symptomology also experienced lower sense of purpose (r = -.27, p < 0.05). Extent of unfulfilled wishes fully mediated the relation between grief symptomology and sense of purpose (t = -2.26, p < 0.05); unresolved conflict did not act as a mediator. Findings indicate that the association between experiencing pervasive grief symptomology and a disrupted sense of purpose may be due, in part, to ongoing rumination about unfulfilled wishes: missed opportunities to meaningfully engage with one’s spouse before death. Results are poignant given recent COVID-19 physical distancing requirements that separated older couples during spouses’ dying days, potentially prompting unfulfilled wishes across bereavement. Findings highlight the need for palliative care practices that facilitate optimization of relationships at end of life and grief support practices that re-ignite purpose after difficult spousal loss.
SOCIAL SUPPORT AND STRAIN AS PREDICTORS OF MULTIMORBIDITY FOLLOWING A MARITAL TRANSITION
Authors: Denning Emily , Newsom Jason , Botoseneanu Anda , Allore Heather , Nagel Corey , Dorr David , Quiñones Ana
Published: December 2022

Marital transitions (MTs; widowhood or divorce) are stressful events that impact the health of older adults. This study examined the impact of social support and social strain on multimorbidity trajectories using data from the Health and Retirement Study (HRS). Participants were 377 adults age 50+ with a single MT between years 2006 and 2016. We used piecewise growth curve modeling to investigate whether social support and strain from one’s spouse, children, family, or friends, measured prior to transition, predicted trajectories of chronic conditions (count of 8 conditions: hypertension, diabetes, cancer, lung disease, heart disease, stroke, arthritis, and cognitive impairment) following MT. Covariates included sex, age, education, race/ethnicity, and wealth. On average, chronic conditions were increasing before MT, B = .172, SE = .021, p < .001, and after MT, B = .211, SE = .031, p <.001. Participants had an average of 2.2 chronic conditions at MT. Spousal support prior to MT was associated with fewer chronic conditions at MT, B = -.863, SE = .427, p = .043, whereas support and social strain from friends were each associated with more chronic conditions at MT (support: B = .772, SE = .354, p = .025; strain: B = 1.288, SE = .387, p = .001). Support from children was positively associated with more chronic conditions following MT, B = .212, SE = .084, p = .011, which may reflect adult children providing support in response to parental health decline.
DOES DEPRESSION IMPROVE DURING RETIREMENT AMONG BINGE DRINKERS?
Authors: Diaz-Valdes Antonia , Sellers Christina , Ponce Julian
Published: December 2022

Data from the Health and Retirement Study (1992-2016) was used. All non-institutionalized respondents aged 50+ were included in our sample (n=12,618). Mixed models were conducted to study the association between transitioning to retirement and depressive symptoms (CESD) among retirees, and to test the mediation effect of alcohol use.

Results: Those retired for at least 6 years had increased probability of binge drinking. Additionally, binge drinking mediated the association between the retirement transition and depressive symptoms, making the effect stronger for those retired for 3 to 5 years (p< 0.05), and weaker and no significant for those retired for 6+ years (p>0.05). Thus, the decrease on depressive symptoms was higher for those retired between 3 to 5 years when being binge drinkers. Discussion and Implications: Addressing depressive symptoms and binge drinking among older adults is sorely needed. Binge drinking was associated with decreased depressive symptoms, consistent with the self-medication hypothesis. Treatment and screening for depression as well as binge drinking are especially important as both are associated with increased mortality. Treating depression would reduce the risk of increased alcohol use and its detrimental effects on health.
MOTIVATIONAL FACTORS AFFECTING THE INTENTION TO VOLUNTEER IN ELDER CARE AGENCIES: A PILOT STUDY
Authors: Fu Rong , Xu Qi
Published: December 2022

The rapid rise of the aging population and the “4-2-1” family structure in China calls for speeding up the construction of the elderly care service system. To facilitate this process, it is desirable to encourage voluntary participation in elder care agencies. This study aims to identify motivational factors that may affect the intention to volunteer in elder care agencies in China. Data were collected in a sample of 199 residents of Beijing, China. Our results revealed gender differences in the demographic and socioeconomic factors that affect the volunteer intention. For men, earning more than 12,000 Yuan (about $1900) significantly increased the intention to participate in voluntary services (p = .043). For women, those younger than 60 years of age were more willing to participate in voluntary services than their older counterparts (p = .014). Participants identified three key motivational factors for providing volunteer services in elder care agencies: (1) to show love and kindness to older adults; (2) to fulfill oneself and take social responsibilities; and (3) to gain more life experience. We also found that most participants prefer to provide spiritual comfort services (e.g., chatting, shopping) and life care services (e.g., cooking, house cleaning) than other types of services. Our study suggested that effective interventions should be designed and implemented to match volunteering resources to the needs of elder care agencies in China.
PURPOSE IN LIFE, STRESS REACTIVITY, AND COGNITIVE AGING: A LONGITUDINAL INVESTIGATION
Authors: Nelson Niccole , Bergeman Cindy
Published: December 2022

This study examined (1) the time-varying relationship between purpose in life and perceived stress reactivity, (2) the trajectory of perceived stress reactivity as it relates to both within- and between-person purpose in life, as well as (3) the predictive utility of perceived stress reactivity and its rate of change on cognitive ability and allostatic load. The sample comprised 933 participants from the Notre Dame Study of Health & Well-being, a 10-year study of annual questionnaire packets and biennial daily diary bursts. Analyses included three-level multilevel models from which random effects were extracted and used to predict allostatic load and cognitive ability. Results indicated that individuals were affectively reactive to perceived stress, and that perceived stress reactivity declined over time. Considering the effects of purpose in life on these processes, there were two cross-level interaction effects indicating (1) more purposeful individuals were less stress reactive than less purposeful individuals, and (2) more purposeful individuals declined less in negative affect over time than less purposeful individuals. There was also preliminary evidence for a within-person interaction effect between yearly purpose in life and daily affective reactivity such that when individuals felt particularly purposeful, they also tended to be less stress reactive. Finally, higher perceived stress reactivity, as well as less decline in this construct, was predictive of better cognitive ability. These findings indicate purpose in life buffers against environmental and maturational effects on negative affect, and that perceived stress reactivity may indicate a different, more adaptive process than affective reactivity to experienced stressors.
THE IMPACT OF BEHAVIORAL LIFESTYLE INTERVENTION ON INFLAMMATORY CYTOKINES IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Jiwani Rozmin , Serra Monica , Espinoza Sara , Patel Darpan
Published: December 2022

Chronic inflammation, a hallmark of type 2 diabetes (T2D) and adiposity, increases the risk for age-related co-morbidities, including physical frailty. This study aimed to examine the effects of a mobile technology-enhanced behavioral lifestyle educational intervention on frailty and associated clinical, inflammatory, and laboratory outcomes in overweight older adults with T2D. Twenty participants (≥65 years, BMI ≥25 kg/m2) with T2D were recruited to complete a single-arm 6-month lifestyle intervention modified from the Action for Health in Diabetes (Look AHEAD) study, enhanced with technology for self-monitoring of diet and physical activity. Clinical assessments were collected at baseline and end of the study and analyzed with paired t-tests. Inflammatory cytokines (interleukin [IL]2, IL4, IL6, IL8, IL10, granulocyte-macrophage colony-stimulating-factor [GM-CSF], interferon [IFNγ], tumor necrosis factor [TNFα]) were quantified using a commercially available multiplex kit (Millipore Sigma, Burlington, MA, USA). Clinical lab analysis was performed by Quest Diagnostics (Dallas, TX, USA). Eighteen participants completed the study (71.5±5.3 years; 56% female; 50% Hispanic). At baseline, 13 participants were pre-frail, 4 were frail based on Fried frailty criteria. Inflammatory cytokines and liver enzymes values were within normal limits. At follow-up, the following outcomes significantly improved: frailty score -44% (p=0.01), BMI -3% (P< 0.00), alanine transaminase -18% (p=0.03), aspartate aminotransferase -13% (p< 0.00), IL2 -33% (p=0.01), IL4 -31% (p=0.05), IFNγ -36% (p=0.03), GM-CSF -43% (p=0.03). No other significant differences were observed. The results suggest the efficacy of a technology-enhanced lifestyle intervention on frailty and associated clinical, inflammatory, and laboratory outcomes in overweight older adults with T2D.
FACTORS RELATED TO MOBILE INTERNET USE AMONG MIDDLE-AGED AND OLDER ADULTS: A MODERATING EFFECT OF DISABILITY
Authors: Yang Eunjin , Lee Kyung Hee
Published: December 2022

Although mobile devices are preferred as internet access devices, and the number of older adults with and without disabilities is rapidly increasing, little is known about the disability moderating effect on mobile internet use among older adults. This study examined the moderating effect of disability on older adults' mobile internet usage. This study was a secondary data analysis using 2020 Digital Divide Survey in South Korea. A total of 3,629 participants aged 55 and above were included. With the complex sample design in mind, multiple regression analysis was conducted to identify factors related to mobile internet use and test the moderating effects of disability on mobile internet use. Older adults with disabilities used mobile internet less than older adults without disabilities. However, disability status had a moderating effect on the relationships between mobile internet use and (1) operational skills of mobile devices (B=0.31, P=.004), (2) skills of internet use (B=1.46, P<.001), (3) motivation to use digital devices (B=0.46, P=.01), and (4) attitude towards new technology (B=0.50, P=.002). The results revealed that these positive relationships were stronger among older adults with disabilities than those without disabilities. Although older adults and people with disabilities are considered vulnerable populations for technology adoption, disability creates a stronger positive association between several factors and actual mobile internet use. Therefore, policymakers and practitioners should deliver tailored information and technological education for older adults with disabilities. Older adults with disabilities could be the primary beneficiaries of various mobile services.
UNDERSTANDING CULTURAL DIFFERENCES OF SOCIAL ISOLATION AND ITS EFFECTS ON COGNITIVE FUNCTION OF HISPANICS/LATINOS
Authors: Arroyo-Miranda Mirna , Ochoa-Lopez Andrea , Medina Luis
Published: December 2022

Social isolation negatively impacts cognitive health. Although the mechanism is not fully understood, cultural values such as familismo, may help partially explain this susceptibility. Our work sought to understand how cultural differences in objective and perceived social isolation affect cognitive performance of Hispanic/Latinos (H/L) compared to non- H/L Whites. In our first study, using the TARCC dataset, objective covariates of social isolation (i.e. marital status, number of children, number of siblings, living situation), significantly explained a higher percentage of the variance in composite cognitive scores of H/Ls, compared to non-H/L Whites. In our second study, using the HABS-HD dataset, personal and health characteristics influenced the effect of perceived social isolation on cognitive status among older adults. Furthermore, compared to non-H/L Whites, fewer factors accounted for greater variance in cognition of H/Ls. Results suggest enhancing social connectedness of H/L older adults could be a modifiable factor for prevention of cognitive decline.
SERIAL MEDIATION BY DIGITAL ASSISTANCE, INTERNET SELF-EFFICACY, DIGITAL CITIZENSHIP, AND UNMET NEEDS
Authors: Joo Susanna , Choi Bomi , Park Hayoung , Lee Changmin , Kim Yoon-Myung , Kim Hyoun K
Published: December 2022

Although many social services are getting digitalized with the rapidly growing digital technology, there is little information available on the specific process of meeting personal needs in digital aging contexts. The present study examined the serial mediation model from digital assistant to unmet needs via internet self-efficacy and digital citizenship. An online survey was used to collect data in December 2021, and the sample included 223 older Korean adults aged 65 and above (M=68.79, SD=4.18, range=65-84) who owned at least one digital device. Unmet needs, the dependent variable, was the number of problems (e.g., housing, physical functioning) that participants responded to as ‘unmet.’ The independent variable was digital assistance, meaning getting help from friends or others when having problems with the digital device. The first mediator was internet self-efficacy, and the second mediator was five subtypes of digital citizenship (internet political activism, technical skills, local/global awareness, critical perspective, and networking agency). Covariates were gender, age, education, and income. SPSS Process Macro was utilized for serial mediation analysis. The result showed that only a serial mediation path from digital assistance to unmet needs via internet self-efficacy and internet political activism was significant. Additionally, a simple mediation path from digital assistance to unmet needs via internet political activism was significant. Technical skills, local/global awareness, critical perspective, and networking agency did not reveal significant mediational paths. Findings imply providing digital assistance system may be useful to reduce unmet needs among older adults by enhancing self-efficacy and political participation in the current digitalized world.
EXAMINATION OF THE DIGIAGE CYBER-SENIORS PILOT STUDY FOR OLDER ADULTS FROM LOWER INCOME COMMUNITIES
Authors: Leedahl Skye , Capolino Alexandria , Brasher Melanie , Fratoni-Souza Kristin , Estus Erica
Published: December 2022

The University of Rhode Island (URI) team implemented a pilot program designed to bridge the digital divide between older adults and younger generations. Through this project, the goal was for older Rhode Islanders to become digitally literate by engaging them in a formal program that provides digital devices (i.e., Apple iPads), connectivity (i.e., internet connection through HotSpots), and training by supervised and trained university student mentors. This project specifically worked to promote social and economic equity by recruiting participants from lower-income communities and areas hit hardest by the COVID-19 pandemic, including those who speak English and Spanish. The final sample (N=124) for the study was primarily female (79%) and low income (82%). They were 41% Non-White and 23% Spanish speaking with 23% having a college degree or more. We conducted preliminary analysis on the first 38 participants who completed both a pre- and post-survey. Based on these analyses, the program participants have shown statistically significant improvements in frequency of tablet use (p<.05), digital competency across all questions (p<.05), quality of life (p<.05), and social isolation (p<.05). In addition, the loneliness and depression questions/variables are trending in the expected direction, so it is possible that with a more robust sample size we may see significant improvement in these areas as well. This presentation will describe the key elements of the pilot intervention and explain the findings from the full sample. The presentation will also discuss the plan for state-wide implementation of the program.
EXISTING KNOWLEDGE ASSOCIATED WITH SMART HOME HEALTH TECHNOLOGIES IN THE CARE OF OLDER PERSONS: A SYSTEMATIC REVIEW
Authors: Tian Yi Jiao (Angelina) , Felber Nadine Andrea , Pageau Félix , Schwab Delphine Roulet , Wangmo Tenzin
Published: December 2022

As a greater part of the global population reaches the golden age, smart home technologies are said to allow older persons to remain independent at a place of residence, or “home”, of their own choice. Though their development has been making their way to the market, there has not been a systematic review of the empirical literature on the knowledge associated with their use for persons who are 65 years or older. Hence, we conducted a systematic review of empirical peer-reviewed English, German, and French articles in ten electronic databases. Data was textually described, separated into key characteristics, logged into a customized data extraction document, and analysed using narrative synthesis. The search across ten databases revealed 144 empirical papers that were admissible to our inclusion criteria. Of which, we discovered 5 first-order categories of benefits and 5 of barriers of smart home health technologies with further sub-themes that together form the concurrent array of existing knowledge. These categories included, for example, allows older persons to live independently at home, reminds older persons to promote self-care, and alternatively, concerns about usability, cost, and social acceptance. These systematically-derived categories of benefits and barriers could be a starting point for researchers interested in caregiving for older persons to conduct further empirical and reflective research. Furthermore, having this understanding of existing challenges and opportunities associated with smart home health technologies then allows the research and technical communities to collaborate upon a joint foundation to inform policy and improve caregiving for the global aging population.
IMPACT OF OLDER ADULTS’ INTERNET USE ON THE ECONOMIC BURDEN OF INFORMAL CAREGIVING
Authors: Kim Jeehoon , Joo Heesoo , Hageman Sally
Published: December 2022

Objectives

Digital technology enables older adults to live independently by handling health-related tasks or shopping/banking online, thus can reduce care burden. This study examines the impact of older adults’ Internet use on formal and informal care hours and its influence on estimating cost savings with active and potential Internet users.

Methods

Medicare beneficiaries ages 65 and above with functional difficulties were sampled from the 2015 National Health and Aging Trends Study (N=1,806). Care is measured by total hours for help older adults received in the past month, separated by formal and informal care. Internet use for health-related tasks and shopping/banking were measured. A survey weighted two-part model with gamma distribution was estimated. The cost savings of informal caregiving was estimated by a replacement approach.

Results

Older adults' health-related Internet use substantially reduced informal care hours by 27.7% (19.8 hours per month, p < .05), but not for formal care hours. A monthly estimated cost reduction of informal caregiving was $3,094 per an older adult with functional difficulties by applying 2020 median wage of home health aide workers. The annual savings in the cost of informal caregiving associated with older adults’ health-related Internet use is estimated to be $8.1 billion with the active users and additionally $20.1 billion with the potential health-related Internet users in the US. Discussion: Promoting health-related Internet use among older adults with functional difficulties to relieve economic burden of informal caregiving will be discussed.
SUFFERING BUT SATISFIED: OLDER ADULTS’ LIFE SATISFACTION WITHSTANDS DEPRESSION AND DEMENTIA
Authors: Van Vleet Samuel , Bass Danica , Mejia Yenifer Morales , Dube Jeanné , McKinney Brandee , Prentice Kailee , Guillory Logan , Barnett Michael
Published: December 2022

Among older adults with neurocognitive disorders, lower life satisfaction has been linked with poorer aspects of physical and mental health that affect quality of life, including depression. However, these associations between life satisfaction and mental health problems have not been found universally. In this study, we further investigated life satisfaction and depression within clinical and healthy older adult populations. Older adults (N = 98), ages 60 to 90 years either with (n = 25) or without (n = 73) a neurocognitive diagnosis, were administered self-report questionnaires measuring depression and life satisfaction. Results showed that although depression was negatively correlated with life satisfaction among both samples, older adults with dementia had higher depression scores but equivalent life satisfaction scores as older adults without dementia. In fact, both the clinical and healthy samples of older adults averaged on the positive or satisfied half of the life satisfaction scale. Older adults with neurocognitive disorders may generally experience higher depressive symptoms, yet despite challenges to quality of life, they seem to find satisfaction in their daily lives. This may stem from older adults viewing current depressive symptoms as a relatively short-term problem while evaluating life satisfaction across their whole lives. The best protective factors for older adults suffering from dementia and depression may therefore be found both in their present and in their past.
IS CEREBRAL AMYLOID ANGIOPATHY A PRECIPITATING EVENT IN THE ETIOLOGY OF ALZHEIMER’S DISEASE
Authors: Edland Steven , Zarow Chris , Shifflett Benjamin , Flanagan Margaret , White Lon
Published: December 2022

Amyloid plaque and cerebral amyloid angiopathy (CAA) are early neuropathologic changes observed in the setting of clinical Alzheimer’s disease (AD), typically preceding biomarker evidence of intraneuronal tau neurofibrillary tangle (NFT) development and associated cognitive decline. Here we apply structural equation models to explore the potential causal associations between amyloid-beta lesions (i.e. plaques and CAA) and NFTs as they affect cognitive performance in the elderly.Brain autopsy data used in this study are from the Honolulu Asia Aging Study (HAAS) of Japanese American men from the state of Hawaii (n=600), and the Nuns Study (NS) of Roman Catholic Sisters largely from the upper midwestern United States (n=378). Cognitive performance within three years of death was assessed by multi-domain dementia rating scales.We found that neocortical neuritic plaque and CAA effects on cognitive performance were mediated by neocortical NFTs for both the HAAS (p < 0.002) and NS (p < 0.043). There were no direct effects of neuritic plaque and CAA after controlling for the mediating effect of NFTs (p > 0.54).These data are consistent with the hypothesis that the association between neuritic plaque and CAA on cognition is mediated by NFT load. This may inform our understanding of the etiology of NFT lesion pathology in aging and AD. The disruption of arterial smooth muscle function by CAA has predictable effects on glymphatic processes and on the regulation of capillary blood flow. These effects are plausibly relevant to the AD neurodegenerative process, and these pathways deserves continued attention by the AD research community.
DETECTION OF PRECLINICAL AND PRODROMAL ALZHEIMER’S DISEASE USING A MULTIDISEASE DIAGNOSTIC PLATFORM
Authors: DeMarshall Cassandra , Viviano Jeffrey , Emrani Sheina , Godsey George , Sarkar Abhirup , Belinka Benjamin , Libon David , Nagele Robert
Published: December 2022

AD-related pathological changes begin in the brain long before symptoms emerge. In the present study, we demonstrate the utility of a panel of AD-related autoantibodies capable of detecting AD at the earliest points along the AD continuum, including preclinical AD, years before the onset of symptoms, and prodromal AD (mild cognitive impairment, MCI). Using a customized panel of AD-specific autoantibody biomarkers and Luminex xMAP® technology, sera from ADNI subjects with preclinical AD or MCI were screened to demonstrate preclinical and prodromal AD detection. A panel of eight autoantibodies with increased titer in MCI and preclinical AD relative to controls was evaluated using Random Forest and Receiver Characteristic Operating curves for their ability to distinguish diseased subjects from age- and sex-matched controls, as well as from individuals with other neurodegenerative and non-neurodegenerative diseases. Results showed that this panel of biomarkers was capable of differentiating patients with MCI from age- and sex-matched controls with high overall accuracy, sensitivity, and specificity. These biomarkers also identified cognitively normal subjects who later converted to MCI and AD. Furthermore, this autoantibody biomarker panel distinguished MCI and preclinical AD subjects from Parkinson’s disease and breast cancer subjects, demonstrating excellent disease specificity. Results demonstrate the utility of our blood-based autoantibody biomarker panel as an accurate, non-invasive, and inexpensive diagnostic screener, not only for the detection of prodromal AD, but also the earlier, preclinical stages of AD pathology. This multi-disease diagnostic platform has been demonstrated to be useful for multiple neurodegenerative diseases including AD, Parkinson’s disease and Multiple Sclerosis.