bluuebunny/crossref_metadata_2025 huggingface dataset:
AGING AMONG JAPANESE OVERSEAS/EXPATRIATES: A COMPREHENSIVE MIXED METHODS STUDY
Authors: Toyama Itsuko
Published: January 2025

The challenges of aging for Japanese individuals living abroad have received limited attention in both Japan and their countries of residence, and they are underrepresented in academic research. This marginalization derives from the small population of Japanese expatriates and the ambiguity surrounding the term “Japanese,” as a nationality and cultural identity. As there are currently no available data on this topic, original research is necessary. Additionally, a holistic perspective is essential to approach aging as a life course. This study employs a convergent parallel mixed methods design to examine four Japanese communities in multicultural societies across the US, the UK, the Netherlands, and Brazil. Quantitative data were collected through nearly identical questionnaires on aging conditions and analyzed in Brazil (2002), the UK (2013), the Netherlands (2014), and New York (2018). Qualitative data, including interviews and oral histories, were collected in the respective communities since 1993. This presentation demonstrates the validity of using mixed methods in minority aging research. The comparison of quantitative research indicates ethnic strategies for supporting aging individuals and preserving dignity, including culturally oriented facilities or residences that use the Japanese language and offer food, activities, and care for older adult. Qualitative research interviews and oral histories reveal individual resilience in terms of aging and escaping isolation. For instance, some participants use their internment experiences to adapt to group living in a retirement or nursing home, while others maintain the hope of returning to Japan. Thus, the mixed methods approach provides a detailed and comprehensive conceptualization of aging.
STATE OF HEALTH AND FUNCTIONAL AGING IN THE IMMIGRANTS AND MIGRANTS IN UKRAINE
Authors: Tomarevska Olena , Poliakov Oleksandr
Published: January 2025

The study of migration factors and the likelihood an impact on aging and health of respondents is important for the healthcare. This study is aimed to evaluate differences in the health of immigrants, migrants, and non-migrants among the 31-105 years. Online study will be perspectives to assess the health state and effectiveness of rehabilitation in migrant’s groups. Analysis of functional aging and health, sensory, cognition and physical capabilities of migrants and non-migrants in 31-105 years (1995-2023) offline and online study in Ukraine. For participants after 90, the impact of immigration processes of interstate and internal migration on health was determined. In persons 60-89 years old was relationship between functional aging and interstate immigration to Ukraine. Primary health assessment was analyzed the impact of outward migration and comparison with people who remained inside the country in Ukraine. In the results the trend are accelerator characters of functional aging. The leading indicators in monitoring health status and functional aging processes were the ability in centenarians to sit-to-stand up test (r=0.176, p< 0.05), in the older adults (r=-0.210, p< 0.05), in the online study (P=0.006) as well as the ability to remember three words after over time (r=0.174, p< 0.05) in ninety-year-olds. We found changes in these parameters, characterized by better indicators for migrants who emigrated and immigrated to the territory of Ukraine. This fact shows that people migrate with better health indicators, and these relationships health status at older persons and centenarian require monitoring and for rehabilitation programs.
IDENTIFYING OPPORTUNITIES TO OPTIMIZE PERSON-CENTERED CARE IN LONG-TERM CARE
Authors: Roberts Tonya , Li Jingxi , Boutilier Justin , Mintz Yonatan
Published: January 2025

Person-centered care (PCC), or care consistent with preferences, improves long-term care (LTC) resident quality of life, family satisfaction, and staff job satisfaction. Despite benefits, PCC has not been fully adopted across homes. One barrier is a lack of knowledge regarding patterns in resident preferences that can meaningfully inform operational decision-making to improve PCC. This study aimed to take the first step toward filling that gap by: 1) describing LTC residents’ preferences; 2) describing the impact of aligning care with preferences, and 3) identifying gaps in care that could be improved with operational interventions. Preference surveys were administered, and audio recorded with 27 LTC residents, or family proxies, over the course of >70 sessions. Descriptive analysis of survey and audio data was conducted. Residents/families rated the majority (84%) of preferences on daily routines, social relationships, caregiving, and leisure as important; however, specific preferences endorsed were highly unique. Residents/families reported nearly half (42%) of preferences were rarely or never met and nearly all (94%) of their current preferences were not the same as before admission. Residents/families described negative impacts on mental well-being, quality of life, or physical health when preferences were not met and engaging in a process of adapting preferences to what was available at the facility. Findings highlight that both idiosyncratic and common preferences and care gaps exist across residents, and different interventions may be needed to address PCC at individual and organizational levels. Possible targets for operational interventions to address these different needs and improve PCC will be discussed.
THE HEALTH OF DIVERSE CALIFORNIANS WITH NEEDS FOR LONG-TERM SERVICES AND SUPPORTS
Authors: Kietzman Kathryn , Chen Lei , Juturu Preeti
Published: January 2025

This study used data from the 2019-2020 California Long-Term Services and Supports (CA-LTSS) survey to identify differences in health outcomes within a population of older adults and adults with disabilities. Our study sample included 2030 adults who lived in home and community settings in California, and experienced at least one type of LTSS difficulty, including cognitive impairment and difficulties performing activities of daily living and/or instrumental activities of daily living. We conducted chi-square tests using weighted representative California population-level data. Among people with LTSS difficulties, we found significant racial/ethnic differences in health insurance coverage, usual source of care, and psychological distress. For example, a larger proportion of Asian adults with LTSS difficulties reported having no health insurance (9.0%), having no usual source of care (21.2%), and experiencing serious psychological distress (37.3%) compared to other racial/ethnic groups. We also found significant differences by employment status. Specifically, adults with LTSS difficulties who were in the labor market were more likely to experience serious psychological distress (28.8%), have no health insurance (11.3%), experience delays in receiving care or prescriptions (26.1%), have unmet needs (41.1%), and report financial worries (68.7%), compared to adults with LTSS difficulties who were not in the labor market. Income level was also significantly associated with health and well-being, health insurance coverage, usual source of care, and unmet needs. These results can be used to inform the development of programs and policies for diverse people with LTSS needs, and further suggest the need for innovative strategies to advance health equity.
TRENDS IN US NURSING HOMES RESIDENTS WITH LIMITED ENGLISH PROFICIENCY (LEP)
Authors: Mickus Maureen , Nguyen Jade
Published: January 2025

Ethnic elders residing in U.S. nursing homes experience significantly lower quality of life compared to their white counterparts. Among the most vulnerable are those with Limited English Proficiency (LEP) who may be unable to communicate even basic needs to staff. Based on the Minimum Data Set (MDS), this study examined the prevalence of LEP residents in the U.S. between 2020 and 2023 as defined by those needing language interpreter services. From 2020 to 2021, the number of LEP residents decreased by 25.3% from 46,877 to 35,021, in part due to the disproportionate rate of death from COVID-10 among minorities. After 2021 an increase was reported by an estimated 2,000 residents per year with an estimated 39,584 LEP residents recorded in 2023. The need for interpreter services in nursing homes varied significantly by state with 14.4% of California and 7.71% of New York residents as compared with 14 states reporting less than 1%. Not surprisingly, U.S. Census statewide data of individuals age 65+ in the general population reporting speaking English less than “very well” was positively correlated with the percentage of LEP residents in nursing facilities, r (47) =.91, p <.001. Based on the unmet needs that are likely associated with LEP residents and the unavailability of interpreters 24/7 in facilities, increased cultural education and sensitivity is warranted for staff in long-term care facilities. Future research determining which specific languages are spoken in facilities in addition to ways to improve communication is needed.
DECODING DEMENTIA STIGMA THROUGH NETNOGRAPHY: LESSONS FROM THE DEMENTIA DIARIES
Authors: Marnfeldt Kelly
Published: January 2025

Worldwide, 10 million people are diagnosed with dementia each year. The experience of receiving a dementia diagnosis is commonly described in terms of lost identity and self-worth, with feelings of grief, fear of decline, and worries of becoming a burden. Such feelings are exacerbated by pervasive stigmatization and narratives that perpetuate the misconception that a diagnosis equals the end of a meaningful life. Moreover, people with dementia (PWD) are not only absent from stigma-reduction campaigns but they are underrepresented and overlooked across the research-practice-public health continuum. The present study aims to (1) explore perspectives and experiences of dementia-related stigma among PWD and (2) to examine how active participation in awareness and education campaigns by PWD influences their feelings/experiences of stigma. Netnographic methods were employed to analyze archived reflections (~3k) gathered from the UK-based Dementia Diaries—an online platform dedicated to fostering dialogue and combating stigma surrounding dementia. Between 2015 and 2023, 109 individuals contributed 2,946 diary entries to the platform, with 1 to 332 (M=64.04; SD=96.3) entries per person. This analysis identified themes of avoidance, abandonment, and invisibility in PWD’s encounters with stigma, and references to the transformative impact of self-advocacy efforts. PWD attest that involvement in awareness activities fosters humanization and shifts attitudes, promoting inclusion, empathy, and solidarity. Future research should examine the mechanisms underpinning these effects, with an emphasis on personal narratives, advocacy, and stigma-countering strategies. Policy interventions could have broader societal impact by prioritizing meaningful social interactions with PWD and harnessing positive representations in stigma-reduction campaigns.
PRELIMINARY RESEARCH ON TOUCHPOINT METHOD TO ENGAGE CHINESE OLDER ADULTS IN PARTICIPATORY DESIGN ACTIVITIES
Authors: Jiang Jiabei , Sun Tongxin , Yin Jianing , Liu Yuanyuan
Published: January 2025

Collaborative engagement with older adults in design research activities is an effective and beneficial method for researchers to understand the needs of this demographic. Participatory design, originally proposed within Western value systems, faces challenges in application across different regions and cultural contexts, particularly in participatory design activities targeting older adults within the Chinese societal context. However, limited literature focuses on the methodologies of participatory design practices with older adults in non-Western countries. This study views the organizational process of participatory design activities as a form of service design research involving older adults, where design researchers serve as providers and older adults as the recipients of the service. Drawing upon service design thinking, this paper introduces the concept of ‘participation touchpoints’—moments within activities that encourage active involvement of older adults—to explore the interactions between participants and the organizers, procedures, and environments of activities. This approach aims to optimize the experience of older participants and enhance their engagement. Furthermore, based on the Theory of Planned Behavior, we proposed a framework of participation touchpoints including attitude guidance, incentive motivation, and capability compensation. We evaluated this framework through a participatory design workshop with older adults and multiple stakeholders, focusing on the dynamic interactions among organizers, participants, and the activities themselves. This research endeavors to foster more effective collaboration with older adults in design research, aiming to develop a participatory design framework that ensures mutual empowerment for older adults and the research team.
SECONDARY EMOTIONAL DISTRESS: SUPPORTING YOUR RESEARCH TEAM THROUGH THE QUALITATIVE RESEARCH PROCESS
Authors: Coccia Kathryn , Hendricks-Ferguson Verna , Wladkowski Stephanie , Wallace Cara
Published: January 2025

Conducting qualitative interviews with older adults experiencing serious illness as a patient or caregiver may include distressing subject matter for researchers. A growing body of evidence shows researchers are at risk of developing secondary emotional distress from eliciting or processing participants’ distressing experiences. Novice researchers or graduate research assistants may be particularly vulnerable to developing secondary emotional distress. Many qualitative research plans include protocols for managing participant distress, but very few include formal considerations for mitigating psychological risk for members of the research team. Using a case study from an ongoing NIH-funded research study on live discharge from hospice, this presentation will focus a wider discussion of how difficult emotional experiences can occur both during the data collection process and again in analysis. This phenomenon will be discussed from the lens of a graduate research assistant, the primary investigator, and senior co-investigators. Presenters will share how these situations were processed, insights gleaned from these experiences, and considerations for developing protocols and cultivating resources to support team members in future studies.
THE OPPORTUNITIES AND CHALLENGES OF CONDUCTING OBSERVATIONAL RESEARCH IN LONG-TERM RESIDENTIAL CARE ENVIRONMENTS
Authors: Haunch Kirsty , Spilsbury Karen
Published: January 2025

Observational research has potential to offer new insights when addressing questions that matter for older people living in long term residential care settings (or care homes); moving beyond what people “say they do” to offer data of what is seen in every-day activities and interactions. However, there are challenges associated with why, how, where and in what context observations should be used in this setting. Care homes are dynamic care environments, and approximately 70% of older people living in care homes will live with dementia or cognitive impairment. These contextual and ‘people’ factors require careful consideration when choosing this method. Drawing on the experiences of two research teams, we share real world examples of the ethical, methodological, and practical concerns when using the observation method in the UK context. We offer examples from our work to guide researchers on: i) ‘making a case’ for observation; ii) the observational ‘gaze’ (or focus); iii) including people who lack capacity; iv) managing concerns about care or practices; v) the role of researcher; and vi) addressing observational sensitivities. As researchers, what we bring, what we do, and what we leave behind when using this method can have a significant impact on the lives (and work) of people in care homes. Our paper addresses a significant gap in the existing literature. It will be of interest to researchers world-wide and has the potential to benefit those living (and working) in care homes by enhancing the quality of research endeavours.
DEVELOPING THE CHINESE VERSION OF THE ASSESSMENT OF INTERPROFESSIONAL TEAM COLLABORATION SCALE IN TAIWAN
Authors: Yu Hsiao-Wei , Orchard Carole , Hu Yu-Ching
Published: January 2025

The delivery of long-term care reablement services emphasizes an interprofessional collaboration (IPC) approach. This study aims to use the existing Assessment of Interprofessional Team Collaboration Scale (AITCS) as an IPC measurement tool, assessing its alignment with Taiwan’s unique caring culture compared to its original use in Canada. Brislin’s Back-Translation Method was employed to create Chinese versions of the AITCS questionnaires, which were then administered to 201 professionals and paraprofessionals involved in reablement services in Taiwan to evaluate reliability and validity. Consistent with the original AITCS, the Chinese Version scale comprises three primary domains—partnership, cooperation, and coordination—with 23 question items. It demonstrates satisfactory reliability (Cronbach’s alpha=0.97 for total scale, ICC=0.91 for test-retest reliability) and acceptable convergent validity (AVE=0.68-0.80, CR>0.90), along with discriminant validity (coefficients < 0.80 between domains). Analysis of IPC performance among participants shows that collaboration (3.82 ± 0.75) and partnership (3.78 ± 0.77) exhibit more favorable scales compared to cooperation (3.56 ± 0.63) (p<.001). This study has preliminarily developed a Chinese Version of the IPC measurement tool, suggesting the need for further investigation into strategies for enhancing cooperation in IPC performance within the context of reablement services in Taiwan.
EXPLORING CIND STABILITY ACROSS TIME: INSIGHTS FOR IMPROVING COGNITIVE IMPAIRMENT CLASSIFICATIONS
Authors: McDowell Cynthia , Tamburri Nicholas , Gawryluk Jodie , MacDonald Stuart
Published: January 2025

Objective

Cognitive impairment no dementia (CIND) classifications are susceptible to false positives and may not be indicative of progressive cognitive decline or dementia risk. The current project sought to investigate the dynamic nature of CIND across six years and to elucidate whether baseline impairment severity (single vs. multidomain impairment) predicts CIND stability patterns such as reversion and fluctuation between cognitive statuses. Method: Utilizing data from Project MIND, participants (N=259; 65-90 years) were classified as either Normal Cognition (NC) or CIND across five annual assessments using a battery of five cognitive tasks. Participants were classified as either Stable NC, Stable CIND, Progressors (NC—CIND), Reverters (CIND—NC) or Fluctuaters (CIND—NC—CIND) according to their across-time stability patterns. Participants initially classified as CIND were further subdivided based on impairment severity: single-task (CIND-S) or multiple-task (CIND-M) impairment. Multinomial logistic regression was utilized to explore whether baseline CIND severity differentiated Reverters and Fluctuaters from those who remained Stable CIND.

Results

Most individuals were unstable in their CIND status for several years following baseline assessment. Compared to those classified as Stable CIND, Fluctuaters (-1.52, p=.01) and Reverters (-1.68, p=.01) were more likely to be classified as CIND-S (72% and 74%, respectively). Conclusions: Reverting back to NC or fluctuating between cognitive statuses is partly a function of instability in CIND-S classifications. Moving forward, CIND classifications could be improved through careful consideration of CIND severity at initial assessment. In particular, those classified as CIND-M may represent an at-risk group most likely to exhibit progressive cognitive impairment.
FACTORS LEADING TO DISCONTINUOUS USE OF GOVERNMENT-SPONSORED LONG-TERM CARE 2.0 SERVICE PLAN IN TAIWAN
Authors: Chen Ya-Mei , Wu Shih-Cyuan
Published: January 2025

The Long-Term Care 2.0 (LTC 2.0) Plan, initiated in Taiwan in 2017, respectively, aimed to provide home- and community-based services (HCBS) for individuals in need. However, a significant proportion discontinued usage within six months, prompting an investigation into influencing factors. This study, analyzing LTC 2.0 data from 2018 to 2021 for older adults in two cities, tracked 59,151 service users for up to a year after their initial assessments through three application stages (assessment to service prescription, service utilization, and continuous service utilization for more than six months). Key factors affecting discontinuation included age, middle-low income family status, behavioral problems, informal caregivers, and foreign caregivers. Individuals with informal caregivers had a higher likelihood of obtaining service prescriptions (OR=1.82***) and utilizing LTC services (OR=1.33***), but were prone to discontinuing LTC 2.0 during continuous service utilization (OR=0.78***). Those with foreign caregivers were less likely to progress beyond the service utilization stage (OR=0.77***), but were inclined to maintain usage once started (OR=1.16***). Similarly, those aged over 85 and individuals with behavioral problems were less likely to progress beyond utilization but inclined to maintain usage (Age OR=1.22***; Behavioral problems OR= 1.14***). In contrast, individuals from middle-low income families were more likely to be prescribed and initiate usage but less likely to maintain it (OR= 0.77***). The presence of informal/foreign caregivers significantly influenced utilization status across these three stages, emphasizing the need for services development that address not only users’ needs but also the needs of both formal and informal caregivers.
INVESTIGATING WITHIN-PERSON MEDIATION OF GAIT-COGNITION ASSOCIATIONS IN A WALKING INTERVENTION FOR OLDER ADULTS
Authors: Tamburri Nicholas , McDowell Cynthia , Hundza Sandra , MacDonald Stuart
Published: January 2025

Objective

Between-person associations between gait and cognitive function are well-documented, with select interventions (e.g., exercise) known to benefit both physiological function and cognitive health. Comparatively few studies, however, have investigated links between within-person changes in gait and cognition in the context of exercise interventions, or the mechanisms that might underlie this relationship. Method: The current study employed data from the Healthy Bodies Healthy Minds study -- a longitudinal walking intervention for initially-sedentary older adults (N = 118, 65-87 years). The study employs an intensive repeated-measures design, with physiological and cognitive function indexed at 5 assessments: baseline, 6, 9, 12, and 16 weeks. Gait velocity was assessed using a GAITRite Computerized Walkway, executive functioning was measured via the Groton Maze Learning (GML) Test, with aerobic capacity indexed by converting performance on the Rockport 1-Mile Walk Test to a V02 max proxy.

Results

Employing longitudinal multilevel mediation (1-1-1) models, we explored the within-person relationship between gait velocity and executive functioning, with particular consideration of aerobic capacity as a mediator. The indirect effect (ab+σajbj=-0.25) was significant, with aerobic capacity mediating 14.5% of the within-person gait-cognition time-varying association. Consistent with hypotheses, increases in gait velocity were associated with increases in aerobic capacity, which, in turn, conferred downstream benefits on GML test performance. Conclusions: These results further our understanding of the gait-cognition relationship, identifying aerobic health as an important within-person mediator in the context of a walking intervention. Key implications include the potential benefits of simple lifestyle interventions for promoting cognitive health in older adults.
MEMORY ISSUES IN RETROSPECTIVE LIFE HISTORY SURVEYS: DO QUESTION TYPE AND TOPIC MATTER?
Authors: Qian Wenqing , Yu Wenshan , Ofstedal Mary Beth , Smith Jacqui , Larkina Marina , Sonnega Amanda
Published: January 2025

Collecting retrospective information from the older population is critical yet challenging, and especially in self-administered surveys. Older adults may have difficulty retrieving autobiographical memories, navigating skip patterns in mail surveys, or using the complex technology often required for web surveys. These factors may lead to potential data quality concerns. Our study investigates data quality in the Health and Retirement Study (HRS) Life History Mail Survey (LHMS: N = 14934), that asks people over age 50 about events and experiences during childhood and midlife. We investigate characteristics of survey items that are related to item-missingness. Items were coded on 4 dimensions: (1) format: whether it was part of a grid or not, (2) life period: childhood vs. midlife, (3) detail: semantic vs. episodic, and (4) topic: residence, education, work, partnership, health. Overall, the item missing rate (IMR) was low (7.8%). Grids had higher IMRs than non-grid items (14.2% vs 6.4%). Controlling for this, we found that the average IMR for midlife questions was higher than for those pertaining to childhood in non-grid formats (8.9% vs. 4.9%), but similar in grid formats (11.6% vs. 12.2%). Additionally, episodic questions had a higher IMR compared to semantic questions in grid formats (13.7% vs. 10.3%), but lower in non-grid formats (3.1% vs. 6.1%). Among the five sections, items related to work and health history exhibited higher IMRs for both grid and non-grid formats. We discuss the implications of these results for the design of self-administered surveys and for analyses based on data from the LHMS.
ASSOCIATION BETWEEN SOCIAL POLICY, STIGMA, SOCIAL ACCEPTANCE, AND MENTAL HEALTH AMONG OLDER MEN WHO HAVE SEX WITH MEN
Authors: Chan Alex Siu Wing , Lachmann Mark , Ku Hok Bun , Yan Elsie
Published: January 2025

Background

Older MSM (Men who have Sex with Men) often face discrimination and marginalization due to ageism and homophobia, impacting their psychological well-being. This study investigates the influence of social factors on the psychological well-being of older MSM, considering variations in social policy and cultural contexts across China, Hong Kong, and Taiwan.

Methods

A comparative approach was utilized, gathering data (N=453) from older MSM in the aforementioned regions. Measures assessing social policy, stigma, social acceptance, and psychological well-being were employed. Control variables, such as age, education level, and income, were included to mitigate potential influences. The data were analyzed using descriptive statistics, ANOVA, and regression analysis.

Results

The findings demonstrate significant negative effects of stigmatization across all three regions. F-statistics indicate the regression models’ overall significance: China (F = 69.583, p < 0.001), Hong Kong (F = 51.971, p < 0.001), and Taiwan (F = 57.725, p < 0.001). This highlights stigmatization’s strong influence on dependent variables in each region. Additionally, high adjusted R-squared values suggest substantial explained variance: China (Adj R2 = 0.632), Hong Kong (Adj R2 = 0.514), and Taiwan (Adj R2 = 0.565), emphasizing the model’s ability to account for variability in dependent variables.

Conclusion

The study underscores the need for targeted interventions and policy changes to combat stigma and promote social acceptance, thereby enhancing the psychological well-being of this vulnerable population.
HEALTH CARE WORKERS’ PERSPECTIVES ON PROVIDING PALLIATIVE CARE TO MULTILINGUAL POPULATIONS WITH DEMENTIA
Authors: Strohl Katyayani , Ghosh Neeta , Ahmed Syeda A Fatima , Dotolo Danae , Sharma Rashmi
Published: January 2025

Importance

Persons living with dementia (PLWD) who prefer a language other than English (PLOE) are at high risk for sub-optimal palliative care. Although data suggest that multi-level (individual, clinical, healthcare system, community/policy-level) interventions may help address inequities, few studies have identified specific targets. Objective: To identify targets for multi-level interventions to improve palliative care for PLWD and PLOE.

Methods

We conducted qualitative interviews with social workers and medical interpreters who work with Chinese, Spanish, or Vietnamese speaking PLWD. Interviews were conducted from October 2022-October 2023, audiotaped, transcribed, and coded by an interdisciplinary investigator team using an inductive iterative approach.

Results

Interviews were conducted with 5 Spanish, 2 Chinese, and 2 Vietnamese interpreters and 5 social workers. Four themes emerged: 1) interpretation when the patient ‘wasn’t making sense’; 2) complexity with patient/family dynamics in decision-making; 3) barriers to anticipatory communication about dementia trajectory and quality of life; and 4) lack of culturally- and language appropriate resources. These data suggest multi-level intervention targets to improve palliative care in the context of dementia and linguistic diversity: 1) training interpreters about palliative care and how to navigate interpretation with PLWD, and providing clinicians communication skills training; 2) facilitating clinician-interpreter pre-meetings; 3) improving staffing and resources for social workers to shift from a crisis-focus to facilitating goals-of-care communication; and 4) increasing culturally and linguistically-appropriate and accessible resources. Impact: Our findings contribute to a gap in the literature about how to address the unique barriers PLWD with PLOE face, informing future intervention development.
RACIAL DIFFERENCES IN ADVANCE CARE PLANNING IN SAN ANTONIO, TEXAS
Authors: Dao Jonathan , Kittleman Cory , Gangupantula Pratima , Siby Ninette , Kakulavar Avinash , Gogia Rhea , Morrow Jason
Published: January 2025

Advance directives (AD) convey patient’s preferences about end-of-life care to physicians and loved ones when they lose capacity. Only 45.6% of older adults (OA) have filled out an advance directive due to lack of time, knowledge, or comfort discussing the topic. Our organization prepared and delivered presentations on ADs at seven community centers in San Antonio, Texas to primarily caregivers, community health workers, and OA. Pre- and post-surveys were developed to assess demographics and evaluate attitudes (Likert scale) regarding ADs. Of 119 surveys, 50 respondents were OAs over 65 years old with a mean age of 74.8; 48% (n=24) identified as Hispanic/Latino, 30% (n=15) as African American (AA), and 25% (n=13) as White. 37.5% of Hispanic, 40% of AA, and 61.5% of White respondents reported previously completing an AD. 29.17% of Hispanic, 46.7% of AA, and 69.2% of White respondents reported previously completing an MPOA. 37.5% of Hispanic, 29.7% of AA, and 46.2% of White respondents reported being offered help from a physician to complete an AD. A higher proportion of White OAs had completed an MPOA, AD, and were offered help by a physician than AA or Hispanic/Latino OAs. This data remains consistent with previous studies on racial disparities in AD completion. A majority of respondents (68%) were never offered help from a doctor to complete an AD indicating a need to continue engaging patients, especially those of lower socioeconomic status.
SOCIAL CLASS AND SOCIAL TRUST: THE CASE OF A NORDIC WELFARE COUNTRY
Authors: Jylha Marja
Published: January 2025

Trust in societal institutions and other people is an important foundation of democratic systems and contributes to the quality-olf-life. Finland has been considered as a high-trust society, with a reasonably egalitarian society and educational system, and the welfare state, including universal public services. In recent years the availability of health care and home and long-term care for older people has decreased, and”care poverty” has increase. In the project”Aging and social well-being” we investigated the trust of older individuals in societal instutions and health and old people´s services, and the differences in trust between social classes, measured as education, income, and occupational social class. The nation-wide survey included 3085 invdividuals aged from 65 to 84 years. Of the five societal institutions incluced, schools and educational system was the most trusted, and business life the least trusted. Trust in each five societal institutions and for the summary score showed a linear association with each measure of social class. For health and care services, a clear majority in each social class trusted acute health care and care services for chronic conditions, but a clear minority trusted home care, and only one in fourth trusted long-term care. Trust in health care was associated with social class, but trust in older people´s services was low in all social classes. The findings show that even in a Nordic welfare state, trust in societal institutions is highly dependent on social position, but low trust in old people´s care is shared by all social classes.
A SCOPING REVIEW OF HOME AND COMMUNITY-BASED SERVICES AND OLDER ADULTS’ HEALTH OUTCOMES
Authors: Kim Seon
Published: January 2025

Background and Objectives

Most older adults aspire to age in their homes and communities rather than in institutions. However, as functional limitations grow with aging, older adults often find independent living challenging. The demand for home- and community-based services (HCBS) has steadily increased to alleviate the challenges faced by older adults. This scoping review explores the relationship between HCBS and the health outcomes of older adults.

Methods

A search of the literature was conducted across major electronic databases between January 1, 2005, and August 1, 2023. 11,317 relevant peer-reviewed articles were identified, and 12 articles were selected for the final sample.

Results

HCBS is consistently found to be related to better health outcomes, including physical, mental, and hospitalization. However, black and Asian older adults reported lower accessibility to HCBS and SRH compared to their White counterparts. Also, the low density and lack of HCBS in the neighborhoods are also related to the lower health of older adults.

Discussion and Implications

HCBS is helpful in enhancing older adults’ health outcomes; however, the better accessibility of HCBS in neighborhoods and older individual demographic characteristics should be considered. Also, policymakers should consider addressing the diverse needs of older adults and tailor HCBS.
LEISURE ENGAGEMENT AND HAPPINESS IN LATER LIFE BASED ON A LEVEL OF FLOW EXPERIENCE
Authors: Ryu Jungsu
Published: January 2025

There has been a growing body of literature that examines various environmental predictors (e.g., time spent outdoors, and social interaction) of happiness. Furthermore, scholars have reported on the contributing role of leisure activities to happiness. However, research has rarely examined the associations between different types of leisure activity and happiness based on a different extent of flow experiences at an advanced age. Therefore, the purpose of this study was to explore what kinds of leisure activity contribute to happiness in later life based on the level of experiencing flow. A convenience sample of 188 participants was recruited from senior centers in South Korea, which consisted of 67 males and 121 females with ages ranging from 60 to 90 years (M = 74.99, SD = 5.49). The results showed that the participants in the high flow state significantly feel happier than those in the low flow state. Additionally, home-centered and social activity was the only significant contributor to happiness for the high flow state. For the low flow state, there was no significant relationship between each leisure engagement and happiness. Our findings elucidate that the importance of social engagement in happiness should be emphasized than any other activities in later life, and experiencing flow during social engagement considered meaningful also needs to be accentuated. It implies that older adults are more likely to be happy when social engagement is a meaningful and motivating activity compared to when simply participating in socializing without any motivation.
SOCIAL CAPITAL PROFILES AMONG CHINESE OLDER ADULTS: A LATENT CLASS ANALYSIS
Authors: Li Yuekang , Morrow-Howell Nancy
Published: January 2025

Existing literature often overlooks the multifaceted social engagements of older adults, neglecting how well-being is intricately influenced by diverse combinations of social capital. This study investigates social capital profiles among Chinese older adults, examining how these profiles vary in relation to demographic characteristics and health outcomes. The China Family Panel Study (CFPS) 2016 wave provided data for 7,295 adults aged 60 and above. Based on three levels of social capital (family, community, and societal), Latent Class Analysis (LCA) was employed to identify the social capital profiles of older adults. Multinomial logistic and linear regression models analyze the influence of personal and neighborhood factors on social capital profiles and their correlation with depressive symptoms. Through LCA, three distinct social capital profiles emerged: “Family-centered,” “Family Plus Society,” and “Diverse.” These profiles, each with their unique configurations of social capital, are linked to specific demographic and community features as well as mental health statuses. Notably, this research underscores the particular vulnerability of the “Family-centered” group, characterized by their restricted access to various forms of social capital. Meanwhile, older adults’ social capital is highly connected with the neighborhood they live in. The findings from this study deepen our understanding of social capital by adopting an ecological perspective. The methodology employed to discern social capital compositions and profiles more accurately reflects the diverse social engagements of older adults, offering important insights into the intricate interplay between different levels of social capital and varied older populations.
USING LATENT CLASS GROWTH ANALYSIS TO IDENTIFY SUBGROUPS OF OLDER ADULTS WITH SHARED TRAJECTORIES OF FRAILTY STATUS
Authors: Spangler Hillary , Xie Wenyi , Lynch David , Lin Feng-Chang , Batsis John
Published: January 2025

Background

Frailty is a geriatric syndrome with significant clinical heterogeneity among older adults. Identifying groups experiencing different frailty trajectories is critical for identifying those at high risk of frailty progression and prevention.

Methods

We used data from the National Health and Aging Trend Study (2011-2020), a cohort of Medicare beneficiaries >65 years. Individuals were categorized using Fried’s frailty phenotype. We included older adults (n=6,904) with ≥2 interviews with frailty status (improving, stable, worsening). We used latent class growth analysis (LCGA) to identify patterns of change in frailty status and the impact of social determinants of health (SDOH: transportation, family support, income, education) on frailty trajectories. We defined rural by The Office of Management and Budget’s standards.

Results

Participants were 56.9% female, median age of 70-74. At baseline, 24.6% were robust, 50.4% were pre-frail, and 25.0% were frail. LCGA identified three trajectories over 10 years. Most participants (54.1%) had a stable trajectory, with almost no change in frailty status. Fewer participants (29.1%) had an improving trajectory, initially experiencing a decrease in the number of frailty items at ~6 years, followed by a slow increase over time. The smallest group (16.9%) had a worsening trajectory, with an increasing number of frailty components over time. The worsening trajectory group was older at baseline, majority female. Marital status, lower education and income levels, and Medicaid enrollment were associated with higher odds of worsening frailty trajectory.

Conclusion

SDOH and rurality were associated with progressive frailty trajectories, highlighting the need for policy-level interventions for frailty mitigation.
ASSOCIATION BETWEEN PATTERNS OF SOCIAL ACTIVITIES AND FRAILTY STATUS AMONG OLDER ADULTS IN CHINA
Authors: Che Sok Leng , Chao Ka Kei , Wong Ka Kit
Published: January 2025

Loneliness has been identified as a public health priority by WHO. Studies have indicated that participating in social activities could reduce loneliness and the probability of being frail. This study examines social activity among Chinese older adults and its impact on frailty. This investigation utilizes data from 10,762 participants aged 60 years and over in the 2018 wave of the China Health and Retirement Longitudinal Survey (CHARLS). Frailty status was assessed by constructing a Frailty Index using health deficit accumulation model. Latent class analysis was employed to explore patterns of social activities, and logistic regression was used to identify factors associated with frailty status. The study identified five distinct types of social activity pattern, e.g. face-to-face interaction, socially active and diverse, socially inactive, socializing through the role of caregiver, and socializing through the Internet. Older adults in China are characterized by being socially inactive, accounting for 82% (n=8,827) of the total participants. Compared to older adults who practice face-to-face interaction, older adults who are identified as socially inactive (aOR=2.05, p< 0.001, 95% C.I.=1.68 to 2.51), and socialize in the role of caregiver (aOR=1.43, p=0.01, 95% C.I.=1.08 to 1.88) showed significantly higher odds of being frail. Older adults who hold the role of caregiver are particularly susceptible to frailty. The caregiving role may restrict their social network, while social inactivity may increase the risk of social isolation. Therefore, older individuals exhibiting these patterns of social activity may benefit from enhanced community and family support.
CONNECTING THREADS: SOCIAL PARTICIPATION’S ROLE IN REDUCING LONELINESS AMONG OLDER ADULTS
Authors: Kim Nahyun , Katagiri Keiko
Published: January 2025

Social participation among older adults occurs within the context of local community networks, suggesting that engaging in such activities can expand neighborhood networks, enhancing social connections and fostering a sense of belonging. Active social participation serves to both bridge and bond social networks by expanding them to diverse communities and reinforcing close-knit within groups. Despite the acknowledged advantages of social participation in alleviating loneliness, research gaps persist regarding its specific function and effects on loneliness. This study explores the effects of social participation on loneliness, particularly through the lens of bridging new communities and reinforcing internal group bonds, focusing on relationships with weak neighborhood ties and their impact on reducing loneliness. An online survey was conducted with Japanese individuals aged 60–79 years (n=1000), focusing on 570 respondents who were actively involved in social participation. The survey collected data on variables such as bridging to new communities, internal group bonds, the size of weak neighborhood ties (greetings, casual conversations), and loneliness. A path analysis revealed that strong internal group bonds were negatively related to loneliness, highlighting the importance of deep, supportive relationships within groups. Although direct links between the extent of bridging to new communities and immediate loneliness reduction were not found, an indirect positive effect through the expansion of neighborhood networks was identified, associated with decreased loneliness. This highlights the dual benefits of social participation: fostering close-knit group connections and expanding community engagement through weak ties; both are crucial for reducing loneliness and enhancing well-being in older adults.
EFFECTS OF SOCIAL ISOLATION ON THE WELL-BEING AND COPING MECHANISMS OF OLDER ADULTS IN BISHOFTU TOWN, ETHIOPIA
Authors: Kotecho Messay , Kassay Abraham , Adamek Margaret
Published: January 2025

Research concerning older adults is gaining attention in Ethiopia. Nevertheless, previous research has disregarded the issue of social isolation among elders in Ethiopia. The prevalence of social isolation among older adults is now a significant concern worldwide due to its impact on both individuals and society at large. This study examined how social isolation affects the well-being of older adults and their coping mechanisms, focusing specifically on the experiences of older adults in Bishoftu Town, Ethiopia. A phenomenological approach was used to investigate the experiences of 10 older adults (5 male and 5 female) aged 60 and above, purposefully selected for in-depth interviews and observations. The results indicate that participants are increasingly susceptible to social isolation due to factors such as negative perceptions of aging, loss of meaningful relationships, economic hardships, and age-related health issues. Consequently, elders experience a reduction in social connections, health issues, psychological distress, and challenges in meeting basic needs. Despite these obstacles, older adults have developed various coping strategies, including engaging in prayer and spiritual practices, depending on intergenerational support, participating in traditional savings associations (Idir), and sleeping excessively. Nonetheless, many participants express feelings of pessimism, weakness, lack of affection, and a sense of worthlessness about their future. Additionally, participants report facing disengagement and a loss of social ties alongside grappling with severe poverty and inadequate access to healthcare services. The study underscores the urgent need to bolster intergenerational solidarity and social capital within the community to tackle the multifaceted challenges confronting older adults in Ethiopia.
THE EQUITABLE AGING IN HEALTH CONCEPTUAL FRAMEWORK: CASE STUDIES OF SOCIAL ISOLATION AND LONELINESS
Authors: Perone Angela , Zhou Leyi , Yaisikana Mo’e , Urrutia-Pujana Leixuri
Published: January 2025

Research has well-documented health disparities associated with social isolation and loneliness among older adults. However, much of this research focuses on the United States, and conceptual and theoretical frameworks incorporating power are underdeveloped. This poster presents a new conceptual framework that bridges theories of power and social and political determinants of health to provide a new vision for developing interventions that incorporate power and justice from a global perspective. The Equitable Aging in Health Conceptual Framework foregrounds power as a core driver of social and political determinants of health and the interventions addressing health disparities that flow from power inequities. We argue that interventions that infuse justice must inherently address power, and this conceptual framework aims to help researchers, policymakers, and practitioners accomplish that objective. To illustrate the utility of this conceptual framework, this poster presents three case studies. The first case study applies this conceptual framework to loneliness among rural indigenous older adults in Taiwan. The second case study applies this framework to social isolation among urban community-dwelling older adults in mainland China. The final case study applies this framework to social isolation and loneliness among nursing home residents in Spain. These case studies illustrate how this framework can serve as a tool to visually identify and map how five domains of power can shape social and political determinants of health and a blueprint for conceptualizing interventions that infuse justice.