bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Different 16-Week Exercise Interventions on Bone Mineral Density of Sedentary Older Women
Authors: Ellis Amy , Crowe-White Kristi , Hunter Gary
Published: December 2021

Multicomponent exercise that includes both resistance and aerobic training is recommended to prevent loss of bone mineral density (BMD) in postmenopausal women. However, optimal training frequency has not been determined. Sixty-three non-osteoporotic sedentary women ages 60y and older were randomized to one of three exercise groups for sixteen weeks: 1) one resistance and one aerobic session per week, 2) two resistance and two aerobic sessions per week, or 3) three resistance and three aerobic sessions per week. Resistance exercise included supervised sessions on weight machines, and aerobic exercise was treadmill walking. BMD of the hip and lumbar spine (L1-L4) was assessed by dual energy X-ray absorptiometry (Prodigy, GE Medical Systems Lunar, Madison, WI, software version 6.10.029), and z scores were calculated from a reference population adjusted for age and sex. Among the total cohort with BMD measurements at week 16 (n=58; 83% white), z scores improved for the trochanter, Ward’s triangle, total hip, L1 and L4. Within-group comparisons showed improvement at the trochanter, total hip, and L1 for group 2 only, while only group 1 demonstrated an increase at L4 (p<0.05 for all). However, no time-by-group interactions were observed. Sixteen weeks of combined resistance and aerobic training is effective for improving BMD of older adult women. Results suggest training frequency of two sessions per week may be optimal. Postmenopausal women should be encouraged to do aerobic exercise such as walking plus resistance training at least once weekly to prevent osteoporosis.
The association between vision acuity, sleep duration, and physical activity among US adults aged 50 years and older
Authors: Xu Shu
Published: December 2021

Studies suggested that people with low vision are more likely to have worse sleep quality and less frequent participation in physical activities compare with people with better vision. Studies also showed that physical activities is a very important factor for one’s sleep. However, there is relatively little research on the association between vision acuity, sleep, and physical activity. This study examines the relationships between vision acuity and sleep duration among middle-aged and older adults in the US, and the role of leisure-time physical activity in this relationship. Using nationally representative data from the National Health and Nutrition Examination Survey 2007-2008, a cross-sectional analysis on adults age 50 years and older was conducted (n=2.247). Visual acuity was assessed by participant’s vision of better-seeing eye (i.e., none, mild, moderate, and server visual impairment), and we measured sleep duration (i.e., short, average, and long duration) and leisure-time Physical Activity (i.e., inactive/insufficiently active and sufficiently active). Descriptive analysis showed that 31.06% of older adults experienced moderate or severe visual impairment, and 46.81% respondents experienced abnormal sleep duration. Multinomial logistic regression analyses showed that compared to people without visual impairment, people with moderate or severe visual impairment were more likely to have longer sleep duration than normal sleep duration (OR, 1.62, p<0.05). Leisure-time physical activity was not found to significantly mediate the relationship between visual acuity and sleep duration. Other variables were controlled in the models. Findings suggest that US adults age 50+ with low vision are at greater risk of experiencing abnormal sleep duration.
Recalling Memories of Life’s Challenges with Purpose and Redemption: Resources to Foster Resilience?
Authors: Sharma Shubam , Perlin Joshua , Bluck Susan
Published: December 2021

Unique life challenges occur across life phases, including later life. Life story research suggests that the way challenges are narrated has consequences for multiple domains of well-being. Two factors for positively reframing challenges are one’s sense of purpose in life (Windsor et al., 2015) and redemption (McAdams et al., 2001). This study used moderated-mediation analyses to investigate whether: 1) challenge relates to psychosocial and cognitive well-being, differentially by age, and 2) narrating with greater purpose and redemption ameliorates effects of challenges on well-being, by age. Participants (N = 99 young, 88 older adults) rated self-disruption of challenging events from their lives (IV1) and reported number of recent life challenges experienced (IV2). Eudaimonic well-being (DV1) and cognitive well-being (DV2) were assessed. Purpose (M1) and redemption (M2) were reliably content-analyzed from participants’ narratives of autobiographical challenges (e.g., illness, loss of other). For Aim 1, young and older adults who experienced more challenges showed lower eudaimonic well-being but higher cognitive well-being. Perceived self-disruption was unrelated to well-being. For Aim 2, results showed that how individuals narrate (i.e., with purpose, with redemption) the challenges that have occurred in their lives mediates effects of challenge. Specifically, exhibiting a sense of purpose mediated the relation between perceived self-disruption and cognitive well-being. Redemption buffered negative effects of both self-disruption and number of challenges on eudaimonic well-being. Mediation results held regardless of age. Findings suggest purpose and redemption are two narrative mechanisms that act as psychological resources to support well-being in the face of life’s inevitable challenges.
Benefits of Wise Organizations on Employees’ Well-Being: A Comparison of Younger and Older Workers
Authors: Ardelt Monika , Sharma Bhavna
Published: December 2021

Research has shown a positive relation between personal wisdom and well-being, particularly in old age. Yet, it is unknown whether wisdom in the workplace also has a positive impact on workers’ well-being. We created a wise organization index for nine organizations based on 74 to 390 average employees’ ratings of perceived flexibility at work, work opportunities for training and development, satisfaction with work benefits, absence of time pressure at work, work-life balance, job fulfillment, and job security. We predicted a stronger relation of wise organization on well-being for older workers (N=269; age range 50-74, M=56.08, SD=5.04) than for younger workers (N=552; age range 19-49, M=35.10, SD=8.17) who can more easily change jobs. Results of multigroup analyses in LISREL 9.30 showed that the wise organization index had significant indirect effects on employees’ physical and subjective well-being at the second wave of data collection, mediated by employees’ perception of wise (fair and supportive) leadership assessed six months earlier and overall work satisfaction (career as calling, satisfaction with career progress, enthusiasm at work, and great workplace) at Wave 2. Contrary to expectations, the effects were not statistically different between the two age groups. However, physical well-being had a statistically stronger association with subjective well-being among younger rather than older workers, possibly indicating a positive health selection effect in the older age group. It appears that wise organizations encourage wise leadership and enable workers to work longer by contributing to their work-related, physical, and subjective well-being.
Poor Sleep Moderates the Association Between Generalized Anxiety and Hippocampal Volume Among Older Adults
Authors: Bygrave Desiree , Wright Regina
Published: December 2021

Poor sleep is common among older adults, and associated with hippocampal atrophy -- a strong predictor of memory decrements. Underlying this association are psychosocial risk factors, such as generalized anxiety, that may further exacerbate poor sleep and brain pathology. Given that poor sleep and generalized anxiety are often comorbid, there is a critical need to establish whether generalized anxiety is related to hippocampal volume among poor sleepers. To address this gap, this cross-sectional study examined the relationship between generalized anxiety (GAD-7), and total hippocampal volume, and whether it varied as a function of sleep quality (PSQI Total < 5 good sleepers; PSQI Total ≥ 5 poor sleepers). Data were analyzed from 165 older adults (mean age = 68.48y, 33% male, 41% African American), free of major disease. Linear regression analysis, adjusting for sex, race, education and depression, showed a statistically significant Generalized Anxiety x Sleep interaction for hippocampal volume (p=.02). Further probing of this interaction revealed that among poor sleepers, greater generalized anxiety was associated with lesser hippocampal volume (p=.01). Findings suggest generalized anxiety may influence hippocampal volume in the context of poor sleep among older adults. As poor sleep is associated with age-related neurodegeneration, our findings suggest that improvements in sleep quality may reduce the impact of generalized anxiety on hippocampal volume in older adulthood. Future research should examine whether generalized anxiety mediates relations of sleep quality to specific memory outcomes.
COVID-19 and the Long-Term Care Ombudsman Program: Findings From a National Study
Authors: Smetanka Lori , Du Chenguang , Teaster Pamela , Ratliff Kathryn
Published: December 2021

The purpose of our study was to explore changes for long-term care ombudsman programs across the country in response to the COVID-19 pandemic. The study team explored the effect of COVID-19 on programs: cases, resident engagement, complaint Investigation and resolution, services, complaints, changes in visitation, and preparedness plans. The research team developed survey items and beta-tested them with state and local LTCOs prior to distributing the survey nationally to State Long-Term Care Ombudsman and Local Long-Term Care Ombudsman in order to characterize experiences of the participants. From 62 state LLTC respondents we learned there were 81.0% fewer cases received, 97.36% were less able to engage with residents, 78.95% were less involved in the engagement of residents in complaint investigation and resolution and there were 71.05% fewer activities involved in investigations. Not surprisingly, there was an 80.0% increase in information that the LTCO provided to the media.
Birth of the Society of Divorees – Changing Patterns of Civil Status in Later Life
Authors: Bildtgard Torbjorn , Öberg Peter
Published: December 2021

Half a century ago Lopata used the concept “society of widows” to describe the gendered reality of late life singlehood, where widowed women were excluded from coupled social life, depended on a community of other widows for social integration, and refrained from initiating new relationships due to “sanctification” of their former husbands. We use Swedish, American and EU census data and a national survey to Swedes 60-90 years old (n=1225; response rate 42%) to illustrate a substantial change in the demographic landscape of late life singlehood. More people enter later life as divorcees or become divorced at a high age. Among Swedes 60+ divorcees outnumber widowed people, and the incidence of late life divorce has more than doubled since the millennium in what has been called the “grey divorce revolution”. Many other Western countries follow the same demographical trend, posing important questions about the transformation of late life singlehood. Based on two Swedish studies we will show that the structure of the late life single community is becoming less gender skewed as a consequence of the emerging society of divorcees, and that in this society relationship careers are increasingly complex, attitudes to repartnering increasingly liberal and partner sanctification seldom an issue. We conclude by proposing the concept “society of divorcees” for this new demographic landscape of late life singlehood, argue that research is needed to capture this new reality, and discuss the implications of this change for access to social support later life.
Community Collaborations & Technology Successfully Connect Isolated Older Adults to Education & Activities
Authors: Spradley Laura
Published: December 2021

Providing programs, activities and education to older adults (OA) is a challenge under normal circumstances. The Arkansas Geriatric Education Collaborative (AGEC) is a HRSA Geriatric Workforce Enhancement Program with a mission to “provide high quality programs that support healthy aging in Arkansas.” Prior to the pandemic, AGEC educators provided face-to-face programs to OA’s through senior centers, places of worship and other public venues. The pandemic changed all that. In-person programs were replaced with zoom presentations, social media events and pre-recorded programs placed on websites and patient-learn platforms for 24/7 viewing. Gaining viewership proved difficult and after collaborative research, it was determined the major barrier was a digital divide between access, usage and knowledge of digital platforms. To overcome this barrier, AGEC utilized TV, radio, libraries, digital infographics, newsletters and video tips addressing Wi-Fi and technology training. Videos, distributed via multiple routes, addressed basic topics such as “Creating and Utilizing Zoom and Facebook accounts” and “how to improve telehealth visits”. After establishment of a regular audience, AGEC engaged new and established partners and hosted a plethora of educational programs and activities further expanding the viewing audiences. In addition, with personalized emails and targeted marketing, AGEC engaged OA audiences in caregiving workshops, on-line caregiver support groups, telephone check-ins and exercise programs. Many OAs have found ways to bridge the digital divide and are engaged and active with educational and program activities and have used their new skills to connect with other OAs, grandkids, friends and even their spiritual communities.
Social Media Use and Emotional Well-Being: The Role of Physical Activity
Authors: Lin Xin Yao , Lachman Margie
Published: December 2021

There are mixed findings as to whether social media use (SMU) is positively or negatively related to well-being (positive/negative affect), and this relationship varies by age. The current study seeks to further explore this relationship by examining physical activity (PA) as a potential mediator at both a within (intraindividual) and between-person (interindividual) level across adulthood. The data are from the Midlife in the United States Refresher eight-day daily diary study (N=782, ages 25-75) with self-reported frequency of SMU, PA, and well-being (positive/negative affect). Multilevel structural equation modeling simultaneously tested how the relationships between the variables differed at both the between- and within-person levels. Between-person results showed that across the week, those who reported less SMU reported engaging in more PA, and more PA was associated with more positive affect. PA significantly mediated the relationship between SMU and positive affect for midlife and older adults, but not for younger adults. Effects for negative affect were not significant. Within-person results indicated that days with more PA were associated with more positive affect; however, PA did not mediate the relationship between SMU and positive or negative affect. These findings suggest the benefits of engaging in PA on one’s positive emotional well-being at both the between- and within-person levels. However, for midlife and older adults, more SMU across the week may take away time from engaging in PA, which in turn lowers their positive affect. Implications of the effects of SMU on PA and well-being across adulthood are discussed.
Perceived Financial Vulnerability Is Related to Perceived Cognitive Impairment and Living Alone
Authors: Lichtenberg Peter , Tocco Maggie , Moray Juno
Published: December 2021

Objective: Perceived financial vulnerability is linked to physical and mental health and also to risk for financial exploitation (Lichtenberg et al., 2020a,b). This study examined the relationship of risk scores for financial exploitation to demographic variables, perceived memory loss and living alone. Methods: The 17-item self-report Financial Exploitation Vulnerability Scale (FEVS) posted on our website https://olderadultnestegg.com was completed by a convenience sample of 258 older adults. Correlational, multiple regression and Chi Square analyses were used. Results: Thirty percent of the sample scored at an elevated risk for financial exploitation due to perceived financial vulnerability. Although this was a convenience sample the results were similar to what was found in a sub-study of the HRS. Thirty eight percent of participants were living alone and 38% reported that their memory was less reliable than a year ago. Financial vulnerability risk score was significantly related to decreased education (r=-.12), living alone (r=.21) and perceived memory loss (r=.35). Eighteen percent of the variance was accounted for in a multiple regression (F(5,250)=10.73, p<0.001, r2=0.18) with all three measures predicting FEVS risk score independently. The combination of perceived memory loss and living alone was significantly associated with the highest percentage of elevated risk scores. Discussion: Perceived financial vulnerability and its relationship to health (e.g. memory loss) and financial exploitation, continues to be under-appreciated in gerontology and geriatrics research. Our findings, consistent with GSA's Longevity Fitness report further highlights this important dimension.
Brain Cellular Senescence in Mouse Models of Alzheimer's Disease
Authors: Riordan Ruben
Published: December 2021

Abstract The accumulation of senescent cells contributes to aging pathologies, including neurodegenerative diseases, and its selective removal improves physiological and cognitive function in wild type mice as well as in Alzheimer’s disease (AD) models. AD models recapitulate some, but not all components of disease and do so at different rates. Whether brain cellular senescence is recapitulated in some or all AD models, and whether the emergence of cellular senescence in AD mouse models occurs before or after the expected onset of AD-like cognitive deficits in these models is not yet known. The goal of this study was to identify mouse models of AD and AD-related dementias that develop measurable markers of cellular senescence in brain and thus may be useful to study the role of cellular senescence in these conditions. We measured levels of cellular senescence markers in brains of P301S(PS19), P301L, hTau, and 3xTg-AD mice that model amyloidopathy and/or tauopathy in AD and related dementias, and in wild type, age-matched control mice for each strain. Expression of cellular senescence markers in brains of transgenic P301L and 3xTg-AD mice was largely indistinguishable from that in WT control age-matched mice. In contrast, markers of cellular senescence were significantly increased in brains of transgenic P301S and hTau mice as compared to WT control mice at the expected time of onset of AD-like cognitive deficits. Taken together, our data suggest that P301S(PS19) and hTau mice may be useful for the study of brain cellular senescence in tauopathies including, but not limited to, AD.
Intersections of ageism and gender stigma: Exploring long-term care employees' attitudes towards aging
Authors: Loy-Ashe Tarah , Hawkins Brent
Published: December 2021

The purpose of this mixed methods, single case study was to explore long-term care (LTC) employees’ attitudes towards age and gender. The intersection of Rosemary Garland-Thomson’s theory of feminist disability (2001) and Hailee Gibbons’ compulsory youthfulness theory (2016) provided the conceptual framework for this project. The sample consisted of 60 LTC direct care employees, all employed at the same organization, who completed an on-line survey during the COVID-19 pandemic. The survey consisted of demographic questions and the Fraboni Scale of Ageism. Twenty-one of these employees participated in a 30-45 minute phone interview. Cultural artifacts were also collected. All data were collected during the COVID-19 pandemic. Although quantitative results showed no statistical significance, qualitative results suggest that employees do exhibit some ageist attitudes towards the residents for whom they care. Despite evidence that most employees felt a deep connection with residents, they detached themselves from the aging process. The theoretical framework lends hand in explaining how both ableism and ageism appeared to contribute to this detachment. Findings indicated employees’ interactions and attitudes towards residents were influenced by themes compassionate ageism, ableism, and identity, which resulted in meta theme caregiver validation and reward. Employees received validation and altruistic reward from positive interactions with what they perceived to be “ideal” residents; those who fit the stereotype of a nursing home resident, such as older, pleasant, and dependent. The perceived “ideal” residents varied by gender. Generally, female residents were expected to be more independent and at times viewed negatively when requesting assistance.
Introducing the Attitudes toward Technology Longitudinal Aging Study (ATLAS): Initial Wave 1 Findings
Authors: Stuart Robin
Published: December 2021

Differences between younger and older adults' use and adoption of technology have declined over the past two decades, though the mechanisms behind observed trends are uncertain. Few longitudinal studies have tried to capture detailed changes in technology attitudes, adoption, and usage over time among older adults. This presentation presents newly collected data from the first wave of the Attitudes toward Technology Longitudinal Aging Study (ATLAS), a 5-wave questionnaire-based longitudinal study of older adults' attitudes toward technology and levels of technology use (N = 88; Men = 30; Women = 58; Mage = 69.7 years). We present baseline characteristics of Wave 1 and explore predictors of technology use, adoption, and proficiency. Waves 2 through 5 will assess changes in these domains. Wave 1 results replicated previous findings in that older age was associated with lower computer and mobile device proficiency (computer: r = -.219*, p < .05 , mobile device: r = -.291**, p < .01). However, there was variability among both types of proficiency (McomputerProf = 27.39, SD = 3.57 ; MmobileProf = 31.52, SD = 9.21), indicating room for change over time. Both types of proficiency were correlated with level of technology use (computer: r = -.219*, p < .05 , mobile device: r = -.572***, p < .001). Taken together, these initial relationships suggest the possibility that future waves will see changes in technology use predicted by changes in age-related differences in technology proficiency and attitudes.
Predictors of positive or negative reactions to learning Alzheimer’s biomarker results
Authors: Erickson Claire , Chin Nate , Jonaitis Erin , Ketchum Fred , Gleason Carey , Clark Lindsay
Published: December 2021

With improved detection of Alzheimer’s disease and biomarker accessibility, more adults with no or mild symptoms may learn their AD biomarker results. Yet, potential psychosocial impact of learning AD biomarkers is not well understood. In a phone survey, we assessed potential reactions after learning about a hypothetical positive AD biomarker result. Data were collected from cognitively healthy participants (n=334, mean age=64.8±7.7) enrolled in longitudinal AD studies. Exploratory factor analysis identified five latent factors following a hypothetical positive biomarker result: advanced care planning, lifestyle changes to reduce dementia risk factors, psychological distress, subjective cognitive complaints, and stigma. Using linear regression, we found that predictors of potential pessimistic reactions (distress, cognitive complaints, stigma) included higher trust in research (Distress:b:0.04, p:0.04), no dementia family history (Stigma:b:-0.30,p:0.04), poorer memory self-rating (Cognitive complaints:b:-0.19,p:0.02), and Black racial identity (Cognitive complaints:b:0.30,p:0.02, Stigma:b:0.40,p:0.003). Predictors of potential optimistic reactions (advanced care planning, lifestyle changes) included more trust in research (Planning:b:0.07,p<0.0001) and Black racial identity (Planning:b:0.38,p:0.003), as well as younger age (Lifestyle:b:-0.02,p:0.02) and belief in AD controllability (Planning:b:0.22,p:0.003, Lifestyle:b:0.23,p:0.002). Concern about developing AD was associated with increased likelihood of all potential reactions. While AD concern associates with optimistic and pessimistic potential reactions, specific factors of family history, racial identity, trust, belief in AD controllability, and memory rating differentially predict each of the potential outcomes of learning AD biomarker results. These findings may help target education efforts to prepare and reduce risk of negative reactions for cognitively healthy adults who learn their AD biomarker results.
Predictors of Sleep Among Spousal Care Dyads Living With Chronic Conditions
Authors: Johnson Florence , Robinson-Lane Sheria , Lei Lianlian , Liu Yin , Song Yeonsu , Choi Seung-won Emily , Antonucci Toni
Published: December 2021

Sleep health relates closely to physical health and well-being among older adults with chronic health conditions. However, little is known about the dyadic sleep patterns of these individuals and their spousal caregivers. Secondary analyses of the 2015 National Health and Aging Trends Study and National Study of Caregiving (N= 62 care dyads, mean age 78.59 years for care recipients and 75.77 years for caregivers) were completed to examine the sleep patterns, and related factors, of spousal dyads at both the individual and dyadic levels. Sleep measures included frequency in trouble falling back asleep and insomnia symptoms. Predictors included demographics, depressive symptoms, and positive affect for dyads and contextual factors such as dementia caregiving, care burden and support, neighborhood cohesion, and relationship quality. Multilevel dyadic and actor-partner interdependence models were used to complete analyses. Though intraclass correlation was poor (dementia care dyads ICC=0.123, non-dementia care dyads ICC=0.043), persons with dementia/spousal caregiver dyads (n=102) had more similar sleep and insomnia patterns than dyads with other chronic conditions. Poor sleep among dyads was correlated with higher care burden (β = -0.31, p <.0001), however, better relationship quality marginally enhanced the association (β = -0.23, p = .08). Individual depressive symptoms negatively affected dyadic sleep patterns. However, positive affect only had an actor effect and was related to better individual sleep. Other contextual factors did not affect sleep patterns. These findings suggest the importance of both caregiver and care recipient characteristics on sleep at dyadic levels, particularly those with dementia.
Psychoactive Substance Use Among Middle-Aged and Older Adults With Visual Impairment
Authors: Lopez Francisco , Leddy Jason , Han Benjamin , Palamar Joseph
Published: December 2021

Older adults with visual impairment may be at risk for developing substance use disorder (SUD) as psychoactive substance use is often used to cope with the stressors of vision loss. This study estimates the national prevalence and risk of psychoactive substance use among older adults with visual impairment. We analyzed data of respondents age ≥50 from the 2015-2019 National Survey on Drug Use and Health, an annual cross-sectional survey of a nationally representative sample of non-institutionalized individuals in the U.S. (N=43,886). We estimated and compared prevalence of past-year use of cannabis, cocaine, misuse of prescription opioids, sedatives, stimulants/tranquilizers, alcohol use disorder (AUD), any SUD, and nicotine dependence between adults with visual impairment to those without. Comparisons were conducted using chi-square and we used multivariable generalized linear models using Poisson and log link to estimate adjusted prevalence ratios (aPRs) for adults with visual impairment relative to those without, controlling for demographics and diagnosis of ≥2 chronic diseases. An estimated 6.1% experienced visual impairment. Those with visual impairment had higher prevalence of AUD, nicotine dependence, misuse of prescription opioids, tranquilizers, and stimulants, and SUDs. In adjusted analyses, vision-impaired adults had higher risk of AUD (aPR=1.71, 95% CI: 1.40-2.09), nicotine dependence (aPR =1.53, 95% CI:1.35-1.73), opioid misuse (aPR =1.54, 95% CI:1.26-1.90), and SUD (aPR=1.67, 95% CI:1.40-2.01). Psychoactive substance use adds unique health risks for older adults with vision loss, who may suffer significant psychological stress and loss of independence. Screening for substance use among all older adults with visual impairment should be considered.
The Effect of Nurse Aide Retention on Ohio's Nursing Home Resident Care Experience Scores: A Facility-Level Analysis
Authors: Kennedy Katherine
Published: December 2021

The objective of the study was to analyze whether higher nurse aide retention was related to better resident care experiences using an overall score and seven domain scores among a sample of Ohio nursing homes. The 2017 Ohio Biennial Survey of Long-Term Care Facilities was used in combination with the 2017 Ohio Nursing Home Resident Satisfaction Survey. These data were merged with the Ohio Medicaid Cost Report, Certification and Survey Provider Enhanced Reports, LTC Focus, Area Health Resource File, Rural Urban Commuting Area data, and Payroll-based Journal Public Use Files. The analytic sample (N=690) represents freestanding facilities with a full-year cost report. The analysis included means and frequencies, ANOVAs with Tukey adjustments, and linear regressions that controlled for heteroskedasticity. Quartiles of the CNA retention rate were used to define four groups: low, medium, high, and extremely high. After controlling for facility and county characteristics, facilities with high CNA retention (61-72%) had significantly higher overall resident care experience scores by 1.27 percentage points and better environment scores by 1.35 percentage points compared to those with low CNA retention (0-48%). Medium retention (49-60%) also had significantly better environment scores than low retention. Compared to the high retention group, facilities with extremely high retention (73%+) had significantly lower scores for the overall resident care experience, facility culture, caregivers, and spending time. Maintaining a high retention rate of CNAs is important, but there were surprising negative effects from having extremely high retention potentially due to high burnout or poor person-job fit.
Visualizing Person-centered Long-term Care: An Exploratory Scoping Review and Evidence Mapping
Authors: Ciolfi Mary Lou , Coastlines Rocky , Taylor Catherine , Thompson Kayla , Crittenden Jennifer , Kaye Lenard , Hunt Angela , Nebenzahl Paul
Published: December 2021

Despite decades of professional, academic, and policy interest in person-centered long-term care (LTC), the field continues to be challenged by the absence of a comprehensive depiction of the concept and a lack of consistency reflected across studies and measures. In response, a participatory action, research-focused, partnership between an institution of higher education and an LTC community (the University of Maine Center on Aging and The Cedars), with funding from The Mayer-Rothschild Foundation, is identifying and mapping the landscape of person-centered LTC in nursing homes and assisted living communities. A collaborative, ongoing, exploratory scoping literature review and evidence mapping has compiled a database of 663 academic and 115 grey literature articles through 65 systematic searches reviewing over 4,296 articles. An iterative process from both the resident and organizational perspectives revealed nine core domains (e.g. dining, resident care, environment, quality improvement, identity and personhood, etc.) and two substantive research gaps (the intersection of person-centered long term care with diversity, equity, and inclusion issues, and pandemic considerations). For mapping purposes, domain content was analyzed categorically based on concept, information revealed about resident, family, and staff experience, and operations applicability. The identified person-centered LTC domains, categorical analysis, identified gaps, and visual representation via mapping will contribute to generating research ideas, supporting the development of effective operationalization for LTC settings, and contributing to an understanding of the theoretical scope and concrete elements of a person-centered care model that aims to improve the wellbeing and quality of life of older adults in long-term residential settings.
Better Brain Health through Equity: Addressing Health and Economic Disparities in Dementia
Authors: Ahuja Rajiv , Levy Cara
Published: December 2021

Dementia disproportionately impacts the health and financial security of women and certain minority groups. Long-standing inequities create distrust of the medical system, fewer treatment options, and reduced access to care. Research predicts that from 2020 to 2060, the number of African Americans and Latinx living with dementia will grow by nearly 200 percent and 440 percent, respectively, while prevalence among non-Hispanic Whites will increase by 69 percent. As the prevalence of dementia rises, so will the costs associated with dementia care. African Americans bear 1/3 of the costs associated with dementia. And the costs for Latinx living with Alzheimer’s disease are expected to exceed $100 billion by 2060. To mitigate these growing health and economic concerns, efforts to improve dementia care must put equity front and center. This presentation highlights five actionable recommendations to build health equity by reducing disparities in dementia prevention, detection, diagnosis, and care. These recommendations center around two overarching themes: (1) Strengthening the infrastructure among health-care, long-term care, and community-based organizations to achieve greater health equity for people living with dementia and their caregivers and (2) Expanding dementia-friendly networks and workplaces in racially and ethnically diverse communities. The recommendations discussed in this presentation will offer guidance for policymakers, health services researchers, businesses, health systems, and communities to reduce the inequitable impact of dementia on African Americans and Latinx, which is even more vital amid demographic trends showing a population growing older and more racially and ethnically diverse.
Butterfly Garden Connects Community Living Center Residents, Family, and Staff During the COVID-19 Pandemic
Authors: Rodriguez-Gonzalez Maribel , Miller Maura , Pratt Gelda , Silverman Micheal A , DiScala Sandra
Published: December 2021

The COVID-19 Pandemic has led to significant morbidity and mortality in older residents of long-term care facilities. In addition, the stringent restrictions on visitation of family and loved ones has further socially isolated residents leading to an increase in depression, loneliness, and spiritual distress. The Community Living Center (CLC) staff at West Palm Beach VA Medical Center wanted to address this dilemma and created a unique “Butterfly Garden” (BG) visitation space. This space is a therapeutic garden adjacent to the CLC that can be accessed by families without having to enter the facility. Participants in the BG reported feelings of peace, undisturbed reflection, and tranquility as they observed and experienced nature’s life cycle. This show of nature’s beauty promotes visual, tactile, and olfactory sensory stimulation while attracting hummingbirds, bees, butterflies, and peace to this calm garden space. The BG visitations offers residents, family, and staff opportunities to experience the health benefits of nature during their visits under strict CDC social contact guidelines. From September through December 2020 and from January through March 2021 there were 67 and 184 visits respectively as families became more involved. The feedback from residents, families, and staff indicated that the spirits of all participants were raised by the BG visits despite the difficult challenges of social distancing and limited CLC visitations. This BG concept could serve as a model for other long-term care facilities to allow socially distant family visits to loved ones in a safe nature-based environment of care with or without a pandemic.
Changes in Daily Life Conditions among Korean Older Adults after COVID-19 Outbreak
Authors: Lyu Jiyoung , Kim Young Bum , Lim Yeon Ok
Published: December 2021

The pandemic of COVID-19 has had a significant impact on peoples’ daily life conditions. Therefore, it is worth understanding changes in daily life conditions among older adults after COVID-19 outbreak. This study was aimed to explore the impact of the pandemic on daily life conditions among Korean older adults. To achieve this aim, an online survey was conducted during April, 2021 to include 184 Korean adults aged 60 years or older nationwide. The results are as follows. First, about 54.9% older Koreans reported that their daily life has stopped since COVID-19. Second, the top 3 increased daily life conditions were spending time at home (77.2%), using internet (60.3%), and shopping online (51.6%). Third, the top 3 decreased daily life conditions were traveling (90.2%), meeting with friends (90.2%), and meeting with family members (80.4%). Fourth, the top 3 daily life conditions with no change were sleeping time (72.3%), eating instant food (58.2%), and household income (53.8%). These findings suggest that several daily life conditions changed after COVID-19 outbreak. Further study is needed to examine the impact of these changes on physical and mental health among older adults.
Cross-National Analysis of Bereavement From COVID-19 and Depressive Symptoms Among Older Adults in Europe
Authors: Wang Haowei , Verdery Ashton , Margolis Rachel , Smith-Greenaway Emily
Published: December 2021

The COVID-19 pandemic has left older adults around the globe grieving the sudden death of relatives and friends. We examine if COVID-19 bereavement corresponds with older adults’ depressive symptoms in 27 countries, and test for variation by gender and country context. We analyzed the Survey of Health, Ageing and Retirement in Europe (SHARE) COVID-19 data collected from N=51,383 older adults (age 50–104) living in 27 countries between June-August 2020, of whom 1,363 reported the death of a relative or friend from COVID-19. We estimated pooled-multilevel logistic regression models to examine if COVID-19 bereavement was associated with depressive symptoms and worsening depressive symptoms for older men and women, and we tested whether the national COVID-19 mortality rate in their country had an additive, or multiplicative, influence. COVID-19 bereavement from the death of a relative or friend is associated with significantly higher odds of reporting depressive symptoms, and reporting that these symptoms have recently worsened since the outbreak of COVID-19. Net of personal loss, living in a country with the highest COVID-19 mortality rate corresponds further with women’s depressive symptoms; however, living in the midst of more COVID-19 deaths does not alter the implications of personal loss for depressive symptoms. COVID-19 deaths have lingering mental health implications for surviving older adults. Even as the collective toll of the crisis is apparent, bereaved older adults are in particular need of mental health support.
Intergenerational connections to improve social well-being of older adults with ADRD: A research protocol
Authors: Xu Ling , Fields Noelle , Daniel Kathryn , Troutman Brooke , Cipher Daisha
Published: December 2021

There is growing concern about social isolation, loneliness, and diminished emotional well-being among persons with ADRD who live in the community. Research suggests that reminiscence strategies, especially with the production of a digital story book, combined with an intergenerational approach may yield significant benefits for older adults. Reminiscence approaches are typically implemented by trained professionals. However, the use of trained volunteers is of growing interest due to the costs associated with reminiscence programs. This research protocol describes the development and testing of an intergenerational, telephone-based reminiscence program offered by trained, young adult volunteers that includes the use of digital storytelling (DST). Specifically, the study addresses three aims: 1) Quantitatively test the effectiveness in improving social and emotional well-being of older adults with ADRD; 2) Quantitatively test attitudes towards aging and knowledge and awareness of ADRD disease among the young adults; and (3) Qualitatively evaluate the usefulness of this intervention from perspectives of the dyads. A randomized control trial is used to assess the effects of the intervention using an explanatory sequential mixed methods design. The older and younger participants (n = 92 dyads) are randomly assigned to intervention (reminiscence) or sham (social visit) group, and then randomly matched. Data are collected at baseline, mid-intervention, post- intervention, 3 months-post intervention and through qualitative interviews (selected dyads). The proposed evaluation activities will allow us to determine the applicability of intergenerational reminiscence with DST as an effective intervention for supporting the social and emotional needs of persons with ADRD.
Financial Hardship and the Pain of Social Disconnection During the COVID-19 Pandemic in the United States
Authors: Bhatta Tirth , Lekhak Nirmala , Goler Timothy , Kahana Eva , Maheshwari Sfurti
Published: December 2021

Considerable scholarly attention has been directed at increasing social isolation and loneliness during the COVID-19 pandemic, and their adverse impact on later life psychological well-being. Notably absent is the focus on financial hardship in the context of overlapping unprecedented economic and public health crisis. It is unclear whether loneliness continues to differ across different levels of financial hardship even amidst immense uncertainty, social isolation, and anxiety induced by the pandemic. Based on our nationwide web-based survey of adults aged 50 years and older (n=1861), we used ordinal logistic regression to examine the influence of financial hardship on loneliness and assessed the role of socioeconomic status (SES), emotional support, and health status in contributing to such influence. We found significantly higher odds of greater loneliness (β = .28, p < .001) among individuals who reported experiencing greater financial hardship. Among two measures of SES, only household income contributed substantially to the influence of financial hardship on loneliness. We documented significantly lower emotional support and greater health disadvantage among individuals experiencing greater financial hardship. Consideration of emotional support and health status explained the remaining influence of financial hardship, due to their association with both financial hardship and loneliness. Despite a sense of shared vulnerability and social isolation across the general population, our findings suggest that SES inequalities in later life loneliness are maintained even in the midst of the pandemic.
Physical Indicators of Aging are Related to Cellular Senescence Signal P16INK4a in Midlife Adults
Authors: Rentscher Kelly , Seeman Teresa , Cole Steve , Carroll Judith
Published: December 2021

Cellular senescence signal p16INK4a has been identified as a biomarker of aging that accumulates with chronological age across several tissues in mice and humans and may be potentially modifiable by interventions. This study examined whether physical indicators of aging were associated with p16INK4a and other markers of the aging process in midlife adults. Participants were 543 adults aged 26–78 years (Mage=54.0; 50.5% female) in the Midlife in the United States Refresher cohort. Interviews, questionnaires, and performance tests measured physical indicators of aging, including the Fried frailty index, limitations in daily activities, and age-related comorbidities. RNA sequencing of whole blood assessed biomarkers of aging: p16INK4a (CDKN2A), the DNA damage response (DDR), and the senescence-associated secretory phenotype (SASP). Older age was associated with enhanced p16INK4a (r=.11, p=.01), DDR (r=.34, p<.001), and SASP (r=.38, p<.001) expression. Multiple regression models that adjusted for age, sex, race/ethnicity, BMI, comorbidities, and time between assessments revealed that frailty (pre-frail/frail vs. non-frail) was associated with greater p16INK4a (B=0.13, p=.048) and marginally greater DDR (B=0.06, p=.06) expression. Limitations in daily activities were also associated with p16INK4a (B=0.12, p=.045). History of heart disease, stroke, arthritis, and cancer were associated with DDR and SASP expression in unadjusted models only (ps<.05). In summary, senescence indicator p16INK4a was elevated in whole blood samples from middle-aged adults who showed signs of frailty and limitations in daily activities. Findings suggest that whole blood p16INK4a expression might potentially be used to detect early signs of aging and target interventions to reduce biological aging and frailty.
Precarious Aging: A Working Definition
Authors: Grenier Amanda , Phillipson Christopher , Martin Grace , Karalasingam Abiraa , Kobayashi Karen , Marier Patrik , Laliberte-Rudman Debbie
Published: December 2021

Until recently, studies of precarity have overlooked aging and late life. This poster presents a snapshot of conceptual work in progress on a Canadian Social Sciences and Humanities Research Council (SSHRC) Insight Grant on precarity and aging. The poster outlines existing definitions and theoretical perspectives, key results, a current evolving conceptual model, and a working definition of Precarious Aging. It situates existing knowledge and definitions of precarity, highlights crucial intersectional locations of gender, im/migration and (dis)ability, and clarifies the concept of precarity in later life. Results at this point in the study are based on conceptual reviews, reviews of literature on precarity and aging, and the consideration of allied concepts. In conclusion, the concept of precarity offers a promising lens to guide research in the field of social and critical gerontology, providing a foundation for an enhanced understanding of the lives and realities of older people with regards to aging, disadvantage, and inequality.