bluuebunny/crossref_metadata_2025 huggingface dataset:
THE DEVELOPMENT OF ADHERENCE SUPPORT MESSAGES FOR AN AI-BASED REMINDER SYSTEM
Authors: Zhang Shenghao , Dieciuc Michael , Dilanchian Andrew , Boot Walter
Published: December 2022

Artificial Intelligence (AI) holds tremendous potential for aiding in the customization and tailoring of interventions. This talk will focus on the initial development of an adherence support system to maintain older adults' engagement with at-home cognitive training and assessment delivered via mobile devices. As part of the NIA funded Adherence Promotion with Person-centered Technology (APPT) project, a reminder and adherence support system is being developed to automatically detect adherence lapses and provide just-in-time reminders with tailored messaging to facilitate reengagement. The results of an initial study (N=40) will be presented in which participants were delivered reminders via SMS text messaging that were either tailored or not tailored to their self-reported motivation to engage with the intervention. Tailored messages were perceived as more motivating, and qualitative data informed additional ways in which messages might further be tailored based on individual preferences to support adherence.
CLAIMS-BASED FRAILTY INDEX (CFI) AS A MEASURE OF DEMENTIA SEVERITY IN MEDICARE BENEFICIARIES WITH ADRD
Authors: Park Chan Mi , Sison Stephanie Denise , McCarthy Ellen , Gouskova Natalia , Kim Dae
Published: December 2022

Lack of a dementia severity measure in administrative claims data is a major barrier in Alzheimer’s Disease and Related Dementias (ADRD) research using such data sources. A claims-based frailty index (CFI; range 0 to 1, higher scores indicating greater frailty) is a validated measure of frailty that can be calculated from administrative claims data and is correlated with functional status. We conducted a cross-sectional study to examine whether CFI can be a claims-based measure to differentiate dementia severity in 814 participants with ADRD with linked to Medicare claims in the National Health and Aging Trends Study (NHATS). We estimated the Functional Assessment Staging Test (FAST) scale (3: mild cognitive impairment; 4: mild dementia; 5: moderate dementia; 6–7 moderate-to-severe dementia) using NHATS variables and calculated CFI from Medicare claims in the prior 12 months. The prevalence of FAST stage 5 or higher was 244 (weighted percentage, 25.9%). The C-statistic of CFI to identify FAST stage 5 or higher was 0.78 [95% CI:0.73–0.82], with a CFI cut-point of 0.3 achieving the maximum sensitivity 72.5% and specificity 67.5%. The equipercentile linking procedure showed that CFI scores of 0.30, 0.35, and 0.40 corresponded to FAST stages 4, 5, and 6, respectively. Our results support the utility of a CFI as a proxy of dementia severity in administrative claims data.
ANXIETY, COGNITIVE FUNCTION, CHANGE, AND IMPAIRMENT AMONG DIVERSE OLDER HISPANICS/LATINOS
Authors: Gonzalez-Prado Roberto , Paredes Alejandra Morlett , Tarraf Wassim , Stickel Ariana , Testai Fernando , Gallo Linda , Pendedo Frank , González Hector
Published: December 2022

Introduction

Anxiety and depression often co-occur and may be risk factors for neurodegenerative diseases such as Alzheimer’s disease and related dementias. We examined associations between symptoms of anxiety and cognitive change and impairment in middle-aged and older Hispanics/Latinos. Method: 6,162 participants aged ≥50 (mean age=63.4, SD=±8.2 years) were enrolled in the Study of Latinos-Investigations of Neurocognitive Aging study (SOL-INCA), an ancillary to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Exposures included the Spielberger State-Trait Anxiety Inventory 10-item (STAI-10) and the Center for Epidemiology Scale for Depression 10-item (CESD-10) at HCHS/SOL Visit 1 (2008–2011). Outcomes include cognitive tests at Visit 1 and 2 about 7 years later in SOL-INCA and mild cognitive impairment diagnosis (MCI; NIA-AA diagnostic criteria). Separate models were created to examine associations between cognition and anxiety adjusting for demographic variables, antianxiety medication, and depressive symptoms.

Results

After adjusting for demographic variables and medication use, STAI-10 scores were associated with Visit 2 cognitive function (p < 0.05) and MCI (p < 0.01), but not with changes in cognitive function over time. After adjusting for depressive symptoms, most effects of anxiety were attenuated, with exception of B-SEVLT-Recall (p < 0.05). Discussion: Anxiety symptoms were associated with lower memory function 7 years later among diverse older Hispanics/Latinos. Anxiety was associated with 7-year cognitive change and MCI, but those associations were explained by depressive symptoms and other covariables. Future research should examine cognition in relation to anxiety and depression since the two commonly co-occur.
BRINGING THE HAND TO THE HEAD: AGE-RELATED CHANGES IN MOVEMENT STRATEGY
Authors: Droste Andrew , Cain Stephen , Trenary Tanner , Cook Rachel Logue , Sample Alanson , Burke David , Newman-Casey Paula Anne , Brown Susan
Published: December 2022

Functional independence in older adults relies heavily on the ability to perform daily activities requiring motion of the upper extremity that brings the hand to the head. Such tasks include hygiene activities, eating and drinking, adjusting hearing aids, or putting in eye drops – all of which can be challenging for the older individual. Despite the importance of these activities of daily living, little is known regarding age-related changes in control strategies that may contribute to performance impairments. Twelve older (mean age: 75±5.5y) and 12 young (mean age: 23±1.6y) participants performed arm movements that stopped in front of the ipsilateral eye. Movements were made under proprioceptive guidance by occluding visual feedback via blindfold. Participants first made a reference movement to determine final hand position and then reproduced the memory-based movement. The task was performed by each arm from a seated position. Inertial sensors attached to each wrist captured movement data, which were used to calculate movement characteristics (velocities, timing, smoothness). As expected, proprioceptively guided movements made by the young group were highly irregular, particularly during the deceleration phase, indicating intermittent proprioceptive monitoring of arm position in the absence of vision. In contrast, a clear difference in movement strategy was seen in older adults where movements were faster and smoother (p < 0.05), suggestive of impaired utilization of movement-related position feedback. Future studies will determine to what extent such age-related differences in control strategy contribute to functional difficulties with tasks requiring accurate placement of the hand to the head.
FRAMEWORKS OF THE RELATIONSHIP BETWEEN HIV AND AGING AMONG HIV CLINIC PROVIDERS: A QUALITATIVE STUDY
Authors: Villalba Madeline , Schenkel Rachel , Yin Michael , Gordon Peter , Baim-Lance Abigail
Published: December 2022

As a result of advancements in antiretroviral therapy (ART), people living with HIV (PLWH) are living longer: it is estimated that 70% of PLWH in the US will be over the age of 50 by 2030, raising questions of what it means to age with HIV and how to care for these individuals most effectively. To qualitatively explore how providers who care for older PLWH and other comorbidities conceptualize the relationship between HIV and aging, we conducted 11 semi-structured interviews with physicians, RN case managers, and administrators at two health systems’ HIV clinics in New York City and the Hudson Valley between November 2019 and July 2020. We coded the interviews, developing a codebook through an iterative process, and thematically analyzed the data. Analysis revealed a range of interrelationships between HIV, aging, and comorbidities across pathophysiological and psychosocial dimensions. Providers commonly espoused that, for older PLWH, comorbidities are comparatively more difficult to manage than HIV and constitute the primary driver of pathophysiology and/or mortality. In contrast, providers viewed patients as regarding HIV as more deadly and engaging with HIV care more diligently, which providers related to patients’ long-term experiences of living through the HIV/AIDS epidemic. Providers’ comorbidity-centric framings of the clinical relationship between HIV, aging, and comorbidities mark a departure from HIV-dominant forms of thinking. Our findings have important implications for interdisciplinary care management and suggest how to support the development of asset-based approaches to encourage patient engagement with comorbidity care based on fidelity to HIV regimens.
CORRELATES OF CANNABIS USE AMONG MIDDLE-AGED AND OLDER ADULTS: FINDINGS FROM NESARC-III
Authors: Yang Kevin , Bergstrom Jaclyn , Moore Alison
Published: December 2022

Cannabis use is increasing faster among both middle-aged and older adults compared to younger adults, but its demographic and physical health correlates comparing middle-aged and older adults need further exploration. We examined data from a US representative sample of middle-aged (50–64 years, Nf8,932) and older (65+ years, Nf5,806) adults from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-IIII). We conducted logistic regression analyses to test associations of cannabis use with demographic and past-year physical health correlates and examined differences between the two age groups. An estimated 5.6% of middle-aged and 1.3% of older adults used cannabis in the past year. Compared to middle-aged adults, older adults had higher rates of cannabis use for medical purposes (15.8% vs. 12.3%, p=0.033). Both age groups had increased odds for being male (Odds Ratio (OR)=2.32 and 2.63, for middle-aged and older adults, respectively) and residing in the West (OR=1.82 and 3.04, respectively). Middle-aged cannabis users were at decreased odds for having at least some college education (OR=0.63), income >$70,000 (OR=0.37), being married (OR=0.32), and reporting excellent/very good general health (OR=0.65). Middle-aged cannabis users were at increased odds for reporting digestive disease (OR=1.96), musculoskeletal pain (OR=1.34), and nerve pain (OR=1.77), while older cannabis users were only at increased odds for reporting digestive disease (OR=2.91). Findings indicate differences in cannabis use correlates between middle-aged and older adults. With increasing legalization of cannabis nationally, improved understanding of these correlates among more recent cohorts will assist in monitoring cannabis use among the older adult population.
A FRAMEWORK FOR IDENTIFYING MAJOR RESEARCH PRIORITIES: THE CITRA RESEARCH-TO-PRACTICE CONSENSUS WORKSHOP MODEL
Authors: Pillemer Karl
Published: December 2022

The CITRA Research-to-Practice Consensus Workshop Model is an evidence-based method for identifying research priorities on aging-related topics. Its major goals are to promote knowledge translation and equal-status dialogue among stakeholders from multidisciplinary backgrounds. In this presentation, Dr. Pillemer, co-creator of the CITRA model, will provide an overview of the 5-step method: (1) Identifying a topic that is both an important challenge in aging-related policy or practice and one on which there is scientific evidence; (2) Selecting a panel of multidisciplinary experts from relevant stakeholder groups; (3) Preparing a non-technical background document that summarizes available research findings; (4) Convening multidisciplinary experts in a consensus conference involving panel presentations, discussion of the background document, and consensus activities; and (5) Preparing a final consensus report and disseminating the findings to relevant policy organizations, practice groups, and funding agencies. Common challenges and practical tips for executing each of the 5 steps will be addressed.
HEALTH DISPARITIES RELATED TO COST OF MEDICAL COVERAGE
Authors: Palmer Nathaniel , Bernstein Laura , Patrick Julie Hicks
Published: December 2022

Older age is often associated with challenges to functional ability. There are many government and private programs in place to help support the functioning of adults, including Medicaid, Medicare, and Tricare. These programs are not always effective, especially for middle aged and older adults. We examined whether cost was a barrier to receiving care and whether health insurance status acted as moderators of the relationship between age and functional ability. We used data from 379,606 adults who completed the 2020 Behavior Risk Factor Surveillance System (median age = 54.4 years; 54.2% women; 75.3% white non hispanic). The moderated regression equation was significant, F (7, 379598) 3275.74, p < .001, R^2 = .057. Although direct effects of age emerged as significant, the relation on functional ability was qualified by two 2-way interactions: age by insurance (b = .003) and age by prohibitive cost (b = .008). No other effects emerged as significant. Examination of the means revealed that lack of insurance was especially challenging to the functional ability of middle aged adults, whereas cost prohibitiveness was especially challenging for the functioning of older adults. Our results highlight the critical need to research the efficacy of health insurance policies amongst the middle aged and older populations in the United States
INVESTIGATING THE NEURAL AFFECTS OF 17 ALPHA-ESTRADIOL (17Α-E2) ON APOE4 PHENOTYPES
Authors: Roache Tavia , Pike Christian , McGill Cassandra
Published: December 2022

Aging and APOE4 genotype are the primary risk factors for late onset Alzheimer’s disease (AD). Previous drugs trials for AD have focused on amyloid beta which has yielded minimal effects; hence a drug targeting aging could prove more efficacious. 17 alpha-estradiol (17α-E2) is an enantiomer of 17 beta-estradiol that has been shown to extend lifespan in male mice. We hypothesize that 17α-E2 will improve aging related phenotypes caused by the APOE4 genotype. We enrolled 10-month-old APOE3 or APOE4 targeted replacement mice and randomized them to either control or 17α-E2 diet for 20 weeks. At weeks 15 to 17, mice underwent various behavior assays and tissues were collected at the end of the 20 weeks. We observed behavioral improvement in APOE4 mice treated with 17α-E2 and asked whether this effect is associated with: (1) change in activity or anxiety, (2) change in neural stem cells, or (3) change in microglial activation. Activity levels but not neurogenesis of microglial burden were affected by APOE genotype and 17α-E2 treatment, suggesting a potential contribution to observed memory improvement in APOE4 mice treated with 17α-E2. Continued research on the neural effects of 17α-E2 pose potential benefits to mitigate the effects of aging.
CONVENING A NATIONAL CONSENSUS CONFERENCE TO PROMOTE DEMENTIA CAREGIVERS' ENGAGEMENT AND SUPPORT IN CARE DELIVERY
Authors: Griffin Joan
Published: December 2022

The goal of the 2021 Conference on Engaging Family and Other Unpaid Caregivers of Persons with Dementia in Healthcare Delivery, funded by the NIA, was to establish a policy- and practice-aligned research agenda for enhancing dementia caregivers’ engagement and support in health and long-term care settings. Using the CITRA model as a guiding framework, Dr. Griffin will discuss important planning decisions leading up to the event, including the formation of a Steering Committee, selection of expert panelists and conference participants, and preparation of the non-technical background report. Her presentation will also describe the format of the consensus conference itself, focusing on the structure of the panel presentations and consensus activities, including small group breakout sessions in which conference attendees were charged with generating research recommendations; the process for voting on and prioritizing the identified recommendations; and method for refining and organizing the recommendations into major priority areas.
USING VIRTUAL REALITY IN AGED CARE SETTINGS: A SCOPING REVIEW
Authors: Hung Lillian , To-Miles Flora , Kan Winnie , Temirova Alisha , Mann Jim , Wallsworth Christine
Published: December 2022

Recent advancement of virtual reality (VR) technology has led to growing interest in using VR in aged-care settings. VR can help ameliorate experiences of loneliness and social isolation, which is especially important during the COVID-19 pandemic. As a result, increasingly more studies are being published on this topic, and a comprehensive review of studies examining the facilitators and barriers of adopting VR in these settings is needed. This scoping review reports the facilitators and barriers to implementing VR in care settings among older adults, as well as the impact on social engagement and/or loneliness. We followed the Joanna Briggs Institute scoping review methodology, and searched the following databases: CINHAL, Embase, Medline, PsycInfo, Scopus, and Web of Science. Inclusion criteria includes articles published in the last five years that focus on older adults using VR in aged-care settings. 199 articles were retrieved and 21 articles were included in our review. Most of the articles (38%) originated from Australia. Key facilitators for using VR in aged care settings are the technology being user-friendly, comfortable, and easy to clean. Barriers included: technology issues (e.g., internet connectivity), staff attitude/ worries, and impact on residents, and structural considerations (e.g., lack of staff and time to assist with the VR program). VR technology can decrease loneliness and feelings of isolation, and provide opportunities to engage with others. Our review of the current evidence offers insights and recommendations for health care professionals to use VR technology in aged care settings, maximizing benefits and minimizing risks among users.
RETHINKING NURSING HOME ARCHITECTURE AND DESIGN IN THE LIGHT OF THE COVID-19 PANDEMIC
Authors: O’Neill Desmond , Grey Tom , Xidous Dimitra , O’Donoghue Jennifer , Puntambekar Mehak
Published: December 2022

Introduction

The huge death rate in nursing homes during the COVID-19 pandemic raised serious questions as to whether the built environment of nursing homes was a factor in this very high mortality, as well as a factor in quality of life.

Method

We embarked on a wide-ranging study involving a review of Irish policy, stakeholder engagement, Irish case studies, literature review, and international case studies to understand the key issues that influence the planning, design, and operation of nursing home settings settings, and to identify how these shape care models and the physical environment.

Results

The project generated the following key themes: a) including the voices of residents, family and staff in co-creation of design and research; b) integrating nursing homes with the overall housing spectrum; c) linking nursing homes with ageing in place policy; d) further research on optimal design; e) understanding resident diversity; f) greater inclusion of Universal Design principles; g) designing for resilience; and h) Convergence between infection control and quality of life Discussion: Our Research Findings have been developed to identify major current issues related to the built environment and its role in creating a balance between quality of life and COVID-19 infection control in Irish and international nursing home settings. These findings are relevant for a wide range of stakeholders and will be disseminated across a number of channels to continue this conversation and help to continue the evolution of nursing home design.
MEASURING WORKPLACE LEARNING CONDITIONS FOR NURSING STAFF IN LONG-TERM GERIATRIC CARE
Authors: Van Lierop Merel (E A ) , Meijers Judith , van Rossum Erik , Zwakhalen Sandra
Published: December 2022

To deal with challenges in practice such as workload and complexity in long-term care delivery, learning in practice (workplace learning) is becoming increasingly important. Nursing staff needs to take the lead and learn continuously in practice using a bottom up approach to promote workplace learning. Therefore, insight in workplace learning conditions (like work culture and learning climate) in long-term care is necessary. Based on these insights, nurses can define challenges and goals on how to stimulate workplace learning. Currently, no instruments are available that measure these conditions in the long-term nursing care setting in a snap shot. Therefore, the goal of this study was to develop a quick-scan to measure workplace learning conditions for nursing staff in long-term geriatric care. This quick-scan was developed in 3 steps: (1) investigating how to measure conditions for workplace learning, (2) selecting appropriate measurement tools to measure conditions for workplace learning, and (3) testing the feasibility of the quick-scan in practice. As a result, the final feasible quick-scan measured 11 conditions regarding workplace learning: (1) Trust: values and culture, (2) Team: support and management, (3) Colleagues: support and respect, (4) Constraints in undertaking the job, (5) Urgency, (6) Learner agency, (7) Collaboration, (8) Hybrid learning, (9) Coaching, (10) Flexibility – formal and informal learning, and (11) Assessment-as-learning. Additionally, questions were added regarding availability of sources for learning, knowledge and skills, and communication. Validated questionnaires that were included were the Culture of Care Barometer and HILL model questionnaire.
CALL FOR ACTION: STRENGTHENING LONG-TERM CARE IN NEPAL
Authors: Dhakal Usha , McLaughlin Sara
Published: December 2022

This paper aims to introduce the existing long-term care (LTC) system in Nepal, identify key emerging issues, and provide possible policy recommendations for addressing weaknesses in the current system. Although the majority of older Nepali adults rely on their adult children for care, this traditional care arrangement is weakening for a variety of reasons. As a result, older Nepali adults increasingly seek care elsewhere such as “old age homes” (OAH), which generally meet only their basic needs. More recently, adult day centers have been established that enable older Nepali to receive help with personal care and instrumental tasks and/or health care needs in the absence of their families; however, they are primarily located in big cities and largely limited to those who can afford to pay. With a growing older population and societal changes that make familial care increasingly challenging for adult children, the Government of Nepal must foster the development of a sustainable system of LTC. This will necessarily involve building and sustaining a skilled geriatric workforce, capitalizing on the natural “villages” that have existed in Nepal for hundreds of years, and standardizing and monitoring the operation of LTC facilities. Additionally, public service campaigns to help destigmatize the use of OAH and day centers and integration of home and community-based services to make care arrangements locally could help make these newer LTC approaches more acceptable. Finally, nationally representative studies aimed at understanding the health and care needs of Nepal’s rapidly increasing older population is of utmost priority.
THE EFFECT OF SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM GENEROSITY ON DEPRESSIVE SYMPTOMS AMONG OLDER AMERICANS
Authors: Lu Peiyi , Kezios Katrina , Zeki Adina , Hazzouri Al
Published: December 2022

Food insecurity has been indicated to associate with more depressive symptoms. Supplemental Nutrition Assistance Program (SNAP) is an established anti-poverty government program that targets food insecurity. The goal of this study was to assess whether SNAP generosity, defined at the state level, impacts the relationship of food insecurity and depressive symptoms among older Americans. We linked state-level SNAP policy data to the individual-level data of older adults (aged 60+) from the longitudinal Health and Retirement Study (Nf12,801). Our study baseline was survey year 2000. A state is considered SNAP generous when it eliminates income/assets limit from its SNAP eligibility criteria. All HRS participants reported their food insecurity status and depressive symptoms biennially. Participants were followed until 2018. We conducted state fixed-effect models adjusted for demographic and health measures. Results indicate household food insecurity was associated with higher risk of elevated depressive symptoms (OR=1.83, 95%CI=1.61, 2.07) from a fixed effect logistic model, and this effect was stronger when living in non-generous states compared with generous states though confidence intervals were too wide to be conclusive (OR_interaction =1.09, 95% CI= 0.83, 1.42). The relative excess risk due to interaction (RERI) was 0.17 (95%CI= -0.30, 0.63). Our study finding suggested that there is no to weak evidence that state-level SNAP generosity may alleviate or offset the risk of depressive symptoms associated with food-insecurity.
A COLLABORATIVE AUTOETHNOGRAPHY OF FOREIGN-BORN FACULTY IN THE FIELD OF AGING
Authors: Liou Chih-ling , Kalaw Karel
Published: December 2022

We draw from our personal insights as foreign-born females in the U.S. to explore how our minority status has affected our experiences/identities as faculty in the field of aging. We practiced intersectionality by considering how our understandings of “foreignness” in academia and the aging field are intertwined with other markers of difference, including race, national origin, language, and academic programs. We also draw from tenets of collaborative autoethnography to engage two autoethnographies from two countries in Asia to pool their lived experiences and collaboratively analyze and interpret them for commonalities and differences. We begin by sharing stories about graduate study pursuits and becoming faculty in the U.S. We note how our foreignness shapes our lives as aging scholars in the U.S. academy and our personal views on aging. After exchanging our first set of writings, we identified key experiences to focus on in the subsequent writing periods. Our minority backgrounds, teaching aging subjects, and using qualitative methodology are shared identification. However, our personal stories within the U.S. society and within the academy also diverge our identities and aging experiences from each other. Moreover, the themes that deal directly with identity development and the perception of aging provide a deep understanding of aging among the non-native-born population. This study highlights the value of collaborative autoethnography as a method of inquiry and reflection. Findings demonstrate that non-native-born female faculty in the field of aging faced multi-faceted challenges in both professional and personal realms. Implications for supporting foreign-born female aging scholars are discussed.
ENGAGING AND SUPPORTING FAMILY CAREGIVERS IN CARE DELIVERY: RECOMMENDATIONS FROM A NATIONAL CONSENSUS CONFERENCE
Authors: Riffin Catherine
Published: December 2022

This presentation, by Consensus Conference Director, Dr. Riffin, will describe the major priorities identified by the 2021 Conference on Engaging Family Caregivers of Persons with Dementia in Healthcare Delivery. Recommendations centered on the need for multidisciplinary collaborations that attend to (1) Identification and assessment of dementia caregivers in care delivery settings, (2) Reimbursement and financing for caregiver assessment and support, (3) Caregiver training and support across the care continuum, (4) Healthcare provider education on family-centered care, and (5) Technology innovations that support dementia caregivers. Across all areas, there was consensus regarding the need to leverage implementation science to promote the uptake of evidence-based interventions in clinical practice and use community-driven approaches to engage stakeholders from traditionally marginalized groups in future and ongoing initiatives. Findings are being used to inform federal agencies and foundations about high-priority areas, provide guidance to national committees, and accelerate programmatic research on caregiver engagement and support.
EMERGENCY DEPARTMENT USE FOR DENTAL PROBLEMS AMONG MEDICARE FEE-FOR-SERVICE OLDER ADULTS IN THE U.S. (2016 TO 2020)
Authors: Dahal Roshani , Jarosek Stephanie , Virnig Beth
Published: December 2022

Medicare Fee-for-Service (FFS) does not include dental coverage for older adults (65 years of age and older) but does cover emergency visits for dental problems. This study leverages Medicare Limited Data Sets to examine the use of emergency department (ED) for preventable, non-traumatic dental conditions (NTDCs) among Medicare FFS older adults from 2016 to 2020. Nationally, ~43.6 million beneficiaries sought care at the ED (average: ~8.7 million annually). Among these, ~550,000 ED visits (1.27%; ~110K annually) were for NTDCs as one of the diagnosis codes and ~200,000 ED visits (0.45%; ~40K annually) were for NTDCs as a primary diagnosis. Approximately, 5–6% of older adults with ED-NTDCs have multiple visits (94% with 1 ED-NTDC visit annually). Rates were similar in most years; however, ED use was lower in 2020 (COVID-19 pandemic). The most common diagnosis reasons include periapical abscess (tooth infection), sialadenitis, dental caries, jaw pain, and lesions of oral mucosa. Younger (65 to 74 years) and Black older adults were more likely to have primary ED-NTDC visits. Medicare paid ~$190 million for ED-NTDC visits (average: $38 million annually). Costs vary by inpatient (9%) and outpatient visits (91%). For ED-NTDCs as a primary diagnosis, the average Medicare payments for outpatient and inpatient visits were approximately $330 and $8,100, respectively. ED use for NTDCs indicates inappropriate use of valuable resources, because care provided in the EDs is incomplete (e.g., antibiotics, pain medication). Lack of follow-up with a dentist likely results in return ED visits, thus increasing costs to beneficiaries and public programs.
CHILDHOOD ADVERSITY IMPACTS PERSONALITY DEVELOPMENT ACROSS ADULTHOOD
Authors: Miller Sarah , Willard Meredith , Alderson Jacob , Turiano Nicholas
Published: December 2022

Throughout adulthood, people’s personalities typically change favorably such that agreeableness and conscientiousness increase, and neuroticism decreases. However, the impact of early life adversity on these changes in personality has yet to be examined. We utilized data from 6,382 community dwelling adults (ages 25–75) that completed 3-waves of the Midlife Development in the U.S. Study (MIDUS) in 1995–96, 2005–06, and 2013–14. Early life adversity was computed using 16 retrospective items assessing emotional and physical abuse, socioeconomic disadvantage, familial instability, and early-life poor health. Personality was assessed with the Big 5 MIDI measure. Latent growth curves confirmed there was significant variability in change over the ~20 year follow-up (all RMSEAS < .06; and CFI/TLI > .96). More specifically, higher levels of early adversity predicted higher initial levels of neuroticism, and lower levels of conscientiousness and extraversion. Additionally, higher adversity predicted a steeper decrease in neuroticism across 20-years (all p’s < .05). Examination of specific adversity types revealed that emotional abuse and having poor health at a young age were especially detrimental to personality development. This research provides evidence that high levels of adverse experiences in childhood predict unfavorable personality development throughout adulthood. Moreover, this research demonstrates that early life adversity, especially certain types, can have lifelong detrimental effects on development. Interventions for those who have experienced adversity should be implemented as early in life as possible to prevent suboptimal psychological development trajectories. Such interventions could improve life outcomes if personality development is more normalized.
‘THEY ASKED ME TO JOIN; I JOINED:’ LESSONS FOR SENIOR CENTERS ON SUPPORTING PHYSICAL ACTIVITY
Authors: Chard Sarah , Schumacher John
Published: December 2022

Among older adults, physical activity (PA) remains a foundation for maintaining and improving health. However, over 25% of adults aged ≥ 50 engage in no physical activity outside of work hours (CDC 2016). PA does correlate with senior center participation but little is known about the social factors that contribute to sustaining senior center PA routines. We report on findings from qualitative interviews conducted with Black older adults (Nf22) on the “story” of their senior center involvement, particularly their PA participation. Interviews were recorded and transcribed verbatim; co-authors independently conducted a line-by-line analysis to identify themes. They then reconciled and sorted themes. Four themes provided insights on participants’ PA engagement: 1) Retirement as opportunity; 2) Invitation and welcome; 3) Physician messaging; and 4) Sense of community. Participants strongly connected retirement with the opportunity to engage in regular PA; work and family obligations previously prevented PA in daily life. Participants also linked trying new PA programs to the senior center’s culture of extending one-to-one invitations. Physician messaging specifically “to exercise” provided additional validation for prioritizing senior center PA within daily schedules. Finally, a sense of community, of being missed if not attending, provided further incentive to sustain PA routines. These findings provide guidance and simple lessons that senior centers can employ to encourage participation in their PA programming. The themes may also inform the design of survey research examining patterns of PA among older adults.
PHYSICAL ACTIVITY IN DEMENTIA PATIENTS AND CAREGIVERS
Authors: Kakarla Prabhash , Ramirez Madieska , Alvarez Jessica , Gieniusz Marzena , Swartz Ann , Tarima Sergey , Nouryan Chris , Burns Edith
Published: December 2022

Many studies have explored the benefits of physical activity (PA) in mitigating risk for and symptoms of dementia. However, there are challenges to implementing PA with dementia patients. We conducted an acceptability/feasibility study of PA in patients with Dementia and their caregivers. A semi-structured telephone interview was conducted. Questions piloted with 2 independent faculty for content validity. A random sample of 10 participants was recruited from patient-caregiver dyads enrolled in an Alzheimer’s Dementia Care program (ADCP) at an academic geriatrics practice. Responses manually recorded and personal health information omitted. Descriptive statistics generated using SPSS and response themes categorized by the authors. Major themes included lack of time for caregivers; time requirement would increase caregiver burden (50%). Caregivers of patients with home health aides were less likely to consider time a barrier. Other themes included functional status as a challenge (40%), difficulty motivating patient (40%), unsteady gait (20%), difficulty using devices for video-based exercise (20%). Caregivers expressed preference for asynchronous, in-home PA that could be adapted to their schedules and patient capabilities. Although PA is beneficial for patients with dementia, multiple challenges to PA implementation exist. Main barriers are time requirements and greater caregiver burden. Time would be required to motivate patients, assist with managing technology, and functional impairment that poses potential risk of injury (e.g., gait instability). Engaging Home Health Aides in PA programs could address some of these barriers. Alternative PA (i.e.: chair exercises) could be a solution. Responses will be utilized to modify a future PA intervention.
OBESE AFRICAN AMERICAN OLDER WOMEN’S EFFECT OF EXERCISE TRAINING ON HEALTH CAPABILITIES AND LIFE SATISFACTION
Authors: Cho Dongwook , Kim Sung Kyeom
Published: December 2022

The purpose of this study is to determine whether a 12-week exercise course influences obese African American older women’s health capabilities and life satisfaction levels. Participants, who passed an initial screening and pre-assessment, were asked to measure current health capabilities and life satisfaction levels both prior to, and following, the 12-week exercise training. Researchers found that improvement in health capabilities, although there were no significant differences following exercise training participation, while obese African American older women had significantly higher life satisfaction levels. The findings suggest that a 12-week exercise training can be beneficial to enhance obese African American older women’s health capabilities and life satisfaction levels. Professionals in the field of gerontology and exercise should provide the appropriate exercise trainings so that obese African American older women would be able to optimize their life satisfaction levels.
INFLUENCE OF ASPIRIN ON AGING SKELETAL MUSCLE SIZE
Authors: Fountain William , Naruse Masatoshi , Claiborne Alex , Finch Holmes , Trappe Scott , Trappe Todd
Published: December 2022

Aspirin is one of the most commonly consumed cyclooxygenase (COX)-inhibitors and anti-inflammatory drugs and may provide insight into the control of age-related skeletal muscle atrophy. This investigation compared skeletal muscle size (via computed tomography) of older individuals from the Health ABC study that did not consume aspirin or any other COX-inhibiting drug (non-consumers; n=1,155, 74±3y, 48% women, 45% black) to those that consumed aspirin daily (and not any other COX-inhibiting drug) and for at least one year (aspirin consumers; n=515, 74±3y, 39% women, 30% black, average aspirin consumption: 6y). In white and black men, the long-term aspirin consumers had significantly larger quadriceps muscle size compared to non-consumers (p < 0.05). In white men only, these differences were influenced by age (p < 0.05). In white and black women, quadriceps muscle size was not different between the aspirin consumers and non-consumers (p>0.05). In men and women of either race, there was no hamstrings muscle size difference between the aspirin consumers and non-consumers (p>0.05). These data suggest that long-term regulation of the COX pathway with the common over-the-counter drug aspirin may impact aging muscle mass in a sex and muscle group specific fashion, which is supported by previous mechanistic human and animal studies.
EFFECTS OF FLAVANOL (+)-EPICATECHIN ON SKELETAL MUSCLE OF AGED RATS
Authors: Ramirez-Sanchez Israel , Navarrete Viridiana , Galera Leonor , Villarreal Francisco
Published: December 2022

Sarcopenia is a progressive and generalized age-related skeletal muscle (SkM) disorder characterized by the accelerated loss of muscle mass (atrophy) and function. SkM atrophy is associated with increased incidence of falls, functional decline, frailty and mortality. In its early stage, SkM atrophy is associated with oxidative stress, increased pro-inflammatory cytokine levels and proteasome-mediated protein degradation. These processes also link to the activation of atrophy associated factors and signaling pathways which lack any approved, targeted pharmacotherapy. We have characterized the capacity of flavanols specifically, epicatechin to favorably modulate SkM mass and function in animal models of SkM disease and in proof of concept studies in humans including muscular dystrophies. In this study we wished to evaluate the capacity of this flavanol to ameliorate aging associated sarcopenia. Using 24-month-old male rats a 4 week oral administration of the flavanol (+)-epicatechin (1mg/kg/day) was implemented while control rats only received vehicle (water). SkM strength (grip) and endurance (treadmill walk), muscle size, (muscle mass, cross sectional area of fibers), ubiquitin-proteasome atrophic pathway (including myostatin, Murf1 and Atrogin1 by Western blots) and markers of oxidative stress and inflammation in gastrocnemius were quantified. We also analyzed a relevant protein synthesis pathway (IGF/AKT/mTOR). The use of (+)-epicatechin in aged rats led to significant changes as follows: 1) improved SkM mass and function, 2) downregulation of atrophic pathway, 3) reduced levels of oxidative stress and proinflammatory cytokines and, 4) upregulation of protein synthesis pathway. Given its safety and tolerance profile this agent warrant its rigorous investigation in clinical trials.
EFFECTS OF A SIX-MONTH EXERCISE PROGRAM ON PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH CHRONIC CONDITIONS
Authors: Malani Revati , Erlenbach Emily , McAuley Edward , Gothe Neha
Published: December 2022

Health benefits of structured physical activity (PA) for older adults have been well documented. Older adults are highly impacted with major chronic conditions, leading to limitations in daily activities. This study examined the effects of an exercise program on moderate-vigorous physical activity (MVPA) and sedentary time after six months of exercise. Participants from a larger-ongoing trial were randomized into either yoga, aerobic or stretch-tone groups. A subsample of 58 participants was classified as chronic individuals (CI) based on presence of at least one chronic condition, and 31 as healthy individuals (HI), who completed accelerometer measures before and after the exercise program. A repeated measures analysis was performed to identify changes in PA over time for HI and CI. At both time-points, MVPA was significantly higher for HI. There was a significant increase in MVPA at month six for all participants, irrespective of health status. Mean MVPA in minutes for baseline HI: 153, CI: 98 and for month 6 HI: 188 CI: 116. There were no significant differences in sedentary time after the six-months of exercise. Although there was an increase in MVPA for HI and CI after structured exercise, no change was noted for sedentary time. Increased sedentary time has been proven to be a risk factor for poor health and although meeting criteria for MVPA is important, it is essential to address sedentary time in CI by implementing educational and interventional components that focus specifically on sedentary time. Funding: This data is from NCT04323163 funded by NIH-NIA – grant-AG066630.
DOES TAI CHI PROMOTE COGNITIVE FUNCTION WITHOUT THE EFFECTS OF PHYSICAL FUNCTION?: META-REGRESSION APPROACH
Authors: Song Rhayun , Park Moonkyoung , Shin Jacqueline , Gao Xianqi , Li Yuelin
Published: December 2022

This systematic review aimed to examine the effects of TCQ on cognitive and physical functions in older adults using a meta-regression approach. The systematic search in 13 electronic databases identified 19 randomized studies (n=2365, mean age=70.3 years) published in English (k=17), Korean (k=1) and Chinese (k=1). A review of bias was assessed by two raters according to Cochrane RoB 2.0, resulting in low risk (k=6), some concern (k=12), and one high-risk study. Tai Chi (k=16) and Qigong (k=3) were applied for an average duration of 20.2 weeks. The control groups received either alternative exercise (k=14) or no treatment (k=5). The results of the meta-analysis on 19 RCTs using a random-effects model showed the significant effect of TCQ on cognitive function (Hedges’s g =0.32, 95% CI= 0.18, 0.46) and physical function (Hedges’s g= 0.35, 95% CI= 0.21, 0.49). In addition, meta-regression was used to explore the effect size of TCQ in association with the level of physical function. The effects of TCQ on cognitive function remained significant (Q=38.86, p=.003) when controlling for the effect of physical function in this model (unexplained variance = 0.0199). The coefficient of the physical function was significant (b=0.47, p=.008), showing that 58% of heterogeneity was explained by physical function as a moderator variable. It confirmed that changes in physical function were associated with changes in cognitive function. The findings imply the potential health benefits of TCQ in promoting cognitive function among older adults directly and indirectly through improving physical function.
CONSTRUCT VALIDITY OF EXERCISE ADHERENCE RATING SCALE IN COMMUNITY DWELLING OLDER WOMEN: PROOF OF CONCEPT
Authors: Graham Helen , Scott Judith , Benton Melissa
Published: December 2022

Exercise is an effective health promotion strategy that has a positive effects on frailty and sarcopenia, particularly in older women, yet they do not adhere to exercise guidelines. Accurate assessment is critical for clinical management and research with this population. Interviews and exercise logs are most commonly used to assess adherence to exercise. However, they are burdensome and not highly reliable. A brief validated measure of exercise adherence for assessment is greatly needed. The six-item Exercise Adherence Rating Scale (EARS) was originally validated among a clinical orthopedic population but not been used in community-dwelling adults. Our aim was to determine the feasibility of using the EARS to assess exercise adherence among community-dwelling older women. Twelve women (age=72±7 years) completed one-time assessment for this proof-of-concept study. For the EARS, overall Cronbach’s alpha was 0.78 with inter-item correlations of 0.72–0.89 for all but item three that pertains to healthcare professionals (correlation of 0.27). When item three was removed, overall Cronbach’s alpha increased to 0.80. Correlation analysis with the reduced five-item scale demonstrated good construct validity. There were significant relationships with global quality of life (r=0.76, p < .01) and physical function (r=0.61, p < .05). There were also moderate to strong relationships with variables expected to be linked to exercise adherence including mobility (r=0.57), BMI (r=0.51), vigorous (r=0.40) and moderate (r=0.36) exercise, upper body strength (r=0.41) and lower body strength (r=0.30). Based on these findings use of a five-item version of the EARS is feasible and appears to be a valid measure of exercise adherence.
THE IMPACT OF THE OLD AGE PENSION EXPANSION ON BLOOD PRESSURE AMONG OLDER MEN IN RURAL SOUTH AFRICA
Authors: Chang Haeyoon , Jock Janet , Rosenberg Molly , Kobayashi Lindsay
Published: December 2022

The impact of improved socioeconomic welfare after retirement on cardiovascular health among older men in low-income settings is unknown. Using natural experiment, we investigated the impact of eligibility for additional Old Age Pension (OAP) income on systolic blood pressure (SBP) among older men in rural South Africa using data from 1,208 men aged ≥60 in the population-representative “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in Rural South Africa” (HAALSI) cohort. The South African Old Age Pension (OAP) incrementally expanded age eligibility for men from age 65 prior to 2008 to age 60 in 2010. This expansion provided exogenous variation in pension income among men, based on their year of birth. We estimated predicted SBP among the birth cohorts of men who were eligible for one through five extra years of OAP income, using a multivariable linear regression model estimated in those without access to extra pension income (over age 65 when the expansion rolled out) based on covariates. We then estimated mean SBP difference scores among men in each of these five birth cohorts, based on their observed SBP minus predicted SBP. Men in OAP expansion birth cohorts had lower SBP than those who were not exposed to extra pension, although the differences were not statistically significant (5-years estimate = -2.735 (p=0.353) vs. 1-year estimate = 1.633 (p=0.531)). This trend suggests a possible long-term benefit of blood pressure control with greater cumulative pension income among men living in rural, low-income settings.