bluuebunny/crossref_metadata_2025 huggingface dataset:
THE PUBLIC HEALTH IMPLICATIONS OF DEMENTIA CAREGIVING: NATIONAL AND STATE-LEVEL VARIATIONS
Authors: Gaugler Joseph , Johnson Elma , Koffski Maya , Denno Benjamin , Baumgart Matthew , Belza Basia , McGuire Lisa
Published: January 2025

Unpaid dementia care has emerged as a public health priority. Specifically, dementia caregiving influences the health of those providing assistance (e.g., family members, friends) and recipients of care. However, the intensity of care provision and its health implications are often disproportionate within the population. Public health can engage in various initiatives to address such disparities, including improving surveillance of dementia caregivers with greater precision; engaging in outreach and education about the potential health risks of dementia care; and coordinating initiatives across traditional silos (e.g., public health, aging service providers, healthcare systems) to result in more available, accessible, and ultimately effective dementia care. Relying on 2021-2022 data from the Behavioral Risk Factor Surveillance System data from 47 states, we conducted a series of three-way cross-tabulations between dementia caregivers, non-dementia caregivers, and non-caregivers to ascertain key disparities and contextual factors that could serve as subsequent health targets. Nationally, although dementia caregivers provided more extensive help to care recipients for longer periods, variations in other domains (e.g., lifestyle behaviors) were less apparent nor consistent. More crucially, those patterns of statistical differences that emerged in the national analysis were far more variable and diverse when considering specific states, suggesting the urgent need for granular, more local data sources to better inform services, supports, and public health action to support dementia caregivers.
SOME WHOS, WHYS, AND HOWS OF BEING MORE DEMENTIA-INCLUSIVE IN AND BEYOND THE CLASSROOM
Authors: Montepare Joann
Published: January 2025

Demographic statistics predict a dramatic rise in the incidence of dementia (D) and Alzheimer’s disease (AD) as populations age. An estimated 5.3 million Americans were diagnosed with D/AD in 2015, and national predictions are that the number of adults diagnosed with D/AD will rapidly grow each year as the size of the population aged 65 years and older continues to increase (CDC, 2018). As such, researchers, practitioners, and policy makers have called for examining more broadly how we can develop interventions that target stigma, knowledge, diagnosis, resilience, caregiving, and related issues. An important, although overlooked, component of this call is developing educational opportunities for young adults. To this end, this presentation will describe research that aimed to gather information about undergraduate students’ dementia experience, knowledge, and concern. Specifically, a survey of 106 students distributed in diverse classes found that more than 50% of students had experience with someone with D/AD, showed low levels of knowledge, expressed strong concern about developing D/AD, and had an interest in educational activities. As well, this presentation will argue why efforts to be more dementia-inclusive should be incorporated into contemporary age-inclusive initiatives in higher education (Age-Friendly University/AFU, Age Inclusivity Domains of Higher Education/AIDHE). Finally, several activities in (TimeSlips) and beyond the classroom (Dementia Friends) will be described to show how experiential learning opportunities about dementia can be mounted.
USING NCI-AD FOR LONG-TERM SERVICES AND SUPPORTS AGING AND DISABILITY SYSTEM IMPROVEMENT
Authors: Giordano Stephanie , Plasencia Rosa
Published: January 2025

National Core Indicators Aging and Disabilities (NCI-AD™), survey data support State Medicaid, aging, and disability agencies to conduct surveys with individuals receiving publicly-funded long-term services and supports and measure and track their own outcomes and performance using reliable data collection methods and tools. Established in 2015, NCI-AD is now in use by 23 states nationwide. The NCI-AD portfolio includes the flagship survey – the Adult Consumer Survey (ACS) and the State of the Workforce—Aging and Disabilities (SotW-AD) survey. The ACS collects data directly from older adults and people with physical disabilities to assess the outcomes of services provided to individuals. Indicators address key areas of concern including service planning, rights, community inclusion, choice, health and care coordination, safety and relationships. In 2022, NCI-AD piloted the SotW-AD is a first of its kind for the aging and disabilities field, this new effort collects and aggregates statewide information about wages, benefits, and turnover of the direct service workforce—as reported by the agencies that employ them. This session will provide an overview of the NCI-AD program, the type of data collected from each survey, and how state-level and research partners have utilized the data sets. Additionally, 18 NCI-AD measures are included in the newly released CMS HCBS Quality Measure Set. We will discuss how this impacts states, and potential ways that these and other measures will be implemented and used to support important aspects of services access and equity.
PRINCIPLES OF QUEER GERONTOLOGY
Authors: Fabbre Vanessa , Oswald Austin , Jen Sarah
Published: January 2025

Gerontology has advanced greatly in recent decades in its attention to the lives of LGBTQ+ people. To this end, an increasing number of scholars have argued for a queering of gerontologists’ understanding of the human life course, as well as a queering of the field of gerontology itself. Yet, to date there exists no clear articulation, in practical terms, of what queer gerontology is and how it could be applied to scholarship and activism. Coming from a first-person, reflexive position, we argue that a clear vision of queer gerontology should be based on scholars’ historical use of queer theory to challenge normative ideas about the self and social life. In this presentation we will briefly present the historical landscape of LGBTQ+ aging studies, with an emphasis on recent conceptual and methodological advances, followed by a description of the iterative process through which we (as both early and mid-career scholars) developed the following five principles of queer gerontology: 1) Deeping Visibility and Awareness, whereby the identities and lives of LGBTQ+ and all oppressed peoples are elevated and illuminated; 2) Developing and Applying Critical Perspectives, whereby concepts and theories that challenge the status quo are engaged; 3) Challenging Oppression and Injustice, whereby critical theories are explicitly used to guide social change efforts; 4) Engaging Multiple Epistemologies and Modes of Inquiry, whereby scholars actively promote and use various approaches to scientific and social inquiry; and 5) Fostering Transdisciplinary Advancement, whereby scholars seek out and develop relationships that transcend traditional disciplinary boundaries.
RESHAPING LONG-TERM CARE SYSTEM INTO A SUSTAINABLE AND HIGH-QUALITY HEALTHCARE FIELD GLOBALLY: IT IS POSSIBLE!
Authors: McGilton Katherine , Spilsbury Karen , Thompson Carl
Published: January 2025

Years of investigation have revealed that despite compelling evidence, long-term care (LTC) home policies and procedures remain resistant to change. Globally, LTC homes grapple with subpar labor conditions stemming from structural and institutional elements, resulting in precarious work environments for its workforce. The revitalization of the LTC necessitates immediate attention to adequate staff and skill mix and innovative models of care to enable effective and person-centered care of residents. In this symposium, we will present an interactive overview and discussion of the work from international researchers exploring sustainable recruitment and retention of the LTC workforce, optimal staff and skill mix and initiatives for the intricate care requirements of residents and to mitigate precarious work conditions for the workforce. Specifically,: 1. Dr. Devi’s team presents findings from a Realist Review called the REACH including an explanatory framework to implement strategies to attract, recruit and retain LTC staff. 2. Dr. Montse and team highlight findings from a narrative review of measures taken by national European administrations to optimize working conditions for the LTC workforce including during the COVID-19 pandemic. 3. Dr. Bleijlevens and colleagues present the successful implementation of DAIly NURSE Intervention that transformed breakfast time for LTC residents. 4. Dr. McGilton and team implemented and evaluated the impact of nurse practitioner-led huddles that helped reduce moral distress amongst staff. 5. Prof. Zúñiga’s team prepares the scale-up of a registered nurse-led care model strengthening their geriatric expertise to reduce unplanned hospitalization for LTC residents.
REQUIREMENTS FOR POLICY MEASURES THAT FAVOR BETTER WORKING CONDITIONS FOR THE LONG-TERM CARE WORKFORCE IN EUROPE
Authors: Gea-Sánchez Montserrat , Mateos Jose
Published: January 2025

There is a need to improve key working conditions, such as low wages, high rates of part-time employment, and insufficient autonomy and support for workers. In addition, the pandemic has highlighted the need for better coordination between the long-term care sector and the wider health system, and recruitment and training policies must be accompanied by strategies to improve management within the sector. A narrative review of the main measures carried out by several national European administrations to improve working conditions in long-term care was conducted. Documentation was retrieved from a scientific literature review, grey literature and key informants (n = 9). The results of the review suggest that the long-term care sector suffers from structural deficiencies that were accentuated during the COVID-19 pandemic. Among these deficiencies the following were highlighted: the lack of professionals in long-term care mainly due to poor working conditions and gaps in training and role definition, especially for nurses. Measures to reverse this situation, such as the integration of new technologies or the replacement of nurses by other professionals who have acquired some of their competencies have been implemented in some European countries. These measures, in addition to being insufficient, may lead to a decline in the quality of care. Persistent problems of high turnover and low retention pose a threat to both accessibility and quality of services.
“KEEP AN EYE ON MY PLACE”: THE DYNAMICS OF SOCIAL CONNECTION FOR OLDER ADULTS LIVING IN SUBSIDIZED HOUSING
Authors: Cudjoe Thomas
Published: January 2025

Social isolation is a burdensome problem for low-income older adults. Many low-income older adults live in subsidized housing. However, few studies have examined this problem in this context. We sought to understand processes that may facilitate, or are barriers to social connections in older adults who live in this setting. We conducted in-depth semi-structured interviews with a purposeful sample of older adults living in subsidized housing communities in Baltimore City. Many residents had a small but meaningful residential network, facilitated by housing characteristics that support connection. Overall, though, residents were cordial but not connected. Challenges related to aging, the undesirable behaviors of others, and a desire for privacy limited social connections or hindered meaningful connection and led to social isolation within the housing communities.
THE LONG-TERM RELATIONSHIP BETWEEN SENIOR HOUSING, SOCIAL ISOLATION, AND COGNITIVE DECLINE
Authors: Park Sojung , Jeon Gyeahyung , Kwon Eunsun , Kang Ji young
Published: January 2025

Community-based senior housing has been advocated as an alternative living environment that promotes a sense of community. This study explores the long-term relationship between living in senior housing, social connection, and cognitive decline. Data came from the 12 waves (year 2010-2022) of the National Health and Aging Trends Study (NHATS) in the U.S. to compare two groups (Traditional Housing and Senior Housing) of older individuals aged 70 and over (Obs=50,128 in TH & 6078 in SH). We analyzed a long-term pattern of social isolation and cognitive function and examined the impacts of social isolation on changes in cognitive function by income groups. Weighted propensity score matching to ensure comparability between the two groups. To focus on the relations during the pandemic, we conducted a Synthetic Difference in Difference (SDID) analysis. In both housings, social isolation increased, and cognitive function decreased over a 12-year period. The regression analysis showed a clear pattern of drastic drops and recovery in the level of social isolation and cognitive function. Compared to senior housing, residents in traditional housing were likely to experience increased social isolation [coef: 0.20, p<0.001] and decreased cognitive function [coef: -0.79, p<0.01]. A series of subgroup analyses showed the protective effect of senior housing was pronounced for low-income older adults. With the long-term evidence about the protective effects of senior housing within the context of the COVID-19 pandemic, our study provides a rigorous basis for much-needed future research to identify core factors and mechanisms for healthy aging among low-income senior housing residents
THE ASSOCIATION BETWEEN LONELINESS AND CHILDLESSNESS IN MIDDLE TO LATE LIFE: DOES FRIENDSHIP AND GENDER PLAY A ROLE?
Authors: Rataj Alison , Alberth Andrew , Su Yan-Jhu , Stam Elisabeth , Stokes Jeffrey
Published: January 2025

Objective

Loneliness is a risk factor for negative health outcomes; however, little attention has been paid to the role of parental status as a contributor to loneliness in later life. Limited research has explored how this association may vary based on levels of friend support, friend strain, and gender. This study addresses these gaps by exploring whether those who are childless, have less friend support or friend strain, and are female are at a higher risk of loneliness.

Methods

This cross-sectional study used pooled data from 11,900 older adults 50 years and older from the 2016 and 2018 waves of the Health and Retirement Study. Loneliness was assessed across parental status groups, friendship support and friendship strain scales, and gender using ordinary least squares regression. Multiple imputation was conducted to address missing data.

Results

Those who did not have children (n=1,444, 13.0%) were substantially lonelier than those with children in adjusted models. Friend support was associated with reduced loneliness, particularly for childless adults when compared to parents. Midlife and older men were lonelier than women overall, and interaction effects show that childlessness played a larger role in shaping loneliness among women than men. Loneliness did not differ across levels of friendship strain.

Discussion

Parental status and gender are intertwined concerning their effects on loneliness. With the changing demographics of “family”, future research should identify specific categories of parental status (i.e., did not want children, blended families) and how the mechanics of friend support (i.e., how much, what types) impact loneliness.
SHIFTING SOCIAL PARTICIPATION AND LEISURE PATTERNS AMONG CHINESE OLDER ADULTS: EVIDENCE FROM NATIONAL SURVEYS
Authors: Fang Yu , Ouyang Zheng
Published: January 2025

Based on the data of “The National Survey on Older Persons in Urban and Rural China” conducted in 2000, 2006, 2010 and 2015, the paper examines the changing dynamics of social participation and leisure activities among Chinese older adults. Findings from the 2015 survey indicate a notable increase in the participation rate of public welfare activities among the older adults, with nearly half actively involved in various community endeavors. Particularly, urban areas showed enhanced participation, contributing to individual fulfillment and societal harmony. Moreover, a significant proportion of older adults expressed willingness to assist peers in need, underscoring the prevalence of mutual support networks within communities. Additionally, the development of Older Person’s Associations (OPA) has gained momentum, serving as vital platforms for older people self-management and social engagement. However, challenges persist, with disparities in participation rates between urban and rural areas. While static leisure activities remain prevalent, there is a notable rise in Internet usage among the older adults, offering avenues for social interaction and information dissemination. Despite advancements in spiritual and cultural engagement, attention to mental health among the older adults remains crucial, especially in addressing issues like suicide and mental health concerns among the rural older people population. The paper emphasizes the importance of bolstering support systems and services to promote holistic well-being among the aging population.
SOCIOLOGY AND GERONTOLOGY: NEW PERSPECTIVES AND VITAL ISSUES
Authors: Katz Stephen
Published: January 2025

The relationship between sociology and gerontology continues to forge dynamic pathways that cross critical thinking with innovative methodologies and radical advocacy. Sociological studies (and its specialties) have deepened understanding of aging by exploring its social contexts, life-course trajectories, intersecting inequalities, lifestyle cultures, social determinants of health, and political governance. Despite such advances, mainstream research is criticized for resisting their implications by returning ‘to the safety of traditional, individual-level explanations’ (Dannefer 2022). This trend parallels an increasing neglect of the social dimension of aging in technocratic policy-making. This symposium addresses these challenges by presenting research on the vital and everyday issues of aging, both to strengthen the sociological lens in gerontology and to explore new perspectives on social changes affecting aging societies. Stephen Katz reviews the loneliness ‘epidemic’ amongst older adults and the limitations of diagnostic approaches, suggesting instead how historical and qualitative research can formulate loneliness within diversely lived social and material environments. Chris Phillipson examines the sociological consequences of COVID-19 and its impact and consequences for different groups of older people, and discusses the role of social science in contributing to policy responses to the pandemic. Vera Gallistl and Anna Wanka explain the importance of materialist sociological theories in expanding aging relationships to include the interplay of human, more-than-human and non-human actors in digital societies. Amanda Grenier provides a critical overview of the disjuncture between professional knowledge-production and aging experiences, offering a radical proposal for an ethnographic case-study methodology to tackle issues of frailty and mobility.
THE “EPIDEMIC” OF OLDER ADULT LONELINESS: PROBLEMS OF DIAGNOSTIC INTERVENTION AND CRITICAL SOCIOLOGICAL RESEARCH
Authors: Katz Stephen
Published: January 2025

Loneliness, more than a feeling, has become a new ‘geriatric giant’ (Freedman & Nicolle 2020) and epidemic health crisis for older adults, affecting their physical, cognitive and emotional well-being. During the COVID epidemic, the intersecting effects of loneliness and isolation (often blurred in the literature) have intensified, as varying public health measures restricted visiting, gathering, routines and activities. While technical interventions, such as digital communication technologies (DCTs), tele-health meetings, online games, robotic pet companions and simulated presence therapy (SPT) are offered as beneficial aids, even where available or co-designed they tend to individualize and universalize loneliness. Professional, recreational and prescriptive interventions can also disregard the structural relations and socio-material environments that configure everyday lonely-making experiences over time. For both residential and community dwelling older adults, such experiences include lack of affordable housing, care-giver burden and insufficient community resources and planning. This presentation, drawing upon data and examples from senior health policy, loneliness surveys, national reports and qualitative research, reflects on these troubling matters in their complexity and heterogeneity. Conclusions explore the making of an ageist emotional economy that depicts and neglects older adults as inevitably lonely, while advocating for their rights to age in safe, healthy and socially connective ways.
DEVELOPING A SOCIOLOGY OF COVID-19: CHALLENGES AND PRIORITIES FOR SOCIAL GERONTOLOGY
Authors: Phillipson Chris
Published: January 2025

Much of the discussion about the impact of COVID-19 has been around its biomedical and epidemiological dimensions, with analysis focusing on the origins of the disease, the development of vaccines, and lessons to be learnt to protect against future pandemics. But the sociological issues arising from COVID-19 are important as well. Pandemics are viewed through particular social values and cultural perspectives, reflect economic and social inequalities in their development and impact, and are managed through socially organized forms of care and support. People will almost certainly view themselves and their society in a different way during and following a pandemic: diminished through the loss of partners and friends; strengthened through coming together at a time of crisis; or, conversely, weakened through a sense that some have suffered more than others. COVID-19 affected groups in different ways: by age, location, occupation, quality of housing, and ethnic group. But the highly unequal effects of the pandemic were often overlooked, or just assumed to be an inevitable part of ‘living with the virus’. The paper argues that research in social gerontology over-emphasized the impact of ageism on the experience of COVID-19, neglecting the wider social fissures and economic and racial injustices that unleashed the pandemic. The paper will review priorities for social gerontology in developing work on COVID-19, including understanding new inequalities which have emerged coming out of the pandemic, and developing a sociologically-informed public health working directly with groups in low-income communities to develop partnerships to tackle ongoing and future pandemics.
STRESSOR-RELATED PERSEVERATIVE COGNITION PREDICTS MORTALITY RISK IN MIDLIFE AND OLDER AGE
Authors: Stawski Robert , Mogle Jacqueline , Witzel Dakota
Published: January 2025

Perseverative cognition (e.g., worry and rumination) has been highlighted as a key indicator of stress and a mechanism linking stress to health and mortality risk. Despite this, research linking daily stress to mortality has focused on affective pathways (e.g., affective reactivity), largely ignoring the role of perseverative cognition in daily stress-mortality associations during midlife and older age. We address this gap by leveraging data from the National Study of Daily Experiences Refresher cohort (2012-2014). Respondents (N=694, Mage=47.5, SD=12.6, Range=25-75; 57% women) completed telephone interviews assessing perseverative cognition, negative affect, and the daily stressors on eight consecutive evenings. Decedents (n=15) date and cause of mortality, through 2019, were obtained from the National Death Index. Multilevel models were used to derive cognitive reactivity slopes – reflecting stressor-related increases in perseverative cognition - which were subsequently used in Cox proportional hazards regression models to predict survival. Results indicated higher levels of average daily perseverative cognition (on non-stressor days) were associated with a two-fold increase in mortality risk (Hazard Ratio=2.04, p=.007), while larger stressor-related increases in perseverative cognition (i.e., cognitive reactivity) were associated with an 81% increase in mortality risk (Hazard Ratio=1.81, p=.002). Findings were robust to adjustment for age, sex, differential stressor exposure, daily negative affect, and affective reactivity to daily stressors. Discussion will focus on why daily perseverative cognition is important for understanding health and wellbeing and represents an important intervention target to reduce health and mortality risk during midlife and older age.
CAN’T STOP THINKING ABOUT OTHERS’ PROBLEMS: COUPLING OF DAILY SUPPORT PROVISION AND COGNITIVE INTERFERENCE
Authors: Cichy Kelly , Witzel Dakota , Stawski Robert
Published: January 2025

The perceived availability of social support is cited as protective against the adverse effects of stressors and curtails cognitive interference (e.g., worry and rumination) linked to anxiety and depression. Social support exchanges, however, also involve providing support to others, which has costs to emotional well-being. Although receiving support may disrupt worry and rumination, providing support may elicit thoughts of concern about the situations requiring support provision, leading to increased cognitive interference on days when support is provided and among those who provide frequent support. Using data from the third wave of the National Study of Daily Experiences (NSDE 3) we examined associations among daily social support provision and cognitive interference between persons and within persons across days. Given gender differences in social networks and rumination, we also explore whether gender moderates these associations. Across eight consecutive days, respondents (N=1,236, Mage= 62.6, 57% women) reported on their affect, completed a six-item measure of cognitive interference (e.g., how often think about situations that upset you?), and indicated whether they provided emotional support. Multilevel models controlling for age and gender revealed significant within- and between-person associations, where cognitive interference was higher on days individuals provided emotional support compared to non-support days and for those who provided more support (p<.001), independent of daily negative affect. Gender did not moderate the associations. Findings underscore how listening to others’ concerns confers a mental load not accounted for by negative affect, such that cognitive interference may be one mechanism underlying the costs associated with providing support.
DAILY WORK-TO-FAMILY CONFLICT AND SELF-REPORTED COGNITIVE HEALTH IN MIDLIFE
Authors: Chandler Kelly , Nichols Madeline , Stawski Robert
Published: January 2025

Work-family conflict (WFC) is a potent stressor in midlife linked to numerous detrimental physical and mental health outcomes; however, less is known about its effects on cognitive health. Increasing research demonstrates the utility of intensive repeated measures designs to examine within-person variability in WFC and health. Therefore, the aims of the present study were (a) to examine within-person associations between daily WFC and cognitive interference and memory failures and (b) to test age and gender as moderators. The data come from 131 IT employees who participated in an eight-day daily diary in the Work, Family, & Health Study (Age M=45, SD=6.33; 45% women). We found both significant between- and within-person associations from our two-level multilevel models. On average, adults who had higher WFC experienced more cognitive interference, Est.=0.22, SE=.06, p<.001, and memory failures, Est.=0.41, SE=.09, p<.001. On days when adults experienced higher WFC than was typical for them, they experienced more cognitive interference, Est.=.10, SE=.03, p<.01, and memory failures, Est.=0.18, SE=.06, p<.01. Age moderated the association between average WFC and memory failures. Simple slopes tests showed significant positive associations for adults aged 35, Est.=0.86, SE=.20, p<.001, and 45 (the mean), Est.=2.15, SE=.70, p<.01, but not 55, Est.=0.11, SE=.15, p=.43. Gender was not a significant moderator. These preliminary results indicate that there is day-to-day variability in WFC and self-reported cognitive health, particularly for adults in their 30s and 40s. Learning more about days with high WFC could suggest strategies for daily interventions to minimize the impacts of WFC on cognitive health.
THEORIZING FORTITUDE: PERSPECTIVES FROM GSA’S ARTS, HUMANITIES, AND CULTURAL GERONTOLOGY ADVISORY PANEL
Authors: McKiddy Sarah , Ritchey Katherine , Kriebernegg Ulla
Published: January 2025

This symposium explores the impact of arts and humanities on cultural narratives of aging. Through the lens of theory-based examples, the authors argue for reaching beyond orthodox engines of gerontological exploration, such as medical research and the social sciences, to develop a more nuanced gerontology. However, moving beyond the arts-as-intervention model is not without pitfalls. Here, theoretical explorations challenge conventional ways of knowing by offering new insights into how cultural narratives of aging can be interpreted and shaped through the lens of the arts and humanities from a theoretical standpoint. Ultimately, the symposium suggests that fortitude, that is, courage in the face of adversity, resonates both as we travel through life facing our own challenges, and as the field of gerontology seeks to understand diverse human experiences of aging.
AESTHETIC PATHWAYS IN GEROTRANSCENDENCE
Authors: McKiddy Sarah
Published: January 2025

This presentation aims to enrich and expand the discourse on aging by exploring overaps and areas for exploration within Tornstam’s theory of gerotranscendence and the tenets of Rowe & Kahn’s successful aging model, with a focus on aesthetics as a mechanism for exploring and expressing the aging process. Gerotranscendence involves a shift in cognitive and emotional paradigms, marked by a reevaluation of purpose, interconnectedness, and self-awareness. Gerotranscendence augments the potential for well-being and health promotion by cultivating increased and meaningful engagement with the world and an evolution in perceptions and consciousness as individuals age. Encompassing diverse artistic expressions such as visual arts, music, and creative activities, aesthetics provide an individualized medium for introversion and self-expression. This multipronged approach to aging considers how individuals navigate senescence and nurture a connection with their inner selves alongside chronic conditions, diseases, limitations, or age-related changes. Engaging in aesthetic experiences offers depth and cognitive consonance in addressing feelings of loss, nostalgia, or existential questions related to aging. Aesthetics, then, emerge as a compelling conduit to convey the transitions and shifts described in the process of gerotranscendence. Integrating gerotranscendence and aesthetics within the context of traditional aging notions both illuminates and deepens the understanding of successful aging by accentuating the psychological, emotional, and creative dimensions, promoting a more holistic and arguably more incisive perspective on aging.
CONCEPTUALIZING A NEURO-ETHNOMUSICOLOGY OF AGING
Authors: Colverson Aaron
Published: January 2025

This presentation accounts for disciplinary similarities and differences between ethnomusicology and neuropsychology in the context of a project on rhythm perception, learning and performance, and cognitive functioning in healthy young and older adults. It draws from Judith Becker’s Deep Listeners (2004) and “Ethnomusicology and Empiricism in the 21st-century” (2009) to characterize many of the challenges present in building bridges between humanists and scientists studying music. Becker cites Ann Harrington in this regard, regarding what it might mean to teach an attitude of thinking neurobiologically about culture and ethnomusicologically about the brain. Applied to brain and social health in older adults, two notable scholars’ work extends from Becker’s and Harrington’s within the domain of ethnomusicology: Jennie Gubner and Theresa Allison. Building from these prior influences, my work forged a collaboration between neuropsychologists interested in the cognitive and brain health of older adults, with ethnomusicologists interested in contributing to new directions for the field, such as cognitive and medical ethnomusicologies. Through this collaboration, important questions were raised in the execution and evaluation phases of the project, namely: what counts as knowledge; what counts as evidence; how do we gather information; and how do we draw conclusions? By entering these conceptual domains/discussions between these disciplines, this work exemplifies a bridge toward a neuro-ethnomusicology of aging, prolonging the pioneering works of Becker, Harrington, Gubner, and Allison. The conclusions direct attention to more fluidly include both disciplines’ traditions in research design, to promote more collaborative work between humanists and scientists studying music and health.
UNION-DRIVEN PROGRESS IN WASHINGTON STATE: IMPLICATIONS FOR POLICY AND PRACTICE
Authors: Scales Kezia , Glickman Adam , Morante Mariana
Published: January 2025

Recruitment and retention challenges related to direct care workers across long-term services and supports continue. Policy and practice at the federal, state, community and organizational level has the potential to improve retention, widen recruitment pipelines and create new person-centered models that attend to both the needs of workers and people who receive services and their care partners. With input from SEIU 775 leadership, this presentation will provide an overview of union reach in Washington state within the LTSS sectors, review some of the interplay between city-based living wage laws and wage improvements for direct care workers, and talk about successes in improving access and affordability of health insurance for workers and increased access to paid-time off. Panelists will ask questions related to agenda setting and co-design of solutions related to both research and policy. Policy and practice levers at the federal, state and community levels will be identified and discussed using a co-design framework.
ASSESSING MINDFULNESS FACETS TO INTERROGATE THE “WELL-BEING PARADOX” IN NIGERIA
Authors: Amanambu Peace , Allard Eric
Published: January 2025

The role of mindfulness for explaining the well-being paradox in aging has been examined within Western samples. However, whether this association exists cross-culturally has not been previously addressed. Furthermore, investigations on the role of mindfulness facets on the associations between age and well-being is limited. The present study assessed whether distinct mindfulness facets (i.e., observing, describing, acting with awareness, non-judgment, and non-reactivity) mediate the relationship between age and positive and negative affect in an adult lifespan sample in Nigeria. Participants were 242 (95 women, age range = 18-75 years, Mage = 41.79; SDage = 13.58) adults, affiliated with the University of Nigeria-Nsukka, who completed the Positive and Negative Affect Scale and Five Facet Mindfulness Questionnaire (FFMQ). Increased age was associated with diminished negative affect (NA) but unrelated to positive affect (PA). In terms of mindfulness facets, older age was significantly related to increased endorsement of the Describing, Acting with Awareness, and Non-Reactivity facets. Separate mediation models were conducted with these three facets in predicting NA. Here, diminished age-related NA was mediated by the Describing facet. No significant mediating relationships were observed for Acting with Awareness and Non-Reactivity. The present findings suggest some cross-cultural coherence in mindfulness as an arbiter of the well-being paradox in aging, further specifying aspects of the mindfulness construct contributing to this relationship.
ADVANCING THE SCIENCE OF SENSORY HEALTH AND COGNITION: FROM EPIDEMIOLOGY TO INTERVENTION
Authors: Nieman Carrie , Deal Jennifer
Published: January 2025

Sensory health and cognition are at the intersection of two major public health challenges facing an aging global population. Sensory impairments are among the most common and disabling comorbidities among individuals at risk for cognitive impairment and those already aging with cognitive impairment. Sensory impairments may also serve as key biomarkers in dementia and may worsen the trajectory of decline. Although prevalent, sensory impairments frequently go unrecognized and unaddressed. Importantly, sensory impairment has been identified as modifiable risk factors for dementia. Optimizing sensory function may be an important yet overlooked approach to reducing the risk of cognitive decline as well as providing potential nonpharmacological interventions to aid in the management of neuropsychiatric symptoms, improve quality of life for persons living with dementia, and reduce burden for care partners. This symposium presents the latest evidence from epidemiology to intervention in advancing our understanding and approach to sensory health and cognition. The symposium begins with a focus on the epidemiology of sensory function among individuals with or at risk for cognitive impairment and then moves to a focus on intervention, understanding the potential impacts of optimizing sensory function on brain structure, barriers to addressing sensory function in clinical settings, and envisioning how to optimize interventions by learning directly from individuals aging with cognitive impairment, their care partners, and experts. This symposium features leaders in the field of sensory health and cognition from diverse career stages, disciplines, and settings.
HEARING AND OLFACTORY LOSS ASSOCIATED WITH ALTERED BRAIN STRUCTURE AND CONNECTIVITY IN DEMENTIA RISK
Authors: Phillips Natalie , Best Tristin , Grant Nicole , Kabir Ameera , Pichora-Fuller M Kathleen , Campos Jennifer , Mick Paul , Wittich Walter
Published: January 2025

Sensory loss in hearing, vision, and olfaction is highly prevalent in older adults and each is associated with higher risk of developing dementia. We sought to identify whether these sensory factors are associated with alterations in brain function and structure in older adults with or at risk for dementia. Our groups included those with low risk (normal cognition, no cognitive complaints (NC=128; mean age=69 years; mean education=16 years)), and those with higher risk, namely 135 individuals with subjective reports of cognitive decline (SCD) but normal cognition (age=70; education=17), and 241 participants with mild cognitive impairment (MCI; age=72; education=16), and 93 with Alzheimer’s disease (AD, age=75; education=15). We used data from the COMPASS-ND study (Release 7). Hearing loss was assessed with pure-tone screening, vision with contrast sensitivity, and olfaction with the Brief Smell Identification Test. Normal sensory performance was observed in a minority of participants and decreased across the dementia risk spectrum groups (e.g., NC: 29%; SCD: 29%; MCI: 11%; AD: 2%). Olfactory deficits were the most frequent, followed by hearing impairment, and then deficits in visual contrast sensitivity. Deficits in multiple sensory domains were highly prevalent, with 37% of participants with AD having deficits in two or more domains. Preliminary analyses indicate that hearing loss is associated with altered connectivity in the default mode network and olfactory loss is associated with reduced hippocampal volumes in SCD. Thus, sensory loss is highly prevalent and co-morbid in persons with or at risk for dementia and has implications for cognition and brain function.
INSIGHTS ON OLDER ADULTS WITH COGNITIVE IMPAIRMENT AND HEARING LOSS: EXPERT PERSPECTIVES
Authors: Blinka Marcela , Oh Esther , Hope Peter , Lee Paul , Tu Xueting , wang Natalie , Yasar Sevil , Nieman Carrie
Published: January 2025

Although hearing loss is highly prevalent among older adults, especially among older adults aging with cognitive impairment, few use hearing aids. Older adults with co-morbid cognitive impairment and hearing loss experience multiple barriers to hearing care, including hearing loss often going unrecognized by clinicians and deprioritizing hearing care among competing health priorities. To understand the barriers and facilitators to hearing care among persons living with dementia and inform the development of a hearing care intervention, we conducted semi-structured interviews with 10 experts. Experts included professionals with expertise in dementia, hearing loss, neuropsychiatric symptoms, behavioral intervention development, implementation science, and technology adoption. We used purposive sampling and snowball recruitment to recruit experts with demonstrated experience and diverse backgrounds. Qualitative content analysis was used to identify themes. Among the experts, 56% self-identified as male, and 78% self-identified as white. Experts highlighted the importance of a multi-component approach to hearing care, including education on hearing and dementia, management of neuropsychiatric symptoms, and employing effective communication strategies. Experts prioritized the need for interdisciplinary collaboration and dedicated training for clinicians. Experts emphasized the need to engage stakeholders throughout intervention development and testing, including the key role care partners play in prioritizing hearing care and supporting the ongoing use of assistive technologies. Experts also identified the need to integrate practical strategies to support communication needs and hearing technology that is affordable. Our findings support the importance of hearing care within dementia care and identify tangible opportunities to support hearing health among persons aging with cognitive impairment.
ASSESSING MEDICAID PAYMENT RATES AND COSTS OF CARING FOR THE MEDICAID POPULATION RESIDING IN NURSING HOMES
Authors: Miller Edward , Simpson Elizabeth , Karon Sara
Published: January 2025

This symposium reports findings from an analysis of the relationship between Medicaid payment rates and costs for caring for the Medicaid population residing in nursing homes (NHs). Prior to the COVID-19 pandemic, there were about 1.37 million Americans using one of the nation’s 15,000+ NHs. Medicaid is the primary and largest single payer for NH care, covering approximately two-thirds of NH residents. The residents paid for by Medicaid’s nursing facility benefit are typically long-stay residents who often require custodial-type care due to cognitive or physical impairments that must be provided on a long-term basis. Until recently, there has been limited information examining the relationship between Medicaid payment rates and the costs of caring for Medicaid NH residents. Such information is essential to support discussion of policy reforms that aim to improve the safety and quality of NH care. This study used Medicaid payment and cost report data for freestanding NHs in 44 states collected during the latest pre-pandemic period (2019). The national average and median per diem Medicaid payment rates and costs and Medicaid payment-to-cost ratios were calculated for the nation as a whole and by NH characteristics and state Medicaid payment policies. The first presentation establishes the context for the study (Miller). The second presentation describes the study methodology (Simpson). The third presentation reports study findings (Cohen). The last presentation delineates implications of the study findings for policy and practice (Bowblis). Sara Karon will serve as discussant.
FEDERAL AND STATE POLICIES AND STAKEHOLDER VIEWS ON MEDICAID NURSING HOME PAYMENT
Authors: Miller Edward , Bowblis John , Simpson Elizabeth , Karon Sara , Oliveira Iara , Dey Judith , Squillace Marie , Cohen Marc
Published: January 2025

How much nursing homes (NHs) are paid by Medicaid is determined at the state level. Medicaid coverage of NH care is a significant expenditure for states. Consequently, states design Medicaid payment models to achieve desired policy objectives related to NH costs and quality, access to care, payment equity, service capacity, and budgetary control. Setting Medicaid payment rates too high can lead to excess profits at the expense of taxpayers with unknown implications to improvements in quality and staffing levels. At the same time, NHs need financial resources to pay nursing staff and invest in other quality improvement efforts to assure proper care. The industry claims that NH costs are not fully covered by their Medicaid payments. Consumer advocates argue that NHs are already adequately paid, and profit incentives potentially divert funds away from resident care. There is no federal requirement that Medicaid payments cover the full cost of care.
IMPLICATIONS OF MEDICAID NURSING HOME PAYMENT AND COSTS FOR POLICY AND PRACTICE
Authors: Bowblis John , Miller Edward , Simpson Elizabeth , Karon Sara , Oliveira Iara , Dey Judith , Squillace Marie , Cohen Marc
Published: January 2025

This study is the most comprehensive analysis to date on the relationship between state Medicaid payment rates and nursing home (NH) reported costs of caring for Medicaid residents. The findings provide insight into how, on average, Medicaid payments compare to reported costs, and how that differs by different types of NHs. It does not address the adequacy of Medicaid payment, whether NHs were operating efficiently or were adequately staffed based on the acuity of their residents; nor does it address the quality of the data from the cost reports. Nonetheless, it does provide important information on state Medicaid payment rates and reported costs that can inform current discussions assessing potential Medicaid payment policy reforms. Findings from this study also can be used to examine the impact of potential changes in Medicaid payment on financial performance and disparities across NHs. Study limitations and directions for further investigation are discussed.
BIOLOGICAL RESOURCES FOR AGING RESEARCH AT THE NATIONAL INSITUTE ON AGING
Authors: Moro Manuel , Cogliati Tiziana , Fox Jennifer , Wang Fei
Published: January 2025

Research on aging, by its nature, requires the acquisition of data over an organism’s lifespan or at later stages in life. For animals with medium to long lifespans such as rodents and nonhuman primates (NHPs), time is a limiting factor for the acquisition of data and samples. One of the missions of the National Institute on Aging (NIA) is to maintain and manage biological resources needed to support aging research that would be otherwise less accessible or excessively costly or time consuming to the investigators. The resources made available to publicly funded investigators comprise: 1) live rodents (Aging Mouse and Rat Colonies); 2) cells from different species including human, NHP, rodent, and domestic companion animals (Aging Cell Repository); 3) tissues from aged rodents (Rodent Tissue Bank) and NHPs (NHP Tissue Bank); and 4) a database of NHP vital parameters (Primate Aging Database). The NIA also supports two multi-institutional programs investigating interventions with the potential to extend lifespan and delay disease/dysfunction in worms (Caenorhabditis Intervention Testing Program, CITP) and in mice (Interventions Testing Program, ITP). The NIA values feedback to continue to provide valuable resources that will help the field move forward.