bluuebunny/crossref_metadata_2025 huggingface dataset:
Atypical presentation of lipomatous hypertrophy of the interatrial septum: a case report
Authors: Gopal Dipika J , Han Yuchi , Silvestry Frank E , Ferrari Victor A
Published: November 2019

Background

Lipomatous hypertrophy of the interatrial septum (LHIAS) is a common finding on transthoracic echocardiogram (TTE). Occasionally, the appearance of LHIAS is atypical and multimodality imaging is helpful to make the diagnosis. We present a case of atypical LHIAS to highlight the potential aetiologies for an interatrial septal mass and review features on multimodality imaging that help decrease uncertainty and establish a diagnosis.

Case summary

A 64-year-old man with a history of hypertension, diabetes mellitus, and coronary artery disease with multiple percutaneous coronary interventions presented to the emergency room with chest pain. Transthoracic echocardiogram showed a homogenous echo-dense, intracardiac mass present within the interatrial septum. Computed tomography (CT) angiogram of the chest showed a homogenous mass similar in radiodensity to extracardiac and pericardial fat. Cardiac magnetic resonance (CMR) confirmed LHIAS by homogenous signal that was nulled on fat suppression images.

Discussion

This case highlights that while most LHIAS has the standard ‘dumbbell’ appearance on TTE, there are instances where it can appear more like an adherent mass prompting a wider differential. Unenhanced CT of the heart can be used to confirm LHIAS by the presence of low attenuation values for tissue. Alternatively, CMR can be used for tissue characterization and confirmation of LHIAS. Precontrast T2/T1-weighted CMR images with steady-state free precession show high signal intensity in the area of LHIAS and produce a black/hypointense boundary effect between fat and myocardium. A multimodality approach is crucial in arriving at the appropriate diagnosis using the tissue characterization capabilities of CT and CMR.
THE ROLE OF EDUCATORS AND EMPLOYERS IN REDUCING (OR PERPETUATING) AGEISM
Authors: Kruger Tina M
Published: November 2019

As the population ages, increasing numbers of people are at risk of being harmed by ageism found in interpersonal interactions, medical settings, employment opportunities, and public policies. The way older people are talked to and about can facilitate the inclusion or exclusion/dismissal of the older population. Gerontology educators are well-positioned to combat ageism by discussing ageist beliefs with students and by teaching about stereotype development, aging stigma, and inclusive language and interactions. Aging services providers can address ageism by hiring the candidates most qualified to engage with older adults in a non-ageist manner. We explore these ideas in this symposium. First, information from the Gerontological Literacy Network’s Sketches study regarding college students’ (mis)perceptions of aging will be presented. Second, the Ageism First Aid online training modules, designed to reduce ageism, will be introduced. Third, the Disrupt Aging Classroom practice model, created by AARP CT, and Borrow My Glasses, used to transform attitudes about aging among college students, will be shared. Fourth, the disjoint between aging services job descriptions and how those who study aging/gerontology search for jobs will be reviewed. Finally, data from the GELS project, regarding where gerontology program graduates have gained employment, will be presented. Efforts to educate all college students and aging services providers about appropriate language and interaction styles, combined with modifying aging services employers’ efforts to identify the most qualified candidates to hire, can ultimately reduce ageism and enhance quality of life for the fastest growing segment of the population.
OLDER ADULTS’ IMMIGRANT STATUS AND SELF-REPORTED ABILITY TO NAVIGATE THROUGH THE HEALTHCARE SYSTEM
Authors: Tzeng Huey-Ming
Published: November 2019

This exploratory study examined the association between older adults’ immigrant status and their self-reported ability to perform each of the 51 self-care behaviors that are needed for them to navigate through the healthcare system. Secondary data analysis was conducted based on a 2018 telephone survey of community-dwelling adults 65 y/o or older, living in a western Canada province (N = 1,000). A previously validated survey tool, Patient Involvement Behaviors in Health Care (e.g., indicating Yes=1 or No=0 regarding their ability to perform each self-care behavior), and a demographic data form (e.g., are you an immigrant? Yes=1 or No=0) were used. Descriptive analyses and chi-square tests for independence (alpha= 0.05) were conducted. Among the 993 adults who indicated their immigrant status, 51 (5.1%) self-declared as immigrants. 32 (62.7%) of the immigrant participants and 457 (48.5%) of the non-immigrant participants resided in the urban areas. 88.2% of these immigrant participants was white, 7.8% was Asian, and 2% was black; 72.5% indicated that English is their first language. Immigrant participants were less likely to report being able to perform 5 self-care behaviors than non-immigrant participants. These 5 behaviors were: bringing someone to help you move around when needed; asking your providers to share your medical record with each other; finding insurance that best matches your needs; changing health insurance coverage as needed; and knowing of any interactions with old and new treatments. Clinicians should co-create approaches with older adult immigrants to improve their self-care capacity (e.g., connecting with relevant peer support networks).
MEETING SOCIAL NEEDS TO IMPROVE HEALTH OUTCOMES: PARTNERSHIPS BETWEEN COMMUNITY-BASED ORGS AND HEALTH CARE
Authors: Wilson Traci L , Kunkel Suzanne R , Straker Jane , Scala-Foley Marisa , Blair Elizabeth
Published: November 2019

Unmet social needs negatively affect individual and population health, and better integration of community-based supports and health systems is a promising approach to improve health outcomes and avoid unnecessary health care use. Community-based organizations (CBOs) such as Area Agencies on Aging (AAAs) and Centers for Independent Living (CILs), as providers and coordinators of social services, are well-positioned within their communities to coordinate care and provide for unmet social needs. Partnerships between CBOs and health care entities have clear potential to improve health care outcomes while also reducing expenditures. This paper will present a cross-sectional analysis of a national survey of AAAs, CILS, and other CBOs at two time points (2017: n=593; 2018: n=763) to understand the extent, type, and evolution of CBO engagement with health care providers. In addition, longitudinal analysis (n=374) shows movement at the organization level: 33% of organizations who did not have a contract at T1 but were pursuing one had achieved a contract by T2. This presentation will: describe details of the services delivered, contracting arrangements, and populations served under CBO/health care contracts, as well as challenges experienced by CBOs; examine differences by state and organizational structure; and discuss the implications of state policy on integrated care and contracting.
AN IOT TROLLEY FOR LONG-TERM CARE FACILITIES TO PROVIDE EFFICIENCY AND REDUCE RISKS
Authors: Chou Chia-Ching , Liu Ting-Ju , Kang Shih-Chung
Published: November 2019

One of challenges facing the long-term care facilities in Taiwan is the burden of the paperwork affecting nurses, which limits their time to look after the residents. Nurses usually estimate spending one quarter of their shifts with paperwork. The aim of this study is to develop a mobile care information system - Jubo IoT Trolley: a trolley with IoT vital-sign devices collecting and delivering timely care information to care professionals. Based on user-centered design (i.e., discover-define-develop-delivery), we conducted stakeholder interviews and rapid prototypes to zero in on the communication problem, and designed the IoT Trolley to support nurses in their daily workflow, facilitate vital-sign measurements at the bedsides, and collect the measured values to the cloud database automatically. Through design iterations, we have validated usability of the system in multiple care facilities. The result shows, with the IoT Trolley, the nurses can receive the senior’s critical vital status from the caregivers more promptly, provide instructions remotely and therefore, reduce potential care risks. Furthermore, the cloud analyzes the collected residents’ health data, the vital sign alerts can be sent to the nursing directors, so they can coordinate and intervene instantly. At last, this work demonstrates that through the technology, care qualities are improved, and care professionals can spend more valuable time with residents in the long-term care facilities.
LIVING LIFE TO THE FULL 55-PLUS: A COMMUNITY-BASED INTERVENTION FOR REDUCING DEPRESSION AND ANXIETY
Authors: Khatri Nasreen , Perkovic Stephen , Hamadani Tara Faghani
Published: November 2019

Living Life to the Full 55+ (LLTTF) was an 8-week, 12-hour, community educational program based on CBT principles. The program aim was to teach participant skills and techniques to cope effectively with life stress. Participants self-referred to the program by responding to advertisements or were otherwise referred to the program by local community centres. Following the promising results of the pilot study, a follow-up empirical study was conducted to assess the impact of the program on clinical measures and other notable measures over time. Study participants (N = 514) were recruited at partner sites hosting the program. Demographic and other data was collected to assess the impact of the program. Measures collected to assess the impact of the program were the Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and a brief measure of loneliness/social connectedness. Participant data was collected pre/post-intervention, and at post-course follow-up periods (3/6/9-months). Preliminary repeated-measures ANOVA analyses found statistically significant changes in depression, anxiety, mental well-being, and loneliness scores, from pre- to post-intervention. Participant’ depression, anxiety, and loneliness scores significantly reduced from pre- to post-course. Participants also experienced a significant improvement in mental well-being from pre- to post-course. Observed decreases in loneliness and depression did not significantly change from post-course to any of the follow-up periods. Results suggest the viability of a nonclinical program for addressing depression and loneliness in older individuals, and have implications for community-based strategies attempting to address mental health issues in older Canadians
FACTORS ASSOCIATED WITH SEVERITY OF DEPRESSION: EVIDENCE FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
Authors: Zheng Mingyang , Liu Xian
Published: November 2019

Depression among older adults in China is widespread. To explore factors associated with depression among older adults, most studies focus on the individual as the unit of analysis. However, since individuals are nested in families, it is important to understand depression within a family context. To address this gap, the current study examines the degree to which individual and dyad-level characteristics were associated with the severity of depression among older couples in China. Data for the study were drawn from wave 4 of the China Health and Retirement Longitudinal Study. The total sample size in the study was 2560 older couples aged 60 and above. Multilevel modeling was used to analyze the dyadic data. Our preliminary findings suggested the partial intraclass correlation between a dyad’s depression scores was 0.32, which shows that a couple’s scores were similar to one another. Those who were female, were younger, lived in rural areas, had lower cognition, and those whose spouses had lower cognitive ability were associated with more severe depression. The findings provided empirical evidence to support the argument that more community mental health resources should be allocated to rural areas in China. Moreover, given that female older adults are more vulnerable to depression compared to male older adults, it is imperative to develop tailored services to support women to enhance their psychological wellbeing. In addition, as spousal cognition was negatively correlated with depression, services to support older couples where one has dementia are needed.
LIFETIME EXPERIENCES OF GRIEF AMONG RECENTLY BEREAVED AFRICAN AMERICANS
Authors: McDuffie Danielle L , Allen Rebecca S , Black Sheila , Crowther Martha R , Whitlow Ryan , Acker Laura
Published: November 2019

This study sought to investigate the ways recently bereaved African American middle to older aged adults conceptualized both prior and present loss. Fourteen African American men and women aged 46 years and older (M=62.6) completed one time, in-person semi-structured interviews detailing their grief experiences. Interview transcripts were then coded using a content analysis. Four themes were reported during prior loss (Continuing on with Normal Life/ Time, Faith/ Religion, Reminiscing/ Reminiscence, Social Support) along with present loss (Faith/ Religion, Keeping Busy, Reminiscence, Social Support). Men and women in the sample were found to cope in relatively consistent manners despite the timing of the loss, and in manners consistent with literature detailing African American grief outcomes. This information could help inform both bereaved African Americans and those seeking to aid African Americans during times of bereavement in proactively having knowledge of coping mechanisms that have been used historically and found to be beneficial.
GENDER DIFFERENCES IN RECEIVING ASSISTANCE WITH DAILY CARE NEEDS AMONG OLDER BLACK AMERICANS LIVING WITH DIABETES
Authors: Sherman Ledric D , Fabius Chanee D , Bonner Timethia , Spears Erica
Published: November 2019

Older Black Americans living with diabetes often receive social support critical to their self-care management practices and quality of life. Studies have reported positive relationships between support and diabetes care among this population, although gender differences exist, with men reporting better quality of life outcomes associated with diabetes self-management than women. More information is needed to to assist healthcare providers indeveloping gender-tailored interventions to improve diabetes self-management. Using data from the 2015 National Health and Aging Trends Study (NHATS; Round 5), a nationally representative sample of Medicare beneficiaries aged 65 and older, our cross-sectional study describes gender differences in receiving assistance with self-care, mobility, and household needs among older Black adults with diabetes (N=621). Participants were majority female (59% Females; 41%Males). Bivariate analyses showed women were often older with fewer years of education, lower incomes, and were more likely to live with others than men. A larger share of respondents reported receiving assistance with household activities (34%; e.g. shopping, medication administration), followed by self-care (21%; e.g. bathing, dressing), and mobility tasks (17%; e.g. getting around inside and outside of the house). Binary logistic regression showed that women were more likely to report receiving assistance with all three tasks after adjusting for age, education, income, living arrangements, number of health conditions, and self-rated health. Future research should identify the relationships between caregivers and care recipients (e.g. spouse/partner, children), as receiving support with daily needs has the potential to impact both the health and quality of life of both caregivers and care-recipients.
OBESITY AND MIDLIFE PHYSICAL FUNCTIONING IN TWO BRITISH BIRTH COHORTS: THE MEDIATING ROLE OF PHYSICAL INACTIVITY
Authors: Pereira Snehal Pinto , De Stavola Bianca L , Rogers Nina T , Hardy Rebecca , Cooper Rachel , Power Chris
Published: November 2019

Associations between obesity and physical inactivity are bi-directional. Both are associated with physical functioning (PF) but whether obesity influences PF via inactivity is unknown. We investigated whether mid-adult obesity trajectories were associated with subsequent PF and mediated by inactivity in the 1946 National Survey of Health and Development (1946-NSHD; N=2,427) and the 1958 National Child Development Study (1958-NCDS; N=8,674). Estimated randomised-interventional-analogue natural direct (rNDE), indirect (rNIE) and total (rTE=rNDExrNIE) effects of obesity trajectories on PF via inactivity are expressed as risk ratios. In 1946-NSHD, rTE of incident obesity at 43y (vs never) on poor PF=2.32(1.13,3.51); at 53y=1.53(0.91,2.15). rNIEs via inactivity were 1.02(0.97,1.07) and 1.02(0.99,1.04) respectively. Estimated rTE of persistent obesity from 36y=2.91(1.14,4.69), with rNIE of 1.03(0.96,1.10). Longer obesity duration was associated with increased risk of poor PF. Inactivity played a small mediating role. Findings reinforce the importance of preventing and delaying obesity onset to protect against poor PF.
OBJECTIVE AND SUBJECTIVE SLEEP DURATION AND ACTIVITY LEVEL IN OLDER ADULTS WITH MILD DEMENTIA
Authors: McPhillips Miranda V , Kim Jinyoung , Petrovsky Darina V , Li Junxin , Talwar Sonia , Caffeé Laurel , Hodgson Nancy
Published: November 2019

Little is known about the relationship between sleep duration and activities of daily living (ADLs) in those with mild dementia. We sought to examine the independent relationship between objective and subjective sleep duration and ADLs in community-dwelling older adults with mild dementia. Analyses were conducted on baseline data from participants enrolled in the Healthy Patterns Clinical Trial (Hodgson; R01NR015226). Measures included 24-hour wrist actigraphy for objective sleep duration, proxy-reported Pittsburgh Sleep Quality Index (sleep duration subscale) for subjective sleep duration and the Barthel Index for performance of ADLs. We used Spearman’s correlation and multivariate linear regression. A total of 30 individuals (56.7% male) aged 74.6 (SD 7.4) with mean Clinical Dementia Rating (CDR) scores of 1 (SD 0.5) were enrolled. Objective sleep duration ranged from 2.7 to 11.5 with mean 6.7 (SD 2.4) hours; subjective sleep duration ranged from 4 to 13.5 with mean 7.9 (SD 2.4) hours. Longer objective and subjective sleep duration were significantly associated with worse ADL scores (r = -0.48, p = 0.03; r = -0.59, p=0.007, respectively) in bivariate analyses. After controlling for age, CDR, and depression, subjective sleep duration was independently associated with ADLs (β = -1.90, p =0.03) and objective sleep duration trended toward significance (β = -1.47, p =0.10). These preliminary results suggest self-reported longer sleep could be indicative of declines in ADLs in older adults with mild dementia. Further prospective studies are necessary to determine the independent association between objectively assessed sleep duration and ADLs in patients with mild dementia.
IMPACT OF OFFLINE AND ONLINE SOCIAL NETWORKS ON LONELINESS AND MENTAL HEALTH AMONG ITALIAN OLDER PEOPLE
Authors: Zaccaria Daniele , Casanova Georgia , Guaita Antonio
Published: November 2019

In the last decades the study of older people and social networks has been at the core of gerontology research. The literature underlines the positive health effects of traditional and online social connections and also the social networks’s positive impact on cognitive performance, mental health and quality of life. Aging in a Networked Society is a randomized controlled study aimed at investigating causal impact of traditional face-to-face social networks and online social networks (e.g. Social Network Sites) on older people’ health, cognitive functions and well-being. A social experiment, based on a pre-existing longitudinal study (InveCe - Brain Aging in Abbiategrasso) has involved 180 older people born from 1935 to 1939 living in Abbiategrasso, a municipality near Milan. We analyse effects on health and well-being of smartphones and Facebook use (compared to engagement in a more traditional face-to-face activity), exploiting the research potential of past waves of InveCe study, which collected information concerning physical, cognitive and mental health using international validate scale, blood samples, genetic markers and information on social networks and socio-demographic characteristics of all participants. Results of statistical analysis show that poor social relations and high level of perceived loneliness (measured by Lubben Scale and UCLA Loneliness scale) affect negatively physical and mental outcomes. We also found that gender and marital status mediate the relationship between loneliness and mental wellbeing, while education has not significant effect. Moreover, trial results underline the causal impact of ICT use (smartphones, internet, social network sites) on self-perceived loneliness and cognitive and physical health.
THE INFLUENCE OF SOCIAL ISOLATION AND NEIGHBORHOOD DANGER ON OLDER ADULTS’ FUNCTIONAL STATUS
Authors: Engel Ilana J , Baker Tamara A
Published: November 2019

Social isolation is often associated with smaller social networks, bereavement, and chronic health problems. In addition, underserved neighborhoods, without the resources and social support of other areas, may further promote social isolation among older adults. This study utilized data from the 2nd wave of the nationally representative National Social Life, Health, and Aging Project (NSHAP) to examine if perceived neighborhood danger mediates the relationship between social isolation and functional impairment. We hypothesized that those who are less socially connected and feel less safe in their communities may experience worse health outcomes. Data for the total sample (N=1,804; 62-91 years of age) showed that partial mediation was supported, (F 2, 1801 = 22.91, p<0.01). Similar statistics were found by gender (men, F 2, 985 = 8.20, p<0.01; women, F 2, 813 = 14.79, p<0.01). This relationship, however, showed a stronger association among women (β = -.39, p<.01) than men (β = -.26, p<.05). Findings indicate that the relationship between perceived social isolation and impaired functional status may be partially explained by perceived neighborhood danger. These findings suggest that older adults who perceive their neighborhoods as dangerous, may be more socially isolated, and at risk for functional decline. These results support the Reserve Capacity Model, which posits that social resources are of increased importance for socioeconomically disadvantaged individuals. Additional research is needed to examine how such factors as stress, environment, and access to care contribute to our understanding of health outcomes among this population of adults.
DEPRESSION AMONG OLDER CANADIAN REFUGEES: THE PROTECTIVE ROLE OF SOCIAL SUPPORT
Authors: Fuller-Thomson Esme , Lin Shen (Lamson) , Kobayashi Karen , Arora Simran R , Tong Hongmei , Davison Karen
Published: November 2019

This study’s objective was to identify which factors attenuate refugees’ higher odds of depression. A secondary analysis of 272 refugees and 29,398 non-refugees in the Canadian Longitudinal Study on Aging, a 2012 study of Canadians aged 45 to 85, was conducted. The prevalence of depression was higher among refugees than non-refugees (22.1% vs 15.2%, p<.001). The age-sex adjusted odds of depression for refugees (OR=1.70, p<.001) was only modestly attenuated when sociodemographic characteristics, physical health conditions, chronic pain, binge drinking and level of physical activity were taken into account (ORs ranged from 1.61 to 1.70, all p<.05). However, in the model adjusting for social support, the odds of depression for refugees was reduced to non-significance (OR=1.30, p=0.92). Refugees have higher odds of depression than non-refugees, and this excess vulnerability is associated with lower levels of social support. Targeted interventions to decrease isolation and improve refugees’ social support warrant greater attention
NEUROENDOCRINE NETWORKS IN AGING
Authors: Sell Christian
Published: November 2019

It has become clear that nutrient regulatory pathways are the major determinants of lifespan. From early studies on caloric restriction to genetic ablation studies in yeast, worms, flies, and more recently mice, a unifying theme has emerged that suppressing nutrient sensing pathways and neuroendocrine networks results in lifespan extension. This work has laid the foundation for interventions designed to ameliorate late-life dysfunction. Inhibition of the mechanistic target of rapamycin (mTOR) pathway using rapamycin, an FDA-approved drug used clinically to inhibit solid organ rejection, is one of the most promising of these interventions. It has been demonstrated that rapamycin enhances longevity in mice, even when initiated in relatively old animals. We will discuss the development of anti-aging therapies, the potential for emerging therapies, and pitfalls associated with clinical trials designed to test these therapies.
THE ROLE OF NETWORKS IN TEACHING GERONTOLOGY THROUGH COMMUNITY ENGAGEMENT AND SERVICE-LEARNING PROJECTS
Authors: Kruger Tina M
Published: November 2019

As we seek to prepare the next generation of researchers, teachers, and service providers in the field of aging, it is vital that students garner experience interacting directly and appropriately with older adults. Community engagement and service-learning (CE/SL) are high impact pedagogical practices associated with enhanced learning, retention, and student success and can facilitate positive interactions across generations. Creating CE/SL opportunities requires authentic relationships with community members and organizations, allowing faculty, staff, and students the opportunity to network with a variety of individuals and agencies. In this presentation, we define CE/SL, examine the role of networks in creating CE/SL opportunities, and discuss challenges and threats to effective CE/SL projects. Tools and resources will be highlighted to provide guidance to those wishing to harness the power of networks to teach gerontology content while also working to have positive, lasting, and measurable impact on the communities in which they serve.
AGING, DISASTERS, AND THE ENVIRONMENT: ROLE OF CLIMATE CHANGE IN DISASTER PREPAREDNESS AND RESPONSE
Authors: Phillips Judith Robertson R , Cannon Melissa L , Cong Zhen
Published: November 2019

Continuing changes in the world’s climate put the older adult population more at risk than other age groups. Multiple circumstances such as disasters and environmental events brought about by climate change impair the ability of older adults to maintain healthy physical and psychological well-being. Unfortunately, during these times, public and individual emergency preparation plans often fall short of having the needed resources to reach out and offer assistance to older adults. Co-sponsored by the Environmental Gerontology and Disasters and Older Adults Interest Groups, four presenters will highlight multiple circumstances where older adults face serious physical and psychological consequences as a result of climate change issues: 1) the loss of electrical power and its impact on hypothermia and hyperthermia in older adults, 2) the loss of basic public health services after Hurricane Maria and its contribution to older adults’ reduced psychological well-being including increased levels of suicide, 3) homeless older adults experiencing a disaster and their resulting increased need for resources, and 4) older adults in the path of violent tornadoes and their ability to cope on their own. These presenters will discuss actions, interventions, and development of emergency disaster preparation plans that would be beneficial for older adult response and recovery. The fifth paper will review the theoretical backgrounds of and previous studies on Anthropocene with a focus on climate change policy and practice. Collectively, these papers will address various means by which older adults are affected by climate change and optimal practices to speed recovery.
ACTIONS TO REDUCE RISK OF OLDER ADULTS DURING EXTREME WEATHER EVENTS THAT THREATEN HEALTH AND LIFE
Authors: Brown Lisa M
Published: November 2019

Climate change places many older adults at unique risk for adverse, potentially life-threatening consequences. Compared to younger adults, older adults are more susceptible to the effects of extreme weather events and at greater risk for heat stroke and hypothermia. With advanced age, some people have vulnerabilities, such as social isolation and physical and mental health conditions that predispose them to a greater level of danger. Loss of power, that leaves people without functioning cooling or heating systems, can cause death because it exacerbates preexisting medical conditions and impairs thermoregulatory function for those with medical illnesses or taking certain medications. Many older adults who function independently may not self-identify as being vulnerable and take necessary precautions to remain safe. This presentation will describe recent research that found that many older adults are unaware of hypothermia and hyperthermia symptoms and the actions needed to maintain health and life.
CLIMATE CHANGE FOR OLDER INDIVIDUALS EXPERIENCING HOMELESSNESS: CONSIDERATIONS FOR DISASTER EVENTS
Authors: Gibson Allison
Published: November 2019

There is a growing field of evidence that individuals experiencing homelessness are disproportionately impacted by climate change due to factors like exposure to the elements, lack of resources and services, as well as disenfranchisement and stigma; all while experiencing greater occurrences of environmental injustice. Given that there are distinct needs for older individuals experiencing homelessness when affected by disasters, this study will report salient themes identified from qualitative interviews with five residential shelters on considerations they incorporate when disaster planning for their older residents. Thematic analysis revealed older age and homelessness have serious implications for planning, responding and in the recovery of disasters. Challenges to finding accessible transitional and permanent housing, limitations to workforce re-entry, increasing income inequality between classes, limitations to mental health services and policies, and cultural justifications for criminalizing poverty and homelessness contribute to our collective understanding of disaster vulnerability when older adults experience homelessness.
FEASIBILITY OF AN EVIDENCE-BASED MENTAL HEALTH INTERVENTION WITH OLDER ADULTS IN POST-HURRICANE MARIA PUERTO RICO
Authors: Burnette Denise
Published: November 2019

Owing to out-migration, decreased fertility and longer lifespans, 18.5% of Puerto Rico’s population is aged 60+ -- 36% live alone and 40% are below poverty. Out-migration after Hurricane Maria may well raise the proportion of older adults to 30%. Mental health problems are among the most widespread and enduring effects of disasters. Common Mental Disorders (CMD) (anxiety, depression, traumatic stress) are most common. Before Maria, CDC data showed 38 % of persons age 65+ reported fair or poor health and 20% had been told they had a depressive disorder. In the months after Maria, the overall suicide rate rose 29%, while it more than doubled for people aged 65-69 and tripled for those aged 75- 79. This pilot study assesses the feasibility and acceptability of adapting the Friendship Bench, an evidence-based intervention developed in Zimbabwe for CMD, for use with older adults in primary care in Puerto Rico.
COGNITIVE HEALTH AND ADRD: GENDER, RACE, AND ETHNIC ISSUES
Authors: Antonucci Toni C , Ajrouch Kristine , King Jonathan W
Published: November 2019

This symposium addresses minority issues in aging, specifically issues of gender, race and ethnicity, in the study of cognitive health and Alzheimer’s Disease and Related Dementia (ADRD). Cabrera examines ADRD in the Latino community noting that there are or may be important differences among subgroups of Latinos, e.g. Mexicans and Puerto Ricans, who are too often considered a homogenous group. Using qualitative methods, specifically focus groups, she explores whether these two groups have a different understanding of or different concerns about ADRD. Dallo considers the epidemiology of ADRD among Arab Americans. Noting the dearth of evidence on this ethnic group, she uses the National Health Interview Survey from 2000-2017 to examine the prevalence of ADRD among foreign-born Arab American compared to Whites, Blacks and Asians. Indiro et al., consider the long reach of childhood SES on age-related brain changes in different racial and ethnic older adults. Finally, Byrd considers gender differences in cognitive health in the Baltimore Study of Black Aging and finds that women actually report better cognitive health than men, controlling for age, education and health status despite previous literature suggesting that women experience more dementia than men. In total, this symposium highlights the need to consider contexts such as gender, race and ethnicity in order to fully understand factors influencing cognitive health and ADRD
LATINOS’ PERCEPTIONS AND CONCERNS ABOUT ALZHEIMER’S DISEASE
Authors: Cabrera Laura Y
Published: November 2019

Several studies indicate that Latinos are at higher risk of developing Alzheimer Disease (AD). While research has centered on African-American/White or Latino/non-Latino differences, there exists heterogeneity within those groups. Clustering Latinos under a single group in AD resources, neglects cultural, biological and environmental differences. To address this complexity we examine perceptions and concerns about AD symptoms, diagnosis, and care among Mexicans and Puerto Ricans via six focus groups. A priori variables for thematic exploration include familiarity, cultural beliefs, trust, privacy, notions of identity and personhood. We use a pragmatic neuroethics framework as a lens to discuss and assess our findings and related implications. This will help address the multidimensional and multidirectional nature of knowledge and communication about diagnosis, treatments and nature of AD. These findings will help to identify differences and similarities among two distinct Latino groups, thereby contributing to scholarship in the fields of Latino’s health, aging, and neuroethics.
PREVALENCE AND RISK FACTORS FOR ADRD AMONG ARAB AMERICANS
Authors: Dallo Florence
Published: November 2019

In the United States (U.S.), Alzheimer’s Disease and Related Dementias (ADRD) afflict over 4.7 million individuals ages 65 or older. Arab Americans are a subgroup of whites in which ADRD is not well understood. This study estimates prevalence and risk factors for ADRD among Arab Americans ages 45 or older. Data for 2000-2017 from the National Health Interview Survey (NHIS) using the region of birth question was used (N=222,219). The age- and sex-adjusted prevalence of ADRD was 10.3% for foreign-born Arab Americans compared to approximately 7.5% for US-born non-Hispanic whites (NHW), blacks and Asians. The prevalence of ADRD was 8.6% for Hispanics (all p-values <.0001). When controlling for age and sex, Arab Americans were 1.4 times (OR=1.02,1.93) more likely to have ADRD compared to US-born NHW. Future studies should capture other generations of Arab Americans to better understand the trend of ADRD among this understudied, often invisible population.
CHILDHOOD SES AND AGE-RELATED BRAIN CHANGES RACIALLY-ETHNICALLY DIVERSE OLDER ADULTS
Authors: Turney Indira C , Arce Rentería Miguel , Chesebro Anthony G , Colon Juliet M , Schupf Nicole , Mayeux Richard P , Brickman Adam M , Manly Jennifer J
Published: November 2019

Socioeconomic disadvantages in childhood has been linked to dementia in late life. However, the underlying pathways through which childhood socioeconomic status (CSES) affects health in old age is unclear. CSES has been linked to age-related differences in regions affected by Alzheimer’s disease (AD; e.g., hippocampus). CSES varies across race/ethnicity; It is critical to examine the relationship between CSES and age-related brain structural changes across diverse aging populations. We used an established proxy for CSES, number of siblings (i.e., sibship size), to examine whether CSES buffered age-related changes in hippocampal volume in a community-based sample of racially/ethnically diverse older adults. Sibship size moderated age-related differences in hippocampal volume in Whites (β=-5.61[-11.09,-0.12]), but not in Blacks and Hispanics. Results indicate that Whites with no sibling (vs. Whites with siblings) show less age-related difference in hippocampal volume. Future analyses will examine other CSES factors (i.e., parental education/occupation) on age-related structural changes across race/ethnicity.
POLICY SERIES: CONGRESSIONAL UPDATE
Authors: Lindberg Brian W
Published: November 2019

This popular annual session will provide cutting-edge information on what the 116th Congress has and has not accomplished to date, and what may be left for this year. Speakers will discuss key issues such as Social Security, Medicare, Medicaid, and the Older Americans Act, caregiving, the National Institutes of Health. Hill staffers, advocates, and lobbyists will present.
IDENTIFYING BARRIERS TO MENTAL HEALTH SERVICES IN A RURAL COMMUNITY
Authors: Maiden Robert J , Gagne Danielle , Segal Daniel l , Hayslip Jr. Bert
Published: November 2019

Unmet mental health care needs of older people living in rural areas have been identified as a fundamental problem. This project engaged a rural consortium of service agencies to support recruitment through advertising, word of mouth, social media. So far, 100 rural participants aged 50 and older have completed our survey which includes the revised Barriers to Mental Health Services Scale, (BMHSS-R) which measures intrinsic barriers attributed to internal characteristics and beliefs, e.g. stigma, and extrinsic barriers, e.g. insurance costs, and lack of transportation. Preliminary results revealed increased services utilization compared to past research. However, several serious barriers remained, e.g. as lack of insurance/costs, distance/location, stigma, and lack of knowledge. The BMHSS-R results e demonstrate how the two types of barriers are related and interact within individuals. Implications are that internal barriers (e.g., stigma) and external ones (location, costs) can be reduced or eliminated through integrated medical/behavioral services.
USING COMMUNITY-BASED MODELS TO PROVIDE INTEGRATED CARE FOR RURAL OLDER ADULTS
Authors: Crowther Martha R , Ford Cassandra D
Published: November 2019

Rural elders are one of the most at-risk populations for experiencing physical and mental health problems. In many rural communities, there are no psychosocial services available to meet the needs of the rural elderly. To provide rural older adults with integrated healthcare, we build upon our existing community-based infrastructure that has fostered community capacity for active engagement in clinical activities and has served as a catalyst to increase participation of rural older adults in clinical services. Our rural community model draws upon the role of culture in promoting health among rural older adults to provide rural service delivery. This model is built upon our network of partnerships with surrounding communities, including potential research participants, community-based organizations, community leaders, and community health-care systems and providers. By engaging the community we can create a sustainable system that will encourage rural older adults to utilize the health care system at a higher rate.
FAMILY DEMENTIA CAREGIVERS’ EPIPHANIES AND CHANGES IN THEIR APPROACH TO CARING FOLLOWING THE VIRTUAL DEMENTIA TOUR
Authors: Harrington Candace C , Harrington Candace C
Published: November 2019

Previous interventional studies have failed to show long-term improvements in caregiver stress, health indices, burden, or delay in long-term care placement. The Virtual Dementia Tour® (VDT) provides a vicarious first-person perspective of symptoms related to dementia. This interpretative phenomenological study revealed family dementia caregivers’ perceptions of the VDT® and its impact on their perception of a person living with dementia. In-depth open semi-structured interviews were conducted with ten VDT® participants following a community event. Participants’ statements described a life-changing process with eye-opening epiphanies about the lived experience of dementia and served as a “call to action” to change their approach to caring. Innovative advances in family caregiving research are critical to support this valuable geriatric workforce. This original study provided new knowledge about the value of the VDT® to inform interventions that harness the unrecognized power of vicarious experiences like the VDT® for family dementia caregivers to improve long-term outcomes.
A MIXED-METHODS STUDY OF NURSING HOME RESIDENTS’ EXPERIENCES OF RELATIONSHIPS AND DAY-TO-DAY SOCIAL INTERACTIONS
Authors: Washburn Allyson M , Williams Susan
Published: November 2019

Nursing home residents with and without cognitive impairment (N=38) answered open-ended questions about their day-to-day social interactions and ongoing relationships with family and friends. One author (SW) completed a conventional content analysis of the transcripts and the other (AW), a phenomenological-hermeneutic analysis. Findings from these analyses were combined and examined further using data from measures of social cognition and staff ratings of social behavior. Participants’ social experiences appeared to be determined not only by long-established habits and preferences and length of nursing home stay but also by their cognitive status and social cognition competencies. A central theme was the importance of managing ongoing relationships and day-to-day interactions so as to reduce one’s own stress as well as the burden on others. This presentation details how findings from distinct analytic strategies were combined to characterize the researchers’ understanding of participants’ lives in their networks of care from their own perspective.
KANSAS’S PEAK 2.0: AN ACADEMIC-STATE PARTNERSHIP IMPROVING THE LIVES OF NURSING HOME RESIDENTS
Authors: Doll Gayle , Cornelison Laci , Stone Robyn
Published: November 2019

Most academic institutions welcome partnerships with industry and state government. These collaborations can lead to interventions to create social and environmental changes on a broad scale. Along with the opportunities, some challenges are inherent with these working relationships. The Kansas State University Center on Aging and the Kansas Department for Aging and Disability Services has been working together for more than 15 years on the Promoting Excellent Alternatives for Kansas nursing homes (PEAK) program. This collaboration has led to beneficial changes for nursing home residents and provided fertile ground for researchers wanting to examine these environments. This symposium will offer researcher insights as well as to elucidate process and procedures related to developing and maintaining collaborations with a state agency.
NURSE PRACTITIONERS’ PRESCRIPTIVE AUTHORITY AND THE RURAL URBAN DISPARITY IN MORTALITY RATES
Authors: Ferdows Nasim B , Kumar Amit
Published: November 2019

Although nurse practitioners (NPs) might be the main providers of primary care to some communities, different states pursue different regulations for NP’s practice authority. This study compared the trends in mortality rates and supply of physicians in states with different policies, using AHRF and CMF data. We categorized states based on their restrictive policies into: full, reduced, and restricted practice. We compared the trends in age-adjusted mortality rate and physician supply in rural and urban areas, and examined within-state changes in rural-urban difference in physician supply and mortality. Our results indicate that as the level of restrictive policy increased the rural-urban mortality gap increased while physician supply declined. Furthermore, regardless of increase or decrease in physicians supply disparity, rural-urban mortality disparity declined in full practice states, with a negative association between a decline in rural-urban physician supply disparity and decline in rural-urban mortality disparity in full or reduced practice states.
LONELINESS FOLLOWING WIDOWHOOD: THE ROLE OF THE MILITARY AND SOCIAL SUPPORT
Authors: King Brittany M , Carr Dawn , Taylor Miles G
Published: November 2019

Social support provides important benefits following widowhood. One context promoting social support throughout life may be the military, where benefits extend to both service members and their spouses. A substantial proportion of older men served in the military, so many widowed women today were married to veterans. We tested two hypotheses: 1) surviving military spouses will experience lower persistent loneliness following widowhood compared to their nonmilitary counterparts, and 2) this benefit is explained by increased emotional and structural social support. Our study uses the Health and Retirement Study (HRS) to examine changes in loneliness following widowhood among spouses of veterans and nonveterans. We used OLS regression and mediation tests to address our hypotheses. Overall, results supported our hypotheses. Widows of veterans reported lower levels of loneliness following widowhood compared to nonveteran widows (=-0.122; p<0.05). Emotional and structural social support mediated the relationship between veteran status of the deceased spouse and loneliness. Specifically, the beneficial effect of veteran status was reduced by almost 50% and became nonsignificant. Our findings suggest the military may facilitate lifelong cultivation of social support that flows not only to veterans but also to their families. These findings are suggest that the military may offer important opportunities to cultivate emotional and structural social supports that enhance the ability of veteran wives to more readily adjust to widowhood. Additionally, they emphasize the importance of having social support in later life when faced with adversity, as it seems to ameliorate some of the negative effects.
FALLS AMONG CAREGIVERS AGE 45 AND OLDER IN 15 STATES, DC, AND PUERTO RICO, 2016
Authors: Bouldin Erin D , Labi Vanna , Edwards Valerie , McGuire Lisa
Published: November 2019

Family and friends who provide care to people with chronic conditions or disability (caregivers) are a critical component of community-based care in the US. Falls could negatively impact a caregiver’s ability to provide care. In 2016, 15 states, DC, and Puerto Rico included the optional Caregiver Module on the Behavioral Risk Factor Surveillance System. We used these data to estimate fall and injurious fall prevalence among caregivers age ≥45 who had provided care for ≥2 years. Among 71,541 respondents, 11.8% provided care for ≥2 years. One-third of caregivers had fallen in the past year (16.6% once; 16.4% more than once), and 47.3% of caregivers who fell reported at least one resulted in an injury that limited activity or required treatment. Caregivers were significantly more likely to fall (p=0.02) and to experience injury (p=0.002) compared to non-caregivers. Falls are common among caregivers and potentially harmful to them and their care recipients.