bluuebunny/crossref_metadata_2025 huggingface dataset:
Can We Replace Our Human Connection With Technology?
Authors: Cone Nicholas , Lee Jeongeun
Published: December 2021

The COVID-19 pandemic has led to social distancing protocols, subsequently increasing social isolation for older adults. The purpose of this study was to explore the relationship between social connectedness and mental health outcomes. Leveraging NHATS, a nationally representative study (n = 2,558, Mage = 79.20, SDage = 6.25), we examined the association between the method of social connectedness and mental health outcomes. Descriptive analyses revealed older adults are using various methods (e.g., in-person, phone, and video calls) to remain connected with their social networks during COVID-19. Findings from all of the linear regression analyses indicated phone or video calls are associated with negative affect, whereas in-person visits are associated with lower levels of negative affect. These findings suggest substituting in-person visits with video calls or phones may not be sufficient to relieve their loneliness and negative affect. Future studies should investigate this effect on physical or emotional health outcomes.
Immunometabolic Stress and Ketone Bodies in Disorders of the Aging Brain
Authors: Newman John
Published: December 2021

Delirium is an acute confusional state that is a common complication of acute illness in older adults, and is associated with increased risk of death, disability, and dementia. Delirium in older adults is an example of a geriatric syndrome, with multifactorial, multi-system causes that include existing aging-related physiological changes as well as external acute stressors. Its pathophysiology delirium is not well understood but may include glycolytic energy deficits associated with acute inflammation in the brain. The endogenous ketogenic system provides ketone bodies as a lipid-derived alternative to glucose for cellular energy, and ketone bodies are increasingly understood to have immunomodulatory effects particularly on innate immune cells. We used a mouse model of acute inflammation-associated behavioral change to investigate how age-related differences in energy utilization in the brain affect delirium-like phenotypes, focusing on energy metabolism and innate immune activation in the brain as an example of immunometabolic approaches to geriatric syndromes.
Behavioral Health and Most-Interested Topics Among Older Adults in Three Aging-in-Community Programs in Florida
Authors: Hou Su-I
Published: December 2021

This study compares behavioral health and most-interested topics among older adults in three aging-in-community (AIC) programs: a university-based lifelong learning program (LLP; 38%), a county neighborhood lunch program (NLP; 29%), and a village program sample (33%) (total n=289). Mean age was 72.4 (SD=8.68) years. Although perceived health was similar (mean=3.76), LLP and village members reported higher quality of life than NLP participants (p=.004). Two-thirds of the participants indicated at least half of their daily plates filled with fruits and vegetables, and at least 10 min. walking in 4.5 days during a typical week. The duration of each walking was lower among NLP members (23 min.), compared with village (31 min.) or LLP members (35 min.) (p=.002). The top three most interested topics were brain health, giving back, and keep community healthy. Older adults in AIC programs were overall healthy and active. Results have implication on tailored program development.
A Comparison of Long-Term Care Use by Community-Dwelling Older Adults With and Without Dementia
Authors: Young Yuchi , Stone Arianna , Chung Kuo-Piao , Chen Hsiu-Hsi , Yeh Yen-Po
Published: December 2021

Introduction. This study compares long-term care (LTC) use among community-dwelling older adults with and without dementia. Methods. Participants (n=14,483) were aged 65+ residents of Changhua County, Taiwan who qualified for LTC services. Data were collected (4/1/2017-10/26/2018) through health assessments. Multivariate logistic regression quantifies the study aim. Results. Preliminary results show that on average participants with dementia are older than people without dementia (81.1 vs. 80.5; p<.001), more females (13.4% vs. 8.0%; p<.001), higher mean ADL (12,4 vs. 9.8; p< .001) and IADL (21.4 vs. 17.8; p<.001), and lower mean comorbidity (2.5 vs. 2.8; p<.001). Multivariate regression results indicate people with dementia use twice the health-related LTC services than their counterpart (OR= 2.0; 95% CI 1.90–2.14). Discussion. People with dementia use more health-related LTC services. Future dementia studies should examine the pattern of non-health-related LTC services concomitant with health-related services, so that person-centered care can be tailored to foster aging-in-community.
Disaster Preparedness and Coping Among Older Adults: Empirical Analysis and Virtual Reality Platform Development
Authors: Cong Zhen
Published: December 2021

This symposium included 4 studies that use national and regional data to examine older adults’ disaster preparedness and coping. The first study examined age differences in preparedness for the continuation of COVID-19 with a sample of 443 residents in Dallas, TX. The findings highlight older adults’ resilience and special needs for different types of support during the pandemic. The second study examined the association of having COVID-19 and intergenerational relationships using the COVID-19 module of the Health and Retirement Study with a sample of 3266 respondents. Using a national sample of 1,467 respondents from the 2017 U.S. National Household Survey, the third study examined age differences relationships among the type of disasters (i.e., disasters with different lead-time), response efficacy, and disaster preparedness. The findings highlighted older adults’ unique vulnerability and resilience in different types of disasters. The fourth study discussed a pilot virtual reality platform under development to assist older adults to develop tailored household emergency preparedness plans and practice those plans with simulated extreme weather conditions and warnings for older adults to practice disaster response and develop relevant knowledge and skills as well as test and revise their emergency preparedness plans. Overall, this symposium emphasizes the uniqueness of older adults’ needs, vulnerability, and resilience to disasters.
Embracing Age-Inclusivity Through Multimodal, Active Student Learning in a Health and Aging Policy Course
Authors: Leedahl Skye
Published: December 2021

One of the goals for an upper-level undergraduate seminar course is for students to identify and discuss existing policies, programs, and resources for meeting the needs of the aging population. To encourage active student learning, the course provides a mix of readings and assignments, six intergenerational discussions, and reflective writing. The idea is that these varying experiences help foster a deep understanding of how these policies and related issues pertain and matter to everyone, not only older individuals, and how their future career and family experiences will benefit from the knowledge gained in the course regardless of their next career steps. This course model has been effective for challenging ageism, and has been taught four times, each time with modifications based on student numbers, current issues, and the pandemic. The presenter will discuss assessment methods, identify best practices, and offer suggestions for others interested in utilizing a similar model.
Journal of Gerontology: Social Sciences—Global Scholarship Challenges and Opportunities
Authors: Kelley Jessica
Published: December 2021

The Social Sciences section of The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences aims to publish the highest quality social scientific research on aging and the life course in the U.S. and worldwide. The disciplinary scope is broad, encompassing scholarship from demography, economics, psychology, public health, and sociology. A key substantive focus is identifying the social, economic, and cultural contexts that shape aging experiences worldwide. In the coming decade, social gerontology research is poised to present many opportunities for cross-national and cross-cultural scholarship – driven in part by the proliferation of large parallel data sets from many nations in Europe, Latin America, and Asia. I will discuss the role that peer-reviewed cross-national scholarship can play in disseminating knowledge that informs gerontological research, policy, and practice internationally. I will also identify under-researched areas that will be of great interest to scholars in the coming decade, including LGBT older adults, aging in the Global South, reconfigured families, and centenarians.
The Costs and Benefits of Choice: Family Managers in Directly Funded Home Care
Authors: Dansereau Lisette , Kelly Christine , Aubrecht Katie , Grenier Amanda , Williams Allison
Published: December 2021

Directly funded (DF) home care, or consumer directed home care, gives program users a budget to choose their own services. Set in the Canadian province of Manitoba, our study examines the local DF program “Self and Family Managed Care”, which does not allow program users to hire and pay a family member. Incorporating a disability lens into care and aging studies, we share findings from a qualitative study based on 24 semi-structured interviews with DF users. We focus on the experiences of family managers, that is, representatives acting as a decision maker for an older adult. About half of the family managers in this study care for people living with dementia or cognitive decline. We identify two main themes: 1) service flexibility in DF reduces caregiver strain, 2) family managers tend to hire agencies rather than individuals to avoid administrative burden. Our discussion highlights the costs of DF from the perspective of caregivers as administrative burden (financial paperwork, finding workers, choosing a ‘good’ agency), and the benefits as flexibility (choosing workers, trusting workers, setting schedules, assigning work). We also consider the goals of family managers to enhance quality of life and avoid long-term residential care, in contrast to younger self-managers who desire control and autonomy. We recommend that DF programs need to reduce administrative work for users, support users in making informed choices, and find better ways to support, acknowledge and value the work of family managers and substitute decision makers.
Critical Thoughts About Health Disparities With the NIA Division of Neuroscience
Authors: Martin Damali , Elliott Cerise
Published: December 2021

Population-based health disparities studies requires improved research design and appropriate research questions for investigation that will inform evidenced-based interventions and prevention strategies. The NIA Division of Neuroscience is committed to supporting new studies that 1) invests in health priorities as reflected by needs of minoritized populations (e.g. Race/Ethnic minorities; Rural or Sexual Gender Minorities); 2) examines Alzheimer’s Disease and cognitive changes across the individual lifespan; and 3) understands intersectionality of cohorts and minimize potential biases in participant selection. This brief session will outline updated steps to permit critical thought about the use of the NIA’s Health Disparities Framework to examine relevant biological, sociocultural, behavioral and environmental across multiple levels of influence.
Kuakini HHP Center for Translational Research on Aging: Aims and Preliminary Findings
Authors: Willcox Bradley , Allsopp Richard , Martin Peter
Published: December 2021

Kuakini Medical Center (Kuakini) is creating an interdisciplinary Hawai’i-based Center for translational research on aging. This Center will build upon Kuakini’s five-decades of NIH-funded research, its 420,000-specimen biorepository, and existing strengths in aging research, notably, the 56-year ongoing Kuakini Honolulu Heart Program cohort study (Kuakini HHP), Kuakini Honolulu-Asia Aging Study (Kuakini HAAS), and Kuakini HHP Offspring Study. The overall goal is to find practical means to enhance healthy human lifespan (healthspan). Four research project leaders (RPLs) have been selected from various disciplines for mentorship in translational aging research. The first RPL presentation will introduce a novel mouse model, enabling controlled expression of the pro-longevity gene FoxO3, and assess the impact on lifespan and healthspan phenotypes in mice. These phenotypes will be compared to similar phenotypes in humans with/without the FOXO3 longevity genotype. The second RPL presentation will assess the relation between leukocyte telomere attrition rates (from banked blood collected at three time points over 20-plus years) in older Kuakini HHP men with/without the FOXO3 longevity genotype. The third RPL presentation will assess whether FOXO3 genotype, peripheral leukocyte telomere dynamics (attrition rate, telomerase activity) and inflammatory cytokines mediate the human brain integrity and function with age. This project will utilize structural and functional MRI data from male and female Kuakini HHP Offspring Study participants. The fourth RPL presentation will assess whether APOE e2, e4, and FOXO3 longevity-associated alleles impact 34-year incidence of intracerebral hemorrhage. We will summarize the findings, address the healthspan implications and provide future directions. Supported by NIH 5P20GM125526.
Assessing Lifespan and Aging Phenotypes Resulting From FOXO3 Induction Using Mouse Models
Authors: Owens Jesse , Hew Brian , Tran Christopher , Xie Kristal , Willcox Bradley
Published: December 2021

Environmental signals, including caloric restriction and oxidative stress, trigger FoxO3 to upregulate genes involved in stress resistance, metabolism, cell cycle arrest, and apoptosis that may help mitigate age-related diseases. Activation of FoxO3 has been shown to have a profound life-extending effect on model organisms. Protective SNPs in FOXO3 are strongly associated with exceptional longevity in humans. The objective of this study is test the relation between FoxO3 and longevity using mouse models. We generated a mouse line containing an extra copy of FoxO3 that can be induced at any age. In our model, FoxO3 remains driven by its natural promoter to avoid mis-expression in inappropriate cells and to maintain the gene’s ability to respond to signals such as stress. We are utilizing this new model to assess survival endpoints and test a panel of aging phenotypes reflecting healthspan throughout the mouse lifespan and compare these to similar human phenotypes.
The Impact of ApoE and FOXO3 Genotype on the Risk of Intracerebral Hemorrhage Among American Men of Japanese Ancestry
Authors: Nakagawa Kazuma , Chen Randi , Greenberg Steven , Ross G , Willcox Bradley , Masaki Kamal
Published: December 2021

This study assessed the impact of APOE e2, e4 minor alleles and the FOXO3 longevity-associated genotype (carrier of SNP rs2802292 “G” allele) on 34-year incidence of intracerebral hemorrhage (ICH). Cox regression models were performed to assess the impact of the APOE e2, e4 and FOXO3 G alleles on the incidence of ICH. A total of 6483 participants were eligible for the analyses. 213 participants developed ICH. Cox-regression model showed neither APOE minor allele vs. common genotype (APOE e3/e3: RR 0.89, 95% CI: 0.64-1.22, p=0.46) nor FOXO3 G carrier status (RR 0.97, 95% CI: 0.72-1.29, p=0.82) was associated with incident ICH. Conversely, both hypertension (RR: 1.46, 95% CI: 1.07-2.00, p=0.02) and low cholesterol level (RR: 0.99, 95% CI: 0.99-1.00, p=0.001) were associated with incident ICH. Carriage of APOE e2 or E4 alleles and the FOXO3 G allele do not appear to impact risk of ICH over 34 years in this cohort.
Association of Walking Energetics With Amyloid Status: Findings From the Baltimore Longitudinal Study of Aging
Authors: Dougherty Ryan , Li Fangyu , Wanigatunga Amal , Tian Qu , Simonsick Eleanor , Bilgel Murat , Schrack Jennifer
Published: December 2021

Higher energetic costs for mobility are associated with slow and declining gait speed. Slow gait is linked to cognitive decline and Alzheimer’s disease (AD), but the physiological underpinnings are note well-understood. We investigated the cross-sectional association between the energetic cost of walking and amyloid status (+/-) in 174 cognitively unimpaired men and women (52%) aged 78.5±8.6 years. The energetic cost of walking was assessed as the average oxygen consumption (VO2) during 2.5 minutes of customary-paced overground walking. Amyloid status was determined from 11C-Pittsburgh compound B (PiB) positron emission tomography (PET) imaging. Average energetic cost of walking was .169±.0379 ml/kg/m and 30% of the sample was PiB+. In logistic regression adjusted for demographics, APOE-e4, body composition and comorbidities, each 0.01ml/kg/m higher energy cost was associated with 12% increased odds of being PiB+ (OR=1.12; 95% CI:1.01-1.24). Inefficient walking may be a clinically meaningful physiological indicator of emerging AD-related pathology.
Early Prediction of Cognitive Deficits After Traumatic Brain Injury Based on AD-Like Patterns of Neurodegeneration
Authors: Irimia Andrei , Maher Alexander , Rostowsky Kenneth , Chaudhari Nikhil , Chowdhury Nahian , Jacobs Elliot , Robles David , Dharani Ammar
Published: December 2021

Traumatic brain injuries (TBIs) are frequently followed by persistent brain alterations and by cognitive sequalae, especially in older adults. Although mild TBI (mTBI) is a risk factor for Alzheimer’s disease (AD), the extent to which the two conditions are related remains largely unexplored. Using structural, functional and diffusion magnetic resonance imaging (MRI), we have identified AD-like post-traumatic neurodegeneration patterns that accurately prognosticate cognitive decline after geriatric mTBI. Our results indicate that these features involve cortical regions and circuitry mediating memory and executive function, and that AD neurodegeneration has key structural and functional similarities to post-traumatic neurodegradation. Using machine learning of such similarities, we have accurately forecast the severity of chronic cognitive deficits after geriatric mTBI based on acute neuroimaging measures. Our findings demonstrate that AD-like alterations in brain structure and function observed early after injury can predict post-traumatic mild cognitive impairment, which is itself strongly associated with AD risk.
Longitudinal Changes in Leadership and Person-Centered Care Over 5 Years in Swedish Nursing Homes
Authors: Backman Annica , sjögren karin , Lövheim Hugo , Lindkvist Marie , Edvardsson David
Published: December 2021

Nursing home leadership has been described as crucial for person-centred care and psychosocial climate, but longitudinal data are lacking. The significance of manager educational qualifications and operational model of nursing homes for perceived leadership, person-centred care and psychosocial climate also needs further exploration. This study aimed to explore changes in nursing home managers’ leadership, person-centred care and psychosocial climate comparing matched units in a five-year follow-up. Also, to explore changes in leadership characteristics’ and the significance of manager qualifications for perceived leadership, person-centred care and climate. Repeated cross-sectional, valid and reliable, measures of leadership, person-centred care, psychosocial climate and demographic variables were collected from managers and staff n=3605 in 2014 and n=2985 staff in 2019. Descriptive and regression analyses were used. Leadership remained significantly associated to person-centred care in a five-year follow-up, but no changes in strength of associations were seen. Leadership also remained significantly associated to psychosocial climate, with stronger associations at follow-up. Also, certain leadership characteristics significantly increased over time, thus, partly confirms previous findings. It was also shown that a targeted education for managers was significantly associated to person-centred care.
Sustainability of INFORM: A Complex Team-Based Improvement Intervention in Long-Term Care
Authors: Hoben Matthias , Ginsburg Liane , Berta Whitney , Dearing James , Norton Peter , Doupe Malcolm , Keefe Janice , Spiers Jude
Published: December 2021

Improving Nursing Home Care Through Feedback On perfoRMance Data (INFORM) was a complex, theory-based, three-arm, parallel cluster-randomized trial. In 2015–2016, we successfully implemented two theory-based feedback strategies (compared to a standard approach to feedback) to increase nursing home (NH) care aides’ involvement in formal communications about resident care (formal interactions [FI], the primary outcome). Here, we report the extent to which FI was sustained 2.5 years following withdrawal of intervention supports. We also report on several determinants of sustainability. We analyzed data from 18 NHs (46 units, 529 care aides) in the control group, 19 NHs (60 units, 731 care aides) in the basic assisted feedback group (BAF), and 14 homes (41 units, 537 care aides) in the enhanced assisted feedback group (EAF). We assessed sustainability of FI, using repeated measures, hierarchical mixed models, adjusted for care aide, care unit and facility variables. In EAF, FI scores increased from T1 (baseline) to T2 (end of intervention) (1.30–1.42, p=0.010), remaining stable at T3 (long-term follow-up) (1.39 p=0.065). FI scores in BAF increased from T1 to T2 (1.33–1.44, p=0.003) and continued to increase at T3 (1.49, p<0.001). In the control group, FI did not change from T1 to T2 (1.25–1.24, p=0.909), but increased at T3 (1.38, p=0.003). Better culture, evaluation and fidelity enactment significantly increased FI at long-term follow-up. Theory-informed feedback provides long lasting benefits in care aides' involvement in FI. Greater intervention intensity neither implies greater effectiveness nor sustainability. Modifiable context elements and fidelity enactment may facilitate sustained improvement.
Engagement of Family in a Goal Setting Strategy: Impact Upon 30-Day Hospital Readmissions
Authors: Boltz Marie , Kuzmik Ashley , Resnick Barbara , Best Irene , Mogle Jacqueline
Published: December 2021

Family-centered Function-focused Care (Fam-FFC) works with family caregivers as care partners in the assessment, function-promoting goal setting, implementation, and evaluation of goal attainment during hospitalization and immediate post-acute period. ANCOVA technique examined the preliminary impact of Fam-FFC upon 30-day hospital readmissions and logistic regression tested the association of goal attainment, measured with the Goal Attainment Scale (GAS) with 30-day hospital readmissions. The majority of the patients were Black (50%), female (62%), had a mean age of 81.6 (SD=8.4), mean Barthel Index of 60.29 (SD=27.7), and mean MoCA of 10.67 (SD=7.0). Goals represented six main categories: mobility, cognition, self-care, toileting, sleep, and pain management. Patients in the intervention group had less 30-day hospitalizations (F= 4.6, p=.033) and goal attainment was significantly associated with less recidivism (B=.179, Wald= 2.8 (1), p= .045). FamFFC shows promise in reducing 30-day hospital readmissions; results support the contribution of family engagement and use of GAS
Reliability and Validity of the Neuropsychiatric Inventory Questionnaire in Dyads With Dementia at Hospitalization
Authors: Resnick Barbara
Published: December 2021

This study expanded on the limited psychometric testing of the Neuropsychiatric Inventory-Questionnaire (NPI-Q), and extended testing to include hospitalized persons with dementia upon admission to the hospital, with reports from family caregivers. Using data from 318 dyads in the ongoing Fam-FFC trial, a Rasch analysis was conducted. Most patients were female (62%), non-Hispanic (98%), and Black (50%) with a mean age of 81.62 (SD=8.43). There was evidence of internal consistency for all subscales (behavior, severity, caregiver distress); a DIF analysis showed invariance across race and gender. The items on the NPI-Q fit with each subscale. Hypothesis testing showed a significant association between the AD8 (F=30.04, p=.001) and MoCA (F= 5.05, p=.03) with behaviors; the AD8 (F =27.91, p=.001) and MoCA (F = 6.65, p=.01) with severity; and the AD8 (F = 29.23, p=.001) with caregiver distress. Findings provide support for the NPI-Q use in persons with dementia during acute illness.
Promoting Self-Care in Caregivers of Older Adults Living With Chronic Illness: The iCare4Me Study
Authors: Massimo Lauren , Hirschman Karen , Buck Harleah
Published: December 2021

Informal caregivers provide a substantial amount of social support to older adults which can be stressful and lead to poor self-care. When stressed, caregivers of persons living with chronic illness are less vigilant and less motivated to engage in self-care behaviors that are important for maintaining their own physical and emotional health. Support interventions can encourage self-care by helping caregivers to focus on values, solve problems, and transform their goals into action. In this symposium, we will discuss the iCareMe study, a randomized controlled trial (RCT) (NCT03988621) that tests a virtual support intervention which utilizes health coaching to increase self-care behaviors in caregivers of older adults living with chronic illnesses, such as heart failure and dementia. The first session will discuss the translation of self-care theory to the basis for the “Virtual Caregiver Coach for You” (ViCCY) intervention and will provide an overview of the iCare4Me randomized control trial designed for caregivers of persons living with advanced heart failure. The second session will describe the adaptation of the iCare4Me RCT to caregivers of persons living with dementia. The third session will highlight findings from a qualitative descriptive study examining the characteristics of effective health coaching used in these two RCTs. Finally, the last session will share findings from a cross-sectional analysis examining moderators of self-care in heart failure caregivers. Together, these presentations will illustrate the unique and innovative approach that iCare4Me has taken to improve self-care in caregivers of older adults living with chronic illness.
Support Quality Moderates the Impact of Total Household Occupancy on Self-Care Neglect in Informal Caregivers
Authors: Matus Austin , Riegel Barbara
Published: December 2021

Caregiver self-care may be impacted by the household environment. We evaluated the impact of support quality (e.g., ratings of quality of emotional support, information, material help, errands performed by others) and total household occupancy on a validated measure of self-care neglect in caregivers of patients with heart failure. Multivariate regression modeling was used to examine predictors of self-care neglect and we introduced an interaction term between support quality and household occupancy. The main effects model included terms for years of caregiving experience, hours caregiving daily, support quality, and total household occupancy (R2: 0.31; p <0.05). The interaction term between support quality and household occupancy contributed significantly (p < .05) to the respecified model (R2: 0.41; p <0.05). We suggest that the potential benefit of total household occupancy on caregiver self-care depends on perceived support quality. Clinicians should assess quality of household resources with caregivers during interactions.
Explaining Gender Differences in Depressive Symptoms Among Caregivers of Older Patients With Critical Illness
Authors: Fu Wenhao , Li Jiajia
Published: December 2021

The aging of baby boomers makes caring for the elderly an increasingly important topic. As rising cost of health care, the care for seriously ill patients has gradually shifted from hospitals to families, particularly in the countryside. Along with growing demand for informal care, informal caregivers are at increased risk of depression. The aim of this study was to explore the potential protective factors or risk factors associated with depressive symptoms of caregivers for patients with critical illness (45 to 93 years of age) across gender groups, explain their different pathways of influence, and elucidate targeted measures to improve their outcomes (N=518). Results from the statistical model showed that the paths of effect from care needs to caregiver depressive symptoms differed between male and female informal caregivers. Care needs were not significantly associated with depression symptoms among informal caregivers, for either men or women. Care hours of more than 12 hours per day and financial difficulties at home are risk factors for depressive symptoms in caregivers, with significance of OR=3.42; 95%CI,1.97 to 5.94; P=0.000 and OR=2.98; 95%CI, 1.46 to 6.05; p=0.003, respectively. For male caregivers, years of caregiver education and the feel relied upon by relative's were both protective factors, whereas Job-Caregiving conflict, was a risk factor (P<0.05). For female caregivers, caregiver burden and higher caregiver age were its risk factors (P<0.05). These important findings demonstrate that to be effective in reducing depressive symptoms among informal caregivers, both cointerventions and triage interventions by gender are warranted.
Policy Considerations for Geriatric Social Workers in Healthcare Settings During COVID-19
Authors: Washington Tiffany , Lewinson Terri
Published: December 2021

Social workers are essential to the delivery of health care with older adults the during COVID-19 pandemic. This paper focuses on the impact of policies in health care systems that affect geriatric social work practice. Semi-structured interviews were conducted with 55 social workers from a variety of health care settings. Data were analyzed to identify the scope of social work practice in health care settings during the COVID-19 pandemic, and how policies in their respective settings impacted their work. Conditions that impeded participants’ ability to provide quality care and work within their scope of practice included inconsistent expectations of interdisciplinary team members, disparate access to resources, restriction of opportunities to address emotional distress experienced by workers. Recommendations for policy enhancements in health care settings include interprofessional education on effective team communication, protocol development for the equitable distribution of resources among essential workers, and trauma-informed in-service trainings for health care administrators.
Understanding and Measuring Frailty: Insights From the Canadian NuAge and CLSA Cohorts
Authors: Gaudreau Pierrette , Cohen Alan
Published: December 2021

Frailty is one of the most central concepts in geriatrics; nonetheless, multiple definitions and operationalizations abound, and the underlying biology remains a topic of much discussion. Here, we bring together four talks that join questions of understanding with questions of measurement, in order to explore how answering each is necessary to make progress on the other. We cannot measure frailty if we have not understood and defined it, but we cannot understand if we cannot measure it and study it. Turcot et al. present work on operationalizing frailty in the NuAge cohort. Mayo et al. establish a scale to test the extent to which frailty can be operationalized as a ladder rather than a condition, again using the NuAge cohort. Mendo et al. use mediation analyses to understand how grip strength and other aspects of frailty may play a role in the relationship between diabetes and atherosclerosis. Ghachem et al. test the relationship between physiological dysregulation of different systems and different criteria of the Fried model, in order to assess the evidence for frailty as an emergent physiological state. Together, these talks will push the boundaries of how we think about frailty at levels ranging from biological to clinical to operational.
Involving Older Adults in the Data Analysis Process
Authors: Nolte Julia , Turker Hamid
Published: December 2021

Because involvement of older adults in the research process continues to be low, we review existing approaches to engaging older adults in qualitative and quantitative data analysis. In doing so, we examine in which contexts older adults have or could serve as analysis consultants, collaborators, or even leaders. We also discuss the benefits and challenges associated with inviting older adults into the analysis process: On the one hand, this age group can contribute unique viewpoints and draw on a lifetime of experience and expertise. On the other hand, involving older adults in data analyses typically requires resources and time while bearing the risks of health-related attrition, tokenistic treatment, and power imbalances between researchers and older adults. As a result, we close with recommendations on how to navigate this process effectively and respectfully (e.g., building trust, reducing hierarchies, being mindful of older adults’ needs, and assessing their satisfaction throughout the collaboration).
The Role of Community Support and Social Networks Among Marginalized Groups in Later Life
Authors: Van Vleet Samuel
Published: December 2021

As the aging population in the United States continues to grow, so does the need for advancement and critical research to better understand later life experiences. The presence of cumulative disadvantages among racial minorities can often lead to later life health disparities. The goal of this study is to assess the role that social networks and community support play in later life health for marginalized communities. Data from the National Health and Aging Trends Study were analyzed using general linear regression techniques. This allowed for better understanding into the relationships between community support, social networks, race/ethnicity and self-reported health. The final sample included 3,857 participants aged 65 and older. After controlling for other variables, community support and social networks had statistically significant positive relationship with later life health. Race/ethnicity was the strongest predictor of worse later life health. The results of this study show the importance of later life social support for predicting health scores. White participants not only maintained higher health scores as compared to Black and Hispanic participants, but they also reported higher levels of social networks and community support. Findings from this study help build upon the literature regarding community support and social networks in later life.
All in the Family? Age, Period, and Cohort Differences in Kinship Ties Among Older U.S. Adults
Authors: Compernolle Ellen , Howard Khoa Phan , Hedberg Eric
Published: December 2021

In general, older adults’ social networks—characteristics of which (e.g., size, type, frequency) have been linked to important health and well-being outcomes--tend to be kin-centered, although this has changed over time. Disentangling these changes, however, is difficult given typical mobility decline and shrinking networks in old age (age), the rapid social and demographic changes that occurred during the 20th century (cohort), and, in recent decades, the 2008 Recession and technological advances (period). This study uses data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of older adults (ages 57-85; 2005-2016), to examine patterns in older adults’ social networks, with particular emphasis on the role that family plays. Specifically, we ask: 1) Have older adults’ social networks become less kin-centered over the past decade (2005-2016)? 2) Are they less kin-centered among younger cohorts? And 3) Does the recession explain part of these period effects? We find that, between 2005 and 2016, family still comprises the majority of older adults’ social networks, although their network size and range have grown larger and become less family-centric. They also report fewer close family members and friends, living with fewer family members, and less frequent interaction with network ties. Results from multi-level regression models suggest that age, and to a much lesser extent, cohort, plays a key role in many of these changes, although this varies between the first and second 5-year intervals of data collection, underscoring older adults’ adaptivity to current social and economic circumstances.
Stressful Family Contexts and Health in Divorced and Married Mothers
Authors: Klopack Eric , Wickrama Kandauda
Published: December 2021

Using prospective data over 25 years from a sample of 416 women, the first objective of the current study was to investigate the biopsychosocial process over the second-half of the life course comparing mothers with diferent marital histories. The second objective was to investigate this biopsychosocial process for 296 maried mothers focusing on their marital quality over middle years. The results suggested that, compared to being married, divorcing in early-midlife launched an adverse biopsychosocial process for women leading to physical pain, physical limitations, and depressive symptoms over their mid-later years, largely through early-midlife financial stress, regardless of later recoupling. However, subsequent financial stress did not influence divorced mothers’ later-life health problems, suggesting their development of resilience. For consistently married mothers, both marital stress and financial stress uniquely influenced all three health problems throughout their mid-later years. For all mothers, these health problems progressed over mid-later years, as indicated through their stabilities and mutual influences, and these health problems also selected mothers into further escalating financial and marital stress over their mid-later years. Elucidating differential short- and long-term health influences of marital and financial stressors for divorced and married mothers provides a potentially useful information for targeted early preventive intervention efforts and policy formation. Such interventions can promote and develop resiliency factors, thereby aiding middle-aged mothers to prevent from adverse biopsychosocial processes.
A Systematic Review of Effects of Physical Activity of Family Caregivers of Older Adults With Chronic Disease
Authors: Baik Dawon , Song Jiyoun , Tark Aluem , Coats Heather , Jankowski Catherine
Published: December 2021

More than 17 million family caregivers (FCGs) provide care for older adults with chronic illness in the US. Caregiving for older adults with chronic disease places a considerable burden on FCGs and they tend to neglect their personal health. Generally, physical activity (PA) programs benefit the physical and psychological health of FCGs. However, no review of PA randomized clinical trials (RCTs) focused on FCGs of older adults with chronic disease. In this systematic review, we analyzed the most recent trends (2010-2020) in RCTs identifying the effects of PA in this population. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases (PubMed, CINAHL, Embase, PsycInfo, Cochrane Library) were searched for publications dated from 2010 to 2020. All studies included were appraised for quality using the Cochrane Collaboration Risk of Bias Tool. Of the resulting 16 studies, most studies (n=11) targeted FCGs of older adults with dementia or cancer. Most FCGs were non-Hispanic white. PA interventions with mixed modes (e.g., aerobic and resistance exercise), mixed delivery methods (e.g., in-person and telephone) and mixed settings (e.g., supervised gym- and unsupervised home sessions) were used most frequently. PA interventions significantly improved psychological health but had inconsistent effects on physical health. Tailored PA programs, designed based on FCGs’ goals, preferences and limitations, may improve upon physical health outcomes. Future PA studies should include samples of racially and ethnically diverse FCGs of older adults representing a broader range of chronic diseases.
At-Homeness: Rethinking Personhood-in-Community Through the Lens of Social Identity
Authors: Gan Daniel R Y , Rowles Graham , Chaudhury Habib
Published: December 2021

Since Chaudhury’s seminal work (2008), spatial ethnographies of the everyday lives of people living with dementia(PLWD) have proliferated. From an experiential perspective, geographies of home (Blunt & Varley, 2004) and geographies of dementia may overlap significantly. We conducted a meta-ethnographic synthesis of n=28 articles to identify points of convergence and divergence in these literatures using comparative thematic analysis with NVivo 12. Whereas geographies of home highlight at-homeness (e.g., ontological safety and daily activities), geographies of dementia underscore communal and civic participation (e.g., social relationships). These themes converge around “social identity” which may be an important construct that helps PLWD feel at home. The quality of life of PLWD in the community may be influenced by prior (and present) experiences of at-homeness. These become more pertinent as older adults shelter in place. We discuss the implications of these findings in relation to relational models of personhood-in-community (Swinton, 2020) and community gerontology.
Investigating Barriers and Facilitators to Congruence in Place of Care Among Unhoused Palliative Care Patients
Authors: Johnson Ian , Light Michael
Published: December 2021

An important quality marker for end-of-life services is congruence with patient’s preferred place of care, but this congruence in place of care is less likely for those facing structural inequalities (Grunier et al., 2007). As homelessness among older adults in the United States grows (Culhane et al., 2013), the urgency in understanding place of care in palliative care with unhoused patients grows. This presentation illustrates results from an organizational case study (Yin, 2014) of a novel homeless palliative care team and focuses on a qualitative content analysis of charts of patients over 50 receiving care both before and during the COVID-19 pandemic (n=27). Findings highlight (1) the interplay between environmental factors, psychosocial resources and constraints, and medical acuity in determining where care can take place, (2) facilitators for care in marginal settings such as emergency shelters and encampments, and (3) where opportunities for more equitable age-friendly healthcare system interventions exist.
Patterns Among Same-Sex Spousal Couples: Diverse Sociocultural Representation in Alzheimer’s Research
Authors: Stites Shana
Published: December 2021

Emerging evidence shows that understanding characteristic patterns between study partners (SP) and subjects can inform initiatives to diversify representation of sociocultural groups in ADRD research. This study examined same-sex spousal dyads with the goal of identifying bellwethers of opportunities to build diversity in ADRD research. Descriptive analysis of The Aging, Demographics and Memory Study (ADAMS), which enrolled a subset of subjects from the Health and Retirement Study and a SP for each subject. Eight same-sex spousal couples were among 718 SP-subject dyads (1.1%). Gay men were 3 times as likely to be spousal SPs (n=6) than lesbians (n=2), even though women far outnumber men overall. Patterns in caregiving and other characteristics also differed. Same-sex couples are underrepresented in ADRD research. Patterns among those enrolled suggest masculine and feminine norms may drive research engagement. This is discussed in the context of increasing sociocultural diversity in ADRD research across key social groups.
COVID-19 in German Nursing Homes: A Panel Study on Morbidity, Burden of Care, and Social Isolation
Authors: Seibert Kathrin , Domhoff Dominik , Heinze Franziska , Preuss Benedikt , Rothgang Heinz , Wolf-Ostermann Karin
Published: December 2021

Germany was hit by the second wave of the pandemic much harder than by the first wave. The study aims to describe the extent to which nursing homes (NH) are affected by COVID-19. About 8,000 NHs were invited to participate in two waves of an online survey, with a share of 5-10% participating. The share of all deceased NH-residents with COVID-19 is about 50% (04/2020-02/2021). Factors that increase the risk of an outbreak in NH are the spread of the virus in the population, the size of the institution and staff-resident-ratio. The initial lack of protective equipment has decreased during the second wave, but the facilities have to cope with massive additional care needs with reduced staff. NHs have partly banned contacts between residents and relatives. As a conclusion the support of NH in their attempt to fight the impact of this and further pandemic situations requires highest attention.
Food Insecurity and Mental Health Trajectories During the COVID-19 Pandemic: Longitudinal Evidence
Authors: Kong Dexia , Lu Peiyi , Kozlov Elissa , Shelley Mack
Published: December 2021

The extent to which food insecurity impacts changes in mental health outcomes over time in the context of Covid-19 remains unknown. Using longitudinal data from a nationally representative survey, the objectives of the present study were to: (1) assess the prevalence of food insecurity among U.S. adults amid the Covid-19 pandemic; and (2) investigate the relationships between food insecurity statuses and changes in mental health outcomes over time as the pandemic unfolds. Longitudinal data from the Internet-based Understanding Coronavirus in America survey collected bi-weekly between April and December 2020 were used (n=4,068, 15 repeated measures). Adult respondents (aged ≥18) were asked about their food insecurity experiences and stress/anxiety/depressive symptoms. Linear mixed-effect models examined changes in mental health outcomes over time among groups with various food insecurity statuses. Overall prevalence of food insecurity was 8%. Food insecurity was consistently associated with higher levels of stress/anxiety/depressive symptoms (p<0.001). Stress/anxiety/depressive symptoms declined over time among food-secured U.S adults. However, mental health trajectories of respondents with various food insecurity categories, including food insecurity status, persistent food insecurity, and food insecurity of higher severity and longer duration, remained stable or worsened over time. Moreover, the mental health gap between food-secured and food-unsecured participants widened over time. Food insecurity represents a pressing public health problem during the Covid-19 pandemic with substantial mental health implications. Persistent and severe food insecurity may contribute to mental health disparity in the long term. Food insecurity reduction interventions may alleviate the estimated alarming mental health burden as the pandemic unfolds.
Good Trouble Along the Winding Road: Disruption and Accomplishment
Authors: Sterns Harvey , Ruby Joseph
Published: December 2021

The establishment of a accreditation body for gerontology degree programs was seen as disruptive. Many key leaders were against creating such a body and wanted this to be delayed or to never happen. In 2012, the AGHE Accreditation Task Force was established with a Competency Work Group and an Organization Work Group..There have been 5 programs evaluated with a number of schools/university currently in process. The task force filed documents for creating a legal entity and obtaining non-profit status for the new Accreditation for Gerontology Education Council. The Task Force developed the dimensions for program evaluation based on the Competencies and shared information with AGHE members. The Task Force obtained start-up funding for the organization and identified the first programs for accreditation and has been providing outreach and guidance to new programs. There is continual refinement of the process.