bluuebunny/crossref_metadata_2025 huggingface dataset:
EXPERIENCE BEYOND NARRATIVE: A PHENOMENOLOGICAL ACCOUNT OF MEANING-MAKING WHILE LIVING IN THE WORLD WITH DEMENTIA
Authors: Gaurke MaryKatherine
Published: December 2022

Narrative-based approaches in dementia care emphasize the importance of understanding humans as beings who make sense of themselves and others through constructing life narratives, taking this process to be morally significant for constituting or characterizing identities (and for holding others into their identities) (Kitwood, 1997). Yet, placing too much emphasis on the formation of a cohesive life narrative risks dismissing or otherwise failing to acknowledge the activities of meaning-making and narrative-sharing/constructing that those with dementia engage outside of, or even counter to, a unified narrative. This paper offers a Heideggerian-inspired phenomenological analysis of interactions detailed in the Friendship Study (de Medeiros et al. 2011) and from supporting published accounts and personal observation in clinical settings. This account reveals significant meaning-making possibilities engaged and shared among those living with dementia in long-term care settings that may be left unexamined in traditional narrative-based approaches suggesting that micro-narrative construction needs further attention.
A TRANSDISCIPLINARY TEAM APPROACH TO TECHNOLOGY DEVELOPMENT TO SUPPORT HEALTH AND WELL-BEING
Authors: Azevedo Renato Ferreira Leitao , Nicholas Jennifer , Lee Jeannie , Insel Kathleen , Rogers Wendy
Published: December 2022

Diverse disciplinary and experiential knowledge is required to understand the challenges and develop workable solutions to support the health and wellbeing of a rapidly aging population. We are developing a theory-based, digital therapeutic for self-management of hypertension medication adherence for older adults; namely, the Medication Education, Decision Support, Reminding, and Monitoring (MEDSReM) system. This development process has necessitated a transdisciplinary approach with members co-learning and working collaboratively to advance the MEDSReM system. Our group includes complementary expertise in pharmacy, nursing, human factors, cognitive aging, gerontology, and technology development. We describe the challenges of transdisciplinary teamwork, our collaborative processes, and strategies that led to successful integration of expertise in advancing MEDSReM. Lastly, we discuss useful approaches to technology conceptualization, and digital therapeutic development and implementation, as well as lessons learned in effective communication and coordination among the diverse team members to ensure that the MEDSReM goals are achieved.
METABOLOMIC SIGNATURES OF BRAIN ATROPHY PATTERNS IN AGING AND ALZHEIMER'S DISEASE
Authors: Tian Qu , Mitchell Brendan , Erus Guray , Davatzikos Christos , Resnick Susan , Ferrucci Luigi
Published: December 2022

Can plasma metabolomics reveal mechanisms of brain aging? We investigated metabolomic signatures of brain atrophy patterns related to cognitive decline and Alzheimer’s disease(AD) risk. Relationships between metabolomics(Biocrates-p500) and annual rates of change in two neuroimaging-based brain atrophy patterns(SPARE-BA indexing brain aging, SPARE-AD indexing AD-related atrophy) were examined using multivariable linear regression in 477 Baltimore Longitudinal Study of Aging participants aged 60+, adjusted for demographic variables and BMI. Higher concentrations of sarcosine, triglycerides, diglycerides, and ceramides and lower concentrations from phosphatidylcholines and cholesteryl ester were associated with faster rates of SPARE-BA increase longitudinally. Higher concentrations of diglyceride and alpha-amino-butyric acid and lower concentrations of tryptophan, hippuric acid, cholesteryl ester, phosphatidylcholine and sphingomyelin were associated with faster rates of SPARE-AD. Metabolites have differential associations with age-related and AD-related brain atrophy patterns, which may provide new insights into preventive and therapeutic interventions. Future studies should examine whether metabolite changes precede brain atrophy patterns.
METABOLOMIC PROFILE OF DIFFERENT DIETARY PATTERNS AND THEIR ASSOCIATION WITH FRAILTY
Authors: Tanaka Toshiko , Talegawkar Sameera , Jin Yichen , Tian Qu , Simonsick Eleanor , Ferrucci Luigi
Published: December 2022

Diet quality is an important behavioral determinant of healthy aging, however the mechanisms underlying the protective effect of diet are not fully understood. To address this question, we explored whether plasma metabolites mediate the relationship between diet and frailty index (FI) in the Baltimore Longitudinal Study of Aging. Adherence to different dietary patterns was evaluated using the Mediterranean diet score (MDS), Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND), and Alternate Healthy Eating Index 2010 (AHEI). Higher adherence to the dietary patterns was associated with lower FI. There were 127 plasma metabolites that were associated with all three dietary patterns including lipids, fatty acids, ceramides, amino acids, and bile acids. Metabolomic signatures of diet mediated 42%, 70%, and 61% of the association between MDS, MIND, and AHEI with FI, respectively. Overall, we found common metabolomic biomarkers of dietary patterns that explain part of the relationship between diet and frailty.
THE INFLUENCE OF NURSING HOME CONTEXT ON IMPLEMENTATION: EARLY FINDINGS
Authors: Estabrooks Carole , Beeber Anna , Vogelsmeier Amy
Published: December 2022

Evidence suggests that organizational context, including context of care in nursing homes (NHs) is associated with implementation and improvement success and that optimized context contributes to improved resident and staff outcomes. However, evidence on mechanisms of these influences is scarce. The longitudinal Translating Research in Elder Care program (2007 to present) is our data source. This symposium reports findings of a secondary analysis of longitudinal organizational structural and contextual, staff worklife, and resident care quality data collected in nursing homes from 2007-2021, in a cohort of 94 Canadian nursing homes. Our data include continuously collected administrative data (RAI-MDS 2.0), 5 waves of primary surveys from multiple care providers in NHs (15,000 cases to date), extensive qualitative case study data, and data from two large scale pragmatic trials. The TREC program was framed originally and continues to be, using the Promoting Action on Research Implementation in Health Services (PARiHS) framework. Each of our 5 papers will report on a critical aspect of the findings. The symposium will conclude with a discussion of implications of these findings of phase one and a description of phase two and how it is shaped by our interactions with expert panels (context and implementation experts, policymakers, NH managers, paid care providers, and residents and families). Early implications of this work for future research in nursing homes and for practice and policy will be mentioned.
COPING STYLES AND COGNITIVE FUNCTION IN OLDER NON-HISPANIC BLACK AND WHITE ADULTS
Authors: Lee Ji Hyun , Sol Ketlyne , Zaheed Afsara , Morris Emily , Meister Lindsey , Palms Jordan , Martino Alexa , Zahodne Laura
Published: December 2022

Coping styles refer to cognitive and behavioral patterns used to manage the demands of stressors. This study aimed to characterize associations between coping styles and cognitive functioning across non-Hispanic Black and non-Hispanic White older adults. Cross-sectional data comes from the Michigan Cognitive Aging Project (N=457; 53% non-Hispanic Black). Coping styles are measured with COPE inventory. Global cognition was a composite of five cognitive domain factor scores derived from a comprehensive battery. Results show that Black older adults reported more emotion-focused coping than Whites, but there were no differences in problem-focused coping. Less emotion-focused and greater problem-focused coping were each more strongly associated with better global cognition among Black older adults, who showed disproportionately worse cognitive performance in the context of less adaptive coping. Coping style may be a particularly important psychosocial resource for cognitive health among Black older adults who may have less access to compensatory resources than Whites.
ADVERSE CHILDHOOD EXPERIENCES AND DEPRESSIVE SYMPTOMS AMONG RACIALLY/ETHNICALLY DIVERSE OLDER ADULTS IN THE US
Authors: Camacho David , Vazquez Julia , Vargas Laura , Henderson Charles , Jones-Harden Brenda J
Published: December 2022

Adverse childhood experiences (ACEs) and depression are major public health concerns. However, few studies have examined the relationship between ACEs and mid- and late-life depression among racially/ethnically diverse groups. We explore this relationship among U.S. racially/ethnically diverse community-dwelling midlife and older adults (≥50 years of age). Guided by ACEs and Minority Stress Frameworks, we used general linear models to examine this relationship with data from Wave 3 of the National Social Life, Health, and Aging Project. We created an ACEs composite ranging from 0 to 7 (e.g., violence, health, poverty) and assessed the role of individual ACEs on depressive symptoms (CES-D). Final adjusted models (n:1424) included key demographic, health (e.g., chronic disease), social (living alone, social isolation, loneliness), and minority stress factors (e.g., limited access to healthcare and treatment, perceived discrimination). Results indicated that higher composite score ACEs (particularly childhood violence and poor health) were positively associated with higher levels of depressive symptoms. We found no interactions between race/ethnicity and ACEs. Our results suggest that ACEs contribute to the presence and severity of depressive symptoms into mid- and late-life adulthood. Consistent with Minority Stress Framework, common life-course stressors for minoritized groups may explain a lack of significant interactions in our models. Future research should explore the association of ACEs and other important health outcomes in diverse midlife and older adults. Finally, research is needed to examine if and how culturally appropriate depression interventions can be adapted to address the role of ACEs in later life health.
COHORT DIFFERENCES IN EARLY-LIFE SOCIOECONOMIC STATUS AND LATE-LIFE COGNITIVE IMPAIRMENT IN MEXICO
Authors: Downer Brian , Gutierrez Mariela , Arango Silvia Mejia , Wong Rebeca
Published: December 2022

Socioeconomic characteristics over the life course are associated with late-life cognitive impairment. However, evidence is lacking from countries like Mexico where population aging is occurring in the context of rapidly changing socioeconomic conditions. We used the Mexican Health and Aging Study to investigate differences between participants aged 60-76 in 2001 (n=5085) and 2018 (n=5947) in childhood (home with indoor toilet, parents’ education) and midlife (education, longest held occupation) socioeconomic characteristics and late life cognitive impairment. Cognitive impairment was defined as a low score on >2 out of five assessments. Most participants in the 2018 cohort lived in a home with an indoor toilet as a child (58.1%) and 36.9% had parents who both completed at least some education compared to 41.9% and 28.7% of participants in the 2001 cohort, respectively. Men and women in 2018 had on average 2.34 and 1.83 more years of education than men and women in 2001, respectively. The percentage of women with no main job and men who worked in agriculture were lower in 2018 than 2001 (women: 27.0% vs. 34.6%; men: 23.3% vs. 30.4%). The 2018 cohort had lower odds for cognitive impairment when adjusting for age, sex, marital status, and living in a rural/urban community (OR=0.67 95% CI=0.56-0.81). This difference was reduced after adjusting for childhood socioeconomic measures (OR=0.76 95% CI=0.67-0.86) and was no longer statistically significant after adding midlife socioeconomic measures (OR=0.98 95% CI=0.86-1.12). These findings suggest that improved early-life socioeconomic conditions in Mexico contribute to birth-cohort differences in late-life cognitive impairment.
PANDEMIC CAREGIVING: A LONGITUDINAL ASSESSMENT OF THE TRAJECTORIES AND CORRELATES OF STRESS
Authors: Litzelman Kristin , Kim Christina , Kerr Margaret
Published: December 2022

In public health emergencies, caregivers are a crucial but often overlooked human resource. The purpose of this longitudinal study was to assess the well-being of caregivers and non-caregivers over the first 18 months of the COVID-19 pandemic. We used three waves of data from the Survey of the Health of Wisconsin’s COVID-19 Community Impact Survey (Wave 1: May-June 2020; Wave 2: January-February 2021; Wave 3: June 2021; n=2,434 observations of 1,653 unique respondents). Caregivers were identified as those providing care for an adult with an illness or disability. Perceived stress (Global Stress Scale; mean=5.08, SD=4.81) was regressed on caregiver status and covariates in mixed models accounting for repeated measures. On average, caregivers had higher stress than non-caregivers (beta=2.10, p< 0.0001). Across the sample, stress increased between summer 2020 and winter 2021 (mean of 4.8 versus 5.8, p<.01), and lowered somewhat by summer 2021 (mean=5.0, p<.05); this trajectory was similar on average for caregivers and non-caregivers. Respondents who transitioned into a caregiving role during the pandemic had the highest stress (beta=2.55, p< 0.01 compared to non-caregivers). Other factors associated with higher stress (p<.01) include marginalized racial/ethnic identity (beta=1.74), being employed (beta=1.47) or female (beta=0.66), or caregiver having more health conditions (beta=0.22 per condition). Public benefits use and higher self-efficacy were associated with lower stress (betas=-1.18 and -0.30, respectively, p<.01). The findings emphasize the adverse outcomes experienced by caregivers and non-caregivers over the course of the pandemic and highlight potential factors that can inform risk stratification and interventions to support well-being in future crises.
THE COMBINED EFFECTS OF SOCIAL ISOLATION AND LONELINESS ON PSYCHOLOGICAL WELL-BEING DURING THE COVID-19 PANDEMIC
Authors: Li Ke , Tang Fengyan
Published: December 2022

Social isolation and loneliness are related but distinct constructs. A number of studies have examined these two constructs separately; however, the combined and interactive effects of social isolation and loneliness on health outcomes have rarely been studied. Using the most recent data of the Health and Retirement Study (HRS 2020) collected during the pandemic, this study aimed to explore the latent classes of social isolation and loneliness among adults aged 60 and older (N=3,486) and to examine the associated psychological well-being. Social isolation was measured by five indicators, including living alone, no membership in any organizations, and less than once a month contact with children, relatives, and friends. Loneliness was measured by the 3-item UCLA scale. Four classes were identified by the Latent Class Analysis (LCA): neither isolated nor lonely (class 1, 35%), living alone and lonely (class 2, 25%), no social participation and lonely (class 3, 18%), and highly isolated and lonely (class 4, 23%). The results of multivariate regression indicated that compared to respondents who were neither isolated nor lonely, those who were in the class of living alone and lonely and the class of highly isolated and lonely had more depressive symptoms, stress, anxiety, worry, loneliness during the pandemic. The latent class of no social participation and lonely was associated with more depressive symptoms and covid-related stress. This study emphasizes the importance of specialized intervention strategies targeting the unique needs of older adults with different experiences of social isolation and loneliness.
ADIPOCYTE-DERIVED FACTORS: IMPACT ON HEALTHSPAN AND LIFESPAN
Authors: Scherer Philipp
Published: December 2022

Adipocytes secrete numerous lipid and protein factors with profound effects on systemic energy homeostasis. One such adipokine that we first identified in the early 1990’s, adiponectin, has garnered significant attention as a potent mediator of insulin sensitivity and cell survival. FGF21 is another factor that is secreted by a number of cell types (including adipocytes), which has a beneficial effect on metabolism. Our group generated a novel mouse model that overexpresses, in an inducible fashion, physiological levels of FGF21 from adipocytes in the adult mouse. While comparable levels of constitutive overexpression of FGF21 from the liver do not have an impact on aging, adipocyte-derived FGF21 exerts a profound beneficial impact on health- and lifespan. This demonstrates that selective manipulation of adipose tissue per se has the potential to significantly reduce mortality and extend lifespan. The adipocyte-specific FGF21 transgenic animals have increased energy expenditure, weigh considerably less and exhibit an improvement in all systemic metabolic parameters examined to date. The mice further display unique immune-metabolic profiles of their adipose tissue depots, which defy the conventional changes associated with aging. Importantly, all these phenotypic alterations are achieved without a significant impact on adipose tissue beiging/browning. Moreover, at least some beneficial aspects of FGF21 appear to be mediated through a lowering of leptin, which leads to central leptin sensitization. Combined, these efforts shed additional light on the physiological effects of FGF21.
HDL-localized plasma ceramides support body temperature regulation
Authors: Wade Gina , Simcox Judith
Published: December 2022

As organisms age, the balance of energy expenditure is disrupted. One of the major ways in which this disruption is observed is in an inability to maintain body temperature. Our lab is interested in understanding the signals that regulate this energy balance, and we focus on lipids as energy substrates and signaling molecules to regulate this process. During cold exposure, plasma lipids produced by peripheral tissues are required to fuel and activate heat production in the brown adipose tissue. One of the lipid classes that increases with cold exposure is plasma ceramides. Beyond cold exposure, ceramide lipids are also elevated in aged individuals and are associated with increased cardiovascular disease risk and age-related diseases such as Alzheimer’s disease where they are thought to signal inflammation. However, the functions of ceramides in non-disease states are unknown. To address this gap in knowledge, we have shown that ceramide production in 12-week-old C57Bl6/J mice is required for body temperature maintenance in the cold. Moreover, plasma ceramide levels in 2-year-old mice are unchanged in the cold, and these mice are unable to maintain their body temperature. In disease states, ceramides are transported through the plasma in LDL, but ceramides are enriched in the HDL plasma fraction in the cold. This differential plasma lipid transport suggests dynamic modes of lipid uptake and tissue targeting to regulate energy expenditure. This work will identify molecular mechanisms governing ceramide function in the mammalian response to cold and better our understanding of the systemic lipid metabolism dysregulated in disease.
IMPACT OF AN EDUCATIONAL INTERVENTION ON KNOWLEDGE AND ATTITUDES ABOUT MEMORY LOSS AND CARE ISSUES
Authors: Galambos Colleen , Ellis Julie
Published: December 2022

While previous studies have evaluated the impact of education interventions on knowledge and attitudes about Alzheimer’s disease and other dementias (Kaf, Barboa, Fisher, & Snavely, 2011; Kimzey, Mastel-Smith, & Alfred, 2016; Yamashita, Kinney, & Lokon, 2011), there is little research about the impact on knowledge and attitudes about issues related to caregivers of those with dementia. This paper reports on the results of an education intervention to increase college students’ knowledge, and positive attitudes on memory loss, Alzheimer’s disease and other dementias, and related caregiver issues. The intervention consisted of a series of lectures and readings, including a caregiver memoir. The intervention was conducted in social work and nursing classes over two semesters. A questionnaire, using established scales that measured knowledge and attitudes about dementia and caregiving issues, was administered to the students using a pretest-posttest design. The educational intervention tested successfully increased knowledge and positive attitudes about Alzheimer’s disease, dementia, memory loss, and caregiving (p=.0001). This finding held across courses, grade levels, previous experience with older adults, knowledge of someone with memory loss, and relationships with caregivers and persons with memory loss. A memoir as a storytelling informational narrative, and structured lectures and readings served as effective learning tools that influenced both knowledge and attitude levels about Alzheimer’s disease, dementia, memory loss, and caregiving. Gains made in knowledge and attitude changes were true for both face- to- face and online teaching venues. Implications for training, classroom teaching, and workforce development will be discussed.
WHAT AND HOW DID IT WORK? A SYSTEMATIC REVIEW OF THE INTERVENTION STUDIES OF CHANGING PERCEPTION TOWARD OLDER ADULTS
Authors: Lee Yeonjung , Li Lun , Shrestha Laxman
Published: December 2022

Social workers are one of the major professionals serving for older adults. However, social work students often rank gerontology at the bottom of their future professional practice. Studies show that students have negative attitudes about, and perceptions of older adults and aging. Such stereotypes result in social work students considering practice areas other than gerontological social work. The objective of this study is to conduct a systematic review and identify any types of the intervention studies of changing perception and attitudes toward older adults and aging among social work students. This systematic review identified empirical research studies written in English that were published in a peer-reviewed journal before November 2021. Systematic search was carried out within four electronic databases (AgeLine, Education Research Complete, Social Work Abstracts, SocINDEX with full text) with the key words such as “social work student” and “aging or ageing or elderly or older adults or seniors or geriatrics or gerontology”. A total of 470 abstracts were identified, and after careful review of 143 full articles yielded from the databases, 43 journal articles were included in this study. Analysis of the selected literature provides that major interventions have been tried include service learning, lecture, curriculum development, simulation, training program, and intergenerational program. This systematic review highlights the importance of the experiential learning, partnership development with community, and interprofessional collaboration to provide the best model of practice for changing perception toward aging and older adults among social work students.
EMBRACING OUR DIVERSITY: ENHANCING THE GEROFIT PROGRAM FOR PATIENT EXPERIENCE
Authors: Hall Katherine , Serra Monica
Published: December 2022

The Veterans Health Administration has long been at the forefront of telehealth development and advances. Gerofit to Home (GTH) is a novel, telehealth-based adjunct to a widely successful Gerofit facility-based program for Veterans ages 65 and older with multi-morbidities and functional limitations. Of note, participants are allowed to remain in the program as long as they wish, all of which enhances social engagement and camaraderie. Now disseminated to nearly 30 VA medical centers across the country, all of our sites transitioned within 6 weeks of the COVID-19 pandemic to group-based virtual classes, aptly called GTH. Because of the rapid and continuously evolving changes in telehealth, we had near daily Veteran feedback on what was working and what was not working. We cast a wide net and used multiple methods to obtain Veteran feedback. These were quite successful and allowed us to make ongoing improvements to our classes. The first presentation describes results from a telephone survey deployed to all patients who transitioned from facility-based Gerofit to GTH. The second presentation describes the development of a Gerofit Veterans Advisory Panel and the perspectives they provided in terms of scheduling, patient-requested content, feasibility and access. The third presentation explores patient satisfaction and retention in GTH participants, with an emphasis on rural vs non-rural settings. The fourth paper details an innovative approach to integrating student learners in to the Gerofit program, and explores the impact of these inter-generational interactions.
BUILDING CAPACITY FOR PATIENT-CENTERED OUTCOMES RESEARCH IN AGING RESEARCH: TRAINING ACROSS THE CONTINUUM
Authors: McGaffigan Erin , Cohen Marc
Published: December 2022

Patient-centered outcomes research (PCOR) models are increasingly used to ensure stakeholders inform evidence-based systems of care. Unfortunately, older adults are often left out of PCOR, leading to continued health and service disparities. The Aging PCOR Learning Collaborative was funded by the Patient-Centered Outcomes Research Institute in 2020 to conduct a series of training activities to change how older adults are viewed and engaged in research. Training was extended to Gerontology students, researchers new to engagement, established researchers, and to older adults to advance the strategies needed to infuse PCOR within aging research design and implementation. Project staff analyzed data relevant to these activities, which demonstrated the project’s reach to over 300 older adults, researchers, funders, and academic leaders. This session will review the steps required to implement training, our project reach, outputs, and mid-term outcomes, providing one of the first glimpses into how to measure this shift in our research paradigm.
RECRUITING, FACILITATING, AND SUPPORTING PERSONS LIVING WITH DEMENTIA AS TRAINERS IN RESEARCH
Authors: Hirsch Jen , Sun Fei , Cohen Dan , Kim Ha-Neul , Barbieri Steven , LeBlanc Brian
Published: December 2022

Research demonstrates that dementia education programs are effective in improving knowledge of dementia, but it takes more effort to change attitudes or skill sets. Empathy toward people living with dementia (PLWD) is low among college students due to lack of experience interacting with PLWD. Exposure to PLWD is recommended in training aimed to improve dementia literacy. We engaged PLWD from an active advocacy group, The National Council of Dementia Minds, to be co-trainers in an intervention with college students in health and social care professions to provide quality care for PLWD. Presenters will discuss the process for recruiting, engaging, and training PLWD successfully, including explanation of informed consent, preparation for training sessions, and structural support around communication and information processing needs. Emphasis will be on lessons learned directly from our co-trainers for successful support mechanisms, particularly in an online environment as all interaction occurred primarily over zoom and email.
PILOT STUDY TO PRAGMATICALLY EMBED CAREGIVER DEMENTIA EDUCATION AND SUPPORT IN HEALTH CARE SYSTEMS
Authors: Fortinsky Richard
Published: December 2022

Evidence-based interventions offering meaningful benefits to informal caregivers of people living with dementia (PLWD) would be attractive to office-based practitioners if pragmatic linkages could be made between these interventions and outpatient care settings. This presentation will explain experiences and lessons learned in an ongoing pilot study in which we are: pragmatically identifying and inviting caregivers of PLWD to join online dementia education and support programs; collecting and storing caregiver outcomes data into electronic health records where these data are accessible to clinicians. Participating outpatient health care settings are a geriatrics practice at UConn Health and a memory care clinic at Emory Healthcare. Caregivers recruited at both sites participate in either Tele-Savvy or Caregiving During Crisis programs. Outcomes data will inform effects of program participation on caregivers’ competence and stress, and help clinicians gain insights into caregivers’ capacity to manage PLWD. Implementation evaluation strategies and results also will be discussed.
INFUSION OF AGE-FRIENDLY PRINCIPLES INTO CURRICULA USING INTERACTIVE MODULES
Authors: Greenberg Sherry , Adrian Shayle , Twal Riad
Published: December 2022

This presentation highlights the development of Age-Friendly care interactive modules to prepare the future healthcare workforce to care for older adults in Age-Friendly Health Systems. To date, there is a gap in the educational preparation of nurses, advanced practice nurses, and other health professionals to work in Age-Friendly Health Systems upon entry into practice. This project, funded by a faculty innovation grant at Seton Hall University, provides undergraduate and graduate nursing and interprofessional students with the background knowledge to care for older adults in Age-Friendly Health Systems. The aim of this project was to develop five interactive modules to embed in undergraduate and graduate nursing and interprofessional curricula focusing on the provision of care to older adults using the evidence-based 4Ms Framework: What Matters, Medication, Mentation, and Mobility. Faculty collaborated with instructional designers in development of the modules using Articulate 360 to embed them in curricula. The first module focuses on the background of the Age-Friendly Health Systems movement, how health systems may become an Age-Friendly Health System, and the evidence for the 4Ms Framework. The second module focuses on assessment and act on strategies related to What Matters to older adults including advance care planning strategies. The third module covers crucial information related to Medication such as avoiding potentially inappropriate medications, deprescribing, and antibiotic stewardship. The fourth module focuses on Mentation and covers assessment and act on strategies for depression, delirium, and dementia. The fifth module focuses on Mobility such as promoting mobility and decreasing fall risk.
COMPARISON OF SLEEP PARAMETERS FROM WRIST-WORN ACCELEROMETERS IN OLDER ADULTS
Authors: Liu Fangyu , Schrack Jennifer , Wanigatunga Sarah , Rabinowitz Jill , He Linchen , Wanigatunga Amal , Simonsick Eleanor , Spira Adam
Published: December 2022

Researchers often prefer different accelerometers for measurement of sleep and physical activity (PA) in older adults, but wearing multiple accelerometers increases costs and participant burden. We tested the hypothesis that the Actiwatch-2, commonly used to measure sleep, and the ActiGraph GT9X Link, commonly used to measure PA, yield comparable sleep parameters among 331 participants (aged 71+/-14 years, 50.5% women) who wore them simultaneously for 7+/-1.6 nights in the BLSA. Compared to the Actiwatch-2, the ActiGraph estimated 50% greater wake after sleep onset, 89% longer wake bout length, 18% lower sleep fragmentation index (SFI), 5% lower total sleep time (TST) and 5% higher sleep efficiency. Yet, despite yielding different absolute values of TST and SFI, the devices generated similar between-person (relative) differences in TST and SFI. These devices may only be interchangeable for measurement of some relative sleep parameters in older adults. Studies with both devices and gold-standard polysomnography are needed.
NOVEL INSIGHTS INTO GAIT, MOTOR CONTROL, AND THE BRAIN: IMPLICATIONS FOR COGNITIVE AGING
Authors: Rosso Andrea , Fraser Sarah , Holtzer Roee , Salzman Talia , Rosano Caterina , Baillargeon Emma , Sprague Briana , Tian Qu
Published: December 2022

What can muscles, gait, and brain activity tell us about cognitive decline? Are there certain markers we can track that are early predictors of cognitive status years later? In the current symposia, our goal is to address these questions with recent pilot, longitudinal and cross-sectional studies that measure potential markers of cognitive decline in different older adult cohorts. The first speaker will present findings on changes in skeletal muscle adiposity and 10-year change in global cognition from the Health Aging and Body Composition (Health ABC) study. The second speaker explores cross-national comparisons of gait speed and its association with cognitive function from the Cohort Studies of Memory in an International Consortium (COSMIC). The third speaker investigates changes in brain activity with functional near infra-red spectroscopy (fNIRS) from single to dual-task walking and its relation to changes in several gait quality parameters. The fourth speaker presents pilot work that examines dual-task gait and tapping with fNIRS and compares the dual-task performance and brain activity of older adults who report experiencing subjective cognitive decline to those that do not. The final speaker presents findings from the Baltimore Longitudinal Study on Aging (BLSA) that demonstrate that early markers of slow gait and metabolic dysfunction could identify those at risk of progression to dementia 7 years prior to onset. Taken together, the findings from this symposium present novel markers of changes in cognitive function in older adults and ultimately targets for prevention or slowing of cognitive declines in older adults at risk for dementia.
THE RESPONSIBLE DESIGNER: USING A HUMAN-CENTERED DESIGN APPROACH TO CREATE AN ASSISTIVE TECHNOLOGY FOR AD
Authors: Mitchell Kimberly , Zhao Xiaopeng
Published: December 2022

Our interdisciplinary team of designers, computer scientists, and engineers have begun the development of a low-cost social robot called FRED (the Friendly Robot to Ease Dementia). FRED has a conversational capability which will allow the device to be used as assistive companions for people with AD, engaging conversation, assisting with reminders, playing simple games and music, and relieving caregivers of some of their responsibilities. FRED was created using 3-d printing technology and a single board computer based on raspberry Pi. Interaction between human and the system was implemented using the Mycroft open-source voice assistant. The overall cost of the robot is estimated to be less than $300, rendering it possible for wide distribution among the public. Our presentation will share results from our participatory focus group which helped assist in the design and interactions of FRED. This human-centered design approach included neurologists, healthy older adults, as well as ADRD patients and their caregivers. A common language of important terms (e.g., feedback, interface, training, cognitive assessment) to aid in initial conversations were implemented. A thinking-aloud protocol was adopted once we had a prototype of FRED, where users were able to express freely any problems and/or concerns during interaction. Insights from the thinking-aloud results were used to improve the user interface design to enable the users and robot to interact and collaborate in an effective, natural way. Feedback from the focus group were carefully documented and the results will be shared during our presentation.
INTERMUSCULAR ADIPOSITY: A NOVEL RISK FACTOR FOR COGNITIVE DECLINE IN A BIRACIAL COHORT OF OLDER ADULTS
Authors: Rosano Caterina , Newman Anne , Zhu Xiaonan , Santanasto Adam , Goodpaster Bret , Miljkovic Iva
Published: December 2022

Skeletal muscle and brain health both decline with age. Poorer skeletal muscle characteristics may be early markers of cognitive decline. The Health ABC study obtained repeated measures of thigh intermuscular adiposity via CT (IMAT, Years 1 and 6) and Mini-Mental State Exam (MMSE, Years 1 through 10), in 1634 adults (69-79 years, 48% women, 35% black). Linear mixed effects models accounted for change (Years 1 and 6) in weight, muscle (strength, area), and adiposity characteristics (abdominal subcutaneous, visceral, total fat mass) and for dementia risk factors (education, APOE4, diabetes, hypertension, physical activity). IMAT increased by 0.97 cm2/year (SD:1.16), and MMSE declined by 0.4 points/year (0.02). Each SD of IMAT corresponded to a MMSE decline of 0.22 points/year (p<0.0001), similar in adjusted models and stratified by race or gender. Aging-related IMAT increase may be a novel predictor of cognitive decline beyond traditional risk factors, with potential implications for muscle-brain cross talk.
HOUSING, AGING, AND HEALTH: NEW FINDINGS AND FRAMEWORKS FROM HOUSING-FOCUSED RESEARCH IN THE CONTEXT OF COVID-19
Authors: Berlinger Nancy
Published: December 2022

Older adults have been the most vulnerable population to severe illness, hospitalization, or death from COVID-19. During the pandemic, housing became a site of health and safety for some, while reinforced inequities for others due to underlying problems of affordability, accessibility, safety, and service access. This symposium showcases five housing-focused studies reflecting the pandemic context, including research by early-career investigators. The first speaker will present findings from a study of materials preserving promising practices and policy ideas generated by housing-focused pandemic responses to middle-income and low-income community-dwelling older adults. The second speaker will discuss narrative lessons from “avoidance hotels” – an infection-reduction strategy that transferred older adults from shelters to hotel rooms – with potential to guide planning for the needs of older adults facing homelessness and serious illness. The third speaker will analyze findings from multi-city research on the pandemic housing experiences of lower-income Black women, who faced severe intersectional threats to housing security. The fourth speaker will share data from a qualitative study of a Medicare-financed home care program for residents of HUD housing, including recommendations for improving experiences of participants and providers. The fifth speaker will describe the evolution of the pandemic-response roles of HUD service coordinators, based on findings from surveys in 2020 and 2021. We will conclude with audience discussion about ways for age-focused researchers to collaborate in crafting policy solutions and effective public narratives about housing equity in America's aging society.
ENHANCED COMMUNICATION BETWEEN A RURAL CRITICAL ACCESS HOSPITAL, A RESIDENTIAL CARE FACILITY, AND PRIMARY CARE
Authors: Morissette Lee
Published: December 2022

A need to improve the transitions of care between a small rural emergency department, a residential care facility and a primary care practice emerged early on in our work to become a level 2 accredited emergency department. One challenge is bringing together 3 partners all with distinct types of health records, unique foci of care and a variety of disciplines and workforce. This paper will focus on our journey of creating an individualized plan of care to help mitigate problems of poor communication with a focus on the 4Ms framework including: What Matters Most, Mobility, Medication and Mentation.
TRAINING THE NEXT GENERATION OF GERONTOLOGICAL LEADERSHIP: WHO AND HOW?
Authors: Charness Neil , Heyn Patricia , Appleby James
Published: December 2022

Knowing how to train the next generation of gerontological leaders involves understanding where we are now and where we want to be in the coming decades. We outline the results of a survey of the membership of Directors of Aging Centers. The Directors of Aging Centers interest group in GSA has representation from the USA, Canada, and Europe. A survey was sent to the membership in late December with reminders in January and had 31 respondents. We discuss the results of the survey, highlighting the demographics of the current leadership (Neil Charness), perceived need for training by current leaders (Peter Lichtenberg), and consensus content of leadership training programs (Patricia Heyn). Patricia D’Antonio provides a perspective on GSA’s approach to professional development programs and avenues for soliciting funding for leadership training. Our discussant (James Appleby, CEO of GSA) will reflect on the need for training in the context of building the next generation of gerontological leadership. We plan to devote significant symposium time to solicit audience input on next steps for supporting the effort to improve the quantity, quality, and diversity of the gerontological leadership workforce.
GSA ACTIVITIES TO SUPPORT CAREER DEVELOPMENT: RELEVANCE TO DIRECTORS OF AGING CENTERS
Authors: D'Antonio Patricia
Published: December 2022

GSA continues to support our members through career development activities. These activities are designed to empower members to develop the necessary skills to advance their careers as leaders in the field of aging. Through activities like the GSA NIA R13 Diversity, Mentoring, and Career Development Technical Assistance Workshop, we strive to support, promote, and advance the training of diverse students in aging. This presentation will discuss how the experiences with this R13 project and other career development efforts inform additional activities of the Society through a well-framed aging lens. We also discuss the process of soliciting funding to support leadership training and the role that GSA can play in the application process.
STUDYING BIOLOGICAL AGING AND GEROSCIENCE IN HUMANS
Authors: Newman Anne
Published: December 2022

For geroscience to impact human health, its scientific underpinnings observed in animal models must also be relevant to humans, and therapies grounded in geroscience principles must be translatable to humans. Given the heterogeneity of human aging, chronological age alone is not a sufficient indicator of susceptibility to specific diseases, disabilities, or death, nor does it provide insights into the likelihood of benefiting from specific geroscience-inspired approaches. Bringing these metrics to large epidemiological studies and clinical trials has provided a number of important insights. For example, indices developed from aggregates of biomarker, physiological and clinical data have been shown to perform well in terms of predicting healthy aging, specific aging-related traits and mortality. Functional or composite outcomes have been favored for capturing health span in translational trials.
ASSESSING PURPORTED AGING THERAPIES IN THE CLINIC
Authors: Newman John
Published: December 2022

Aging is a universal human experience that looms large in popular and commercial culture. It can be difficult for patients and providers alike to sort fact from unproven plausibility and from potentially harmful fiction. Geroscience is an emerging field, and while some interventions involve repurposed or over-the-counter drugs with early clinical data, it is important to note that none yet have a specific aging-related indication and none have a consensus recommendation for clinical use in an aging context. Even highly plausible links to mechanisms of aging do not ensure that an intervention will be effective or risk-free, and not all purported therapies align with preclinical science. Finally, some purported therapies fall into potentially problematic regulatory gaps. With all of these considerations in mind, attendees will gain insights into applying their existing skills to evaluate this field, and new tools for critically evaluating geroscience literature to assist in patient-centered decision making.
DEMENTIA LIFE EXPECTANCIES: NEW KNOWLEDGE AND CONSIDERATIONS FROM THE HEALTH AND RETIREMENT STUDY
Authors: Garcia Marc , Tarraf Wassim , Chiu Chi-Tsun , Saenz Joseph , Reyes Adriana
Published: December 2022

Alzheimer's disease and related dementias (ADRD) are a growing public health crisis. Estimates on the prevalence and incidence of ADRD across and within population-based studies have varied in part due to competing measures to assess dementia status. Disentangling these inconsistencies is crucial for understanding dementia disparities among racial/ethnic, and nativity groups among older adults. Based on the Health and Retirement Study we examined across (Whites, Blacks) and within-group differences (US- and non-US-born Latinos) in estimates of dementia life expectancy, using four competing algorithmic techniques (i.e., the Langa-Weir, Expert, Hurd, and Lasso) for the classification of dementia ascertainment. Estimates of dementia life expectancy across algorithms largely point to dementia disparities in the prevalence of the disease across racial/ethnic, and nativity groups, regardless of the algorithmic technique utilized. Elucidating algorithms that can be utilized with different racial/ethnic groups may reduce bias in dementia assessment in the future.
NEW BEREAVEMENT IS A RISK FACTOR FOR BINGE DRINKING, SMOKING, AND POOR MENTAL HEALTH (2019 GEORGIA BRFSS)
Authors: Miles Toni
Published: December 2022

This presentation advances studies of population health by estimating the association between new bereavement and binge drinking rates among adults aged 50 years and older. In other reports, bereavement is associated with significantly higher rates of binge drinking among older adults. In 2019, the state of Georgia used an optional module in the Behavioral Risk Factor Surveillance Survey (BRFSS) to measure the prevalence of new bereavement. This is the first effort to capture population-level data on bereavement in Georgia. 45% of adults (4 million persons) aged 18 and older were newly bereaved in the 24 months prior to survey. Highest bereavement rates: adults aged 55 to 64 years (51%), unemployed (49%), and Black respondents (60%). Binge drinking rate for bereaved was 31 % (versus 23.6% not bereaved). Combined bereavement and binge drinking increased risk for poor mental health (OR = 2.83) and smoking (OR = 4.54).
REGULATION OF NEURONAL MITOCHONDRIAL BIOENERGETICS BY LIPID METABOLITES UPREGULATED IN DEMENTIA
Authors: Heimler Stephanie , Amick K Allison , Bergstrom Jaclyn , Jain Mohit , Molina Anthony J
Published: December 2022

Mitochondrial dysfunction occurs early in Alzheimer’s disease (AD) progression and is evident in the Central Nervous System (CNS) and peripheral circulating cells. While there is evidence indicating that bioenergetic decline can drive the early pathogenesis of AD, little is known about the extracellular factors that alter neuronal bioenergetic capacity. We hypothesized that circulating metabolites contribute to neuronal bioenergetic decline associated with AD. Using a cohort comprised of participants with normal cognition, mild cognitive impairment, and dementia, we show that human serum harbors circulating, non-cellular factors capable of mediating neuronal bioenergetic differences according to the cognitive status of the serum donor. We developed a novel screening-based approach to identify candidate “mito-active” lipid metabolites in human serum that could mediate differences in bioenergetic capacity. Among these, Nervonic Acid and 15-epi-PGA1 were predicted to be mitochondrial inhibitors upregulated in participants with dementia. Neurons exposed to physiologically-relevant ranges of these molecules in-vitro exhibited a dose-dependent reduction in maximal mitochondrial respiration. We found that 500ug/mL of Nervonic Acid and 9ug/mL of 15-epi-PGA1 reduced maximal mitochondrial respiration by 62.3% and 63.3%, respectively, thereby validating our screening and prediction approach. Future experiments may be directed towards investigating if and how these and other mito-active metabolites of interest cross the blood-brain barrier to meaningfully affect AD. Furthermore, identified mito-active molecules can be investigated in other clinical cohorts to examine their role/s in multiple age-related or neurological conditions. This work expands our mechanistic understanding of how extrinsic factors associated with age and cognitive status contribute to neuronal bioenergetic decline.