bluuebunny/crossref_metadata_2025 huggingface dataset:
PATIENT AND CARE PARTNER QUESTIONS AND CLINICIAN RESPONSES DURING INITIAL OUTPATIENT PALLIATIVE CARE APPOINTMENTS
Authors: McDarby Meghan , Silverstein Hannah , Rosa William , Parker Patricia , Carpenter Brian
Published: December 2023

Person-centered palliative care (PC) requires person-centered communication. This study characterized questions asked by persons with neurologic illnesses and their care partners and PC clinicians’ responses. We analyzed audio recordings from 38 initial outpatient PC appointments to characterize questions stated by patients and care partners. Based on previous research, we identified two question types: direct questions (typically-phrased, stated to obtain or clarify information) and indirect questions (declarative statements, not phrased as a typical question, made with information seeking intent). We rated the completeness of clinicians’ responses on a 4-point scale ranging from 1 (completely addressed question and provided additional information) to 4 (no response). We also coded features of clinicians’ responses, including offers of support or action and unprompted recommendations. Patients and care partners asked both direct (n = 442; 79.6%) and indirect (n = 113; 20.4%) questions. More than 60% of all questions were about symptoms, treatment, and lifestyle issues. Clinicians responded to 90.9% of direct questions and 90.2% of indirect questions; their responses to both question types were similar in completeness (median = 1, mode = 1). Clinicians’ responses to direct questions included more offers of support or action compared to responses to indirect questions (17% v. 11%). Responses to indirect questions included more unprompted recommendations compared to responses to direct questions (21% v. 9%). Persons with neurologic illnesses and their care partners use different question types to obtain information during PC appointments. Implications include the need for clinician training to effectively respond to different question types and topics.
AGE INVARIANCE IN THE FACTOR STRUCTURE OF ADVERSE CHILDHOOD EXPERIENCES ACROSS THE LIFESPAN
Authors: Rusch Amber , Patrick Julie Hicks
Published: December 2023

Adverse Childhood Experiences (ACEs) are associated with negative health and well-being across the adult life span. However, it is unclear whether measures of ACEs are equally predictive for adults of differing ages. Using responses from 125,212 adults on the 11-items in the ACEs Module from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), we conducted both an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Our EFA identified three interpretable factors, including a 3-item sexual abuse factor (α = .80), a 3-item physical/emotional abuse factor (α = .69) and a 5-item household dysfunction factor (α = .64). Results of our CFA supported the 3-factor solution, X2 (DF = 11) = 14.289, p < .001. A series of 1-way ANOVAS examined age differences in childhood adversity, where middle aged adults reported experiencing more sexual abuse relative to younger and older adults, and younger adults reported experiencing more physical/emotional abuse and household dysfunction compared to middle-aged who reported more than older adults. Additional analyses examined the influence of adverse childhood experiences on physical and mental health outcomes, including depression. Our analyses highlight the persistent effect of ACEs across the lifespan and identify a need for intervention resources for younger and middle-aged adults in order to mitigate effects of ACEs at late life.
EVIDENCE OF AGE BIAS ON THE ALTERNATIVE MODEL OF PERSONALITY DISORDERS
Authors: Stone-Bury Lisa , Premovich Alyssa , Segal Daniel
Published: December 2023

Introduction

Previous research established substantial age bias on personality disorder (PD) diagnostic criteria for older adults. The Alternative Model of Personality Disorders (AMPD) is a new model of PDs proposed in DSM-5’s Section III that measures PDs dimensionally along two criteria: personality functioning with four domains (measured by the Levels of Personality Functioning Scale; LPFS) and pathological personality traits with five domains (measured by the Personality Inventory for DSM-5; PID-5). This study examined age bias on the AMPD in a cross-sectional design. Method: Older (n = 200) and younger adults (n = 213) completed the LPFS-Self-Report (LPFS-SR) and the PID-5-Brief Form (PID-5-BF).

Results

Differential Item Functioning (DIF) analyses were computed on items of the LPFS-SR and PID-5-BF. An item exhibits DIF if two age groups with similar levels of an underlying scale have different probabilities of endorsing an item. Overall, 18 of 80 items on the LPFS-SR demonstrated large DIF. The Empathy (50% of items) and Intimacy (25% of items) domains were most aged biased. For the PID-5-BF, 10 of 25 items showed large DIF. All five domains demonstrated large age bias, with Psychoticism (100% of items) most impacted. Across both DIF models, items showed evidence of being biased for (disproportionately high endorsement of an item) or against (disproportionately low endorsement) older adults.

Discussion

Findings indicate meaningful age bias on both AMPD diagnostic criteria, indicating that older adults are at-risk of being under- and over-diagnosed with PDs under the AMPD. Revision of the AMPD is warranted to achieve age neutrality.
THE EFFECT OF LIFESPAN TRAUMA EXPOSURE ON PATHOLOGICAL PERSONALITY TRAITS
Authors: Stone-Bury Lisa , Hurd Julie , Segal Daniel
Published: December 2023

Introduction

The Alternative Model of Personality Disorders (AMPD) is a dimensional model of personality disorder pathology focusing on pathological personality traits, with five trait domains. Limited knowledge exists about relationships between cumulative exposure to traumatic events and the AMPD, a gap particularly relevant for older adults who have had a lifetime of potential exposure. Method: Older adults (n = 200) completed the Trauma Health Questionnaire (THQ) and Personality Inventory for DSM-5 (PID-5).

Results

Multivariate analysis of covariance (MANCOVA) revealed significant differences in the five PID-5 domains across four levels of cumulative trauma exposure (Pillai’s Trace =.14, F(5, 519) =1.73, p =.04, ηp2=.05). Years since first traumatic event was not significant as a covariate (Pillai’s Trace =.02, F(4, 173) =0.80, p =.55, ηp2=.02). Significant group differences were found in the PID-5’s Psychoticism (F(3, 175) = 5.71, p < .001, ηp2 = .09) and Detachment (F(3, 175) = 2.91, p = .03, ηp2 = .05). According to Bonferroni post-hoc tests, the high trauma exposure group was significantly higher in Psychoticism than low trauma exposure, low to medium trauma exposure, and medium to high trauma exposure groups. For Detachment, the high trauma exposure group was significantly higher than the low trauma exposure and low to medium exposure groups.

Discussion

Findings suggest that cumulative trauma exposure is associated with specific pathological personality traits in older adults. High levels of trauma exposure may be particularly related to eccentric and detached traits that persist in later life, reflecting the need for clinical assessment in both domains.
THE IMPACT OF GROUP-LED YOGA AND MINDFULNESS ON MENTAL AND PHYSICAL HEALTH IN SOUTH ASIAN WOMEN
Authors: Jiwani Rozmin , Malik Mishel , Mithani Sara , Espinoza Sara , Serra Monica
Published: December 2023

One in five South Asians (people from India, Pakistan, and Bangladesh) living in the U.S. report experiencing a mental illness, with women reporting a three-fold greater risk of distress than men. South Asian women commonly interpret mental health symptoms as physical illnesses and resist seeking medical help. Yoga is a multifaceted, effective practice promoting well-being by integrating mind and body. This study aims to determine the feasibility and impact of a 12-week (Jan-April 2023) yoga and mindfulness intervention on mental and physical health outcomes in South Asian women. Thirty community-dwelling South Asian immigrant women, age ≥45 years were recruited to complete weekly 90-minute sessions of Ashtanga yoga including meditation and mindfulness practice. We are currently reporting baseline and 6-week data of mindfulness and physical activity self-reported questionnaires as the intervention is ongoing, but 12-week data will be available for the final presentation. At baseline, participants were 53±6 years old and a majority (80%) were overweight/obese with BMI ≥25kg/m2. At 6 weeks, twenty-eight (93%) participants continued with the study and twenty-five (83%) attended ≥4 of the 6 sessions. By 6 weeks, participants’ scores improved on Five Facet Mindfulness by 17% (p< 0.001) and Godin Leisure-Time Exercise by 15% (p>0.05) from baseline. These results suggest the preliminary feasibility, retention, and potential impact of the intervention on mental health outcomes in this population. Future directions include developing a large-scale, randomized lifestyle intervention trial to delay/manage mental health outcomes in South Asian women of all ages.
URBAN OLDER ADULTS PERSPECTIVES ON NATURE: A DIRECTED CONTENT ANALYSIS
Authors: Cassidy Jessica , Lee Kathy
Published: December 2023

Biophilia is a theory which hypothesizes humans have an instinctual desire to interact with nature that in turn, supports health and well-being outcomes through gains in physical and mental functioning. This study aimed to explore how concepts outlined in the theory of Biophilia related to urban older adults’ experiences and perceptions of nature. This secondary data analysis examined five focus groups with community-dwelling, urban older adults. All participants were female, and majority were African Americans (83.3%). Using directed content analysis, we developed a codebook from concepts and mechanisms outlined in the theory of Biophilia. Our analysis resulted in six themes, 1) Infinite wonder of nature; 2) Nature activating long-term memories; 3) Nature influencing feelings of well-being; 4) Connecting with nature; 5) Conservation ethic; and 6) Nature across the lifespan. Overall, the data fit the theory well. Through the lens of Biophilia we understood why the sample of participants valued their interactions with nature, as well as how experiences in nature promoted their feelings of well-being. We observed appreciation for nature interactions can deepen in later life suggesting nature-based interventions may be especially well-suited for older adult populations. We suggest the theory of Biophilia can lend well to public health approaches towards addressing the social and economic implications presented by growing numbers of urban dwelling older adults. Moreover, Biophilia can provide a theoretical basis for tailoring nature-based interventions delivered across a variety of settings to match diverse study goals and overall, to promote the health and well-being of older adults.
CHILDHOOD PARENT–CHILD RELATIONSHIP, PARTNER RELATIONSHIP CLOSENESS, AND DEPRESSIVE SYMPTOMS IN LATER LIFE
Authors: Zhou Zexi , Qu Yang
Published: December 2023

Attachment theory suggests that quality of early-life parent-child relationships may influence how people establish other types of relationships (e.g., romantic relationship, friendship) later in life, and have long-lasting effects on individuals’ psychosocial development. Yet, little research has investigated whether such effects may last until later adulthood and the potential moderators in these processes. To address this issue, this study examined the associations among childhood parent-child relationship quality, current partner relationship closeness, and depressive symptoms in late life using a sample of 12,292 community-dwelling adults aged 51 or older (Mage = 63.15, 51% female). We leveraged the seven-wave longitudinal data between 2006–2018 from the Health and Retirement Study. Depressive symptoms were assessed using the CESD score at each wave. Participants also reported closeness with their partner every other wave, and relationship quality with their parents in childhood. Multilevel models showed that better mother-child and father-child relationships during childhood were both associated with greater closeness with partner in late life, especially for female compared to male. Poorer childhood mother-child relationship was associated more depressive symptoms in late life, but this association was attenuated for those who overall reported a greater level of closeness with their partner over the study period. The findings suggest that negative early life parent-child relationship may put people at greater risk for developing depressive symptoms and weaker social connections in late life, and highlight the protective role of positive partner relationship in buffering this association.
LIFESTYLE CHANGES AFTER FRAILTY ONSET AMONG MIDDLE-AGED AND OLDER ADULTS IN THE UNITED STATES
Authors: Xu Hui-wen , Chen Yu-Ming , Yang Zhou , Xu Bei-bei
Published: December 2023

Frailty could be the teachable moment to promote a lifestyle change for middle-aged and older adults. This study aimed to investigate the impact of sociodemographic characteristics on lifestyle changes among frail adults aged ≥50 years. A total of 5,440 frail individuals aged ≥50 years from the Health and Retirement Study (HRS) 2004-2020 were included. The Paulson–Lichtenberg Frailty Index was used to measure frailty. Lifestyle included smoking status, alcohol consumption, physical activity, and sleep problems. Logistic regression models were used to examine the associations between sociodemographic characteristics and lifestyle change among frail participants. After frailty, a higher proportion of individuals reported maintaining their smoking and drinking status without change. Compared to increased physical activity, more people reported reducing their low, moderate, and high-intensity physical activity. Similarly, a greater proportion of individuals reported worsened sleep problems compared to those who experienced improvements in sleep problems. Age was negatively associated with quitting smoking and increased light, moderate, as well as vigorous physical activity, while was positively associated with improving sleep problems. Males were more likely to quit smoking, quit drinking, and increase light physical activity. Individuals with medium and high education levels were more likely to quit drinking and less likely to increase moderate physical activity. A sensitivity analysis based on the 4-year interval between pre-diagnosis and post-diagnosis of frailty showed that being unmarried was associated with an increased likelihood of quitting smoking. Some people reported lifestyle changes after frailty. Age, gender, marital status, and education levels may affect lifestyle changes after frailty.
THE 12 DS: AN UPDATE TO EDWARDS’ AND RAY’S REASONS FOR NONPARENTAL CAREGIVING
Authors: Lopez Acacia , Nadorff Danielle
Published: December 2023

This study examined the prevalence of the “Nine D’s,” a framework developed by Edwards and Ray for understanding the heterogeneity of reasons for which grandparents assume care of grandchildren (i.e., Death, Disease, Detention, Divorce, Departure, Drugs, Desertion, Delivery, Deployment) within a contemporary sample. Using a nationwide sample (N = 427) of custodial grandparents and foster parents, caregivers were asked their reason for assuming care of the grandchild or foster child within their care. The results of the study suggest that the Nine D’s are a useful framework, but fail to capture many of the reasons for assuming care. Three new themes—Dollars, Duty, and Daily Grind—were identified and are applicable to both grandfamilies and foster families. These themes represent different motivations for assuming care and provide insight into the social structures which may act as barriers to family formation. This study provides a foundation for future research examining the impact of assumed care by non-parental attachment figures on the health and well-being of both grandchildren and foster children.
THE EFFECTS OF GRANDPARENTAL CARE ON MENTAL HEALTH AMONG CHINESE GRANDPARENTS: A LIFE COURSE PERSPECTIVE
Authors: Lyu Jiahui
Published: December 2023

As the population continues to age, grandparental care has become a more prevalent form of childcare, particularly in China. Limited research has investigated the effects of grandparental care on grandparents’ mental health and the conclusions are ambiguous with both positive and negative outcomes being found. In this study, a life course perspective is adopted to examine the mechanisms of such effects. Using data from the China Health and Retirement Longitudinal Study (2011–2013), I conducted logistic regression models to examine the association between various stages of grandparental care and depressive symptoms among Chinese grandparents between the ages of 45 and 80 (N = 3946). Specifically, this study examines the impact of transitions into or out of grandparental care on depression and the potential moderating role of gender. Results show that grandparents who stop providing care for grandchildren are less likely to experience depression compared to those who provide no grandparental care (OR = 0.78). Additionally, grandmothers who provide ongoing grandparenting tend to have a higher risk of experiencing depression. The findings presented in this study offer valuable insights into the various mental health implications of grandparental care in the Chinese context, underscoring the significance of accounting for gender differences. This study also highlights the need for evidence-based policies and interventions that promote the well-being of older adults.
A PHOTOVOICE STUDY OF THE EXPERIENCES OF BIPOC OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Ekwonye Angela
Published: December 2023

The coronavirus disease 2019 (COVID-19) pandemic intensified the stressful and already difficult circumstances of communities of color. Yet, no current photovoice research has highlighted the lived experiences of low-income Black, Indigenous, and persons of color (BIPOC) older adults during the pandemic. This qualitative study used photovoice to visually portray the struggles of low-income BIPOC older adults and how they recovered from and adapted to the impact of the pandemic. The data analyzed were drawn from interviews, focus groups, photographs, and written stories exploring their experiences and how they found meaning. Results show that participants faced different challenges during the pandemic, such as the fear of COVID-19 exposure and death, struggles to adopt COVID-19 mitigation strategies, loneliness, and social isolation. Amid this crisis of suffering, isolation, and sadness, participants found meaning through a positive reappraisal of the negative situation and engaging in emotional, spiritual, social, and physical self-care practices. The findings have implications for clinical social workers, mental health counselors, faith communities, nurse managers and administrators, and policymakers.
ARE INEQUALITIES IN HEART DISEASE CHARACTERIZED BY INTERGENERATIONAL EDUCATIONAL ATTAINMENT?
Authors: Kemp Blakelee , Rush Carli , Morton Patricia
Published: December 2023

Intergenerational patterns in educational attainment are associated with later-life heart health. Yet, whether the association between intergenerational education patterns and adult heart disease varies by cohort and gender is unclear despite the increasing importance of education for health, especially among women. Informed by a life-course perspective, this study aims to further contextualize the link between education and heart disease in time and across groups. Using data from the Health and Retirement Study, a nationally representative panel survey of adults over the age of 50, we examine how patterns in intergenerational education are associated with heart disease prevalence (n=31,141) and incidence from 1998 to 2018 (person-year observations=253,521) and whether these patterns vary by gender and cohort. Overall, individuals characterized by stable-high education (i.e., parent and respondent have at least some college education) consistently had the lowest prevalence and incidence of heart conditions, whereas those with low adult education, regardless of parent’s education, had the highest risk of heart conditions. Findings also indicate that the effects of intergenerational education patterns on adult heart disease were most pronounced for women and the younger cohorts compared to men and older cohorts, respectively. For example, women and the youngest cohort (born 1954-1967) with upward and stably high intergenerational education had the most favorable heart disease outcomes, whereas the same groups with downward intergenerational education experienced the highest heart disease prevalence. Our findings demonstrate the importance of contextualizing how intergenerational educational attainment influences later-life heart conditions by considering variations by gender and cohort.
ARE RURAL OLDER ADULTS READY TO ADOPT AUTONOMOUS VEHICLES (AV)? PREDICTORS OF ATTITUDES TOWARD AV IN RURAL AREAS
Authors: Zoaktafi Mojgan , Gandy Tyler , Yoon Jong Sung
Published: December 2023

Transportation for older adults residing in rural areas is particularly vital for maintaining their everyday activities including access to health services and community activities. Given unique features of rural areas (e.g., limited public transportation, greater distances to travel but less traffic), autonomous vehicles (AV) can be an innovative solution to rural older adults. Nevertheless, attitudes toward AV can be a significant barrier for older adults to adopt it. In fact, older adults in rural areas tend to hold different attitudes toward and experiences with new technologies. The current study explored how individual difference variables (i.e., age group, gender, technology proficiency, & personality traits) predict attitudes toward AV in rural areas. We first conducted a factor analysis on a 16-item attitude survey (collected from rural areas in USA) which uncovered three factors: concern with AV, willingness to adopt AV, confidence on human driving over AV. ANOVAs on the attitudinal factors showed that older adults (60+ yrs, n = 45) had a lower willingness to adopt AV than young adults (17-21 yrs, n = 47) despite a lower confidence on human driving over AV. There was no age group difference in concern with AV. Multiple regressions supported that technology proficiency can be another significant predictor of willingness to adopt AV over and above other individual difference factors (i.e., age groups, gender, & personality). These results indicate that older adults in rural areas have complex and ambivalent attitudes toward AV, which suggest different approaches to the dissemination of AV technology for them.
COGNITIVE AND FUNCTIONAL IMPACTS OF CHILD LABOR IN INDIA: THE MEDIATING ROLE OF EDUCATION
Authors: Lee Seolah , Vikram Kriti , Lee Hyo Jung
Published: December 2023

This study aims to examine how entry into the labor market in childhood is associated with deficits in late-life cognitive and functional health. Using the Cumulative Advantage/Disadvantage Theory, it further explores how educational attainment, an indicator of socio-economic status, mediates the associations between child labor and cognitive and functional health among older adults in India. Lastly, it investigates if the results vary by gender. We use the nationally representative World Health Organization Study on global AGEing and Health (SAGE), and select respondents aged 50 years or older (n = 6,215 for Mini-Mental State Examination (MMSE); n=6,408 for the Functional Limitation (FL)). Mediation models were performed for each dependent variable using the sgmediation2 program, bootstrapped 5,000 resamples, and percentile bootstrap confidence interval. The indirect and total effects of child labor on MMSE were significant, while the direct effect of child labor was not. For FL, the indirect effect was significant, but the direct and total effects were not. Gender difference was found in terms of the direct effect, child work was directly associated with a lower MMSE score in older women (p < .01), whereas it was not significant for older men. Findings suggest that early entry into the labor market (as a child) has a negative impact on older adults’ MMSE and FL through deprivation of educational opportunities. Providing opportunities for completing certain level of education can mitigate the negative impact of child labor on health in old age.
HOUSEHOLD ENVIRONMENTS AND COGNITIVE DECLINE AMONG MIDDLE-AGED AND OLDER ADULTS IN CHINA
Authors: Luo Ye , Zhao Dandan , Pan Xi , Zhang Lingling
Published: December 2023

Household conditions play a crucial role in the well-being of older adults, who usually spend much longer time in their homes than younger adults. Few studies have examined the compound effects of multiple household conditions on trajectory of cognition function among older adults. This study examines the relationship between household environments and trajectories of cognitive function among middle-aged and older adults in China. It also examines urban/rural, gender, and age variations in this relationship. Using a representative sample of 16,111 respondents aged 45 years and over from four waves of the China Health and Retirement Longitudinal Study (2011-2018), we estimated multi-level linear growth curve models of household social, economic, and physical conditions on cognitive decline over seven years. The results show that older people who lived with spouse but not with children and those with higher living expenditures, better housing quality, and indoor clean fuels for cooking had slower cognitive decline. Living arrangement more strongly predicted men’s cognitive decline while living expenditure, solid fuel use and housing quality significantly predicted only women’s cognitive decline. Only for adults aged 60 year and over, living alone or living with spouse and adult children significantly predicted a faster cognitive decline. Only for rural residents, living alone or living with young children and no adult children significantly predicted a faster cognitive decline. These findings underscore the importance of social policies and programs targeting at improving the living conditions of older adults to help mitigate their cognitive decline.
INEQUALITY IN AWARENESS, TREATMENT, AND CONTROL OF VISUAL IMPAIRMENTS AMONG OLDER ADULTS AND ELDERLY IN INDIA
Authors: Singh Rajeev
Published: December 2023

Globally, 1.1 billion people have some form of visual impairment, and 90 percent of them live in low and middle-income countries. The prevalence of visual impairment is increasing, and the likelihood of increasing this trend is also higher. Yet, there is little evidence on the extent of awareness, treatment, and control (ATC) of visual impairment in India. We estimate the prevalence and ATC of visual impairment among older adults and the elderly across socioeconomic groups. We used the unit data from the first round of the Longitudinal ageing study of India (LASI), 2017-18, bivariate analysis, estimated age sex-adjusted prevalence, logistic regression, concentration index, and concentration curve used in the analyses. Among the 45+ population, 30.18% have any form of visual impairment, around 47.96% have awareness about the visual impairment, 17.21% have taken treatment for vision-related issues, and 12.70% have control vision after treatment. The prevalence was higher among the illiterate poor and females; however, the awareness, treatment, and control were higher among those with higher education who belongs to the richer richest wealth quintile. The concentration index and concentration curve suggest that higher prevalence was concentrated among the poor, and contrary to that, awareness treatment and control were concentrated among richer. To deal with it, public health services from the primary, secondary, and tertiary levels may be integrated for effective care of growing, underdiagnosed, and untreated visual impairments among older adults and the elderly in India.
PERCEIVED SOCIOECONOMIC STATUS, PRODUCTIVE SOCIAL ENGAGEMENT, AND SUBJECTIVE HEALTH: LONGITUDINAL STUDY IN TAIWAN
Authors: Su Chin-Yi , Chao Shiau Fang
Published: December 2023

Productive social engagement (PSE) has been identified as a crucial factor in promoting subjective health in later life. However, there has been limited focus on how perceived socioeconomic status (SES) among older adults mediates this relationship over the long term. This study employed data from the Taiwan Longitudinal Study on Aging to examine a sample of 2,865 individuals aged 55 or above from 2011 to 2015. By employing a path analysis, this study tested the hypothesized effects developed from active aging theory and social capital theory. Results indicates that : 1. Higher levels of PSE and perceived SES predicted higher subjective health within the same wave, both in T1 and T2. 2. Perceived SES mediated the relationship between PSE and subjective health only in T1. Also, the effect of T1 PSE on T2 PSE operated through T1perceived SES. 3. T1 PSE positively predicted T2 subjective health through T1 perceived SES and T2 perceived SES over the time. This study sheds light on the mechanism linking PSE, perceived SES, and subjective health. The findings suggest that higher perceived SES is associated with more PSE in a four-year interval, which in turn predicts higher subjective health. This indicates that social capital may facilitate older adults’ access to PSE over time. Future research should investigate the role of perceived SES and how it interacts with objective and subjective physical well-being in later life. Interventions should target ways to help older adults access opportunities for engaging in productive activities to improve their health.
PRIMARY MOTIVATIONS OF AFRICAN AMERICANS AND LATINOS TO PARTICIPATE IN ALZHEIMER’S PREVENTION RESEARCH
Authors: Murillo Lizbeth Vera , Collie Angel , Meulen Maria Vander , Villamor Monique , Nicholson-Bell Jody
Published: December 2023

The prevalence of Alzheimer’s Disease and related dementias (ADRD) is higher among racial/ethnic minorities as compared to White/Caucasian individuals, yet there is poor representation in ADRD research for these minoritized groups. It is essential to investigate the motivation to participate in research for individuals from minoritized groups to optimize inclusiveness through recruitment and retention strategies. The current project explores racial/ethnic differences in motivations to participate in an ADRD prevention study using case-controlled matching between White/Caucasians (n=210; M = 71.01 years, SD = 4.41) and African American/Black (n=210; M = 71.26 years, SD = 4.47) participants, and between non-Hispanics (n = 158; M =71.13, SD = 5.33), and Hispanic participants (n = 157; M = 71.48 years, SD = 5.14). Results indicated Latinos/Hispanics were more likely to report concerns about brain health and aging (59.7%; χ ² = 3.99, p < .05, φ=.11) and improvement of personal brain health (60.9%; χ ² = 4.30, p < .05, φ=.12) as a motivator compared to non-Hispanics. African American/Blacks were more likely to report concerns about brain health (59.6%; χ ² = 4.66, p < .05, φ=.12) as a motivator compared to White/Caucasians. Data from the current study about the concerns of cognitive decline and brain health for African Americans/Blacks and Latinos/Hispanic opens an avenue by which participation in clinical trials may be increased by better project marketing/advertisement focusing on the advantages of preventative health behaviors involving non-pharmacological methods and cognitive health resources that might be available within a research environment.
REPORTED HISTORY OF ABORTION AS A CONTRIBUTOR OF RELIGIOSITY AMONG OLDER WOMEN HELD IN CORRECTIONAL CUSTODY
Authors: Minet Hailey , Barnett Brianna , Bishop Alexander , Randall Kevin
Published: December 2023

This study assessed the interconnection between abortion, forgiveness, and social provisions on religiosity for N = 157 older women (45 years and older) under correctional custody in Oklahoma. Guided by the Model of Developmental Adaptation, path analysis was conducted positing positive religiosity as the developmental outcome, regressed on proximal influences assessed by social provisions and forgiveness and the distal influence, the independent predictor, whether or not a woman had ever had an elective abortion in their lifetime. Endogenous measures were controlled for age, race, marital status, education, and crime type. Using Mplus 8.8 and an estimator that provides parameter estimates and a chi-square test statistic robust to non-normality, the model fit well with a non-significant chi square test statistics and significant parameter estimates as expected. Reported history of abortion was significantly associated with forgiveness (β= .25, p < .05) and social provisions (β = .31, p < .05). Forgiveness was also significantly associated with religiosity (β = .32, p < .01). Mediating paths were not significant. Among these women, 37% of the developmental outcome, religiosity was explained primarily by forgiveness. It appears that older women in correctional custody who have received an elective abortion have a greater disposition to engage in forgiveness and seek social support. A greater disposition to forgive also directly contributes to increased religious activity among these same women. Results have implications relative to how forensic counselors, correctional social workers, and prison chaplains provide intervening services and rehabilitation programming to sustain quality-of-life for older women aging-in-custody.
SLEEP DISTURBANCE AND DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS: DO GENDER DIFFERENCES EXIST?
Authors: You Suha , Kim Giyeon
Published: December 2023

Sleep is a key part of a healthy lifestyle, but aging causes sleep problems by decreased melatonin levels. Sleep disturbance includes problems falling or staying asleep, too much sleep, or obstructive sleep apnea (OSA), the most common sleep-related breathing disorder in older adults. Thus, aging-related changes in sleep should be studied in various aspects of elderly’s health such as physical, mental, and cognitive health. As part of that, this study aims to (1) examine the connection between sleep disturbance and depressive symptoms and (2) investigate whether gender differences exist. Participants were Korean adults aged 65 and older (N=1,316) from the 2020 Korean National Health and Nutrition Examination Survey. The survey measured sleep disturbances (OSA, insomnia, hypersomnia), depressive symptoms, and sociodemographic characteristics. Hierarchical multiple regression analysis was conducted to examine whether sleep disturbances influence depressive symptoms and test the interaction between sleep disturbance and gender. Results revealed that after adjusting for covariates, those with more risk factors for OSA (B=1.056, p=.000) or with insomnia (B=1.527, p=.000) were more likely to have greater depressive symptoms than their counterparts. Additionally, the relative influences of OSA (B=1.295, p=.000) or insomnia (B=.965, p=.023) on depressive symptoms were contingent upon gender. However, no correlation was observed between hypersomnia and depressive symptoms. Although both OSA and insomnia are risk factors for depressive symptoms, older women with OSA or insomnia showed more severe depressive symptoms than older men with OSA or insomnia. Findings suggest the need to make sophisticated approaches considering homogeneity and heterogeneity within older adults.
SOCIAL DETERMINANTS OF HEALTH AND EMERGENCY DEPARTMENT VISITS AMONG OLDER ADULTS WITH MULTIMORBIDITY
Authors: Lim Arum , Benjasirisan Chitchanok , Liu Xiaoyue , Ogungbe Oluwabunmi , Himmelfarb Cheryl Dennison , Davidson Patricia , Koirala Binu
Published: December 2023

Multimorbidity is prevalent in older adults and is related to various adverse health outcomes, including high emergency department (ED) visits. Evidence suggests that social determinants of health (SDoH) are associated with many health outcomes, but the association between SDoH and ED visits among older adults with multimorbidity has received limited attention. This study aimed to examine the association between SDoH and ED visits among older adults with multimorbidity. A cross-sectional analysis was conducted among 25,078 adults aged 50 years and older from the 2010 to 2018 National Health Interview Survey. Multimorbidity was defined as the presence of two or more self-reported diseases among nine common chronic conditions, such as hypertension, diabetes, asthma, stroke, and cancer. The SDoH assessed included race, education, poverty, marital status, employment status, insurance status, and having a usual place for medical care. Participants’ mean (±SD) age was 68.06 (±10.16) years, and 55.13% were female. After adjusting for age, sex, and categories of comorbidities in the logistic regression model, high school or less education (AOR=1.14, 95%CI=1.05-1.24), poverty income ratio < 1 (AOR=1.50, 95%CI=1.35-1.66), unmarried (AOR=1.23, 95%CI=1.15-1.32), and unemployment status (AOR=1.36, 95%CI=1.25-1.48) had higher odds of having 1 or more ED visits. Non-Hispanic Blacks had higher odds (AOR=1.28, 95%CI=1.18-1.40), while non-Hispanic Asians had lower odds (AOR=0.69, 95% CI=0.56-0.84) of 1 or more ED visits than non-Hispanic Whites. SDoH are associated with ED visits among older adults with multimorbidity; providers should consider SDoH in health-seeking behaviors and to promote health equity.
COPING STYLES AS MEDIATORS BETWEEN PURPOSE IN LIFE AND COGNITIVE FUNCTION: A LONGITUDINAL STUDY
Authors: Sesker Amanda , O’Súilleabháin Páraic , Luchetti Martina , Terracciano Antonio , Sutin Angelina
Published: December 2023

This study tested the association between purpose in life and coping styles and whether coping styles mediate the association between purpose and cognitive function. Longitudinal data from the Midlife Development in the United States (MIDUS) study were used to investigate associations between purpose assessed at MIDUS I (1996-1997) and coping assessed at MIDUS II (2004-2006) (N=2,386). Emotion-focused and problem-focused coping styles were then tested as mediators of the association between purpose and cognitive function (i.e., memory, executive function, and global cognition) assessed at MIDUS III (2013-2014). Higher purpose was associated with higher problem focused coping (β=.191, p<.001) and lower emotion-focused coping (β=-.227, p<.001). Coping style partially mediated the association between purpose and cognitive function about two decades later. Emotion-focused coping accounted for 14.3% of the total effect of purpose on cognitive function. Problem-focused coping mediated 16.7% of the total effect of the association of purpose on episodic memory, but did not mediate the associations between purpose with either executive function or total cognitive function. These findings provide new evidence for associations between purpose and coping, as well as links between coping and cognitive function in a large, longitudinal sample of adults. The results are consistent with the literature on purpose and better cognitive function in adulthood and suggest that coping is one mechanism linking purpose with better cognitive function.
HYDRATION STATUS AND COGNITIVE FUNCTIONING IN OLDER ADULTS
Authors: Singer Katelyn , Katz Benjamin
Published: December 2023

Hydration status may play a role in chronic behavioral and physiological conditions commonly experienced by older adults (Begum & Johnson, 2010; Lee et al., 2010; Stookey et al., 2020). However, research on the impact of hydration status on cognition specifically, however, has often focused on single outcome tasks or more global measures; furthermore, research is heterogeneous in methodologic approaches. The current study aimed to identify specific cognitive domain(s) most closely associated with hydration status among older adults. Utilizing a wide range of cognitive performance data from the Health and Retirement Study’s Harmonized Cognitive Assessment Protocol (2016) and hydration data derived from the physiological data from the Venous Blood Study (2016), curvilinear regression analyses identified a significant relationship between hydration status (measured by serum osmolarity) and processing speed in older adults. Specifically, being in a state of euhydration, compared to being hyper- or hypo- hydrated, was associated with better cognitive performance only on measures of processing speed such as letter cancellation, digit symbol, and trail making A tasks. These associations indicate that hydration is most closely linked to tasks involving mental speed, which include everyday tasks such as doing mental math, decision making, and processing visual information (Owsley et al., 2002). These findings provide complementary evidence to support earlier work suggesting links between processing speed and hydration status (Mantantzis et al., 2020) , but also highlights the need for further studies assessing the causal pathways of this association.
PREDICTORS OF EVERYDAY FUNCTIONING, ADLS/IADLS AMONG OLDER ADULTS USING THE ACTIVE STUDY
Authors: Dadson Deborah , Ball Karlene
Published: December 2023

The increase in life expectancy over the years has triggered both researchers and the aging population to focus more on achieving an active engagement with life. This ability to perform daily living activities (functionality) is a key component in healthy aging which aids older adults live independently with or without disease and disability. Gaining insight into the key elements that enhance physical functioning is necessary as the issue of limited physical functioning affects not only older adults but also, middle aged adults. This study examines the predictors of everyday functioning, Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) among 1920 older adults using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. ADLs and IADLs were self-reported. Results of the hierarchical linear regression at baseline indicate that, being female and being African American significantly predict lower performance on everyday functioning, after adjusting for age and years of education. Fewer falls in the past 2 months, better cognition and normal weight significantly predict high performance on everyday functioning (all p < .05). For ADLs, being African American and female gender significantly predict higher scores on ADLs while female gender predicted lower scores on IADLs. There were no differences on living arrangements and access to healthcare on everyday functioning, ADLs and IADLs. 43.1% of variability in IADLs were explained by the predictors. Findings from this study identify target populations for interventions to promote active engagement with life.
AGE AND EXERCISE DIFFERENTIALLY INFLUENCED MENTAL HEALTH DURING THE PANDEMIC
Authors: Feliachi Zohra , Patrick Julie Hicks
Published: December 2023

With over 103,436,829 confirmed COVID-19 cases and more than 1.13 million deaths in the USA between January 2020 and August 2023 (WHO, 2023), the pandemic has affected most aspects of life. Regarding emotional wellbeing, most research has shown that older adults fared better than their younger peers (e.g., Ebert et al., 2022), although explanatory mechanisms for this effect have not been examined fully. We sought to fill this gap by examining the influence of age and exercise before and after vaccines were developed for the COVID-19 pandemic in the USA. Using data from the Behavioral Risk Factor Surveillance System (BRFSS), we compared a model in which age and exercise were used to examine the number of poor mental health days experienced. We compared responses from 423367 adults from 2018 and 2019 with responses from 417964 adults interviewed in 2021 and 2022. Results of a 4 (year) by 4 (age group) by 2 (exercise) ANOVA revealed significant effects for for each factor. More importantly, these main effects and two 2-way interactions were moderated by the 3-way interaction, F (9, 841330) = 2.57, p=.006. Adults who exercised after the pandemic was underway reported fewer poor mental health days relative to those who did not exercise, especially among those younger than age 45 years. Given the ongoing challenges to emotional wellbeing, younger and middle-aged adults may need additional support to age well. Exercise may provide one avenue to greater wellbeing, particularly in the face of non-normative and history-graded events like pandemics.
AGE DIFFERENCES IN EMOTION-RELATED OUTCOMES OF COGNITIVE ENGAGEMENT AND MEANINGFULNESS AT WORK
Authors: Johnson Melanie , Growney Claire , Chu Li , Carstensen Laura
Published: December 2023

Research suggests that there are few age differences in the enjoyment of cognitive engagement, but the importance of engagement in emotionally meaningful goals increases with age. In the present study we examined the interplay between cognitive engagement, meaningfulness at work, and related emotional states in older and younger workers. We used a five-day modified day reconstruction method in which 203 employees (aged 25–76) described their work, emotions, and cognitive engagement during the beginning, middle, and end of their workdays. A three-way interaction revealed that older employees who were more cognitively engaged at work reported higher levels of negative emotions than younger employees, and the association was reduced among those who perceived their work as meaningful (b=–0.006, SE=0.003, p<.05). Interestingly, perceived meaningfulness was a stronger predictor of pride at work among younger employees than older employees (b = –0.015, SE = 0.006, p = .018). Cognitive engagement at work was predictive of feeling pride among older employees, and not younger employees (b=0.02, SE=0.01, p<.01). Age also moderated the relationship between cognitive engagement and time-savoring, such that higher levels of cognitive engagement predicted more time-savoring at work among older employees, but not younger employees (b=0.011, SE=0.005, p< 05). Results suggest that the emotional benefits of perceiving one’s work as meaningful may be different for younger and older workers. Furthermore, associations between cognitively engaging work and emotional outcomes such as time-savoring and pride may be especially relevant for older employees.
EXPLORING THE POTENTIAL OF PHLPP INHIBITORS FOR OSTEOARTHRITIS TREATMENT
Authors: Victoria-Sanchez Leslie , Torres Haydee , Westendorf Jennifer
Published: December 2023

Osteoarthritis (OA) is a degenerative joint disease characterized by pain, stiffness, and limited joint motion affecting 7% of the world’s population. PH domain leucine-rich repeat protein phosphates (PHLPPs) have been identified as modifiable targets for cartilage regeneration and joint pain. PHLPP1 and PHLPP2 are abnormally expressed in osteoarthritic cartilage and sensory neurons. PHLPP1-/- mice are protected from cartilage degradation and pain-related behaviors (allodynia and reduced mobility) after surgery that destabilizes the medial meniscus (DMM). Here, we investigate the effects of PHLPP inhibitors (i) on human chondrocytes and the effect of Phlpp1 deletion on cell populations within lumbar dorsal root ganglia (DRGs). Immunohistochemistry was performed on mouse DRGs by cryosectioning fixed L3-5 DRGs and using primary antibodies against Fabp7, Anti tubulin beta 3, and PGP9.5/UCHL1. Human chondrocytes were subjected to Cycloheximide chase experiments and treated with PHLPPi (NSC117079 or NSC45586), followed by Western blot analysis to assess protein levels including Phlpp1, Phlpp2, Sox9, p-AKT (Ser473), total AKT, and B-actin, at various time points. We found that PHLPPi prolongs the phosphorylated AKT response when compared to controls and does not affect degradation of Phlpp1 or Phlpp2; additionally, NSC117079 increased production of cartilage extracellular matrix components (glycosaminoglycans and aggrecan) in over 90% of human articular cartilage explants from OA patients. These data advance our understanding of how PHLPPi function within chondrocytes and provide a basis toward understanding their activity and safety in vivo. Our results indicate that PHLPPi NSC117079 is a novel osteoarthritis disease-modifying drug candidate that may have palliative effects.