bluuebunny/crossref_metadata_2025 huggingface dataset:
RELATIONSHIP BETWEEN LEISURE CONSTRAINTS AND WELL-BEING IN MIDDLE TO OLDER ADULTS
Authors: Tian Junyan , Sardina Angie , Allan Alexa , Gamaldo Alyssa , Mogle Jacqueline
Published: December 2023

Leisure activity engagement is correlated with several health outcomes, such as depression, a lower risk of dementia and better physical health. However, older adults report experiencing leisure constraints in daily lives due to intrapersonal (e.g., stress), interpersonal (e.g., interaction with friends) and structural factors (e.g., availability of opportunity). Since relatively few research investigated the impact of leisure constraints on middle and older adults’ eudaimonic well-being, the major aim of this study was to explore whether perceived leisure constraints are uniquely associated with eudaimonic well-being after adjusting for sociodemographic, loneliness, health and neighborhood covariates. This study accessed leisure constraints using Leisure Barriers and Interest Questionnaire, and accessed eudaimonic well-being by 4 items from the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire among 378 adults (age range: 40-92, M = 58.4). Correlation results indicated that better well-being was correlated with less perceived leisure constraints (r = -.40, p < .01), greater household income (r = .14, p = .01), less reported loneliness (r = -.53, p < .01), greater reported neighborhood safety (r = -.18, p < .01), and better reported neighborhood quality (r = .23, p < .01). Linear regressions revealed that individuals who perceived a lower level of leisure constraints associated with better well-being (β = -0.20, p < .01) after adjusting for age, sex, income, health conditions, loneliness, and neighborhood quality and safety. Our results highlight the importance of reducing leisure constraints in intrapersonal, interpersonal and structural levels to help older adults live a meaningful and happy life.
RELATIONSHIP BETWEEN QUADRICEPS ECHOGENICITY AND KNEE EXTENSOR STRENGTH IN OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: Harris-Love Michael , Oranchuk Dustin , Boncella Katie , Rush Ben , Bodkin Stephan
Published: December 2023

The clinical availability of assessing muscle quality through diagnostic ultrasound provides a viable screening tool for geriatric syndromes that impair mobility. However, relationships between muscle echogenicity and clinical assessments require further inquiry. The authors aimed to systematically identify and synthesize the literature regarding the relationship between quadriceps echogenicity and maximal knee extensor strength in older adults. A total of 12 extracted articles (N=701, 73.6±5.4 years) independently assessed the relationship between quadriceps echogenicity and peak knee extensor torque. Correlations were weak to moderately negative between knee extensor strength and rectus femoris echogenicity in older adults (mean ±standard deviation; r=-0.398±0.159 [range=-0.681 to -0.080]). While the limited number studies did not warrant advanced analyses, but it appears that the echogenicity of the vastus medialis (study n=3, r=-0.426±1.97 [range=-0.640 to -0.253]) and vastus lateralis (n=3, r=-0.411±0.095 [range=-0.511 to -0.322]) may be superior to the vastus intermedius (n=4, r=-0.341±0.166 [range=-0.484 to -0.120]) and rectus femoris (n=7, r=0.290±0.140 [range=-0.460 to -0.080]) for predicting knee extension strength in older adults. Furthermore, averaging across multiple quadriceps muscles generally improved correlations (n=4, r=-0.544±0.154 [range=-0.681 to -0.334]). Overall, correlations with knee extensor strength were stronger when echogenicity was corrected for subcutaneous fat thickness (n=3, r=-0.491±0.04 [range=-0.521 to -0.453]). However, results regarding fat correction were inconsistent within studies (n=2, uncorrected r=-0.120 and -0.527 versus corrected r=-0.500 and -0.453, respectively). Future studies should aim to report correlations for all quadriceps muscles and for both corrected and uncorrected echogenicity values to allow for more thorough analytical approaches.
ROAD DIETS IMPACT ON DRIVING BEHAVIOR AMONG OLDER ADULTS WITH AND WITHOUT PRECLINICAL ALZHEIMER’S PATHOLOGY
Authors: Carr David , Wisch Julie , Ances Beau , Babulal Ganesh
Published: December 2023

Road diets (that is, the reallocation of one or more lanes of car traffic to other uses) have been proposed as a modification to increase pedestrian safety, particularly for older adults. We considered the impacts of road diets on aging drivers, and on those with early pathological accumulation of AD. We observed naturalistic driving data for 60 cognitively normal older drivers (Age Range = 62 – 87 years, Median = 75 years) driving across three road segments located in St. Louis, Missouri. We used neuroimaging and lumbar puncture derived biomarker data to determine which of the drivers had preclinical AD. Since previous AD studies identified a variety of changes in driving behavior among older drivers with preclinical AD, we examined driving speed before and after lane repurposing. We found that drivers with preclinical AD drove at lower speeds compared to those without preclinical AD prior to road diet implementation. After lanes were repurposed, there was no statistical difference in the speed between older drivers with and without preclinical AD. We evaluated cognitive performance and found that attentional control had a mediating effect on driver speed, suggesting that an individual’s ability to focus on a specific task and filter out distractions was associated with faster driving. Driving speed after lane repurposing is not mediated by attentional control, suggesting that road diets are impervious to individual driver capacity. We conclude that lane repurposing has potential as an important mobility infrastructure solution that could enhance older driver safety and facilitate aging in place.
ROLE OF THE METHYLTRANSFERASE METTL21C IN DRIVING MUSCLE ATROPHY WITH AGING AND HIV INFECTION
Authors: Castillo Jorge Gonzalez , McGee-Lawrence Meghan , Kress Taylor , Kovacs Laszlo , de Chantemele Eric Belin , Hamrick Mark
Published: December 2023

Osteoporosis and sarcopenia are both frequently observed in older people living with HIV. We developed an animal model to investigate the cellular and molecular mechanisms underlying accelerated muscle aging in the setting of HIV infection. Wild-type C57BL/6 mice received bone marrow from Tg26 HIV-1 transgenic mice at 8 weeks of age and tissues were collected 8 weeks later. Tg26 mice express 7 of 9 HIV proteins but lack gag and pol so are non-infectious. RNA was isolated from the tibialis anterior and microarray was performed using the Clariom S Mouse array that contains more than 22,100 well-annotated genes and 150,300 transcripts. Differential expressions were calculated using ANOVA and filtered with a p-value cutoff of 0.05. Results show that the methyltransferase Mettl21c, a methyltransferase previously shown to stimulate muscle protein synthesis and suppress muscle degradation, is one of the most highly downregulated (more than two-fold) genes in muscle from mice receiving Tg26 bone marrow. We then analyzed GEO data sets to identify changes in muscle Mettl21c expression in various disease settings. These data sets reveal that Mettl21c is consistently downregulated in skeletal muscle with inflammatory conditions such as cancer cachexia and sepsis. In addition, GWAS studies have previously shown Mettl21c deficiency in patients with sarcopenia and osteoporosis. Our data suggest that HIV proteins may produce epigenetic modifications in skeletal muscle leading to muscle loss, and that therapies restoring expression of methyltransferases such as Mettl21c might improve muscle health in patients living with HIV.
RU AGE-FRIENDLY? THE RUTGERS AGING INITIATIVE
Authors: Snedeker Lauren , Davis Tracy
Published: December 2023

Ageism is harmful to everyone everywhere, including university settings. Rutgers is among America’s highest-ranked, most diverse public research universities. While efforts have been made to increase diversity, equity, and inclusion, few efforts have focused specifically on ageism. Like many individuals and groups experience, ageism is often the last experience identified in the DEI equation (can cite if needed). The objective of this project was to begin to take steps to end ageism at Rutgers University and beyond and move towards becoming an age-friendly university. As a part of this project, we surveyed 109 full or part time faculty members about their understanding of ageism and their experiences with ageism at the university. Furthermore, faculty were asked about the feasibility of including ageism into their courses and whether they would need training or materials to do so. Our survey results indicate that faculty feel prepared to lead discussions on ageism with students, recognize its importance in advancing equity and inclusion, and but largely lack any formalized training on the matter. Our project, supported by a university grant, helped respond to these findings and create a sustainable action plan for the future that ensures ageism and age inclusivity are experiences that continue to be addressed at the university level.
SERUM TRANSTHYRETIN LEVEL IS ASSOCIATED WITH COGNITIVE FUNCTION IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Nakamura Misa , Imaoka Masakazu , Tazaki Fumie , Hida Mitsumasa , Imai Ryota , Kubo Takanari , Sakai Keiko , Takeda Masatoshi
Published: December 2023

Serum transthyretin (TTR) level has been shown in several studies to be associated with mild cognitive impairment (MCI) and dementia. This study aims to clarify the usefulness of TTR as a biomarker of change in cognitive function in people with normal cognitive function (NC) as a phenotype. We therefore investigate the relationship between cognitive scores and TTR in a cross-sectional study. A longitudinal study then examines the involvement of TTR level in the transition from NC to MCI. Cognitive function was evaluated using Addenbrooke’s Cognitive Examination-Revised (ACE-R). A cross-sectional study was conducted in community-dwelling older people (n=211) classified into NC, MCI, or dementia by ACE-R score. A 32-month longitudinal study was then conducted (n=29). Multiple regression analysis used sex, age, years of education and TTR as dependent variables and ACE-R scores as an independent variable. TTR was significantly associated with ACE-R in people with NC (β = -0.295, p =0.0008). No association with TTR was found in the MCI or dementia groups. Multiple regression analysis using sex, age and each ACE-R subdomain as dependent variables and TTR level as independent variable showed significant association with memory and language. In the longitudinal study, data analysis revealed that TTR level at baseline in females with MCI was significantly higher than it in females with NC. Our results suggest serum TTR levels might be a useful marker for cognitive function in preclinical AD. Elevated TTR might be a predictor of transition to MCI in old-aged adults with NC.
SIAH E3 UBIQUITIN LIGASE2 (SIAH2) DELETION MIMICS AGE-ASSOCIATED PHENOTYPES IN MOUSE MACROPHAGES
Authors: Ghosh Bhaswati , Panta Pradip , Scott Matthew , Floyd Elizabeth
Published: December 2023

Aging is generally characterized by physiological as well as metabolic decline. Crosstalk between metabolic organs is remarkably altered by aging. For one, adipose tissue exhibits distinct cellular and molecular attributes of aging. Impaired adipogenesis is one of the aging hallmarks. Previously, we demonstrated Siah E3 Ubiquitin Ligase2 (Siah2) is upregulated during adipogenesis. We are interested if and how Siah2 expression is altered by aging. Recently, the age-related decline in immune function was first detected in mouse adipose tissue. To explore the regulatory role of Siah2 in immune response, we generated mice with Siah2 knockout in macrophages (SKM) and observed elevated expression of inflammatory regulators including TNF-α and Trem2 in SKM macrophages compared to control. Additionally, we detected increased lipid accumulation and expression of Plin2 (lipid droplet marker) in the co-culture model of adipose tissue macrophages derived from SKM mice. These data are consistent with previous research showing an age-related increase in TNF-α expression and lipid content. Varying degrees of age-related alterations have been observed in different adipose tissue depots. For example, aging attenuates “beiging” of white adipose tissue (WAT) to brown adipose-like tissue and consequently is associated with lower levels of mitochondrial respiration. Interestingly, oxygen consumption rate, a quantitative measure of mitochondrial function, is lower in the SKM macrophages compared to the control group, hinting that Siah2 may regulate browning of WAT during aging. Altogether, these data suggest that Siah2 KO phenotypes mimic major aging hallmarks and that Siah2 could be a potential therapeutic target for age-related adipose tissue disorders.
SOCIAL DETERMINANTS OF BRIDGE EMPLOYMENT: DO BIRTH COHORTS MATTER?
Authors: Choi Gayoung , Lee Haena
Published: December 2023

A growing number of retirees now engage in bridge employment, a term referring to their continued participation in the workforce post-retirement. The generation in South Korea born between 1945 and 1955, a period marked by leading industrialization and experiencing economic crises during their working age, exhibits unique socioeconomic characteristics distinct from later generations. Consequently, their retirement trajectories diverge from those of later cohorts, including the Baby Boomer generation (born between 1956 and 1965). In this paper, we investigate whether social, demographic, psychological, and health factors are associated with bridge employment and whether this association differs across birth cohorts. Data were drawn from seven waves of the Korean Longitudinal Study of Aging, conducted between 2008 and 2020. We employ an integrative framework that considers socioeconomic status, health status, and psychological factor s as the main variables to explain the odds of continuing to work after retirement. Retirement status includes three categories: employed, bridge, and total retirement. Results from a multinomial logit model reveal birth cohort differences in the relationship between social/psychological predictors and bridge employment. Additionally, higher educational attainment, a private pension, and poor mental health are associated with decisions regarding bridge employment for the industrialization generation, but not for Baby Boomers. Furthermore, females are more likely to participate in bridge employment than males for the industrialization generation, but not for Baby Boomers. Our findings contribute to the current literature on bridge employment by identifying the social determinants of bridge employment and highlighting the importance of cohort differences in bridge employment.
SOCIAL ISOLATION AND HOSPITALIZATION IN A NATIONAL SAMPLE OF COMMUNITY-DWELLING OLDER ADULTS BY DEMENTIA STATUS
Authors: Pomeroy Mary Louise , Ornstein Katherine , Gimm Gilbert , Cudjoe Thomas
Published: December 2023

Social isolation poses risks for poor health, yet its impact on hospitalization for persons with dementia is unknown. Dementia may result in reduced social contact that increases the risk of hospitalization. This observational cohort study examined longitudinal associations between social isolation and hospitalization among a nationally-representative sample of community-dwelling older adults with and without dementia. Using the National Health and Aging Trends Study, we conducted multivariable analyses for 5,533 Medicare beneficiaries. Social isolation was measured using a multi-domain 4-item typology. Logistic regression tested associations between social isolation in 2015 and self-reported hospitalization over the next twelve months, stratifying by dementia status. Covariates included sociodemographics and health characteristics. About 21.5% of older adults were socially isolated, with a much higher proportion of social isolation among those with dementia (38.0%) versus without (20.7%) (p < .001). Overall, the odds of hospitalization were not significantly associated with social isolation (OR 1.13; p = .184). While there was no association between social isolation and hospitalization among those without dementia (OR 1.09; p = .394), social isolation was significantly associated with hospitalization among older adults with dementia (OR 2.07; p = .001). Among older adults with dementia, social isolation increased the predicted probability of hospitalization by about 14.1% over one year (p = 0.030). In this population-based study, social isolation was common among community-dwelling older adults with dementia and significantly associated with increased odds of hospitalization over twelve months. Efforts to reduce hospitalization should explore ways to bolster social relationships for older adults with dementia.
SOCIAL SANDWICHING AND PAID WORK IN LATER LIFE: CONSEQUENCES ON MENTAL HEALTH
Authors: Albertini Marco , Lewin-Epstein Noah , Silverstein Merril , Tur-Sinai Aviad
Published: December 2023

Conflicting demands over time allocation – between family care and paid work – can be harmful to individual’s wellbeing. Individuals who are socially sandwiched and in employment experience potential conflict between supporting older and younger family generations, and with respect to the demands from paid work. These competing time demands may have negative effects on individuals’ health. Adding to most existing research, this study focuses on the mature sandwich generation – i.e. European individuals aged between 50 to 65 years, who are demographically sandwiched between adult children and older parents. Using data from the Survey of Health, Ageing and Retirement in Europe and fixed effects models we assess the effect of becoming socially sandwiched (a transition and not a status) on respondents’ mental health in according to their status on the labor market. Euro-D and CAS12 are utilized as proxies of individuals psychological wellbeing. It is shown that the effect of becoming socially sandwiched varies by in paid status and gender. The results demonstrate that a transition into social sandwiching has a negative effect on the mental health of working women, while the effect on women who are not in paid work is not statistically significant. The mental health of becoming sandwiched for men who are not in paid work for reasons other than being retired is also negatively affected by becoming socially sandwiched. Whereas, for men who are neither in paid work nor retired, the effect of transitioning into social sandwiching on their mental health is not statistically significant.
SOURCES OF VACCINE INFORMATION: MISGIVINGS AND TRUST ISSUES AMONG OLDER ADULTS IN NORTH DAKOTA
Authors: Huseth-Zosel Andrea , Fuller Heather
Published: December 2023

Older adults consistently have relatively high vaccination rates. What is not fully understood is how trust in immunization information sources impacts vaccine decision-making among older adults. This study examines older adults’ perceptions and decision-making processes for vaccines such as influenza, pneumonia, shingles, and COVID-19. Older adults (65+) in North Dakota (N=51) who participated in a larger survey study on vaccine behaviors voluntarily agreed to participate in a follow-up phone interview (November 2022-January 2023). Qualitative, semi-structured phone interviews focused on access, knowledge, and decision about vaccines. Interview transcripts were inductively coded for emergent themes related to trust. Three themes were identified: implicit trust in information sources, uncertainty who to trust for vaccine information, and regaining trust in information sources. Implicit trust focused on familiarity with sources of information (such as inherently trusting family members), source expertise (such as doctor recommendations), and reliability of sources (including if the source always provides accurate information). The second theme, uncertainty who to trust, stressed confusion over source inconsistency, such as changing positions on vaccines, or having opposing sources that both seem to be trustworthy. The final theme, regaining trust in information sources, highlighted if and how trust in a source of vaccine information could be recovered, including transparency, sincerity, and verifying immunization information through obtaining a second opinion. These findings contribute to the understanding of vaccine decision-making among older adults and provide focus areas for interventions to address lack of trust in information sources and improve immunization rates for this population.
SPIRITUAL NEEDS OF ELDERLY IN CHINESE FAITH-BASED NURSING HOME: ADMINISTRATOR VIEWS
Authors: Jiang Lin , Hodge David , Bonifas Robin , Sun Fei
Published: December 2023

Objectives

Recognizing and addressing the spiritual needs of elderly individuals constitutes a crucial facet of comprehensive caregiving. Despite China’s immense aging population, research on the spiritual needs of Chinese seniors remains limited. This study aimed to: 1) delineate prevalent spiritual needs among Chinese nursing home residents, including those with dementia; 2) elucidate the method employed by staff to identify these needs in non-verbal residents; and 3) expound on the strategies utilized by staff to fulfill these identified needs.

Methods

In this qualitative exploration, semi-structured interviews were conducted with 21 administrators from faith-based nursing homes, chosen for their potential concentration of residents with dementia. Encompassing establishments across 14 Chinese provinces, interviews were conducted in the participants’ native language, subsequently translated into English. Utilizing a constant comparative approach, the collected data underwent analysis to uncover recurring themes.

Results

The analysis yielded five interconnected themes concerning the spiritual needs of older adults: expression of faith, reception of love and care, familial interaction, social engagement, and participation in activities. For individuals with dementia unable to articulate their needs, staff employed careful observation and communication with family members as means of identification. In response to identified needs, staff harnessed local resources and personalized services whenever feasible.

Discussion

The findings offer practical insights for holistic caregivers catering to the spiritual needs of Chinese elderly. This study fills an existing gap, aiding in the provision of culturally sensitive care that addresses the spiritual aspects of aging Chinese individuals.
STUDENTS GAIN APPRECIATION FOR PATIENT-CENTERED AND TEAM-BASED CARE PARTICIPATING IN A GERIATRIC CASE COMPETITION
Authors: Talley Kristine , Berg-Weger Marla , Zubatsky Max , Osterbur Elaina , Williams Rhiannon , Schicker Teresa , Wyman Jean
Published: December 2023

Health science students must attain interprofessional teamwork and collaboration competencies to provide effective, patient-centered care to older adults requiring complex care. However, students typically learn in disciplinary silos and lack engaging opportunities for interprofessional teamwork. To provide students with an interprofessional learning activity the Geriatric Workforce Enhancement Programs (GWEP) at Saint Louis University and the University of Minnesota implemented a Geriatric Case Competition. We present the students’ experience with the 2022 competition. Students assigned to interprofessional teams with a coach had one month to prepare a 20-25 minute presentation of a comprehensive care plan using a simulated complex geriatric patient case. Judges scored team presentations using a rubric of core competencies for interprofessional collaborative practice. Each GWEP held local competitions with winning teams presenting at the inter-GWEP competition held via live videoconferencing. Top scoring teams received prizes. Students completed an eight-item satisfaction survey using a 5 point likert scale (5=poor to 1=excellent). Answers to open ended questions were analyzed qualitatively to find themes about their experience. 132 students joined the competition and 54 completed an evaluation survey (response rate 41%). Students rated their experience as good to excellent with mean ratings on 8 questions ranging from 1.5-2.2 (N=54). Themes included: the importance of patient centered care and the power of multiple perspectives/expertise. Students offered improvements related to student, coach, and judge expectations. In summary, the competition provided a very positive learning activity that helped students value the importance of patient centered care and interprofessional collaboration for older people.
SUBJECTIVE COGNITIVE DECLINE MODERATES THE ASSOCIATION BETWEEN AGE AND MEMORY DECLINE IN MIDLIFE
Authors: Park Kyoung Shin , Etnier Jennifer , DuBois Samantha , Kibildis Samuel , Som-Pimpong Hadassah , Vance Jarod , Wahlheim Christopher
Published: December 2023

Subjective cognitive decline (SCD) represents self-perceived worsening of memory and thinking abilities, in the absence of objective cognitive impairment, and serves as a prognostic marker of Alzheimer’s disease (AD). However, no study to date has investigated whether SCD moderates the relationship between aging and memory before older ages. We tested the hypothesis that SCD interacts with age to predict memory performance in midlife. A subset of 123 cognitively unimpaired, middle-aged adults (Mage=56.6±6.44 years; 87% females) from an ongoing clinical trial (NIH R01AG058919) were included for analyses. Multiple linear regression models tested the effects of age and SCD in predicting performance of mnemonic discrimination, auditory-verbal memory, visuospatial memory, paired associative memory, and verbal logical memory, while controlling relevant covariates (e.g., education, sex, and APOE ε4). Based on the optimal cutoff of the Everyday Cognition Scale, 28.2% of the sample were considered to have SCD and 71.8% perceived themselves to have normal cognition. After covariate adjustments, there were significant main and interaction effects of SCD and age on mnemonic discrimination performance on the Mnemonic Similarity Task (MST) but not on other memory outcomes. The negative relationship between age and mnemonic discrimination was evident in middle-aged adults who self-report cognitive concerns but not in those without such concerns. Since mnemonic discrimination is highly sensitive to hippocampal function, these findings support the utility of the MST to detect age-related hippocampal changes and ensuing memory declines in midlife as well as the importance of early interventions among middle-aged adults with SCD to prevent AD.
SUBJECTIVE SOCIAL STATUS AND DEPRESSION AMONG KOREAN OLDER ADULTS: FORMAL SOCIAL ACTIVITIES AS MEDIATOR
Authors: Park Junmin , Lee Yeonjung
Published: December 2023

Previous studies have examined an association between depression and socioeconomic factors such as education, economic status, and social support among older adults. It is widely acknowledged that socioeconomic status (SES) plays a pivotal role in the manifestation of depression. However, subjective social status (SSS) representing the subjective perception of the accumulation of life experiences and the associated overall deprivation may hold even greater importance in older adults. Especially, statistics in Korea shows that most people are likely to consider themselves in middle class regardless of their objective financial status. Therefore, the objective of this study is to examine whether subjective social status is associated with depression in later life as well as how participation in formal social activities (i.e., religion/social gathering, leisure/cultural/sport activity, reunion/hometown alumni, volunteering, party/civil society organization/advocacy group) mediate this association. Multiple regression analyses and Baron & Kenny (1986) analytical approach were applied using a panel data from the 2020 Korean Longitudinal Study of Ageing. Selected sample include those who are aged 65 and older (n= 4,405). Results show that there is a negative association between SSS and depression. SSS was positively associated with formal social activities. Additionally, formal social activities have significant impact on mitigating depression. Participation in formal social activities partially mediates the relationship between the SSS and depression. Findings have implications for promoting an opportunity for older adults to participate in some formal types of social participation. Furthermore, additional research investigating the factors that can augment SSS should be warranted.
SUPPORTING CHINESE FAMILY CAREGIVERS OF RELATIVES WITH DEMENTIA——A PILOT INTERVENTION STUDY IN SHANGHAI
Authors: Liu Ethan , Zhang Xinyu , Huang Jiahui , Ayrat Ansar , An Qiuling , Sun Fei , Zhang Xuehan
Published: December 2023

Background

Effective interventions are urgently needed to assist dementia family caregivers in China, where limited formal support and services are available. This pilot study aims to test a psychoeducational program that consists of information, skills training, and the use of binaural sound through the Processing Inner Strength toward Actualization Therapy (PISTA) device to alleviate caregiver burden and improve mental health outcomes.

Methods

Single subject design approach was used. Eight dementia family caregivers in Shanghai, China, were recruited and received a two-stage intervention over 12 weeks: Stage 1 (S1, Six 90-minute weekly sessions: Psychosocial education programs +PISTA) and Stage 2 (S2, Six 90-minute weekly sessions: Psychosocial education only). Caregiver outcomes, including caregiving burden, anxiety, depression, and positive aspects of caregiving (PAC), were assessed through established scales. Paired t-tests and visual analyses were used to compare outcome levels and trends between stages.

Results

Seven participants completed the entire study, and 1 participant dropped out during S2. Participants showed a decrease in caregiver burden, anxiety, and depression and an increase in PAC during S1. A similar trend was observed during S2 on burden, anxiety, and PAC outcomes, except for depression. Furthermore, the decrease in burden and anxiety scores and the increase in PAC scores were less salient during S2 than during S1, suggesting more effects were observed in S1 with PISTA.

Conclusion

Evidence is promising that psychoeducational programs combined with PISTA can lead to better psychological outcomes for dementia family caregivers. Findings need to be affirmed in future investigations using an experimental design.
SURVEYING ADULTS’ DESIRE TO KNOW AND PAY FOR A TEST OF DEMENTIA RISK
Authors: Reed Alexandra , Hooyman Andrew , Fauth Elizabeth , Love Jill , Schaefer Sydney
Published: December 2023

Advances in biomarkers of Alzheimer’s disease (AD) and other dementias are promising, but it is also important to characterize the general public’s desire for such biomarkers. It is also important to disentangle the desire to know test results from the desire to disclose the test results with a medical provider/insurance provider. This is particularly important for populations who are at higher risk of developing dementia but who either do not regularly engage with the medical system or who are skeptical of it. The purpose of this study was to survey adults’ desire to know about their short-term risk of developing dementia, and the factors that impact their desire to know. A survey of 326 participants (mean+SD age: 41.9 + 11.9 yrs; 76% White non-Hispanic; 48% F) was completed via Amazon MTurk. Results indicated that 75% of participants would take such a test, but only 12% of them would want their medical/insurance provider to know. Non-White participants (n=73) also reported less desire to share knowledge with a medical/insurance provider, but still wanted to know their risk as much as White participants. Furthermore, the out-of-pocket price that participants were willing to pay for such a test was $100. These data suggest that a diverse set of biomarkers needs to be developed that would enable affordable screening within and outside of a medical context.
SUSTAINABILITY OF CARE COORDINATION FOR PEOPLE WITH DEMENTIA WHO LIVE ALONE: LESSONS FROM A FEDERAL GRANT PROGRAM
Authors: Kim Yoon Chung , Lepore Michael , Gordon Kate , Menne Heather
Published: December 2023

Approximately one-third of older adults with dementia or cognitive impairment in the US live alone. People living alone with dementia (PLAWD) are at high risk for undesirable outcomes including malnutrition and falls, and the absence of cohabitants—who typically coordinate care—can contribute to unnecessary hospitalization and institutionalization. Since 2014, the Administration for Community Living (ACL) within the US Department of Health and Human Services has required PLAWD-focused services in ACL’s Alzheimer’s Disease Program Initiative. As part of a larger study of PLAWD-focused service sustainability, we examined ACL project final reports (n=73) to describe care coordination services for PLAWD and their sustainability plans. We excluded projects without services for PLAWD (n=14) or care coordination services (n=29) and where the lead organization closed (n=2) or project director died (n=1). Of 27 project reports indicating PLAWD-focused services and care coordination services, most were community-based organizations (CBOs, 67%); others were health systems/medical centers (15%), universities (11%), and government agencies (7%). PLAWD-focused care coordination services commonly entailed identifying PLAWD, assessing their needs, developing care plans, connecting PLAWD to need-relevant services, and purchasing supportive equipment, and sometimes involved training volunteers. Most organizations (70%) planned to sustain PLAWD services. The primary sustainability barrier faced by CBOs was lack of funding, whereas for health systems and universities partnering with CBOs was key to sustainability. This review of ACL-supported care coordination services for PLAWD and their sustainability highlights the need for research on the effectiveness of care coordination services for PLAWD and of different approaches to service sustainability.
SYSTEMATIC REVIEW OF REHABILITATION IN SKILLED NURSING FACILITIES FOR PERSONS LIVING WITH DEMENTIA
Authors: Frechman Erica , Semelka Charles , Freeman Valerie
Published: December 2023

We conducted a systematic review of published literature though April 2023 to identify the experiences and outcomes of persons living with dementia (PLWD) undergoing post-acute care rehabilitation in skilled nursing facilities (SNF). A systematic search for studies published in English was carried out in eight databases including PubMed, Scopus, Google Scholar, Embase, PsycINFO, CINAHL, Cochrane Library, and Web of Science. Two reviewers independently screened articles and conducted a quality appraisal of selected studies. Forty-one articles met inclusion criteria. There was heterogeneity of study designs with most articles (n=33) being observational and cross-sectional, while randomized clinical trials (n=3) and qualitative studies (n=5) were less represented. Certain themes emerged from the results regarding patient outcomes and experiences. Measured outcomes demonstrated increased health service utilization, varied functional outcomes, and suboptimal patient care. Patient experiences included significant challenges with health care transitions, gaps in healthcare worker and caregiver knowledge & education, emphasis on alternate models of care, and importance of goal alignment. Overall, this systematic review provides a comprehensive understanding of the outcomes and experiences of post-acute care rehabilitation in SNFs for PLWD. The findings highlight the need for alternative care pathways, improved healthcare transitions, tailored rehabilitation approaches, enhanced dementia training for healthcare professionals, and person-centered goal setting. By addressing these critical aspects, future interventions can be developed to improve the delivery of post-acute care for PLWD and enhance their health outcomes.
TEAMWORK MAKES THE DREAMWORK: CHANGES IN INTERPROFESSIONAL READINESS
Authors: Rhodes Ann , Zimmerman Kristin , Marrs Sarah , Waters Leland
Published: December 2023

Creating Interprofessional Readiness for Complex & Aging Adults (CIRCAA) is an evidence-based program grounded in the 4Ms of age-friendly care. CIRCAA aims to improve care for older adults by enhancing Scholars’ ability to affect patients, learners, and team members by emphasizing interdisciplinary collaboration in person-centered care. Among other assessments, Scholars assess their interprofessional skills using the interprofessional education competency (IPEC) tool at the beginning and end of the year-long program. Evaluation data from all four CIRCAA cohorts (2020-2023; n = 22) demonstrated significant improvement in interprofessional readiness; t(34) = -4.72, p < .001. The sample across years was well-balanced; there were no significant differences in size of cohort {F(1) = 0.516, p = .47}, race {F(3) = 0.62, p = .6}, or discipline and clinical practice of Scholars {F(1) = 0.33, p = 0.56}. There was a significant difference in knowledge gained based on years of experience working with older adults {F(4,26) = 3.308, p = .025}; those who had worked with older adults for less than five years made the largest gains. Scholars working in primary care settings had larger knowledge gains than Scholars who did not work in primary care, with gains of 4.95 points and 7.87 points, respectively. This difference was not statistically significant; t(16.3) = 1.14, p = 0.2, 95% CI [-2.49-8.32]. Overall, assessment of outcomes across the four years shows substantial gains in interprofessionalism, which are particularly pronounced in new clinicians and those working in primary care settings.
TESTING OF A WEB-BASED DECISION AID TOOL FOR DEMENTIA CARE PLANNING AMONG CHINESE AMERICAN FAMILY CAREGIVERS
Authors: Li Chien-Ching , Lei Xiao Ying , Paun Olimpia
Published: December 2023

In the US, the Chinese American population is aging rapidly. It is anticipated that Chinese American family caregivers of loved ones living with dementia will face increasing needs for health care planning. The study aimed to examine the usability and acceptability of a linguistically and culturally appropriate and wen-based decision aid (DA) tool for home care and long-term care planning among Chinese American family caregivers. The DA tool provides caregivers with information on (1) dementia stages, behaviors, symptoms, and care tips, (2) home care and long-term care choices, and their benefits and risks, (3) what matters to you when making care decisions, (4) what else do you need to make your decision, and (5) a summary to facilitating decision making with family and providers. A total of 16 family caregivers were recruited in the study. About 88% of study participants were very satisfied with the DA tool. Key feedback reported by the majority of participants includes: (1) the length and amount of information presented in the tool was just right, (2) this tool can provide sufficient information to make appropriate care decisions for loved ones with dementia., (3) the tool is easy to use and most people would learn to use this tool very quickly, (4) various functions in this tool are well integrated, and (5) I will frequently use this tool to help me discuss dementia care plans and decisions with family and providers. Further intervention with the DA tool can be developed within the Chinese population.
THE 4MS AGE-FRIENDLY FRAMEWORK PROVES SUCCESSFUL TO ENHANCING A CERTIFIED NURSING ASSISTANT TRAINING PROGRAM
Authors: Bearden Valerie , McAtee Robin
Published: December 2023

The Arkansas Geriatric Education Collaborative, a HRSA-funded Geriatric Workforce Enhancement Program grantee, partnered with a local Certified Nursing Assistant training program to develop a curriculum utilizing the 4Ms Framework of Age-Friendly Care of older adults. The curriculum was designed to empower CNA students and other direct care staff with knowledge of how to deliver more effective, person-centered care. This was accomplished by synthesizing current content with each of the 4Ms: What Matters, Medication, Mentation, and Mobility. During the introduction to person-centered care, strategies infused included instruction about how to have meaningful conversations about What Matters to the older adult. For Mobility, instruction was provided regarding safety and the use of adaptive equipment. Mentation was addressed by teaching the students ways to prevent and identify conditions such as depression and delirium. To include the “M” of medication, the students were taught about using non-pharmacological strategies for conditions such as insomnia and pain. The way all elements are intertwined and can interfere with What Matters was emphasized and examples provided. Of the 34 CNA students trained, 100% of students achieved both objectives during a clinical experience. Improvement of care was identified by a student as recognizing how to calm a frightened resident by using validation therapy. Another student reported the strategy of providing a bed bath in lieu of a shower to a resident who was unsteady because of a pain medication. Program development was completed in April, 2023, at which time it was put into practice and evaluated.
THE DUAL IMPACT OF EDUCATION AND OCCUPATION ON COGNITIVE FUNCTIONING IN OLDER MEXICAN ADULTS
Authors: Castro Jose Cabrero , Gutierrez Mariela , Andrasfay Theresa , Vega Emma Aguila , Downer Brian
Published: December 2023

Our research investigates the relationships among educational attainment, occupational mental demands, and cognitive functioning in Mexican adults aged 50 and older. We expand on prior studies demonstrating education’s link to cognitive function by examining how the complexity of one’s primary occupation also influences cognitive health. We hypothesize that cognitively demanding work, irrespective of education level, correlates positively with enhanced cognitive performance. Furthermore, we propose an additive effect, wherein high occupational mental demands amplify cognitive functioning beyond education’s influence. Our study uses data from 12,939 participants in the 2012 Mexican Health and Aging Study (MHAS) linked to an occupational database (Occupational Information Network O*NET). Employing generalized linear models to predict a summary cognition score, the findings unveil compelling insights. Both mental processes (β=0.17) and cognitive abilities (β=0.16) required in participants’ main occupations demonstrate positive correlations with cognitive scores (p<.01). Education emerges as a predictor of cognitive performance and had a stronger relationship with cognitive functioning compared to occupational mental demands (β=0.79, p<.01), highlighting the long-lasting effects of education in cognition emphasizing its role in shaping cognitive abilities throughout life. Adjusting for demographic and health factors reaffirms these associations. Moreover, our research introduces an innovative approach by creating an additive score for education and occupational mental demands. Our results reveal that the combined impact of education and mental demands is associated with higher cognitive scores (β=0.97, p<.01). In conclusion, our study presents a novel perspective by demonstrating that a combination of education and occupational mental demands may yield amplified cognitive benefits.
THE EARLY LIFE CONTEXTS OF THE HEALTH AND RETIREMENT STUDY HCAP SAMPLE: NEW INSIGHTS INTO DEMENTIA RISK FACTORS
Authors: Smith Jacqui , Larkina Marina , Yu Wenshan
Published: December 2023

There’s increasing interest in identifying potentially modifiable early-life socioenvironmental factors associated with late-life cognitive decline and dementia. To date, much research points to the importance of the number of years spent in education and age. We sought to extend evidence for potential modifiable targets by examining life history data available to date for women and men in the 2016 HRS-HCAP sample (N = 2645; Mean Age = 76; 61% women). The life history data were drawn from three HRS public cross-wave files: the 2015-2017 Life History Mail Surveys, the 1992-2018 Childhood Family and Childhood Health file, and the 1992-2020 Geographical Mobility File. Among the early factors examined were the US Census region of birth and school location at age 10; childhood physical and mental health conditions; childhood family SES; early learning and sensory/motor problems, early life activity engagement (cognitive, physical, social), college majors, and post-education work. The HRS-HCAP algorithm classifications (Dementia, MCI, vs Normal Cognition) served as outcomes. In addition to quantity of education and age/cohort, significant effects (all ps < .001) were revealed for childhood geographical locations, childhood mental health, and early-life access to and engagement in enriching activities. Over time, whereas the impact of changes such as increased access to post-secondary education and enriching high school activities are observed, other modifiable factors emerge. Tracking the impacts on cognitive aging of historical changes and disparities in the life course contexts of people in the HRS-HCAP subsample opens a new window into relevant social-environmental factors to target for intervention
THE EFFECT OF THE JIGSAWDIO PROGRAM ON COGNITION AMONG OLDER ADULTS WITH DEMENTIA
Authors: Kim Yongseop , Young Amy , Lee Jungjoo , Welsh-Bohmer Kathleen , Ory Marcia , Kim Junhyoung
Published: December 2023

Puzzle activities in dementia patients have been associated with improvements in mood and cognition across a number of studies. Our research team designed and developed Jigsawdio, a digital technology that provides an innovative and interactive multisensory solution which supports memory recall in patients with dementia through the completion of personalized, audio-visual jigsaw puzzles. This device builds on the benefits derived from traditional puzzles by integrating salient audiovisual stimuli aimed at evoking nostalgia and encouraging reminiscence. The purpose of this study was to assess pre- and post-intervention effects of Jigsawdio use after six weeks among older adults with mild to moderate cognitive impairment. Using a single arm, twice weekly intervention, nine persons participated in the Jigsawdio program study. The Montreal Cognitive Assessment (MoCA) was used to measure changes in cognitive function and recall on the first and last days of the intervention. A paired t-test was used to investigate the group mean differences in cognition before and after participation in the intervention program. We found a significant group mean difference between the post-assessment and the baseline assessment MoCA scores of participants. This study presents suggestive evidence of cognitive benefits and feasibility of the technology in older adults with dementia.