bluuebunny/crossref_metadata_2025 huggingface dataset:
CONCURRENT CHANGES IN COGNITIVE FUNCTION AND FUNCTIONAL LIMITATIONS: A BIVARIATE LATENT TRAJECTORY ANALYSIS
Authors: Handing Elizabeth , Aichele Stephen
Published: December 2022

With a rapidly aging global population, declines in cognition and functional abilities are an increasingly salient challenge and fear among many older adults. Researchers and clinicians often study changes in cognition and changes in functional limitations as separate trajectories although they frequently co-occur. In this study, we used two-stage structural equation modeling (SEM) to estimate longitudinal trajectories of cognitive and functional limitations using data from the Health and Retirement Study (2010-2016) (N = 12,431, aged 50–91). First, individuals’ longitudinal factor scores (at three measurement occasions, spanning 6 years) were estimated for cognition (indicated by verbal fluency, numeracy, and recall memory) and functional limitations (indicated by difficulties performing daily living activities, instrumental activities, and mobility). A bivariate latent trajectory model was then fit to these scores. Model fit was acceptable (CFI = .91; RMSEA = .036). Parameter estimates showed that, on average, cognition declined slightly (-.08SD/decade) and functional limitations increased gradually (0.38SD/decade). Importantly, individual cognitive declines were significantly correlated with increases in functional limitation (r = -.19, p < .001). This study fills an important research gap by using advanced statistical modeling (bivariate latent growth models) to examine the joint trajectory of cognition and functional decline which underscores the need to consider the interplay of these two abilities. Methods that quantify both individual and group trajectories can aid in better identification of aging patterns and lead to new ways of thinking about interventions to reduce the burden of concurrent decline.
EXAMINING AGE, RACE, AND COMMUNITY ON PREVENTIVE HEALTH AND COVID-19 VACCINATION AMONG ADULTS 65+
Authors: Patskanick Taylor , Ashebir Sophia , Balmuth Alexa , Lee Sophia , Le Joie , D'Ambrosio Lisa , Coughlin Joseph
Published: December 2022

During the ongoing spread of COVID-19 and its variants, older adults remain an age group particularly at-risk for poorer health outcomes, not only related to infection with COVID-19, but also due to disruptions in access to preventive health services, including routine vaccination. In the U.S., older adults have generally had high uptake of the COVID-19 vaccines, but differences persist regionally and between older adults from minority racial backgrounds. The purpose of the following study was to better understand how groups of Black and white-identifying adults ages 65+ described the impact of the COVID-19 pandemic on their preventive health behavior and healthcare use, including what contributed to their decision to receive or not receive a primary COVID-19 vaccination series. Seventy-five participants were purposively sampled and stratified into virtual focus groups based on their age, racial identity, vaccination status, and relationship to a local community. Findings leverage data from a pre-group questionnaire and focus groups conducted in November 2021. Analyses revealed differences among sub-groups about how the pandemic has impacted their relationship to their local community. Participants described the extent of the pandemic’s disruption to their healthcare access, including modifications to in-person care, use of telehealth, and engagement in new health behaviors. Decision-making related to the COVID-19 vaccine differed among the vaccinated and unvaccinated and white and Black-identifying groups, including factors related to interpersonal and systemic trust, independent research, and bodily autonomy. Implications of this research for public health and practitioners working with older adults will be discussed.
DAY-TO-DAY VARIABILITY BETWEEN AFFECT AND LEISURE ACTIVITY ENGAGEMENT IN BLACK ADULTS
Authors: Sardina Angie , Gamaldo Alyssa , Allaire Jason , Whitfield Keith
Published: December 2022

This study examined daily variability in affect and leisure engagement, within community-dwelling Black adults (age range=50-80 years). Associations between affect and leisure engagement, and moderating sociodemographic factors, were explored. Fifty adults (78% women; M education=11.62) reported affect and leisure engagement across 8-occasions over 2-3 weeks. Participants averaged 3-leisure activities/day with more engagement in watching TV, walking, reading, and visiting others. Significant within-person variation across daily affect and domains of leisure engagement were observed. Greater negative affect was significantly associated with lower social and total leisure engagement, particularly for adults with lower levels of education (p’s<.05). Results demonstrate within-person changes in the type of leisure engagement among Black adults, with potential factors related to interconnections between affect and sociodemographics (e.g., education). This study reveals promising directions for future research to implement models estimating both between- and within-person effects of daily leisure engagement, within minority populations and across racial groups.
RELATIONSHIPS BETWEEN LEISURE CONSTRAINTS AND MODES OF TRANSPORTATION AMONG OLDER ADULTS IN SUBSIDIZED HOUSING
Authors: Tian Junyan , Tan Shyuan Ching , Sardina Angie , Gamaldo Alyssa , Ross Lesley
Published: December 2022

Transportation needs among lower-income older adults is understudied, particularly regarding how transportation utilization is related to leisure constraints. This preliminary study included 39 adults residing in subsidized housing in North Carolina and Pennsylvania (M=68.03, SD=10.26, female=74.4%) and assessed reported modes of transportation for daily activities and perceived leisure activity constraints. Much of the sample reported driving (57.9%) or relying on others to drive (70.3%) with a significant sample reporting use of public transportation (48.6%). Transportation utilization was differentially correlated with leisure constraints. Perceived difficulties getting to/from activities in the community was associated with greater utilization of having ‘others drive you’ (r=0.43, p=.011), but lower utilization of ‘driving oneself’ (r=-0.40, p=.019). Walking as a mode of transportation was associated with lower (r=-0.41, p=.014) perceived difficulties getting to/from activities in the housing complex. These results indicate the importance of further exploring the association between transportation and leisure needs of these lower-income older adults.
USING HYBRID EFFECTIVENESS DESIGNS TO FACILITATE IMPLEMENTATION: THREE CASE STUDIES IN DEMENTIA CARE RESEARCH
Authors: Gaugler Joseph , Baier Rosa , Fortinsky Richard , Gustavson Allison , Hodgson Nancy , McPhillips Miranda , Sefcik Justine , Gitlin Laura
Published: December 2022

This individual symposium presentation will provide case examples of three “hybrid effectiveness” trials in dementia care in different care settings including community-based and residential long-term care settings, each of which incorporate implementation methods alongside traditional evaluations of effectiveness. We offer considerations related to conceptualization, study design, sampling, data collection, and analysis that may guide gerontologists who aspire to adopt hybrid effectiveness designs in their own work. We conclude with methodological recommendations to incorporate an implementation science lens throughout the lifecycle of gerontological (and/or dementia care) intervention development. By applying key principles from implementation science throughout the intervention development process, a truncated and more efficient implementation pipeline may be achievable in gerontological research. Moreover, incorporation of implementation science methods into standard intervention development and testing methodologies will result in older persons, their families, healthcare providers, and communities having the best evidence available at their disposal.
INTO THE VOID: A CAREER IN INCONTINENCE… AND BEYOND
Authors: Resnick Neil
Published: December 2022

Long-believed inevitable with age, urinary incontinence (UI) --like dementia – has proved neither ineluctable nor untreatable. Moreover, older adults remain continent despite abnormal lower urinary tract (LUT) function! The key is that the LUT is just one risk factor, and incontinence results from contributors at every level: from drugs and diseases beyond the LUT, to problems of brain and physical function, to multiple issues within the LUT itself. Such insights have provided the rationale for a nontraditional diagnostic and therapeutic strategy, one that has not only improved outcomes but also enabled creation of previously-believed heretical approaches that address the LUT last and only if necessary. In addition, this approach enabled development of Medicare’s Minimum Data Set for frail elderly and, more importantly, may facilitate development of scalable ways to raise the floor of care for other geriatric syndromes as well.
ARTS AND CREATIVITY AND THEIR IMPACT ON HEALTH AND WELL-BEING: A SYSTEMATIC REVIEW OF THE EVIDENCE
Authors: O'Sullivan Roger , McQuade Laura
Published: December 2022

Aim

The aim of this mixed method systematic review was to develop a better understanding of the evidence on the impact of arts and creativity on the physical health and well-being of people aged 50+. Method: 73 studies were eligible for inclusion within the review and were appraised using the Mixed Methods Appraisal Tool.

Results

Dance was associated with improved balance, lower body physical strength and flexibility, aerobic fitness. Promising evidence showed that music and singing were associated with improved cognitive function, quality of life, affective states, and a sense of well-being. Preliminary evidence showed that visual and creative arts were associated with reduced feelings of loneliness, improved sense of community and social connectedness. Initial evidence showed that theatre and drama were associated with emotional well-being.

Conclusion

These findings highlight the value of participation in the arts and have implications for both public health and the arts and creativity agenda.
BEST PRACTICES IN COMMUNICATING ABOUT PALLIATIVE CARE TO PATIENTS AND PHYSICIANS
Authors: Kogan Alexis Coulourides , Rahman Anna , Lomeli Sindy , Enguidanos Susan
Published: December 2022

Home-based palliative care (HBPC) programs are proliferating across the U.S, yet face significant, documented challenges in promoting uptake of services and sustaining sufficient patient referrals. There is a tremendous need to understand effective methods for engaging physicians, patients, and caregivers in palliative care. Thus, the purpose of this study was to elicit best practices in how to communicate about HBPC to both healthcare providers and patients/caregivers. Focus groups with nine California-based HBPC organizations were conducted between January and April 2020. Discussions lasted approximately 54 minutes, were guided by a semi-structured protocol, audio recorded, and transcribed verbatim. Thematic analysis was used to identify themes and codes from the data. Twenty-five interdisciplinary HBPC staff members participated in a focus group. Most identified as white (76%), female (76%), and working in their current position for five years or less (56%). Three themes were identified from the data: (1) value of relationships; (2) communication do’s and don’ts; and (3) need for education. Participants discussed actionable recommendations for each theme. Study findings highlight several best practices for HBPC programs to communicate- and foster relationships with healthcare professionals and patients/families about palliative care, with education at the crux. Lessons learned about key words and phrases to say and to avoid are particularly valuable for budding HBPC programs. Our results suggest that HBPC providers exert enormous efforts to increase patient referrals and enrollment through strategic, continuous outreach and education to physicians, patients, and their caregivers; however, palliative care educational interventions are needed.
IMPACT OF SUBSIDY ON THE USE OF PERSONALIZED MEDICINE IN BREAST CANCER
Authors: Chen Cynthia , Lim Jue Tao , Lim Swee Ho , Tan Ern Yu , Tan Veronique Kiak Mien , Tan Su Ming , Tan Tira , Hartman Mikael
Published: December 2022

Advances in adjuvant therapy have led to increased survival rates after cancer prognosis. Herceptin, a targeted therapy, had first been introduced to Singapore in 2006. We aimed to assess whether subsidies for Herceptin from 2012 will lead to changes in uptake among Human Epidermal Growth Factor Receptor 2 (HER2) positive patients by socio-economic groups. Two-level random-intercept logistic regression was used to model diagnostic test and Herceptin uptake using the Singapore Breast Cancer Cohort from 2006 to 2018, adjusting for covariates such as education, housing type and marital status before and after subsidies. Interrupted time series (ITS) analysis was used to evaluate the impact of Herceptin subsidy on treatment uptake. The concentration index was also computed to measure inequality in uptake by ethnicity and education. We found that the odds of diagnostic testing were not associated with socioeconomic factors. However, before subsidies, the highest education attained (OR = 4.57, 95% CI= (1.90, 11.02), P< 0.01) significantly increased the odds of Herceptin uptake. These odds were levelled after the introduction of subsidies to Herceptin treatment in 2012. After subsidy, we also found that Herceptin uptake increased significantly by 11.4% (95% CI= (3.47%, 19.4%), P=0.016). Also, inequality of Herceptin use decreased especially amongst the Indians, where at least 40% were used in the higher educated group prior to the subsidy. Subsidies have lowered the barriers to Herceptin uptake for marginalized individuals. Having targeted subsidies for socio-economically disadvantaged groups may work more efficiently in providing ease of access than a blanket subsidy in Herceptin.
POTENTIAL AND PITFALLS IN THE USE OF EXTENDED REALITY TO SUPPORT OLDER ADULTS
Authors: Boot Walter , Dilanchian Andrew
Published: December 2022

Extended Reality (XR), including Virtual Reality (VR) and Augmented Reality (AR), holds tremendous potential with respect to being able to support older adults' performance of Instrumental Activities of Daily Living (IADLs), activities crucial for independence, and Enhanced Activities of Daily Living (EADLs), activities that promote enjoyment, wellbeing, and quality of life. This presentation will draw from multiple empirical studies conducted within the CREATE Center, and other studies from the literature, on potential barriers older adults may face to obtaining these benefits. In particular, this presentation will focus on the construct of presence, the sense of "being there" in a virtual environment, which has been described as the defining characteristic of successful VR experiences, usability challenges, and challenges related to cybersickness.
PRESIDENTIAL SYMPOSIUM: EMBRACING OUR DIVERSITY IN GERONTOLOGY EDUCATION: PERSPECTIVES ON STRATEGIES AND LEARNERS
Authors: Montepare Joann , Bradley Dana , Baker Tamara
Published: December 2022

Our populations are not only becoming older, but also becoming more diverse on several fronts. Our new social structures call for new strategies for embracing our diversity in how we design and deliver education about aging in and beyond the classroom. In this AGHE Presidential Symposium, educators will discuss innovative and needed ways we can integrate diversity in gerontological pedagogical practices. To begin, Rona Karasik (St. Cloud State University) will discuss the call for integrating anti-racist strategies in classroom practices, and offer examples of several such strategies. Next, Brian Carpenter (Washington University in St. Louis) will discuss shrinking geropsychology pipelines, especially for students from racial and ethnic groups, and will share recommendations for expanding these pipelines. Aaron Guest (Arizona State University) will then discuss the need to extend diversity and education efforts to include LGBTQ individuals and issues. Karen Lincoln (University of Southern California) will discuss the need to move educational efforts beyond our classrooms to diverse learners in our communities. To this end, she will describe a dynamic academic−community partnership that provides aging-focused education to African-American older adults. Dana Burr-Bradley (University of Maryland, Baltimore County) will give the final presentation with a discussion about the need for an international lens that appreciates the global diversity of the aging experience. Tamara Baker (University of North Carolina, Chapel Hill) will serve as the discussant and offer her perspective on how the need to embrace our diversity in gerontology education cuts across all GSA units and connects them with AGHE’s educational mission.
DIVERSIFYING THE PATHWAY: A MULTIFACETED APPROACH WITHIN GEROPSYCHOLOGY
Authors: Carpenter Brian , Ma Flora , Hiroto Kimberly
Published: December 2022

Like other health services disciplines, geropsychology is facing a paucity of diverse intersectional identities within a larger shortage of interest in aging across all levels of training. We need an incisive and comprehensive plan to enhance the representation of historically marginalized groups within geropsychology and address systemic factors limiting entrance into the field. In this presentation, we review the projected need for mental health services attuned to equity, diversity, and inclusion and current trends in the geropsychology pathway. Then we describe several initiatives to expand attention to cultural humility and antiracism. These include the development of foundational competencies that include attention to diverse representations, which can be disseminated to pre- and post-licensure generalists and specialists; diversity-infused offerings within recent conferences and webinars; and efforts to intensify the focus on diversity within psychology’s aging-related professional organizations. Finally, we conclude with additional suggestions to expand and sustain attention to diversity.
THE PSYCHOSOCIAL IMPACT OF COVID-19 ON COGNITIVE AGING ARAB AMERICAN IMMIGRANTS IN MICHIGAN
Authors: Sayed Linda
Published: December 2022

This study examines the psychosocial impact of COVID-19 on cognitive aging Middle Eastern/Arab Americans immigrants and refugees in Michigan. Sociopolitical experiences as an immigrant and/or refugee may have unique effects on late-life cognitive health. Given that social engagement reduces the risk of ADRD, this study sought to examine the consequences of COVID-19 socialization restrictions on familial and communal support systems for aging Middle Eastern/Arab immigrants and refugees. Three focus groups discussions with 8-10 participants each (N=31) conducted at local Arab organizations and religious institutions were conducted followed by inductive analysis. Preliminary results indicate two prominent themes: 1) Social and Familial Hardships; and 2) Isolation. Narratives illustrate the prevalence of psychosocial ADRD risk from COVID-19. Findings are discussed within a stress framework to advance universal and unique elements of Arab immigrant and refugee cognitive aging.
COHORT EFFECTS IN OLD-AGE COGNITIVE AGING: A STUDY OF SOCIAL CONTEXT IN CHILDHOOD IN 140,030 OLDER ADULTS
Authors: Scott Stacey , Shawver Zared , Clouston Sean , Zhang Yun , Voll Stacey , O'Keefe Patrick , Rodgers Joeseph , Hofer Scott M
Published: December 2022

Researchers have reported that later-born cohorts often have higher scores on cognitive tests, potentially indicating that some of the differences normally attributed to cognitive aging may reflect developmental differences. The present study examined the hypotheses that social factors at birth and in early adolescence might partially explain birth cohort effects. This secondary analysis of data collected prospectively as part of four internationally comparable and nationally representative studies of individuals aged 50 and older residing in 17 European countries and the United States (N=140,030). Cognition was prospectively measured longitudinally 360,150 observations spanning, on average, 4.27 (SD=5.12) years allowing us to leverage age/cohort variability. Multilevel longitudinal modeling was used incorporated random intercepts and slopes at the country and individual levels to model lifetime cognition while adjusting for contextual factors. Birth cohort was associated with height (B=0.095, SE=0.002, P< 1E-06), episodic memory (B=0.105, SE=0.001, P< 1E-06), and verbal fluency (B=0.217, SE=0.002, P< 1E-06). Approximately 7.72% (95% C.I.=[7.60-7.86]) of participants were exposed to at least two years of famine in childhood, and were born into countries with moderate levels of income inequality. Multivariable adjustment accounted for 15.10-24.96% of birth cohort effects in episodic memory and verbal fluency respectively. Longitudinal modeling revealed that after adjusting for famine, war, income inequality, educational attainment, and height, these factors explained 81.58-63.65% of the birth cohort effect in episodic memory and verbal fluency respectively. Global research has reported that early life factors can have an impact on development, so this study extends this to suggest these factors have a lifelong impact.
IN THE EYES OF THE BEHOLDER: RACE, PLACE, AND HEALTH
Authors: Velasquez Alfredo , Douglas Jason , Guo Fangqi , Robinette Jennifer
Published: December 2022

Racial and ethnic health disparities are fundamentally connected to neighborhood quality. For example, racial and ethnic minorities are more likely to live in neighborhoods with signs of physical disorder (e.g., graffiti, vandalism), and physically disordered environments have been noted to associate with increased risk for chronic illness. Given that older adults may spend more time in their neighborhoods than younger adults as they transition out of the workforce, examining associations between neighborhood physical disorder and health among older minorities is of critical importance. Using 2016-2018 Health and Retirement Study (HRS) data, a representative sample of US adults aged 51 years and older (n= 9,080, mean age 68 years), we conducted a series of weighted linear regressions to examine links between neighborhood disorder as rated by third parties and both participant-perceived neighborhood safety and self-rated health. Study results indicated that higher neighborhood physical disorder was significantly related to more neighborhood safety concerns among non-Hispanic White and Hispanic residents, but not among non-Hispanic Blacks. On the other hand, neighborhood physical disorder was significantly associated with poorer health among all racial/ethnic groups. These patterns persisted after adjusting for education, sex, age, and census tract concentrated disadvantaged, population density, and racial/ethnic diversity. Our results indicate that community level interventions targeting neighborhood physical disorder may improve community health and minimize racial/ethnic health disparities.
CORRELATES OF ELEVATED C-REACTIVE PROTEIN AMONG BLACK OLDER ADULTS: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: Farmer Heather , Tobin Courtney Sinclair , Thorpe, Jr. Roland J
Published: December 2022

Substantial evidence documents gender and racial disparities in C-reactive protein (CRP), a measure of systemic inflammation, among older adults. Yet, the comparative approaches of these studies may obscure distinct risk and protective factors associated with elevated CRP among older Black Americans. To pinpoint opportunities for intervention, this study utilizes a “within-group approach” to identify the sociodemographic, psychosocial, behavioral, and health-related determinants of elevated CRP among older Black women and men. The sample consisted of 2,420 Black respondents aged 51+ in the Health and Retirement Study (2006-2016). Gender-stratified, random effects logistic regression models were used to examine determinants of elevated CRP (>3.0 mg/L). More than 50% of Black women had elevated CRP, and we found that younger age, Medicaid, lower mastery, religiosity, overweight/obesity, physical inactivity, and ADLs contributed to elevated CRP among this group. In contrast, elevated CRP was reported among only 37.25% of Black men, for whom financial distress was associated with lower odds of elevated CRP; religiosity, less neighborhood cohesion, current smoking, overweight/obesity, ADLs, and more chronic conditions were associated with greater odds of elevated CRP among this group. Sociodemographic factors had a limited association with elevated CRP among older Black Americans. Rather, a range of psychosocial, behavioral, and health-related factors were more influential determinants of elevated CRP among older Black Americans. Most notably, findings demonstrate distinct determinants of CRP among Black women and men, underscoring the critical need to further evaluate the risk and protective mechanisms undergirding disparities among this aging population.
METHODOLOGICAL AND ETHICAL REFLECTIONS FROM RESEARCH ON NEIGHBOURHOOD-BUILT ENVIRONMENT AND DEMENTIA
Authors: Seetharaman Kishore , Chaudhury Habib , Hung Lillian , Freeman Shannon , Groulx Mark , Randa Cari
Published: December 2022

The neighbourhood is widely regarded as a setting that affords emotional and practical support and opportunities to maintain community-based activities and social participation for people living with dementia (PLWD). Creating a supportive neighbourhood built environment that facilitates outdoor mobility, wayfinding, and access to community destinations is key to making our communities dementia-inclusive. Research on the built environment and dementia-inclusive planning is relatively sparse in the broader research domain of neighbourhoods and dementia. Further, how PLWD perceive, interpret, and interact with the neighbourhood built environment is not adequately understood. Although it is acknowledged that PLWD should be more meaningfully included and engaged in research in this area, there is a lack of guidance on methodological and ethical considerations necessary to explore people-place relations in the neighbourhood built environment through the lens of the lived experience of PLWD. To address this gap, our paper draws from the Dementia-inclusive Streets and Community Access, Participation, and Engagement (DemSCAPE) study to highlight reflections on conducting walk-along interviews, embodied videography, photo documentation, semi-structured sit-down interviews, and visual elicitation to explore the influence of the neighbourhood built environment on the outdoor walking experience of PLWD. We discuss 1) methodological strengths, including the triangulated strategy of capturing experiential data in-situ in real time and in retrospect, and flexibly working around memory and communication-related challenges experienced by PLWD, 2) ethical challenges and measures for mitigation, 3) logistical difficulties in undertaking complex fieldwork with PLWD, limitations of the research methods, and potential alternative methods to explore in future research.
SUBJECTIVE VIEWS OF AGING AND SOCIAL RELATIONSHIPS AMONG OLDER ADULTS: THEORY OF MIND AS A MEDIATOR
Authors: Bergman Yoav , Shrira Amit , Swisa Orel
Published: December 2022

Research has demonstrated the importance of subjective views of aging (VoA) for older adults’ well-being. However, little is known regarding how understanding others’ emotional states may affect this association. Accordingly, we examined whether Theory of Mind (ToM), or the ability to comprehend others’ emotions, may mediate the effect of VoA on older adults’ social functioning. Thirty community-dwelling older adults (mean age= 71.23, SD= 8.57, 50% women) filled out daily questionnaires concerning ageist attitudes, attitudes toward aging, and satisfaction with social relationships for two weeks. Positive VoA (i.e., low ageist attitudes and positive attitudes toward aging) were associated with increased ToM and higher satisfaction with social relationships. Moreover, ToM was a significant mediator for the VoA-social relationships link, as positive VoA on a given day were indicative of higher ToM levels, which were associated with increased positive social relationships. Results are discussed from the perspective of Socioemotional Selectivity Theory.
LESSONS FROM FIVE YEARS OF POLLING THROUGH THE NATIONAL POLL ON HEALTHY AGING
Authors: Solway Erica , Keenan Teresa , Lampkin Cheryl , Kirch Matthias , Singer Dianne , Kullgren Jeffrey , Malani Preeti
Published: December 2022

Since 2017, the National Poll on Healthy Aging (NPHA) has surveyed older adults on a vast array of topics related to health, health care and health policy. With robust nationally representative samples of 2,000 adults age 50-80, the poll’s format allows for the fielding of timely questions with important public health and policy implications. For example, polls examining delayed care during the COVID-19 pandemic and experiences of physical deconditioning and falls helped to demonstrate the ways in which the pandemic may have long-lasting effects if strategies are not implemented to address them. In this presentation we will discuss how the NPHA has increased awareness of the facilitators and barriers to healthy aging and where gaps exist in supporting older adults to live with optimal health and well-being. This presentation will also describe how researchers can access publicly available NPHA data to inspire their own future research.
OLDER ADULTS' PREPAREDNESS TO AGE IN PLACE: FINDINGS FROM THE NATIONAL POLL ON HEALTHY AGING
Authors: Robinson-Lane Sheria , Solway Erica , Singer Dianne , Kirch Matthias , Kullgren Jeffrey , Malani Preeti
Published: December 2022

Though aging in place is a stated goal for many older adults, complications of advanced disease or disability can derail these plans. Little is known about the current preparedness of older adults to age in place. The January 2022 National Poll on Healthy Aging surveyed adults age 50-80 (n=2,277) about their home and available supports. Findings indicate that while 80% of adults believe they have the necessary features in their home to support aging in place, less than one in five had homes that were wheelchair accessible and fewer than half had other common safety and accessibility features. Older adults were most confident they could obtain help with household chores (51%) and were least confident about getting assistance with personal care (33%). Persons with disabilities (n=683) and those living alone (n=639) reported the most concerns. Several opportunities exist to better prepare older adults to successfully age in place.
ADAPTATION OF FACE-TO-FACE COGNITIVE ASSESSMENTS FOR TELEPHONE ADMINISTRATION: A POTENTIAL THREAT TO VALIDITY
Authors: Smith Jason , Gibbons Laura , Mungas Dan , Glymour Maria , Zahodne Laura , Mayeda Elizabeth , Jones Richard , Gross Alden
Published: December 2022

Telephone-administered cognitive assessments are a cost-effective, feasible, and sometimes necessary alternative to in-person assessments. However, there is a scarcity of information in large cohort studies concerning mode effects, or differences in cognitive performance attributable to assessment method instead of underlying cognition, as a potential measurement threat. We evaluated mode effects on individual cognitive items and overall cognitive score using a population-based sample of community-living older adults aged 65-79 in the US in the 2014 Health and Retirement Study for whom interview mode was randomized (n=6825). We assessed mode differences in test means and reliability, whether mode modifies associations of cognition with criterion variables, and formal measurement invariance testing by mode. Relative to those assessed face-to-face, people assessed by telephone tended to have higher scores for memory and calculation items (0.06 to 0.013 standard deviations (SD)) and lower scores for non-memory items (-0.09 to -0.01 SD). We also found evidence that estimated cognition was significantly differentially related to IADL score depending on mode of assessment, observing a stronger association among participants completing telephone interviews. Measurement invariance testing identified the largest mode differences in memory and attention items: immediate noun recall, delayed noun recall, and serial 7s scores were higher when administered by telephone. Differences by telephone vs face-to-face mode of administration are apparent in cognitive measurement in older adults, and most pronounced for tests of memory and attention that can be easier to answer via telephone. Future investigations are warranted to further evaluate methods to correct for such differences.
AFFECTIVE TRAJECTORIES: RISK OF DEMENTIA AND UNDERLYING STRUCTURAL BRAIN VARIABLES IN OLDER WOMEN
Authors: Petkus Andrew , Wang Xinhui , Resnick Susan , Beavers Daniel , Espeland Mark , Millstein Joshua , Gatz Margaret , Chen Jiu-Chiuan
Published: December 2022

Understanding how trajectories of positive and negative affect relate to dementia risk and underlying structural brain variables is important for dementia prevention. We examined associations between annually assessed Positive and Negative Affect Scale subscales and dementia risk (2000-18) among cognitively-intact community-dwelling women (N=948; aged 72.9±3.7) from the Women’s Health Initiative Study of Cognitive Aging (years 2000-2010) and Magnetic Resonance Imaging Study (2005-2006). Joint latent class mixture models were constructed to identify latent classes of women with similar trajectories of affect and dementia risk over time. Multinomial and logistic regressions examined whether structural MRI measures predicted latent class membership (adjusted for sociodemographic, lifestyle, clinical characteristics, and intracranial volume). Two latent classes of positive affect (high stable:88% and decreasing:12%) and four classes of negative affect (Minimal stable:75%; high stable:4%; emerging:12%; moderate decreasing:9%) were identified. With the high stable trajectory as referent, women with decreasing positive affect were more likely to develop dementia (HR=4.33;p<.001). The odds of being classified as this high-dementia risk group were increased among women with more (per SD) global small vessel ischemic disease (SVID;OR=1.42;p<.001), deep white matter SVID (OR=1.93;p<.001), and smaller parahippocampal volumes (OR=1.41;p=.016). For negative affect, with minimal stable negative affect as referent, women with smaller hippocampal volumes were more likely to be classified as having moderate decreasing negative affect (OR=1.45;p=.024) while emerging negative affect was associated with higher dementia risk (HR=2.00;p=.014). These findings highlight the importance of changes in affect in later-life with dementia risk and potential underlying role of cerebrovascular disease and medial temporal lobe structures.
“I'M NOT A RISK-TAKER”: RISK PERCEPTIONS OF NURSING HOME RESIDENTS WITH DEMENTIA
Authors: Behrens Liza , Anderson Hannah , Kowalchik Kalei , Mogle Jacqueline , Van Haitsma Kimberly , Boltz Marie
Published: December 2022

Persons living with dementia (PLWD) in nursing homes (NH) are often left out of care conversations about their health and safety. These omissions impinge on their personhood and rights to have care preferences heard and honored. PLWD maintain the ability to communicate values and preferences long after their decision-making abilities are affected by cognitive changes. This study explored risk perceptions of PLWD associated with their care preferences. As part of a larger focused ethnography conducted during the COVID-19 pandemic, in-depth interviews explored risk perceptions of residents (N=7) with dementia (BIMS M=9.29). Using a risk propensity survey, residents self-identified as risk avoiders (M=3.2) and content analysis of interviews revealed that PLWD perceive physical and psychosocial harms (e.g., high blood sugar, falls, choking) and benefits (e.g., feeling good, social interactions, reminiscing) related to care preferences. Results suggest it is possible for PLWD with varying levels of cognitive decline to participate in discussions about their health and safety.
DEMENTIA IN INCARCERATED SETTINGS: MAKING A DIFFERENCE IN OHIO'S PRISON SYSTEM
Authors: Sanders Margaret
Published: December 2022

The number of individuals living in incarcerated settings with dementia will double by 2030 and triple by 2050. Older adults are the fastest growing demographic in incarcerated settings and age is the number one risk factor for dementia. The HRSA-sponsored Geriatric Workforce Enhancement Program, Ohio Council for Cognitive Health, Benjamin Rose Institute on Aging and the Ohio Department of Rehabilitation and Correction (ODRC) worked together to develop Dementia Friends for Incarcerated Settings to impact the lives of those living with dementia within the correctional setting. This pilot furthered the development of this Dementia Friends programming and measured ODRC staff knowledge/attitudes about dementia, as well as uncovered the experiences and needs of staff within the ODRC. Online Dementia Friends sessions were conducted in all 27 Ohio prisons with voluntary, anonymous pre- and post-session surveys based on the Brief Tool for Dementia-Friendly Education and Training Sessions developed to measure the impact of dementia-friendly education efforts on knowledge, attitudes/perceptions, and interacting with people living with dementia and their caregivers. The results of this pilot underscored the need, usefulness and applicability of dementia education throughout the ODRC system, indicating teaching effective communication techniques within a correctional facility are helpful for those working within such settings. The results indicate benefits on both a personal and professional level. These sessions provide a starting point for potential future educational sessions to serve all members of the correctional sector. Future proposed projects will focus on people living in incarcerated settings and those transitioning back into the community.
IMMEDIATE AND FUTURE IMPLICATIONS
Authors: Williman Martha
Published: December 2022

ODRC leadership was engaged in developing and promoting this first-of-its-kind initiative. Success was enhanced by making the training mandatory and providing CEs for employees in ODRC’s medical, behavioral health, mental health, dental and dietary departments. Our goals are to expand to all the ODRC’s over 12,000 employees and to increase dementia education in correctional settings across the U.S. In addition, we propose further developing the program to include people living in incarcerated settings and those being released into the community. With 95% of staff agreeing they would be able to use what they learned in their workplace, and over 63% of attendees stating they know someone who lives/lived with dementia, this training has implications for not only professional development, but personal support as well and provides a starting point for future education sessions to serve both staff and those living in incarcerated settings within and beyond Ohio.
PREDICTORS OF PARTICIPATION IN A TELEPHONE-BASED SOCIAL CONNECTEDNESS INTERVENTION FOR OLDER ADULTS
Authors: Adepoju Omolola , King Ben , Luo Jiangtao , Woodard LeChauncy , Dobbins Jessica , Pierett Jason , Glasheen William
Published: December 2022

Background

Social isolation is a well-documented contributor to poor mental and physical health, and interventions promoting social connectedness have been shown to be protective. This study examined predictors of participating in a telephone-based social connectedness intervention for socially isolated older adults.

Methods

Data was obtained from a social connectedness intervention that paired students with older adults. Eligible participants included Houston area older adults, 65 years or older, enrolled in Medicare Advantage plans. Eligible participants were contacted telephonically and asked to complete the 3-item UCLA Loneliness Scale. Those who screened positive for loneliness were invited to participate in the social connectedness intervention. Logistic regression models, that accounted for sociodemographic, clinical and functional indices, were used to identify predictors of participation.

Results

Females (OR: 1.23, 95% CI: 1.04-1.45), and racial/ethnic minorities (African American OR: 1.39, 95%CI: 1.16-1.68; Hispanic OR: 1.43, 95%CI: 1.04-1.99) were more likely to participate in a telephone-based social connectedness intervention. Older adults with a disability (OR: 2.37, 95%CI: 1.96-2.87), higher CMS Hierarchical Condition Category risk scores (OR: 1.15, 95%CI: 1.06-1.25) and those who reported having 1+ social needs (OR: 1.38, 95%CI: 1.14-1.66) were more likely to participate. Of all Charlson Comorbidity Index flags examined, diabetes was the single strongest predictor of participation (OR=2.49, p=0.02). Older adults who reported functional comorbidities for anxiety and depression were also more likely to participate.

Conclusion

Telephone-based social connectedness interventions can reach vulnerable older adults with clinical and social needs, and can be useful in addressing racial/ethnic health equity gaps in socially isolated older adults.
INTEGRATING DIVERSE CANCER PERSPECTIVES: FROM DEVELOPMENT TO IMPLEMENTATION
Authors: Halpin Sean
Published: December 2022

Cancer among older adults is pervasive, putting excessive strain at the individual, caregivers, and wider society levels. In our symposium, we bring together researchers from varied disciplines—with a focus on easing the strain of cancer on older adults by identifying important gaps in care and developing and implementing innovative methods for improving health services. First, Carrion will discuss the multifactorial experience of fears and beliefs about cancer and cancer prevention in 57 older Latino men. Krok-Schoen will discuss the longitudinal association between religiosity and cognitive functioning among older adults with hematological cancers. Next, Seaman will discuss engaging hard-to-reach patients and those who underutilize the health system. Blackberry will then describe an implementation and impact framework of a five-year research program to improve care in older people with cancer. Lastly, Halpin will discuss the 36-month implementation of a video-based patient education program for patients with multiple myeloma who are preparing for autologous stem cell transplant. Understanding the development and implementation of programs aimed at improving health services among older adults with cancer will help improve understanding potential methods for identifying and addressing health services challenges in these populations.
IMPLEMENTING AND MEASURING IMPACT OF A FIVE-YEAR TRANSLATIONAL GERIATRIC ONCOLOGY RESEARCH PROGRAM
Authors: Blackberry Irene , Steer Christopher , Rasekaba Tshepo , Rich Stacey , Webb Nicole , Young Kim
Published: December 2022

The Geriatric Oncology Regional Victorian Trials Alliance, Linkages, Special populations, Equity program (GO ReViTALISE) is part of a five-year state-wide grant to increase access to cancer clinical trials in regional Victoria, Australia. The initiative covers engagement with key stakeholders and trial sites, co-design of research programs with consumers, implementation of multiple interventional and non-interventional research, and capacity building. Employing a framework prospectively is critical to guide and scaffold implementation of complex interventions and capture the process of how several activities interact. Likewise, there is a need to show research impact beyond successful implementation and clinical outcomes. Using the GO ReViTALISE as a case study, we will demonstrate how an implementation framework and the Framework to Assess the Impact from Translational health research can deliver a cohesive, impactful and measurable program of research to increase older adults’ participation in cancer clinical trials, trials availability and build capacity in regional cancer sites.
SUPPORTING DECISIONS ABOUT END-OF-LIFE CARE IN DEMENTIA: FEASIBILITY OF A DECISION AID
Authors: Davies Nathan , Aker Narin , Vickerstaff Victoria , Sampson Elizabeth , Rait Greta
Published: December 2022

Decisions about end-of-life care are often left to family caregivers to make with professionals. Caregivers find these decisions difficult. A decision aid is one option to support family caregivers. We aimed to test the acceptability and feasibility of a co-produced decision aid for family carers of people with severe dementia or those towards the end of life in the UK. We aimed to recruit 30 family caregivers for a 6 month pre-post test feasibility study. Primary outcome was the feasibility of the study. We included quantitative measures at baseline, 3 month and 6 months, including: Decisional Conflict scale (DCS) and Kessler Psychological Distress Scale (K10). We recruited 28 carers (93% target), 26 completed baseline and 20 completed 6 month follow up. All outcomes changed indicating improvement at 6 months. Qualitative interviews reported the decision aid was acceptable. We met our success criteria, the study is feasible and the decision aid acceptable to caregivers.
IT'S ABOUT WHO YOU KNOW: RELATIONSHIPS BETWEEN SOCIAL NETWORKS, COGNITIVE FUNCTION, AND BRAIN HEALTH IN LATER LIFE
Authors: Hamilton Lucas , Moorman Sara
Published: December 2022

Evidence has been steadily increasing about the benefit of social connectedness for healthy aging. Yet, thanks to the complexity of human social interactions, it remains difficult to pinpoint specific benefits and mechanisms by which such benefits emerge. We offer this symposium to address this issue by presenting new findings from ongoing work at Indiana University in collaboration with the Indiana Alzheimer’s Disease Research Center. First, an overview of recent literature will be presented alongside a brief introduction to egocentric network analysis and its utility in probing social determinants of health. Next, we turn our attention to characteristics of social networks and their importance for cognitive health in later life. Different types of social enrichment will be evaluated in terms of their respective influence on cognitive reserve (i.e., neuropsychological evaluations, brain health). Additional attention will be paid to the comparison of emotionally supportive (i.e., social bonding) and more informationally supportive (i.e., social bridging) ties as promoters of brain health. Then, the final talks will describe potential avenues for increasing social connectedness in older adulthood. Individual differences in social cognitive function, namely Theory of Mind (i.e., reading another person’s thoughts, feelings, and intentions), has been implicated as mechanism by which older adults can maintain larger networks with more weak ties, in turn, promoting cognitive function. Separately, the presence of ambivalent ties (i.e., connections that beget positivity and negativity) may serve as a window of opportunity whereby older adults can leverage strengths in emotion regulation to maintain these ties without negative health consequences.