bluuebunny/crossref_metadata_2025 huggingface dataset:
Discrete Emotion Profiles in Old Age: Stability and Change for Better or Worse
Authors: Hamm Jeremy , Wrosch Carsten , Barlow Meaghan , Kunzmann Ute
Published: December 2021

Although discrete emotions can change in salience across adulthood, little is known about developmental shifts in the co-occurrence of multiple discrete emotions. The present study (n=389, Mage=73) adopted a person-centered approach to identify stability and change in commonly-occurring profiles of calmness, excitement, sadness, and anger. Daily emotions were assessed over 1-week periods at baseline and two years later. Latent class analyses yielded consistent 3-profile solutions at both waves: a positive emotion (high calmness-moderate excitement-low sadness and anger), a mixed emotion (moderate/high calmness-moderate excitement, sadness, and anger), and an apathetic emotion profile (low calmness, excitement, sadness, and anger). Latent transition analyses revealed both stability (82% remained in the same profile) and change (18% changed profiles) in profile membership. Higher baseline optimism and fewer chronic conditions were associated with adaptive changes in profile membership. Findings point to the importance of considering the co-occurrence of distinct emotions in studying emotional aging.
Daily Social Interactions and Well-Being in Older Adults: The Role of Interaction Modality
Authors: Hueluer Gizem , Macdonald Birthe , Luo Minxia
Published: December 2021

Older adults increasingly use digital communication technologies to stay connected to others. In the present study, we examine the role of social interactions for older adults’ daily well-being focusing on three interaction modalities (face-to-face, telephone, and digital). We use data from 116 participants (age: M = 72 years, SD = 5, range = 65 to 94; 41% women), who reported on their social interactions and well-being over 21 days. Our findings show that frequency of face-to-face interactions is more consistently related to well-being than telephone or digital interactions. On days where participants report more face-to-face social interactions than their own average, they report higher positive affect and lower loneliness than usual. Similar effects are not found for telephone or digital interactions. In summary, our findings suggest that face-to-face social interactions are uniquely relevant to older adults’ daily well-being. We discuss implications of these findings for future research.
Conducting Community-Based Qualitative Research With LGBTQ Older Adults of Color During COVID-19
Authors: Oswald Austin , Guess Aundaray
Published: December 2021

COVID-19 continues to transform the way scientists conduct research with study participants, particularly older adults who are at high risk of becoming seriously ill from the virus. For older adults who may be negatively affected by the digital divide, inclusive data collection practices become even more nuanced. Qualitative researchers moving their research into digital spaces must think critically about their use of technology, and how it affects the quality of data as well as the participant experience. This presentation highlights ethical and methodological considerations from a completely digital, community-based, qualitative research study conducted alongside LGBTQ older adults of color during COVID-19. Strategies to build and strengthen community partnerships are discussed along with challenges and opportunities for collecting data in the current digital landscape. Publicly available records are identified as a potential data source to understand the lives of LGBTQ older adults of color when in-person research is not feasible.
Social Relations, Stress, and Racial Health Disparities
Authors: Ajrouch Kristine , Webster Noah , Antonucci Toni
Published: December 2021

This symposium brings together four papers that address racial health disparities by investigating stressful aspects of social relations at different points in the life course. Cleary and colleagues focus on racial disparities in psychological health by testing cross-sectional effects of intergenerational stress over time. In particular, they investigate effects of network composition on the relationship between mothers' stressors and their children's depressive symptoms at three time points over 23 years. Camacho and colleagues use longitudinal data from the National Social Life, Health and Aging Project to examine cognitive decline among U.S. African-American, Latino, and White adults aged 60 and above. Results indicate loneliness predicted greater global cognitive decline over time in all groups. However, race differences in this association were found across cognitive function domains. Turner and colleagues consider dementia caregiving challenges among non-Hispanic Blacks. Data from five focus groups were analyzed to reveal distinctive challenges to caregiver health during the COVID-19 pandemic including increased burden and barriers to service access. Finally, Sol and colleagues examined the bidirectional association between loneliness and self-rated health over time among a racially diverse sample. Findings illustrate racial patterns in how loneliness at midlife influences health in later life. Antonucci will discuss the role of stress from social relations as a means to fully understand racial disparities in health across the life course.
Maternal Stress, Familial Ties, and Children’s Well-Being Across 23 Years
Authors: Cleary Jennifer , Manalel Jasmine , Brauer Simon
Published: December 2021

According to the family stress model, parental stress impacts child well-being through several mechanisms, which may be amplified in ethnic/racial minority families given increased experiences of stress. We extend this model to examine associations between maternal stress and child well-being at three points spanning 23 years, beginning when children were aged 8-12 years and mothers were aged 24-59 (n=193 dyads). Preliminary results indicate that maternal stressors are associated with increased depressive symptoms in childhood (B=3.56, p<0.001), and this association was stronger among Black children compared to White (B=4.12, p<0.001). Effects of maternal stress on children’s depressive symptoms strengthened among White children with proportionally larger kin networks (B=0.05, p<0.001). However, this association weakens as children enter adulthood. Future work will focus on identifying social resources that account for changes in the intergenerational effects of stress.
Exploring the Relationship Between Subjective Age and Worry for Older Adults in Times of a Pandemic
Authors: Tingvold Maiken , Kornadt Anna , Albert Isabelle , Murdock Elke , Hoffmann Martine , Nell Josepha
Published: December 2021

Given the role of age as a risk factor in the covid pandemic, we examined the longitudinal cross-lagged relationship between subjective age and Covid-related worry, and possible moderators of this relationship. Data were obtained at two-time points (June and October 2020) by a phone/online survey, from N = 611 older participants (Mage = 69.92 years). Participants felt on average 10 and 8.5 years younger than their chronological ages at the two-time points, respectively. Younger subjective age at T1 increased the level of worry at T2 irrespective of age, perceived control and subjective health. Higher worry increased subjective age at T2, but only for those with worse subjective health. Our results show that subjective age and Covid-related worry interact over time. This relation needs to be explored further in order to understand the relationship between subjective age and well-being especially, but not only in the pandemic context.
A scoping study of low-wage workers’ retirement in the U.S. after the Great Recession
Authors: Yeo Hyesu
Published: December 2021

Background Retirement comes with high risks for low-wage workers because of their cumulative disadvantages, and the Great Recession aggravated this population's working lives. However, there has been a lack of research about this vulnerable population's retirement. The purpose of this scoping study is to offer a comprehensive understanding of low-wage workers' retirement after the Great Recession. Methods Based on the rigorous method of scoping review by Arskey and O'Mally, the researcher systematically searched, selected, and synthesized literature. The articles were collected from eight databases and were published in January 2008 - February 2019. The search terms included terms related to retirement and low-wage. After systemically reviewing titles, abstracts, and full-texts from 5,268 articles, the final chart contains sample characteristics, definitions of low-wage workers, policy/programs, etc., from 23 peer-reviewed empirical studies. Results The results indicated that: 1) Most of the retirement studies covered middle-wage class workers, excluding low-wage workers because of their lack of retirement affordability; 2) There was no common definition of low-wage workers among scholars; 3) 11 studies assumed Social Security is the only retirement income for low-wage workers, and 12 studies investigated how to improve the workers' participation in other retirement programs; 4) Most studies were economic-centered; 5) Low-wage workers had different socioeconomic and labor market characteristics. Conclusion and Implications First, a consensus on the definition of low-wage is required to improve policies and programs associated with this population's retirement. Second, the life-course perspective approach from various disciplines is necessary to improve low-wage workers' retirement, considering diverse backgrounds.
A Study of Social Isolation, Multimorbidity and Multiple Role Demands among Middle-age Adults Based on the CLSA
Authors: Li Lun , Wister Andrew , Mitchell Barbara
Published: December 2021

Our understanding of the influence of concurrent multiple social and family roles on social isolation among the middle-aged generation remains limited. Given the increasing complexity of parenting, caregiving and working patterns over recent decades in many countries, and greater concern of multimorbidity in mid-life, this study examines the longitudinal effects of these contexts on social isolation among middle-aged persons. We apply Linear Mixed Models to analyze a sub-sample of 29,847 middle-aged (aged 45 to 64) participants drawn from the Baseline and Follow-up 1 waves of the Canadian Longitudinal Study on Aging. Separated analyses were conducted for participants with or without multimorbidity in order to identify patterns across these groups. Both middle-aged participants with and without multimorbidity experienced greater social isolation over time. Among participants without multimorbidity, holding multiple roles serves as a protective function to prevent social isolation over time. Among participants with multimorbidity, the parenting role remain as a protective factor; however, the caregiving role increases the risk of social isolation over time. This study confirms several life-course transitions from middle age to older age, including increased risk of social isolation and caregiving demand, and decreased parenting and working involvement. Different associations were uncovered among middle-aged persons occupying multiple roles on social isolation with and without multimorbidity over time. The findings emphasize the necessity to study multimorbidity as a salient contextual factor, and to provide enhanced support to multimorbid middle-aged individuals with increasing family caregiving demands.
College Students Life Course Drawings And Their Descriptions
Authors: Schuster Amy , Terhune Katherina , Newsham Tina K , Guest M Aaron , DuMont Renee , Hackett Lauren , Patton J R , Segosebe Kebafe
Published: December 2021

Drawing as a qualitative method has been employed to elicit views on aging. The subject matter of the drawings, without an explanation from participants, can be misinterpreted. Therefore, in this research, we explored college students’ drawings of the life course and the extent to which the content of these drawings corresponded to their written descriptions. A content analysis was performed on 524 college students’ life course drawings and their descriptions. Participants drew, on average, five life stages. The majority (75%) of the human beings represented were alone in each life stage. Twelve percent of the drawings were non-human representations of the life course (e.g., flower, tree). The majority of the images (85%) included in the drawings were not mentioned in the written descriptions, for example, hair changes (e.g., from long and straight to curly and short for women). Some physical characteristics (e.g., wrinkles [29%], hunched back [22%]) and some contexts (e.g., tombstones [37%], nursing home [100%]) were present in both the drawing and descriptions. Findings highlight which ideas associated with aging participants thought needed an explanation and which they might have seen as intrinsic to aging, warranting no explanation, emphasizing the importance of examining both drawn and written content when using drawing as a method in aging research. A more thorough and precise examination of the beliefs and perceptions of college students, who will serve as future professionals working with older adults, allows for the development of educational and engagement strategies that accurately target commonly held misperceptions regarding aging.
“It isn’t Going to Last Forever!” The Effects of COVID-19 Pandemic on Older Adults
Authors: Liou Chih-ling
Published: December 2021

The media puts a spotlight on older adults’ vulnerability to COVID-19 with limited consideration on how they view and cope with this crisis. This study is to give older adults voices to share their experiences of this pandemic. Data were collected using semi-structured interviews with 46 adults between the ages of 66 and 97 from the midwestern United States. Participants were asked to share how the pandemic affects them, their vision for the future, and how they cope during the pandemic. Although they worried about their health, felt isolated and missed seeing family and friends, most participants shared an optimistic view for the future. Some said that they are looking forward to receiving the vaccine, some believed that the effects of the pandemic are just temporary, and others compared that of the pandemic to the wars and other types of hardships which were much worse. Strategies for coping during the pandemic vary from spiritual practices to positive thinking, from exercises to new hobbies, and from calling family members to cutting down on the news. The results also show that the oldest-old and old-old participants seem to be better at regulating their negative effects compared to the young-old. One female participant in her 90s shared that she does not worry about the pandemic because there is nothing that she can do about it. Older adults’ adaptability during the COVID-19 pandemic should be better understood to reverse the image of their vulnerabilities and promote late-life coping during crises.
Pandemic-Inspired Strategies for Cross-Sector Collaboration on Food Equity Across the Lifespan
Authors: Ilardo Joan , Zell Angela
Published: December 2021

Early during the pandemic, access to food by residents across the lifespan was problematic in many communities. We observed well-intentioned responses by community organizations but a lack of centralized coordination across sectors, even as donations and resources significantly increased. Most of the organizations were in various sectors and not aware of the efforts and capabilities of others causing duplication or gaps in services. To prepare for future emergencies, our team created a project to develop and pilot a user-friendly, evidence-based roadmap to guide communities through the process of developing and sustaining effective collaborative partnerships for food and nutrition-related problems they could address together. We will describe the process through which we developed the roadmap structure and recruited stakeholders and content experts for our advisory board. To determine the effectiveness of our interventions, we designed methods with which we can analyze the organizations willing to use the roadmap and participate in the collaborative partnership; how they implement the roadmap; and ways they cope with challenges they face during implementation using strategies in the roadmap. We will describe elements of an effective, efficient roadmap development process using as many currently available evidence-based resources as possible and creating evidence-informed resources when we identify gaps. Expected outcomes are: 1) format of the final roadmap; 2) types of groups willing to use it; 3) how well the roadmap was implemented; 4) feasibility of continued use of the roadmap by groups over the long term; and 5) potential to expand roadmap use to other communities.
Perceived Stress and Life Stressors in Adults With and Without Fibromyalgia
Authors: Nguyen Ha , Buck Courtney , Cherry Barbara , Zettel-Watson Laura
Published: December 2021

Fibromyalgia (FM) is a widespread chronic pain condition often accompanied by comorbid conditions, such as depression, which may impact perception of stress severity. The current study examined perceived stress and life stressors in adults ages 50 and older with and without FM. It was hypothesized that individuals with FM and/or depression would subjectively rate stressors as more severe than those without. Ninety-four participants (52% with FM, 78% female) aged 50 to 93 (M = 67.72, SD = 9.26) were administered the Perceived Stress Scale (PSS) to measure perception of stress and an updated version of the Social Readjustment Rating Scale (SRRS) to assess stressors (i.e., major life events). The difference between the SRRS pre-determined values and participants' subjective ratings was calculated. Difference scores indicated that self-reported severity exceeded standardized values. Hierarchical regression analyses revealed that older adults and men were less likely to report exaggerated stress severity. Controlling for age and gender, individuals with FM were significantly more likely to report stress severity far above standardized severity scores. Both depression and chronic pain impact stress ratings, but when controlling for the former, FM impact was no longer significant, suggesting that the impact is significantly greater for depression. Results also found a significant interaction between FM status and depression for perceived stress, but not for life event stressors, which may further emphasize the distinctions between the two measures. The findings underline the importance of assessing different types of stress and stressors in individuals with chronic pain and other related comorbidities.
Increased Self-Efficacy among Older Adults Aging-in-Place during COVID-19.
Authors: Lindquist Lee , Miller Amber , Muhammed Ruqayyah , Opsasnick Lauren , Murawski Alaine , Ramirez-Zohfeld Vanessa
Published: December 2021

Self-efficacy is defined as a person's belief in their capacity to execute behaviors necessary to produce specific performance attainments. It also reflects confidence in the ability to exert control over motivation, behavior, and environment. During the COVID-19 pandemic, older adults were stressed with forced isolation, concerns over mortality, and finding alternate means of fulfilling their home-based needs. We sought to assess how COVID-19 pandemic affected the self-efficacy of a cohort of older adults aging-in-place. The LITCOG cohort is a group of community-dwelling older adults (65 years and older) who have had longitudinally assessment of cognition, health literacy, and functional skills over the past 15 years. As part of a larger study of the LITCOG cohort assessing decision making for aging-in-place, we assessed self-efficacy using validated PROMIS (Patient-Reported Outcomes Measurement Information System) measures with older adults prior to COVID-19 and during the COVID-19 pandemic. Survey results were obtained from 214 subjects (n=66 pre-COVID and n=148 during COVID). Nearly half of the sample (48.2%) had either marginal (25.5%) or low health literacy (22.7%). PROMIS General Self Efficacy was higher among those assessed during the COVID-19 pandemic (45.8 (7.7) pre-COVID vs 43.7 (8.0), p=0.07). PROMIS Self Efficacy for managing social interactions was higher during the COVID pandemic (45.0 (6.1) pre-COVID-19 vs. 48.7 (8.3) during COVID-19, p=0.02). During the stress and social isolation of the COVID-19 pandemic, older adults exhibited increased levels of self-efficacy. Ongoing longitudinal follow-up will determine how this self-efficacy evolves after the COVID-19 pandemic and impacts the ability to age-in-place.
Association between Loneliness and Diseases Self-Management in Older Adults: Systematic Review
Authors: Cho Emma , Garcia Alexandra , Huang Ya-Ching , Kuo Hsuan-Ju
Published: December 2021

Purpose: Older adults with chronic diseases are more at risk for loneliness, and loneliness has a negative impact on health behaviors, which are key to managing chronic diseases. However, little is known about the association between loneliness and self-management behaviors in older adults with chronic diseases. As societies worldwide experience the growth of aging populations who are at higher risk of having chronic diseases as they age, clinicians and researchers should assess and address loneliness of older adults with chronic diseases. Methods: This systematic review synthesizes research found in PubMed, MEDLINE, PsychINFO, CINAHL, and SocINDEX. Findings: fourteen studies were conducted in four countries and represented n= 128,610. Loneliness was measured by three different instruments. Reports of loneliness were frequent and ranged from 7.7% (in a report of severe loneliness) to 43.2% (moderate loneliness) of older adults. Older adults who experienced loneliness were less likely to be physically active, eat a healthy diet, or cope in positive ways and more likely to be female and seek healthcare. Conclusions: This systematic review found that loneliness was moderately prevalent, and that loneliness was associated with negative disease self-management behaviors in older adults with chronic diseases. Gaps in the research include a need for studies guided by theoretical pathways, using a consistent, theoretically-based measure of loneliness, and conducted on among people with specific chronic diseases.
Death With Dignity: A Policy Analysis
Authors: Suntai Zainab
Published: December 2021

Death with dignity is one of many titles attributed to the practice of providing a patient with terminal illness a means to die in light of extreme suffering as a result of a terminal illness. The purpose of the Oregon Death with Dignity Act is to provide individuals suffering from a terminal illness with the right to make a written request for life-ending medication to end their life in a “humane and dignified manner.” Deborah Stone’s policy goals of equity, efficiency, welfare, security, and liberty provides a framework to analyze whether a policy is doing what it says it wants to do. As such, the goal of this presentation is to apply the policy goals framework to determine if the Death with Dignity Act is accomplishing its stated goals. Applying a theory of the policy process, the Death with Dignity Act was analyzed using the most recently available data from the Oregon Health Authority. Results showed that since the Death with Dignity Act passed in 1997, 2,518 people have received prescriptions for life-ending medications, and of those, 1657 or 66% have used the medication to end their lives. Based on the data aggregated between 1997 and 2019, the Death with Dignity Act has mostly met its purpose of providing individuals with a terminal illness with the right to die on their own terms and with dignity. However, there are still several issues regarding equity, especially for low-income BIPOC populations. Implications for practice, policy and research are discussed.
User Perceptions & Subjective Memory Concerns are Associated With Brief, Remote Cognitive Assessment Performance
Authors: Lee Samuel , Dorociak Katherine , Mattek Nora , Gothard Sarah , Lee Jonathan , Kaye Jeffrey , Hughes Adriana
Published: December 2021

Online cognitive tests offer a cost-effective, accessible means of cognitive screening and may prove especially important for individuals with memory complaints, a risk factor for cognitive impairment (Kaup et al., 2015). Although older adults’ perceptions of everyday technologies impact their uptake and adoption, there is limited understanding about how perceptions of online cognitive screening tests impact test performance. The purpose of the current study was to examine relationships between performance on a brief, self-administered, web-based cognitive assessment tool (SMART) and user perceptions (e.g., ratings of challenge and length), technology confidence, brain health activities, and memory complaints. Participants were 1336 adults without a diagnosis of cognitive impairment (Mage=60.48 years, SD=15.18; 65.8% female; 81.8% White; 21.2% with subjective memory complaints). Most participants (97%) were willing to complete the SMART again, with over half (53.5%) willing to complete the SMART on at least a weekly basis. After adjusting for age and education, better SMART performance (i.e., faster completion time) was associated with user ratings of greater ease of completion, higher technology confidence, and greater participation in brain health activities (p<.05). In a subsample aged 60+, individuals with memory complaints took longer to complete certain SMART tasks (Trail Making Test B, Total SMART) than those without memory complaints (p<.05). Results suggest that the SMART is a well-accepted tool for frequent remote cognitive screening and highlight the importance of user perceptions, technology confidence, and memory complaints on online cognitive test performance.
Impacts of COVID-19 on the Utilization of the Medicare Hospice Benefit
Authors: Plotzke Michael , Fout Betty , Christian Thomas
Published: December 2021

The Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE) has had a substantial impact on the provision and utilization of healthcare services. Given the high mortality rate associated with COVID-19 amongst older adults, COVID-19 is likely to have a profound impact on all hospice users due to disruptions in providing services. Our work describes how Medicare beneficiaries have utilized the Medicare Hospice Benefit (MHB) during the PHE and how that compares to utilization of the MHB prior to the PHE. We conducted a retrospective analysis of 100% Part A and Part B Fee-for-Service (FFS) Medicare claims from January 1, 2019 – December 31, 2020. We identified approximately 42.3 million unique Medicare FFS beneficiaries from January 2019 through December 2020. Of these, 1.6 million (3.8%) had at least one hospice claim and 1.7 million (4.0%) had at least one Medicare Part A or Part B claim with a COVID-19 diagnosis during the same time period. The rate of COVID-19 amongst FFS Medicare patients who utilized hospice was 8.3%. Average per-beneficiary per-month hospice visits fell by 28.2% for aides and 15.4% for nurses from December 2019 (7.1 aide visits, 6.5 skilled nursing visits) through December 2020 (5.1 aide visits, 5.5 skilled nursing visits). CMS should continue to monitor the prevalence of COVID-19 amongst hospice users and measures of hospice utilization amongst all hospice users in order to better understand how the PHE impacts the provision of the MHB and ensure beneficiaries continue to have access to needed services.
Prescription Patterns of Anti-dementia and Psychotropic Drugs in People Living With Dementia in China
Authors: Yingyang Zhang , Luo Hao , Wong Gloria H Y , Lum Terry Y S , Chui Celine , Wong Ian C K , Wang Huali
Published: December 2021

Pharmacotherapy of dementia is a critical intervention for managing symptoms of and slowing progression of dementia. However, evidence on prescribing patterns of dementia medications and their associated factors in China is lacking. This study aimed to examine prescribing rates of anti-dementia and psychotropic drugs, and investigate factors associated with prescription of anti-dementia drugs and its co-prescription with psychotropic drugs in China. We used data from the Clinical Pathway for Alzheimer’s Disease in China study, an eight-week multi-center registry study that was conducted in tertiary hospitals between Nov 12, 2012, and Jan 31, 2013. Anti-dementia and psychotropic drugs were coded according to the Anatomical Therapeutic Chemical codes. Logistic regressions were performed to examine factors associated with prescription patterns after controlling for demographic and clinical characteristics of people living with dementia and caregivers’ characteristics. A total of 746 participants were included in this study, of which almost 80% of participants were prescribed anti-dementia drugs, and one-third were prescribed at least one psychotropic drug. The concomitant prescription rate of anti-dementia and psychotropic drugs was 24·3%. Logistic regression results showed that first consultation, dementia subtypes, dementia severity, functioning level, and having symptoms of psychosis and apathy were significantly associated with anti-dementia drug prescription. Frontotemporal dementia, worse functioning level, psychosis, agitation, and depression were significantly associated with co-prescription of anti-dementia and psychotropic agents. Practices of dementia prescriptions generally concurred with clinical guidelines in tertiary hospitals in China, while prescription of anti-dementia and psychotropic medications mainly depended on clinical symptoms of patients with dementia.
Gait Speed and Grip Strength Are Predictors of Cognitive Decline and Dementia in Older Individuals.
Authors: Orchard Suzanne , Ryan Joanne , Polekhina Galina , Storey Elsdon , Shah Raj , Chong Trevor , Murray Anne , Woods Robyn
Published: December 2021

Lower gait speed and grip strength are common in older adults. However, the results of lower motor function on cognitive outcomes have been mixed. We examined the longitudinal association between baseline slow gait speed and weak grip strength, alone and in combination, with risk of incident dementia or cognitive decline in a cohort of older adults. Participants (n=19,114) aged 70 and over (65 if U.S. minority) without documented evidence of dementia, significant cognitive impairment, physical disability or previous cardiovascular disease at baseline, were recruited from community settings. Incident dementia was adjudicated by an expert panel using DSM-IV criteria. Incident cognitive decline was defined as a persistent intra-individual decline in score of >1.5 SD from baseline on any of the cognitive tests. Using cox proportional hazard models, slow gait speed at baseline was associated with an increased risk of dementia (63%) and cognitive decline (43%), over a median 4.7 years. Weak grip strength was not as strong a predictor, but was also associated with risk (43% and 11%, respectively). Both outcomes showed higher risk for dementia than cognitive decline. There was no gender-specific interaction. When considered together (adjusted for one another), gait speed and grip strength were both independently associated with cognitive decline and dementia. The synergistic association of these physical measures, each of which is readily administered in the clinic or home, serve as effective early markers of increasing risk of cognitive decline and incident dementia and thus, should be considered for routine health assessments for older adults.
Exercise and Attitude for Exoskeletons: The Mediation of Technology Anxiety and Perceived Usefulness
Authors: Lee Seolah , Yoon Do Kyung , Kang Miseon , Kim Kwang Joon , Kim YoonMyung , Lim Yun Mook , Jun Hey Jung
Published: December 2021

The present study aimed to examine the effects of regular exercise on attitude towards using exoskeletons and the mediating effects of technology anxiety and perceived usefulness among Korean older adults. Data was collected through online recruitment in February 2021. The sample comprised 310 people (Age: 65-89, M=70.18, SD=4.58) who did not report dementia. The dependent variable was the attitude towards using technology, especially lower limb exoskeleton robots for exercise. The independent variable, regular exercise, was coded as a binary variable. The mediating variables were technology anxiety and perceived usefulness measured by the sum of three questions about exoskeleton robots, respectively. Gender, age, education level, and household income were included as control variables. The mediating effect was estimated by serial path analysis and bootstrapping (model fit indices: χ2=18.400, df=8, p<0.05, RMSEA=0.065, CFI=0.973, TLI=0.940, SRMR=0.044). Results showed the total effect of regular exercise was significant (B=1.253, p<0.01) and the total indirect effect of it was significant(B=1.540, p<0.001). There was no significant direct effect of regular exercise on the attitude towards using technology. The association between regular exercise and the attitude of using technology was completely mediated by perceived usefulness (B=1.439, CI=0.569-2.358, p<.01). Although technology anxiety had no mediating effect alone, the serial mediating effect via the path from technology anxiety to perceived usefulness was significant (B=0.119, CI=0.004-0.332, p<.05). This study will be the first empirical study to examine the effects of health habits by expanding the senior technology acceptance model for older adults in Korea.
Trust with Autonomous Intelligence Systems to Promote Adoption in Assistive Technologies: A Literature Review
Authors: Carrillo Jared , Pena Maria , Milyavskaya Nonna , Chan Thomas
Published: December 2021

While advancements in machine learning are increasing rapidly, very little progress has been made in its mass adoption despite its benefits in assistive technologies for older adults. By examining how users interact with smart technologies, characteristics of trust can be identified and enhanced to increase adoption of the next generation of assistive systems. The current study conducted a literature review to understand better how trust with autonomous systems is formed and maintained. Twenty-two pertinent articles were identified in which three themes emerged. First, people tend to forgive human errors more than errors made by machines -- meaning mistrust is exaggerated when systems make mistakes. Second, the development of trust depends on how the system solves the tasks it is assigned, for instance if a user does not believe the system acted in an “ethical way,” distrust may form and the continuation of adoption is decreased. Lastly, trust depends on the situation and the risk/reward associated with using the system, for example the trust needed to board an autonomous plane differs from that for a simple grammar correction. Taken together, the black box ideology of autonomous systems may be an issue that prevents trust in them to be formed and maintained. Promising future directions are to create machine language translators that improve transparency of autonomous system behaviors (i.e., explainability). Even if assistive technologies are created to aid older adults -- the lack of focus on understanding the factors that foster trust may dampen their actual use.
Demonstration Of Age-Related Increase In Blood-Brain Barrier Permeability By Longitudinal Intravital Microscopy
Authors: Toth Adam Nyul , Tarantini Stefano , DelFavero Jordan , Yan Feng , Balasubramanian Priya , Tang Qinggong , Csiszar Anna , Ungvari Zoltan
Published: December 2021

Age-related blood-brain barrier disruption and cerebromicrovascular rarefaction contribute importantly to the pathogenesis of both vascular cognitive impairment and dementia (VCID) and Alzheimer's disease (AD). Recent advances in geroscience research enable development of novel interventions to reverse age-related alterations of the cerebral microcirculation for prevention of VCID and AD. To facilitate this research there is an urgent need for sensitive and easy-to-adapt imaging methods, which enable longitudinal assessment of changes in BBB permeability and brain capillarization in aged mice, that could be used in vivo to evaluate treatment efficiency. To enable longitudinal assessment of changes in BBB permeability in aged mice equipped with a chronic cranial window, we adapted and optimized two different intravital two-photon imaging approaches. By assessing relative fluorescence changes over the baseline within a volume of brain tissue, after qualitative image subtraction of the brain microvasculature, we confirmed that in 24 month old C57BL/6J mice cumulative permeability of the microvessels to fluorescent tracers of different molecular weights (0.3 kDa to 40 kDa) is significantly increased as compared to that of 5 month old mice. Real-time recording of vessel cross-sections showed that apparent solute permeability of single microvessels is significantly increased in aged mice vs. young mice. Cortical capillary density, assessed both by intravital two-photon microscopy and optical coherence tomography (OCT) was also decreased in aged mice vs. young mice. The presented methods have been optimized for longitudinal (over the period of 36 weeks) in vivo assessment of cerebromicrovascular health in preclinical geroscience research.
The Interplay Between Stress Related Genes and Its Role in Human Longevity: Insights for Translational Studies
Authors: Yashin Anatoliy , Wu Deqing , Arbeev Konstantin , Bagley Olivia , Akushevich Igor , Yashkin Arseniy , Duan Matt , Ukraintseva Svetlana
Published: December 2021

Human lifespan is a multifactorial trait resulted from complicated interplay among many genetic and environmental factors. Despite substantial progress in clarifying many aspects of lifespan’ variability the mechanism of its multifactorial regulation remains unclear. In this paper we investigate the role of genes from integrated stress response (ISR) pathway in such regulation. Experimental studies showed that persistent cellular stress may result in cellular senescence (for proliferating cells), or in apoptosis (for post-mitotic cells) which may affect health and lifespan in laboratory animals. These studies also showed which ISR genes are likely to interplay to produce joint effects on these traits. Note that in humans, the interplay between these genes does not necessarily influence these traits. This is because biological mechanisms regulating these traits in laboratory animals and humans may differ. This means that, when possible, the experimentally detected connections promising for human applications, should be verified using available human data before their testing in expensive clinical trials. In this paper we used HRS data to test connection between SNPs from the EIF2AK4 gene that senses cellular stress signals and the DDIT3 gene from the apoptosis regulation part of the ISR. We found genome wide significant associations between interacting SNPs from these genes and longevity. This result shows that available human data may be successfully used for making important steps in translation of experimental research findings towards their application in humans. Following this strategy may increase efficiency of clinical trials aiming to find appropriate medications to promote human health and longevity.
Geriatric Oncology: Cognition and Communication
Authors: Parker Patricia , Alici Yesne , Nelson Christian , Banerjee Smita , Malling Charlotte , Coyle Nessa , Korc-Grodzicki Beatriz
Published: December 2021

With the dramatic increase in the older adult population, assessment and care of chronic diseases of aging, notably cancer, cognitive impairment and functional decline, have increasing clinical importance. Most healthcare practitioners (HCPs) receive minimal education in geriatrics and/or communication skills and are not optimally prepared to treat older cancer patients. Geriatric Oncology: Cognition and Communication (Geri-Onc CC) trains HCPs to identify cognitive impairment and/or functional decline and improve communication with patients and caregivers. Geri-Onc CC is a 2-day virtual training. Day 1 covers depression, dementia, delirium, pharmacology, cognitive rehabilitation, language barriers, and decision-making capacity. Day 2 focuses on communication skills experiential practice in geriatric syndromes, cognitive syndromes and shared decision making. In addition, HCPs engage in 6 bimonthly web-based collaborative learning activities post-training. Thus far, three cohorts have participated (n=56). Participants were primarily female (88%), 68% non-Hispanic White, and represented multiple disciplines [psychologists (29%) social workers (25%), physicians (21%), others(25%)] and they work in various settings: comprehensive cancer centers (43%),community hospitals (18%), and others (33%). Most (48%) have been caring for older cancer patients for 1-5 years. All reported the training had value to them as a clinician, increased their knowledge of geriatrics, and helped them meet their training goals and 84% were extremely satisfied with the program. Recruitment has been successful. Participants have been diverse in terms of race/ethnicity, profession, practice characteristics and the populations they serve. Overall, participants have found the training valuable, future work will describe outcomes of the training.
Shaken Identities, Reserve Masculine Capital, and the Lived Experiences of Aging Men with Breast Cancer
Authors: Thompson Edward , Beard Renee
Published: December 2021

A question that begs to be examined is: How does aging men’s discovery they have breasts as a result of their breast cancer diagnosis and having a breast removed through a mastectomy, affect their masculine subjectivities and practices, as they also go about also living with a life-threatening illness? The present study aimed to better understand how men come to live with the knowledge that they have both breasts and cancer. Interviews with seventeen men in the U.S. (mean age 62.8) with a breast cancer diagnosis, mastectomy, and, most often, post-surgical hormonal treatment uncovered stories of body-self disruption and identity dilemmas. All the men’s identities had been shaken. After their mastectomy, they were reminded every morning that the body reflected in the mirror differed significantly from who they once were. Their stories revealed strategic themes: how they lived with cancer by slightly modifying conventional masculinities; and how others interacted with them, with the exception of mammography technologists, in terms of their gender, not their atypical illness. Only a few men initially felt their breast cancer was a gendered stigma. Noticeable was how the historical era when diagnosed and the age of the man at diagnosis contextualized their illness stories. In this presentation, three cases are used to exemplify the men’s varied experiences with their non-normative bodies and their commonality in finding reserves of masculine capital to rebuke the existential loneliness of a man with breast cancer.
A qualitative inquiry on self-management decision making among rural African Americans with type 2 diabetes
Authors: Harvey Idethia Shevon
Published: December 2021

Living in a rural area has been recognized as a unique health disparity associated with higher rates of chronic disease. It is further compounded for those who are the most structurally vulnerable complicating access to care and negatively affecting health outcomes. Barriers to type 2 diabetes (T2DM) self-management remain a growing concern, particularly among minority communities living in underserved geographical areas. Much of the self-management research focused on compliance with medication regimens and modification of lifestyle choices. A less well-understood but arguably more critical aspect is the social factors in disease management decision-making. Purposive sampling was used to identify rural African Americans (n = 34). The mean age of participants was 65.9 years (SD = 12.3), and T2DM diagnosis was 15 years (SD = 12.4). The study utilized the consensual qualitative research methodology and the "Sort and Sift, Think and Shift" approach to identify themes. The participants reported an alternative way of integrating glucose monitoring through a "feedback loop" of body sensing. The longer they live with the condition (i.e., knowing my body), the more they can interpret whether they are hypoglycemic or hyperglycemic (i.e., deciphering the cues) to create and navigate their disease management strategy (i.e., body sensing). Self-management decision-making is a complex developmental process that includes disease trajectory and cultural and environmental factors. Findings from this study may provide a conceptual framework for ongoing inquiry and may provide insights to help T2DM educators and clinicians fully understand the complexity of long-term disease management among rural African Americans.
Fall Prevention in Adults With Cognitive Impairment: Systematic Review and Meta-Analysis
Authors: Racey Megan , Markle-Reid Maureen , Ali Muhammad Usman , Gagné Hélène , Hunter Susan , Ploeg Jenny , Sztramko Richard , Sherifali Diana
Published: December 2021

Cognitive impairment increases an individual’s risk of falls due to the role cognition plays in gait control. Older adults with dementia fall 2-3 times more than cognitively healthy older adults and there is a lack of evidence for effective fall prevention interventions for community-dwelling cognitively impaired adults. We conducted a systematic review and meta-analysis to investigate the effectiveness of fall prevention interventions in improving falls, perceived risk of falls, gait, balance, and functional mobility. We searched 7 databases for interventions involving community-dwelling adults ≥50 years with mild to moderate cognitive impairment. Reviewers screened citations, extracted data, assessed risk of bias and certainty of evidence (GRADE). We performed a meta-analysis of 509 community-dwelling adults (mean age 67.5 to 84.0 years) with mild to moderate cognitive impairment from 12 randomized controlled trails (8 exercise interventions, 3 multifactorial, and 1 providing medication). Interventions had medium significant effects on perceived risk of falls (SMD -0.73 [-1.10, -0.36]), balance (SMD 0.66 [0.19, 1.12]), and timed up and go test (SMD -0.56 [-0.94, -0.17]) and small significant effects on gait speed and control (SMD 0.26 [0.08, 0.43]) with moderate certainty of evidence. There were no significant effects for falls. Sub-analysis showed that exercise and studies at low risk of bias remained significant for balance and perceived risk of falls. The effect of fall prevention interventions on falls remains unclear; exercise interventions are effective at addressing fall risk factors. However, high quality and longer studies with adequate sample sizes are needed to determine their effectiveness on falls.
Harmonizing Data Collection and Analysis In Worldwide FINGERS Trials
Authors: Peltonen Markku
Published: December 2021

One of the goals of the World-Wide FINGERS (WW-FINGERS): A Global Approach to Dementia Prevention network is to prospectively facilitate data sharing and joint analyses across clinical trials on prevention of cognitive impairment and dementia. The aim with prospectively harmonizing studies in different countries and settings regarding interventions, outcomes, measurements, data collection, and establishing best practices for responsible data sharing and access to data for remote joint analyses, is to increase the use of clinical trial data. By utilizing federated database system which connects multiple autonomous, decentralized databases and enables data-analyses to be conducted without individual level data being transferred, could be a feasible and acceptable technical solution for countries around the world, given wide variations in data protection and sharing regulations. Ultimately, prospectively harmonizing clinical studies and establishing a culture of harmonization and sharing, will promote international joint initiatives to identify globally implementable and effective preventive strategies.