bluuebunny/crossref_metadata_2025 huggingface dataset:
HEALTH PROMOTION BEHAVIORS AMONG SPOUSAL CAREGIVERS WITH HIGH DAILY MANAGEMENT CHRONIC CONDITIONS
Authors: Cho Jinmyoung , Horstman Molly , Stevens Alan , Sands Laura , Allore Heather
Published: January 2025

As the disease trajectory of dementia increases caregiving intensity, family caregivers are less likely to take care of their own health. Although the potential health threats from chronic caregiving distress are known, far less is known about health behaviors among caregivers with chronic conditions while caring for a person with dementia (PWD). This study aims to identify caregivers diagnosed with chronic conditions requiring high daily self-management and examine their health promotion behaviors associated with the intensity of caregiving among spousal caregivers for PWD. Using ICD-10 codes from medical records of 152 spousal caregivers aged 65 and older, six chronic conditions requiring high daily self-management (CCHDSM) were asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, heart failure, and ischemic heart disease. The intensity of caregiving was identified by cluster analysis (high vs. low). Self-rated health promotion behaviors were assessed as: health responsibility, physical activity, nutrition, interpersonal relations, and stress management. Ninety-nine caregivers (61.5%) were diagnosed with at least one CCHDSM. No significant difference in the intensity of caregiving was observed between CCHDSM and non-CCHDSM caregivers. A significant interaction between the intensity of caregiving and CCHDSM in performing physical activities (F=5.03, p<.01) indicates that caregivers with CCHDSM and providing high intensity of caregiving were the least engaged in physical activities compared to others. Findings highlight caregiving role hinders physical activities for spousal caregivers in the most needs of physical activities. Future studies, interventions, and support systems are urgently needed to reduce burden of caregiving for spousal caregivers struggling with chronic conditions.
PREVALENCE AND ASSOCIATED FACTORS FOR POSSIBLE SARCOPENIA IN KOREAN OLDER ADULT FALLERS
Authors: Lee Jae Jun , Kim Gwang Suk , Park Min Kyung , Kim Layoung , Kim Namhee , Lee Ji Yeon
Published: January 2025

Sarcopenia causes adverse health outcomes in older adults, especially in those who have fall experience. Asian Working Group for Sarcopenia (AWGS) introduced possible saropenia for screening sarcopenia in 2019. Identifying the prevalence and associated factors of possible sarcopenia is essential to prevent and manage sarcopenia, however research on possible sarcopenia is still lacking. Therefore, the purpose of this study is to identify the prevalence and associated factors for possible sarcopenia in Korean older adult fallers. This is a cross–sectional study with 184 community-dwelling older adults who aged 65 or over and have at least one fall experience within the last two years. Possible sarcopenia was evaluated based on the AWGS 2019 using calf circumference, five times sit-to-stand test, and handgrip strength. Age, gender, number of fall, depression, cognitive impairment, nutritional status, physical inactivity, and fear of falling were collected and assessed as covariates, and logistic regression analysis was conducted. The mean age of the participants was 74.3±6.5 and 79.3% was female. Among the 184 participants, 47 (25.5%) were possible sarcopenia. Using logistic regression analysis, physical inactivity (odds ratio = 2.55, 95% confidence level = 1.15–5.67) and fear of falling (odds ratio = 1.71, 95% confidence level = 1.01–2.92) were significantly associated with possible sarcopenia, whereas other covariates were not significant. Possible sarcopenia is prevalent in Korean older adult fallers. Our results indicated that encouraging physical activity and making efforts to reduce the fear of falling can be effective strategies for preventing possible sarcopenia in older adult fallers.
IMPLEMENTATION OF ENGAGE IN A GERIATRIC MENTAL HEALTH SERVICE LINE WITH NONSPECIALIST PROVIDERS
Authors: Schurr Matthew , Post Emily , Walker Teresa , Renn Brenna
Published: January 2025

Despite development of efficacious psychosocial treatments for depression in older adults, implementation in real-world settings is limited, particularly in the context of patient comorbidities and across interprofessional teams. Engage is an empirically-supported psychotherapy for late-life depression but has yet to translate from randomized controlled trials to widespread implementation. Engage’s utility as a brief, structured behavioral protocol holds potential for feasible dissemination across multiple provider disciplines. This study evaluated a real-world training and pilot implementation of Engage psychotherapy across a geriatric mental health care hospital team. Care managers (N = 22) across interprofessional healthcare backgrounds (occupational therapy, social work, nursing) participated in training, consultation, and implementation of Engage with older adult patients with depression. Upon completion of the implementation trial, providers participated in a 1-hour focus group to provide feedback about their experience. Focus group interviews were double-coded using thematic analysis to extract implementation themes informed by the Consolidated Framework for Implementation Research (CFIR). Thirteen themes emerged related to CFIR constructs of innovation adaptability, innovation design, critical incidents, compatibility, access to knowledge and information, need, and capability. Overall findings suggest that Engage is a feasible treatment method that fits the needs of providers, patients, and larger health care systems. Barriers to implementation included depressive symptom burden, patient complexity, and provider concerns related to self-efficacy and previous related experiences. Implementation trials and elicitation of provider feedback to inform commensurate modifications should be a staple procedure to ensure optimal implementation of newly adopted mental health treatment services.
OPTIMIZING FUNCTION AND INDEPENDENCE: NATIONAL IMPLEMENTATION OF THREE CLINICAL PROGRAMS WITHIN VA
Authors: Hughes Jaime , Kappler Caitlin , Drake Connor , Zullig Leah , Decosimo Kasey , Webb Sara , Hastings Susan
Published: January 2025

Older Veterans aged 65+ account for roughly one-half of Veterans Affairs (VA) Healthcare users. Comprised of more than 170 medical facilities, VA promotes programs to support function and independence for both Veterans and their caregivers. The VA Optimizing Function and Independence Quality Enhancement Research Initiative (Function QUERI) focuses on the national scale-up of three evidence-based programs (EBPs) for older Veterans and their caregivers: STRIDE (hospital-based mobility), Caregivers FIRST (caregiver education and training), and Group PT (group-based rehabilitation for knee osteoarthritis). As part of the Function QUERI program, three individual Type III hybrid effectiveness-implementation trials were conducted to, first, identify baseline organizational characteristics (organizational readiness, implementation climate, and implementation experience) associated with successful program adoption of each EBP; and, second, to evaluate strategies to adopt and sustain each EBP. To date, 142 VA facilities have participated in the implementation of one or more EBPs (STRIDE=67, Caregivers FIRST=142, Group PT N=19). The trials tested a similar implementation approach where all sites received foundational support tools (e.g. program toolkits, documentation templates, technical assistance); and, sites that did not adopt their respective EBP by pre-specified benchmarks received enhanced implementation support via virtual external facilitation (STRIDE= 13, Caregivers FIRST=13, Group PT =9). Barriers to program adoption were similar across EBPs (e.g., competing demands, staffing challenges, coordination between disciplines, poor leadership support). Offered as part of both foundational tools and enhanced support activities, implementation strategies (e.g., adaptation, engage and train stakeholders, monitor and evaluate feedback) were used to address adoption barriers across all EBPs.
QUALITATIVE DATA INTEGRATION IN DISASTER PREPAREDNESS CAREGIVER INTERVENTION
Authors: Anderson Brittany , Adeagbo Morolake , Donohoe Maria , Wunderlich Tiffany , Ashida Sato , Seaman Aaron
Published: January 2025

Disaster PrepWise Caregiving (DPW-C) is an online disaster preparedness program for caregivers of persons with dementia (PWD). DPW-C works with collegiate AmeriCorps volunteers to develop and build caregivers’ household disaster plan in a location of their choosing, whether at home, in public, or through online platforms. The program utilizes an all-hazards approach, which highlights all-encompassing disaster preparedness, while accommodating the specific needs of caregivers and the importance of maintaining their caregiving tasks during and after a disaster. Within the hybrid type one trial, an evaluation of the program’s potential determinants of implementation is being conducted. Guided by the PRISM (Practical, Robust Implementation, and Sustainability Model) framework, the team is utilizing the triangulation of qualitative methods to assess the implementation process and fidelity through observational evaluation of the social interactions between the AmeriCorps program interventionists and the caregiver participants. This entails examining interventionists’ communication and engagement with caregivers regarding their disaster plans. Observation data elucidate traits and themes in approach and engagement that were more successful in leading to positive social interactions that facilitated in-depth discussion and careful development of the household disaster plan. In response to the project’s needs, the research team is using observation data to adapt the program and intervention processes to improve the overall success of interventions. As the project progresses, the qualitative team will expand the project evaluation by including examinations of the program’s effectiveness and long-term sustainability. This poster will discuss how the qualitative team helped integrate gained knowledge to improve the program implementation.
STRENGTHENING FAMILY CAREGIVER SUPPORTS: QUALITATIVE FINDINGS FROM THE ADULT DAY SERVICES PLUS PROGRAM TRIAL
Authors: Bailey Dionne , Cotton Quinton , Marx Katherine , Gitlin Laura , Gaugler Joseph
Published: January 2025

Home and community-based services, such as adult day services (ADS), that support people with dementia (PLWD) and their family caregivers frequently fail to meet the full range of dementia care and management needs. There is insufficient data on implementation mechanisms that achieve desirable results among existing interventions targeting dementia family caregivers. In a pragmatic trial, we evaluated the feasibility and acceptability of integrating a caregiver-specific intervention [ADS Plus] delivered through adult day services. Post-intervention, we conducted a directed content analysis using the Consolidated Framework for Implementation Research, drawing from semi-structured interviews with dementia family caregivers (n=15) and ADS site staff (n=14). Our findings demonstrate that key aspects of ADS Plus supported delivery and uptake: intervention adaptability, personalization, and structure (innovation); responsive to external changes and intervention marketability (outer domain); aligned goals and familiarity (inner setting); involvement of research staff, connections among practitioners, and meeting caregiver needs (individual domain), and; understanding caregivers needs and addressing staff capacity to take action (implementation process). ADS Plus offers a viable community-based solution for supporting dementia family caregivers. Future studies can assess fidelity across diverse implementation contexts to ensure greater transferability of findings.
TOWARD SUCCESSFUL IMPLEMENTATION OF A QUALITY IMPROVEMENT INTERVENTION IN NURSING HOMES: EXTERNAL FACILITATION
Authors: George Regina , Miranda Jacob , Snow A Lynn , Hilgeman Michelle , McCullough Megan , Hartmann Christine
Published: January 2025

Nursing home interventions are challenging to implement and sustain. Implementation scientists have identified facilitation as a strategy that impacts the success of an intervention. Facilitation is a complex and dynamic process that requires facilitators to develop expertise in a wide range of activities necessary to effectively support the implementation. There is limited understanding of how these activities are executed in a dynamic facilitation process. This understanding gap impacts training of facilitators and consequently, efficient delivery and sustainment of interventions. A qualitative analysis of the real-time interactions between implementation facilitators and recipient sites would contribute to our understanding of the practice of facilitation in nursing homes. In this study an expert external facilitator’s interactions with nursing home teams were recorded and the activities of the external facilitator (EF) were analyzed. Data comes from a pilot three-site pragmatic clinical trial of a complex quality improvement and sleep intervention for residents living with dementia in nursing homes. The intervention is based in relational coordination, person-centered care, and adult learning principles. EF largely took place in leadership team 30-minute coaching sessions via videoconference. Reflexive thematic analysis of 24 EF session transcripts is ongoing: preliminary code clusters include metacognition (connecting actions and impact), strategic compliments (praise that encourages specific action) and problem solving (connecting causes and developing individualized solutions). Transcripts provide real-world examples of EF activities. This project provides insight into the practice of facilitation and may inform training of implementation facilitators, thus increasing incorporation and sustainment of interventions in nursing homes.
LATE-LIFE OUTCOMES OF FEELINGS OF BELONGING THROUGHOUT THE LIFE COURSE
Authors: Briggs Emily , Smith Jacqui
Published: January 2025

Belonging is a fundamental human need that encourages fortitude throughout the life course. In the literature, belonging has been studied primarily from two perspectives: place attachment (Chawla, 1992, Scannell, 2021) and belonging within a social group (Allen, 2020). Less research, however, has been conducted about how belonging is experienced by the individual – self-perceptions of belonging. Using data from the Health and Retirement Study Life History Mail Survey (N=3,091, M Age =70.48 [50-98]) we investigated retrospective self-reports of belonging from three life stages, childhood, adolescence and midlife, as predictors of belonging and activity engagement in late life. First, we conducted linear regressions controlling for sociodemographic variables (gender, age, race, marital status). This revealed that self-reported feelings of belonging in childhood (β=.11, p<.001), adolescence (β=.13, p<.001), and midlife (β=.23, p<.001) were significantly predictive of heightened feelings of belonging in late life (Adj R2=.043,.051,.068). Second, we assessed self-reported belonging in childhood, adolescence, midlife and late life as predictors of late life engagement. These analysis revealed that belonging in childhood (β=.06, p<.001), midlife (β=.15, p<.001), and late life (β=.13, p<.001) were significantly predictive of heightened activity engagement in late life (Adj R2=.026,.037,.040). Overall this study demonstrates the importance of assessing how individuals think about their belonging retrospectively throughout their lifespan as a predictor of subsequent late-life belonging and activity engagement– both protective factors as a person ages.
ACT FOR OLDER VETERANS: TELEHEALTH-BASED ACCEPTANCE AND COMMITMENT GROUP THERAPY FOR OLDER VETERANS
Authors: Kelley Johnna , Dragan Deanna , Luci Katherine
Published: January 2025

Acceptance and Commitment Therapy (ACT) is a transdiagnostic intervention with promise for use with older adults due to its relevance to a variety of mental health conditions, overall well-being, and adjustment to life changes. This pilot study (n = 10) sought to demonstrate that a novel group therapy intervention for older adults, delivered via telehealth, is efficacious and acceptable to Veterans aged 60 years of age or older. Retention rates (10/10) and attendance (M = 12.7/16 sessions) of study completers suggest feasibility and acceptability of the group. Six participants demonstrated high engagement (attended ³ 12 sessions) and four demonstrated average engagement (attended 5-11 sessions). Participants completed a structured, post-intervention interview; feedback was analyzed for themes and generally supported acceptability of the intervention. Additional themes referred to participants’ experience of the virtual format, connections made with other group members, and areas for improvement. Finally, paired sample t-tests were conducted to analyze pre-post measures of anxiety, depression, loneliness, well-being, and engagement in meaningful activities. Outcome data suggests no statistically significant changes on these measures; however, the decrease in scores on a measure of depression reflects a small to moderate effect size (t(9) = 1.467, p =.18, d =.46). Future studies with larger sample sizes are needed to determine the impact of treatment engagement on these outcome measures. Overall, preliminary outcome data combined with qualitative feedback from participants, retention rates, and attendance rates, suggest that ACT delivered in a virtual group format is acceptable, feasible, and likely beneficial to older Veterans.
ASSOCIATION BETWEEN FUNCTIONAL LIMITATIONS AND SOCIAL ISOLATION AMONG PEOPLE WITH AND WITHOUT DEPRESSIVE SYMPTOMS
Authors: Zhong Chuwen , Mezuk Briana , Dang Linh
Published: January 2025

Functional limitations are prevalent among older adults with depression, and prior research suggests that social isolation can be an underlying mechanism. This study examines whether the structure of linkages between functional limitations and social isolation differs by the presence of cardinal depressive symptoms (dysphoria/anhedonia) using network analysis. Data came from the 2014/2016 Health and Retirement Study (n=7,270). Cardinal depressive symptoms were assessed using the Composite International Diagnostic Interview. Isolation (n=14 nodes) and functioning (n=16 nodes) were measured using multiple indicators (e.g., having a partner, balance test, feeling isolated, having difficulty dressing). We compared the centrality, network density, network structure, global strength, and correlation of edges between the networks of respondents who did vs. did not have cardinal symptoms of depression. Respondents who had depressive symptoms (n=628, 8.64%) were younger and more likely to be female. Compared to those without depressive symptoms, the network of those with depressive symptoms had a lower density of edges (ratio = 0.14 vs 0.20) and had different central nodes (lack of common peers vs difficulty taking medications, respectively). However, the network comparison tests showed that the two networks were similar in terms of correlation of edges (Pearson r = 0.81,p< 0.01), network structure (Network Invariance Test statistic = 1.82, p = 0.48), and strength (Global Strength Invariance Test statistics = 35.28, p = 0.79). Findings suggest that the network linkages between functional limitations and social isolation do not substantially differ as a function of cardinal depressive symptoms.
CHRONIC DISEASE, DEPRESSION, AND SUICIDAL IDEATION IN OLDER ADULTHOOD: THE ROLE OF INTERPERSONAL FACTORS
Authors: Dent Kallisse , Dang Linh , Kalesnikava Viktoryia , Mezuk Briana , Richmond-Rakerd Leah
Published: January 2025

Suicide risk increases in older adulthood, and new chronic-disease diagnoses can be a precipitating factor. Motivated by the interpersonal theory of suicide, we tested interpersonal constructs --thwarted-belongingness, perceived-burdensomeness, and hopelessness -- as mediators of associations of chronic-disease with depression and passive suicidal ideation (PSI). Data were from the Health and Retirement Study, a nationally-representative, longitudinal cohort of older adults. We identified incident chronic-disease diagnoses and changes in interpersonal factors over a four-year period (2010-2014 or 2012-2016). Depression and PSI were assessed two years later (2016 or 2018) using the Composite International Diagnostic Interview- Short Form. We measured thwarted-belongingness by social contact, positive and negative social support, loneliness, and community engagement; perceived-burdensomeness by activities of daily living (ADLs), instrumental ADLs, financial strain, number of helpers, and employment status; and hopelessness using a four-item scale. Statistical analyses accounted for complex survey design and adjusted for demographics, baseline health characteristics, and the outcome at baseline. Older adults with a newly diagnosed chronic-disease, relative to those without a new diagnosis, were at elevated risk for depression (odds ratio (OR)=1.34 [1.03-1.75]) and PSI (OR=1.63 [1.26-2.11]). They also experienced greater increases in thwarted-belongingness (β=0.11 [0.01-0.20]), perceived-burdensomeness (β=0.12 [0.06-0.15]), and hopelessness (β=0.07 [0.01-0.13]) following diagnosis. Accounting for these changes in interpersonal factors modestly attenuated associations of new chronic-disease diagnoses with depression and PSI. New chronic-disease diagnoses antedate depression and PSI, even within a population with pre-existing chronic-disease burden. Targeting interpersonal factors, including thwarted-belongingness, perceived-burdensomeness, and hopelessness, following incident chronic-disease diagnoses may modestly reduce depression and PSI risk.
INTEGRATED BEHAVIORAL AND PSYCHOLOGICAL INTERVENTIONS IN VHA COMMUNITY LIVING CENTERS
Authors: Page Kyle , Ryu HyeRim , MacDonald Elizabeth , Szymanski Benjamin , Curyto Kimberly , Karel Michele
Published: January 2025

Veterans Health Administration (VHA) Community Living Centers (CLC), or nursing home care settings, care for Veterans with high rates of mental illness and behavioral concerns. VHA requires the integration of psychologists on CLC teams and access to psychiatric services. An anonymous national survey of CLC mental health professionals aimed to characterize the status of CLC mental health practice, including intervention services. One hundred seven of 221 (48.4%) psychologists and psychiatric providers responded to the survey. Half or more of respondents reported these psychological interventions to be most helpful in the CLC: supportive therapy (76%), behavior therapy (75%), behavior management (66%), reminiscence/narrative therapy (65%), relaxation training (59%), cognitive behavioral therapy (54%), problem-solving therapy (52%), and motivational interviewing (50%). Respondents also identified barriers to utilizing Evidence Based Psychotherapies (EBPs) in the CLC, including Veteran cognitive impairment (57%), illness (48%), and preference for another form of intervention (32%). About a third (32%) reported offering group interventions. Respondents reported frequent collaboration with CLC team members in mental health interventions, most commonly by asking about their observations (76%), co-signing others on progress notes (71%), having them monitor signs and symptoms (68%), and many other strategies for team-based care. One third reported having regular, interdisciplinary behavior rounds and 67% reported that their teams used a team-based behavioral intervention (“STAR-VA”) for managing dementia-related behaviors. Findings suggest a wide range of mental health intervention practice patterns in the CLC, the importance of team engagement, and opportunities for additional clinical and training resources.
INTEGRATION OF PSYCHOLOGICAL ASSESSMENT SERVICES IN VHA COMMUNITY LIVING CENTERS
Authors: Page Kyle , Ryu HyeRim , MacDonald Elizabeth , Szymanski Benjamin , Curyto Kimberly , Karel Michele
Published: January 2025

Psychologists embedded in Veterans Health Administration (VHA) Community Living Centers (CLC), or nursing home care settings, serve a crucial role in providing neurocognitive, clinical capacity, suicide risk and other evaluation services for residents with medical, psychiatric, and cognitive comorbidities. An anonymous national survey of CLC mental health professionals aimed to characterize the status of CLC mental health practice, including psychological assessment services. Eighty-two percent of respondents were psychologists (n=88). The majority (92%) do not complete portions of the Minimum Data Set (MDS) assessment. Reported practice varied regarding use of brief cognitive tests, with 57% using these tests when a resident they are following exhibits dementia warning signs. Focused or expanded cognitive testing batteries were conducted by the majority (75%), with 26% of respondents conducting them at least monthly. Eighty-seven percent of respondents reported that their cognitive evaluations had some to great impact on informing treatment plans. The large majority (94%) reported conducting medical decision-making evaluations at least sometimes, and at least half reported evaluating other decision-making or functional capacities. At the same time, a significant minority of psychologists reported that additional training regarding neurocognitive (27%) and capacity (46%) evaluations would be helpful. The majority (85%) indicated that, if the suicide risk screening upon admission to the CLC was positive, the psychologist typically completed a comprehensive suicide risk evaluation. Findings highlight the extent and importance of psychological assessment services to inform person-centered treatment planning for Veterans with complex care needs, pointing to areas of resource development to support these evaluation practices.
THE RELATIONSHIP BETWEEN VOLUNTEERING AND SUBJECTIVE WELL-BEING AMONG OLDER ADULTS IN JAPAN
Authors: Fujita Koji , Yokoyama Yuri , Nishi Mariko , Matsunaga Hiroko , Fujiwara Yoshinori
Published: January 2025

The aim of this study is to examine the relationship between the frequency of volunteer activities among older adults and their subjective well-being. We mailed a questionnaire survey to 354 people aged 60 and over who belonged to volunteer organizations registered with a social welfare council within Saitama Prefecture. We received 235 responses for a response rate of 66.4%. Out of 215 participants, we excluded non-consenting and invalid responses, and subsequently analyzed the responses of 204 participants. We categorized these participants into three groups by frequency of volunteer activities: high activity, low activity, and non-activity. We performed a Kruskal-Wallis test with a multiple comparison test on the WHO–Five well-being index (range: 0-25 points). The high activity group accounted for 45.6% (n = 93), the low activity group for 35.8% (n = 73), and the non-activity group for 18.6% (n = 38). A significant difference was observed among the three groups in the WHO–5 (p=.013); the non-active group had the lowest mean score, while the high-activity group had the highest mean score. According to the multiple comparison test, this difference between the high and low activity groups was significant (p=.013). More frequent participation in volunteering among older adults is associated with higher subjective well-being. Volunteering may help maintain the physical and mental health of older adults and can reduce social isolation and loneliness. Therefore, participating in volunteer activities may help older adults to maintain and improve their mental health and subjective well-being.
THE ROLE OF GENDER IN THE RELATIONSHIP BETWEEN VIOLENCE EXPOSURE AND PSYCHOLOGICAL DISTRESS IN MIDDLE AGE
Authors: Iktilat Khalil , Isacson Michal , Tzemah-Shahar Roy , Agmon Maayan
Published: January 2025

Middle age is a critical period in the lifecycle, with unique dynamics in men and women respectively. It represents a sensitive window for health prevention that can improve the aging process. To date, it remains unclear how environmental factors, like exposure to violence, influence psychological distress in this age group. In other age groups, women were observed to develop heighter distress than men following violence exposure. Here we aim to examine this gender-specific association between levels of exposure to violence and psychological distress in a population of middle-aged Muslims in Israel, who have been exposed to increasing violence in the past decade. A cohort of 363 middle-aged adults (223 women) from three Muslim villages in northern Israel was recruited. Psychological distress was assessed by the Kessler 6 Psychological Distress questionnaire, and violence exposure was assessed by the Screen for Adolescent Violence Exposure (SAVE) questionnaire. We controlled for age, sex, education level, and socioeconomic status using multivariate linear regression models with post-hoc models for each gender separately. Middle-aged males reported significantly greater exposure to violence whereas women reported significantly heightened psychological distress levels. A positive link between exposure to violence and psychological distress (β=0.145, p=0.017) was found using a multivariate model, and sex was a significant covariate (β=0.132, p=0.045). Post-hoc modelling revealed that this relationship was only significant among women (β=0.160 p=0.041). Our findings demonstrate that middle-aged women are at risk for violence-associated psychological distress. This research provides evidence for gender-based prevention and intervention programs.
THE SALUTOGENIC EFFICACY OF THE VOICE-ACTIVATED INTELLIGENT PERSONAL ASSISTANT INTERVENTION: A CASE STUDY
Authors: Lau Terence , Leung Angela
Published: January 2025

Existing Parkinson’s disease (PD) interventions are primarily focused on physical rehabilitation and pathogenic-based. The lack of positive, health-orientated psychosocial interventions prompted the research team to develop a salutogenic VIPA user protocol and examine its preliminary efficacy through an 8-week pilot RCT. This case report selected the participants with the largest sense of coherence-13 item scale (SOC-13) improvement to explore their user experience through the salutogenic perspective. A 32-minute face-to-face, post-intervention semi-structured interview adopting the interpretive descriptive approach was conducted on 31st Jan, 2024. The interviewee was a 63-year-old male, level 3 Hoehn and Yahr Scale with 2 years of PD history, documenting a 100% compliance rate and a 16-point improvement in SOC-13 across all comprehensibility, manageability, and meaningfulness subdomains. The transcripts were coded deductively through thematic analysis referencing the salutogenesis and psychosocial well-being framework. Written consent was signed before the research, and the participant agreed to be audiotaped during the interview. The encyclopedia-like features within VIPA facilitated participants’ comprehensibility by retrieving desired online information. On manageability and psychological well-being, the participant metaphorically described the VIPA intervention as an electric wheelchair for physically disabled people to that of people with Parkinson’s Disease (PWP). Thus, the intervention could benefit the autonomy and environmental mastery domain within psychological well-being alongside the manageability domain. For meaningfulness, the participant further elaborated the VIPA intervention could minimize the difference between PWP and other citizens. The salutogenic-based VIPA intervention can contribute a salutogenic force, lessening the effect of constantly deteriorating PD progression experienced by PWP.
“OUR ELDERS LOVE WHEN WE MAKE THE BUFFALO DINNERS AND SOUP”: TRADITIONAL FOODS AND TITLE VI NUTRITION PROGRAMS
Authors: Wilson Traci
Published: January 2025

Title VI Native American Aging Programs (Title VI programs), funded by Title VI of the Older Americans Act, support the health, wellness and social engagement needs of Native elders by providing nutrition, supportive services and caregiver supports to American Indian, Alaska Native and Native Hawaiian people. There are over 290 Title VI grantees, representing a diverse group of more than 400 tribal nations. Title VI programs provide culturally-relevant services to address the health-related social needs of elders, such as meals, transportation, in-home services, social engagement opportunities, and family caregiver supports, helping to ensure that elders can continue to live in their homes and communities as long as possible. A large portion of Title VI funding is allocated to nutrition programs, including congregate and home-delivered meals. Every three years, USAging, with funding from the Administration for Community Living, surveys Title VI directors about their program funding, staffing, services, and unmet needs. The most recent survey, conducted in late 2023 with an 80% response rate, included a new module on if and how Title VI nutrition programs incorporate traditional foods. This poster will describe the prevalence and types of traditional foods in OAA Title VI nutrition programs, involvement of elders in providing recipes and passing on knowledge, and the challenges and successes Title VI programs have when sourcing and incorporating traditional foods into their nutrition programs.
CONCEPTUALIZING BLACK FEMINIST-WOMANIST GERONTOLOGY
Authors: Wallace Brandy , Ford Cassandra , Baker Tamara
Published: January 2025

There is a long history documenting Black women being particularly vulnerable to negative implicit and/or explicit behaviors, which marginalizes their social positioning and puts them at an increased risk of feeling powerlessness, and physically and emotionally stressed. This has created a chasm, particularly between this group and the healthcare industry - resulting in poorer health outcomes across generations of Black women. Recent scholarship has questioned the lack of culturally responsive, theory-guided research addressing the connections between aging, Black womanhood, and what is needed to advance health equity. Models that utilize traditional theories of aging often do not account for cultural context that undergirds the aging experience specifically among Black women. To understand the ways in which Black women thrive, we must consider various approaches that define their well-being. Dichotomizing aging into concrete categories as healthy/unhealthy may unintentionally isolate this group where aging successfully presents as a contradiction, thus perpetuating further marginalization. It is important that scholarship and intervention projects reflect cultural humility in dissemination. Applying Black-Feminist-Womanist methods in gerontology provides a curation of thought that creates a foundation by which Black women survive, live, and age, despite the ‘gold standard’ of aging being dominated by white ethnocentric context that pathologizes older Black women’s lived experiences. In this presentation, we summarize the principles and methodological approaches of Black Feminist and Womanist perspectives and use them to conceptualize “Black Feminist-Womanist Gerontology,” a culturally relevant model for older Black women. Factors of the model and recommendations of its use will be discussed.
DISCRIMINATION AND COGNITIVE HEALTH DISPARITIES AMONG OLDER AMERICANS: A FOCUS ON NATIVITY AND RACE/ETHNICITY
Authors: Wang Yi , Guo Man , Shen Huei-Wern , Stangl Morgan
Published: January 2025

Discrimination, characterized by unfair or prejudicial treatment based on perceived differences, has been identified as a significant stressor with potential detrimental effects on cognitive health in the aging population. Disproportionately experienced by immigrants and racial/ethnic minorities, discrimination can exacerbate existing health disparities. Using data from the 2016 and 2018 Leave-Behind Questionnaire of the Health and Retirement Study (N=9,440), this study aims to examine 1) What is the associations between discrimination and cognitive health (global cognitive functioning score), and whether such relationships vary by nativity (US born: yes/no)? 2) Does race/ethnicity (White, Black, Hispanic) moderate the above relationships? and 3) Do contextual resources (neighborhood social cohesion, social support from family and friends) and activity engagement (volunteering, cognitively stimulating activities) serve as protective factors for cognitive health in the face of discrimination? Results from linear regression models revealed that discrimination is negatively linked to cognitive health and this relationship is stronger for immigrants than non-immigrants. Across nativity and race/ethnicity groups, only Hispanic immigrants reported a significantly lower cognitive score (in comparison with U.S. born Whites) when facing higher levels of perceived discrimination. As for protective factors, both activity engagement indicators were associated with higher cognitive scores among immigrants. These findings emphasize the heightened vulnerability of immigrant populations, particularly Hispanic immigrants, to the negative effects of discrimination on cognition. The protective factors, such as volunteering and engaging in cognitively stimulating activities, highlights avenues for intervention and support to mitigate the adverse consequences of discrimination on cognitive health among older immigrants in the U.S.
DISPARITIES IN TYPE 2 DIABETES ONSET AMONG MIDLIFE AND OLDER ADULTS IN THE US: A FOCUS ON NATIVITY AND RACE/ETHNICITY
Authors: Asiedu Charlotte , Davey Adam
Published: January 2025

Type 2 Diabetes Mellitus (T2DM) disproportionately affects midlife and older adults in the US and globally and is marked by significant disparities across certain nativity groups (foreign-born, native-born, and second-generation immigrants (SGI)). While previous research has predominantly focused on diabetes prevalence across racial groups, there exists a significant gap in understanding how this disease prevalence and onset may differ based on immigration status and nativity. This study utilized data from a nationally representative sample of the California Health Interview Survey (CHIS, 2003–2022) to understand disparities in the onset of diabetes among midlife (45–64) and older adults (65+) in the US. Survey-weighted analyses suggested an association between nativity and age of diabetes onset (early, mid-life, and late). The study sample, N = 200,730, comprised 42.35% males and 57.65% females within ages 40-85+. The overall survey-weighted chi-square tests revealed a statistically significant association between nativity and diabetes onset (p < 0.001). Foreign-born adults had the highest prevalence of diabetes (15.1%), followed by SGI (13.3%). Foreign-born adults were also more likely to have received their diabetes diagnosis before age 40 (23.1%, P< 0.001) followed by SGI (20.9%, p< 0.001). Native-born adults were more likely to receive their diagnosis after age 60 (30.5%) compared to SGI (29.7%) and foreign-born adults (21.8%). Findings highlight disparities in T2DM prevalence and onset by nativity. The study underscores the necessity for further research on the socioeconomic, biological, psychological, cultural, and behavioral determinants of these disparities to inform targeted policies and interventions.
MARKETING ISN’T MAGIC: HOW ALTER LEVERAGED THESE BEST PRACTICES TO INCREASE RECRUITMENT AND RETENTION
Authors: Epps Fayron , Suggs Andy
Published: January 2025

Dementia-Friendly Faith Villages was launched in 2018 to address the lack of resources and awareness of dementia in African American and faith communities in the State of Georgia. The program struggled to meet recruiting, retention, and program goals in its inaugural year. In response to less-than-desirable progress, the principal investigator partnered with Reckon Branding to define a messaging focus for the program that better connected with each of its key audiences: Church leaders, caregivers, and partner programs within their space. Considering 71% of customers recommend a brand based on their emotional connection to it, Reckon knew they had to tell a story that extended beyond facts and figures. The program was provided with a new verbal and visual focus through internal ideation sessions, audits of competitive programs, and external interviews of Church leadership and caregivers of those with cognitive impairments. Armed with the more memorable name ALTER, a new logo, and more consumer-friendly marketing materials, the team was able to secure 83 partnerships over the next 4 years. This strategic pivot has helped ALTER exceed its partner goals by over 300% and empowered the program to develop consistently impactful marketing materials, which provided improved recruitment reach, increasing the participants from 7,500 to more than 100,000. Thanks to this success, ALTER has extended its reach from Georgia, to many more African American communities of faith across 14 states.
PREDICTORS OF LIVER FUNCTION AMONG MEXICAN AMERICAN WITH DISABLING ARTHRITIS
Authors: Harrison Tracie , Villareal Shelley Blozis , Hunter Heather
Published: January 2025

In this secondary analysis of data from our recent biobehavioral study of Mexican American men and women with disabling arthritic conditions, we analyzed the relationships between mental health predictors, inflammation and liver enzymes, after controlling for age and sex. Consistent with the theoretical paradigm evaluating the prevalence and impact of diseases of desperation, the relationships between grief, anxiety, depression, inflammation (c-reactive protein, CRP) and liver function (Serum glutamic oxaloacetic transaminase (SGPT)) were analyzed. The 67 men (N=18) and women (N=46) 46-83 years of age (age M=62.4 years) were primarily unemployed (55%), married (43%) and high school graduates (36%). Participants were community residing and recruited through flyers, word of mouth, and known key informants. After IRB approval, surveys and blood samples were collected in homes and then analyzed. Results using Pearson correlations with reliable measures indicated significant relationships between SGPT and CRP (r=.46, P< 0.01), SGPT and anxiety (r=.365, p<.01), SGPT and depression (r=.34, p< 0.02), and SGPT and grief (r=.30, p<.04). Using a regression analysis, after controlling for age and sex, mental health (anxiety, depression, and grief) explained an additional 16% (R2 change =.16, F = 2.4, p =.08) of the variance in liver enzymes. This study was limited to a small sample size. In conclusion, psychological variables may influence physiological outcomes in Mexican Americans aging with severe arthritis, and further research is needed on mental health needs among Mexican Americans aging with disability in the community setting.
UNRAVELING THE THREADS OF DEMENTIA PERCEPTION AMONG OLDER ASIAN INDIAN IMMIGRANTS IN THE UNITED STATES
Authors: Neelamegam Malinee , Patil Shilpa , Nhpang RoiSan , Griner Stacey
Published: January 2025

The Asian Indian (AI) population, the second-largest immigrant group in the US, includes a substantial proportion aged 50 and older. Despite facing cognitive risks, they’re underrepresented in aging research. Our study delves into dementia perceptions among older AI immigrants in the US. We conducted in-depth interviews with 12 Asian Indian immigrants aged 50 and above in the Dallas-Fort Worth Metroplex. Guided by a semi-structured interview guide, we explored their perceptions of dementia and aging in the US. Thematic analysis, utilizing both predetermined and emerging codes, was employed to analyze the data. Of the participants, the majority were women (n=21), with an average age of 68.9 years (SD=5.3) and an average length of stay in the US of 35.1 years (SD=13.1). Alarmingly, there was a notable lack of awareness regarding cognitive aging and dementia. Emerging themes included concerns about the financial burden of screening and treatment, societal acceptance, and access to support services. Moreover, participants’ immigration journeys significantly influenced their social networks and caregiving choices as they aged. Addressing the expense of care, enhancing caregiving resources, and addressing the low awareness of brain health among older AI immigrants in the US are crucial focal points for future research. These findings can inform culturally tailored initiatives and interventions aimed at dementia and aging within South Asian communities.
EXPLORING MEDICATION CONVERSATIONS IN NURSING HOME CARE CONFERENCES: A QUALITATIVE STUDY
Authors: Ku Te-Lien , Li Jingxi , Ford James , Roberts Tonya
Published: January 2025

Care conferences (CCs) represent a structured opportunity for nursing home (NH) staff, residents, and families in collaborative discussions about medication care planning, a fundamental component ensuring resident disease management and safety. Yet, how medication issues are addressed within CCs remains unexplored. This study aimed to describe how medications were discussed and who discussed them through a convenience sample of naturally observed CCs (n=15) in a 40-bed, nonprofit, short-stay, Midwestern NH. Observations were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. CCs lasted 20 to 55 minutes each (mean=36 minutes). The number of attendees in CCs ranged from 5 to 15, with 6 being the most frequent (33.3%). Of these, 14 CCs (93%) involved medication conversations. A variety of staff attended CCs; however pharmacists were absent. Social workers and registered nurses were primarily engaged in medication conversations. Residents and families typically participated passively. Medication conversations centered around three main themes: (1) Information Seeking and Sharing—unifying participants’ understanding regarding current medication and offering opportunities for consultation; (2) Decision Making—negotiating and making decisions about adding, changing, or stopping the resident’s medication during NH stay; and (3) Discharge Planning—confirming the continuity of the resident’s medication post-discharge and navigating access to managing medication resources. The findings of this study could enhance our understanding of how medications-related discussions are conducted during CCs in NHs. Future studies can further identify the different professional roles of NH staff in medication care planning according to residents’ and families’ needs, and explore the inclusion of pharmacists in CC.
BODY COMPOSITION CHANGE AND PHYSICAL FUNCTION AFTER INTENSIVE BEHAVIORAL WEIGHT LOSS INTERVENTION
Authors: Chae Kacey , Bettencourt Amie , Houston Denise , Simonsick Eleanor , Ferrucci Luigi , Kalyani Rita , Clark Jeanne , Gudzune Kimberly
Published: January 2025

The LookAHEAD trial, an RCT of adults with obesity and diabetes, has demonstrated weight loss (WL) efficacy through intensive lifestyle intervention (ILI), but also a decline in lean mass (LM) after ILI. One potential concern with LM reduction is worsening physical function (PF), particularly among older adults. Our study objective was to evaluate the change in PF across different categories of body composition changes during ILI. We conducted a secondary analysis within the LookAHEAD trial, among ILI participants with dual-energy X-ray absorptiometry (DXA). The independent variables were 1). percent WL, 2). percent FM change, and 3). percent appendicular lean mass (ALM) change at 12 months (12M). The dependent variable was the change in self-reported PF at 12M, measured by the SF-36 (higher scores indicating better PF). At baseline, 628 participants (63% women) had mean age 58.3 years (SD 6.7), weight 96.1 kg (16.8), FM 39.8 kg (10.7), ALM 22.9 kg (5.1), and PF score 81.5 (17.6). Mean WL was 9.2% (6.3); PF scores increased in the WL ≥10% and 5-9.9% groups. Mean change in FM was -14.8% (11.7); PF scores increased in the high FM-loss, moderate FM-loss, and low FM-loss groups [high-loss vs. low-loss (p=0.02); high-loss vs. gain (p=0.04)]. Mean change in ALM was -4.8% (4.9); PF score increased in the high ALM-loss, moderate ALM-loss, and low ALM-loss groups, but the between-group differences were not significant (p=0.06). Results suggest that LM loss does not necessarily contribute to PF declines; FM loss may be a greater contributor to PF improvement.