bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ACHIEVE RANDOMIZED TRIAL: EFFECT OF HEARING LOSS INTERVENTION ON COGNITIVE DECLINE IN OLDER ADULTS
Authors: Deal Jennifer
Published: December 2023

Hearing loss in older adults is linked to accelerated cognitive decline and incident dementia in population-based observational studies; whether intervention can reduce cognitive decline is unknown. The multi-center NIH-funded ACHIEVE randomized controlled trial is testing efficacy of a best-practices hearing intervention (amplification and rehabilitation) versus a successful aging health education control intervention, on 3-year cognitive decline in 977 dementia-free adults aged 70-84 years with untreated mild-to-moderate hearing loss. This presentation will describe results for the primary outcome of 3-year cognitive decline, measured using a 10-item neurocognitive battery summarized using latent variable methods. Secondary outcomes include (1) domain-specific cognitive declines in memory, language and executive function and (2) time until cognitive impairment defined as a composite of adjudicated dementia or mild cognitive impairment diagnosis, a 3-point drop in the 30-item Mini-Mental State Exam (MMSE) administered in-person, or a 3-point drop in a factor score derived from the 10-item MMSE orientation subscale and 11-item Blessed scale administered over the phone and rescaled to be equivalent to the 30-item MMSE. The trial is ongoing with data closeout March/April 2023; data will be analyzed per the ACHIEVE Coordinating Center statistical analysis plan, approved by the NIA and ACHIEVE DSMB. Although preliminary results are not possible to include here to protect trial integrity, results will be available to present for GSA. ACHIEVE is the first large-scale randomized study to determine if hearing loss intervention reduces cognitive decline. Whether findings are positive or null, this study will have substantial clinical and public health impact.
EFFECT OF HEARING INTERVENTION ON SOCIAL FUNCTION, DEPRESSION, AND HEALTH-RELATED QUALITY OF LIFE IN OLDER ADULTS
Authors: Huang Alison
Published: December 2023

Prior observational studies show associations between hearing loss and worse social and mental health among older adults. Whether hearing loss treatment is an effective intervention is unknown. The Aging and Cognitive Health Evaluation in Elders Study (ACHIEVE) randomized controlled trial (n=977) tests the effect of a best-practices hearing intervention vs. successful aging health education control intervention on pre-specified exploratory outcomes including social isolation (Cohen Social Network Index), loneliness (UCLA Loneliness Scale), depressive symptomology (11-item Center for Epidemiologic Studies Depression scale), and health-related quality of life (RAND-36 Health Survey). Generalized linear mixed effects models test if 3-year change in social and mental health outcomes differ by intervention assignment. Participants have untreated hearing loss and are 70-84 years, 88% White, 54% female, and 53% had a Bachelor’s degree or higher. At baseline, prevalence of loneliness was higher among those with moderate or greater (69%) compared to mild (64%) hearing loss. Physical health-related quality of life was lower among those with moderate or greater (mean[standard deviation(SD)]: 44[10]) compared to mild (46[9]) hearing loss. Prevalence of depression (4%), social network characteristics (e.g., mean(SD) social network size: 22[11] members), and mental health-related quality of life (mean(SD): 56[7]) were similar by hearing loss severity. This presentation focuses on hearing intervention effects and results will be available by the time of the conference (data collection ends early 2023). Existing interventions for improving social and mental health are limited in effect size and scalability. Hearing treatment may be an effective intervention with potential for greater widespread implementation.
DEMENTIA CARE PARTNERS’ ANXIETY, DEPRESSION, AND BURDEN AT HOSPITAL DISCHARGE
Authors: Kuzmik Ashley
Published: December 2023

At the time of hospital discharge, family care partners are typically planning to deal with the increased care dependency and medically complex needs of the person living with dementia. Consequently, they experience compounded stress to their psychological wellbeing. This study examined patient and care partner factors associated with family care partners’ anxiety, depression, and burden when caring for patients with dementia at hospital discharge. The sample consisted of 434 patient and care partner dyads enrolled in the Family centered Function-focused Care (Fam-FFC) study. Multiple regression analyses were conducted to examine factors associated with care partners’ anxiety (Hospital Anxiety and Depression subscale anxiety; HADS-A), depression (Hospital Anxiety and Depression subscale depression; HADS-D), and burden (Short Form Zarit Burden Interview; ZBI-12). Care partner anxiety was associated with higher levels of patient behavioral and psychological symptoms of dementia (BPSD; β=.13; p = <.001). Care partner depression was associated with cohabitation (β=1.30; p = <.001), and patient factors including increased BPSD (β=.17; p = <.001) and lower function (β=-.03; p = <.001). Care partner burden was associated with care partner relationship with patient (adult child; β=-.27; p = .02) and higher patient BPSD (β=.67; p = <.001). Findings suggest the need to incorporate the functional and behavioral status and needs of the patient when preparing the care partner for discharge, which may be especially critical if the patient is discharged to the care partner’s residence.
LOWER INCOME IN CAREGIVERS PREDICTS LESS EMOTIONAL WELL-BEING IMPROVEMENT AFTER CAREGIVING ENDS
Authors: Scheffer Julian , Yee Claire , Wells Jenna , Chen Yuxuan , Heath Diana , Levan Darius , Merrilees Jennifer , Levenson Robert
Published: December 2023

Lower income in familial caregivers has been shown to associate with increased distress, depression, and burden during active caregiving. However, findings are less clear on whether lower income associates with changes in well-being that occur after caregiving ends. To investigate this question further, we recruited familial caregivers (CGs) of people with neurodegenerative diseases (PWD; N=36). Emotional well-being was assessed using the SF-36 Emotional Well-being and Energy scales both during active caregiving and after caregiving had ended (predominantly due to the PWD’s death or transition to institutional care, ~10 years later). Household income was measured after active caregiving had ended. Overall, CG’s emotional well-being and energy improved between active caregiving and after caregiving had ended (emotional well-being change: t(35) = 2.22, p = .033; energy change: t(35) = 2.88, p = .007). However, this improvement associated with household income, such that when controlling for levels during active caregiving, income associated with worse emotional well-being (B = -6.72, t(33) = -4.56, p < .001) and energy (B = -8.07, t(33) = -4.99, p < .001) in caregivers after caregiving had ended. During the adjustment period after caregiving ends, lower income may limit opportunities for caregivers to take time away from work to mourn the loss of their loved one or address their own health concerns adequately. Thus, low-income caregivers may experience fewer of the benefits associated with these activities. These findings underscore the importance of providing support for lower income caregivers during the critical period after caregiving ends.
NEURODEGENERATION BIOMARKERS HELP EXPLAIN ASSOCIATION BETWEEN INFLAMMATION AND COGNITIVE DYSFUNCTION
Authors: Klopak Eric T , Crimmins Eileen M
Published: December 2023

There is past evidence that immune aging (or immunosenescence) and high systemic inflammation are associated with cognitive dysfunction and ADRD. However, it is unknown whether these immune-related aging processes are associated with neurodegeneration, tauopathy, amyloid accumulation, and/or vascular issues in the brain.

To address this gap, we utilized a set of recently assayed highly innovative markers of neurodegeneration, biomarkers of inflammation, and proportions of naïve lymphocytes (indicative of less immune aging), and cognitive dysfunction (errors on the Telephone Interview for Cognitive Status) in the Health and Retirement Study, a nationally representative sample of US adults over age 50 (N = 3985).

Using structural equation modeling (SEM), we estimated latent factors representing neurodegeneration (neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and phosphotau 181 (pTau181)), inflammation (c-reactive protein, IL10, IL1 receptor agonist, IL6, TNF receptor 1, albumin, and percentage of neutrophils), and immune aging (percentages of naïve CD8+ and CD4+ T cells). Results indicate inflammation is associated with neurodegenerative biomarkers (β = .31, p < .001) and with cognitive dysfunction (β = .08, p < .001) after controlling for age, race, gender, education, BMI, smoking, drinking, and immunosenescence. Neurodegenerative biomarkers mediated about half of the association between inflammation and cognitive dysfunction.

It appears that greater systemic inflammation may be associated with brain damage and tauopathy. Interventions focused on reducing systemic inflammation may be successful in reducing neurodegeneration and cognitive dysfunction in older adults.
ADVANCING FOOD EQUITY AMONG OLDER ADULTS AND ADULTS WITH DISABILITIES IN THE US
Authors: Samuel Laura , Kim Boeun
Published: December 2023

Older adults and adults with disabilities face challenges related to food insecurity, defined as limited or uncertain access to adequate food due to economic and social conditions. Adults with disabilities have triple the risk of food insecurity than their peers and rates of food insecurity have been rising over the past two decades among older adults and food insecurity is known to be a risk factor for numerous adverse health outcomes. Despite knowledge of disparities, research is needed to identify and test strategies for addressing food insecurity disparities. This symposium will examine mechanisms that may contribute to food insecurity, including local food environments, vision impairment and access to the Supplemental Nutrition Assistance Program, which is the largest food assistance program in the U.S.. National data is used in all three studies to allow population-based inferences to be drawn from study findings. Results have potential to inform our understanding of food equity and advance data-driven policy and programmatic decisions.
COMPOUNDING WEAKNESS IS ROBUSTLY ASSOCIATED WITH COGNITIVE FUNCTIONING
Authors: McGrath Ryan , Parker Kelly , Hamm Jeremy
Published: December 2023

Muscle strength has been linked to cognitive functioning, but the utility and discernment of absolute and normalized weakness cut-points for identifying persons at greater odds of poorer cognitive functioning has not yet been examined. We sought to determine whether being weak under multiple definitions was associated with greater odds of cognitive dysfunction. The analytic sample included 17,980 Americans ≥50-years (age: 64.8±10.0 years) from the 2006-2018 waves of the Health and Retirement Study. A handgrip dynamometer measured handgrip strength and the highest recorded measurement was included in the analyses. Sex-stratified absolute, body mass normalized, and body mass index normalized weakness cut-points were used. Individuals were categorized as having weakness under 0, 1, 2, or 3 cut-points. Persons with scores ≤11 on the Telephone Interview of Cognitive Status had any cognitive impairment, while those scoring ≤6 had a severe cognitive impairment. Separate covariate-adjusted multilevel logistic regression models were used for analyses. Persons classified as weak using 2 cut-points had 1.17 (95% confidence interval (CI): 1.02-1.35) greater odds for future any cognitive impairment. However, for those below all 3-weakness cut-points, the magnitude of the odds ratios elevated to 1.68 (CI: 1.44-1.94) and 1.74 (CI: 1.73-2.21) for future any and severe cognitive impairment, respectively. Being below more weakness cut-points increased the odds for cognitive dysfunction, which suggests combining definitions may better identify persons more at-risk for future cognitive impairment. Engaging in modifiable lifestyle behaviors that are conducive to preserving strength and maintaining a healthy body mass during aging may have implications for cognitive function.
BRINGING ART TO LIFE: EXPERIENTIAL LEARNING OUTCOMES WITH GRADUATE AND UNDERGRADUATE STUDENT LEARNERS
Authors: Allen Rebecca , Carden Keisha , Reel Candice , Potts Daniel
Published: December 2023

The University of Alabama experiential learning program, Bringing Art to Life (BATL) pairs teams of undergraduate students with persons with dementia attending an adult day services program and engaging in structured art therapy and reminiscence. Graduate students in clinical geropsychology work with an interdisciplinary team and conduct outcomes research focused both on individuals with dementia and student learners. Across seven semesters, we found that students in the BATL course compared with students in either didactic psychology of aging courses or an introductory psychology courses demonstrated improved attitudes towards persons with dementia and increased empathy. Graduate and undergraduate students learned mixed method and community-engaged research methods, producing clinically meaningful research. Experiential learning is essential to the recruitment of a new gerontology workforce.
THE ROLE OF WISDOM IN ADAPTING TO LATE-LIFE SPOUSAL LOSS
Authors: Cogdill-Richardson Kiana , Bluck Susan
Published: December 2023

Death of one’s spouse is normative but one of life’s most challenging events (Carr et al., 2001). Wisdom involves compassion, tolerance for uncertainty and reflection, so may be particularly useful in dealing with spousal loss. Past research has related personal wisdom to well-being and life satisfaction in general (Ardelt, 2019). Almost no research, however, has examined wisdom as a resource in the context of bereavement. We (1) expected that higher wisdom would predict better grief adaptation in widowed older adults and, (2) explored whether wisdom effects might be moderated by older adults’ physical status. Participants (N = 54, Mage = 81; SD = 7.57, 62.3% female) completed the Brief Wisdom Screening Scale (Glück et al., 2013) and two assessments of grief adaptation: Inventory of Complicated Grief (Prigerson et al., 1995) and Integration of Stressful Life Experiences (Holland et al., 2011). Hierarchical regression, F(2, 51) = 4.25, p <.05, showed greater wisdom, β = -.27, t(52) = -2.061, p < .05 and higher physical functioning (β = -.27) both predict lower symptoms of complicated grief, with no moderation. A second regression, F(2,51) = 4.44, p < .055, showed a similar trend with greater wisdom associated with better integration of loss, β = .46, t(52) = 1.96, p = .055. Though preliminary, these findings suggest wisdom may serve as a resource for individuals facing loss in later life. Results are discussed in terms of theoretical models (Glück & Bluck, 2013) identifying reciprocal relations between wisdom development and life challenges.
PHYSICAL ACTIVITY AND THE DEVELOPMENT OF DEMENTIA BETWEEN AGES 70 AND 95
Authors: Stessman-Lande Irit , Stessman Jochanan , Jacobs Jeremy
Published: December 2023

Whilst the protective effects of physical activity (PA) on cognitive function are well documented, it remains unclear if the preventive effect continues irrespective of advancing age. This study examines the association between physical activity and subsequent dementia between ages 70-95. The Jerusalem Longitudinal Study (1990-2023) prospectively follows a representative community-dwelling cohort born 1920-21, assessed at home visit during 1990,1998, 2005, 2010, 2015 at ages 70, 78, 85, 90, and 95 (n=430, 715, 1136, 660, 492) respectively. Comprehensive assessment included Mini Mental State Examination (MMSE) defining dementia (≤23/30), and PA assessment, dichotomized to Active (PA-A) (>4hours a week) versus Sedentary (PA-S) (< 4 hours weekly). Logistic regression analyses determined Odds Ratios (OR) for developing dementia, adjusted for baseline MMSE, gender, education, depression and BADL. At ages 70, 78, 85, 85, 90, and 95 the frequency of PA-A was 45.9%, 69.7%, 48.7%, 9.5%, 11.9%; and frequency of dementia among PA-A vs. PA-S was 1.7% vs. 5.0%, 1.7% vs. 12.6%, 10.6% vs. 48.5%, 8.6% vs. 35.5%, 18.3% vs. 29.9% (all p< 0.0001 except age 70 due to small numbers) respectively. Adjusted ORs ratios among PA-A at baseline for subsequently developing dementia between ages 78-85, 85-90, 90-95 were: OR 0.44 (95%CI 0.20-0.98); OR 0.52 (95%CI 0.30-0.90); OR 0.37 (95%CI 0.13-1.07) respectively. Our findings show that physical activity is associated with reduced development of dementia throughout follow-up between ages 70-95, and support the hypothesis that there is no upper age-limit to the beneficial effects of PA on cognition.
AGING IN PLACE IN THE RURAL SOUTH
Authors: Nix Caitlyn
Published: December 2023

Aging in place in the rural south involves regionally unique concerns. Understanding the interaction between factors such as geographical isolation, smaller communities, and access to resources is critical for researchers, as results from research in urban areas may not generalize to this population. This symposium will outline regional barriers and protective factors related to aging in place from researchers in a distinctly rural area in the deep south. The symposium will begin with a discussion from Darby Mackenstadt on person-environment fit in a sample of older adults from Mississippi, with an emphasis on predictors of health status such as access to grocery stores and level of education. Carolyn Adams-Price will then review results from qualitative research on older adults’ self-reported attachment to home and local communities in rural Mississippi. Finally, Mary Dozier will give an overview of excessive household clutter as a barrier to maintaining functional independence for older adults enrolled in treatment studies for hoarding disorder in the state of Mississippi.
THE ASSOCIATION BETWEEN JOB COMPLEXITY AND COGNITIVE FUNCTION IN LATER LIFE ACROSS RACIAL/ETHNIC GROUP
Authors: Cao Katy (Qiuchang) , Carr Dawn , Carpenter Rebekah
Published: December 2023

The health of older Black and Hispanic populations are disproportionately impacted by cognitive decline later in life. Although cognitive stimulation through work protects against cognitive decline and dementia in later life, Black and Hispanic individuals have less access to cognitively stimulating employment opportunities compared with their white counterparts. This study aims to disentangle the relationship between work complexity and cognitive function later in life across racial/ethnic groups. Using nationally representative data from the Occupation Information Network (O*NET) linked to the Health and Retirement Study’ Life History Mail Survey (n=1080), we examine how cumulative exposure to cognitively complex work between ages 25 to 55 is associated with cognitive function at age 70 in regressions controlling for cognitive function at age 55 and relevant socio-demographic measures. A composite measure of work complexity was constructed from making decisions and solving problems, thinking creatively, coaching and developing others, frequency of decision making, and freedom to make decisions. Results from regression analyses suggest that compared with cumulative exposure to less cognitively complex work, cumulative exposure to moderately cognitively complex work was associated with a 0.74 point increase in the cognitive score (p<0.01), and cumulative exposure to highly cognitively complex work was associated with a 1.25 point increase (p<0.01) in cognitive score. Among those who held moderately cognitively complex jobs, Black individuals experienced fewer cognitive benefits than their white counterparts later in life. Findings have implications for research and interventions addressing disparities in cognitive health among Black and Hispanic populations through employment-related policies and interventions.
MENTAL HEALTH VULNERABILITIES AND STRENGTHS OF OLDER WOMEN WITH HIV DURING THE HUMANITARIAN CRISIS IN UKRAINE
Authors: Rozanova Julia , Shenoi Sheela , Zeziulin Oleksandr , Rich Katherine , Bromberg Dan , Kiriazova Tetiana , Deac Alexandra , Earnshaw Valerie
Published: December 2023

Humanitarian crises impact mental health, yet data lacks among older individuals. We explored how Covid-19 and the Russian invasion has impacted older people with HIV (OPWH, ≥50 years) in Ukraine. We surveyed a longitudinal cohort of 123 OPWH (50% female) during four periods: April-June 2020 (Wave 1), December 2020-February 2021 (Wave 2), December 2021–February 2022 (Wave 3), and July–September 2022 (Wave 4). The primary outcomes were depressive (PHQ9>5) and anxiety symptoms (GAD7>5). Factors associated with these symptoms were assessed using a mixed effects logistic regression model that included gender, time since HIV diagnosis, history of a substance use disorder (SUD), history of another chronic condition, HIV disclosure, living alone, and social support. Logistical regression controlling for SUD assessed factors associated with resilience (BRS). During Wave 4, OPWH were offered free psychological counseling through our project. Across all Waves, women were more likely than men to have mild to severe anxiety and depressive symptoms, but also to have higher resilience, and to accept psychological counseling during the war. Comorbid SUD and other chronic conditions increased likelihood of anxiety, and longer time since HIV diagnosis increased likelihood of depressive symptoms. Unlike women, men showed distress discussing “Social Support” topic during the war. OPWH with SUD had higher resilience across all waves. While female OPWH had more depressive and anxiety symptoms during the crises they have higher resilience, social support, and help acceptance, suggesting bespoke approaches are needed to assist male and female OPWH in humanitarian settings.
ALIGNING ASSESSMENTS AND MEASURES OF CAREGIVER NEGLECT WITH INTERVENTION DEVELOPMENT: NEW INSIGHTS AND DIRECTIONS
Authors: Chang E-Shien , Hancock David , Stevens Alan
Published: December 2023

As one of the most common forms of elder mistreatment, caregiver neglect is associated with significant morbidity and mortality. The unique stresses, demands, and challenges associated with family caregiving likely increases the risk of neglect. Addressing the multifaceted nature of caregiver neglect in diverse family caregivers of older persons necessitates alignment of meaningful assessments and methodologies with evidence-based intervention development. Gaps in knowledge that urgently need filling include refining conceptual and operational definitions of caregiver neglect, validating novel measurement approaches, and identifying effective caregiver-centered study engagement and recruitment strategies. To address these gaps, this symposium will draw upon insights from four caregiver neglect studies across community and clinical settings. Dr. David Hancock will characterize prevalence and correlates of caregiver neglect using unmet activities of daily living needs in a sample of dementia patients and their caregivers. Dr. E-Shien Chang will test the impact of varying operational definitions of caregiver neglect on prevalence estimates and associated risk and protective factors. Dr. Tony Rosen will present a novel, validated caregiver neglect severity measure to more accurately assess the impact of neglect on older persons’ health and quality of life outcomes. Dr. Farida Ejaz will highlight challenges and successes in identifying and involving family caregivers at risk of neglectful caregiving behaviors to inform intervention. Finally, Dr. Alan Stevens, as policy and advocacy expert for family caregivers, will provide summative comments and recommendations for policy and practice changes to better reduce risk of neglect and improve support for family caregivers.
PRESIDENTIAL SYMPOSIUM: EXTENDING HEALTHSPAN AND LONGEVITY
Authors: Rogina Blanka , de Cabo Rafael
Published: December 2023

Aging is associated with a functional decline in physiological, metabolic, proliferative, and tissue homeostasis leading to deterioration at an organismal level and an increase in risk for disease and death. To prevent or postpone such deterioration, genetic, pharmacological, and nutritional interventions have been successfully utilized, which lead to preserved healthspan and extended longevity. This symposium will discuss new approaches to target aging and the mechanisms underlying interventions that extend healthspan and longevity. The speakers of this symposium include internationally distinguished aging researchers who have dedicated their research to reveal new approaches to extending healthy lifespan. Rafael de Cabo, from NIA, Co-Chair and speaker in this symposium, will talk about the effects of calorie restriction on physiology, metabolism and health in a variety of organisms. Ana Gomes, from Moffitt Cancer Center, will talk about how aging promotes cancer resistance to therapy. Vishwa Deep Dixit, from Yale University, will discuss immunometabolic checkpoints of aging and lessons learned from CALERIE studies in humans. Payel Sen, from NIA, will present her studies on epigenetic mechanisms underlying tissue aging.
AGE-INDUCED SYSTEMIC REPROGRAMMING DRIVES DRUG RESISTANCE IN LUNG CANCER
Authors: Gomes Ana
Published: December 2023

Lung cancer accounts for the largest number of cancer-associated deaths in the United States. While great strides have been made due to the introduction of immunotherapies and targeted therapies against oncogenic drivers, chemotherapies remain the standard of care for the majority of lung cancer patients. However, many patients do not respond to these treatments or relapse following an initial response. We postulate that part of the problem is the lack of consideration in preclinical research and clinical trials of the main driver of lung tumorigenesis, the aging process. Here, we show that the organismal reprogramming that occurs with aging makes lung tumors in an aged host more conducive to withstand chemotherapies and targeted therapies. We traced this to an age-induced chronic accumulation of the stress hormone cortisol in circulation. Mechanistically our data show that chronic accumulation of cortisol drives the upregulation of metallothioneins—small, highly conserved, cysteine-rich metal-binding proteins—through activation of the glucocorticoid receptor in lung cancer cells, which in turn rewire these cells to be refractory to chemotherapies. Together, our work demonstrates a role for age-induced cortisol levels in promoting resistance to standard of care chemotherapies in lung cancer and offers a rationale for using therapeutic agents that block the glucocorticoid receptor to sensitize the average and most vulnerable lung cancer patients, the elderly, to chemotherapy.
ADVANCING AGE INCLUSIVITY IN HIGHER EDUCATION: INTERGENERATIONAL EXCHANGE AS A PATHWAY TO CAREER READINESS
Authors: Montepare Joann , Farah Kimberly , Borrero Lisa
Published: December 2023

Higher education is becoming more age-inclusive on several fronts and age-friendly teaching and learning strategies are being used in new and novel ways to support a variety of students’ educational outcomes. In this AFU-ILRCE collaborative symposium, presenters will discuss ways that intergenerational exchange in the classroom and beyond can help to prepare students for entry into the workforce. To begin, Montepare, Farah, and Frazier will give an overview of the Age-Friendly University (AFU) initiative and discuss how older adults can serve as teaching allies in career-focused classroom activities such as serving as job recruiters in mock interviews. Graf and Terhune will share reflections from focus group data on intergenerational exchanges in the workplace conducted with working and recently retired adults 60+ years of age. They will highlight the utility of such perspectives for informing career training programs for students regardless of major or career path. Mastel-Smith, Kimzey, and Garner will describe Dementia Bootcamp, an online program for high school students that utilized didactic information, experiential activities, presentations by people with dementia, and volunteering at a dementia day program. Focus group findings and how the program has been integrated into a health sciences curriculum also will be presented. Ghazi-Saidi & McKelvey will discuss an innovative experiential learning activity in two core courses of a Speech Language Pathology (SLP) graduate program that prepares future SLPs to use telepractice to provide cognitive health interventions to community older adults. Lisa Borrero, chair of AGHE’s Education Resource Development Workgroup (ERDW) will serve as discussant. This is a collaborative symposium between the Age-Friendly University (AFU) Network and Intergenerational Learning, Research, and Community Engagement Interest Groups.
SIMILARITY IN HEALTH-RELATED BEHAVIORS WITHIN OLDER ADULTS’ CLOSE SOCIAL RELATIONSHIPS
Authors: Webster Noah , Chin Kristi
Published: December 2023

Health-related behaviors are socially contagious, spreading through social networks via multiple mechanisms. It remains unclear though which mechanisms are most salient among older adults. Guided by Social Contagion Theory and the Convoy Model of Social Relations we examine similarity in health-related behaviors (exercise, smoking, alcohol consumption) between older adults and their closest social network members and investigate associations with multiple social factors (homophily, network structure, relationship quality). Data are from Wave 3 of the Detroit-based Social Relations Study collected in 2015. Panel respondents nominated people who were close and important in their lives, and up to the first three nominated were interviewed. Analyses were conducted at the dyad-level, and we selected dyads in which at least one member was age 60 or older (n=247 dyads). Generalized estimating equations were used due to some panel respondents being in multiple dyads. Greater homophily was found to be associated with similarity in both exercise frequency and number of alcoholic drinks consumed per week. Specifically, pairs of close social network members who were more similar in self-rated health were significantly more similar in exercise frequency, and those of the same gender and more similar in age were significantly more similar in alcohol consumption. Network structure, specifically greater contact frequency, was associated with significantly more similarity in alcohol consumption, but less similarity in exercise frequency. Findings suggest the salience of multiple aspects of older adults’ close social relationships that can be incorporated into behavior change interventions and leveraged to encourage healthy lifestyles in later life.
EXPLORING THE LINK BETWEEN SLEEP AND DEMENTIA: MULTIFACETED APPROACHES
Authors: Petrovsky Darina , Luth Elizabeth
Published: December 2023

Sleep and sleep quality have been linked to cognitive function over time. The quality of caregiver sleep can also affect their ability to function and provide support to persons living with dementia. This symposium leverages longitudinal survey data from two large US population-based surveys: the National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC). This symposium aims to explore the relationship between sleep, cognitive function, and care activities for older adults living with and without dementia and their caregivers. First, Dr. Petrovsky will report findings that examined the relationship between caregiver sleep quality and persons living with dementia status using NHATS and NSOC data. Next, Dr. Esiaka will present cross-sectional findings from examining the relationship between older adult sleep quality, neighborhood disorder, and cognitive function using the NHATS data. Drs. Klingman and Sullivan will present the results of an analysis comparing the relationship between sleep and frequent hospitalization in persons living with dementia and those without dementia. Collectively, these papers will report on findings examining how a potentially modifiable factor, sleep, relates to cognitive function and caregiving.
DO SLEEP QUALITY AND SOCIAL COHESION MEDIATE ASSOCIATION BETWEEN NEIGHBORHOOD DISORDER AND COGNITIVE FUNCTIONING?
Authors: Esiaka Darlingtina , Luth Elizabeth
Published: December 2023

Daily exposure to neighborhoods with high levels of disorder, such as public drinking, graffiti, and vandalism, has been linked to worse cognitive functioning and a higher risk for dementia in older adults. The present study examined the association between neighborhood disorder and cognitive functioning. This study also examined sleep quality and social cohesion as potential mediators of this association using Hayes’ (2013) Macro Process via bootstrapping method. The sample included cross-sectional data for 2,529 older adults (1,115 men and 1,482 women, age 70+) using the 2021 National Health and Aging Trends Study. Neighborhood disorder was measured as a 3-item scale capturing physical neighborhood characteristics completed by the interviewer (e.g., trash on sidewalks). The social cohesion scale measured participant agreement with 3 questions about their community (e.g., “People can be trusted”). The sleep quality scale measured participant responses to 3 questions about their sleep in the last month (e.g., taking 30+ minutes to fall asleep). Cognitive functioning was assessed using performance on tasks evaluating memory, orientation, and executive functioning. Results showed greater neighborhood disorder was associated with worse performance on cognitive tasks (B=-0.417; p<0.001). Results of mediation testing indicated that social cohesion was a significant mediator (B=0.224; p<0.0001). Though sleep quality was not a mediator, better sleep quality was associated with better cognitive functioning (B=0.053; p<0.05). Understanding the contribution of neighborhood disorder, sleep quality, and social cohesion to cognitive functioning will inform neighborhood-level interventions that can buffer cognitive decline in older adults aging in place.
HEARING LOSS AND FATIGUE IN MIDDLE-AGED AND OLDER ADULTS
Authors: Jiang Kening , Spira Adam , Lin Frank , Deal Jennifer , Reed Nicholas
Published: December 2023

Fatigue is associated with worse cognitive and physical functioning, psychosocial wellbeing, and quality of life. Hearing loss may be a risk factor for fatigue, perhaps through greater cognitive demand to compensate for degraded auditory signal. However, prior studies are predominantly in audiology clinical samples, which may be oversampled for individuals experiencing hearing-loss-related fatigue. We conducted a cross-sectional analysis including 3,031 participants from the National Health and Nutrition Examination Survey (NHANES) 2015-18. Fatigue was based on self-reported frequency of feeling tired or having little energy over the past 2 weeks. Hearing loss was defined as better-ear 4-frequency (0.5, 1, 2, 4 kilohertz) pure-tone average >25 decibels hearing level. Multivariable-adjusted multinomial logistic regression was used to model the relative risk ratios (RRR) of reporting a higher vs. reference frequency category of fatigue associated with hearing loss, adjusting for age, sex, race/ethnicity, education, smoking, drinking, occupational and off-work noise exposure, body mass index, comorbidities, and depressive symptoms. In this nationally representative sample of middle-aged and older adults (40-80 years, 48% male, 10% Black), 713 (24%) had hearing loss. When compared to normal-hearing participants, hearing-loss participants were more likely to report fatigue for more than half the days (RRR=2.16, 95% confidence interval [CI]: 1.24, 3.75) and nearly every day (RRR=2.09, 95% CI: 1.24, 3.52) relative to not feeling fatigue at all. Hearing loss is associated with fatigue at the population level. Public health efforts to manage hearing loss might improve fatigue and associated downstream health outcomes.
HEALTH CARE SETTINGS: A MISSED OPPORTUNITY TO ADDRESS HEARING LOSS
Authors: Wallhagen Margaret
Published: December 2023

Background

Identifying hearing loss (HL) within the healthcare system is essential to mitigate its risk for associated negative psychosocial and health conditions, including isolation and depression yet is rarely assessed. This qualitative study sought to gain in-depth understandings of how HL affects communication regarding care preferences within the older adult-partner dyad in the context of chronic illness. Its premise was that older adults with HL may not be able to participate effectively in care discussions and are at risk of not receiving patient centered care. Method: Planned as in-person, pandemic restrictions mandated transition to zoom. 15 older adults (≥60) with HL and 13 partners participated.

Results

One key story line evolving from the data is “Compulsory Self-Advocacy”. Almost uniformly, participants reported that healthcare practitioners “Never Asked” about HL. During one-on-one communication, HL wasn’t necessarily brought to the surface and often went unnoted because participants didn’t see it as pertinent to issues discussed. Still, they were unsure the practitioner was aware of their HL. Rather, they asked that information be repeated or noted they had trouble hearing or understanding when they realized problems. Reporting their HL didn’t generally result in on-going consideration of their specific communication needs. They had to self-advocate to obtain accurate information or bring their partner to appointments to help. Some commented on the value of policies mandating access to notes or written reports.

Conclusions

Healthcare settings provide unique opportunities to identify HL and initiate interventions that may mitigate its negative effects, including social isolation and loneliness.
PREVALENCE AND TYPES OF PATIENT PORTAL USE AMONG OLDER ADULTS RECEIVING HOME HEALTH CARE
Authors: Burdgorf Julia , Wu Mingche , Fabius Chanee
Published: December 2023

Home health care (HHC) delivers skilled nursing and therapy services in the patient’s home and is a valuable source of care for community-living older adults, particularly those living with complex conditions such as dementia. However, lack of visibility into patients’ clinical records and difficulty communicating with other providers are perennial challenges to HHC quality. Patient portals― provider-sponsored online applications that allow patients to perform care management tasks including viewing health information and messaging providers―present a promising opportunity to bridge this gap. However, no prior work has examined patterns of portal use among HHC patients. We leveraged a unique dataset containing electronic health record and patient portal utilization data for 10,212 older adults who received HHC between 2017-2019. We found that 25% of HHC patients had an active patient portal prior to HHC and, of those with an active portal, 85% used their portal during HHC. Among those who used their portal during HHC, the most common portal activities were reviewing the clinical record (82%), managing appointments (60%), and seeking provider advice (45%). Compared to community-referred patients, hospital-referred patients were more likely to use their portal to manage appointments or review their clinical record. Compared to patients without dementia, patients with dementia were more likely to use their portal to message their provider but less likely to view their clinical record. Findings suggest that portal users are actively engaging with their portal during HHC, indicating an opportunity to empower patients to facilitate information transfer between HHC and other providers.
MUSCLE MITOCHONDRIAL FUNCTION PREDICTS COGNITIVE IMPAIRMENT AND IS ASSOCIATED WITH PET AND BLOOD BIOMARKERS OF AD
Authors: Tian Qu , Bilgel Murat , Walker Keenan , Moghekar Abhay R , Resnick Susan , Ferrucci Luigi
Published: December 2023

Mitochondrial dysfunction is a hallmark of aging. Whether mitochondrial dysfunction is related to future cognitive impairment and biomarkers of Alzheimer’s disease (AD) is unknown. In the Baltimore Longitudinal Study of Aging, we used Cox regression to examine the association of skeletal muscle mitochondrial function (post-exercise recovery rate of phosphocreatine, kPCr) via MR spectroscopy with future MCI or dementia over an average follow-up of 3.3 years among 460 initially cognitively normal participants (mean age=76.8±11.0 years, 56.7% women, 22.4% Black). We also examined associations with PiB-distribution volume ratio (DVR) for β-amyloid (Aβ)(n=115), Flortaucipir (FTP)-standardized uptake value ratio (SUVR) for tau(n=70), and blood biomarkers of AD pathology (Aβ42/Aβ40 ratio,n=299; pTau181,n=505), neuronal injury (NfL)(n=299), and astrocyte-mediated neuroinflammation (GFAP)(n=299) using linear regression. After adjustment for age, sex, and race, each SD higher kPCr (i.e. 0.005) was associated with 45% lower hazards of developing cognitive impairment (19 MCI, 4 dementia) (p=0.04). In the PET sample, each SD higher kPCr was associated with 51% lower odds of being PiB positive(p=0.003). Higher kPCr was specifically associated with lower DVR in precentral and postcentral gyri, superior parietal lobe, and pallidum (FDR-adjusted p<0.05). In samples with blood biomarkers, higher kPCr was associated with lower GFAP(p=0.01) and showed a trend toward significance with lower pTau181(p=0.08). Preserved skeletal muscle mitochondrial function is associated with reduced risk of cognitive impairment and PET and blood biomarkers of AD. Future studies are needed to investigate the role of mitochondrial function of the central nervous system in dementia risk and the progression of AD pathologic change.
THE INTERTISSUE COMMUNICATION BETWEEN THE HYPOTHALAMUS AND WHITE ADIPOSE TISSUE IN MAMMALIAN AGING AND LONGEVITY CONTROL
Authors: Imai Shin-ichiro
Published: December 2023

Recent studies in model organisms have demonstrated that the intertissue communications play a critical role in the regulation of aging and longevity. Our major goal is to understand the systemic regulation of aging and longevity in mammals and translate that knowledge into an effective anti-aging intervention that could make our later lives as healthy and productive as possible (“productive aging”). In mammals, we have previously demonstrated that the intertissue communication between the hypothalamus and adipose tissue, particularly mediated by extracellular vesicles-contained extracellular nicotinamide phosphoribosyltrasferase (eNAMPT), the rate-limiting NAD+ biosynthetic enzyme in mammals, functions to counteract age-associated physiological decline and promote longevity in mice. We have recently found that Ppp1r17-positive neurons in the dorsomedial hypothalamus (DMHPpp1r17 neurons) regulate white adipose tissue (WAT) function, including lipolysis and eNAMPT secretion, through the sympathetic nervous system (SNS), and the feedback loop between DMHPpp1r17 neurons and WAT plays a critical role in the regulation of aging and longevity in mice. Within DMHPpp1r17 neurons, the phosphorylation and subsequent nuclear-cytoplasmic translocation of Ppp1r17, regulated by cGMP-dependent protein kinase (PKG; Prkg1), affect gene expression regulating synaptic function, causing synaptic transmission dysfunction and impaired WAT function. Both DMH-specific Prkg1-knockdown, which suppresses age-associated Ppp1r17 translocation, and the chemogenetic activation of DMHPpp1r17 neurons significantly ameliorate age-associated WAT dysfunction, increase physical activity, decrease age-associated mortality rate, and extend lifespan. Thus, these findings clearly demonstrate the importance of the intertissue communication between the hypothalamus and WAT in mammalian aging and longevity control and provide critical insights into the development of effective anti-aging interventions.
NAD+ METABOLISM IN MITOCHONDRIA AND MICROBES
Authors: Baur Joseph
Published: December 2023

Nicotinamide adenine dinucleotide (NAD+) is a redox cofactor essential to all living organisms. NAD+ levels fall with age or disease and rise with exercise or caloric restriction. Supplemental NAD+ precursors have beneficial effects on health in rodent models, renewing interest in this molecule and the enzymes that require it. Although NAD+ is present in the mitochondrial matrix and critical to the function of the organelle, the source of mitochondrial NAD+ was only recently elucidated. We identified SLC25A51 as the carrier that is primarily responsible for this activity in cultured cells. Here we show that, like in cells, SLC25A51 is important for establishing the mitochondrial NAD+ pool in vivo. Shifting NAD+ into hepatic mitochondria is sufficient to replicate the effects of supplemental NAD+ precursors on liver regeneration. Thus, the mitochondrial NAD+ pool appears to be responsible for some of the benefits of increasing whole-body NAD+. In a separate series of studies, we have used heavy isotope tracing strategies to show that the popular supplement nicotinamide riboside is metabolized by the microbiome when administered orally to mice. Further studies revealed a surprising role for the microbiome in normal NAD+ metabolism. Host-derived nicotinamide is released into the gut lumen and processed to generate microbial NAD+ as well as nicotinic acid that is reabsorbed by the host. These findings reveal a previously unappreciated cycle by which NAD+ precursors are shared between the host and microbes.
THE CREATION OF THE FIRST INTERNATIONAL GSA STUDENT CHAPTER IN PORTUGAL
Authors: Casanova Giuliana , Passos Lígia , Rodrigues Edna , Ribeiro Oscar
Published: December 2023

The Gerontological Society of America (GSA) Student Chapter Pilot Program provides a platform for students in all academic levels to exchange academic ideas, network with industry professionals, and share scientific and educational experiences. Developing an international student chapter based at the University of Aveiro in Portugal was a challenging but fullfiling task, accomplished through the dedication and perseverance of its members. This student chapter, created by and for students, aims to serve as an opportunity for networking, education, research, and community work. We aspire to create a bridge between Portugal and the United States, promoting educational and research opportunities for students and increasing awareness in the field of aging. By sharing the challenges and rewards we encountered during the creation of this chapter, we hope to inspire other universities worldwide to do the same and build an even larger international network. Through this network, students working with older adults can find common ground, share ideas, create connections, and develop new ways to enhance the field of Gerontology worldwide. The GSA student chapter is a unique opportunity that enables students to connect, share knowledge and contribute to the field of Gerontology. Our hope is that this model will be replicated globally, fostering collaboration and advancing our understanding of aging in all corners of the world.