bluuebunny/crossref_metadata_2025 huggingface dataset:
WHAT DOES INTEGRATION LOOK LIKE IN MIXED-METHODS RESEARCH?
Authors: Saunders Pamela
Published: January 2025

Multi-methods and mixed-methods research usually include both qualitative and quantitative data to gain a more holistic understanding of a research question. Multi-method research involves a variety of data sources and methods. A defining feature of Methods is the potential integration at multiple levels, including schools of thought, data, data collection methods, or analysis. The Friendship Study (de Medeiros et al., 2012) used a mixed-methods approach to examine perceptions of friendship among people living with dementia. The participants included ten staff members and 31 assisted living residents with moderate to advanced dementia. The first step was to define ‘social interaction’ and how it relates to the larger construct of friendship. Staff completed a matrix indicating their perceptions of which residents were friends. We conducted 6-months of direct observation with detailed field notes. The integration process focused on data collection methods, including interviews and surveys with staff and field notes describing direct observations of interactions between residents. Findings showed that the qualitative data from staff did not support the qualitative data from field notes of direct observation. This paper dives deeply into integrating these qualitative and quantitative data and analyses. A summary of specific integration techniques will be outlined.
OPENING MINDS THROUGH ART: CREATING UNIVERSITY PARTNERSHIPS THROUGH AN ADAPTIVE INTERGENERATIONAL ART PROGRAM
Authors: Elliot Amy , Abbott Katherine
Published: January 2025

Opening Minds through Art (OMA) is an award-winning, evidence-based, intergenerational art-making program for people living with dementia. Developed in 2007 at Miami University’s Scripps Gerontology Center, the program is grounded in person-centered care principles and serves the vital need for people living with dementia to engage in creative expression and social connection. The current impact of OMA includes engagement through 1,100 trained facilitators in over 300 communities spanning 37 states and internationally. As a university-based program, OMA has maintained a focus on research with thirteen peer-reviewed studies to support the program’s impact on younger and older participants in areas such as more empathetic attitudes for other generations, improved mood, and increased engagement. Core to OMA’s success are relationships with 30 universities in the U.S. and globally. Through these partnerships, students engage with OMA through academic and service-learning opportunities to fortify their understanding of the aging process and empathy for older generations. Universities also benefit through community support and participation. The success of these programs is highly dependent on OMA’s ability to adapt to each university’s resources, programmatic interests, and community partnerships. This symposium will describe variations of OMA programming at three universities including work with health trainees at Penn State University, a student internship program at Florida State University, and the first and longest running OMA program including an innovative virtual variation at Miami University. Katy Abbott will lead a discussion of implementation, internal evaluation, and research components across programs and will explore future implications for university-based growth and adaptations.
VIRTUAL HEALTH COACHING TO IMPROVE HEART FAILURE CAREGIVERS’ SELF-CARE OUTCOMES
Authors: Hirschman Karen , Walser Tracie , Quinn Ryan , Riegel Barbara
Published: January 2025

Health coaching is assumed to improve self-care, but this assumption has not been well-tested. This randomized controlled trial involved 250 adults with health self-care neglect who provided >= 8 hours of care/week to their relative living with heart failure. We assessed the impact of virtual health coaching (n=125) on self-care compared to health information alone (n=125). The Virtual Health Coach for You (ViCCY) intervention included 10 synchronous sessions with a health coach over 6 months. ViCCY and health information were delivered via a computer tablet. Self-care data were collected with the Self-Care Inventory (SCI) (higher scores indicated better self-care.) at baseline and 6 months (August 2019-April 2023). Caregivers were primarily female (85%), white (62%), spouses (72%), and on average 55 years old (+/-14 years, 19-79). Almost half had a college degree (46%) and were employed full-time (44%). On average caregivers received 6 ViCCY sessions (median: 9) with 62% completing all 10 sessions, 28% completing 1-9 sessions, and 16% completing no sessions. The group-by-time interaction showed significant self-care improvement in the ViCCY group compared to the health information only (p=0.01). Self-care scores improved by 10 points indicating a clinically meaningful improvement at 6 months. Neither the number of health coaching sessions nor the total amount of time spent with the caregivers were statistically associated with the change in self-care rating over time in the VICCY group. The virtual health coaching intervention effectively improved self-care practices among heart failure caregivers, highlighting its potential to positively impact caregiver well-being and support.
POLICY SERIES: GSA CONGRESSIONAL UPDATE
Authors: Lindberg Brian , D’Antonio Patricia
Published: January 2025

This popular annual session will provide cutting-edge information on what the 118th Congress has and has not accomplished to date related to aging policy. Of particular importance will be the Older Americans Act Reauthorization, including funding for the Center for Research and Demonstration in the Aging Network, as well as an update on Medicare Advantage, nursing home regulations, and hospice and palliative care legislation.
GSA CONGRESSIONAL UPDATE
Authors: D’Antonio Patricia
Published: January 2025

This popular annual session will provide cutting-edge information on what the 118th Congress has and has not accomplished to date related to aging policy. Of particular importance will be the Older Americans Act Reauthorization, including funding for the Center for Research and Demonstration in the Aging Network, as well as an update on Medicare Advantage, nursing home regulations, and hospice and palliative care legislation.
PREPARING THE CARE WORKFORCE TO ADDRESS INTERPERSONAL DEMANDS ACROSS THE DEMENTIA TRAJECTORY
Authors: Trudeau Scott , Gitlin Laura
Published: January 2025

This symposium posits that student learning experiences in professional programs are a direct pipeline to impact workforce readiness to address the needs of people living with dementia (PLWD). The presentations will share data and experience with three innovative learning activities that have been implemented with graduate students in occupational therapy. PLWD often face social isolation due to declines in domains such as memory and communication. This estrangement can extend to the care team, as cognitive declines can lead care professionals to focus increasingly on caregivers. While partnering with caregivers is often essential to optimize the health and well-being of the dyad, this may have the unintended consequence of minimizing the voice and perspective of the person with dementia. Similarly, in institutional settings, custodial care may be prioritized over attending to quality-of-life due to staffing challenges and a lack of creativity regarding person-centered practice for those with later stage dementia. These abstracts present three programs, generated to address identified care needs, focused on increasing person-centered approaches for PLWD. First, students engaged in preventive approaches to proactively increase the voice of older adults using the My Life Profile. Second, remote delivery of the My Life, My Story (MLMS) program at Department of Veterans Affairs allowed community-dwelling Veterans with cognitive concerns to share their stories with the care team. And lastly, The Reading Buddies program for individuals in later staged dementia will be shared. Providing experiential learning opportunities empowering care workers is critical to improving the future of dementia services across the continuum.
MARITAL HISTORY AND OLDER ADULTS’ RELATIONSHIPS WITH ADULT CHILDREN
Authors: Choi Won
Published: January 2025

The diverse marital experiences of older adults today may shape their relationship with adult children. This study examined whether marital status (i.e., continuously married, remarried, divorced, widowed) and marital transitions (i.e., age at first marriage, number of marital dissolutions, time spent unmarried after first marriage) are associated with the availability, quality, and stability of older adults’ social network ties to their children. This study used retrospective marital histories and longitudinal egocentric network data from the National Social Life, Health, and Aging Project conducted between 2005 and 2011 (N = 1,873). Multivariate regression models were used to estimate the relationship between marital factors and older adults’: (1) likelihood of listing their children as social network members in 2005/2006, (2) frequency of contact with and (3) emotional closeness to child network members, and (4) likelihood of stop listing their children as network members by 2010/2011. Results showed that remarried older adults were less likely to name a child network member, reported less frequent contact with child network members, and were more likely to stop naming their children as network members over time compared to continuously married older adults. Conversely, previously married individuals (i.e., divorced or widowed) were more likely to name a child network member and reported greater emotional closeness to child network members than continuously married older adults. Marital transitions partly explained these differences. The findings highlight the importance of considering past and current marital experiences in understanding parent-child relationships in later life.
TECHNOLOGY FOR SUPPORTING HEALTH AND WELLNESS
Authors: Boot Walter , Lin Xin Yao
Published: January 2025

As the population ages, there is a growing need for technology to support the health and wellbeing of older people. However, technology solutions, for them to be successful, need to recognize the needs, preferences, and abilities of older people, and must be evaluated rigorously for efficacy. This talk provides an overview of the potential and pitfalls of using technology to support health and wellness. Hye Soo Lee, PhD, explores the role of technology in supporting Medicare-related decision-making by older adults, highlighting the need for improved training and the consideration of user characteristics to enhance engagement with government-provided digital tools. Paul Freddolino, PhD, MDiv, presents findings from telehealth training sessions with older adults, emphasizing the importance of end-user feedback in refining patient-focused content and increasing patient engagement in healthcare. Justin Lam, BS, discusses the design of age-friendly web interfaces, focusing on optimizing user interaction patterns and enhancing readability to accommodate the nuanced needs of older adults and their care partners. Elena Remillard, M.S., shares insights from deploying ‘Telewellness’ programs, such as Tele Tai Chi, in community settings, identifying barriers and facilitators to their delivery and discussing the potential of different models to increase access to exercise classes for older adults with mobility disabilities. Leo He, BSc, introduces a novel, radio-based, non-contact system for monitoring nighttime vital signs and sleep, offering a passive, cost-effective solution for home-based health monitoring that avoids the physical and cognitive burdens associated with existing technologies, aiming to improve health intervention and quality of life for older adults.
ARCH: IMPACTING RESEARCH, IMPACTING CAREERS
Authors: Helmly Victoria , James Jennifer
Published: January 2025

Despite more than 50 years of unprecedented growth in incarcerated populations and the rapidly increasing age of people in prisons and jails, the amount of research and the number of researchers focused on aging and the criminal legal system remains small. For many early career scholars interested in aging, health, and incarceration, supportive mentorship, community, collaboration, and funding opportunities have remained elusive. It is common for scholars studying aging within the criminal legal system to be the only researchers in their institution focused on this critical area. The Aging Research in Criminal Justice Health (ARCH) Network seeks to address this gap by fostering collaboration among researchers and experts in this crucial intersection while providing essential mentorship and support for early career development. Over the last five years, ARCH has created opportunities for Ph.D. students and early-career researchers to contribute to research projects, co-author manuscripts, build networks, hone their skills, and receive feedback on their work. In this session, presenters will share their experience in the ARCH network and how it has impacted their careers through connections and collaborations with mentors and peers. They will describe the ARCH network as a pipeline model for advancing scholars interested in health equity and policy-focused research.
RESPONDING TO THE DIVERSE NEEDS OF STUDENT CAREGIVERS: RECOMMENDATIONS FOR CAMPUSES AND COMMUNITY PARTNERSHIPS
Authors: Nikzad-Terhune Katherina , Graf Allyson , Manning Lydia
Published: January 2025

Informal caregiving continues to steadily increase, warranting attention to the impact of being a caregiver. A growing demographic of caregivers that have received less attention are student caregivers. Currently, five million adult students attending post-secondary education are also caregivers of adults, resulting in negative impacts on academic success, mental health, and retention. Furthermore, the characteristics and experiences of student caregivers are diverse, thus prompting a need to better understand their experiences. Rooted in the age-inclusivity in higher education model, this presentation examines mixed methods data from a campus-wide study that assessed the prevalence and impact of unpaid caregiving on students. Survey results indicated that 16.9% (n = 241) of student respondents identified as a caregiver. Scores on the Adult Carers’ Quality of Life scale (Elwick et al., 2010) revealed that lack of support (46-48.8%) and financial matters surrounding caregiving (25.7-27.2%) place student caregivers at risk for low quality of life. Qualitative data from focus groups (N = 12) provided further explanation and clarification of the data. We found that student caregivers encompass a range of challenges, emotions, and coping strategies. The experiences of student caregivers highlight the need for greater recognition, understanding, and support within educational institutions. Based on the study findings, specific recommendations will be made for universities to better recognize the diverse needs of their student caregivers, and how to respond with support, resources, and empowerment. Additionally, recommendations for partnering with community agencies in the pursuit of supporting student caregivers will be highlighted.
CREATING AN INTERGENERATIONAL COMMUNITY OF CAREGIVERS
Authors: Elfenbein Pamela
Published: January 2025

While the preponderance of those caregiving for older adults are over the age of 45, the 2020 Caregiving in the U.S. study, conducted by AARP and The National Alliance for Caregiving (NAC), revealed that 11 percent of Americans who are caring for older adults are also attending school either full-time or part-time. Adult Children of Aging Parents (ACAP) Hall County invites students, staff, faculty and community caregivers of all ages to meet monthly for information, resources, and support, building a community to enhance the quality of life for area caregivers and their older adult loved ones. Details of the program will be shared to enable presentation participants tp consider the development of a similar program on other campuses. This presentation aligns with AFU Principle 4:To promote intergenerational learning to facilitate the reciprocal sharing of expertise between learners of all ages.
IMPORTANCE OF ASSESSING FOR POSTTRAUMATIC STRESS DISORDER IN OLDER HISPANICS
Authors: Alcantar Sandy
Published: January 2025

Hispanic older adults are at a higher risk of being diagnosed with Alzheimer’s disease or Dementia versus post-traumatic stress disorder due to various factors, one lacking assessment. There are significant factors associated with aging and PTSD in the Hispanic population that must continue to be explored; these include, but are not limited to, a lack of collaboration with community providers, linguistics, and an understanding of assessing for histories of post-traumatic stress disorder. Providers need to evaluate for trauma in Hispanics at this stage of life, especially for those who suffered trauma in their country of origin and post-immigration to the United States. The objective is to reduce misdiagnoses of Alzheimer’s Disease/Dementia in Hispanics by developing and implementing a solid community partner collaboration and not disregarding assessing for post-traumatic stress disorder in a person’s history. As providers, we must communicate effectively in an interdisciplinary approach to review findings during assessments and promote structural social changes, such as education, addressing assessment practices, using effective evidence-based techniques, and reviewing treatment recommendations periodically.
BLACK MEN’S HEALTH AND AGING ACROSS THE LIFE COURSE
Authors: Thorpe Roland , Hill Carl V
Published: January 2025

Much of the research on Black men tend not to focus on concepts that have been found to be important determinants of health for Black men. Nor, do they seek to identify sources of resilience that may be protective of health. This symposium contains a collection of papers that discuss some key social determinants of health (SDOH) that can provide insights to advance our understanding of Black men’s health and aging. Bruce and colleagues examined the association between religious practices and/or beliefs, socioeconomic status, and cognitive status among Black men in the 2016 Health and Retirement Study (HRS). Findings indicate private prayer was inversely related to any cognitive impairment among Black men with more than 12 years of education. Nwaskasi and colleagues examined the effect of active coping and grit on subjective cognitive decline (SCD) among Black men and found that active coping and grit were significant predictors of SCD while controlling for demographic variables. Esiaka and colleagues investigated the relationship between food insecurity and cancer screening behaviors among Black men dwelling in food deserts. Understanding the link between food insecurity and cancer screening behavior provides crucial insights for tailoring targeted interventions for Black men. Thomas Tobin and colleagues investigated the link between psychosocial resilience and allostatic load in Black men in the Nashville Stress and Health Study. Results from latent class analyses suggest different resource combinations produce distinct patterns of resilience among Black men. These presentations will bolster our knowledge on SDOH among Black men across the life course.
TRANSMISSION OF GENERALIZED TRUST AND BELIEF IN A JUST WORLD BETWEEN GRANDPARENTS AND ADULT GRANDCHILDREN
Authors: Li Tianyuan , Sun Yue Yang , Liu Xiaoye , Zhang Yukai
Published: January 2025

Previous research shows that older adults tend to hold more positive beliefs about others and the social system compared to their younger counterparts. This study investigated whether such positive beliefs can be transmitted to the younger generation through intergenerational interactions. We recruited 292 Chinese adult grandchild-closest grandparent dyads and surveyed both members’ generalized trust and belief in a just world. Results revealed significant positive associations between grandparents’ and grandchildren’s generalized trust, β =.21, SE =.05, p <.001, and belief in a just world, β =.20, SE =.07, p =.004. While the intergenerational association of generalized trust was not moderated by other variables, that of belief in a just world was moderated by the grandchild’s familism, F(1, 279) = 4.46, p =.04, and parental intimacy, F(1, 279) = 7.94, p =.005. The intergenerational transmission of belief in a just world was not significant for the grandchildren with lower levels of familism, β =.02, p =.79, or parental intimacy, β =.02, p =.81; but was significant for those with higher levels of familism, β =.28, p =.003, or parental intimacy, β =.35, p <.001. Demographic variables were controlled in all the analyses. The findings underscore the importance of intergenerational transmission of positive social beliefs from grandparents to grandchildren, suggesting that older adults may play an essential role in cultivating social capital.
EMPATHY MODERATES THE RELATIONSHIP BETWEEN RECIPROCITY AND STRESS AMONG AGING PARENTS AND CHILDREN
Authors: Da Jiang  , Huang Zewen , Peng Xinyuan
Published: January 2025

Previous studies examining the relationship between being under-benefitted and stress among aging parents and their adult children have yielded mixed findings. Few studies have examined whether this positive association can be alleviated by state-level or trait-level factors. Given the positive effects of empathy on interpersonal exchanges, we tested the moderating role of empathy on the relationship between being under-benefitted and perceived stress among aging parents and adult children in this 14-day diary study. A sample of 99 pairs of parents (Mage=50.01, SDage=4.53; 79.8% female) and children (Mage=22.38, SDage=3.49; 85.9% female) were recruited to report their level of being under-benefited in the exchange with their parent/child, perceived stress, and empathy as an affective state on a daily basis for 14 consecutive days, after completing a pretest which measured their trait empathy and demographic information. For both parents and children, the positive under-benefited-stress association was only significant when they reported lower empathy as a daily affect. The under-benefitted-stress link was negative when children reported greater daily empathy. Children reported more perceived stress on the days their parents reported a greater level of being under-benefitted. Such association was only significant in children with lower trait empathy. The negative association between children’s being under-benefitted and parents’ perceived stress was only significant in parents with higher trait empathy. These findings highlight the importance of empathy as a daily affect and a trait in the relationship between daily exchanges and mental health in the intergenerational contexts between aging parents and adult children.
MULTISECTORAL PARTNERSHIPS TO ADDRESS SUCCESSIVE DISASTER EVENTS IN HOUSTON’S UNDERSERVED COMMUNITIES
Authors: Adepoju Omolola , Tipton Mary , Hirsch Ben , Gilbert Lauren
Published: January 2025

Objective

Over the past decade, Houston, Texas, has become one of the most diverse cities in America, during which time it has also endured several federally declared disasters. This study describes the creation of formal academic-community partnerships to build a geospatial-photoethnography dashboard, co-owned and co-developed by the community, to chronicle and assess the impact of successive disaster events on affordable housing and mental health outcomes in three historically medically underserved communities in Houston.

Methods

We used geospatial-longitudinal maps to illustrate housing insecurity and mental health trends from 1980 to 2022, with projections for 2030, 2040, and 2050 at the census tract level. Critical ethnography concepts, such as community conversations and photovoice, are employed to gather and present a storyboard of people’s experiences and coping mechanisms.

Results

Community leaders were identified via prior partnerships with social support groups, healthcare organizations, and faith-based organizations. A total of 15 community partners were invited and 10 agreed to serve as partners on the project. Co-ownership was developed through regular meetings as a large group with all partners, as well as one-on-one meetings with individual groups. To capture the richness of the community conversations, visual notetakers were present at the meetings to provide a graphical representation of the content of the meetings.

Discussion

The community-led initiative amplifies the voices and experiences of those affected by climate change disasters, shedding light on enduring effects on housing and mental health in underserved communities. By embracing community-driven empowerment, the project documents community priorities and proposed solutions.
EXAMINING PREDICTORS OF POOR SLEEP AMONG CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Petrovsky Darina , Luth Elizabeth
Published: January 2025

Caregivers who struggle with sleep face increased stress and worse mental health outcomes. This study explored the connection between caregivers’ perceived caregiving burden and benefits and their sleep quality. Using data from the 2017 National Study of Caregiving and National Health and Aging Trends Study, we examined 790 caregivers of individuals with possible and probable dementia. Using time diary interviews, sleep quality was categorized as either “excellent/very good” or “good/fair/poor.” Predictors included caregiver perceived burden and benefit scales, each the summed responses to four questions (burden Cronbach alpha=0.75; benefit Cronbach alpha=0.70). We used multi-variable logistic regression, controlling for the sociodemographic characteristics of caregivers and persons with dementia, as well as relationship quality and sleep disturbance due to caregiving responsibilities. Caregivers’ mean age was 62.5 years old (SD=13). Approximately 69% were women and more than half were non-Hispanic White (58.6%). Fifty-five percent (55%) of caregivers were children and 44% reported “excellent/very good” sleep quality. In the multi-variable logistic regression model, a higher benefit of caregiving was associated with significantly higher odds of reporting “excellent/very good” sleep quality (AOR: 1.09, 95%CI: 1.01-1.17, p=0.02). Conversely, a higher burden of caregiving was associated with lower odds of reporting “excellent/very good” sleep quality (AOR: 0.88, 95%CI: 0.81-0.95, p=0.002). These relationships persisted independent of caregiver and care recipient demographic characteristics and interrupted sleep due to caregiving. Our findings highlight potential modifiable targets for future interventions—specifically, addressing perceived caregiver burden and maximizing benefits—to enhance sleep quality among caregivers of individuals living with dementia.
DYSPHAGIA MANAGEMENT CONTRIBUTES TO BURDEN IN CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Shune Samantha , Namasivayam-MacDonald Ashwini
Published: January 2025

Providing care for persons with Alzheimer’s disease and related dementias (ADRD) comes with significant physical and psychosocial costs. Crucially underexplored in its contribution to caregiver burden is dysphagia (swallowing impairment), which occurs in up to 93% of persons with ADRD and contributes to increased morbidity and mortality. The current study aimed to quantify dysphagia’s contribution to general burden among family caregivers of individuals with ADRD. A total of 110, predominately female (79.1%), family caregivers were recruited (mean age 55.8±15.9). Multiple measures of dysphagia severity were considered, including caregiver-reported dysphagia severity (Eating Assessment Tool [EAT-10]) and degree of diet modification (International Dysphagia Diet Standardisation Initiative – Functional Diet Scale [IDDSI-FDS]). General caregiver burden was measured via the Zarit Burden Interview (ZBI). To examine which variables were unique predictors of burden, dysphagia-related variables as well as demographic (caregiver age, sex, employment status, education; care recipient relationship, age, sex) and disease variables (caregiver-reported diagnosis, severity, duration) were all entered simultaneously in a multiple regression analysis. Preliminary regression results indicated that higher ZBI scores were associated with caregivers who reported higher IDDSI-FDS scores (β =.26, p =.0364), identified as female (β =.25, p =.0450), were the spouse of the care recipient (β =.45, p =.0125), and reported shorter disease duration (β =.29, p =.0072). Findings highlight that aspects of managing dysphagia may independently contribute to caregiver burden, particularly in the context of continued oral intake. Thus, inquiry about dysphagia status should be considered in disease management.
COGNITIVE FUNCTION AND ORAL HEALTH MEASURES AMONG OLDER ADULTS IN INDIA: EVIDENCE FROM THE LASI, 2017–2018
Authors: Kelekar Uma , Pan Xi , T Muhammad , Turner Sidney , Heyn Patricia , Wu Bei
Published: January 2025

Given the rising older adult population and related increase in the prevalence of cognitive impairment in India, the present study aimed to examine the association between cognitive function and oral health measures among the middle-aged and older adults in India. Data for the study were selected from the Longitudinal Aging Study in India (LASI, 2017-2018) and 56,723 respondents>=45 years were included. Oral health was measured by self-reported oral health problems including number of oral diseases, edentulism (i.e., losing some or all natural teeth), and dental care utilization (e.g., dental visit in the past 12 months). Our outcome measure was a composite score of cognitive function measured across five broad domains, specifically memory, orientation, arithmetic function, executive function, and object naming. Negative binomial regression models were used to analyze the relationship between the oral health and cognitive function. Our results showed that complete edentulism was associated with 3% lower cognitive scores [IRR=0.97, 95% CI 0.96, 0.99], while dental care utilization was positively associated with cognitive function. Those who had visited a dentist in the past 12 months reported 6% [IRR=1.06, 95% CI 1.03, 1.08] higher cognition scores than those who had not visited a dentist. The unadjusted univariate regressions demonstrated a negative association between the number of oral diseases and cognitive function. Our findings suggest an urgency for improving the existing oral health infrastructure, including expanding access to dental care and promoting oral health education in India, especially for adults at higher risk for cognitive impairment.
DRUG DEVELOPMENT AND EVALUATION: AGE, SEX, AND FRAILTY CONSIDERATIONS TO FACILITATE THE FORTITUDE FACTOR
Authors: Hilmer Sarah
Published: January 2025

Development and evaluation of drugs used by older adults must consider the effects of ageing, of lifelong factors including sex, and of other characteristics common in geriatric patients that affect pharmacokinetics and pharmacodynamics and outcomes, such as frailty. These factors interact within older people, resulting in major inter-individual variability. In some cases, the intersection of age, sex, frailty and other factors act in the same direction, e.g, age, female sex and frailty may all reduce renal drug clearance. In others they may act in opposite directions, e.g. age may decrease pharmacodynamic sensitivity to a drug, male sex may increase it, and frailty may reduce reserve to tolerate drug effects. Interactions with the older person’s other drugs in the presence of polypharmacy, their other diseases with multimorbidity, their genetics and environmental exposures further complicate prediction of drug effects in older adults. The International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee’s position statement on ‘Measurement of Frailty in Drug Development and Evaluation’ outlines key principles relevant to all phases of translational research. These include measurement of frailty, testing drug exposures and outcomes that are clinically relevant for older adults, use of physiologically based pharmacokinetic-pharmacodynamic modelling and artificial intelligence. In all phases of drug development and evaluation, the pre-clinical models used and clinical trial populations studied should be representative of the people who will use the drugs in age, sex, frailty, and other determinants of drug response. This will inform drug use that facilitates the fortitude factor in older adults.
TRANSLATIONAL BIOMARKERS FOR AGING AND FRAILTY: IMPORTANT SEX DIFFERENCES
Authors: Kane Alice
Published: January 2025

Frailty can be measured using a frailty index, which quantifies the accumulation of health-related deficits. Frailty increases the risk of adverse outcomes including hospitalization and mortality, but there are no validated frailty biomarkers and the underlying mechanisms of frailty remain unknown. Additionally, women are more frail than men at all ages, despite having a lower risk of mortality, but sex differences in frailty are poorly understood. We have assessed health outcomes, including frailty, in male and female C57BL/6 mice from middle age to natural death. We collected blood and stool samples at each timepoint, for untargeted plasma metabolomics, blood DNA methylation assessment and gut microbiome analysis. As in humans, female mice have higher frailty scores than males in middle-to-late life. Sex explains more variability than age or frailty in our DNA methylation data, and preliminary analysis identifies 100s of sex-specific differentially methylated regions with frailty. Metabolomics analysis identifies a set of 104 metabolites (enriched for amino acid and lipid pathways) associated with frailty, independent of sex and age. Additionally, we identify many sex-specific metabolomic markers for frailty, including creatine for females and FAD for males. Analysis of the microbiome data identifies microbes that are both positively and negatively associated with frailty across sexes including A. colihominis. Integrated analysis across data-types is ongoing. Overall, we see clear sex differences in the association of frailty with molecular outcomes in mice. Further investigation of these factors, and validation in human cohorts, will identify determinants and biomarkers of frailty in both sexes.
POLYPHARMACY: TRANSLATIONAL RESEARCH TO UNDERSTAND EFFECTS OF AGE, SEX, AND FRAILTY ON KEY OUTCOMES FOR FORTITUDE
Authors: Mach John
Published: January 2025

Chronic medication use is common in older men and women. Older people, particularly those with polypharmacy (use of 5 or more drugs) for multi-morbidity, are rarely included in clinical trials to establish efficacy and safety of therapeutic drugs. Based on clinical observational studies, polypharmacy is associated with impaired physical function and exacerbates frailty in older adults, particularly women, who make up the majority of this age group. In addition, there is evidence that women are at greater risk of drug-related harm than men. Preclinical models would be useful to screen for adverse geriatric outcomes and understand the impact of age, sex and frailty. This presentation will cover our advancements in the development and use of preclinical models to understand the effects of polypharmacy on geriatric outcomes that are important contributors to the ‘fortitude factor’ in both sexes and old age. We will present recent data from studies in our preclinical models that: (1) describe how chronic polypharmacy use impairs translatable functional outcomes in ageing; (2) demonstrate differences in outcome response for different sex, age and frailty.
WORK EXPECTATION AND PSYCHOLOGICAL STRESS DURING THE GREAT RECESSION: THE ROLE OF LATE-LIFE EMPLOYMENT TRANSITIONS
Authors: Dang Linh , Antonucci Toni , Gonzalez Richard , Clarke Philippa , de Leon Carlos Mendes , Mezuk Briana
Published: January 2025

Perceived uncertainty about future employment during economic crises negatively affects the mental health of older adults. Moreover, such health impact varies across countries and employment contexts. This study examined the longitudinal association between work expectation and psychological stress among Baby Boomers in the US and South Korea and how employment transitions moderated this association during the Great Recession (2008-2009) and its recovery (2010-2018). Data came from 2006-2018 Health and Retirement Study (n=2,647) and Korean Longitudinal Study of Aging (n=1,454). Perceived expectation of working in the next five years was reported on a probability scale (0-100%). Psychological stress was assessed by the Center for Epidemiologic Studies Depression Scale. Six distinct employment transitions were constructed based on labor force status: entrance to full-time employment, precarious employment, stable full-time employment, self-employment, exit labor force, and being out of labor force. Multivariate mixed-effects logistic regressions were fit, adjusting for sociodemographic and health characteristics. Effect modification by employment transitions was examined via stratification. Higher work expectations were associated with lower odds of psychological stress during recession (OR=0.93 [0.89, 0.98]) and recovery (OR=0.95 [0.92, 0.98]) in US respondents; this association was more pronounced during the recovery in Korea (OR=0.83 [0.79, 0.87]). Among those who transitioned to self-employment, higher expectations were associated with higher odds of stress in US (OR=1.22 [1.02, 1.46]) but lower odds in Korea (OR=0.90 [0.77, 1.05]). Findings suggest opportunities for country-specific workplace policies to support mental health of older adults transitioning to different employment paths, particularly during the uncertain period of economic crisis.
DIFFERENCES IN PROTECTIVE MENTAL HEALTH RESOURCES AMONG WIDOWED IN THE UNITED STATES AND INDIA
Authors: Chauhan Shekhar , Carr Dawn , Taylor Miles , Sonnega Amanda
Published: January 2025

Widowhood is among the most consequential stressful events for mental health. Although social support is protective for mental health at widowhood, most of widowhood studies are based on US populations. This study uses a harmonized dataset we created to evaluate differences in depressive symptoms among recently widowed individuals (i.e., within the last 2 years) in the United States and India using the first (2017-18) wave of the Longitudinal Ageing Study in India (LASI; n=1571) and the 2016-2018 waves of the Health and Retirement Study (n=202). Using OLS regression, we evaluate depressive symptoms based on a four-item depression instrument (CESD; mean=1.19), by country status and we use interaction effects to evaluate differences by country. Results show that mean depressive symptoms are lower among US widows (0.95 vs 1.22). Having children and higher relative socioeconomic status are both associated with protective effects for US and Indian widowed people, but having friends and rural status are only associated with lower depressive symptoms among US widows. Rural status is associated with higher symptoms in India. Gender is not significant in either sample. Self-rated health is associated with protective effects for depressive symptoms for both groups, but the effect is greater for US widows. Findings suggest there are certain protective resources that are consistent across contexts, especially self-rated health, socioeconomic status and having children. Mental health interventions for widows that focus on non-family social engagement, however, may only benefit recent widows in the US.
RESIDENTIAL PREFERENCES FOR CURRENT AND FUTURE RESIDENTIAL ENVIRONMENTS AMONG KOREAN MIDDLE-AGED ADULTS
Authors: Lee Eunju , Kim Kyungmin
Published: January 2025

Midlife adults often plan for life after retirement, forming their own preferences for where to live after retirement. Their residential preferences for life after retirement may be different from the past as they consider their well-being in later life. This study compared middle-aged adults’ preferences for residential features between current and future residential environments (i.e., past and current residential preferences) and examined how differences in preferences for current and future residential features were associated with health and social characteristics. A sample of 1,651 Korean middle-aged adults (aged 49–64) rated their preferences for each of 12 residential features (e.g., proximity to family/relatives, low living expenses, accessibility to health services) regarding their current and future residential environments, separately. Respondents considered “house price” and “safe and clean environments” most important for both current and future residential environments, while “accessibility to health services” and “opportunity for leisure activities” were more important for future residential environments. Regression results showed that respondents with poorer health considered features that help them compensate for health decline more important, while those who contacted friends/neighbors more frequently and participated in more cultural activities considered features that help them maintain their social interactions more important for future residential environments than the past. Across residential features, respondents with poorer health showed lower similarity in overall preferences between current and future residential environments. Our findings suggest the importance of identifying various demands for residential features after retirement to support successful adaptation in later years.
PSYCHOMETRICS OF THE PHYSICAL RESILIENCE SCALE IN OLDER ADULTS LIVING WITH DEMENTIA: PROXY RESPONSES
Authors: Resnick Barbara
Published: January 2025

Physical resilience is defined as the ability to recover or optimize function in the face of physical challenges. Physical resilience has been conceptualized as a trait focusing on the way individuals respond to stressors versus an outcome of the stressor(s) or physically challenging experience. Due to cognitive changes, including decreased ability to recall new information or aphasia, it is difficult for individuals living with dementia to respond to questionnaires. Consequently, a family member or identified proxy is often asked to respond. The purpose of this study was to determine if proxies can complete the Physical Resilience Scale for older adults living with dementia. This was a descriptive study using Rasch analysis and baseline data from the Function Focused Care for Acute Care Using the Evidence Integration Triangle trial. The first 240 patients living with dementia were included. There was evidence of reliability based on person and item separation index. There was no evidence of Differential Item Functioning (DIF) between genders although there was evidence of DIF by race on Item 7 (He/she accepted help from others). Validity was supported based on items fitting the model except for Item 10 (He/She found it difficult to ask for help from others). Controlling for age, gender, race and comorbidities there was a significant relationship between resilience and function (R2 =.08, F=.4.75, p=.001) and resilience and pain (R2 =.08, F=3.95, p.002). The Physical Resilience Scale is reliable and valid when completed by proxy reports. Future use should remove Item 10 due to redundancy.
PROMOTING LIFELONG LEARNING AT OREGON’S AGE-FRIENDLY UNIVERSITIES
Authors: Cannon Melissa , Toyokawa Noriko , Guest M Aaron
Published: January 2025

The Age-Friendly University (AFU) global network “aims to shape how we live and work by increasing educational opportunities across the life span” (https://www.afugn.org/). In Oregon, USA, Portland State University (PSU), Western Oregon University (WOU), and Southern Oregon University (SOU) have endorsed and adopted the AFU Principles to become part of the network of age-friendly higher education institutions. Although each institution has implemented different initiatives as part of this work, a common thread across the three has been promoting lifelong learning. Melissa Cannon will present findings from preliminary research that identified several strengths, weaknesses, and opportunities for WOU becoming age-friendly, including those detailed in their own AFU campus report. Participants will learn some of the recent initiatives that have advanced the university’s age-friendly and lifelong learning efforts. Noriko Toyokawa will guide a discussion on the distinct challenges small-sized universities face when initiating and maintaining age-friendly university initiatives. The presentation will explore potential strategies for effectively managing these situations, using the case of SOU as an illustrative example. Serena Hasworth and Lauren Bouchard will highlight findings from PSU’s “Age-Friendly University Campus Report” and provide an overview of activities to improve age-friendliness through the Better with Age Initiative. They will describe efforts to develop an age-inclusive micro-credential program for students and faculty at PSU. The concluding discussion fosters a dynamic exchange of creative ideas between the audience and presenters, aiming to optimize existing resources for mobilizing and sustaining age-friendly university initiatives across diverse contexts.
ENHANCING AND SUSTAINING THE MEMORY CARE NAVIGATOR MODEL IN HAWAII
Authors: Nishita Christy
Published: January 2025

Hawaii’s memory care navigator model aims to educate, support, and connect local families to the resources that they need. The Kupuna Collective, a cross-sector coalition led by the University of Hawaii Center on Aging and Hawaii Public Health Institute, has taken steps to enhance the model. First, community health workers, given their close ties and relationship with local communities were targeted and trained to provide person-centered, dementia support in a culturally tailored manner. To ensure quality and explore collective impact, community health workers, who were embedded within local organizations, use a standardized, electronic platform to collect assessment and care planning data. In addition, the model has been sustained by integrating the model within Hawaii’s workforce development efforts. Trainings are widely disseminated as part of Hawaii’s Building Our Largest Dementia Infrastructure initiative, funded by the Centers for Disease Control. Trainings are stored in an online library for ongoing continuing education and training and available for use by community college CHW training programs. Taken together, the memory care navigator model has supported the development of a more coordinated system of dementia care in Hawaii.
LATENT CLASSES AND PROGRESSION OF MMSE IN YOUNG-ONSET DEMENTIA: DATA FROM THE SWEDISH DEMENTIA REGISTER
Authors: Finkel Deborah , Kårelind Fanny , Zarit Steven , Bielsten Therése , Wijk Helle , Johansson Linda
Published: January 2025

Studies have shown significant heterogeneity in the longitudinal progression of dementia. Growth mixture models have detected up to 4 classes that differ in both baseline Mini-Mental State Exam (MMSE) and rate of decline over time. Most analyses focus on adults over age 65 and investigate group differences in demographic and health variables. The current analysis focused on adults with young onset dementia (YOD) and examined the role of demographic and support variables. Sample included 1025 adults (55% women) registered in the Swedish Dementia Register prior to age 65 with at least 3 registrations. Age at baseline was 38 to 64 (mean=59.3, SD=4.1); follow-up ranged from 1 to 12 years (mean=4.6, SD=2.0). Growth mixture models identified 4 classes: high baseline MMSE and moderate decline over time (56.1%), intermediate baseline MMSE and somewhat faster decline (39.2%), low baseline and stable MMSE over time (3.5%), and high baseline with steep decline (1.2%). Group 2 had the highest proportion Alzheimer’s Disease (AD) diagnosis and Group 4 had the lowest. Group 3 was more likely to have vascular or unspecified dementia and Group 4 was more likely to have vascular or frontotemporal dementia. Groups differed in age at diagnosis (Group 2 youngest), participation in adult daycare (Group 4 most likely), and having home health assistance (Group 2 most likely). Results highlight that YOD is just as heterogeneous as later onset dementia; therefore, it is vital that people with YOD get early diagnosis and a case manager to help identity and meet their individual needs.