bluuebunny/crossref_metadata_2025 huggingface dataset:
ADVANCING DIVERSITY IN AGING: THE AGE-ADAR SCHOLARS PROGRAM AT WVU
Authors: Patrick Julie Hicks , Rusch Amber , Pullen Carly
Published: December 2023

As the number and racial/ethnic diversity of older Americans, ages 65+ years increases, recruiting, training, and retaining a diverse workforce to support aging-related fields is essential. Supported by an R25 grant from the NIA, the goals of the Appalachian Gerontology Experiences: Advancing Diversity in Aging Research (AGE-ADAR) Scholars Program include training undergraduate MSTEM majors in aging and health disparities research, especially as these topics interact in Appalachia. In this brief presentation, we will review the goals and mechanisms through which these aims are accomplished. We will review both hard outcomes (i.e., conference presentations, publications) and soft outcomes (attitude change, career specialization) among our first two cohorts of Scholars. For example, each Scholar prepares two empirical abstracts, presents a poster on campus, presents one or more posters off-campus, produces a public-facing infographic about health disparities and aging, conducts a literature review, and composes an integrated essay related to how their MSTEM major can help to solve issues of health disparities among older adults in Appalachia. About half of our Scholars have co-authored published manuscripts, as well. Finally, other funding mechanisms to support training the next generation of researchers, scholars, and applied workers in aging will be discussed.
ESPO AND BUTLER-WILLIAMS SCIENTIFIC SYMPOSIUM: CAREER DEVELOPMENT TO PROMOTE DIVERSITY, DISCOVERY, AND AGING
Authors: Davis Jamaine , Morgan Brianna , Jones Patricia
Published: December 2023

The NIA’s Butler-Williams Scholars Program and GSA’s ESPO Section are united in providing career development opportunities in a manner that promotes leadership, diversity, and inclusivity. This year’s theme challenges our emerging scholars to embrace diversity and discovery while thinking—or rethinking—about the perspectives of older adults. Disparities in health associated with race/ethnicity, lived experience, sociocultural and socioeconomic factors, as well as access to and provision of health care are chief concerns of our aging population. GSA’s early career professionals and 2022 alumni of the prestigious NIA Butler-Williams Scholars Program address these issues. Dr. Shekinah Fashaw-Walters will discuss her work examining how high-quality providers influence high quality of healthcare, particularly for Black patients. Dr. Sara LaHue will discuss how biological age can be a measure associated with delirium or neuronal inury markers in a cohort of hip fracture patients. Dr. Imilce Rodrigues-Fernandez will present on the importance of identifying pathways that can lead to improvements in stem cell function that can improve age-related tissue degeneration. how both demographics and genetic factors contribute to cognitive performance. The final speaker, Dr. Helena Zomer will present findings on the mechanism by which a hormone can extend healthspan and longevity. The featured talks by rising stars deepen our understanding of the influence of diversity and key discoveries so we can reimagine aging research.
PROTECTIVE EFFECT OF SHINGLES VACCINE ON ALZHEIMER’S DISEASE CAN BE MODULATED BY RISK VARIANT OF NECTIN2 GENE
Authors: Ukraintseva Svetlana , Duan Hongzhe , Holmes Rachel , Wu Deqing , Akushevich Igor , Yashkin Arseniy , Arbeev Konstantin , Yashin Anatoliy
Published: December 2023

The aging-related decline in immune surveillance was suggested to play a major role in Alzheimer’s disease (AD). Adult vaccinations may support the aging immune system beyond prevention of the target disease, and through this provide a protection against AD. Such off-target effects of vaccines may potentially be affected by genetic risk factors for AD. To explore this possibility, we estimated association of the vaccination against shingles (reactivated herpes zoster virus infection) received between ages 65-75 with AD onset at ages 75+ in the Health and Retirement Study (HRS) survey participants, comparing the carriers and non-carriers of rs6859 A allele of NECTIN2 gene (AD risk factor that is also involved in vulnerability to viral infections). We used logistic regression model with covariates including sex, race, education, and smoking status. We found that shingles vaccine was significantly associated with lower odds of AD onset later in life, in the total sample (p-value=0.021; OR=0.55 (0.33, 0.92)). After stratification by genotype, the protective effect of vaccine became stronger in rs6859 A carriers (p-value=0.016; OR=0.44 (0.22, 0.86)), but disappeared in the non-carriers, for both significance and size (p-value=0.81; OR=0.90). We conclude that adult shingles vaccine may reduce chances of AD at older ages, and this effect appears more beneficial for carriers of rs6859 A allele of NECTIN2 gene. Repurposing of existing vaccines may benefit the aging immune system, and be a promising approach to personalized genotype-tailored prevention of AD.
WHEN DISASTER STRIKES: ADDRESSING THE UNIQUE NEEDS OLDER ADULTS FACE IN EMERGENCY SITUATIONS
Authors: Fazal Amaanali , Lalji Kahir , McMillan Barbara
Published: December 2023

Older adults are more at risk for harm in emergency situations (e.g., pandemics, natural disasters, extreme weather events) and often require more assistance in response and recovery efforts. The COVID-19 pandemic and the increase in climate related emergencies has emphasized the critical need to prepare and respond more effectively to the unique needs of older adults in emergency situations. There is much that community-based seniors serving (CBSS) organizations, emergency management professionals, and local governments can do to develop and implement policies, programs, and practices to effectively support the needs of older adults in emergency preparedness and response. In British Columbia, the COVID-19 pandemic and recent extreme weather events (i.e., forest fires, flooding, and heat waves) have prompted the development of an intentional network strategy for emergency preparedness and response. This innovative approach, which is coordinated by United Way British Columbia, has allowed for increased communication, coordination, collaboration, peer learning, and knowledge translation among CBSS agencies, as well as partner organizations, allied professionals, and other stakeholders. This presentation describes our comprehensive approach to supporting communities to understand and address the specific needs of older adults in emergency planning and management, including: 1) community grants and capacity building; 2) tools and resource development; 3) policies and rights-based strategies; and 4) fostering collaboration between CBSS agencies, emergency management professionals, and all levels of government. Examples are also provided illustrating how these approaches have been utilized in British Columbia to respond to the COVID-19 pandemic and severe weather events.
GEOGRAPHIC AND DEMOGRAPHIC PREDICTORS OF SELF-RATED HEALTH IN OLDER RURAL AFRICAN AMERICANS
Authors: Mackenstadt Darby , Adams-Price Carolyn , Israel Sarah
Published: December 2023

Person-Environment (P-E) fit is a major tenet of environmental gerontology and can predict aspects of physical and mental health. Rural older adults may vary greatly in their P-E fit, but their in-group differences have yet to be explored. The current study examines predictors of self-rated health in middle and older adult African Americans in rural Mississippi. Predictors of self-rated health examined included distance from grocery store, age, education, and income. Participants were 47 African Americans (20 males) over 50 (M = 65.2) who were recruited from two rural, adjacent Mississippi Counties and lived at least five miles outside of a micropolitan town. Consistent with literature on health disparities in African American communities, participants on average rated their health as average to low. Results from a multiple regression model indicate that education and distance to grocery stores are significant predictors of subjective health, where more education and being further from a grocery store predicted higher self-rated health. It appears that within this sample, the further from a grocery store they were, the better the P-E fit. This may be due to an increase in gardening or farming, increased necessity for physical activity, or other aspects of this environment that promote healthy behaviors, despite being further from resources. Future research should continue to pursue aspects that add to P-E fit in rural older adults.
CULTURAL CONSIDERATIONS AND ATTACHMENT TO PLACE FOR RURAL-DWELLING OLDER ADULTS
Authors: Adams-Price Carolyn
Published: December 2023

Mississippi is the only state in the United States where the majority of African Americans live in rural areas. African Americans have lived in rural Mississippi for many generations, despite few resources and health inequities. However, it is a mistake to look at older rural African Americans and see only poverty and illness. Previous research by Rowles and others in Appalachia has indicated that older adults tend to be satisfied with homes in impoverished rural areas. This study examined attachment to home and community in older African Americans living in rural parts of two counties in north Mississippi. Participants were 47 African Americans between 52 and 79 (20 male), with a mean age of 65. Phenomenological analysis for attachment to home yielded 6 themes: home as a peaceful/safe place, legacy/historical roots, attachment to natural features, ownership/I’ve made it my own, and everyday functionality. The first two themes (peaceful/safe and legacy/historical roots) were far more prevalent than the theme of everyday functionality; these findings will be discussed in the context of other researchers’ findings on attachment to place in later life. However, although our participants have experienced discrimination in the larger environment, home is for most of them a place of safety, warmth, and meaning. Attachment to features of the land is also important.
INTRODUCING A NEW AGE-BASED DATASET FOR EVALUATING OCCUPATIONAL CHARACTERISTICS ACROSS THE LIFE COURSE
Authors: Chen Qize , Sonnega Amanda , Carr Dawn , Carpenter Rebekah , Cao Katy (Qiuchang)
Published: December 2023

The connection between early life career choices and later life outcomes is a topic of interest to gerontology researchers, but research has been limited by data availability. In this paper, we present a newly constructed LHMS-HRS-O*NET linked dataset. The 2017 Health and Retirement Study (HRS) Life History Mail Survey (LHMS) includes information on up to 10 jobs that respondents worked for more than a year. We consolidated this employment history with the biennial HRS Core survey data. Then, respondents’ occupations from the LHMS were mapped to the O*NET 26.1 Database to add information on their exposure to different work contexts, activities, and etc. The final dataset is a panel at individual-year level with annual occupational exposure from the first job after full-time education until the last job people held before 2017. The data covers over 4,000 individuals in the HRS with all O*NET measures available in O*NET 26.1. This presentation will demonstrate how researchers can use these data to calculate the cumulative occupational exposures for any period of one’s career and connect that information to socioeconomic, health, and other outcomes at older ages that are available in HRS. This new data is ideal for studying how full life histories of work are related to differential aging outcomes.
CHARACTERIZING CAREGIVER NEGLECT IN OLDER PERSONS WITH DEMENTIA: OPERATIONAL DEFINITIONS AND RISK FACTORS
Authors: Chang E-Shien , Moxley Jerad , Pillemer Karl , Lachs Mark , Rosen Tony , Czaja Sara
Published: December 2023

Neglect by caregivers, a combination of behaviors through acts of omission or commission, is one of the most widespread forms of elder mistreatment. Examining varying definitions and thresholds of caregiver neglect may yield insights to inform intervention development. Our data were drawn from 244 dyads of racially/ethnically diverse dementia caregivers (CG) and care-recipients (CR). Informed by prior research, we developed three definitional thresholds of caregiver neglect: (1) CR’s needs were unmet by CG (least restrictive); (2) CR’s needs were unmet by CG and there was no additional informal care (moderate restrictive); and (3) CR’s needs were unmet by CG and there was no additional informal or formal care (most restrictive). Variables selected for multivariate logistic regression models examining predictors of neglect were based on significance in bivariate analysis (p< 0.10). One-week prevalence of caregiver neglect varied according to the three thresholds (43% to 11%). Sociodemographic characteristics of neglect differed across thresholds in bivariate analyses. The caregiver being male (OR=4.1, 95%CI=1.68-10.53) and being African American (OR= 2.12, 95%CI=1.01-4.54) was significantly associated with greater risk of neglect but only in the model predicting the least restrictive neglect. In models predicting moderate and most restrictive neglect, greater CG social support was associated with lower risk of neglect (OR=0.95, 95%CI=0.90-0.99; OR=0.93, 95%CI=0.89-0.98; respectively). Our findings indicate that caregiver neglect was common in our sample and that social support may play a key role in alleviating risk of neglect. Our analysis demonstrates important nuances in predictors of neglect by operationalizing neglect as a multifactorial phenomenon.
RACIAL AND ETHNIC DIVERSITY IN FAMILY CARE INTERVENTIONS: A CALL FOR ACTION
Authors: Meinertz Naomi , Lee Jeong Eun , Gilligan Megan
Published: December 2023

In the United States, women are disproportionately represented as family caregivers and racial and ethnic minority families experience the challenges of caregiving at greater rates, such as poorer health and psychological distress. Recent research results demonstrate the effectiveness of family care interventions through improvements for caregiver depression, anxiety, and caregiver knowledge; yet most of these programs were developed for and evaluated with White families. The extent to which caregiver support interventions attend to racial and ethnic diversity is inadequate. Limited understanding of intervention results by racial and ethnic subgroups may ultimately further exacerbate disparities across groups by limiting our ability to account for any differences in treatment outcomes. Advances in research on caregiver interventions warrant an examination of the degree to which gender and/or racial differences are considered in the field of caregiver intervention research. Using a combined theoretical lens of symbolic internationalism and gender role theory, we argue for the development of care programs for racially and ethnically diverse family care perspectives. Thus, we conducted a systematic review of caregiver interventions and further explored whether common evidence-based care interventions are efficacious with non-White populations. Additionally, we emphasize the importance of developing targeted intervention programs by reviewing the impact of recently develop programs for specific target populations. This work underscores the gap in current family care interventions and identifies the need for evidence-based family care programs for diverse populations. Our systematic review will further our understanding about disparities in intervention outcomes to develop culturally appropriate interventions.
ONLINE DEMENTIA BOOTCAMP FOR HIGH SCHOOL STUDENTS
Authors: Mastel-Smith Beth , Kimzey Michelle , Garner Jennifer
Published: December 2023

Caring for people with dementia requires specialized competencies. Previous education programs had a positive effect on college students’ dementia knowledge, communication skills, empathy for and attitudes towards people with dementia. To prepare high school students to care for people with dementia – whether it be in a professional or personal capacity - a six session online Dementia Bootcamp was created. Topics included dementia overview, prevention, symptoms, and a framework for understanding them, communication, family support, and evaluation. Information was delivered via short didactic instruction, presentations by people with dementia, and experiential activities such as a virtual dementia simulation. Students met with a mentor, a person with dementia, or volunteered at a dementia day program. Parental consent and student assent were obtained for six students who participated in a focus group. The focus group was audio recorded and an interview schedule was used to understand what students learned, their response to online delivery, and recommendations for future offerings. Data was transcribed and verified, coded for categories and themes developed. Increased dementia awareness and knowledge, confidence in the ability to communicate with someone with dementia, how to prevent dementia, improved cognitive empathy and empathic imagination, and reduced stigma were reported. Online delivery was well received; students recommended longer sessions, more engagement with content and each other, and more information about how dementia affects the brain. The program has been integrated into a high-school health sciences curriculum.
INTERGENERATIONAL BONDING: A PATHWAY TO CAREER READINESS IN SPEECH LANGUAGE PATHOLOGY GRADUATE STUDENTS
Authors: Ghazi-Saidi Ladan , McKelvey Miechelle
Published: December 2023

We present a new experiential learning activity for graduate students in two core courses in Speech-Language Pathology. Speech-Language Pathology is a healthcare profession that provides care to people of all ages, including older adults with language, communication, and cognitive disorders. Students typically find these course contents heavy and have limited opportunity to practice the required skills for their future profession. In this multi-faceted program, we provide cognitive intervention to community older adults via telepractice with an intergenerational approach. Students receive real-life interaction to practice the knowledge and skills learned in their academic program. These interactions provide hands-on experience that facilitates better preparation for their future healthcare career. We measure students’ perception of competency pre and post-intervention. Additionally, we survey alumni and their supervisors on students’ preparedness (required skills) and performance during their clinical internship experience. This intergenerational bonding program creates a fun and enjoyable experience that impacts students’ active engagement with older adults. Students report an easier application of academic material, great ownership of learning, and increased motivation to learn new skills. Further, this real-life, interactive experience will impact their career success as future aging healthcare professionals (SLPs).
IMPACTS OF ACCULTURATION ON HEALTH OF US OLDER CHINESE IMMIGRANTS
Authors: Jiang Yanping , Tang Fengyan , Wu Bei
Published: December 2023

Acculturation from Asian- to Western-oriented values and cultural practices is a key aspect of social experience for many Asian Americans. The growing body of literature on this topic shows mixed findings on health impacts of acculturation and is largely relied on cross-sectional studies, preventing to draw definitive conclusions on the health impact of acculturation. The study aimed to examine long-term effects of acculturation on mental, physical, and cognitive health in U.S. older Chinese immigrants. Data were drawn from 2,811 participants (aged from 60 to 104 years) from the Population Study of Chinese Elderly in Chicago study. Acculturation was measured using a 12-item Acculturation Scale assessing language use, ethnic social relations, and media use. Health outcomes included depression assessed using the Patient Health Questionnaire-9, activities of daily living (ADL) assessed using the adapted Katz ADL Scale, and global cognition indexed by a composite score of episodic memory, working memory, executive function, and mental status. Results from latent growth curve models showed that high levels of acculturation were not associated with depression at baseline but predicted a faster decline in depression during the 6-year follow-up. Similarly, acculturation was not related to ADL at baseline but predicted a slower decline over time. Contrarily, acculturation was associated with better global cognition at baseline but was not related to long-term changes in cognition. These results suggest the long-term benefits of acculturation on mental and physical health among U.S. older Chinese immigrants. The health advantages related to acculturation, however, seem not to generalize to cognitive function.
MULTIPLE SEVERE WEATHER EVENTS: ARE OLDER ADULTS MORE VULNERABLE?
Authors: Cherry Katie , Calamia Matthew , Elliott Emily , Bordes Piper , Sampson Laura , Galea Sandro
Published: December 2023

Hurricanes and floods have psychosocial consequences for directly and indirectly affected individuals. In August of 2016, historic flooding in Baton Rouge, Louisiana resulted in catastrophic damage across a 22-parish (county) region only 11 years after the 2005 Hurricanes Katrina and Rita devastated the US Gulf Coast. In this study, we compared three groups of mostly middle-aged and older adults on the SF-36 Health Survey Questionnaire: (1) non-flooded (controls), (2) single disaster (flooded in 2016), and (3) double disaster (flooded in 2005 and again in 2016). Results indicated that the groups did not differ in self-reported physical health, although the single and double disaster groups reported worse mental health than did the controls. Correlation analyses revealed that age was positively associated with mental health. State hope was positively associated with both physical and mental health. Implications of these findings for reducing vulnerabilities after multiple disaster exposures are considered.
HEARING AND VISION LOSS: EPIDEMIOLOGIC AND INTERVENTION IMPLICATIONS FOR SOCIAL ISOLATION, LONELINESS, AND MOOD DISORDERS
Authors: Huang Alison , O’Sullivan Roger , Lubben James
Published: December 2023

This session will discuss hearing loss and vision impairment as modifiable risk factors for social isolation, loneliness, and mood disorders from both epidemiologic and intervention perspectives. Prevalence of hearing and vision loss is high; two-thirds of older adults have hearing loss and over one-quarter have vision impairment. Hearing loss and vision impairment have been linked to poor cognitive and physical health but remain understudied in the context of social and mental health in large, population-based studies. Research gaps remain in measurement (findings typically based on subjective assessments) and generalizability. This session will investigate associations between objectively measured hearing, vision, and dual sensory loss on social isolation and mood disorders using a sample nationally representative of older adults in the US. This session will also describe potential mechanistic and environmental factors, such as fatigue and exclusion of hearing loss and vision impairment in health care settings that may explain observed associations. Whether treatment of hearing loss and vision impairment is an effective intervention for improving social and mental health is unknown. We will conclude by presenting findings from a randomized controlled trial designed to test whether a hearing intervention consisting of provision of hearing aids and related technologies, counseling, and education could reduce cognitive decline in older adults with untreated hearing loss. We focus on the effect of hearing intervention on social isolation and loneliness, both pre-specified outcomes of this trial. This is a Loneliness and Social Isolation Interest Group Sponsored Symposium. This is a collaborative symposium between the Loneliness and Social Isolation and Sensory Health Interest Groups.
EFFECT OF HEARING INTERVENTION ON LONELINESS AND SOCIAL ISOLATION IN THE ACHIEVE STUDY
Authors: Huang Alison
Published: December 2023

Social health interventions in older adults typically have small effect and limited large-scale implementation. Treating hearing loss is a potential intervention, but efficacy is unknown. This study presents baseline associations between hearing loss, loneliness, and social isolation as well as the 3-year effect of a hearing intervention on social health. The Aging and Cognitive Health Evaluation in Elders Study (ACHIEVE) randomized controlled trial (n=977) tests the effect of hearing intervention (provision of hearing aids/related technologies, counseling/education) vs. successful aging health education control intervention on loneliness (UCLA Loneliness Scale) and social network characteristics (Cohen Social Network Index) (pre-specified exploratory outcomes) among older adults with untreated hearing loss. Hearing loss was quantified by better ear, speech-frequency pure tone average (PTA). Speech-in-noise recognition and hearing-related quality of life were also measured. Baseline associations between hearing loss and social health outcomes are assessed by robust Poisson regression adjusted for demographic and health characteristics. Three-year hearing intervention effects are assessed by generalized linear mixed effects models. Participants were 70-84 years, 54% female, and 87% White. At baseline, better speech-in-noise recognition was associated with greater social network characteristics (e.g., larger social network size [IRR: 1.04, 95% CI: 1.00, 1.07]). Worse hearing-related quality of life was associated with higher prevalence of loneliness (PR: 1.15, 95% CI: 1.11, 1.20) and smaller social network size (IRR: 0.96, 95% CI: 0.93, 1.00). Hearing intervention effect results will be available prior to the conference (data collection ends early 2023). Hearing treatment could be an effective social health intervention with greater scalability.
THE ASSOCIATION OF HEARING LOSS AND FRAILTY AMONG OLDER ADULTS IN THE US
Authors: Amezcua Pablo Martinez , Assi Sahar , Zhang Wuyang , Reed Nicholas
Published: December 2023

Frailty is common in older adults and increases the risk of functional limitations and death. Hearing loss affects ~2/3 of older adults in the U.S. and is associated with poorer physical and cognitive function and social isolation, which may increase the risk for frailty. We aimed to determine if hearing loss is associated with higher odds of being frail or pre-frail versus robust and if hearing aid use is protective. We analyzed data from 2,361 participants from the National Health and Aging Trends Study (NHTAS), a U.S. nationally representative sample of older adults, collected in 2021. Hearing was assessed by pure-tone audiometric testing, and we used a speech-frequency (0.5-4 kHz) better hearing ear’s pure-tone average (BPTA) to categorize participants into no hearing loss (BPTA≤25 dB HL), mild (26-40), and moderate or greater (>40) hearing loss. Physical frailty was categorized according to the presence of the frailty phenotype components (unintentional weight loss, exhaustion, low physical activity, weakness, slow walking speed) into robust (0), pre-frail (1-2), and frail (≥3). In our study population (mean age=81, 56% female, 19% Black), there were 1,724 (73%) participants with hearing loss. Using multinomial logistic regression, we found that participants with moderate or greater hearing loss (vs. those without) had higher odds of being frail versus robust (OR=1.82, 95% CI 1.11, 2.99, p-trend=0.016). Hearing loss may be a risk factor for frailty. Future studies on the impact of hearing interventions in preventing and managing frailty will have significant public health and clinical importance.
PRACTICE EFFECTS ON BRAIN EFFICIENCY OF WALKING IN AGING AND NEUROLOGICAL DISEASE
Authors: Holtzer Roee , Izzetoglu Meltem
Published: December 2023

Evidence provides support for using functional near-infrared spectroscopy (fNIRS) to quantify brain activations, notably in the pre-frontal cortex (PFC), under different walking conditions. Dual-tasks that involve walking impose additional demands on attention resources relative to the single tasks, and Studies using fNIRS revealed increased HbO2 in the PFC in Dual-Task-Walk (DTW) compared to Single-Task-Walk (STW) conditions in several populations. Burst measurement within session, which involves repeated administration of the same task, affords evaluation of short-term practice effects on changes in walking performance and the efficiency of its underlying neural activation. Here, we examined the effects of task (STW vs. DTW) and burst measurement (three counter-balanced repeated trials of each task condition) on walking performance and fNIRS-derived HbO2 in the PFC in older adults with multiple sclerosis (n=80, %female=65%, mean age=64ys) and controls (n=79, %female=65, mean age=69ys). Participants were enrolled in an ongoing cohort study designed to determine cognitive and brain predictors of locomotion in older adults with MS. Results from linear mixed effects models (LMEMs) revealed: 1) higher fNIRS-derived HbO2 in DTW compared to STW (p<.01). 2) fNIRS-derived HbO2 levels declined over repeated trials, notably in DTW (p<.01). 3) gait velocity was slower in DTW compared to STW (p<.01). 4) gait velocity improved over repeated trials (p<.01). The combination of decline in fNIRS-derived HbO2 levels and faster walking over repeated trials under DTW suggests more efficient usage of brain resources to support attention-demanding locomotion in aging and neurological disease.
HETEROGENEITY OF PREFRONTAL CORTICAL ACTIVITY DURING WALKING AMONG OLDER ADULTS
Authors: Baillargeon Emma , Huppert Theodore , Rosano Caterina , Rosso Andrea
Published: December 2023

Higher prefrontal cortical (PFC) activity during simple walking may indicate neural compensation for impaired gait automaticity. On average, older adults have higher PFC activity during walking than younger adults, but the heterogeneity amongst older adults is understudied. We examined PFC activity during simple and dual-task walking in adults aged 65+ (n=173, mean age=72, 62% female). Participants walked quietly and while reciting every-other-letter of the alphabet (dual-task; 4 repsx15 meters). Change in PFC activity from standing was estimated using functional near-infrared spectroscopy. We grouped participants with significantly increased, significantly decreased, or no change in PFC activity from standing to simple walking (t-test, alpha=0.05). We tested for group differences in PFC activity change from simple to dual-task walking, task performance (gait speed, rate of correct letters), age, and cognitive function (trail-making A/B). PFC activity increased from standing to walking in 52 (30%), decreased in 21 (12%), and did not change in 100 (58%) participants. Those who reduced PFC activity from standing to simple walking (vs no change or increased, respectively) walked faster (mean+/-SD=1.12+/-0.17 vs 1.00+/-0.17 0.99+/-0.18m/s; both p=0.014) and had a greater increase in PFC activity from simple to dual-task walking (t-stat=1.96+/-2.2 vs 0.49+/-1.53 vs -0.26+/-1.43; p=0.008, p=0.0006). Those who increased PFC activity from standing to simple walking had a smaller PFC change (vs no change) from simple to dual-task walking (p=0.005). Age, alphabet performance, and cognitive function did not differ across groups. Differences in PFC activity during simple walking may contribute to differences in task performance and capacity for walking challenges.
A COMMUNITY-DRIVEN INITIATIVE TO ENGAGE EMPLOYERS AS ADVOCATES TO SUPPORT WORKING CAREGIVERS
Authors: Meyer Kylie , Zachmeyer Morgan , Paccione Jane , Smith Christina , Cardenas Cynthia , Teran Dianne , Zernial Carol
Published: December 2023

Approximately 62% of family caregivers to older adults living with a chronic illness or disability are employed. Nearly 6 in 10 caregivers report that caregiving has affected their employment in the last year, such as by requiring them to turn down a promotion, reduce work hours, or leave the workforce. Loss of employment income affects caregivers’ immediate and long-term financial well-being. To help family caregivers balance employment and caregiving and promote their long-term financial security, in 2021, the Successfully Living and Aging in San Antonio Caregiver/Socialization Workgroup developed a 5-part discussion series to encourage local employers to consider how to better support employees who are caregivers. The series was attended by 75 individuals representing 34 organizations. During initial discussions, attendees identified the importance of institutional culture in affecting workplace policies around caregiving. To help promote supportive workplace cultures, in the third discussion session, participants used a modified nominal group technique to co-develop a 10-point pledge that employers can use support employees who are caregivers. In this presentation, the authors will describe the development of the pledge. Further, we contextualize this initiative in terms of the Shilton Model of Policy Advocacy. By integrating employers into discussions about supporting employees who are caregivers, this local initiative provides an example of how communities can incorporate employers as stakeholder advocates to support policies to help family caregivers remain in the workplace. This work is particularly valuable to advance policy recommendations to promote caregiver financial well-being within the 2022 National Strategy to Support Family Caregivers.
HOW WILL AGE INCLUSIVITY SURVIVE IN AN ERA OF ANTI-DEI INITIATIVES?
Authors: Bradley Dana , Allen Laura
Published: December 2023

For the first time, we have five different generations in the workplace in the United States. Generational diversity in the office is a trend that is not only expected to continue, but it is expected to grow. In that same vein, as companies continue to evolve in the way they work, it will be vital for organizations to understand, embrace and establish a diversity, equity, and inclusion (DEI) strategy in an ongoing effort to help employees of all ages feel like they are respected, valued, understood and belong in their workplace. Recent state court decisions and administrative decisions by governors suggest that DEI strategy implementations may be limited in some states. This paper explores the evolution of age inclusivity as part of DEI policies and practices. Grounded in the work of the United Nations Convention on the Rights of Older Persons, advocates have expanded their work to address ageism and ableism and ensure that society reflects persons’ lives as they age. We reviewed state-level court and administrative decisions regarding DEI initiatives across the US in 2021-23. While findings rarely note age, language in these decisions is written broadly so that outcome is unclear which subsequent court decisions. Our analysis concludes with “best practices” from the corporate sector and higher education, which emphasize systems where people on either end of the age spectrum have a more precise connection point to the decision-makers, each other, and conversations around the age at work. These strategies offer a cautious pathway forward in the US.
CATALYZING DEMENTIA CARE THROUGH THE LEARNING HEALTH SYSTEM AND CONSUMER HEALTH INFORMATION TECHNOLOGY
Authors: Wolff Jennifer , Powell Danielle
Published: December 2023

To advance care for persons with Alzheimer’s disease and related dementias (ADRD), real-world health system effectiveness research must actively engage those affected to understand what works, for whom, in what setting, and for how long – an agenda central to Learning Health System principles. The spread of consumer health information technology affords new opportunities to support ADRD caregivers within health care delivery. Patient portals allow patients to view test results and sections of their electronic medical record, perform health management tasks (e.g., scheduling visits, billing, filling prescriptions), access educational materials, and communicate with clinicians using secure messaging. Many care delivery organizations allow patients to share access to their portal account by registering a “care partner” to have their own identity credentials (login/password). Through shared access, patients may select whether and who electronically interacts with clinicians on their behalf, thus, respecting patient preferences while supporting care partners with timely information about patient health and treatments, and a mechanism to electronically navigate health system demands. Little is now known about electronic information sharing preferences and practices of persons with ADRD and their caregivers, the feasibility of deploying novel interventions, or existing initiatives through consumer health information technologies to better support ADRD care and management. This symposium presents early results from projects seeking to increase evidence regarding the role and use of consumer health information technology in ADRD care and management by examining the existing landscape of patient portal use in the context of dementia care from a large integrated academic health system.
THE MEDICARE ANNUAL WELLNESS VISIT: POTENTIAL FOR EMBEDDED INTEGRATION OF THE PATIENT AND FAMILY PERSPECTIVE
Authors: Powell Danielle , Wu M J , Gleason Kelly , Nothelle Stephanie , Oh Esther , Reed Nicholas , Wolff Jennifer
Published: December 2023

Patient portals are secure online platforms that provide an opportunity for patients to actively participate in their care by viewing their health information, messaging with clinicians, and completing health risk assessments, like the Medicare Annual Wellness visit (AWV). Using electronic medical record and patient portal (MyChart) data (October 3, 2021-October 2, 2022) from a large integrated academic medical center, we examine uptake of the AWV among Medicare beneficiaries 65+ years with 2 or more primary care visits. We then examine whether responses to the AWV health risk assessment differ by whether patients are registered for and actively use the patient portal. Among 11,378 eligible beneficiaries, 7,194 had an AWV billed (62% female, 69% White, 8.7% dementia, 78% patient portal users). Among those billed, 98% answered at least 1 health risk assessment question +/- 30 days of billing, and 76% completed questions related to all risk assessment themes. Nearly 8 in 10 (79.6%) older adults who completed the AWV were patient portal users. While highly active overall, completion of the AWV and health risk assessment was higher for active patient portal users. Compared to non-active portal users, active users were less likely to report difficulty with ADLs, transportation, chores, mobility issues, vision concerns, living alone, and seeing a dentist. Evaluation of billed AWV alone does not fully characterize completion and care provided for the preventive care visit. Systematic incorporation of the patient portal may aid in integration and dissemination of preventive care.
HOST-MICROBE METABOLIC INTERACTIONS IN DISEASE AND AGING
Authors: Li Xiaoling
Published: December 2023

As a key mediator of environmental influences on cellular functions, metabolism is crucial for cellular adaptation to the environment. Perturbations of metabolic homeostasis by various environmental factors, including diet and lifestyle, are associated with numerous metabolic diseases and contribute to acceleration of aging. To understand how metabolism mediates environmental regulation of cellular functions and how disruption of metabolic homeostasis contributes to pathogenesis of diseases and aging, we have been focused on a nutrient-sensing pathway consisting of NAD+, SIRT1, the most conserved mammalian NAD+-dependent protein deacetylase/deacylase, and protein acylations. Employing genetically modified mice and cultured cells as model systems, we have recently shown that NAD+ and SIRT1 are key mediators of host-microbe metabolic interactions. On one hand, host NAD metabolism is regulated by gut microbiota. On the other hand, SIRT1 age-dependently modulates gut microbiota through regulation of intestinal bile acid metabolism and Paneth cell activation. Furthermore, we identified SIRT1 as a key regulator of methionine metabolism in embryonic stem cells and developing embryos, thereby modulating their sensitivity to methionine restriction, a dietary regimen that protects against metabolic diseases and aging. Intriguingly, we recently demonstrated that dietary methionine restriction impairs anti-tumor immunity through interaction with gut-microbiota. Together, our findings uncover an important role of the NAD+-SIRT1 axis in mediating host-microbe metabolic interactions that influence disease and aging.
THE UNIVERSITY OF OKLAHOMA GSA STUDENT CHAPTER AND MULTICAMPUS COORDINATION AND COLLABORATION
Authors: Kleszynski Keith
Published: December 2023

The University of Oklahoma is a public university system comprised of a main campus in Norman, Oklahoma, a health sciences campus in Oklahoma City, a campus in Tulsa, Oklahoma, as well as robust online education programming. The University of Oklahoma GSA Student Chapter launched in late 2022 and is open to student membership from all campuses within the University of Oklahoma system. Student membership recruitment is facilitated by a team of inter-professional faculty whom seek to engage any learner on any campus with an interested in gerontology in its broadest sense. The University of Oklahoma GSA Student Chapter utilizes an umbrella and sub-committee structure to maintain governance. This structure is a result of inter-disciplinary collaboration across campuses, colleges, and among faculty and is replicable in university settings with multiple campuses and diverse sets of learners.
INTEGRATING PRACTITIONER KNOWLEDGE INTO AN ALGORITHM TO IDENTIFY CASES FOR REVIEW BY AN ADULT MALTREATMENT MDT
Authors: Thayer Erin , Martinez Julia , Mars Lori , Gassoumis Zach
Published: December 2023

Case review multidisciplinary teams (MDTs) bring together professionals from health, social service, and justice systems to address complex cases of elder abuse, neglect, self-neglect, and maltreatment of younger adults with disability or vulnerability. MDTs are a promising intervention, but MDTs nationwide face challenges identifying cases for review. In partnership with San Francisco Adult Protective Services (APS), we developed an algorithm-driven process to systematically identify APS cases that appear appropriate for MDT review. To construct the algorithm, a retrospective analysis of APS case data was augmented by insights received during six listening sessions held with 48 study partners (MDT members and APS staff). These sessions gauged perspectives on cases’ suitability for MDT review. Listening session transcripts were coded using constant comparative analysis, revealing themes of Client, Case Details, and Service Utilization Patterns. Client included physical or cognitive impairment, high-risk of abuse or other harms, need for assistance from multiple service systems, and limited motivation to make changes. Case Details referred to aspects of the abuse such as concurrent self-neglect, client protectiveness of the suspected abuser, client denial of the abuse, and limited evidence of criminal conduct. Service Utilization Patterns were recurrence within APS, attempting multiple solutions, inability to provide services, and referral by medical professionals, fire departments, or paramedics. These topics guided the inclusion of variables in the project’s algorithms. This mixed-methods approach provides an example of community-engaged research being applied to develop knowledge and guide the practice of service delivery for vulnerable older adults and other victims of adult maltreatment.
THE EFFECT OF MENTAL HEALTH ON DETROIT RESIDENCE IN OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Vaughn Ivana , Yaphe Sean , Sundaresan Lakshmi , Freedman Jonathan , Weinberg Samuel Jesse , Lamerato Lois , Budzynska Katarzyna
Published: December 2023

The COVID-19 pandemic had a tremendous impact on global experience of anxiety and depression. Due to social isolation and quarantine, older adults faced unique challenges that disproportionately increase their risk for health outcomes. The purpose of this retrospective study was to examine the relationship between Detroit versus non-Detroit residence and incident mental health disorders. The patient population included older adults (age 65 and older) from a large metropolitan urban health system with patient encounters between December 2018 - June 2021. The primary predictor, Detroit metropolitan status, was based on zip code. Outcome variables, incident depression, anxiety, and composite mental health disorders, were based on screening measures (PHQ-2, PHQ-9 and GAD-7 scores), ICD diagnosis, medical prescriptions, and behavioral health referrals. Fully adjusted logistic regression analysis derived odds ratios of incident outcomes in Detroit versus non-Detroit patients. A total of 5,300 older adult patients were included in this study. Older adults residing in Detroit had significantly reduced odds of incident anxiety compared to non-Detroit residents (OR:0.45; 95%CI:0.26,0.75, p=0.003). Incident depression and composite mental health outcomes also showed protective effects in Detroit patients; however, these outcomes were not statistically significant. Overall, patients residing in Detroit had 55% decreased odds of developing anxiety during the pandemic. Additional research should explore facilitators and barriers to mental health diagnoses during the COVID-19 pandemic for older adults in an urban setting.
ASSESSING BIDIRECTIONAL LONGITUDINAL ASSOCIATIONS BETWEEN SOCIAL RESOURCES AND COGNITIVE DECLINE IN LATE LIFE
Authors: Zhang Yun , Clouston Sean , Scott Stacey , Smith Dylan
Published: December 2023

Objectives

To better understand bidirectional longitudinal relationships between social networks and cognitive decline. Method: We examined nine waves of data from the National Health and Aging Trends Study (2011-2019). Our primary outcome was global cognition, consisting of a summation of scores on episodic memory, orientation, and executive function tests. Social network measures included measures of social participation, number and type of social ties, attributes of network alter, and neighborhood markers of social cohesion and disorder. We applied linear mixed models to study associations between time-invariant measures of social cohesion and disorder with cognitive decline over time. We employed dual-outcomes mixed models to examine the bidirectional linkages between time-varying measures of social network structures and cognitive decline. Result: Eligible participants (N = 7,325) were included at baseline and followed for an average of 4.86±3.22 years/waves. Having more friend-ties and a higher percentage of college graduates within a social network at baseline were associated with slower declines in global cognition and episodic memory. Additionally, higher global cognition at baseline was associated with smaller reductions in social network size. Less disorientation at baseline was associated with a slower decline in social participation. Social cohesion and environmental disorder were not associated with cognitive decline.

Conclusion

Social networks may improve cognitive health but are also vulnerable to declining orientation. Results suggest that bidirectional longitudinal relationships link social network structure with cognitive decline and inform our understanding of the framework of associations between diverse aspects of social resources and cognitive decline in a longitudinal setting.