bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECTS OF IMPLEMENTING AGETECH TO SUPPORT DEMENTIA CARE IN A RURAL AND NORTHERN SETTING
Authors: Freeman Shannon , Sousa Sarah , Banner-Lukaris Davina , Skinner Kelly
Published: December 2023

Older adults wishing to age in northern and rural communities deserve equitable access to technologies that support optimal health, well-being, and quality of life. A new dementia care home opened in a rural and northern community in 2022 with consciously embedded multiple AgeTech solutions to enhance residents quality of life and care. The AgeTech solutions including hydroponic gardening, circadian lighting, and virtual exercise programming, were implementated into the 10-bed facility through a partnership between the Center for Technology Adoption for Aging in the North (CTAAN), health systems leaders, and community partners. The purposeful implementation of AgeTech within the facility through this partnership aimed to enhance the life-skills and living model of care to maximize independence, function, and resident well-being. We conducted a process evaluation assessing data from interviews with facility staff, health systems leaders, and secondary analysis of existing documentation to objectively measure the implementation process and inform a framework for ongoing assessment of AgeTech. Results highlight areas for ongoing technology innovation and inform policy decisions for future initiatives. Informants described the benefits in use of non-invasive circadian lighting technology to support resident well-being by enhancing sleep, rest/activity, reducing behaviours associated with dementia. Technology enhanced environmental well-being and expanded opportunities for residents to engage in meaningful activities. Participants also described the physical and social benefits for residents using individual and social multiplayer modes of exercise technologies. Providing equitable access to services across dispersed and sparse populations is challenging, yet with implementation of AgeTech quality of care can be enhanced.
EXPLORING THE ROLE OF SOCIAL FACTORS AND CHANGES IN RIDE-HAIL (UBER/LYFT) USE AMONG OLDER ADULTS
Authors: Vivoda Jonathon , Grippa Rosa
Published: December 2023

Previous research has observed low ride-hail (e.g., Uber) use among older adults and identified some factors related to use. However, uptake of technology changes quickly and pandemic-related factors (e.g., social distancing) may have affected ride-hail use. The Pew Research Center’s American Trends Panel (ATP) datasets include variables related to political and social views, behavior, religion, geography, internet use, and other factors that have not been previously assessed in relation to ride-hailing among older adults. ATP waves from 2015, 2018, and 2021 included questions about ride-hail use, and were assessed in this study. In 2015, 15.4% of all respondents and 4.5% of older adults reported having ever used ride-hailing. In 2018, the numbers had increased to 36.1% overall and 18.1% for older adults. In 2021, participants were only asked about ride-hail use during the past year, with 22.4% overall and 8.7% of older adults reporting ride-hail use. Separate logistic regression models were used to determine factors associated with reporting ever using ride-hail services (2018) and having used ride-hailing during the past year (2021), among older adults. Higher odds of reporting any use (2018) were related to living in a metropolitan area, living in the US’s West, attending religious service monthly vs. never, high income, more liberal ideology, female gender, and volunteering. Higher odds of use during the past year (2021) were related to metropolitan area, male gender, more education, Hispanic ethnicity, divorced and single vs. married, unaffiliated vs Catholic religion, less frequent religious attendance, high income, and frequent internet use.
INTERROGATING AGEISM
Authors: Hanes Douglas
Published: December 2023

This paper identifies and addresses a puzzle within the conceptualization of ageism. According to the Reframing Aging Initiative, “Ageism refers to stereotypes, prejudice, and discrimination directed toward people on the basis of age”; these adversely affect older people’s lives in daily lives, including in employment and healthcare. Yet, unlike other marginalized groups, like people of color and women, older people are not underrepresented in powerful positions nor are they worse off. Indeed, they tend to fare better than the population overall: the mean age of US CEOs is 59 years; US Representatives and Senators are 58.4 and 64.3, respectively. Older Americans are more likely to be homeowners and less likely to be unemployed or food-insecure than the overall population. This paper considers several possible explanations. First, unlike racism or sexism, ageism may not be structural, but personal: present in individuals’ attitudes and interactions, but without population-level effects, codification, or institutionalization. Second, ageism may only hold intersectionally, becoming operational under conditions of structural oppression like racism and sexism. For example, while older US whites have less risk of food insecurity than younger whites, older Black Americans are at greater risk than younger Blacks. Finally, ageism may be mitigated by selective mortality: while older people face ageism daily, not everyone reaches older age. Wealthier people and whites are more likely to live to older age; older people’s greater power and welfare reflect their earlier status. Each option presents benefits and drawbacks; together they allow us to address those whom ageism most harms.
SOCIAL PRESCRIBING FOR THE ARTS: LESSONS FROM ABROAD FOR THE HEALTH CARE OF OLDER AMERICANS
Authors: Gleason Shayna , Shreeniwas Sudha , Birabwa Joy
Published: December 2023

Evidence shows the dramatically positive influence of participation in the arts on the health and well-being of older adults (OA). Social Prescribing for the Arts (also called Arts on Prescription or AoP) — in which a professional in a clinical or community setting refers a client to the arts and supports them in accessing arts programming — constitutes one mechanism by which OA may participate in health-promoting arts activities. AoP has been incorporated in other high-income nations including Canada, the UK, and some EU nations. The UK especially has embedded AoP into its healthcare system; however, its universal health insurance program makes its context substantially different from the United States’. This study examined models of AoP abroad and how they could be adapted to the U.S. context for OA. We conducted 25 semi-structured, in-depth interviews with professionals involved in AoP overseas, including physicians, link workers, arts providers, policy experts, and others, as well as 10 interviews with their U.S. counterparts (N=35). Participants were recruited through referral sampling and we intentionally cultivated diversity of role in AoP schemes during recruitment. Transcripts were coded thematically by three team members. Resulting themes included challenges abroad with funding for arts, uneven training among referrers, strain on referrers and arts providers, difficulty reaching the most disadvantaged, skepticism from various stakeholders, the importance of patient involvement in developing a care plan, and a need for open communication between arts providers and referrers. Recommendations for the U.S. include designing and evaluating AoP programs that address these concerns.
LONELINESS AND QUALITY OF LIFE IN OLDER ADULT PRIMARY CARE PATIENTS
Authors: Williams-Farrelly Monica , Schroeder Matthew , Li Claudia , Fowler Nicole
Published: December 2023

Loneliness, defined as the perceived discrepancy in an individual’s desired and actual social relationships, is common among older adults. Loneliness among older adult primary care patients is lacking, considering the implications it has on physical and mental health. Our objective was to determine the relationship between loneliness and quality of life (QOL) in older adult primary care patients. Data come from the Caregiver Outcomes of Alzheimer’s Disease Screening (COADS) study, an ongoing randomized controlled trial evaluating benefits and risks of Alzheimer’s disease and related dementias screening among older primary care patients and their family members. Loneliness (5-item NIH Toolbox), quality of life (QOL)—as measured by physical and mental health component scores— and depression (PHQ-9) and anxiety symptomatology (GAD-7) were measured among primary care patients aged 65 and older from April 2020 to September 2021. Spearman correlation analyses reveal that loneliness was moderately correlated with mental health (r(601) = -.43, p< 0.001), anxiety (r(601) =.44, p< 0.001), and depression (r(601) = .42, p< 0.001), while weakly correlated with physical health (r(601) = -.15, p< 0.001). After conducting unadjusted and adjusted linear regression models, we found that loneliness was associated with both lower mental (p< 0.001) and physical health component scores (p< 0.001). Furthermore, loneliness remained significantly associated with worse mental health when adjusting for depression, anxiety, sociodemographic characteristics, and comorbidity. Primary care providers should discuss loneliness with their older adult patients and provide resources to help patients develop and maintain meaningful social relationships.
ACCEPTABILITY OF THE CONFIDENCE INTERVENTION: INITIAL RESULTS FROM SATISFACTION SURVEYS AND QUALITATIVE INTERVIEWS
Authors: Mage Susanna , Benton Donna , Meyer Kylie
Published: December 2023

Evaluation of an intervention’s acceptability with end-users during the pilot stage can identify barriers to future implementation. Determination of acceptability is particularly important for the CONFIDENCE intervention, as there are no rigorously tested financial wellbeing interventions among family caregivers to persons living with dementia. As a part of the CONFIDENCE pilot study, investigators are using survey techniques and qualitative interviews with participants to assess intervention acceptability. Thus far, N=9 caregivers have completed satisfaction surveys and N=3 participated in a Zoom-based, one-on-one interview. Descriptive statistics were applied to evaluate preliminary satisfaction survey data. Interview transcripts underwent preliminary thematic analysis by the first author. The codebook was guided by the Theoretical Framework of Acceptability (TFA), which posits seven domains of acceptability (e.g., self-efficacy). Results suggest overall acceptability of the intervention. All caregivers who completed the satisfaction survey “Agreed” (3; 33%) or “Strongly agreed” (6; 67%) that they would recommend the CONFIDENCE program to other caregivers. Within specific domains, most caregivers found content easy to understand (8; 89%), easy to access (7; 88%), and convenient to attend (7;78%). The thematic analyses reinforced these findings of acceptability. (“I came into the program right when I needed it.”) Four aspects of the TFA emerged: 1) clear understanding of the intervention and how it works, 2) perception that the intervention was effective in achieving its purpose, 3) confidence in the ability to perform the program requirements, and 4) overall positive affective attitude about the intervention experience. “Every piece of information was helpful,” shared one caregiver.
A BIOPSYCHOSOCIAL APPROACH TOWARD PREDICTING PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH KNEE OSTEOARTHRITIS
Authors: Kaushal Navin , Nemati Donya , Best Thomas
Published: December 2023

Regular physical activity (PA) is imperative for preventing disability among older adults with knee osteoarthritis (KOA). However, PA is a complex behavior that relies on determinants from biological, psychological and social factors. Identifying determinants that predict PA would be informative for providing support for patients with KOA who are physically inactive. This study aimed to employ a biopsychosocial (BPS) approach to identify the strongest PA determinants among older adults with KOA.

Methods: Adults (age 65+) diagnosed with KOA (n=1,343) from the Osteoarthritis Initiative dataset were included to test the BPS model. Putative BPS determinants from baseline were identified by testing if they correlated with two-year follow-up change scores of accelerometry PA data. Each model factor was tested using ordinary least-squared regressions, and significant determinants were then used for the biopsychosocial model test, which employed hierarchical multiple regression.

Results: Bivariate correlations revealed 21 variables representing biological (n=13), psychological (n=4), and social (n=4) variables that correlated with change in levels of PA. Four significant variables were identified in separate regression models. Testing these predictors using hierarchical regression revealed the strongest determinant to be the 400-meter walk (β =-.26, p<.001), followed by age (β=-.23, p<.001), general health (β=-.15, p<.001), and BMI (β=-.21, p<.001).

Conclusion: The BPS model test revealed 50% of determinants to be mutable (fitness and BMI), and the remaining to be non/less mutable. The 400-meter walk test was the strongest indicator of future PA, suggesting that individuals with KOA who score low on this test could benefit from supported PA programs.
RURAL OLDER ADULTS’ VIEWS OF DEPRESCRIBING AND NONPHARMACOLOGICAL METHODS IN PAIN TREATMENT
Authors: Noh Hyunjin , Jeong Haelim , Kan Denise , Lee Lewis
Published: December 2023

Proper pain management is essential to quality of life. Due to the risks of harmful drug interactions, there has been an increasing effort to reduce medication that may be harmful or ineffective (i.e., deprescribing) and to promote non-medication based (i.e., non-pharmacological) strategies in pain management. The purpose of this qualitative study is to understand the views of deprescribing and non-pharmacological methods in pain management among community-dwelling older adults with multiple chronic health conditions. Eligibility criteria included: 65+, Alabama resident living outside of nursing homes, cognitively intact, have two or more chronic health conditions and chronic pain, and take medications for their health conditions including pain medications. Participants were recruited through the Area Agency on Aging across the state of Alabama as well as other community venues serving older adults. Individual, open-ended interviews were conducted by phone to explore their concerns about medications, their views of deprescribing and using non-pharmacological pain management as well as their needs in doing so. Thematic analysis of the interview data revealed various barriers and needs: concerns about various side effects while also worrying about missing out benefits from the medications if reduced or stopped, uncertainty or skepticism toward non-pharmacological pain treatment, lacking financial and logistical access to non-pharmacological options, and lack of knowledge about available non-pharmacological options and their benefits. These findings have implications for future education and advocacy efforts to promote older adults’ knowledge and self-efficacy so that they can consider deprescribing and non-pharmacological methods in managing their pain.
UTILIZING TECHNOLOGY AND INTEGRATED SERVICES TO SUPPORT FAMILY CAREGIVERS IN RURAL COMMUNITIES
Authors: Satz Skye , White Quinn , Watkin Laura Gallagher
Published: December 2023

CRIS Healthy Aging is a non-profit organization in East Central Illinois that serves older adults who are often lower-income and/or living in a rural community. CRIS’ mission is to keep older adults safe, healthy, and independent in their own homes for as long as possible. CRIS’ Memory Care Program (MCP) expanded upon the evidence-based STAR-Caregivers (STAR-C) program. In addition to administering traditional STAR-C training, CRIS provides caregiving dyads with more integrated services, including (1) implementation of technology like the Amazon Alexa Echo Show devices and OneClick video conferencing for older adults, (2) peer support and education opportunities including Memory Café, Stress-Busting Program for Family Caregivers, and the NCOA Aging Mastery Program, as well as (3) providing financial assistance, respite, and additional aging services. In the past 4 years, the CRIS MCP, funded by a federal ADPI grant through ACL, has served approximately 200 caregiving dyads, and collected pre- and post-treatment survey data from a cohort of 52. Those served consistently reported that the STAR-C program was extremely helpful for them. Most importantly, caregivers reported significant decreases in behavior frequency (t=14.75, p<0.01) and severity of personal stress response (t-21.51, p<0.01). Compared to baseline, caregivers also reported feeling less resentful (p=0.005), less socially isolated (p>0.05, however qualitative data supports downward trend), and saw improvements to quality of life (t=-1.77, p<0.042). Ongoing barriers to service in these rural and low-income communities include a global pandemic, misinformation, fear of the unknown, family unwillingness to participate, and financial concerns.
LEVERAGING PROJECT ECHO FOR EVIDENCE-BASED INFECTION CONTROL IN NURSING HOMES: A RANDOMIZED CONTROLLED TRIAL
Authors: Kraschnewski Jennifer , Kong Lan , Lehman Erik , Heilbrunn Emily , Behrens Liza , Calo William
Published: December 2023

Nursing homes were ill-equipped for the pandemic; though facilities are required to have infection control staff, only 3% have taken a basic infection control course. Significant research has focused on infection control in the acute care setting; however, little is known about the implementation of practices and effective interventions. We proposed an intervention utilizing Project ECHO to connect Penn State University experts with remote nursing home staff and administrators to support evidence-based infection control guideline implementation. This study sought to answer the critical research question of how evidence-based infection control guidelines can be implemented effectively in nursing homes. A stratified cluster randomized design was used to randomize nursing homes from the Northeast and Midwest to either: 1) AHRQ-funded COVID-19 ECHO that included 16 weekly tele-mentoring sessions addressing COVID-19 guidelines and best practices plus 9 optional, weekly 60-minute office hour sessions, or 2) AHRQ-funded COVID-19 ECHO+, which included 16 weekly tele-mentoring sessions addressing COVID-19 guidelines and best practices, plus 17 weekly 60-minute sessions with a focus on stakeholder-identified needs and CDC infection control training. A total of 136 nursing homes were recruited. There were no statistically significant differences in COVID-19 infection rate, hospitalization, deaths, or flu-like illness. A multipronged approach to improving infection control and emergency preparedness in nursing homes is important. The ECHO model has significant strengths when compared to traditional training, as it allows for remote learning delivered by a multidisciplinary team of experts and utilizes case discussions that match the context and capacity of nursing homes.
IMPROVING KNOWLEDGE OF LGBTQ+ AGING THROUGH A QUEERING GERONTOLOGY CAMPAIGN
Authors: Oswald Austin , Cooper Lujira , O’Driscoll Leo , Giunta Nancy
Published: December 2023

The marginalization of lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) content in health and human services education is well documented and varies considerably due to instructors’ attitudes as well as government and institutional policies intended to censor conversations about sexual orientation and gender identity. Lack of LGBTQ+ content in the curriculum may require creative solutions to fill the gaps in mainstream education which often goes unchallenged due to dominant heteronormative theory, literature, and teaching. Without adequate training, service providers may not have sufficient knowledge and skills for competent practice with LGBTQ+ older adults. This presentation bridges critical pedagogy with emancipatory gerontology to reflect upon a student led “queering gerontology” campaign to raise awareness about LGBTQ+ aging. Applying principles from participatory action research, the presenters analyze personal narratives in combination with program evaluation data to describe our process conceptualizing, implementing, and evaluating the campaign. We found that students are eager to learn about LGBTQ+ aging experiences and have innovative ideas to close the gaps in knowledge caused by heteronormative educational contexts. Supporting student led learning, intersectional coalition building, and intergenerational wisdom sharing were central to combatting programmatic and institutional constraints that limit LGBTQ+ content in the curriculum. The presentation concludes by highlighting future teaching and research directions that support students in their pursuit of knowledge while challenging heteronormative structures of higher education.
PERCENT TIME SPENT IN AN IMPAIRED GLUCOSE STATE AND ADVERSE MUSCLE OUTCOMES: THE SWAN STUDY
Authors: Leis Aleda , Kilpatrick Sidonie , Strotmeyer Elsa , Karvonen-Gutierrez Carrie
Published: December 2023

Sarcopenia is common among older adults, but associations of sarcopenia and diabetes are mixed. Beyond sarcopenia, relationships between glucose levels and muscle quality and power are understudied. We examined the association of time spent in an impaired glucose state and muscle outcomes. Muscle quality and power were assessed in 2015-2016 in 1,614 women (aged 66 + 2.7 years) without diabetes at baseline. Muscle quality was the average grip strength (measured in three trials using a Jamar dynamometer) per kilogram whole-body skeletal muscle mass (measured using bioelectrical-impedance analysis). Muscle power (Watts/kilogram body weight) was assessed using a 3-cycle timed stair climb: [(body weight (N)*stair height (m))/average ascent time (sec)]/body weight (kg). Fasting blood was collected at 11 visits; glucose ≥100mg/dL was considered impaired, with percent time spent in an impaired glucose state (%IGS) calculated as:(number visits with impaired glucose)/(number visits with glucose)*100 and categorized as ≤24%(n=1,203), 25-49%(n=184), 50-74%(n=136), ≥75%(n=91). Cross-sectional multivariable linear regression models were constructed for muscle outcomes with the independent predictor %IGS, adjusting for age, menopausal status, race/ethnicity, hormone use, and height. Compared to the lowest %IGS, all other groups had significantly lower mean muscle quality (β range: -0.091, -0.110 and -0.135, respectively) with the largest difference vs. highest %IGS (β= -0.135, 95%CI:-0.192,-0.077). Similar results were observed for muscle power (β range: -0.022, -0.024 and -0.020, respectively), though the highest %IGS was not significantly different. Results suggest that a longer time in an impaired glucose state from middle to older age may be associated with lower muscle function in older women.
SOCIAL ISOLATION, UNMET NEEDS, AND LONG-TERM SERVICES AND SUPPORTS IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Pomeroy Mary Louise , Jopson Andrew , Reiff Jenni , Wu M J , Ornstein Katherine , Cudjoe Thomas , Fabius Chanee
Published: December 2023

Social isolation is associated with adverse health outcomes among older adults but can be attenuated through increased social contact and support. Long-term services and supports (LTSS) are a potential mechanism to increase social contact and provide socially isolated older adults with the help needed to perform routine activities. Using a nationally representative sample of 6,705 community-dwelling older adults from the 2015 National Health and Aging Trends Study (NHATS), we examined associations between social isolation, functional difficulty, adverse consequences due to unmet needs, and indicators of the LTSS environment (e.g., Meals on Wheels). About 22% of older adults were socially isolated. Socially isolated older adults had greater functional difficulty compared to those who were not socially isolated (45.3% vs 38.3%; p<0.0001). Socially isolated older adults were more likely to be Medicaid enrollees (17.5% vs 8.4%; p<0.0001) and use LTSS including SNAP benefits (12.7% vs 5.5%; p<0.0001), Meals on Wheels (4.1% vs 1.6%; p<0.0001), energy/gas financial assistance (7.5% vs 4.2%; p<0.0001), and transportation services for older adults or people with disabilities (4.6% vs 2.7%; p=0.001). Despite greater LTSS use, socially isolated older adults more often experienced adverse consequences due to unmet needs compared to those who were not socially isolated (12.5% vs 7.7%; p<0.0001). Findings suggest that LTSS in the form of social and senior services are critical in supporting those lacking social connection, but they may not be adequate to support aging in place in the absence of informal support.
AGE-VARIANT PATTERNS OF WITHIN-PERSON VARIATION IN SELF-REGULATORY CAPACITY REVEALED VIA AMBULATORY ASSESSMENTS
Authors: Hakun Jonathan , Elbich Daniel , Alwerdt Jessie , Benson Lizbeth , Fleming Allison
Published: December 2023

Stressful experiences often evoke changes in experienced negative affect. Individual differences in the degree of stressor-related reactivity may reflect the action of self-regulatory strategies that evolve over the adult lifespan. The executive hypothesis of self-regulation suggests that our ability to exert control over information processing (i.e. cognitive executive control) plays an important role in determining our effective capacity to regulate our emotions and behavior. We recently found evidence in younger adults that stressor reactivity is greater during moments when working memory capacity is lower than usual. Critically, aging is associated with normative declines in executive control and it remains unknown whether this impacts self-regulation in older adults. We’ll present the results of a recent ambulatory assessment study involving a sample of older adults (N = 80; 65-87 yrs; 79% female) where we sampled ratings of negative affect, exposure to everyday stressors, and working memory capacity up to 6 times per day for a period of 14 days. Results related to frequency of stressor exposures, mean levels of negative affect, and degree of negative affect reactivity to stressor exposures in this sample were largely consistent previous findings. However, when modeling stressor reactivity as a function of momentary variation in performance on ambulatory assessments of working memory capacity, we found evidence suggesting that older adults may react more to everyday stressors during moments with higher than average working memory capacity. We interpret these findings in terms of the limits of the executive hypothesis and other well-established theories of cognitive and psychological aging.
THE ROLE OF LEADERSHIP IN DISASTER DECISION-MAKING IN ASSISTED LIVING
Authors: Peterson Lindsay , Dobbs Debra , Dosa David
Published: December 2023

Assisted Living Communities (ALCs) make up a growing segment in long-term care for adults with impairments. Research indicates that functional and cognitively impaired older adults who are evacuated for hurricanes are more vulnerable to harm than those who shelter in place. A high proportion of assisted living residents require help with bathing (63.6%), dressing (48.2%), and other activities of daily living. At least 40% have Alzheimer’s disease or other dementias. Despite residents’ vulnerabilities, we know little about ALC disaster preparedness. In this study, we conducted a secondary analysis of data from interviews with ALC administrative staff after Hurricane Irma to better understand factors influencing the decision to evacuate or shelter in place. Initially we conducted individual interviews and focus groups with stakeholders of 70 Florida-based ALCs concerning a range of preparedness and response issues. We analyzed transcripts using a deductive approach, with research team members meeting regularly to resolve differences, develop/update codes, and identify themes and subthemes. Next, we separately analyzed codes concerning the decision to evacuate or shelter in place. Three overall themes were identified: 1) response to evacuation orders; 2) differing views of how to ensure safety; and 3) characteristics of ALC buildings. Examining our results overall, an overarching theme of leadership emerged, with effective leadership being preparedness based on comprehensive knowledge of residents’ needs, the nature of the threat at hand, and the ALC’s strengths and vulnerabilities. Our finding show the need for training incorporating “lessons learned” concerning both evacuation and sheltering in place for disasters.
GRIEF SYMPTOM PROFILES OF OLDER SPOUSES BEREAVED BY COVID-19
Authors: Stahl Sarah , Kazan Joseph , Krafty Robert , Reynolds Charles , Rollman Bruce , Smagula Stephen , Gebara Marie Anne
Published: December 2023

Many older adults lost their spouse or life partner to COVID-19. Despite the anticipated rise in the prevalence of prolonged grief disorder, the association between COVID-19 bereavement and symptoms of complicated (or pathological) grief in community-dwelling older adults remains unclear. This study compared six clinically meaningful complicated grief symptom profiles between older spouses who were and were not bereaved by COVID-19. Participants included 80 adults aged 60+ years (20% men, 10% Black/minority status) who lost their spouse or life partner within the previous 12 months (M time since loss=6.6 months [SD=3.4 months]) and were enrolled in a randomized controlled trial for depression prevention. Grief symptom profiles were assessed with the Inventory of Complicated Grief. At the time of enrollment, older spouses bereaved by COVID-19 (n=18) reported more shock and disbelief (M = 7.11 [SD=3.16] versus M=3.83 [SD3.30], F=13.84, p<.001) and more hallucinations (M=1.56 [SD=1.29] versus M=0.45 [SD=0.88], F=17.12, p<.001) compared to older spouses bereaved by other causes of death (n=62). The two groups were similar in terms of yearning, anger and bitterness, estrangement from others, and avoidance behaviors. In addition, older spouses bereaved by COVID-19 had over 3 and a half times the odds of screening positive for probable prolonged grief disorder (OR=3.84 (95% CI = 1.28 -11.53, p = 0.016). These symptom clusters, particularly hallucinations, map to the highest level of prolonged grief disorder severity. These findings suggest that clinical treatment for prolonged grief disorder may be warranted for surviving spouses who lost their loved one to COVID-19.
METABOLOMICS OF LONGEVITY AND LIFESPAN
Authors: Sebastiani Paola , Raghavachari Nalini
Published: December 2023

Serum metabolomics has been an important source of biomarkers of aging and longevity for years. This symposium will bring together investigators from large studies of human longevity to provide an overview of recent discoveries on serum metabolomics of aging and extreme human longevity, their connections to genetic variations, and highlight the challenges of correlating metabolomic profiles of aging in human studies and across multiple species. Dr. Sebastiani will describe results from analyses of serum metabolomics of participants enrolled in the Long Life Family Study, highlight similarities and differences between metabolomic profiles of old age and extreme old age, and some connections with genetics of extreme human longevity. Dr. Rappaport will connect specific variations of the APOE alleles to metabolomic profiles and describe a possible role of bioenergetics pathways in mediating the effect of APOE to longevity and resistance to Alzheimer’s disease. Dr. Monti will expand the characterization of metabolomics of aging and extreme human longevity in a large metabolomic study of very old centenarians by using traditional statistical analyses and novel machine learning techniques. His analysis identifies rich signatures of aging and longevity that include well known metabolites and point to bile acids and several classes of steroids as important marker of longevity. Analytical innovations will be taken further by Dr. Schork who will introduce a novel approach based on distance of profiles to analyze multiple metabolites simultaneously and show the value of this approach to analyze metabolomic profiles of maximum lifespan across multiple species. This is a Geroscience Interest Group Sponsored Symposium.
WHAT IT MEANS TO ENGAGE IN FALL PREVENTION: QUALITATIVE ANALYSIS OF MOTIVATIONAL INTERVIEWING SESSIONS
Authors: Kiyoshi-Teo Hiroko , McMahon Siobhan , Northrup-Snyder Kathlynn
Published: December 2023

Evidence-based strategies to decrease fall risks and rates are well established. However, little is understood about how older people engage in fall prevention strategies. Participants’ statements in the motivational interviewing (MI) sessions conducted as part of Motivational Interviewing for Fall Prevention (MI-FP) study were analyzed. The goal was to describe what it means for older adults to engage in fall prevention; specifically, what and how they engage. Participants (n = 16) were purposefully selected from the MI-FP study for maximum variation in age, sex, fall risks, and assigned MI specialist. Participants were community-dwelling, ≥ 65 years old, and high fall risk for which they received fall prevention recommendations from their primary care provider. Baseline MI sessions were recorded, transcribed and analyzed using qualitative content analysis by three researchers. We first coded fall prevention strategies that participants described. Second, we analyzed the characteristics of these strategies and identified themes. Third, we examined how participants engaged in these strategies. Theoretical frameworks were not used for analysis; however, we did use the Capability, Opportunity, and Motivation Behavior model to organize findings. We found participants 1) used evidence-based and personal strategies; 2) engaged in multiple, personally meaningful strategies and engaged at intensities that worked for them; and 3) were influenced by factors such as their capability to engage in fall prevention, their motivation to engage, and access to opportunities. This study identified what matters for older people to engage in fall prevention.
DECONSTRUCTING MULTIMORBIDITY AND MUSCLE MITOCHONDRIAL RESPIRATION AND ENERGETICS IN OLDER ADULTS
Authors: Mau Theresa , Ramos Sofhia , Kramer Philip , Newman Anne , Cummings Steven , Hepple Russell , Coen Paul , Cawthon Peggy
Published: December 2023

Lower cardiorespiratory fitness among older adults is associated with greater multimorbidity burden, including cardiovascular disease, cancer, and dementia. Those with poorer muscle mitochondrial energetics also have lower cardiorespiratory fitness. We have previously shown lower mitochondrial respiration and energetics (OXPHOS and ATPmax) have higher morbidity burden using a summary measure, but the associations among specific conditions have not been examined. We leverage data from the SOMMA cohort (N=856, 76.4yrs, 59% women, 85.5% white); participants self-reported physician diagnosis of 11 age-related conditions (i.e., cancer, cardiac arrhythmia, chronic kidney disease (CKD), chronic obstructive pulmonary disease, coronary heart disease (CHD), depression, diabetes). Mitochondrial respiration was assessed by high-resolution respirometry of vastus lateralis using permeabilized fiber bundles. 31P magnetic resonance spectroscopy of the quadriceps measured ATPmax. In adjusted logistic models with beta-coefficients reported per SD decrement in each mitochondrial measure, fatty-acid-supported Leak respiration was associated with CKD (OR: 2.3(95%CI=1.2,4.3)), fatty acid and complex I&II supported oxidative phosphorylation (OXPHOS) with depression (OR: 1.8(95%CI=1.1,2.7)). Many respirometry measures and ATPmax associated with diabetes, with maximal electron transport system (ETS) capacity having the highest odds (OR: 1.5(95%CI=1.1,2.0)). No other associations were statistically significant for conditions listed above. These results indicate that mitochondrial respiration and energetics are more impaired in depression, kidney disease, and diabetes. This raises new questions about the role of mitochondrial respiration and energetics as cause or consequences of these conditions. Overall, our analyses suggest compromised mitochondrial function may have implications for specific aging-related conditions, and global measures of morbidity burden may not reflect these distinctions.
REFINING AN ICT-ENRICHED NONPHARMACOLOGICAL INTERVENTION FOR PEOPLE WITH DEMENTIA: A PARTICIPATORY DESIGN
Authors: Choy Jacky C P , Wong Gloria Hoi-Yan , Wong Kayla
Published: December 2023

Information and communication technology (ICT) has enabled the rapid development of remote non-pharmacological intervention for people living with dementia (PLwD). Yet, PLwD were seldom actively involved in the design process. We developed a prototype of Virtual Cognitive Stimulation Therapy (vCST) by adapting CST, an evidence-based group activity intervention, for remote delivery and tested among PLwD in the community. Following a participatory design approach, the current study aims to understand the needs of refinement from the users’ and providers’ perspectives for improving person-centred engagement and accessibility of vCST. Participants were 15 PLwD who received fourteen vCST sessions, 15 family carers who assisted the PLwD’s participation, and 15 trained volunteers who delivered the sessions. We observed the video-recordings of vCST sessions, and then conducted semi-structured interviews with dyads of PLwD and carers, and focus groups with the providers. Thematic analysis was conducted to understand their views on refinement needs. Two themes and 7 subthemes representing a two-level refinement needs emerged. At intervention operation level, 3 subthemes were 1) pre-assessment of personal characteristics, 2) consistent and comfortable environment and equipment setup, and 3) optimal level of carer involvement. At activity delivery level, 4 subthemes were 5) facilitating skills for positive relationships and active participation, 5) tailoring activity content to PLwD biography, interest, and ability, 6) interactive and collaborative activity design for rapport building and empowerment, and 7) materials use for enhancing stimulation and engagement. With appropriate research design and interview prompts, PLwD could comprehend novel ideas and actively contribute to intervention design.
TRAINING INTERPROFESSIONAL STUDENTS TO LEAD AND COLLABORATE IN THE FIELD OF GERONTOLOGY AND OLDER ADULT CARE
Authors: Wong Jennifer , Kang Chun-Ya Belinda
Published: December 2023

With the historic demographic transition of older populations outnumbering younger ones comes an urgent need for services and support for older adults, which entails an integration of various fields. Simultaneously, there has been an alarming decline in the amount of professionals entering older adult care. Furthermore, colleges and universities provide limited education on the service of older adults, and even less fieldwork exposure to older demographics. As such, academia and fieldwork teams must prioritize the training of students in the field of gerontology and of equal importance, students in adjacent fields in order to recruit and equip the incoming workforce in older adult care. Moreover, the training must be integrated and emphasize leadership, as the complex care of older adults requires an interprofessional team engaged in multi-level collaboration. Wallis Annenberg GenSpace is an innovative community space dedicated to older adults and is invested in combating ageism and promoting lifelong learning. GenSpace serves as a fieldwork placement for gerontology, occupational therapy, communication, and public health students. Through supporting community programs and larger policy level work, students are immersed in various aspects of gerontology. Students discover a diversity of crucial ways that their respective professions can contribute to serving older adults. Additionally, GenSpace’s team-based environment allows students to understand the various roles of their peers and prepare to build cross-sectoral partnerships when they enter the workforce. The orientation, curriculum, and outcomes of the student fieldwork completed thus far will be presented.
PREVALENCE OF ELDER ABUSE AND NEGLECT OF PERSONS WITH DEMENTIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Sun Fei , Zhang Xuehan , Shen Yan , Feng Yali , Kennedy Teri
Published: December 2023

People with dementia (PWD) are at high risk for abuse and neglect. Little is known about the synthesized prevalence rate of abuse among this population though. This study reviewed articles on abuse and neglect among PWD to learn about the pooled prevalence estimates of elder abuse among this population with a meta-analytic approach and examined the heterogeneity associated with the prevalence estimates through meta-regression and subgroup analyses. A total of 27 studies were selected from 479 relevant studies after careful identification using eight academic databases (e.g., ProQuest, CINAHL Plus). All 27 studies received acceptable scores on study quality and demonstrated no significant publication biases. All the studies included a total sample of 11,246 care recipient and caregiver dyads. In addition to overall abuse, three subtypes of elder abuse including physical abuse, emotional abuse, and neglect were examined. Results showed that the pooled prevalence of overall elder abuse was 41% (95%CI [0.31,0.49], p < 0.001). The pooled prevalence of abuse subtypes were 43%(95% CI [0.35, 0.52], p < .001) for emotional abuse, followed by neglect at 16%, and physical abuse at10% (95% CI [0.07, 0.13], p < 0.01). Overall, studies with caregiver average age below 60. reported higher abuse rates than those with caregivers’ age over 60. These results call for more policy and practice efforts to assist PWD who are victims of abuse and neglect, and more so, to prevent caregivers from exerting abuse and neglect behaviors toward PWD via education, skills training and support.
A LONGITUDINAL EXAMINATION OF THE EFFECT OF RESILIENCE AGAINST ANXIETY DURING COVID-19
Authors: Carr Dawn , Sachs-Ericsson Natalie , Sheffler Julia , Meynadasy Melissa , Schmidt Brad , Hajcak Greg
Published: December 2023

This longitudinal study of community dwelling older adults (N = 453) examined consequences of COVID-related worries on changes in anxiety symptoms before relative to during the pandemic. We further evaluated if pre-COVID psychological resilience (PR) buffered the impact of COVID-related worry. Pre-COVID data were collected in September 2018. COVID-related worry and COVID anxiety symptoms were collected in October 2020 (Wave 2). Controlling for pre-COVID anxiety symptoms, we examined if COVID-related worries (e.g., I’m worried that I might die from COVID-19) were associated with increased anxiety symptoms, and whether pre-COVID PR moderated the association between COVID-related worries and prospective increases in anxiety symptoms. COVID-related worries were associated with increased anxiety symptoms (β = 0.005, p < .01), whereas pre-COVID PR was associated with a decrease in anxiety symptoms (β = -0.029, p < .05). PR moderated the association; COVID-related worries were associated with greater increases in anxiety symptoms among those with low pre-COVID PR (Model η2 = 0.35). Thus, the extent to which COVID-related worries influenced psychological health was dependent on pre-COVID levels of PR. We conclude the combined vulnerabilities of low pre-COVID PR and high COVID-related worries significantly increased the psychological consequences of COVID-19 for our sample of older adults.
A RANDOMIZED CONTROLLED TRIAL OF SELF-HELP GUIDED BY LAY PROVIDERS FOR GENERALIZED ANXIETY DISORDER IN OLDER ADULTS
Authors: Landreville Philippe , Grenier Sébastien , Gosselin Patrick , Carmichael Pierre-Hugues
Published: December 2023

Low use of professional help for anxiety disorders in older adults may be due in part to limited access to mental health services. Self-help guided by lay providers (LPs) could help improve access to treatment. This study evaluated the efficacy and long-term outcomes of self-help guided by LPs for generalized anxiety disorder (GAD) in older adults. Participants (≥ 60 years) with threshold or subthreshold GAD were randomly assigned to an intervention group (n = 75) or a wait-list control group (n = 75). Intervention group participants used a manual presenting readings and exercises based on principles of cognitive-behavioral therapy and received weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the intervention group had decreased significantly on various measures while the wait-list group remained stable: Generalized Anxiety Disorder 7-item (GAD-7): -4.8 vs -.03; Penn State Worry Questionnaire (PSWQ): -11.7 vs .07; Geriatric Anxiety Inventory (GAI): -5.3 vs -.07. Probability of having a diagnosis of threshold GAD decreased significantly more in the intervention group (79% to 16% vs 74% to 53%). Intervention group scores on the GAD-7, the PSWQ, and the GAI as well as probability of having a diagnosis of threshold GAD remained stable at 6- and 12-month follow-ups. Results provide evidence of the efficacy of self-help guided by LPs for GAD in older adults as well as of the maintenance of improvement following this treatment.
A STUDY ON THE TYPES OF CHANGES IN DEPRESSION AND COVID-19 AMONG OLDER ADULTS IN KOREA
Authors: Jeong Kyu-Hyoung , Ryu Ju Hyun , Lee Seoyoon , Kim Sunghee
Published: December 2023

This study focuses on the long-term trends in depression levels in older adults, with a particular focus on the period following the onset of COVID-19. While previous studies have examined depression levels in older adults, this study aims to complement those studies by providing a longitudinal perspective. This study used data from the Korea Welfare Panel Study(KoWePS), which included 2,716 data of older adults aged 65 and above, from 2017 to 2021. The study variables included gender, age, income, educational background, residential area, living alone, and disability status. The results of this study identified two types of changes in depression levels in older adults: the ’rapidly rising’ type and the ’steadily increasing’ type. The study found that those who were more likely to belong to the ’rapidly rising’ type were those with lower equalized annual income, women, those with lower education, those living in urban areas, and those living alone. These findings suggest that those who are already at risk for depression are at even higher risk during and after the COVID-19 pandemic. Given these findings, it is crucial to provide timely and effective guidelines to prevent depression in older adults during outbreaks of infectious diseases such as COVID-19. Policymakers should consider the findings of this study when implementing policies aimed at preventing depression in older adults. Overall, this study provides important insights into the long-term trends in depression levels in older adults and highlights the importance of addressing this issue in response to the ongoing COVID-19 pandemic.