bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Intersectionality Theory as a Lens in a Perspectives on Aging Class
Authors: Munly Kelly
Published: December 2021

The presenter will discuss strategies for using intersectionality as a theoretical lens in her Perspectives on Aging class in order to support students to understand the relevance of aging studies—including health and social disparities in aging—for their contemporary lived lives, as well as for prior generations. With this relevance established, the class also examines the significance and justification for the development of policy, such as Social Security legislation, as well as the need for aging-related career areas. The presenter will discuss the application of key course resources, including research that looks at aging in historic contexts, as well as content highlighting the importance of Age Friendliness and the diversity of career areas to support Age Friendliness and more optimal aging experiences overall. Examining historic roots of aging-related experiences in social contexts creates an informative platform for understanding experiences of aging in society today.
Diverse Caregivers in the United States: Implications for Caregiving Across the Lifespan
Authors: Whiting C Grace , Choula Rita , Cruz Yanira , Pongan Lauren , Lewis Feylyn
Published: December 2021

Caregivers with diverse backgrounds make up an important part of the landscape of caregiving in the US. Their unique experiences have been traditionally under-researched in the field of social sciences and underrecognized by society. To further understand the impact of race, ethnicity, class, gender and sexuality onto caregiving, the National Alliance for Caregiving (NAC) and the AARP Public Policy Institute commissioned an in-depth analysis of the dataset collected from the Caregiving in the US 2020 study, which segments populations based on ethnic and sexual identity, geographic location, and income level. Utilizing survey interviews with 1,392 caregivers in the US, this study found differences amongst the African-American, Latinx, and Asian American-Pacific Islander populations in relation to age, time spent caregiving, ADL/IADLs, caregiving strain and intensity, receipt of formal and informal support, and financial impact. In consideration of the distinct challenges presented by diverse caregiving throughout the lifespan, this presentation will also feature results from a 2020-2021 Diverse Elders Coalition and NAC commissioned study on the unmet caregiving needs in diverse communities. 11 virtual listening sessions were held with 400 caregivers of color, including American Indian/Alaska Native caregivers, and LGBTQ caregivers across the nation. Presentation attendees can expect to learn new insights into the experiences of diverse caregivers, while also gaining a fresh understanding of informal and formal support preferences with a multicultural lens. Finally, this presentation will provide recommendations to further prioritize the needs of historically marginalized caregivers in policy and practice.
Going Virtual When The Doors Close: Addressing Geriatric Workforce Training Needs During A Pandemic
Authors: Edelman Linda , Towsley Gail , Farrell Timothy
Published: December 2021

The focus of our Geriatric Workforce Enhancement Program (GWEP) is to enhance long-term services and support (LTSS) and primary care healthcare workforce capacity through interprofessional education (IPE) and to increase patient, family, and caregiver engagement. When it became evident that LTSS settings, schools, and communities were going to be adversely impacted by the COVID-19 pandemic for the unforeseeable future, our GWEP quickly pivoted to address new challenges and initiate technology to continue our programs. In this symposium, we describe four programs implemented or revised during the COVID-19 pandemic. We utilized CARES (Coronavirus Aid, Relief and Economic Security) funding to develop a 3-part Project ECHO on utilizing telehealth in LTSS settings. We pivoted quarterly Fireside Chats – community-based educational programs held at partnering LTSS settings for older adults and caregivers – to bi-weekly and now monthly webinars addressing topics relevant to COVID-19 and combatting social isolation. Because students could no longer attend an in-person IPE course introducing them to long-term care, we revised the course to be online with a partnering nursing home participating in an interactive mock care conference. Finally, a 2-semester undergraduate Honors College project-based course introducing students to successful aging utilized virtual activities to expose students to the challenges of hospice care during a pandemic. With these adaptations, as well as activities that advocated for, and supported, LTSS settings and older adults, our GWEP program was able to continue to provide education and support to the setting and individuals most impacted by COVID-19.
Pivoting Community-Based Educational Programming for Formal and Informal Caregivers During COVID-19
Authors: Dassel Kara , Telonidis Jacqueline , Witt Catherine , Edelman Linda
Published: December 2021

The Utah Geriatric Education Consortium provides community-based education about Age-Friendly Health Care and Dementia-Friendly Communities targeted towards informal and professional caregivers. As such, we have collaborated with our community partners to host a series of “Fireside Chats”. Since March of 2020, we have hosted 17 Fireside Chats. Our attendance has exceeded our expectations, with over 500 attendees (average of 32 attendees per session). The professional attendees come from a variety of interdisciplinary backgrounds including nursing, medicine, public health, allied health, aging services, and health and long-term care administration. Our non-professional attendees include family caregivers, students, and older adults in the community. This session will address: a) the logistical steps we took (and lessons learned) as we “pivoted” our Fireside Chats into a virtual video-conference format, b) how we redesigned the curriculum to address topics related to COVID-19, and c) will review our evaluation feedback.
Reflections on Identity in Memoirs of Writers With Aphasia: Lessons Learned on the Path Toward Recovery
Authors: Ulatowska Hanna , Olness Gloria
Published: December 2021

Personal stories provide insight into the experience of illness as it intersects with one’s identity. Prior studies by the first author examined identity as manifested in personal accounts of U.S. World War II veterans with and without dementia. The current study examines identity as revealed through written memoirs of middle-aged and older adults who have aphasia, from a cross-section of North American, European, and Australian cultures. The abrupt onset of stroke and associated aphasia, and the subsequent path toward re-engagement in life with an often-chronic communicative impairment, provide a unique window into the nature and evolution of the identity of the writer. The written modality offers an opportunity for reflective formulation that is not afforded to the memoir-writers in their verbal expression. Nineteen memoirs and biographical accounts of individuals with aphasia from a range of primarily individualistic cultures were examined for content reflective of the identity of the author, focused on post-stroke phases of restitution and quest. Primary authors were people with aphasia or rarely their close family member. Some were professional editors, poets or authors. Gender and life backgrounds were varietal. Manifestations of personal identity, its reinforcement, and its evolution were evidenced in: the provision of lessons learned from living with aphasia; content of letters exchanged with friends; engagement with family in life and recovery; fictional and poetic expression; spiritual insight; renewed or altered occupational pursuits; and comments on facing one’s mortality. Findings hold implications for the cross-cultural practice of narrative medicine with the older adult population.
Caring for a Family Member Living With Dementia When Adult Day Services Close
Authors: Marx Katherine , Parker Lauren , Gaugler Joseph , Dabelko-Schoeny Holly , Gitlin Laura
Published: December 2021

Adult Day Service (ADS) centers play an important role in community services that help families keep a person living with dementia (PLWD) at home. We interviewed 33 family caregivers about their experience during the COVID-19 Pandemic and the shutdown of the ADS centers where the PLWD attends. All 33 (100%) reported that the ADS center was shut for a period of time (range: 2 weeks – remain closed). Caregivers reported a decline in their physical health (33%,n=11) and mental health (52%,n=17) and an increase in feelings of loneliness (48%,n=16). For the PLWD, the caregivers noted, a decline in physical (48%,n=16) and mental (55%,n=18) health and an increase in behaviors (39%,n=13). The shutdown of most ADS centers across the country due to the COVID-19 pandemic has had implications not only for the ADS sites but for the families that entrust them with the care for a family member.
Adult Day Services and COVID: A Crisis in Ohio
Authors: Dabelko-Schoeny Holly , Wallace Susan , Bolin Salli
Published: December 2021

An Ohio Executive Order forced adult day service providers across the state to close from March 24, 2020 until September 21, 2020 due to COVID, resulting in significant hardship for providers and families. In fact, 65% of programs reported laying off or reducing staff and 83% of directors reported participants had to move to higher and more expensive levels of care such as nursing homes and assisted living. Programs reported that 74% of caregivers had to choose between working and taking care of their family members. Ninety-one percent of ADS program directors in Ohio reported their caregivers were experiencing an increase in stress and anxiety. This paper explores the experiences of Ohio adult day providers during the COVID epidemic, and identifies the challenges and opportunities to coalition building to educate policy makers about day services and the crucial care centers provide.
Early Versus Late Mild Cognitive Impairment: Neural Event-Related Oscillations During a Go/No Go Task
Authors: Lydon Elizabeth , Nguyen Lydia , Shende Shraddha , Chiang Hsueh-Sheng , Mudar Raksha
Published: December 2021

Amnestic mild cognitive impairment (aMCI) is marked by episodic memory deficits, which is used to classify individuals into early MCI (EMCI) and late MCI (LMCI). Growing evidence suggests that individuals with EMCI and LMCI differ in other cognitive functions including cognitive control, but these are less frequently studied. Using a semantic Go/NoGo task, we examined differences in cognitive control between EMCI and LMCI on behavioral (accuracy and reaction time) and neural (scalp-recorded event-related oscillations in theta and alpha band) measures. Although no behavioral differences were observed between the groups, EMCI and LMCI groups differed in patterns of neural oscillations for Go compared to NoGo trials. The EMCI group showed differences in theta power at central electrodes and alpha power at central and centro-parietal electrodes between Go and NoGo trials, while the LMCI group did not exhibit such differences. Furthermore, the LMCI group had higher theta synchronization on Go trials at central electrodes compared to the EMCI group. These findings suggest that while behavioral differences may not be observable, neural changes underlying cognitive control processes may differentiate EMCI and LMCI stages and may be useful to understand the trajectory of aMCI.
New Directions in Dietary Restriction: Remembering Edward Masoro
Authors: Richardson Arlan
Published: December 2021

In 1935, Clive McCay reported that severe restriction of food increased the lifespan of male rats. In the following four decades, several laboratories replicated this observation with less sever restrictions, which will be referred to as dietary restriction (DR). However, there were concerns even in the aging community in the 1970s as to whether DR increased lifespan by retarding aging. It was the research of two former Kleemeier Awardees, Edward Masoro and Roy Walford, that conclusively demonstrated in the 1980s that DR retarded aging resulting in improved healthspan and reduced pathology. Ed Masoro’s research was focused on lipid metabolism when he was invited to attend a workshop on metabolism and aging in 1969. His interest in aging was piqued such that the more he learned about aging, the more interested he became. In a subsequent workshop in 1973, Ed heard Morris Ross describe his research on restricting food intake on cancer and longevity. Ed was impressed that a relatively simple manipulation had such dramatic effects, and he decided to focus his research on DR. After an extensive review of the DR literature up to the 1970s, Ed established the 40% restriction paradigm, which is used in almost all DR studies to date. Ed’s group was the first to study aging and DR under barrier conditions which he established at San Antonio. Over the next two decades, Ed would direct a Program Project that showed DR had a dramatic effect on most age-related pathologies and improved many physiological functions. Studying the restriction of fat, protein, micronutrients, Ed came to the conclusion that total calories consumed was a key factor in the effect of DR on longevity. His group was the first to show that DR significantly reduced circulating levels of glucose and insulin, which was subsequently shown to occur because of increased insulin sensitivity and is now recognized as a hallmark of DR and potentially important in the anti-aging action of DR. Ed was chair of the Biological Sciences Section of GSA in 1979 and President in 1995. This session is dedicated to Edward Masoro who passed away on July 11, 2020 at the age or 95. Dr. Masoro was president in 1995 and BS chair in 1979, Clive McCay was President in 1949.
Nursing Home Social Services Directors Caring for Residents With Serious Mental Illness
Authors: Gammonley Denise , Wang Xiaochuan , Simons Kelsey , Smith Kevin , Bern-Klug Mercedes
Published: December 2021

Psychosocial care for residents with serious mental illness (SMI) requires understanding of co-morbidities and careful attention to needs, rights, and preferences. Analyses of social services directors (SSDs) responses (n=924) to the National Nursing Home Social Service Director Survey considered perceived roles and competence to provide care stratified by the percentage of NH residents with SMI. Depression screenings and biopsychosocial assessments were common roles regardless of the percentage of residents with SMI. About one-quarter lacked confidence to train colleagues in recognizing distinctions between depression, delirium and depression (23.4% unable) or to develop care plans for residents with SMI (26% unable). A bachelor’s degree (OR=0.64, 95% CI:0.43, 0.97) or less (OR= 0.47, 95% CI:0.25, 0.89) was associated with less perceived competence in care planning compared to those with a master’s degree. SSDs reported less involvement in referrals or interventions for resident aggression in homes with a high proportion of residents with SMI.
Nursing Home Social Services Directors' Roles and Self-Efficacy in Suicide Risk Management
Authors: Wang Xiaochuan , Simons Kelsey , Gammonley Denise , Roberts Amy Restorick , Bern-Klug Mercedes
Published: December 2021

Nursing home (NH) residents face many risk factors for late life suicide, and transitions into and out of NHs represent risk periods for suicide. Based on data from the 2019 National Nursing Home Social Services Directors survey (n = 924), this presentation describes NH social services directors (SSDs) roles in managing suicide risk and factors that influence self-efficacy in this area. Nearly one-fifth (19.7%) of SSDs lack of self-efficacy in suicide risk management, reporting needing significant preparation time or being not able to train others on this topic. Results of ordinal logistic regression indicate that SSDs who consider insufficient social services staffing as a minor barrier (comparing with a major barrier) to psychosocial care, those who report greater involvement in safety planning for suicide risk, and those with Master’s degree, are more likely to perceive greater self-efficacy in suicide risk management. Implications for training and staffing will be discussed.
Another Set of Eyes: Recipients’ Views of the Benefits of Geriatric Specialty Telehealth Services
Authors: Dryden Eileen , Kernan Laura , Nearing Kathryn , Pimentel Camilla , Moo Lauren
Published: December 2021

The aim of GRECC Connect is to increase access to specialty care for medically complex, older, rural patients through e-consultations and telehealth visits. We interviewed 50 outpatient clinic staff and providers as well as 30 patients and caregivers about these services. Overall, the services were considered beneficial. For patients and caregivers, services alleviated the stress and cost of travel, they improved quality of life by increasing their understanding of the progression of an illness and providing treatment and guidance to increase patient functioning and reduce disruptive behaviors, and they eased anxiety associated with not receiving needed care. Having ‘another set of eyes’ on the patients reduced stress and anxiety for providers. Concerns included alignment of telehealth modality with the capabilities of older patients with cognitive problems, hearing loss and/or limited technological abilities and, for some providers, that the referral for and recommendations resulting from the service added to their workload.
Socioeconomic Determinants of Cognitive Aging: A Cross-Country Comparison Between England and China
Authors: Cadar Dorina , Zhao Yaohui , Yan Li , Brocklebank Laura , Steptoe Andrew
Published: December 2021

Lower educational attainment is associated with a higher risk of dementia and a steeper cognitive decline in older adults. However, less clear is how other socioeconomic markers contribute to cognitive ageing and if these socioeconomic influences on cognitive ageing differ between England and China. We examined the relationship of education, household wealth, and urbanicity with cognitive performance and rate of change over 7-8 years follow up in the English Longitudinal Study of Ageing and Chinese Health and Retirement Longitudinal Study, national representative samples of England and China. We found that the rate of cognitive change appears to be socioeconomically patterned, primarily by education and area-based characteristics (urban vs rural), with a stronger impact of inequalities seen in rural China. Public health strategies for preventing cognitive decline and dementia should target socioeconomic gaps to reduce health disparities and protect those particularly disadvantaged in England and China.
Catastrophic Health Expenditures and Mental Health in Older Chinese People: The Role of Social Health Insurance
Authors: Yang Wei , Hu Bo
Published: December 2021

Catastrophic health expenditure (CHE) has considerable effects on household living standards, but little is known regarding the impacts of CHE on people’s mental health. Using China as an example, this study examines the association between CHE and mental health and investigates whether and to what extent social health insurance (SHI) can lessen the impacts of CHE on mental health among older people aged over 60 in China. The data come from three waves of the China Health and Retirement Longitudinal Study (CHARLS 2011, 2013, and 2015, N = 13,166). We built fixed-effects quantile regression models to analyse the data. We found that incurring CHE has significantly detrimental effects on older people’s mental health, whereas the SHI demonstrates a protective effect. The observed protective effects of SHI are the strongest among those with relatively mild mental health problems, i.e., people whose CES-D scores are below the 50th percentile. Our findings provide empirical evidence that encourages the integration of psychologically informed approaches in health services. We also urge governments in low- and middle-income countries to consider more generous health financing mechanisms for those with higher healthcare needs.
The Master’s Tools Will Never Dismantle the Master’s House: The Role of Diversity in Anti-Racist Education
Authors: Lincoln Karen
Published: December 2021

Diversity is a strange fruit that requires critical analysis to understand its meaning, value and impact on education. Depending on the era, diversity has been defined in a number of different ways and has a variety of meanings across a range of contexts. The lack of shared meaning and understanding of diversity and who controls the diversity narrative have significant implications for the development of anti-racist pedagogy in gerontological education. This presentation will discuss the history and evolution of the “diversity discourse” and how mainstream notions of diversity impact diversity initiatives, curriculum design and anti-racist pedagogy. Strategies for engaging in an historical analysis of diversity and how this process relates to the design, leadership and ownership of anti-racist curriculum will be discussed, as well as the role of gerontology in leading these efforts.
Weak Ties That Bind: ICT Use, Social Relations, and Depressive Symptoms Among Older Adults
Authors: Francis Jess , Webster Noah , Fakhoury Nour
Published: December 2021

Information and communication technology (ICT) use has been associated with well-being among older adults. This link is often attributed to the fact that technology use facilitates connecting with social relations generally. What is less known, however, is the extent to which distinct dimensions of social relations uniquely influence how ICT use affects health. Thus, the importance of weak ties is receiving increased attention. Using data from the Detroit-based Social Relations Study collected in 2015, we examine the extent to which separate dimensions of weak ties (contact frequency and network size) mediate and moderate the link between technology use and depressive symptoms among adults age 65+ (n=213). A greater number of less close relations mediated the link as it was associated with technology use and fewer depressive symptoms. A moderating effect was also found as technology use was associated with fewer depressive symptoms only among those with lower contact frequency.
Emotion Regulation Resources Explain Middle-Aged and Older Adults' COVID-19-Related Distress
Authors: Park Cystal , Russell Beth , Fendrich Michael
Published: December 2021

As the pandemic caused widespread disruption across the world, studies suggested younger adults were faring more poorly than other adults. We hypothesized that younger adults might possess fewer emotion regulation resources and skills, accounting for their greater distress. In a national sample of 1528 adults, we examined how baseline resources (in mid-April, during initial peak infections) predicted distress (depression, anxiety, PTSD symptoms) five weeks later, when states began initial reopenings. Younger adults reported greater distress and less social support, mindfulness, and emotion regulation skills than did middle aged and older adults.. Controlling for stress exposure, younger adults’ distress was predicted by impulsivity and lack of perceived strategies while middle-aged and older adults’ distress was predicted by acceptance of negative emotions; perceived social support was related to lower distress for both groups but mindfulness was unrelated. Results suggest that emotion regulation skills are a promising prevention and intervention focus.
Alzheimer’s Disease Research and Outreach in the New Normal: Transitioning to the Virtual World
Authors: Andersen Stacy , Heyn Patricia
Published: December 2021

Following disruptions to research, clinical trials, and support for individuals with Alzheimer’s disease and related dementias (ADRD), 2020 taught us important lessons about the need for creativity, flexibility, and resourcefulness during an urgent and global public health crisis. The COVID-19 pandemic showed that we have knowledge and technology that can be rapidly implemented, adopted, and utilized by many sectors to allow the continued care and research of our older adult population with ADRD. Thus, this symposium will address virtual methods that are transforming ADRD research and support. First, Dr. Rhodus will discuss the implementation of online assessments in clinical trials at an Alzheimer’s Disease Research Center and the effects of sociodemographic disparities in online accessibility. Next, Dr. Bazzano will describe methods of remote collection of brain health data through tablets, smartphones, and wearables in the Bogalusa Heart Study. Then, Dr. Andersen will report on the transition from in-person to virtual assessments of cognitive and physical function in centenarian studies and address strategies for inclusivity of individuals with limited technology experience. Next, Dr. Fazio will introduce Project VITAL which aims to impact social isolation by increasing accessibility to virtual education and support for care community staff, family caregivers, and individuals with dementia. Finally, Dr. Penfold will report on the translation of a paper-based, face-to-face intervention for reducing caregiver burden into a self-directed online learning program. Overall, these presentations highlight successes and challenges in incorporating virtual-based methods to maintain engagement with participants, individuals with ADRD, and caregivers during the pandemic and beyond.
Longevity Studies in the New Normal: The Move to Virtual Assessment
Authors: Andersen Stacy , Rizer Sandra , Souci Lance San , Berlin Melissa , Harris Emily , Cosentino Stephanie , Sebastiani Paola , Perls Thomas
Published: December 2021

Extreme longevity is associated with resilience to Alzheimer’s disease. A major goal of centenarian studies is therefore to identify factors associated with maintaining cognitive function throughout life. Over the past year, two studies of centenarians and their offspring (age 60-110+ years) have pivoted from in-home assessments of cognitive and physical function to hybridized, Zoom-based assessments including comprehensive cognitive testing, blood pressure, grip strength, and accelerometry and biological sample collections. Protocols were optimized for accessibility for individuals with limited technology experience (e.g., investigator remotely controls all functions of the participant’s tablet) and sensory impairments (e.g., integration of wireless headphones) and include high-sensitivity data collection (e.g., sensor-based wearables and digital recording of cognitive test responses). Advantages of virtual administration included the ability to accommodate fatigue through multi-day assessment and to include geographically-isolated individuals. Disadvantages included participant burden due to equipment setup and inability to collect certain measures virtually (e.g., carotid ultrasounds).
Air Pollution Exposure Is Associated With Cognitive Performance: Results From the Einstein Aging Study
Authors: Roque Nelson , Hall Charles , Katz Mindy , Sliwinski Martin
Published: December 2021

Prior research has established that those exposed to higher levels of fine particulate matter (PM1, PM2.5) air pollution have higher levels of accumulated amyloid-beta (Aβ) and tau in frontal cortex at autopsy, higher error rates on cognitive function assessments, and lower scores on memory and both verbal and non-verbal intelligence assessments. We explored the relationship between regional air quality monitoring measures (EPA AirData) and baseline cognitive performance of 312 older adults, from the Einstein Aging Study (EAS, NIA P01AG003949). Participants completed neuropsychological assessments at baseline and each followup wave (i.e., delayed free recall and total recall; Trails A & B, Digit Symbol substitution task (DSST), MoCA). For each participant, based on their zipcode, we computed average PM2.5 exposure at various exposure windows (1-15, 30-60, 60-90, 90-120 days prior to baseline). Adjusting for age, education, and gender across all models, mean of daily particulate matter exposure at various exposure windows (30-60, 60-90 days) was significantly related to performance on the MoCA and Trails A & B, in expected directions (i.e., higher pollution, worse cognitive performance - more error, slower speed). Models with memory performance as the outcome indicated that only distant time horizons were related to memory performance (i.e., 60-90, 90-120 days prior). These findings suggest that particulate matter air pollution likely affects different cognitive domains at different timescales. This methodology cannot address contributions from indoor air quality and mobility - an exposure misclassification likely resulting in significant biases towards the null in the estimation of the effects of air pollution.
Who’s in the House: Staffing in Long-Term Care Homes During the COVID-19 Pandemic
Authors: McGilton Katherine , Vellani Shirin , Chu Charlene , Backman Annica , Escrig-Pinol Astrid , Mateos José Tomás , Zúñiga Franziska , Spilsbury Karen
Published: December 2021

There is an absence of high-quality workforce data that could be used globally for comparative research on workforce planning in the residential long-term care (LTC) sector. We know that older adults residing in the LTC settings have multimorbidities resulting in complex care needs, yet the workforce is insufficiently able to meet their needs. A further reduction in LTC workforce was noted during the COVID-19 pandemic which increased the risk of adverse outcomes for residents. Survey results focused on the workforce in LTC homes collected from several countries during the current pandemic, highlighted that several members of the workforce were either absent or worked virtually (e.g., physicians, social workers). A better understanding of who is/or should be in the house to meet the needs of residents during or after future pandemics requires a workforce data system that routinely collects this information to ensure best quality outcomes for residents and their carers.
Perceptions of the Government’s Response to the Pandemic: Voices From the COVID-19 Coping Study
Authors: Gallo Haley , Kobayashi Lindsay , Finlay Jessica
Published: December 2021

The COVID-19 pandemic was met with conflicting government strategies in the handling of the virus. Older adults were disproportionately impacted by the pandemic, yet little is known about their perspectives of the government response. Using data collected in September and October, 2020 from the online, nation-wide COVID-19 Coping Study, we conducted qualitative thematic analysis on a subsample of respondents (N=500) proportionate to the age, gender, race/ethnicity, and education of the U.S. population age 55+. Two researchers individually coded a random subsample of 50 open-ended responses to the question “How do you feel about federal government responses to and handling of the COVID-19 pandemic?” Using NVivo qualitative software, the researchers compared codes and reconciled differences to achieve a Kappa score of >0.8. The first author coded the remaining responses using the established coding strategy. Analyses identified themes related to President Trump’s leadership, Congress, the broader federal government, and science. Some participants indicated that the federal government’s response to the pandemic was “inadequate,” “too political,” and “lacking coordination.” Others expressed that the president “did the best he could” or that “it’s not the federal government’s responsibility.” While some praised vaccine development efforts and expressed their appreciation for Dr. Fauci, others expressed scientific distrust. Participants’ perspectives were divergent, reflective of the country’s polarization surrounding COVID-19 policies and practices. Differences in perspectives exist by race/ethnicity, gender, geographic region, and age. Study results can help identify groups of older adults who may need targeted programs and policy support.
Self-Administrated Elder Abuse Screening Tool for Older Adults With Visual and Hearing Disabilities
Authors: Swierenga Sarah , Abujarad Fuad , Ismirle Jennifer , Edwards Chelsea
Published: December 2021

Older adults age 60+ with disabilities are at greater risk of elder abuse compared to those without disabilities. We will describe results from our study to evaluate the usability and feasibility of the VOICES tablet-based elder abuse screening tool with older adults who have visual and hearing disabilities. VOICES is a digital health tool that screens, educates, and motivates older adults to self-report elder abuse. The VOICES tool has been developed and tested to be used with older adults without disabilities. We conducted a usability study with (n=14) older adults who were blind, had low vision, or were hard of hearing. Our evaluation method included both quantitative and qualitative measures to evaluate the ease of use and usefulness of the VOICES tool. Usability was measured as the percentage of tasks completed successfully, the average time to perform a task and the issues observed during performance of the tasks. Usability satisfaction was measured by written or verbal feedback on the questionnaires, and verbal comments from each session. Six participants completed the tasks successfully on their own; seven participants (mostly blind participants) completed the tasks with some intervention or help from the moderator. The majority of participants had System Usability Scale (SUS) scores 80 or above. Of all the participants, twelve (92%) stated that they would recommend the VOICES tool to others. Our findings generated universal considerations for more inclusive digital health interventions that accounts for the needs, wants and limitations for older adults with disabilities.
Social Participation and Elder Mistreatment in a National Sample of Older Adults
Authors: Yang Emmy , Lisha Nadra , Kotwal Ashwin , Wong Jaclyn , Huang Alison
Published: December 2021

Little is known about how social participation influences older adults' susceptibility to elder mistreatment. We conducted a cross-sectional analysis of a national probability sample of community-dwelling U.S. adults from 2015-2016 (1,268 women and 973 men; mean age 75 and 76 years, respectively; 82% non-Hispanic white). Frequency of participation in formal activities (community meetings, religious services, and volunteering) and informal social activities (socializing with friends and family) was assessed by questionnaire. Additional measures assessed emotional, physical, and financial mistreatment since age 60. Multivariable logistic regression examined associations between social participation and elder mistreatment, adjusting for age, race/ethnicity, education, and comorbidity. Forty percent of women and 22% of men reported at least one form of mistreatment (emotional, physical, or financial). Women reporting at least monthly formal social participation were more likely to report emotional mistreatment (adjusted odds ratio (AOR) 1.57, 95% confidence interval (CI) 1.08-2.29) and financial mistreatment (AOR 1.56, 95% CI 1.02-2.38) than women with less frequent engagement. Older women who socialized at least weekly were more likely to report emotional mistreatment (AOR 0.59, 95% CI 0.44-0.78) and financial mistreatment (AOR 0.59, 95% CI 0.42-0.85). These associations were not seen among older men. Frequent social engagement in the community does not preclude risk for elder mistreatment, and informal socializing may be associated with decreased exposure to certain forms of mistreatment. Assessment of older adults’ social activities may help guide strategies for detecting and mitigating elder mistreatment in the community.
Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons With Dementia in Sweden
Authors: Johansson Marcus , McKee Kevin J , Dahlberg Lena , Summer-Meranius Martina , Williams Christine , Hammar Lena
Published: December 2021

As welfare providers struggle to meet the care needs of persons with dementia (PwDs), most of their needs are being met by a family carers, most often a spouse. The situation for spouse carers is unique, e.g., with grief, loneliness and loss of intimacy combining with stress and poor health. Research is needed to develop adequate support for spouse carers based on evidence of what influences negative and positive outcomes of care. The present study investigated psychosocial correlates of spouse carers’ (i) negative impact and (ii) positive value of caring. Data from a cross-sectional survey of 165 spouse carers community-resident in Sweden was analysed in two hierarchical regression models to predict negative impact and positive value of caring. Results found that negative impact and positive value were explained by different variables, significant predictors for negative impact included carer stress, health, and emotional loneliness, and change in intimacy with the care-recipient, while positive value was predicted by mutuality, change in closeness to the care-recipient and quality of support. Negative impact and positive value shared variance of only 17.2%. Thus, negative impact and positive value represent different aspects of the carer situation. Consequently, support needs to target several aspects in carers’ life, aiming to; facilitate for spouses to manage PwD’s impairment, increase emotional support while also strengthening the relationship between carer and PwD to reduce negative impact while increasing positive value.
LTSS Direct Care Worker Employment During COVID-19
Authors: Dill Janette , Frogner Bianca
Published: December 2021

The crisis of COVID-19 in long-term care services and supports (LTSS) has brought attention to challenges in staffing long-term care organizations, as shortages of direct care workers led to a dramatic inability to provide needed care for many residents in nursing homes and other residential care settings. In this study, we examine unemployment among LTSS direct care workers during the crisis and recovery. This study uses monthly data from January 2019 to December 2020 from the Current Population Survey, a monthly household survey collected by the Bureau of Labor Statistics, and we compare an individual’s 2019 monthly employment patterns to their 2020 monthly employment. Long-term care workers had an unemployment rate of 2.8% in April 2020, when unemployment rates in the US reached a peak; however, new unemployment among long-term care workers has not declined as consistently as in other settings. Female health care workers were significantly more likely to be unemployed compared to their male counterparts, a trend that is consistent with the overall economy, and workers who earned the lowest wages were more likely to have transitioned to unemployment. COVID-19 has added significant complexity to the provision of direct care services, making LTSS a hazardous place to work. Concerns remain about unemployment in long-term care where demand for workers remains high; additional measures need to be taken to ensure that direct care workers have the resources they need to remain employed.
Perspectives Toward Long-Term Care Measurement From Frontline Workers in Brazil
Authors: de Mello Ruth Caldeira , Wachholz Patrick , Boas Paulo José Fortes Villas , Schutz Vivian , Lepore Michael , Myer Deanna , Olives Ester Villalonga , Corazzini Kirsten
Published: December 2021

The Brazilian long-term care (LTC) sector remains poorly structured and underdeveloped. COVID-19 did not bring unprecedented focus to the sector just because of the high mortality; it also affected the quality of care. In this pilot study, we evaluated the perspectives toward WE-THRIVE LTC measurements from Brazilian frontline workers in five long-term care facilities. For the four WE-THRIVE domains of LTC measurement (workforce and staffing, person-centered care, organizational context, and care outcomes), respondents used a 4-point Likert scale to rate their importance and answered open-ended questions about how these aspects of care changed since COVID-19. With few exceptions, respondents rated these aspects of LTC as extremely important or very important. Qualitative results highlighted concerns about and impacts of COVID-19, such as challenges related to the isolation of residents. The assessed measurement domains are confirmed to be important by frontline staff in Brazil. Measurement adoption must account for current issues.
Mild Parkinsonian Signs Are Related to Lower Cortico-Striatal Connectivity in Executive Networks
Authors: Hengenius James , Huppert Theodore , Rosso Andrea , Rosano Caterina
Published: December 2021

Mild Parkinsonian signs (MPS) affect up to 24% of community-dwelling older adults. We hypothesize that MPS are associated with Parkinson’s-like alterations of functional connectivity (FC) in sensorimotor, executive, and reward cortico-striatal networks. Participants (N=266; mean age=83; 57% female) without Parkinson’s completed resting-state fMRI and Unified Parkinsonian Disease Rating Scale (UPDRS). FC between striatum and cortex was measured within each network. Logistic regression tested associations of each network’s FC with MPS (UPDRS>0), adjusted for MPS risk factors, then including white matter hyperintensities (WMH). MPS was associated with lower cortical-striatal FC in the left executive cortico-striatal network (OR [95%CI]: 0.188 [0.043,0.824]). Association survived adjusting for risk factors (0.162 [0.030,0.874]) but was attenuated after including WMH (0.209 [0.036, 1.200]). In stratified analyses, left executive cortico-striatal FC was associated with MPS only for those with higher WMH (0.077 [0.010,0.599]). Future work should examine whether higher FC protects against the influence of WMH on MPS.
Genetic Variants Correlate With Better Processing Speed
Authors: Song Zeyuan , Gurinovich Anastasia , Christensen Kaare , Nygaard Marianne , Mengel-From Jonas , Andersen Stacy , Perls Thomas , Sebastiani Paola
Published: December 2021

Some cognitive abilities, such as vocabulary, are resilient to brain aging, while others such as conceptual reasoning, memory, and processing speed, decline with age and their rate of decline is genetically regulated. Despite the strong genetic heritability of processing speed assessed by the digit symbol substitution test (DSST), previous studies have failed to identify robust common genetic variants associated with this test. The Long Life Family Study (LLFS) includes long lived individuals and their family members who maintain good DSST scores as they age and who may carry variants associated with better DSST. We therefore conducted a genome-wide association study (GWAS) of DSST in LLFS using ~15M genetic variants imputed to the HRC panel of 64,940 haplotypes with 39,635,008 sites and replicated the findings using genetic data imputed to the 1000 Genomes phase 3 reference panel combining two Danish cohorts: the Middle Aged Danish Twins and the Longitudinal Study of Aging Danish Twins. The GWAS in LLFS discovered 20 rare genetic variants reaching genome-wide significance (p-value < 5x10-8), including 18 variants associated with better processing speed with large effect size. The genetic associations of rs7623455, rs9821776, rs9821587, rs78704059 in chromosome 3 were replicated in the combined Danish cohort. These genetic variants tagged two hormone receptor related genes, THRB and RARB, both related to cognitive aging. Further gene-based tests in LLFS confirmed that these two genes have protective variants associated with better processing speed.
Creation and Validation of a Polysocial Score for Mortality Among Community-Dwelling Older Adults in the United States
Authors: Wu Chenkai , Odden Michelle , Stawski Robert , Magid Hoda
Published: December 2021

The interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. Since the older population had highly diverse social backgrounds, a new approach is needed to quantify the aggregate effect of social factors and develop person-centered social interventions. Participants ([n = 7383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the Health and Retirement Study (HRS) at study entry in 2006 or 2008. Social determinants of health encompassing five social domains: economic stability, neighborhood and physical environment, education, community and social context, and health care system. Five-year mortality was calculated as the number of years from the interview date to the death date. We used the forward stepwise logistic regression to construct the polysocial score and multivariate logistic regressions to assess the associations between polysocial score and five-year mortality. Polysocial score (range: 7 to 59, mean±SD: 35.5±7.5) was created using 15 social determinants of health. Of the 7383 participants, 491 (30.8%), 599 (17.2%), and 166 (7.8%) deaths occurred over five years among participants with a low (0-29), intermediate (30-39), and high (40+) polysocial score, respectively. Participants with an intermediate (Odds Ratio [OR]=0.76; 95% CI, 0.65-0.89) or high (OR=0.46; 95% CI, 0.36-0.59) polysocial score had higher odds of death than those in the low category in the fully adjusted model, respectively. The polysocial approach may offer possible solutions to monitor social environments and suggestions for older adults to improve their social status for specific health outcomes.
Sex Difference in All-Cause and Infection-Specific Mortality Over 10 Years Post Hip Fracture
Authors: Bajracharya Rashmita , Guralnik Jack , Magaziner Jay , Shardell Michelle , Rathbun Alan , Yamashita Takashi , Orwig Denise
Published: December 2021

Men die at a twice higher rate than women in the first two years after fracture and also experience higher infection-related mortality. Most research has only looked at differences in short-term mortality after hip fracture. The objective was to determine if cumulative incidence of all-cause mortality and infection-specific mortality is higher in men compared to women over ten years. Data came from Baltimore Hip Studies7th cohort. Women were frequency-matched (1:1) to men on timing of fracture to ensure equal numbers of men and women. The association of sex and all-cause mortality was analyzed using Cox proportional hazard model and a cause-specific hazard model for infection-specific mortality. Both models controlled for age, cognition, comorbidity, depressive symptoms, BMI, and pre-fracture ADL limitations. Complete-case sample size was 300 (men=145, women=155). By the end of ten years from the date of admission for a hip fracture, there were 237 (men=132, women=105) all-cause deaths and 38 (men=25, women=13) infection-specific deaths. Men had significantly higher all-cause mortality risk [73.7% vs 59.3%; HR=2.31(2.02-2.59)] and infection-specific mortality [17.2% vs 8.3%; HR=4.43(2.07-9.51)] compared to women. In addition to sex, older age, cognition, and comorbidities were associated with all-cause mortality whereas only BMI was associated with infection-specific mortality in adjusted models. Men had a higher risk of mortality over 10 years compared to women, specifically two-fold higher risk of infection-specific mortality compared to all-cause mortality. Findings imply that interventions to prevent/treat infection, tailored by sex, may be needed to narrow significant differences in long-term mortality rates between men and women.