bluuebunny/crossref_metadata_2025 huggingface dataset:
QUALITY OF LIFE IN DEMENTIA CAREGIVERS AFTER USING ONLINE SELF-GUIDED ACCEPTANCE AND COMMITMENT THERAPY
Authors: Batura Josey , Gossner Jacob , Aller Ty , Fauth Elizabeth
Published: January 2025

Background

At home family care for individuals with dementia averages 24.4 hours per week, with one in four caregivers providing 40+ hours. Caregivers identify positive experiences but also report burnout. Acceptance and Commitment Therapy (ACT) is an empirically validated transdiagnostic approach that aims to increase individuals’ psychological flexibility, or their ability to respond effectively to their internal experiences in the present moment. This study examines the efficacy of a 6-session online, self-guided ACT for Caregivers program. Research Design and

methods

A randomized waitlist-controlled trial included 114 dementia caregivers of whom 28 participated in two semi-structured interviews: at end of sessions (post-test) and 6 weeks later (follow-up; each 45-60 minutes). Participants were recruited from the community. Zoom interviews were transcribed and coded by three researchers using deductive qualitative analysis. Current analyses focused on the self-reported impact of the program on participants’ quality of life. The qualitative subsample included 20 (71.4%) spousal and 8 (28.6%) adult offspring caregivers (Age M= 64.2; SD= 13.3).

Results

Longitudinal coding of post-intervention and follow-up interviews indicated themes of positivity, greater self- compassion, feeling less stressed and calmer, living more vibrantly, and leaning into social supports. They also reported engaging in improved health behaviors.

Discussion

Quality of life is an ideal outcome to examine qualitatively, as ACT aims to enhance QoL, rather than merely reduce negative symptoms. Participation in an online, self-guided ACT program yielded initial and sustained improvements in multiple domains of QoL, and participants emphasized different aspects of improvements in QoL at post-test and follow-up.
THE IMPACT OF SLEEP QUALITY ON NEUROCOGNITIVE FUNCTIONING IN CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Chrzanowski Lauren , Elliott Lauren , Schneider Sydnie , Diehl Keegan , Abu-Samaha Amir , Neugebauer Volker , Singer Jonathan
Published: January 2025

Studies have found poor sleep quality is linked to decreased neurocognitive functioning in older adults. Notably, it has been found that older adults who exhibit worse sleep quality have decreased processing speed. However, research with caregivers is extremely limited and current research lacks the use of validated measures and neurocognitive assessments across several functional domains (e.g., processing speed; executive functioning). Further, most of these studies have been conducted with large urban samples. This study included family caregivers of persons with dementia in Lubbock County, which includes a small urban city and multiple rural cities. We compared Pittsburgh Sleep Quality Index (PSQI) scores with Trails Making Test delta (i.e., processing speed), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; i.e., overall neurocognitive functioning), and the Wisconsin Card Sorting Test (WCST; standardized percentiles of perseverative errors and conceptual level responses; i.e., executive functioning). There was no significant relationship between sleep and processing speed (r=-.173, p=.143), executive functioning (i.e., WCST standardized percent perseverative errors (r=-.219, p=.090); WCST standardized percent conceptual level responses (r=-.256, p=.059)), and overall neurocognitive functioning (r=-.110, p=.269). Interestingly, in this unique population of family caregivers there appears to not be a relationship between sleep and neurocognitive functioning in the domains examined. More research regarding sleep and cognition in family caregivers is needed, particularly that which addresses the interplay of sleep and other psychosocial variables impacting cognition in caregivers.
ASSOCIATIONS BETWEEN COGNITIVE PERFORMANCE AND PERCEIVED CONTROL: SPOUSAL SUPPORT AS A MODERATING FACTOR
Authors: Buxton Michael , Williams Adrian , Carranza Erick , Luskey Valerie , Apostolou Hannah , Jacobs M Lindsey
Published: January 2025

Social support can play an important role in cognitive functioning and involves both actual and perceived support. This presentation used data from the 2020 wave of the Health and Retirement Study. The sample consisted of community-dwelling older adults who completed questions of interest (n= 3416). The sample was predominantly female (59.6%) with a mean age of 68.6 years old (SD=10.3). The purpose of this study was (1) to examine the relationship between cognitive performance and perceived constraints on personal control and (2) investigate how perceived social support across relationship categories influenced the nature of this association. Participants who indicated dementia diagnoses were excluded from analyses. To determine the influence of perceived social support on the relationship of interest, moderation analyses were performed with the SPSS macro PROCESS using mean-centered values. Age, years of education, and gender were used as covariates. Perceived social support and cognitive performance had significant effects on perceived constraints. Positive and negative spousal support were the only relationship categories with significant interaction effects. Specifically, as positive spousal support increased, the relationship between cognitive performance and perceived constraints on personal control became weaker (b=-0.14, SE =.007, t(2499) = -2.0, p = 0.048). Increasing negative spousal support strengthened the relationship (b=0.14, SE =.006, t(2499) = 2.4, p = 0.017). Perceptions of spousal collaboration and support seemingly operate to fortify personal sense of control, which may be compensatory. Further research should explore facets of perceived social support and associations with cognitive performance and perceived control in older adults.
PERSONALITY TRAITS ARE ASSOCIATED WITH THE TYPES OF SOCIAL SUPPORT/STRAIN: A LATENT PROFILE ANALYSIS
Authors: Willard Meredith , Alderson Jacob , Turiano Nicholas
Published: January 2025

Research suggests that social connections are important for health and longevity (Cohen, 1985). High levels of social support is a significant predictor of improved well-being and health (White et al., 2009). However, it is important to acknowledge the role social strain can have on health, as well as key predictors of social network functioning. Thus, the current study utilized data from the Midlife Development in the US Study (MIDUS) to extract classes of social support/strain using a latent profile analysis (LPA), and use the Big 5 personality traits to predict class membership (N = 6,178; Mean age = 46.8). Social support/strain was separately computed for each network source (i.e., family, friend, and spouse) using 4-6 items. Iterations of different LPA classes suggested a 4-class solution (lowest AIC/BIC;.83 entropy). Class 1 (high spouse strain and lowest levels of support); Class 2 highest support and lowest strain levels);. Class 3 (highest level of spouse support and low levels from friends and family); Class 4 (average levels of support and strain across all sources). Those high in Conscientiousness and Agreeableness were more likely to belong in the “optimal” class of high support & low strain while those high in Openness and Neuroticism were more likely to belong in the “average” class (all p’s <.05). Findings underscore how personality traits are involved in the exposure to varying levels of support/strain individuals are exposed to. Understanding these processes is key to understanding how social networks impact aging outcomes.
RELATIONSHIP SATISFACTION MEDIATES LINKS BETWEEN OLDER ADULTS’ SOCIAL NETWORKS AND DEPRESSION
Authors: Kole Debarati , Van Vleet Bryce , Fuller Heather
Published: January 2025

Social ties have a significant positive effect on older adults’ psychological well-being. However, limited research has examined the role of relationship satisfaction for the interplay between social ties and psychological well-being. The current study explores if relationship satisfaction mediates the relationship between social network characteristics and depressive symptoms among older adults. The data are from the first three waves of the Social Integration and Aging Study, a community-based, longitudinal study of older adults (aged 60+) in the Upper Midwest. Simple longitudinal structural equation modeling was used to analyze mediation models with baseline demographic variables (Age, Gender, and Education included as covariates. Three network variables (network size, mean proximity, and mean years of connection) were selected from Wave 1 (2013). A four-item relationship satisfaction construct (satisfaction from close family, extended family, friends, and neighbors) from Wave 2 (2015) was used as the mediator variable. The 10-item Geriatric Depression Scale, at Wave 3 (2017) was used as the outcome variable. Relationship satisfaction was found to mediate the effects of network size (paths: a=.022 p=.008; b=-.538 p<.001; c’=-.026 p=.239) and mean network proximity (paths: a=.361 p=.048; b=-.548 p<.001; c’=-.523 p=.237) on depressive symptoms over time. However, relationship satisfaction did not mediate the relationship between years of connection and depressive symptoms. These findings suggest qualitative aspects of social connections more greatly impact older adults’ psychological well-being over time as compared to quantitative social network characteristics. Implications for quality of connections and sense of belongingness will be discussed.
THE CAMARADERIE OF MIDDLE-AGED AND OLDER WOMEN: HOW DOES FLASH MOB BUILD SOCIAL CAPITAL?
Authors: Min Hae Youn , Lee Kyung Eun , Heo Jinmoo
Published: January 2025

The “flash mob”, a new indication of 21st-century digital culture, involves groups of unfamiliar individuals gathering suddenly in public spaces to perform distinctive activities based on pre-arranged instructions and dispersing quickly. Engaging in group events like flash mobs enhances a more profound sense of community, belonging, and friendship. This study explores the potential of flash mobs to encourage social capital, focusing on a specific group of middle-aged and older women who engage in flash mobs as a means of celebrating the aging process. This group of women gathered to welcome the journey of aging, using flash mobs to show the way to enjoy the moment. The study used a qualitative research method, including in-depth interviews with 16 participants. The findings of this study revealed that participants formed a vivid network, and the outcomes of the network are as follows: (a) strong trust, (b) reciprocity, (c) camaraderie, and (d) contribution to the community. These elements are related closely to Putnam’s (1995) conceptualization of social capital, demonstrating the unique role of flash mobs in impacting social networks and community bonds among participants. Primarily middle-aged and older women, during significant life transitions like empty nest syndrome, retirement, and menopause, they often face loneliness, emphasizing the role of social activity. This study provides insights into how the social capital of middle-aged and older women enhances the anticipation of later life.
A DROSOPHILA MODEL OF A MITOCHONDRIALLY INDUCED INNATE IMMUNE RESPONSE
Authors: Wang Adrienne , Dutta Angshita , Putzier Alexandra , Trabant Marieke , Gustave-Schelling Kyla , Sanchez-Contreras Monica , kennedy Scott
Published: January 2025

Mitochondrial function and innate immunity-mediated inflammation are two critical regulators of healthy aging and lifespan. While mitochondrial function is the cornerstone of some of the oldest theories of aging, innate immune function is increasingly implicated as a modifier of age, and age-related neurodegenerative diseases. There is mounting evidence that mitochondria play a role in regulating innate immune function and inflammation, and that mitochondrial dysfunction and mitochondrial DNA (mtDNA) stress can lead to increased innate immune signaling. While severe mtDNA depletion is lethal, studies have shown that moderate depletion (50%) of mtDNA in mice induces a mitochondrial stress response that upregulates innate immune signaling. This signaling depends on release of mtDNA into the cytoplasm, and results in an increase in viral resistance however, the exact mechanisms by which mitochondrial stress leads to innate immune activation and subsequent effects on lifespan and susceptibility to neurodegenerative disease are not well understood. Here, we present a Drosophila model of mtDNA depletion in which expression of UL12.5, a nuclease expressed by the Herpes simplex-1 virus, degrades mtDNA. Expression of UL12.5 is developmentally lethal in an array of tissues, and conditional depletion of mtDNA in adult flies leads to decreased lifespan, exacerbates toxicity of the AD-related protein Tau, and induces an innate immune response that leads to increased resistance to acute bacterial challenge. This model provides an opportunity to extend our understanding of the role of sterile inflammation and mitochondrial stress in the etiology of age-related changes in immune function and susceptibility to neurodegenerative disease.
DHCR24 INSUFFICIENCY PROMOTES VASCULAR ENDOTHELIAL CELL SENESCENCE AND ENDOTHELIAL DYSFUNCTION
Authors: Li Han , Yang Zhen , Liang Wukaiyang , Nie Hao , Yan Jinhua , Zhang Cuntai
Published: January 2025

Endothelial cells (ECs) senescence is critical for vascular dysfunction, which leads to age-related disease. DHCR24, a 3β-hydroxysterol δ 24 reductase with multiple functions other than enzymatic activity, has been involved in age-related disease. However, little is known about the relationship between DHCR24 and vascular ECs senescence. We revealed that DHCR24 expression is chronologically decreased in senescent human umbilical vein endothelial cells (HUVECs) and the aortas of aged mice. ECs senescence in endothelium-specific DHCR24 knockout mice was characterized by increased P16 and senescence-associated secretory phenotype, decreased SIRT1 and cell proliferation, impaired endothelium-dependent relaxation, and elevated blood pressure. In vitro, DHCR24 knockdown in young HUVECs resulted in a similar senescence phenotype. DHCR24 deficiency impaired endothelial migration and tube formation and reduced nitric oxide (NO) levels. DHCR24 suppression also inhibited the caveolin-1/ERK signaling, probably responsible for increased reactive oxygen species production and decreased eNOS/NO. Conversely, DHCR24 overexpression enhanced this signaling pathway, blunted the senescence phenotype, and improved cellular function in senescent cells, effectively blocked by the ERK inhibitor U0126. Moreover, desmosterol accumulation induced by DHCR24 deficiency promoted HUVECs senescence and inhibited caveolin-1/ERK signaling. Our findings demonstrate that DHCR24 is essential in ECs senescence.
THE HARTLEY GUINEA PIG: A NOVEL MODEL FOR PROGRESSIVE NEURODEGENERATION?
Authors: Glennie Kristen , Latham Amanda , Moorthy Arsha , Walsh Maureen , LaRocca Thomas , Santangelo Kelly , Moreno Julie , Hamilton Karyn
Published: January 2025

Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD) affect an estimated 55 million people worldwide; a staggering figure that is expected to grow in the coming years. With these projections looming, we have yet to identify any cures, treatments, or preventative strategies. Historically, AD/ADRD research is conducted using a genetically engineered model, that expresses a specific brain aging pathology. Modern research, however, has identified a complex and dynamic “inflammaging” phenotype that exists with and contributes to AD/ADRD pathology. Currently, we do not have an accessible or tractable preclinical model, that naturally mimics age-related progressive neurodegeneration in humans. Recent findings, however, suggest the Hartley guinea pig may address this need. Hartleys develop systemic inflammation and progressive age-related comorbidities characteristic of human aging. This whole-body aging phenotype prompted analyses in the brain, which found Hartleys exhibit sequence homology and similar transcriptomic mechanisms of human brain aging and AD. Hartleys also develop evidence of neuroinflammation and neurodegeneration in the hippocampus. To further investigate these findings, we examined the histopathology of 4 brain regions often implicated in neurodegenerative decline, for evidence of progressive neuropathology. Analysis is ongoing, though early results support the presence of a neuroinflammatory age-related phenotype. Additionally, biomarker variability between each Hartley may mimic the natural progression of human ‘brain aging’; though more data are needed before conclusions are drawn. Findings from this study will contribute to the hypothesis that AD/ADRD is a whole-body disease, and ultimately support the goal of closing the existing translational gap between preclinical and clinical neurodegenerative research.
TRAFFIC-RELATED AIR POLLUTION AND INFECTIONS JOINTLY INCREASE THE RISK OF ALZHEIMER’S DISEASE IN OLDER ADULTS
Authors: Ukraintseva Svetlana , Popov Vladimir , Duan Hongzhe , Yashkin Arseniy , Akushevich Igor , Arbeev Konstantin , Yashin Anatoliy
Published: January 2025

Accumulating evidence points to a potentially major role of vulnerability to infections in Alzheimer’s disease (AD) development, although the exact mechanism is not clear. AD is a multifactorial disorder, and the presence of other risk factors may exacerbate the impact of infections on AD. Here we investigated how the interplay between a history of infections and exposure to traffic-related air pollution (TRAP), another risk factor for AD that may influence the brain’s vulnerability to infections, affects the risks of AD and other dementias in UKB participants aged 60-75. Infectious diseases, AD, and other dementia diagnoses were based on ICD9/ICD10 codes. Chronic exposure to TRAP was approximated by closeness (50 meters or less) of participant’s primary residence to a major road. Chi-square, Wilson score interval, Wald interval, Wald risk ratio, and Welch tests, and regression were used to assess statistical significance. We found that the presence of both, a history of infections and exposure to TRAP in UKB participants aged 60-75, was associated with 177% higher risk of AD onset after the age of 75 (risk ratio, RR=2.77, 95% CI [1.86, 4.11]), compared to individuals of the same age who had no history of either of these factors. One mechanism could involve TRAP compromising the integrity of the blood-brain barrier (BBB), potentially increasing the brain’s vulnerability to infections and related damage. This, in turn, might contribute to the promotion of AD pathology.
APPLYING TIME-OF-FLIGHT SENSOR IN EARLY MOBILIZATION INTERVENTION FOR HOSPITALIZED OLDER ADULTS
Authors: Chen I-Ling , Yang Po-Lung , Lai Hsiu-Yun , Wang Mu-Cyun , Pien Chien-Jung , Kuo Han-Yueh
Published: January 2025

Early mobilization is crucial in preventing functional decline associated with hospitalization among older adults. To assess the effectiveness of an early mobilization intervention program, this randomized trial implements Time-of-Flight (ToF) sensor technology in quantifying patient mobility. Twenty-five adults aged 65 or above who were hospitalized for acute illness were enrolled in the study. The intervention group received early rehabilitation treatment by physical therapists, while the control group received education on self-exercises. All enrolled patients were monitored with Time-of-Flight sensors to record the number of out-of-bed movements during their hospital stay. Patient mobility scores were calculated upon enrollment and the date of discharge using the de Morton Mobility Index(DEMMI). The patients were followed up by phone call at 1 month and 6 months after discharge, collecting information about re-admission to the hospital and mortality. Results showed that both intervention and control groups improved upon discharge. The average increase of DEMMI score is higher in the intervention group(mean: 9.82; SD: 10.97) than in the control group (mean: 7.07; SD: 10.72). However, no statistical significance was detected(p=0.53). DEMMI scores positively correlated with average daily out-of-bed movements (Pearson correlation coefficient > 0.7 and p < 0.001), validating the measurements of ToF sensors. Our study has strengths in utilizing sensor technology that does not require wearable devices to obtain objective measurements of mobility. However, this study is limited by its small sample size. Future research is needed to further examine the effectiveness of early mobilization among hospitalized older adults in the clinical settings.
CULTURALLY ADAPTING A TAILORED ACTIVITY PROGRAM FOR CHINESE OLDER ADULTS LIVING IN NURSING HOMES
Authors: Zheng Yu , Peng Wenting , Liu Minhui , Gong Ni , Li Chunxiao
Published: January 2025

The behavioral and psychological symptoms of dementia are aggravating among older adults at nursing homes. However, in China, there is no recognized effective program that has improved the behavioral and psychological symptoms of dementia. Therefore, we aimed to cross-culturally adapt and localize a foreign evidence-based intervention program (Tailored Activity Program, TAP), and examine its feasibility and acceptability. A total of 20 people with dementia and 12 caregivers participated in the program, and after 8 sessions. Results showed that there were significant improvements in behavioral and psychological symptoms, daily living activities, depression of older adults and depression, caregiving burden, caregiving response load of caregivers (P < 0.05), but there were no significant changes in quality of life, cognitive function of older adults and caregivers’ readiness (P > 0.05). In the semi-structured interview section, the interview data of people with dementia could be summarized as improved negative emotions, relieved stress, disinterest in activities, and activity-related suggestions; the interview data of caregivers could be summarized as improved negative emotions, relieved stress, and desire to be understood. Finally, 2 adapted suggestions (extending the duration of interventions and adjusting inclusion-exclusion criteria) were obtained based on the feedback from interview section. In conclusion,18 of 20 people with dementia (90% > 80%) and all of 12 caregivers (100% > 80%) fully understood and were willing to accept the program. This program improves the emotional experience, with a high degree of feasibility and acceptability. The tailored activity program was considered to be adapted and localized.
EXAMINING THE COST BURDEN OF DIETARY SUPPLEMENTS IN OLDER ADULT DRIVERS: AN ANALYSIS FROM THE AAA LONGROAD STUDY
Authors: Baird Sara , Moran Ryan , Hacker Sarah , Lawton Dylan , Hill Linda
Published: January 2025

Dietary supplements (DS) are commonly used, yet consistent evidence of benefit remains lacking. Many older adults have fixed incomes, and the relative costs of DS remain poorly understood. Data was obtained from the first two years from the LongROAD study, a multicenter prospective cohort study of older drivers (≥ 65 years old). At baseline and annually, over-the-counter and prescription medications were systematically coded and categorized, with attention to DS formulations. Cost estimates utilizing the lowest priced brand on Amazon.com were matched to registered DS in the National Institutes of Health Office of Dietary Supplements database. Cost burden per participant was based on reported frequency of use and analysed against participant demographics. Of the 2,990 participants at baseline, 2717 participants had follow up through year 2. Almost all participants (n=2518, 84%) utilized at least one DS during the two-year period. Of 146 DS formulations identified, 135 (92%) were included for cost analysis; the remainder were not listed on Amazon.com. Among DS users, the average estimated annual cost burden was $205.15 (SD +/- $259.49) at baseline, $222.35 (SD +/- $282.68) at year one, and $213.56 (SD +/- $273.51) at year two. Female participants had a higher average estimated annual cost (p< 0.001); there was no significant difference by education or income level. The average monthly cost of DS in this population is similar to two or more generic medications. The health implications and potential cost effect on prescription medication compliance warrants further attention.
HISTORY OF HEALTH INSURANCE COVERAGE GAPS AND HEALTH CARE USE AFTER GAINING AGE-BASED MEDICARE COVERAGE
Authors: Morris Jada , Tumin Dmitry , Zhang Yan
Published: January 2025

This study investigates the relationship between gaps in health insurance coverage prior to Medicare eligibility and subsequent changes in healthcare utilization among older adults in the United States. Medicare serves as the primary healthcare system for individuals aged 65 and above, offering access to essential medical services and security to seniors nationwide. Despite this, a significant portion of Americans aged 55–64 experience interruptions in health insurance coverage. Through an examination of Medicare enrollees with the RAND HRS 2020 dataset, we aim to determine whether experiencing coverage gaps before becoming eligible for Medicare is associated with lower utilization of preventive care services after gaining Medicare coverage. We hypothesize that individuals with a history of coverage lapses will present a decrease in attendance at primary care appointments following enrollment in Medicare. The study draws upon existing literature highlighting the challenges faced by uninsured older adults in accessing preventive care, often resorting to emergency department visits for healthcare needs. Additionally, gaps in coverage may lead to delays in diagnosis and treatment, inconsistent access to medications, and increased reliance on emergency room services post-Medicare enrollment. Our objective is to provide insights into the factors influencing healthcare utilization among older adults transitioning to Medicare, with a focus on the impact of pre-Medicare coverage lapses. Our hope is that by understanding these dynamics, policymakers and healthcare providers can develop targeted interventions to address gaps in coverage and promote equitable access to preventive care services for aging populations.
INNOVATION DESIGN: MEDICAL DEVICE TESTING BEFORE DEPLOYMENT FOR RESEARCH STUDIES
Authors: Ashcraft Alyce , Owen Donna , Brashear Jessica
Published: January 2025

Smart technology for point of care (POC) testing, allows the creation of new devices from a design innovation mindset. Refinement in POC testing for infection is profoundly needed because of continuing dissatisfaction with antibiotic stewardship. Determining optimal control conditions to detect when a device is working as expected is a first step.

Aim

To describe the process of validating a device for POC infection assessment. A collaborative team involving Nursing, Clinical Laboratory Sciences, and Electrical Engineering drove device testing following a standard protocol validation for a POC instrument using American Society for Clinical Laboratory Science (ASCLS) guidelines. The protocol included comparison of two presumably identical devices relying on lasers for determination of specimen end points.

Results

Differences between the device operation manual and expected performance indicators provided direction for engaging with the device design team. Functionality of devices was determined by noting operational differences. Validation failed for both devices. Multiple experiments were performed with controlled variables; one device provided expected results on 33% of runs, while the other only had expected results on 16% of its runs. A critical laser error was found in the instrument with the 16% success rate; mechanical issues with the other device were noted and have yet to be fully specified.

Discussion

We engaged in collaborative ZOOM discussions, problem visualization screen shots, and photos of device elements. We learned more about the internal working of the device and proposed changes to the device to facilitate navigation around problems and begin the work of device redesign.
SLEEPING MEDICATIONS AND PREVENTION OF FUNCTIONAL DISABILITY IN OLDER ADULTS WITH LOW CARE NEEDS: THE SOHA STUDY
Authors: Otsuki Naoko , Yamamoto Ryohei , Kono Ayumi
Published: January 2025

Although sleeping medications are extensively used to treat sleep disorders in older adults, their safety and efficacy in term of physical influences are controversial. A previous review reported that the risk of falls and hip fractures was associated not only with sleeping medications but also with sleep disorders. Improving sleep disorders may be vital for preventing functional disabilities. The present prospective cohort study aims to clarify the association between sleeping medication use and the incidence of functional disability in 1,652 older adults aged ≥65 years with low care needs in Japan’s long-term care insurance (LTCI). The present study included 1,291 participants aged 65 years or older at the baseline date after excluding 302 participants who received long-term care certification during the six-month baseline period. The outcome was the identification of functional disabilities based on LTCI certification. The association between the sleeping medications and the incidence of functional disabilities was assessed using Fine and Gray proportional sub-distribution hazards models. During the median observational period of 2.5 years, the incidence of functional disabilities was observed in 54.6% and 49.7% participants in the “No use” group and the “Use” group, respectively. This study clarified that the group using sleeping medications had a significantly lower risk of functional disabilities than the group not using them. (Sub-hazard ratios of “No use” and “Use”: 1.00 [reference], 0.82[CIs, 0.68–0.99]). Our findings differ from those of previous studies and may provide useful suggestions for home care services for older adults with low care needs.
UTILIZATION OF USUAL SOURCE OF CARE AND HEALTH LITERACY AMONG OLDER ADULTS WITH HYPERTENSION
Authors: Hong Dahye , Kim Jennifer , Kang Bada
Published: January 2025

Health literacy (HL) is crucial for health outcomes in older adults with chronic conditions because it influences disease-related knowledge and medication adherence. Although the usual source of care (USC) is recognized as an influencing factor for HL, little is known about the association between the utilization of USC and health literacy among older adults with hypertension. This study examined the relationship between the utilization of USC and HL among adults aged 65 years or older with hypertension (N = 1,482 women and 1,064 men) using data from the Korea Health Panel Survey 2021. Three analyses were performed to examine the association between the utilization of USC and HL after adjusting for sociodemographic and health-related characteristics. The results of logistic regression, showed a negative association between the absence of USC and HL. When HL was divided into three levels (inadequate, problematic, and sufficient), the multinomial regression analysis indicated that the absence of USC demonstrated a more pronounced negative association with higher levels of HL. Linear regression analysis revealed a negative association between the absence of USC and all domains of health literacy (i.e., healthcare, disease prevention, and health promotion). Disease prevention, which is known to be associated with the prevention of multimorbidity, exhibited the most pronounced negative association with the absence of USC. These findings have implications for policymakers, as promoting the utilization of USC can be an effective approach for improving HL in older adults with hypertension and will be beneficial in preventing the incidence of multimorbidity among vulnerable populations.
PILOT STUDY OF A VIRTUAL ART KIT PROGRAM FOR COMMUNITY-DWELLING OLDER ADULTS
Authors: Mertz Laurel , Smith Jennifer
Published: January 2025

Engagement in the arts has been shown to improve health and well-being in older adults. However, previous research suggests that some older adults may experience barriers to arts engagement, such as health concerns, cost, and lack of transport. One method to address these potential barriers for older adults is virtual arts programming. The purpose of this study was to determine older adults’ satisfaction with a six-week virtual art kit pilot program, as well as to examine how participation in the program affected participants’ health and well-being. The program involved participants receiving an art kit via mail with the supplies and instructions needed for each weekly project (e.g., scarf dying, affirmation weaving). Participation in weekly classes delivered via video conferencing and a social media group was encouraged. A total of 285 community-dwelling older adults completed both the pre- and post- surveys (96.1% female; 91.9% between the ages of 55 to 74). Analyses revealed high satisfaction with the program. Participants significantly improved from before to after the program on creativity, sense of community, purpose, stress, life satisfaction, and attitudes toward aging. There was no significant change in sense of mindfulness, loneliness, nor self-reported mental and physical health. This study provides evidence for the positive impact of a virtual art kit program on multiple aspects of well-being for older adults. Given the importance of accessibility in arts engagement, future research should continue to examine virtual arts programs as a method to enhance well-being.
SILVER TSUNAMIS, GRAY TIDES, AND DEAD WOOD: EXPLORING AGEIST METAPHORS AT THE INTERSECTION OF AGING AND CLIMATE CHANGE
Authors: Kriebernegg Ulla , Kainradl Anna-Christina
Published: January 2025

This paper explores the ageist metaphorical language that links demographic change and climate change from a cultural gerontological perspective. Older adults are often labeled as ‘vulnerable’ and ‘at risk’ in the face of the climate crisis, framing it as a costly public health challenge. Simultaneously, they face criticism and animosity, being perceived as contributors to environmental degradation. The metaphorical realms of aging and climate change converge in ageist metaphors such as ‘the silver tsunami’ or ‘the gray flood’ that reinforce the image of the double burden allegedly represented by older people. Canadian sociologist Stephen Katz labeled this perspective “alarmist demography,” challenging the notion that the threat arises from a growing, demanding, and relatively affluent group relying on the welfare state, burdening younger generations (1992, 203). Scrutinizing the rising ageism in climate change discourse, this paper illustrates how ageist metaphors might act as a veil, concealing other socio-political issues that warrant attention, such as social inequalities. To showcase this phenomenon, we will use examples from media and film as well as Margaret Atwood’s short story “Torching the Dusties” (2014), which depicts young people setting nursing homes on fire, burning down “the dead wood” to force the old to “make room” for the young. Using such recent cultural representations, we will make the dangerous ageism inherent in the double burden narrative very explicit. To conclude, the paper shows that generational warfare is not helpful, and that tackling climate protection requires a collective effort involving all generations.
QUALITATIVE PERCEPTIONS OF UNDERVACCINATED OLDER ADULTS AND POTENTIAL AVENUES FOR INTERVENTION
Authors: Fuller Heather , Huseth-Zosel Andrea , Van Vleet Bryce , Undem Teri
Published: January 2025

Though older adults typically have relatively high vaccination rates, some older adults are reluctant to receive recommended vaccinations, a trend that is increasing in recent years. Vaccine hesitancy is not well understood among older adults but could help pinpoint areas of intervention to potentially reduce concerns and improve health outcomes. This study qualitatively examines vaccination decision-making processes among older adults (aged 65+) in North Dakota. Qualitative, semi-structured phone interviews focused on access, knowledge, and decisions about vaccines were conducted with 51 older adults between November 2022-January 2023. Of those participants, 24 were selected for the current study due to lacking 33% or more of recommended vaccines for this age group (i.e., influenza, shingles, pneumococcal, COVID-19). Interview transcripts were inductively coded to identify themes related to perceptions of acceptance and hesitancy with making decision about vaccines. Emergent themes included: skepticism, uncertainty of decisions, regret at being misled/fooled, defiance, and confidence in decisions. Within each theme, transcripts were examined to determine potential intervention approaches. To address skepticism, reduction of propaganda campaigns was identified. Creative educational and outreach interventions that emphasize consistent messaging were identified to address both uncertainty and regret. To address defiance and confidence in decisions, interventions should strategically utilize trusted information sources including physicians, pharmacists, and the church while targeting informed, independent decision-making. Findings contribute to better understanding the perceptions and decisions of vaccine hesitant older adults and suggest potential focus areas for interventions to potentially improve vaccination rates and reduce health risks for this population.
THE EFFECT OF FAMILY RELATIONS AND THE SATISFACTION OF SOCIAL ACTIVITIES BY GENDER
Authors: Kim Meeryoung
Published: January 2025

The retirement age in Korea is 60, and most of the time after retirement is spent at home. Sometimes staying at home can be a source of conflict. However, doing social activities and being satisfied with such activities can become energy in old age. From an ecological point of view, this study investigates family relationships and satisfaction with various social relationships and activities as factors influencing the life satisfaction of older adults. The effects of these relationships may vary by gender. This study used the seventh additional and eighth wave of the Korean Retirement and Income Study. The subjects of this study were adults aged 60 and older. The sample size of men is 232 and the sample of women is 165. Multiple regressions were used for data analysis. Demographic variables were controlled. As for independent variables, this study used: the degree of spousal conflict, conflicts with children who reside at home and outside, satisfaction with leisure, and organizational and relational activities. Life satisfaction was used as a dependent variable. Research findings showed that relationship satisfaction had a significant effect on life satisfaction for both men and women. However, relationship satisfaction was relatively higher for men than for women. Unlike men, women’s life satisfaction was impacted negatively by conflict between a spouse and children living together. These results imply that the same conflicts between spouses and children have different effects on life satisfaction by gender difference. Therefore, we must consider gender difference when deciding on old age policy.
DISPARITIES IN HEALTH OUTCOMES AMONG MIDDLE-AGED AND OLDER SEXUAL MINORITY CANCER SURVIVORS
Authors: Brown Maria , McElroy Jane
Published: January 2025

This cross-sectional, exploratory study analyzed 2021 Behavioral Risk Factor Surveillance System public-use data for a propensity-score matched sample (N=25,545), from states that collected sexual identity and cancer survivorship information, to explore health outcomes among sexual minority (SM) and non-SM cancer survivors. In bivariate analysis, SM survivors had more chronic conditions than non-SM survivors (males 45-64 years: 1.67 vs 1.03; females 45-64 years: 1.46 vs 1.16) and were more likely to report multiple chronic conditions (males 45-64 years: 44.5% vs 29.0%), depressive disorders (males 45-64 years: 42.9 vs 23.4%; males 65+ years: 20.8% vs 11.2%; females 45-64 years: 52.9% vs 36.5%; females 65+ years: 42.7% vs 41.3%), and difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition (females 45-64 years: 30.1% vs 18.9%; males 65+ years: 15.9% vs 8.5%). In logistic regression models, after controlling for demographics, health, and health behaviors, SM males and females in both age groups had similar odds of being a cancer survivor as their non-SM counterparts, and greater odds of poor health, multiple chronic conditions, depressive disorder, ADL limitations, and difficulty concentrating, remembering, or making decisions. Cancer status was not always associated with these outcomes. Further research should explore treatment experiences and factors contributing to disparities within this population and among SM cancer survivors and assess whether health outcomes of SM cancer survivors are related to stage of disease at diagnosis, time since treatment, or decisions made during treatment.
TRANSGENDER OLDER ADULTS HOSPITAL USE IN SOUTH CAROLINA
Authors: May Jennifer , Smyles Hanna , Adams Swann
Published: January 2025

Transgender adults in the South represent a unique population with health disparities and care inequities due to longstanding false stereotypes and discrimination surrounding their transgender status. Transgender adults report less access to health insurance, lower quality of life, and severe mental distress compared to the general U.S. population. There is a paucity of literature identifying the hospital patterns of transgender older adults (≥50 years). This study examines hospital utilization among transgender older adults (≥50 years) in South Carolina to describe their demographic characteristics and use of inpatient, outpatient surgery, and emergency department services. We conducted a secondary analysis of restricted hospital claims data from 2000 to 2022; identified transgender adults, using ICD-9 and ICD-10 codes, who used hospital services in South Carolina. Patient demographics and clinical data were analyzed using descriptive statistics. We identified 382 unique individual transgender adults with our algorithm. Most identified as White (76%); 70% were in the age range of 50-59; sex as reported on the administrative record was mostly male at 51%. 78% (n=299) of transgender adults were from urban areas. Transgender adults could have had more than one type of hospital use with 272 unique individuals using inpatient hospital services, 334 unique individuals using outpatient hospital services, and 346 unique individuals using emergency room services. Understanding the hospital use and the urban vs rural location of the transgender adult population can help identify state resource allocation, capacity building, and creating a foundation for bolstering health services and reducing health inequities.
ORAL HYGIENE AND THE INCIDENCE OF FUNCTIONAL DECLINE IN OLDER ADULTS AGED ≥75 YEARS: THE OHSAKA STUDY
Authors: Otsuki Naoko , Mameno Tomoaki , Takeuchi Satoko , Ikebe Kazunori , Kono Ayumi , Yamamoto Ryohei
Published: January 2025

Poor oral health has been identified as a risk factor for overall health. Management of oral problems is highly significant in the field of public health. This retrospective cohort study aimed to clarify the association between the oral hygiene and the incidence of functional decline in 134,957 participants aged 75 years or older, who underwent public dental checkups in Japan. The oral hygiene levels were scored by dentists as excellent, good, or poor. The outcome was the identification of functional decline based on Long-term Care Insurance certification. An association between the oral hygiene and the incidence of functional decline were assessed using the Fine and Gray model adjusted for clinically relevant factors. During the median observational period of 36 months, the incidence of functional decline was observed in 3,360 (5.3%) men and 2,693 (3.8%) women. The multivariable-adjusted model showed that poor oral hygiene was associated with functional decline in both men and women, respectively (Sub-hazard ratios [95% confidence interval] of Excellent, Good, and Poor: 1.00 [reference], 1.10 [0.99–1.24], and 1.57 [1.33–1.84], respectively for men; 1.00 [reference], 1.29 [1.14–1.46], and 1.56 [1.23–1.97], respectively for women). The findings of the present study suggest that municipal healthcare planning and home care should recommend oral hygiene in older adults aged ≥75 years.
CRITICAL ANALYSIS OF A PRAGMATIC TRIAL TO IMPROVE CHRONIC PAIN MANAGEMENT IN A WELFARE STATE
Authors: Draeger Dagmar , Koios Daniela , Wenzel Arlett , Budnick Andrea
Published: January 2025

High pain intensity and substantial pain interferences impact older community-dwelling adults with a certified need for care, while their pain management is not up to standard. A three-arm cluster-randomized pragmatic trial was conducted, with individualized interventions (IG1), digital staff training (IG2), and a control group (CG). The target group was home-care recipients (aged ≥65 years) with chronic pain. We recruited 190 participants from 22 home care providers (=clusters), drop-out rate was 24%. An expert panel communicated individualized nursing and medical recommendations for each IG1-participant. Nurses and physicians in IG2 were offered digital training. CG-participants received standard care. A dichotomous assessment regarding the acceptability of each participant’s pain situation is the primary outcome for this analysis (group differences assessed by χ²-tests). At baseline, 48.4% of participants described their pain situation as “not acceptable”. At follow-up, 15.9% stated an improvement of their pain situation, while the majority (70.7%) indicated stagnation or worsening (12.4%). There are no differences between the three study-arms. Staff commitment regarding intervention implementation did not meet the pre-defined requirements and varied substantially. Physicians and nursing staff cited heavy workloads, staff shortages etc. as arguments for not implementing interventions. While executives’ support is essential, commitment of those that are supposed to carry out interventions or changes is paramount. Implementing improved pain management in a pragmatic setting encountered structural obstacles in the German health system. When planning pragmatic trials, barriers to implementing interventions under real-world conditions must be critically discussed. We recommend involving required staff early in the planning process.