bluuebunny/crossref_metadata_2025 huggingface dataset:
INCIDENCE AND ASSOCIATED FACTORS OF DEMENTIA IN PEOPLE WITH SCHIZOPHRENIA: A POPULATION-BASED COHORT STUDY
Authors: Zhang Yingyang , Wang Pengcheng , Tang Jennifer Y M , Wong Gloria H Y , Luo Hao
Published: December 2022

Existing evidence suggests that people with schizophrenia may have an increased risk of dementia. This study aimed to quantify the incidence of dementia and examine putative risk factors associated with dementia in people with schizophrenia. This is a cohort study using population-based electronic health records of people who visited public hospitals in Hong Kong. We included participants (≥ 45 years) with schizophrenia diagnosis between 2009 to 2018 without dementia and followed them until March 2021. Incidence of dementia was calculated, and Cox proportional hazard regression was utilized to estimate hazard ratios of dementia, adjusting for covariates. A total of 20,901 individuals (mean [SD] age, 58.4 [10.3] years, 55.7% were women) were followed for 154,630 person-years (median [interquartile range] follow-up, 7.6 [4.7-10.3] years). The incidence of dementia was 5.1 [95% CI, 4.7-5.4] per 1000 person-years (those aged 45-64: 2.0 [1.8-2.3]; those 65 and above: 17.0 [15.6-18.5] per 1000 person-years). Factors independently associated with all-cause dementia were age (Hazard Ratio, 1.11 [95% CI, 1.10-1.11]), diabetes (1.62 [1.36-1.93]), bipolar disorders with at least five-year duration (2.12 [1.50-3.01]), and schizophrenia duration (1.02 [1.01-1.04]). Stratified analysis indicated that the association of these factors with dementia had differences in different sex and age groups. The incidence of dementia after schizophrenia diagnosis was high and two risk factors of dementia that are different from the well-established ones were identified.
PEOPLE LIVING WITH DEMENTIA GUIDED THE WAY: ADAPTIVE STAKEHOLDER ENGAGEMENT TO DESIGN A PRAGMATIC CLINICAL TRIAL
Authors: Lepore Michael
Published: December 2022

Research on non-pharmacologic interventions for people living with dementia (PLWD) has shown many benefits, but healthcare systems do not offer these interventions widely. To strengthen understanding of the real-world effectiveness of evidence-based non-pharmacologic interventions for PLWD requires a pragmatic approach to trialing interventions in the contexts of healthcare systems where they are standardly delivered. Designing pragmatic trials with the engagement of primary stakeholders can support trial feasibility and meaningful outcome measurement, but little evidence is available on approaches for engaging PLWD in designing pragmatic trials. This longitudinal case study introduces adaptive stakeholder engagement, a three-phase approach to engaging PLWD in planning a pragmatic trial. First, a multistakeholder workshop including PLWD was held where participants prioritized topics for research, including research on the impact of increasing social activity. Second, an evidence-based non-pharmacological intervention that addresses this priority area was piloted with PLWD and qualitative feedback was collected from PLWD over the course of intervention piloting to inform the trial design. Finally, PLWD were engaged in facilitated monthly meetings to provide input on the pragmatic trial design. In addition to informing intervention selection, input collected from PLWD informed the pragmatic trial in several ways, including approaches to PLWD recruitment, disclosure of research to PLWD, and intervention orientation processes. The adaptive stakeholder engagement model involved PLWD in different roles, as workshop participants, intervention participants, and trial advisors. This model enabled PLWD to be engaged in priority setting, infrastructure development, and trial protocol design, and may be useful for researchers planning future pragmatic trials.
DEMENTIA CARE IN THE LAST YEAR OF LIFE: EXPERIENCES IN A COMMUNITY PRACTICE
Authors: Bartley Mairead , Manggaard Jennifer , Fischer Karen , Holland Diane , Takahashi Paul
Published: December 2022

Objectives

People with dementia often have high care needs at end of life. We compared care delivery in the last year of life for people living with dementia in the community (home/assisted living facilities, ALF) to those in skilled nursing facilities (SNF).

Methods

This was a retrospective study of people who died with a diagnosis of dementia in the community compared with SNF between 2013 and 2018. Primary outcomes of hospitalizations/ED visits in the last year of life were measured. Secondary outcomes included advance care planning (ACP) completion, hospice enrollment, provider visits and ICU admissions.

Results

Of 1203 people with dementia, 581 (48.3%) were living in a SNF and 622 (51.7%) in the home/ALF. At least one hospitalization was recorded for 70.7% in the home/ALF compared with 50.8% in the SNF (p< 0.01), similar to ED visits (80.2% versus 58% in home/ALF and SNF groups, respectively, p< 0.01). People in the SNF had more provider visits (median 9 (IQR 6, 12) compared with 5 (IQR 3,9) in the home/ALF group (p< 0.01). There was no ACP for 12% of those in the home/ALF, compared with 4.6% in the SNF(p< 0.01). Approximately half (56.5%) in the SNF were enrolled in hospice compared with 68.3% in the home/ALF group (p< 0.01), Median time in hospice was 26.5 days in the SNF versus 30 days in the home/ALF (p=0.67).

Conclusions

People living with dementia have frequent acute care utilization in the last year of life. Hospice care was more common in the home/ALF. Time in hospice was short.
SIGMA PHI OMEGA PRESIDENTIAL SYMPOSIUM: ITS ROLE IN ADVANCING THE FUTURE OF GERONTOLOGISTS AND HEALTH PROFESSIONALS
Authors: Martin Diane , Felsted Katarina Friberg
Published: December 2022

Sigma Phi Omega, The International Academic Honor and Professional Society in Gerontology (aka Sigma Phi Omega), was established in 1980 to recognize excellence of those who study gerontology and aging, and the outstanding service of professionals who work with or on behalf of older persons. The formation of this society provided a much-needed link between educators, practitioners, and administrators in various settings where older persons are served. Through the efforts of the international office and executive board officers, Sigma Phi Omega builds avenues to further their members’ academic and professional gerontological excellence. The goals of Sigma Phi Omega are achieved primarily through activities of local chapters at higher education institutions worldwide. Sigma Phi Omega chapters serve as links within their respective communities to promote interaction between gerontology educators, students, alumni, and local professionals. This international organization has a laser focus on excellence within gerontology and health professions education. In this session, the first presentation will provide the history of Sigma Phi Omega and its outreach efforts; the second presentation will focus on the future goals of Sigma Phi Omega to expand its role as an international honor society in preparing gerontologists, service providers and health professionals working with or on behalf of older adults; and the third presentation will focus on the SPO Chapters and their relationship with the piloted Gerontological Society of America Student Chapters.
THE RELATIONSHIP BETWEEN HEALTHCARE STEREOTYPE THREAT AND ADVANCE CARE PLANNING AMONG HISPANIC PATIENTS
Authors: Cardenas Valeria , Storms Aaron , Lomeli Sindy , van Zyl Carin , Enguidanos Susan
Published: December 2022

Experiencing ethnic/racial stereotype threat, the psychological experience of confronting stereotypes in the healthcare system, has been found to negatively impact healthcare outcomes (e.g. dissatisfaction with healthcare, poorer mental and physical health, higher physician distrust). Few studies have examined healthcare stereotype threat among Hispanics, and no study has tested how it might impact advance care planning outcomes among Hispanic hospitalized patients. This study aims to examine the relationship between healthcare stereotype threat and advance care planning activities among Hispanic hospitalized patients. We analyzed secondary data collected from a feasibility study of a palliative care educational intervention among 50 Spanish-speaking, Hispanic patients, over the age of 40, who were hospitalized in a large public hospital. Fifty percent had discussed future care if they were to become seriously ill, 18% had written instructions about their care (living will or advance directive), and 32% had a durable power of attorney (proxy) for healthcare. Results of logistic regressions revealed that greater healthcare stereotype threat scores were associated with lower odds of having discussed future care or medical treatment with others (OR=0.49, p=.03). However, healthcare stereotype threat scores were not associated with having provided written instructions about future medical care (OR=0.44; p=0.07), or with having a durable power of attorney for healthcare (OR=0.89; p=0.76). Future research should investigate ways to improve the cultural sensitivity in broaching discussions of future medical treatment among seriously ill patients. Additionally, more research and attention to policy implication are needed to reduce racial stereotype threat experienced in the healthcare system.
EFFECTIVENESS OF A HUMAN RIGHTS–BASED APPROACH ONLINE PROGRAM FOR GERONTOLOGICAL SOCIAL WORKERS
Authors: Lee Minhong , Sok An , Kim Kyeongmo
Published: December 2022

The human rights perspective is emphasized through the social work code of ethics and practice principles. However, the efforts to improve the human rights perspective of social workers were insufficient in gerontological social work education in South Korea. Thus, the study aimed to prove the effects of a human rights-based approach intervention for gerontological social workers, which consisted of nine online sessions using Zoom. PI developed the program based on McPherson’s integrated framework for Human Rights Practice in Social Work. A quasi-experimental design was used. The experimental group consisted of 36 social workers, and the control group was 31 social workers at senior centers. The pre-post tests for the experimental group and posttest for the control group were conducted. The socio-demographic characteristics of the two groups were equivalent. The key measure was the Human Rights Lens in Social Work (HRLSW) scale consisting of two sub-dimensions: social problems as rights violations and clients as experiencing rights violations.The effect sizes of the online program’s effects on the social worker’s rights-based perspective were large over .90. In addition, the degrees two dimensions of the HRLSW at the posttest were significantly higher than those of the control group (social problems as rights violations: d = 1.04, p < .001; clients as experiencing rights violations: d=0.98, p<.001). Based on the findings of this study, the implications of human rights education and training were discussed to improve the human rights-based perspective of gerontological social workers.
KNOWLEDGE DEFICITS ABOUT THE SAFE USE OF PRESCRIPTION OPIOIDS AND NALOXONE IN OLDER ADULTS IN ARKANSAS
Authors: Savary Patricia , Azhar Gohar , Amstrong Naomi , Gibson Regina , Eoff Elizabeth , Pangle Amanda , McAtee Robin , Wei Jeanne
Published: December 2022

Older adults might be more likely to experience adverse effects of opioid medications, or accidental overdose because of age-related multi-morbidities and polypharmacy. Arkansas has the second highest legal opioid prescription rate in the nation hence disseminating information to older individuals is key in fighting the opioid epidemic. As part of an Opioid Prevention for Aging and Longevity Program, we conducted a community-based, cross-sectional, anonymous survey of individuals >59 years about opioids, the common side effects and use of naloxone. The total N was 304, and the response per item varied from 236-298. Respondents’ knowledge was strongest for preventative safety measures: to avoid drinking alcohol when using opioids 90.94% and to lock opioids in a secure location when children are nearby (89.49%). About three-quarters of respondents correctly identified medications classified as opioid (70.34%) or non-opioid (74.48%). Similarly, 75.36% recognized a non-opioid, ibuprofen, as the appropriate pain medication for back pain. The side effects of opioids not as well recognized. Sleepiness and trouble driving was the best understood side effect (72.18%). In contrast, the side-effect of constipation was correctly identified in just 34.17% of responses and trouble urinating in only 26.79%. In addition, a key emergency safety measure in case of opioid over-dose was far less known: Only 63.98% were able to correctly identify naloxone as an antidote for opioid overdose.Older adults exhibited gaps in knowledge about the common side effects of prescription opioids and were unaware of the life-saving role of naloxone in reversing the effects of opioid overdose.
SIGMA PHI OMEGA'S FUTURE
Authors: Martin Diane
Published: December 2022

Sigma Phi Omega (SPO) is well established within the United States but as The International Academic Honor and Professional Society in Gerontology, it is time to intentionally expand globally in preparing gerontologists, service providers, and health professionals in the field of aging. This session will build on the platform provided by Dr. Katarina Friberg Felsted, Sigma Phi Omega immediate past president, and encourage discussion with and among attendees on ideas and creative approaches for advancing Sigma Phi Omega at colleges and universities worldwide. Broad input and feedback for mapping the future of Sigma Phi Omega across the national and international arenas provides opportunities and prospects that advances the fields of gerontology and geriatrics. The key is upholding Sigma Phi Omega’s mission and vision that supports aging through the work our members do with or on behalf of older adults.
LIVING WITH MULTIMORBIDITY: SHARED EXPERIENCES OF PATIENTS, FAMILY CAREGIVERS, AND HEALTHCARE PROFESSIONALS
Authors: Peeler Anna , Nelson Katie , Badawi Sarah , Street Lara , Hager David , Davidson Patricia , Koirala Binu
Published: December 2022

Over 50% of patients in intermediate care units (IMCU) present with multimorbidity, two or more chronic conditions. Balancing the effects of multimorbidity and their treatments with quality-of-life can be a challenge. This experience-based co-design project aimed to elicit experiences of patients, family caregivers, and healthcare professionals in IMCU, in the context of challenges and intricacies of multimorbidity management, to inform the development of a symptom management toolkit. Patients aged 55 years and older were recruited and interviewed in person. Healthcare professionals working in IMCU (i.e., physicians, nurses, respiratory therapists, social workers, etc.) were recruited and interviewed virtually. Participants were asked questions about their role in recognizing and treating symptoms, factors affecting quality of life, symptom burden and trajectory over time, and symptom management strategies that have and have not worked. An inductive thematic analysis approach was used for data analysis. Twenty-three interviews were conducted: 9 patients, 2 family-caregivers, and 12 healthcare professionals. Patients’ mean age was 67.5 (± 6.5) years, over half (n=5) were Black or Hispanic, and average number of multimorbidity was 3.67. Five major themes emerged: 1) importance of patient-provider relationship; 2) open and honest communication; 3) accessibility of resources during hospitalization and at discharge; 4) caregiver support, training, and education; and 5) care-coordination and follow-up care. Patients, caregivers, and healthcare professionals often have different priorities for multimorbidity management, treatment, and education. However, given the growing population of patients experiencing multimorbidity, it is imperative to identify shared priorities and target holistic interventions considering their experiences to enhance outcomes.
A LONGITUDINAL INQUIRY OF PATIENT-PROVIDER RELATIONSHIPS AMONG AN UNDERSTUDIED GERIATRIC POPULATION
Authors: Bravo Rosana , Gutierrez Angela
Published: December 2022

Patient-provider relationships have a direct impact on patient outcomes. This study explored patient-provider relationships among an understudied geriatric population of color— foreign-born Latinos¬ participating in an all-inclusive specialized program aimed at controlling patients’ costs and enhancing access to care. Thirteen older adult Latinos with multimorbidities from nine Program of All-Inclusive Care for the Elderly (PACE) centers in Southern California were recruited. Researchers conducted three in-depth interviews in Spanish with each participant (39 interviews total) over 13 months. The first interviews were conducted face-to-face and lasted one hour on average. Subsequent interviews were conducted over the phone (Range: 60-90 minutes). Data were analyzed using codes, identifying categories and themes. The concepts of time and trust were used to analyze the process of relationship development and to capture changes over time. The patient-provider relationship developed on a continuum across time and trust, establishing three stages to the patient-provider relationship. In the first stage emerged the concept of el buen doctor (the good doctor). In the second stage, trust was perceived to have been established, and was only strengthened as the doctor continued to demonstrate trustworthy characteristics over time. The third stage embodied all that a person of trust was plus an additional advocacy dimension. The longitudinal and specialized geriatric program design illuminated the nature of quality of care and patients’ perceptions on relationship development over time. Controlling patient/provider costs and enhancing access to care in an all-inclusive program are beneficial in enhancing patient-provider relationships.
ADVANCE CARE PLANNING FOR SPANISH-LANGUAGE SPEAKERS: PATIENT, FAMILY, AND INTERPRETER PERSPECTIVES
Authors: Puerto Geraldine , Chiriboga Germán , DeSanto-Madeya Susan , Duodu Vennesa , Cruz-Oliver Dulce , Tjia Jennifer
Published: December 2022

Language access is a challenge to advance care planning (ACP). Spanish-language speakers are the largest non-English speaking population in the US. While ACP tools have been translated into Spanish, it is unclear how heterogeneity in country of origin may affect the generalizability of translations across diverse US Spanish-speaking populations. The study objective is to describe challenges and facilitators to ACP for diverse populations of Spanish-language speakers. We conducted 3 focus groups with a total of 29 participants from members of Spanish-language speaking communities whose countries of origin were predominantly from the Caribbean, Central, and South America. Eligibility included being 18 years or older, being a native Spanish-speaker, and having direct experience with ACP as a patient, caregiver, or medical interpreter. We conducted thematic analysis with axial coding. Themes include: 1. Linguistic Challenges with Current ACP Translations; 2. Effect of Country of Origin and Culture on ACP Understanding; 3. Impact of Local Healthcare System Cultural on ACP; and 4. Need for ACP to be Normalized into the Local Community. ACP is both a cultural practice and a clinical practice. Recommendations for improving ACP completion for non-English speakers extend far beyond translation, since simply translating ACP tools without a cultural context is neither equitable nor inclusive. A key step is normalizing ACP into the local community. Understanding the intersection of local healthcare systems of ACP practice with the patient’s and family’s cultures of origin will facilitate introducing ACP in a culturally sensitive manner.
AUTOMATIC CLASSIFICATION OF ADRD CAREGIVERS’ ONLINE INFORMATION WANTS: A MACHINE LEARNING APPROACH
Authors: Ji Yuelyu , Zou Ning , Xie Bo , He Daqing , Wang Zhendong
Published: December 2022

Social media platforms are used by caregivers for persons with Alzheimer’s Disease and its Related Dementias (ADRD) to obtain care information. Understanding what types of information caregivers want is critical to developing interventions to provide tailored information. Existing research on caregivers’ information wants has relied primarily on manual data analysis, unable to handle the vast amount of data available on social media. In our prior work, we adapted the validated Health Information Wants (HIW) framework to the ADRD caregiving context, forming the HIW-ADRD framework that includes 7 types of information commonly wanted by caregivers. Our longer-term goal is to develop machine algorithms that use the HIW-ADRD framework to automatically classify caregivers’ information wants from vast social media posts. Towards this end, we first scrapped posts from ADRD-related subgroups on Reddit, a popular social media platform. We then used few-shot learning, a machine learning method, to extract HIW from the posts. Using questions with question marks as a primary indicator for HIW, we filtered out those sentences and their corresponding background information. Next, we combined the questions and their background information as summaries of the posts. Finally, we sent the summaries to a classification model that classified these summaries based on HIW categories. We used 200 annotated posts to train the model, then tested it on 16779 posts. The evaluation results showed that our model achieved 62.35% in accuracy. These findings provide preliminary evidence for both the deep learning process and the algorithms. This study has implications for future research.
STIGMA IN THE CONTEXT OF ALZHEIMER’S DISEASE AND RELATED DEMENTIAS (ADRD) WITHIN RURAL AND UNDERSERVED POPULATIONS
Authors: Rhodus Elizabeth , Kim Steffi , Epps Fayron
Published: December 2022

Stigma in the context of Alzheimer’s disease and related dementias (ADRD) is associated with a higher prevalence of depression, anxiety, social isolation, and poorer caregiver health. This is particularly true for underserved and rural communities; however, little is known about the sources of stigma and implications of stigma within these communities. This symposium explores sources of stigma along with implications of stigma in rural and/or underserved communities and introduces novel interventional considerations for addressing stigma. The first presentation by Rhodus and colleagues highlights implications of stigma in rural Appalachian communities as it relates to ADRD healthcare service and research participation. Next, Sabat and colleagues present findings of a recent intervention program, “Respite for All,” specifically, implications of this program for caregivers’ perception of stigma, as well as the person living with ADRD. This symposium also includes presentations focused on Alaska Native (AN) experiences with stigma and ADRD. Kim discusses findings of a community-based participatory research project using mixed-method to explore structural stigma in rural communities and needed initiatives for familial care partners. To conclude the program, Crouch and Rosich present results of a grounded theory, exploratory study aimed to understand the cultural practices and values that compose AN Elder beliefs and perceptions of ADRD, including stigmas. This symposium will conclude with a discussion on how researchers may begin to integrate approaches to address stigma in rural and underserved communities in order to enhance care utilization and quality of life for older adults caring for and living with ADRD.
IDENTIFYING GAPS AND MISCONCEPTIONS AND EXAMINING PREDICTORS OF ALZHEIMER’S DISEASE KNOWLEDGE IN KOREAN AMERICANS
Authors: Hong Michin , Lee Sang
Published: December 2022

This study examined Alzheimer’s disease (AD) knowledge and its predictors among Korean Americans (KAs). A total of 268 KAs in the Greater Washington metropolitan area participated in the study and completed a cross-sectional survey. Using the Alzheimer’s Disease Knowledge Scale (ADKS), overall and domain knowledge was assessed. Multiple regression analyses were conducted with predictors including exposure to AD, social engagement, sources and frequency of health-related information, stigmatic beliefs (pity, antipathy, and social distance), English proficiency, and education. KAs reported 59% accuracy in overall AD knowledge. They were most knowledgeable about assessment and diagnosis domain and least knowledgeable about caregiving domain. Regression analyses showed that having more education is associated with greater overall and certain domain knowledge. Having more pity stigmatic beliefs is related to greater knowledge in both life impact and caregiving domains while having less pity stigmatic beliefs is associated with more risk factor knowledge; having less social distance stigmatic beliefs is associated with greater life impact knowledge; and having less antipathy stigmatic beliefs is related to better caregiving knowledge. Our findings revealed areas of misconceptions and knowledge gaps in KAs which need to be addressed in educational interventions. Different knowledge status across the domains demonstrates a multi-dimensional nature of AD knowledge. Multivariate findings confirmed the robust role of education in AD knowledge. Effect of different AD stigmatic beliefs on certain AD knowledge domains suggests ways of how stigma change can be efficient for the purpose of increasing AD domain knowledge in KAs.
TARGETING KNOWLEDGE, BARRIERS, AND FACILITATORS TO PARTICIPATION IN DEMENTIA RESEARCH (THE POWER PROJECT)
Authors: Sajatovic Martha , Herrmann Lynn , Knebusch Clare , Sarna Kaylee , Lerner Alan , Fuentes-Casiano Edna , Burant Christopher
Published: December 2022

Racial and ethnic minorities are under-represented in dementia research. We tested a conceptually-driven health communication approach targeting evidence-based barriers and facilitators to research participation vs. dementia awareness training. Input from the minority advisory board (MAB) of the Cleveland Alzheimer’s Disease Research Center (CADRC) informed development of 2 brief health communication videos which differentially focused on research barriers and facilitators (POWER) versus an education control (EDU). A randomized controlled on-line survey compared POWER vs. EDU among 200 individuals ≥ 50 years. We examined pre/post video change in research motivation measured by the transtheoretical model, dementia knowledge and cumulative barriers and facilitators. Interim analysis included 129 individuals who completed the pre-video survey, mean age 58.8 (SD 14.9), 101 (78.3 %) women, 54 (41.9 %) non-white. 100 (77.5 %) completed the post-video survey. Whole sample dementia knowledge improved from pre (mean 4.6, SD 1.3) vs. post (5.8, SD 0.7) video (p <.01), as did facilitators to research from pre (22.4, SD 2.7) vs. post (22.8, SD 3.0) video (p=.02), while there was no significant change in barriers. Research motivation was increased pre (10.8, SD 2.0) vs. post (22.8, SD 3.0) video (p=.02). Overall, dementia knowledge improved more with EDU vs. POWER (p=.04). African-American participants trended towards greater improvement in dementia knowledge with EDU vs. POWER (p=.07), while non-African-Americans had greater facilitator improvement with POWER vs. EDU (p=.03). Targeted communication approaches that address knowledge gaps and both barriers and facilitators to participation may improve engagement of diverse groups in dementia research.
DAILY STRESS, ANTICIPATORY ANXIETY, RUMINATION, AND NEGATIVE AFFECT IN LATE LIFE
Authors: Zhou Zexi , Fingerman Karen
Published: December 2022

Chronic and daily stress are risk factors to older adults’ health and well-being. However, most studies of stress have focused on the reactivity and recovery process following the onset of stress. Relatively little research has investigated the worries that precede stress (e.g., anticipatory anxiety) and how such worries may contribute to older adults’ subsequent emotional experiences and rumination, especially in daily settings. This study investigated the joint associations of daily stress and anticipatory anxiety on rumination and negative affect in older adults’ everyday life. We leveraged the ecological momentary assessment (EMA) data over 5 to 6 days from the Daily Experiences and Well-being Study (N = 267, Mage = 73.72). Anticipatory anxiety was moderately correlated with stresses experienced that day, r = .23, p < .001. We found significant joint associations between daily stress and anticipatory anxiety with rumination and negative affect. Higher daily anticipatory anxiety (M+1SD) combined with higher stress generated the highest rumination and negative affect, whereas lower daily anticipatory anxiety (M-1SD) paired with lower stress generated the lowest rumination and negative affect. Higher daily anticipatory anxiety paired with lower stress, or lower anticipatory anxiety paired with higher stress, led to a moderate level of rumination and negative affect. These results suggest that anticipatory anxiety toward potential stress has distinct negative effects on older adults’ daily experiences, and these effects may contribute to stressors and to heightened rumination. The findings highlight the role that proactive emotional expectations may play in older adults’ everyday life.
THE RESPITE FOR ALL PROGRAM DECREASES STIGMA AND CAREGIVERS' ANXIETY WHILE INCREASING THEIR CONFIDENCE
Authors: Sabat Steven , Howell Abigail , Johnston Daphne
Published: December 2022

Feelings of burden and stigma are associated with social isolation (Adelman, et al., 2014) which is considered a public health concern (Brodaty & Donkin, 2009; Tatangelo, et al., 2018a). The stigma associated with a dementia diagnosis, care partners’ burden, and diminishing financial resources have been found to be significant contributors to increased social isolation (Lee, et al., 2021; Sun, et al., 2021; Hung, et al., 2021). Care partners report significant anxiety in connection with behavioral manifestations of dementia attracting negative attention (McHugh, et al, 2012; Sanders, et al, 2008) or judged by the general public (Lee, et al., 2021), and those with high levels of grief commonly report experiencing social isolation (Sanders, et al, 2008). The Respite For All program for people living with dementia has led to decreases in stigma and caregivers’ anxiety while increasing their confidence. We will discuss the nature of this program and present supporting data.
PHYSICAL ACTIVITY AND EPISODIC MEMORY IN AFRICAN AMERICAN OLDER ADULTS
Authors: Tate Rio , Small Brent
Published: December 2022

African Americans are more likely to have Alzheimer’s Disease (AD) yet less likely to be included in AD research. Additionally, memory complaints may signal the clinical genesis of AD. Interventions such as physical activity that can help individuals maintain their cognitive functioning as they age have merit in research. The objective of this study is to examine the influence of physical activity of various intensities on episodic memory in African American older adults at the interindividual and intraindividual levels over time. We used data from the Health and Retirement Study over 12 years. Our analyses included an indicator of episodic memory and we examined physical activity of three intensities as predictors while controlling for relevant demographic and health variables. Preliminary data indicates that African American older adults who engaged in more frequent physical activity (regardless of intensity) had better episodic memory. Individuals who engaged more frequently in physical activity had a slightly greater rate of decline than those who engaged less frequently in physical activity. Physical activity may act as a buffer against cognitive decline for older adults. Intensity need not be vigorous to observe changes.
CULTURAL AND SOCIAL ACTIVITIES AND MENTAL HEALTH AMONG INDIGENOUS OLDER ADULTS IN THE UNITED STATES
Authors: Lee Yeonjung , Braun Kathryn , Wu Yanyan , Adamsen Collette , Davis Shelly
Published: December 2022

Although the number and percentage of indigenous older adults are growing, little is known about the risk and protective factors associated with mental health among this population. We estimated regression models for mental health using data from the 2017-2020 needs assessment of indigenous elders (aged 55+) administered by the University of North Dakota, which included 19,143 indigenous elders, including 17,184 American Indians, 1,521 Alaska Natives, and 438 Native Hawaiians. The Mental Health Index (MHI) was used, with five questions: during the past month, how much of the time (1) were you a happy person, (2) have you felt calm and peaceful, (3) have you been a very nervous person, (4) have you felt downhearted and blue, and (5) have you felt so down in the dumps that nothing could cheer you up? The answers for MHI-5 were standardized on a 0-100 scale, where higher scores indicate optimal mental health. Having ADL and/or IADL difficulties was associated with worse mental health. Frequent engagement in social activities was positively associated with mental health. Data also suggest that those engaged in cultural practice all the time compared to people who engaged in cultural practice less frequently had higher levels of MHI-5, controlling for other variables. These findings underscore the importance of cultural activities, as well as social activities and physical health, in the management of mental health.
ALZHEIMER’S DISEASE AND COMORBIDITIES: A COMPLEX INTERPLAY IN THE CONTEXT OF AGING
Authors: Arbeev Konstantin , Bagley Olivia , Yashkin Arseniy , Duan Hongzhe , Nalawade Vinit , Akushevich Igor , Ukraintseva Svetlana , Yashin Anatoliy
Published: December 2022

There is evidence on high prevalence of comorbidity in people with dementia and on associations between comorbidities and progression of Alzheimer’s disease (AD). Comorbidities accumulate with age and age is also a major risk factor for AD. Repeated measurements of comorbidity provide possibilities for gaining more knowledge about dynamic interconnection between comorbidities and AD development in the context of aging. We constructed the comorbidity index (CMI) for participants of the Health and Retirement Study aged 66+ years using data on onset of diseases from linked Medicare service use files (6,830 participants, 3,829 females, 3,001 males). We performed the joint analysis of longitudinal measurements of CMI and data on onset of AD and survival since onset of AD using the approach (the stochastic process model) that allows decomposing the overall association of trajectories of CMI with respective time-to-event outcomes into several aging-related characteristics represented by the model’s components and evaluated indirectly from the data. We found that, overall, CMI is significantly (p< 0.0001) associated with increased risk of onset of AD and decreased survival chances for persons with AD and that this association can be decomposed into associations of AD outcomes with different aging-related components with differentiated impact of genetic and non-genetic factors (such as APOE, polygenic scores, sex, birth cohort). In particular, age patterns and time trends in such components contribute to trends in AD prevalence so that taking into account the age dynamics and time trends in comorbidities (represented by CMI) is essential for forecasting future trends in AD prevalence.
CONTEXT-DEPENDENT SEXUAL CHANGES DURING WOMEN’S MIDLIFE TRANSITIONS
Authors: Watts Amber , Jen Sarah
Published: December 2022

For women, midlife represents an important stage of transition, including shifts in physiological, social, and sexual experiences. Prior research demonstrates that women’s sexuality is more dynamic and context-dependent than men’s. Most research focused on women’s sexuality in mid- to later-life emphasizes physiological changes, while largely ignoring changes stemming from social, psychological, and relational contexts. The present study examined midlife women’s diverse sexual experiences within the context of their lives. We conducted semi-structured interviews with 27 women, ages 39-57 and used interpretive phenomenological analysis to investigate perceptions and interpretations of midlife sexual experiences and changes. Themes included changes in sexual engagement, unwanted sexual experiences, body image, and sexual healthcare. Participants reported changes in frequency of sex and sexual desire within the context of their diverse social roles and identities, prior intimate relationships, and sexual health. Women contrasted perceptions of their own bodies with societal perceptions of sexiness. Frequently reported negative experiences with sexual healthcare informed a distrust of healthcare systems. The diverse and changing nature of participants’ experiences supports prior evidence of sexual fluidity and context-dependence. By questioning societal expectations around sexuality and body image, participants illustrated the potential of counternarratives to combat dominant beliefs and stereotypes about midlife women’s sexuality. To improve sexual health and education, psychoeducational interventions and improved training for healthcare professionals are needed.
HISTORY OF JOB STRAIN AND RISK OF LATE-LIFE DEPENDENCY: A NATIONWIDE SWEDISH REGISTER-BASED STUDY
Authors: Kåreholt Ingemar , Nilsen Charlotta , Agerholm Janne , Kelfve Susanne , Wastesson Jonas , Nabe-Nielsen Kirsten , Meinow Bettina
Published: December 2022

There is substantial evidence that work plays a significant role in post-retirement health. Yet little is known about its role in when late-life dependency may occur. We examined associations between job strain and the risk of entering late-life dependency. Individually linked nationwide Swedish registers were used to identify people 70+ alive in January 2014, and who did not experience the outcome (late-life dependency) during two months prior to the start of the follow-up. Late-life dependency was operationalized as use of long-term care. Information about job strain was obtained via a job exposure matrice and matched with job titles. Cox regression models with age as time-scale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios (HR) for entering late-life dependency during the 24 months of follow-up (n=993,595). Having an initial high starting point of job strain followed by an increasing trajectory throughout working life implied a 23% higher risk of entering late-life dependency at a younger age, compared with the reference group (low starting point with a decreasing trajectory). High initial starting point followed by a stable trajectory implied a 12% higher risk of entering late-life dependency at a younger age. High initial starting point followed by a decreasing trajectory implied a 10% risk reduction, and a low starting point with a stable trajectory implied a 22% risk reduction, of entering late-life dependency at a younger age. Reducing stressful jobs across working life may contribute to postponing late-life dependency.
EARLY-LIFE EXPOSURE TO THE CHINESE FAMINE OF 1959–1961 AND LATER-LIFE HEALTH: EARLY LIFE AS A CRITICAL PERIOD
Authors: Cheng Mengling , Sommet Nicolas , Jopp Daniela , Spini Dario
Published: December 2022

Barker’s fetal origins hypothesis and the critical period theory suggest that early life events have long-term health effects. However, evidence of the famine exposure in early life and its effects on health in later life is scarce and inconsistent. To explore the effects of early-life exposure to the Chinese famine of 1959-1961 on later-life multimorbidity, we performed Poisson growth curve models using CHARLS Life History 2014 and CHARLS 2011-2018 (42,775 observations from 12,060 respondents). Our analyses revealed two findings. First, there was an overall detrimental effect of the early-life famine exposure on multimorbidity, although there was no effect of severity of famine exposure. Second, there was no overall interaction between famine exposure and life stages, although a more parsimonious model suggested that the detrimental effect of famine exposure was more pronounced in earlier life stages than in later life stages. Findings suggest that early life is a critical period in the life course and provides developmental origins of health and disease in later life.
LONGING FOR LOVE: FINANCIAL STRAIN AND LATER LIFE MENTAL HEALTH IN THE US
Authors: Bhatta Tirth , Albert Jeffrey , Torres Stacy , Kahana Eva , Lekhak Nirmala , Goler Timothy
Published: December 2022

Objectives

Emotional support has been consistently identified as a mechanism through which socioeconomic resources influence mental health outcomes. Despite emerging evidence that compassionate love has a beneficial effect on mental health, its distribution across levels of financial strain and subsequent role in mediating the effect of financial strain on later life mental health have yet to be examined.

Methods

Based on our nationwide web-based survey of adults aged 50 years and older (n=1751), we conducted a mediation analysis to estimate the direct and indirect effects (via two mediators, feeling loved and emotional support) of financial strain on depressive symptoms and anxiety.

Results

We documented a statistically significant overall effect of financial strain on depressive symptoms (b=0.14, p-value< 0.001) and anxiety (b=0.196, p-value< 0.001). We found a statistically significant path-specific effect (from financial hardship) through compassionate love alone on depressive symptoms (b=0.018, p-value=0.003) and anxiety (b=0.016, p-value=0.005), but did not find effects for paths through emotional support. There was also a significant direct effect of financial strain on both depressive symptoms and anxiety. Discussion: Our study advances a new line of research by looking at the role of compassionate love in transmitting the effects of financial strain on mental health in later life. Findings suggest that the detrimental effect of financial hardship on mental health operates through its negative effect on the receipt of compassionate love, rather than by its impact on emotional support.
MAKING “NONESSENTIAL” FAMILY/VOLUNTEER CAREGIVING ESSENTIAL IN LONG-TERM CARE HOMES
Authors: Robitaille Annie , Garcia Linda , Adams Michaela
Published: December 2022

For individuals living in long-term care (LTC), loneliness is often a concern. With the COVID-19 pandemic, this is only exacerbated as strict restrictions are put in place on visits between residents and their loved ones and on volunteer presence. Understanding how these changes affect residents, family caregivers, and volunteers is paramount to best implement changes with regards to how family/volunteer caregiving presence is managed during pandemics. The objective of this study was to gain a better understanding of the response to COVID-19 that pertains to the family caregiver and volunteer presence in LTC and increase the evidence about the impact of reduced levels of family caregivers and volunteers on residents, caregivers, and volunteers. A total of 64 semi-structured interviews were conducted with caregivers and volunteers. Of these interviews, 49 were one-time interviews and 15 were weekly interviews over a 5-month period to examine the impact of the ever-changing pandemic restrictions on caregivers, volunteers, and residents. Thematic analysis was used to analyze the interviews and two independent researchers coded each interview. Results highlight the importance of connections in LTC, the feeling that human rights were neglected, the importance of flexibility amongst staff, the role of caregivers as advocates for residents, increased caregiver guilt, and resident decline in physical and emotional well-being. The role of family caregivers and volunteers as essential in LTC homes will be discussed and recommendations to revisit policies on the family caregiver and volunteer presence to improve the preparedness for future pandemics and outbreaks will be presented.
OLDER ADULTS DURING THE COVID-19 PANDEMIC: ROLE OF HEALTH CONDITIONS IN RESILIENCY AND PERCEIVED STRESS
Authors: Sloan Allyson
Published: December 2022

The COVID-19 pandemic has necessitated protracted lockdowns, exacerbating the challenges associated with social isolation. Older adults, who often suffer from social isolation, may have a harder time coping with the added isolation imposed by COVID-19. In this study, we investigated the resiliency and coping skills of older adults amidst the COVID-19 pandemic, and whether they were associated with different co-morbidities. We conducted a 45-minute telephone survey of 107 participants to assess their experiences during the COVID-19 pandemic. Participants were recruited from existing Johns Hopkins studies. The survey included the Brief Resilient Coping Scale, the Perceived Stress Scale, and questions about current health conditions (arthritis, osteoporosis, high blood pressure, heart disease, and depression/anxiety) and whether these conditions worsened, improved, or remained unchanged since the beginning of the pandemic. We regressed scores for resiliency and coping scores on a series of indicators of whether co-morbidities had worsened during the pandemic. On average, participants were 76 years old and 63% were female. There was no association between resiliency scores and any of the co-morbidities (r2=2.8%). With respect to perceived stress, participants who reported their depression/anxiety worsened during the pandemic also reported greater levels of perceived stress (B=0.83, 95% confidence interval: 0.30, 1.36). We were surprised that additional co-morbidities did not affect resiliency or stress. In order to better serve geriatric populations, health professionals should closely monitor those patients who have depression and anxiety during times of social distancing, epidemics, or pandemics.
OLDER AGE IS (STILL) ASSOCIATED WITH MENTAL HEALTH BENEFITS IN JUNE–JULY 2021 OF THE COVID-19 PANDEMIC
Authors: Chappell Amanda , Smith Kelly , Strough JoNell
Published: December 2022

In the early months of the COVID-19 pandemic, older age was associated with less anxiety and depression (Bruin de Bruin, 2021). Similar results were found for data collected during the June-July 2020 spike in cases (Smith et al., 2021). Theorists have suggested that benefits of age for well-being may be reduced when stressors are prolonged and unavoidable (Charles, 2010). Here, we investigated whether older age continued to be protective in June-July 2021, when vaccines had become widely available, but the pandemic persisted. Secondary data analysis was conducted from the Understanding America Study, based on n=5,535 (M=52.69 yrs., SD=16.04) participants who responded to online self-report surveys. Participants reported symptoms of anxiety and depression (assessed by the Patient Health Questionnaire, PHQ-4), engagement in protective behaviors (e.g., wearing a mask), and coping strategies (e.g., getting extra exercise). Multiple regression analyses predicted anxiety and depression from age, coping strategies, and protective behaviors, controlling for marital status, gender, and income. Coping through exercise and calling family/friends were significantly associated with less anxiety and depression, whereas coping by using social media and engaging in protective behaviors was significantly associated with more anxiety and depression. The harmful effects of protective behaviors may reflect the people engaging in these strategies most often are also those most worried about COVID-19. Even after accounting for coping strategies and protective behaviors, older age was still associated with fewer symptoms of anxiety and depression. Implications of older adults’ resilience in the face of a prolonged stressor for promoting mental health are discussed.