bluuebunny/crossref_metadata_2025 huggingface dataset:
INTERDISCIPLINARY DEMENTIA CARE WORKFORCE TRAINING DURING COVID-19 AND TWO HOSPICE CASE STUDIES
Authors: Lassell Rebecca , Durga Aditi , Lin Shih-Yin , Jones Tessa , Ford Ariel , Brody Abraham
Published: December 2022

Hospice is a care model characterized by interdisciplinary team-based, person and family-centered care. To optimize agency-wide interdisciplinary team-based hospice dementia care, at least two levels of tailoring of the dementia care workforce training are imperative, first, by discipline, and second, by hospices’ local culture and needs. As of February 2022, a thousand and one skilled hospice interdisciplinary team members (not counting champions) across 18 hospice agencies have completed their discipline-specific Aliviado dementia care training, including 56 providers, 763 nurses, 129 social workers, and 53 chaplains. In this presentation, we describe how we tailored dementia workforce training for skilled interdisciplinary team members (first level tailoring), as well as provide two case studies elucidating how we performed further tailoring of the program for two large hospice agencies (average daily census: 354 and 868, respectively) in two different states to meet their local needs (second level tailoring), and lessons learned.
CAREGIVER SUBGROUP ANALYSES FROM AN EMBEDDED DEMENTIA CARE EFFECTIVENESS TRIAL
Authors: Fortinsky Richard , Wakefield Dorothy , Zhong Lily , Grady James , Piersol Catherine , Robison Julie , Gitlin Laura
Published: December 2022

Efficacious dementia care interventions for family/informal caregivers are increasingly being tested for effectiveness in “real world” service delivery settings. We conducted an effectiveness trial in which we embedded the Care of Persons with Dementia in their Environments (COPE) program into Connecticut’s publicly-funded Home and Community-Based Services program. COPE is designed to build dementia management skills in caregivers of people with dementia in the home setting. In published results from this trial with the full study cohort, caregivers who received COPE, compared to controls, experienced improved well-being due to the dementia management skills they learned (perceived well-being), but they did not experience reduced levels of distress due to dementia-related behavioral and psychological symptoms (distress). For this presentation, we determined COPE effects for selected caregiver subgroups on perceived well-being and distress. Regarding caregiver sex, we found that COPE effects were statistically significantly positive on both outcomes for females (both p<.05) but on neither outcome for males. Controlling for sex, we also found positive COPE effects on both outcomes for daughters (both p=.03) but on neither outcome for spouses or sons. For perceived well-being, we found positive COPE effects for White (p<.001) but not for Black caregivers. For distress, we found positive COPE effects for caregivers living apart (p=0.03) but not for those living together with people with dementia. Findings suggest that male, Black, and co-residing caregivers may need more support from COPE, and more broadly demonstrate the value of subgroup analyses in offering greater precision when embedding nonpharmacological interventions in effectiveness trials.
A METHODOLOGICAL APPROACH TO IDENTIFY EPISODES OF LUCIDITY AMONG PEOPLE WITH ALZHEIMER'S DISEASE
Authors: Kim Kyungmin , Frangiosa Theresa , Biggar Virginia , Finnie Dawne , Bangerter Lauren , Gaugler Joseph , Lapid Maria , Griffin Joan
Published: December 2022

People with late-stage Alzheimer’s disease and related dementias (ADRD) who are assumed to have lost coherent cognitive capacity may exhibit unexpected episodes of lucidity (EL). Given the transient nature and lack of scientific explanation of the phenomenon, EL is under-investigated and poorly understood. To better understand this phenomenon, we set out to develop an operational definition of EL. Based on survey data from former and current family caregivers participating in UsAgainstAlzheimer’s A-LIST® (N = 480), we defined four EL typologies. We then interviewed 25 caregiver respondents about their experiences and used analyzed qualitative data to refine the preliminary typologies. Finally, we conducted a Delphi consensus panel with clinicians, researchers, and health care providers with medical, pharmacological, and clinical expertise to describe potential explanations for EL to help further refine the typologies. Next we will test the validity of these typologies in a prospective, demographically diverse sample of current family caregivers.
DISRUPTED ACTIVITIES AND CAREGIVERS RESILIENCE: LONGITUDINAL PATTERNS AND ASSOCIATIONS
Authors: Lee Jeong Eun , Peterson Natasha
Published: December 2022

PurposeRelatives are often caregiving for patients with advanced cancer and carry a heavy burden. Self-care and resilience-building activities offer building blocks to enhance their wellbeing and burden-bearing capacity. This study assessed the longitudinal patterns of disrupted activities of caregivers and their association with resilience reported by caregivers. MethodsData came from the National Study of Caregiving, a nationally representative study of caregivers. We analyze outcomes for caregivers for three waves of NHAT (2011-2017), estimating associations of disrupted activities and positive appraisals on 1) caregiving burden 2) resilience. Caregivers reported positive appraisals and the number of activities that have been interrupted due to their caregiving responsibilities. ResultsMultilevel models with heterogeneous within-person variance were fit to test the hypotheses on associations between disrupted activities, positive appraisals, and fluctuations in resilience and caregiving burden. Our analysis confirmed increasing disrupted activities among caregivers over time. When interrupted activities were higher than average, caregivers reported lower levels of resilience and higher levels of caregiving burden, suggesting that disrupted activities can contribute to caregivers. The reverse pattern was found for positive appraisals. ConclusionMore positive appraisals and lower levels of disrupted activities were associated with lower caregiver burden and higher levels of caregiver resilience. This study points to the critical value that caregiver self-care and positive appraisals are essential to bolster caregiver resilience and counteract caregiver burden. Future studies should illuminate the causal relation. This study will broaden our understanding of caregivers' self-care needs and provide practical implications for supporting caregivers.
DIGITAL LEARNING AND ONLINE CHAIR YOGA FOR RURAL UNDERSERVED OLDER ADULTS AT RISK OF COGNITIVE DECLINE
Authors: Wiese Lisa , Park JuYoung
Published: December 2022

We conducted a randomized control trial to test the feasibility of an online chair yoga intervention among rural older adults at risk for cognitive decline in an underserved, racially/ethnically diverse community. Participants were randomly assigned to either chair yoga (n=15) or computer brain games (n=15). Prior to the 12-week intervention, a computer training program was provided to all participants by local high school students, who followed a previously tested curriculum, and mentored the older adults in attending sessions. Digital literacy and cognitive, physical, and psychosocial measures were collected at baseline, 3 weeks, and post-intervention, with 3 and 6-month follow-up. We assessed students’ attitudes toward older adults pre/post-intervention. Both student and resident samples were 98% minority (African American, Latino, and Afro-Caribbean), with residents’ average age of 67.5 (SD = 8.3), years lived rural 38 (M = 11.5), and initial digital literacy of 48.5%. Additional outcomes will be detailed in this presentation.
SELF-PERCEPTIONS OF AGING IN THE CONTEXT OF CHALLENGING EXPERIENCES: PATTERNS OF RISK AND RESILIENCE
Authors: Giasson Hannah , Koffer Rachel , Smith Jacqui
Published: December 2022

Self-perceptions of aging have important implications for health and well-being in later life. Early life experiences, cultural and societal notions about age, and one’s present health and situational context may contribute to one’s expectations and perceptions of their own aging (e.g., Levy, 2009; Diehl et al., 2014; 2021). However, self-perceptions of aging may also predict people's responses in the face of current or future challenges. This symposium takes a closer look at self-perceptions of aging in the context of different types of life challenges. Hu and Larkina discuss early life informal caregiving experiences as antecedents of negative self-perceptions of aging in later life. Koffer and Giasson discuss how ten-year longitudinal associations between subjective age and future loneliness differ among current caregivers and non-caregivers. Mejia and colleagues discuss the role of self-perceptions of aging in adaptation to life following a fall, highlighting potential protective effects of positive self-perceptions of aging and sense of control. Finally, Giasson and colleagues discuss positive self-perceptions of aging as predictors of preventive health behavior and resilience in the context of the COVID-19 pandemic. Dr. Jacqui Smith will conclude the session with an integration of common themes, practical implications, and future research directions that emerge from the four studies.
SUBJECTIVE AGE AND FUTURE LONELINESS: COMPARING CAREGIVERS AND NON-CAREGIVERS ACROSS TEN YEARS
Authors: Koffer Rachel , Giasson Hannah
Published: December 2022

Experiences that make age salient can shape how old or young a person feels relative to their chronological age. Caregiving for a loved one may contribute to subjective age as well as the linkages between subjective age and well-being. We examined longitudinal associations between subjective age and future loneliness ten years later among 2,557 caregivers and non-caregivers (Baseline Mage=55) in the Midlife in the United States Study (2004-2014). Linear regression results indicated an interaction between caregiver status and subjective age (β = 0.60, 95% CI=[0.14, 1.06]), such that among non-caregivers, older subjective age predicted greater future loneliness, but among caregivers, younger subjective age predicted greater future loneliness. Associations hold after controlling for age, baseline loneliness, and caregiver status at follow-up. Future subjective aging research should examine the unique context of caregiving to further understand the meaning of subjective age and how it predicts important well-being outcomes among caregivers.
IMPACT OF CALORIE RESTRICTION ON PLASMA ALZHEIMER’S DISEASE BIOMARKERS IN HEALTHY YOUNG AND MIDDLE-AGED ADULTS
Authors: Parker Daniel , Doraiswamy P Murali , Kraus William , Huffman Kim
Published: December 2022

Midlife cardiometabolic risk factors are associated with an increased risk of Alzheimer’s dementia (AD). Moderate calorie restriction (CR) in healthy, non-obese young and middle-aged adults improves cardiometabolic risk factors. Plasma concentrations of amyloid β oligomers (Aβ-42 and Aβ-40) and total tau are emerging biomarkers of AD pathology. Our objective was to determine the impact of two years of CR in healthy young and middle-aged adults on Aβ-42, Aβ-40, and total tau in the Comprehensive Assessment of Long term Effects of Reducing Intake of Energy (CALERIE) Study. Participants were randomized 2:1 to 24 months of CR (prescribed as 25% reduction in baseline calorie requirements) versus an ad libitum (AL) diet. We quantified plasma Aβ-42, Aβ-40, and total tau using the ultrasensitive single molecule array (SIMOA) technology at baseline and two years in a subset of CALERIE (N=133). We used linear regression to evaluate the impact of CR, including age, sex, and presence/absence of the APOE-ε4 risk allele as covariates. We hypothesized that there would be differential CR effects based on APOE-ε4 carrier status; to test this, we included an interaction term. As compared to AL, there was a trend towards decreased Aβ-40, controlling for age, baseline Aβ-40 concentrations, and APOE-ε4 carrier status (β=-12.59, 95% CI[-27.14, 1.96], p=0.093) with 12% (average achieved) CR. The CR*APOE-ε4 carrier status interaction term was significant at a pre-defined threshold of p<0.10 (p=0.062). Stratified by APOE-ε4 carrier status, CR was associated with a decrease in plasma Aβ-40 (β=-33.72, 95% CI[-65.16,-2.09], p=0.041). In conclusion, moderate CR in healthy, non-obese young and middle-aged adults impacts plasma biomarkers of AD risk, primarily in APOE-ε4 carriers.
POTENTIAL BENEFITS OF THC AND CBD IN THE TREATMENT OF HOSPICE-ELIGIBLE DEMENTED AND AGITATED PATIENTS
Authors: Mintzer Jacobo`
Published: December 2022

Today, half of the patients suffering from Alzheimer’s disease (AD) will use hospice care in the last days of their life. Most of them will present with moderate to severe agitation. In the absence of evidence-based guidelines, Hospice care eligible patients with Agitation and Alzheimer’s disease (AD) or other types of Dementia (HAD) are treated with a combination of antipsychotics, benzodiazepines, and opiates, which generate a variety of side effects. Two cannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD), appear to be promising therapies for agitation in HAD with minimal side effects. Specifically, we suggest that a combination of THC and CBD oils have enhanced synergistic effects while maintaining a low side effect profile that the combination may provide. The evidence for this hypothesis will be discussed during the symposium.
CONTEXTUAL FACTORS ASSOCIATED WITH DECREASED DAILY DEPRESSION AND ANXIETY AMONG DEMENTIA CAREGIVERS
Authors: Puga Frank , Poe Abigail , Rafford Meghan , Wang Danny , Pickering Carolyn
Published: December 2022

Family caregivers of individuals with dementia (IWDs) have an increased risk of developing depression and anxiety. Little is known about daily protective factors that mitigate this risk. The purpose of this study was to identify everyday coping strategies used by family caregivers that reduce the daily odds of experiencing depression and anxiety-related symptoms. Daily diaries were used to examine whether pleasant non-care activities with the IWD, social connection, and exercise were associated with a decrease in depression and anxiety-related symptoms. A national sample of ADRD caregivers (N=165) completed diaries over 21-days (n=2,841). Participants were asked about their daily experiences as caregivers, coping strategies, and mental health. Data were analyzed using mixed-level modeling. Depression and anxiety symptoms were endorsed by 141 (85.45%) and 155 (93.94%) participants, respectively. Social connection was associated with a decrease in the daily odds of depression (OR: 0.71, CI: 0.54 – 0.94, p=0.016) and anxiety symptoms (OR: 0.74, CI: 0.56 – 0.97, p=0.032). Caregivers were also less likely to endorse depression-related symptoms on days when engaging in a pleasant non-care activity with the IWD was reported (OR: 0.70, CI: 0.52 – 0.93, p=0.015). Finally, anxiety-related symptoms were less likely to be endorsed on days when caregivers reported engaging in exercise (OR: 0.65, CI: 0.49 – 0.86, p=0.003). The results from this study help elucidate coping strategies that may mitigate the risk of depression and anxiety associated with caregiving. These findings inform potential components for interventions to help support the health and well-being of family caregivers of IWDs.
SPIRITUAL DEVELOPMENT AND AGING HUMANITIES: READING HESSE'S STEPPENWOLF THROUGH MOODY'S FIVE STAGES OF THE SOUL
Authors: Fogle Stephen
Published: December 2022

This paper explores Herman Hesse’s Steppenwolf through Harry Moody’s Five Stages of the Soul. Steppenwolf speaks to gerontological education objectives as it deals squarely with humanizing old age though, “deeply lived spiritual events which [the main character] has attempted to express by giving them the form of tangible experiences.” (Hesse, 1963, 21) Five Stages of the Soul is a seminal conceptual model for understanding spiritual development across the life course: particularly in old age. It documents lived experiences in five stages: call, search, struggle, breakthrough, and return. This paper follows Steppenwolf’s main character, Harry Haller, though each of these five stages. In doing so, this paper positions aging and spiritual development center stage in a tale featuring themes of enduring struggle such as personal identities, war & violence, sex, magic, and technological advancement. The plot line of Steppenwolf matches Five Stages of the Soul with enlightening consistency. Originally published a century ago, Steppenwolf enjoyed resurgent popularity among the baby boom cohort of older adults in the United States and globally during the 1960s. Today, Steppenwolf retains relevancy for understanding aging and spiritual development in lived contexts of social chaos and uncertainty. Steppenwolf is a classic and engaging piece of literature for contemporary readers of all ages. This paper helps students and teachers of gerontology apply a conceptual model of aging to a relevant case study. The paper contributes to incorporating literary masterpieces into gerontological curricula. Finally, this paper sheds light on the humanity of older adults engaged in spiritual development.
COGNITIVE AGING ACROSS NATIONAL CONTEXTS: EVIDENCE FROM THE HARMONIZED COGNITIVE ASSESSMENT PROTOCOLS
Authors: Kobayashi Lindsay , Gross Alden , Langa Kenneth
Published: December 2022

The global burden of dementia is rapidly rising and shifting to low- and middle-income countries. The triangulation of evidence across country contexts is essential for unlocking the causes of dementia and reducing its global burden. The Harmonized Cognitive Assessment Protocol (HCAP) is a recent innovation administered in the US Health and Retirement Study and several of its International Partner Studies. For the very first time, these HCAPs provide high-quality data for cross-national comparisons of later-life cognitive function that are sensitive to linguistic, cultural, and educational differences across diverse country contexts. However, despite the common HCAP protocols, human cognitive function does not lend itself to direct comparison across diverse populations without careful consideration of necessary test adaptations. This symposium presents results from analyses of the HCAP data in the US, England, Mexico, South Africa, China, and India, highlighting cross-national differences in later-life cognition identified using the HCAP data, and presenting key methodological concerns for cross-national comparisons of cognitive aging. First, Zhang will present findings comparing education gradients in later-life cognitive function across countries. Next, Cho will present longitudinal data comparing the relationships between short-term changes in household wealth in later-life and subsequent cognitive function across countries. Third, Avila-Rieger will present findings comparing sex/gender disparities in later-life cognitive function in the US and India and how they differ by education. Finally, Nichols will conclude the session by discussing differences in the measurement of cognition for the assessment of dementia across countries and implications for data interpretation and the design of future instruments.
EDUCATION GRADIENTS IN LATER-LIFE COGNITIVE FUNCTION ACROSS LOW-, MIDDLE-, AND HIGH-INCOME COUNTRIES
Authors: Zhang Yuan , O'Shea Brendan , Yu Xuexin , Cho Tsai-Chin , Langa Kenneth , Gross Alden , Kobayashi Lindsay
Published: December 2022

Education is positively related to cognitive function. However, educational gradients in cognitive function may vary across older populations with different educational compositions and physical and social environments. We conducted one of the first cross-national comparative studies on educational differences in later-life cognitive function using harmonized data. Multivariable linear regressions were employed to estimate the association between education according to International Standard Classification of Education (ISCED) categories and cognitive function for adults ages 60+ from the United States, England, Mexico, South Africa, India, and China. Cross-country differences were tested using fully interacted models. Controlling for demographics and parental education, we found significant educational gradients in cognitive function in low- and middle-income countries; however, in high-income countries, only those with upper secondary education and above had a consistent cognitive advantage over those with primary education. This study suggests substantial country-level differences in cognitive benefits of educational attainment.
SHORT-TERM WEALTH CHANGES AND SUBSEQUENT COGNITIVE HEALTH AMONG OLDER ADULTS IN CHINA, ENGLAND, MEXICO, AND THE US
Authors: Cho Tsai-Chin , Yu Xuexin , Gross Alden , Zhang Yuan , Kobayashi Lindsay
Published: December 2022

Household wealth is positively associated with later-life cognitive health, but little is known about the effects of changes in wealth over time and whether they differ across populations. In this study, we evaluated the within- and between-country relationships between short-term changes in household wealth and subsequent cognitive function among adults aged ≥65 years in China, England, Mexico, and the US. We used sampling-weighted, multivariable-adjusted linear models to estimate the relationships between household wealth change over 3- to 4-year periods and subsequent harmonized general cognitive performance factor scores using HCAP measures. We found that short-term decreases in household wealth were associated with poor subsequent cognitive health in the US and China, but not in England or Mexico. The observed associations were weaker in Mexico than in the US. In summary, macro-level social and economic structures may modify the association between wealth changes and cognitive health, although further investigation is needed.
POSITIVE APPRAISALS OF CAREGIVING SUPPORT DEMENTIA CAREGIVERS' PHYSICAL ACTIVITY GOAL PURSUIT
Authors: Turner Shelbie , Hooker Karen
Published: December 2022

Middle-age daughters caring for parents with dementia have multiple roles and often neglect their own health. In addition to reporting negative appraisals of caregiving dementia caregivers also report positive appraisals, which may support their health behavior. In this study we examine how positive and negative caregiving appraisals interacted to predict physical activity goal pursuit among 27 daughters of parents with dementia who participated in the ACHIEVE Study, an NIH-funded 30-day study on caregiving (Noccasions=622). On days when caregivers had more positive appraisals than their own average, they had higher physical activity goal pursuit, even after controlling for that day’s negative appraisals (β=0.31, SE=0.09, p=0.001). Moreover, the association between positive appraisals and goal pursuit was not dependent on that day’s negative appraisals (p=0.42). Supporting adult-daughter caregivers to feel positively about their role as a caregiver on a day-to-day basis may support them to stay on track with their physical activity goals.
FALL RISK, FEAR OF FALLING, PHYSICAL ACTIVITY, AND SELF-PERCEPTIONS IN ETHNICALLY DIVERSE LOW-INCOME OLDER ADULTS
Authors: Thiamwong Ladda , Xie Rui , Lighthall Nichole , Park Joon-Hyuk , Loerzel Victoria , Stout Jeffrey
Published: December 2022

Falls and fear of falling (FOF) are the leading cause of disability, and hospitalization in ethnically diverse low-income older adults. The present study included an ethnically diverse sample of low-income older adults (N=121) to examine ethnic and income-based group differences in risk factors for falls (high FOF, depression, avoidance of physical activity) and the role of negative self-perceptions of aging in driving these risk factors. Results revealed the highest levels of fall risk among Hispanics and Asian Americans, FOF among African Americans, and depression among Hispanics. Accelerometer-based physical activity measures confirmed that low-income older adults had lower levels of moderate to vigorous physical activity (MVPA) compared with their high-income counterparts (p=0.04). Further, financial difficulty was related to MVPA (p<0.001), depression, anxiety, and fall risk (p=0.01). Critically, we also found a strong relationship between negative self-perceptions of aging and FOF (p = 0.002) across groups.
IT'S A VERY MANIPULATABLE TOOL: CHARACTERISTICS OF PAL CARD USE THAT IMPACT SUCCESSFUL IMPLEMENTATION
Authors: Moore Reese , Kelley Megan , Kunkel Miranda , Kasler Kamryn , Baker Julia , Heppner Alexandra , Abbott Katherine , Van Haitsma Kimberly
Published: December 2022

Understanding the barriers and facilitators of an intervention can inform implementation efforts. The purpose of this study was to understand the characteristics associated with the PAL Card intervention that led to successful implementation in nursing home (NH) settings. Qualitative telephone interviews were conducted with n=11 NH champions who completed the PAL Card QIP. Interviews were recorded, transcribed verbatim, and coded using the CFIR Intervention Characteristics domain in Dedoose. Three main themes regarding the intervention characteristics emerged including, relative advantage (i.e., advantage of using PAL Cards versus an alternate intervention), adaptability (i.e., how well the PAL Cards can be altered to meet community needs), and complexity (i.e., perceived difficulty of PAL Card usage). Participants voiced the simplicity and benefit of PAL Card implementation within their communities for both staff and residents alike. Implications for policy and practice will be discussed.
PROMOTING AND SUSTAINING A COLLEGE-WIDE LIFELONG LEARNING PROGRAM: FACULTY INSIGHTS AND EXPERIENCES
Authors: Dauenhauer Jason , Heffernan Kristin , Hazzan Afeez
Published: December 2022

Research has identified the benefits and challenges of creating multigenerational classrooms for the purpose of intergenerational learning in higher education. However, much less is known about the systems of support needed at the organizational level to promote intergenerational learning within lifelong learning initiatives. With a focus on formal and informal organizational structures, this session describes insights from faculty who opened their courses to older adults as part of a college-wide course auditing initiative. Many did not understand their own role in the program and offered suggestions to address these issues. Recommendations include ways to acknowledge the work of faculty who participate in the program, and to engage more professors and older adults in the community to ensure program success. To create an age-inclusive, and age-friendly university, formal structural change led from the top-down is as important, if not more important, as creating informal networks that start at the faculty level.
RECRUITMENT AND ENGAGEMENT OF LGBTQIA+ OLDER ADULTS INTO AGING RESEARCH
Authors: Flatt Jason , Kittle Krystal , Flatt Jason
Published: December 2022

Lesbian, gay, bisexual, transgender, queer, intersex, and/or asexual (LGBTQIA+) older adults are a growing population that has been traditionally underrepresented in aging research. Due to stigma and discrimination, many LGBTQIA+ may be reluctant to disclose their sexual orientation and gender identity, which makes it difficult to recruit and engage LGBTQIA+ populations in aging research. In this symposium, we explore current efforts to recruit LGBTQIA+ older adults via social media, snowball sampling, or other novel methods, as well as ways engage LGBTQIA+ subgroups (e.g., caregivers, racial/ethnic minorities, transgender, intersex and other underrepresented groups). Two presentations focus on the recruitment of gender minorities including transgender and intersex older adults. Ethan Cicero will present a systematic review that highlights currents efforts to recruit older gender minority populations include those who identify as racial/ethnic minorities. Next, Nick Lampe will share methodological approaches for effectively recruiting and engaging transgender, non-binary, and intersex (TNBI) older respondents. Then Austin Oswald will highlight barriers and facilitators to engaging LGBTQ+ elders of color in participatory action research during the Covid-19 pandemic. Kasim Ortiz will examine correlates of survey response participation among older sexual minorities (LGB+) using internet-based sampling via the Census Household Pulse Survey. Finally, Krystal Kittle will highlight a three-stage, pilot intervention that aimed to recruit LGBTQ+ caregivers during COVID-19 pandemic restrictions. Jason Flatt, an expert in LGBTQIA+ aging research will facilitate a conversation about these results and place them in the context of current efforts to recruit and engage LGBTQIA+ populations in aging research.
GENDER, MARITAL STATUS, AND COGNITIVE HEALTH IN LATE LIFE: IS MARRIAGE MORE PROTECTIVE FOR MEN?
Authors: Herd Pamela
Published: December 2022

While marital status appears to be protective for one's health, there is also evidence of gender differences in its protective influence. In short, men appear to differentially benefit from marriage compared to women. A growing body of work on later life cognitive functioning and dementia also finds protective effects for those who are married. But there is less evidence as to whether those patterns differ by gender. Using the Wisconsin Longitudinal Study, a nearly full life course longitudinal study, we find evidence that while there are no differences for men, married women, as compared to their unmarried counterparts, have lower levels of cognitive functioning at ~age 80. Differences in underlying health, educational attainment, and adolescent cognitive functioning do not explain the pattern. Similar to broader health, women do not appear to benefit from marriage in late life. Indeed, we find evidence of cognitive benefits of being single for older women.
GPS-DERIVED DAILY MOBILITY AND DAILY WELL-BEING IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Luo Minxia , Kim Eun-Kyeong , Weibel Robert , Martin Mike , Röcke Christina
Published: December 2022

Mobility as a multidimensional concept has rarely been examined as a day-to-day varying phenomenon in its within-person association with older adults’ daily well-being. Using a custom-built mobile GPS sensor („uTrail“) combined with a smartphone-based ambulatory assessment, this study examined associations between daily mobility and daily well-being in community-dwelling older adults. Analysis included 947 days’ data from 109 Swiss older adults aged 65 to 89 years. Multilevel modelling showed that, within persons, a day with larger life space area, more time spent in passive transport modes, and higher number of different locations was associated with higher daily life satisfaction, but not daily positive or negative affect. Follow-up analysis showed that daily maximum distance from home was positively associated with daily life satisfaction, providing a first indication that exposure to non-habitual environments might be a candidate mechanism to explain effects of mobility. Results are discussed in the context of healthy aging research.
REVIEW OF WORKPLACE-RELATED GUIDANCE PRESENTED BY ORGANIZATIONS DEALING WITH DEMENTIA OR MILD COGNITIVE IMPAIRMENT
Authors: Carino James , Taylor Philip , Morgan Damian
Published: December 2022

A range of organisations in English-speaking countries have prepared guidance materials for individuals who are facing concerns regarding dementia while employed. Some of these organisations have also prepared guidance materials for employers to assist them in engaging employees facing this condition. These are available on organisation websites and may be presented as a downloadable booklet, guide or one or more web pages, aiming to inform about the issues that need to be considered. Information of this type is becoming more important in assisting both parties as dementia is being detected and diagnosed earlier, and individuals need to consider their options regarding their future and their ability to continue to work. This presentation reports on a systematic analysis of around guidance items appearing on these websites. The topic areas, content, and approaches used to present this information to its intended audience were reviewed and compared. Analysis showed important gaps in content coverage from one guidance to another. No guidance presented by any of these organisations covers all areas identified that may potentially interest either employees or employers and in most cases it is not presented coherently for these groups. Employee topics that would benefit from further development include awareness of the condition, the importance of diagnosis and support, use of technology to assist in continuing to be functional and productive, and steps in transition from work to other activities. Employer topics that could be developed further include building awareness amongst employers and the workforce, identifying dementia in the workplace, engaging the wider work group, and positively managing employee separation from work.
DAILY STRESSOR APPRAISALS AND SELF-VIEWS OF AGING PREDICT SAME-DAY AFFECTIVE RATINGS
Authors: O'Brien Erica , Neupert Shevaun
Published: December 2022

Prior work suggests that more frequent or higher exposure to stressors relates to less positive affect and more negative affect in daily life. Limited knowledge exists about whether subjective appraisals of such stressors (i.e., perceived negative impacts on daily routine, personal health and safety, and finances) also have negative links to daily well-being. This study examines this link using data from an 8-day daily dairy study (n=675 days) in an online sample of older adults (n = 110 people, ages 60-90). We also explored potential psychological moderators particularly relevant to the experience of aging (i.e., self-views of aging, S-VOA). Results from multilevel models indicate that people reported more negative affect and less positive affect on days with more negative appraisals, especially on those days when they also had more negative self-views of aging. These findings highlight S-VOA as psychological resources that help people cope with stressful events in everyday life.
DAILY ASSOCIATIONS BETWEEN STRESSOR CONTROL AND AFFECT VARY AS A FUNCTION OF STRESSOR TYPE
Authors: Cerino Eric , Charles Susan , Mogle Jacqueline , Klepacz Laura , Piazza Jennifer , Rush Jonathan , Almeida David
Published: December 2022

Perceived control is an important psychosocial correlate of emotional well-being. Using data from the National Study of Daily Experiences (N=1,797, M=55.82 years, SD=10.35, 57.27% Female), we examined how self-reported control over different types of stressors (arguments, avoided arguments, work, home, network) was associated with negative affect (NA) and positive affect (PA). Over 8 consecutive days in waves conducted in ~2008 and ~2017, people reported their daily NA, PA, and control over stressors they had experienced. Within-person associations revealed lower NA on days when stressor control was higher than usual (p<.001), driven by control over arguments, avoided arguments, and work stressors specifically. PA was higher on days when individuals perceived greater control over avoided and actual arguments (ps<.001), but lower on days when individuals perceived greater control over network stressors (p<.01). Results suggest the facilitative role of control over daily stress for emotional well-being depends on the type of stressor experienced.
GETTING TO BOLD USING SYSTEMIC EDUCATION, EVIDENCE, AND NETWORKS: HELPING GEORGIANS B-SEEN
Authors: Head Elizabeth
Published: December 2022

The complex nature of Alzheimer’s disease and related dementias (ADRD) demands a comprehensive public health approach. Georgia is Building Our Largest Dementia infrastructure using Systemic Education, Evidence, and Networks (B-SEEN), with a vision for every Georgian – professional, patient, and care partner – to B-SEEN. The strength of Georgia’s B-SEEN project is the existing infrastructure. Leveraging this established network, Georgia has engaged in population-based efforts to increase impact in the dementia risk reduction, early diagnosis of ADRD, prevention and management of comorbidities and avoidable hospitalizations, and caregiving. These outcomes are being achieved by stakeholders disseminating evidence-based programs personalized to their community needs and the B-SEEN team leading coordinated activities that address dementia and support the promotion of brain health. This presentation will describe how ADRD risk reduction is integrated into a 159 county, de-centralized state and provides examples of several activities being implemented via Georgia extension, faith-based organizations, and dedicated partners.
ALZHEIMER’S DISEASE RISK REDUCTION HEALTH COACHING: ALCOHOL EFFECTS
Authors: Zanjani Faika , Rhodes Annie , Battle Brian
Published: December 2022

Lifestyle risk reduction at the community-level, is currently considered an effective method to decrease Alzheimer’s disease (AD). As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Core, diverse older adults (60+) in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, support, and monitoring for AD lifestyle risk in 2020-21. The study sample (n=40, mean age 68 years (range: 60-77 years) was 88% African American/Black (n=35), 100% Non-Hispanic, 45% males (n=18)), 60% reporting memory problems and 53% reporting any alcohol consumption. Thirty-nine (95%) of subjects successfully participated in coaching sessions; on average 91.9% (11) sessions were completed. Participants provided positive anecdotal feedback and the need for continued coaching during COVID. Average drinks per day decreased across the study period (F=7.44; p=.01) and alcohol risk, defined as more than 1 drink/day, decreased (F=3.46;p=.07). Drinking at baseline was associated with differential change in nicotine dependence (F=14.00 ;p=.02), depression risk (F=3.20;p=.09), light physical activity (F=4.52;p=.05), and cognition (COGTEL) (F=6.35;p=.02). Drinking between-subject effects indicated poorer level differences for smoking risk (F=5.68;p=.02), physical inactivity risk (F=4.66;p=.04), and total health behavior risk (F=14.54;p=.001), but higher cognition-scores (F=3.18;p=.11) for drinkers. In conclusion, there may be a paradoxical health effect for alcohol, with associations for negative health behaviors, but positive cognitive functioning. In conclusion, this preliminary work creates the impetus for future large-scale AD risk reduction investigations to improve the lives of AD-risk, low-income, diverse older adults reporting alcohol consumption.
DO PERSONALITY TRAITS INFLUENCE THE ASSOCIATION BETWEEN DEPRESSION AND DEMENTIA IN OLD AGE?
Authors: Abbasi Khuzeman , Ebili Ujunwa , Egbuchiem Henry , Orekoya Afolabi , Olanisa Olawale , Arisoyin Abimbola , Adaralegbe Adeleye
Published: December 2022

Depression and personality traits are independent predictors of dementia or cognitive impairment. Despite the well-established relationship between these two psychosocial factors and dementia, no research has been documented on how personality traits can influence dementia in older adults exhibiting depressive symptoms. This study explored the influence of personality traits on the association between change in depression and dementia in old age. We used a population-based longitudinal cohort study involving two waves of data collected 5 years apart, containing 2210 American older adults, from the National Social Life, Health, and Aging Project to explore if personality traits influence how change in depression predicts the development of dementia. We used multivariate logistic regression to examine the relationship between depression and dementia at T2 while adjusting for sociodemographic characteristics, comorbidity index at T1, and baseline dementia. Change in depression increased the likelihood of dementia at T2 by 4.2% (AOR = 1.04, p = 0.019) in the co-variate adjusted model. Personality traits, overall, did not influence how depression predicts the development of dementia. However, agreeableness individually nullified the effect of depression on the development of dementia, whereas extraversion was the only personality trait that significantly predicted dementia. We recommend the promotion of prosocial behaviors in old age as these appear to be protective. In addition, early life education and a strong social support can keep the depression-dementia spectrum at bay in old age.
STRATEGIES FOR EFFECTIVE COMMUNICATION USING PERSONAL PROTECTIVE EQUIPMENT IN NURSING HOMES: A QUALITATIVE STUDY
Authors: Shaw Clarissa , Williams Kristine , Coleman Carissa , Wilson Paige
Published: December 2022

Care of persons with living with dementia is complicated by using personal protective equipment (PPE). Masks and other facial coverings although protective, prohibit visualization of lip-reading and nonverbal cues and obscure identity. The purpose of this qualitative study was to determine best practices for effective communication while using PPE from the provider (n=10), resident (n=5), and family perspective (n=4). The 19 participants were recruited from four states. Qualitative content analysis identified two major themes: (1) challenges experienced during nursing home pandemic care, and (2) the communication strategies to overcome PPE challenges. Although our interviews were not focused on experiences outside of using PPE, all participants voiced trauma surrounding the lockdown for residents and separation from their families. All participants expressed pessimism surrounding the PPE, but this was also met with feelings of normalization surrounding its use. The communication strategies discussed focused on emphasizing (1) verbal and nonverbal communication skills, and (2) person-centered communication. The general communication strategies recommended were consistent with expert opinions such as using written messages and gestures, using loud speech, using clear speech, identifying self, and varying approaches based on person and context. Person-centered approaches centered on the staff and resident "knowing each other." Specifically, knowing the resident is essential to understanding their personal barriers and facilitators to successful communication and knowing each other in a personal and trusting manner helps overcome barriers caused by PPE. This study provides practical suggestions for best practices in communication and reinforces the need for person-centered communication focused on psycho-emotional care.
IMAGINING QUEER FUTURES BEYOND BOUNDARIES: A NARRATIVE ANALYSIS OF CREATIVE WRITING
Authors: Jen Sarah , Jones Rebecca
Published: December 2022

Scholars have called for “queering aging futures” beyond normative assumptions or scripts (Sandberg & Marshall, 2019), which is well-aligned with queer theory’s Cruising Utopia which suggests “cruising ahead” toward a queer utopian future that is not yet possible (Muñoz, 2009). Due to emphasis on form rather than content, narrative analyses enable the reimagining of queer futures not bound by material realities. This study presents a narrative analysis of 40 pieces of creative writing in Bi Women Quarterly (BWQ) that examine aging. Authors used writing to queer stories of relationships, activism, and aging. Many used incoherent, non-linear, and dreamlike or omnipotent storytelling to queer narratives, allowing them to “cruise” across time and versions of themselves, imagining futures that were new and unscripted. Narrative analysis allowed researchers to examine choices authors made in taking agency through storytelling. Findings indicate that queer people are well positioned to queer expectations of successful old age.
CREATIVE WRITING AS A TOOL FOR LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER (LGBTQ+) HISTORY AND FUTURE MAKING
Authors: Cooper Lujira , Oswald Austin
Published: December 2022

The shift toward embracing creative methods in qualitative research opens new possibilities for gerontologists and older adults to explore the nuances of aging and its affective undertones. This paper describes the process of facilitating a weekly creative writing group for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults and their subjective experiences. Various creative writing practices (e.g., poetry, fiction, short story, biography) facilitates the retelling of life events and reimaging of new futurities. Done in community, it creates opportunities for social connectedness, collective meaning making, and psychosocial and instrumental support. Creative writing is a useful method for describing the LGBTQ+ aging experience not fully realized in gerontology. Our findings demonstrate the utility of creative methods in describing and re-imagining LGBTQ+ aging histories and futures. We argue for more creative methods that re-present the complexities of LGBTQ+ aging.
FACILITATING CAREGIVER HEALTH AND WELLNESS: AGE-FRIENDLY HEALTH SYSTEM CARING FOR CAREGIVERS (AFHS-C4C)
Authors: Golden Robyn , Mariani Diane , Pelton Leslie , Moro Teresa , Carbonell Ellen
Published: December 2022

Family caregivers of older adults are vital partners in health care. The health care system is uniquely positioned to connect with caregivers and help address their own needs. The Age-Friendly Health System Caring for Caregivers (AFHS-C4C) model focuses on achieving health system change by identifying and incorporating caregivers into standard health care practices while assisting caregivers with their own health and well-being. Created at Rush University Medical Center, this model was tested in six AFHS. At Rush, caregivers (n=322) were mostly female (74%) and African American (38%) or white (37%). Between baseline and follow-up, statistically significant (p<.05) decreases were observed in caregiver burden (BSFC: 18.51 to 13.82), depression (PHQ-9: 8.40 to 4.09), and anxiety (GAD-7: 7.73 to 5.15). Application of this program at additional sites has yielded important lessons learned about engagement, training needs, and sustainability. These lessons will be discussed in the context of scaling and spreading interventions nationally.
CONTEXTS OF COGNITIVE DECLINE: MAPPING NEIGHBORHOOD OPPORTUNITIES AND BARRIERS FOR HEALTHY AGING IN PLACE
Authors: Finlay Jessica , Melendez Robert , Clarke Philippa
Published: December 2022

Stark geographic variation in later-life health outcomes suggests that local built and social environments are critical in shaping disease and disability, physical and cognitive function, and engagement in everyday life among older adults. This paper presents a community-engaged mapping project aiming to depict the uneven distribution of hazards and amenities relevant to cognitive aging across the United States. Living in neighborhoods with opportunities for social interaction (e.g., coffee shops, senior centers), intellectual stimulation (e.g., museums, libraries) and physical activity (e.g., parks, walkable streets) may slow rates of cognitive decline and reduce risk for Alzheimer’s disease. We assembled a community advisory board to translate research findings into a pilot website and interactive map that assesses neighborhoods for cognitive aging resources and amenities. The objective is to increase public awareness and inform public health and policy efforts to ameliorate community barriers and create more equitable opportunities to promote healthy aging in place.