bluuebunny/crossref_metadata_2025 huggingface dataset:
WHAT ABOUT HISPANIC SERVING INSTITUTIONS: THE ROLE OF MICRO-CREDENTIALS AMONG MINORITY-SERVING INSTITUTIONS
Authors: Heyn Patricia
Published: January 2025

Hispanic-Serving Institutions (HIS) are educational institutions that have an enrollment of at least 25% of undergraduate students and constitute one of the fastest-growing categories in higher education. Here, we explore the benefits and implications of micro-credential certifications at Hispanic-Serving Institutions, with the goal of uncovering their potential as transformative tools in addressing educational and workforce disparities faced by Hispanic learners and trainees. We cannot underscore the strengths of micro-credential programs, such as enhancing access to post-secondary education for Hispanic learners, offering flexible educational pathways that are respectful and sensitive to their cultural and life commitments, and directly linking academic achievements with marketable skills in the workforce. Importantly, the alignment of micro-credentials with high-demand career fields offers a promising avenue for improving the economic outcomes of Hispanic graduates. Yet, there are still critical challenges to consider, including the need for broader recognition of micro-credentials in the professional market, concerns about the digital divide affecting equitable access to these programs, and the institutional capacities of HSIs to support high-quality micro-credential offerings. Comprehensive research, evaluation systems, and evidence-based guidance are needed to optimize micro-credentials at HSIs, suggesting research funding and policy adjustments, infrastructure investments, and collaborative initiatives with both academic centers and industry partners to ensure these programs effectively contribute to closing the educational, professional, and economic gaps faced by Hispanic communities.
MACHINE LEARNING MODELING OF LOW QUALITY SURVEY RESPONSES TO PREDICT COGNITIVE IMPAIRMENT AMONG OLDER ADULTS
Authors: Gao Hongxin , Schneider Stefan , Hernandez Raymond , Harris Jenny , Maupin Danny , Junghaenel Doerte U , Jin Haomiao
Published: January 2025

Early identification of cognitive impairment (CI) is critical for managing Alzheimer’s disease and other dementia. Leveraging emerging evidence on the relationship between subtle errors in survey responses and CI, this study uses a novel informatics approach that combines machine learning with psychometric methods to develop a risk prediction model for identification of CI, including mild CI and dementia, in the general older adult population. The study is based on a sample of 12,942 participants aged 50 and above in the Health and Retirement Study, and psychometric indices of low-quality responses (LQR) in a range of different surveys are created as predictors. Our analysis shows an area under the curve (AUC) of 0.66 for identifying current CI and 0.70 for predicting dementia or mortality in the next 10 years. Also, the subgroup analysis shows the LQR indices have better predictive performance in the 50-59 (AUC=0.72), and 60-69 (AUC=0.71) age groups, suggesting the model may be more sensitive to early cognitive deficits. A unique feature of this tool is that it does not require the underlying surveys to be directly relevant to CI; thus, health professionals, especially those working in community settings like health and social workers, may use the tool to assist identifying older adults at risk of CI based on questionnaires of other aspects of their life, such as quality of life and personality. It may also be useful for aging researchers who intend to identify high-risk populations from survey data that do not include direct assessment of CI.
ACCEPTABILITY AND SATISFACTION WITH VIVO: PARTICIPANT FOCUS GROUPS AND SURVEY
Authors: Boucher Nathan , Kemp Elizabeth , Levitan Eric , Starr Kathryn Porter
Published: January 2025

As part of the Vivo feasibility study, each participant (n= 22) completed a program satisfaction survey and participated in a focus group (four groups of 5-8 participants each). The satisfaction survey showed 1) 95% were satisfied with the program; 2) 86% indicated they would continue to do strength training exercises after the study; and 3) 77% indicated participation in Vivo made them more aware of the importance of strength training. To further examine acceptability and satisfaction with Vivo, our team conducted four focus groups focused on identifying key barriers and facilitators to participation in the virtual exercise sessions. Two coders, through individual coding and iterative team meetings with the larger team, used descriptive content analysis to code and identify common themes. Our team identified four themes: 1) self-reported positive outcomes (i.e., regained function after injury, variety of exercise kept interest); 2) positive exercise experience (i.e., manageable exercise with little equipment, felt inclusive, focus on safe exercise); 3) social connection with others (i.e., developed peer group, facilitate group discussion that helped bond group); and 4) importance of an individualized exercise program (i.e., modifiable depending on ability that day, individual feedback from trainers). Areas for improvement included: making rescheduling easier, optimizing trainer communication, and clarifying needed hardware. These findings support the acceptability and high satisfaction with virtual exercise programs for older adults with pre-diabetes.
PROFILES IN FORTITUDE: STATEWIDE AGE-FRIENDLY HEALTH SYSTEMS
Authors: Kennedy Teri
Published: January 2025

The University of Kansas is in the process of developing Age-Friendly Kansas Forum (Kansas 4M), a statewide Kansas Age-Friendly Health Systems Action Community that is a reciprocal partnership between academia and primary care sites, delivery systems, and community organizations serving older adults in rural and underserved communities across Kansas. The Age-Friendly Health Systems (AFHS) Framework, developed by The John A. Hartford Foundation and the Institute for Healthcare Improvement, addresses the needs and priorities of older adults through the lens of the 4Ms: 1) what matters, 2) medications, 3) mobility, and 4) mentation. The framework resulted from a distillation of the core elements common to evidence-based programs serving older adults and is being leveraged as a strategy to address the know-do gap. To date three other states, Michigan, New York, and Nebraska, have developed statewide AFHS Action Communities. This presentation will share what Kansas 4M has learned about the unique approach taken by each of these states in their efforts to launch a statewide AFHS Action Community, their unique and shared experiences, best practices, cautionary tales, and how this information is informing the development of Kansas’ statewide AFHS Action Community.
THE CORRELATION BETWEEN INTRINSIC CAPACITY AND FALLS AMONG COMMUNITY-DWELLING OLDER ADULTS AND ITS APPLICATION
Authors: Li Chen , Chen Xiaodong , He Lingxiao
Published: January 2025

Objective

To explore the link between intrinsic capacity and fall risk among Xiamen’s older adults and to assess the diagnostic value of intrinsic capacity composite scores for falls.

Methods

A survey covering intrinsic capacity and fall history was conducted on 612 Community-Dwelling older adults. Logistic regression and ROC curve analyses determined the intrinsic capacity composite score’s cutoff for fall risk.

Results

Higher scores indicated lower fall risk （OR=0.45,95%CI: 0.30-0.67）. The optimal cutoff value was identified as 0.367, with the maximum AUC of 0.689. Adding chronic diseases as a control slightly reduced the AUC to 0.682 but did not change the cutoff.

Conclusion

Intrinsic capacity is a protective factor against falls. A score of 0.367 effectively diagnostic fall risk, aiding in older adults` fall prevention strategies.
CALORIC RESTRICTION VERSUS TIME-RESTRICTED EATING: THE HEALTH, AGING, AND LATER-LIFE OUTCOMES PILOT
Authors: Houston Denise , Nicklas Barbara , Miller Michael , Fanning Jason , Hsu Fang-Chi , DeLany James , Ard Jamy , Kritchevsky Stephen
Published: January 2025

In animal models, dietary interventions including caloric restriction (CR) and time-restricted eating (TRE) extend both lifespan and healthspan. However, in humans, the long-term benefits of these diets on lifespan and healthspan, and whether benefits outweigh harms, are unknown. The goal of the Health, Aging and Later-Life Outcomes Pilot (HALLO-P) is to inform the design of a definitive, full-scale trial to evaluate the long-term effects of CR and TRE in older adults. HALLO-P randomized 90 older (≥ 60 yrs) adults with obesity, or overweight and at least one comorbidity, to assess the feasibility and acceptability of three different 9-month interventions: 1) 20% CR delivered in-person; 2) 20% CR delivered remotely; and 3) 8-hour TRE with ad libitum caloric intake. Recruitment is complete and final intervention and close-out will be completed in August, 2024. To date, retention is 89% and intervention session attendance is 84%. Those assigned to CR are expected to weigh daily – to date, weights were obtained on 90% percent of days – and expected to maintain their weight within a zone of adherence – 65% of CR participants achieved this >75% of the time. TRE participants are expected to eat within a 7.5-8.5 hour window – TRE participants reported eating within an 8.5-hour window 77% of the time. Final study data will include: 1) the degree of sustained CR (using doubly-labeled water); 2) the sustainability of TRE (number of participants eating within the 8-hr window); and 3) changes in body weight and composition, and metabolic and functional health.
GAIT SLOWING ON TRANSITION TO UNEVEN SURFACES: DOPAMINERGIC NEUROTRANSMISSION AND PERIPHERAL SYSTEM RISK FACTORS
Authors: Rosano Caterina , Rosso Andrea , Newman Anne , Cummings Stephen , Studenski Stephanie , Bohnen Nicholaas , Chahine Lana
Published: January 2025

Identifying mechanisms that compensate for slow gait speed in older adults is crucial. Dopaminergic neurotransmission curbs deleterious associations of cerebrovascular disease with gait, but whether it compensates for peripheral systemic risk factors (PSRF) for gait slowing has not been studied. In this cross-sectional study of community-dwelling older adults, we examined the relationship between nigrostriatal dopaminergic terminal integrity and gait speed in individuals with and without ≥1 PSRF for gait slowing: obesity, joint pain, or reduced muscle strength. The primary outcome was percent change in gait speed (%CGS) on transition from even to uneven surface. Participants underwent dopaminergic imaging with dihydrotetrabenazine [11C]DTBZ positron emission tomography. Among 199 individuals, (mean (SD) age 75.0 (4.6) years; 62.3% female; 91.0% White) 131 (65.8%) had ≥1 PSRF. Relationship between posterior putamen [11C]DTBZ binding and %CGS was modified by PSRF; in those with ≥1 PSRF (but not in those with no PSRF), posterior putamen [11C]DTBZ binding was associated with %CGS (β=0.238, p=0.01) independent of potential confounders. Striatal dopaminergic neurotransmission may offer resilience to effects of PSRF on gait slowing.
SKELETAL MUSCLE MITOCHONDRIAL FUNCTION AND LONGITUDINAL CHANGES IN BRAIN STRUCTURE
Authors: Tian Teresa , Greig Erin , Davatzikos Christos , Landman Bennett , Resnick Susan , Ferrucci Luigi
Published: January 2025

Mitochondrial dysfunction, a hallmark of aging, has been associated with future cognitive impairment or dementia, as well as PET and blood biomarkers of Alzheimer’s disease and neurodegeneration. Whether mitochondrial dysfunction is associated with accelerated loss in brain volumes and microstructural integrity is unknown. We tested the longitudinal association between in vivo muscle mitochondrial oxidative capacity assessed via MR spectroscopy (post-exercise recovery rate of phosphocreatine, kPCr) and changes in brain MRI volumes and DTI microstructure over up to 12 years of follow-up in the Baltimore Longitudinal Study of Aging (2008-2020). In linear mixed effects models, adjusted for demographics, PCr deletion, and physical activity, higher kPCr was associated with less ventricular enlargement, less worsening in MRI-derived brain aging and Alzheimer’s disease scores, and less regional atrophy, especially the primary sensorimotor cortex, temporal white and gray matter, thalamus, occipital areas, cingulate cortex, and cerebellum (n=649). Higher kPCr was also associated with less microstructural integrity loss in white matter tracts connecting identified gray matter areas (n=598). Specific white matter tracts, including splenium of the corpus callosum and superior longitudinal fasciculus showed consistent longitudinal associations in radial diffusivity, but not axial diffusivity, which may indicate demyelination. Higher in vivo mitochondrial function is associated with less worsening in MRI-derived brain aging and Alzheimer’s disease scores, less brain atrophy in specific gray matter regions and less microstructural integrity loss in connecting white matter tracts. Future studies are warranted to investigate the role of CNS mitochondrial function in brain aging and neurodegeneration.
THE FUTURE OF AGING RESEARCH: OPPORTUNITIES AND CHALLENGES FROM GLOBAL AGING SURVEYS
Authors: Lee Jinkook
Published: January 2025

Jinkook Lee is the Director of the Program on Global Aging, Health, and Policy at USC. Dr. Lee advocates for the development of robust data and research infrastructure to better understand aging populations. She has been involved in initiatives like the Harmonized Cognitive Assessment Protocol (HCAP) and is the architect of the Gateway to Global Aging Data, a platform that facilitates cross-national and longitudinal research on aging by providing access to harmonized data from various international studies of older adults. The Gateway serves as a valuable resource for researchers, policymakers, and academics interested in comparing aging-related outcomes across different countries and over time. In this BSS Presidential Symposium, Dr. Lee will describe the challenges and opportunities associated with research on aging around the globe. She will discuss the shift from a focus on aging as being free of disease to a focus on multidimensional aspects of healthy aging, utilizing a life-course framework and capturing multiple aspects of exposure to deepen our understanding of the aging process, and the challenges of environmental hazards for our rapidly aging world. Dr. Lee’s presentation will provide useful background for thinking about how the next decade of research using studies from around the world will advance research on the aging process and aging populations around the world.
ASSOCIATIONS BETWEEN HEARING LOSS AND FUNCTIONAL BRAIN CONNECTIVITY AMONG DEMENTIA-FREE OLDER ADULTS
Authors: Jiang Kening , Reed Nicholas , Soldan Anja , Lin Frank , Albert Marilyn , Deal Jennifer , Pettigrew Corinne
Published: January 2025

Hearing loss is associated with cognitive decline and mood disorders, potentially through functional changes in the brain, as auditory deprivation affects higher-order sensory, attentional, and emotional processing. This study examined the cross-sectional association between hearing loss and functional connectivity, in 141 dementia-free participants from the BIOCARD Study (Median age=71 years). Resting state functional MRI data were processed to construct seven large-scale functional networks: frontoparietal control, default mode, dorsal attention, limbic, salience/ventral attention, somatomotor, and visual. Hearing loss was assessed by pure-tone audiometry. Better-ear four-frequency pure-tone average (PTA: average of hearing thresholds at 0.5, 1, 2, and 4 kHz) in decibels hearing level (dB HL) was analyzed categorically (hearing loss: >25 dB HL vs. normal hearing: ≤25 dB HL) and continuously after scaling to per 10 dB HL higher (worse). We used linear regression models, adjusting for age, sex, education, time between functional connectivity and hearing assessments (-3 to 4.5 years), APOE ε4, vascular risk factors, and diagnostic status. Hearing loss was associated with lower connectivity in the salience/ventral attention network (-0.02, 95% confidence interval [CI]: -0.05, -0.00). After restricting the analyses to 102 cognitively unimpaired (CU) participants, the association was stronger (-0.04, 95% CI: -0.07, -0.01). We also found lower connectivity in the limbic network (-0.04, 95% CI: -0.07, -0.00) associated with per 10 dB HL worse hearing among CU participants. Our study adds to the limited evidence in hearing loss-functional connectivity association. Disrupted functional connectivity in salience/ventral attention and limbic structures might underlie cognitive impairment related to hearing loss.
AN EXPLORATION OF A DIGITAL FALL PREVENTION PROGRAM: “KEEP ON KEEP UP” FOR OLDER ADULTS IN A CHINESE CULTURAL CONTEXT
Authors: Tang Yimin , Smith Sarah , Burden Sorrel , Stanmore Emma
Published: January 2025

The use of digital health interventions can be effective in enabling and maintaining healthy behaviours to help prevent falls and improve physical function in older adults. However, scarce research has been conducted with specific cultural and minority groups living in a cross-cultural setting. The aim of this study was to explore Chinese older adults’ and stakeholders’ experience, needs and preferences related to using digital health interventions, in particular the Keep On Keep Up-Chinese (KOKU-C) falls prevention program (translated to Mandarin language). This research used think-aloud as a novel approach in interviews and was completed within a cross-cultural context to better improve user-experience, engagement and digital inclusion of Chinese older adults living in the UK. A sample of Chinese older adults 55 to 95 years of age (N=40) living in Manchester and stakeholder representatives including healthcare professionals, caregivers, community partners and researchers (N=12) have been interviewed. Results from thematic analysis found that while there are opportunities to better enhance the digital health interventions tailored to the Chinese cultural context, the KOKU-C program can still provide valuable information as well as balance and strength training to help support fall-related health outcomes and improve their quality of life. These important findings point to the need for more research taking cultural considerations into account when co-designing digital health applications. The potential benefits of this study provide a possible solution for better acceptability, engagement and interaction in digital health interventions with Chinese older populations.
LONGITUDINAL ASSOCIATION OF DIGITAL HEALTH TECHNOLOGY USE WITH DEMENTIA IN OLDER ADULTS
Authors: Peng Wenting , Luo Yuqian , Liu Minhui
Published: January 2025

Dementia is a global public concern and is associated with many adverse outcomes, such as disability. However, it remains unknown whether common modalities of digital health technology are associated with dementia. Using the data from 2015 to 2019 of the National Health and Aging Trends Study (NHATS), the study examined whether prior-year digital health technology use predicted dementia in a later year in community-dwelling older adults aged 65 years and older (N=4,002). Digital health technology use was ascertained with four items: filling prescriptions, contacting clinicians, handling insurance, and obtaining health information. Dementia was assessed using a modified NHATS definition, including a physician diagnosis, cognitive performance in three domains, and the AD8 Dementia Screening Interview. Lagged generalized estimation equation models were used to examine the longitudinal associations, adjusting for demographics and health-related factors. Seniors using any digital health technology in the prior year were at a lower risk of having possible or probable dementia in the later year (OR=0.61, 95% CI=0.51-0.74) than those not. Filling prescriptions, contacting clinicians, and obtaining health information statistically significantly predicted possible or probable dementia, with ORs of 0.61, 0.69, and 0.66, respectively. Additionally, any digital health technology use (OR=0.65, 95% CI=0.50-0.82), filling prescriptions (OR=0.60, 95% CI=0.43-0.85), and obtaining health information (OR=0.74, 95% CI=0.56-0.96) decreased the risks of having probable dementia. These findings suggest that digital health technology use is a protective factor of dementia. Intervention programs to delay dementia progression should incorporate strategies to help older adults use digital health technology in their daily lives.
THE GLOBAL PRIDE STUDY: LESSONS LEARNED AND NEXT STEPS
Authors: Fredriksen-Goldsen Karen , Nelson Christi , Oswald Austin , Kim Hyun-Jun
Published: January 2025

As the older adult population becomes increasingly diverse and globalized, new challenges emerge in gerontological research and practice worldwide. This presentation examines sexuality, gender, and aging within a global context, exploring both fortitude and risks, as well as differing social and cultural interpretation of sexuality, gender, and age in relation to research and the development of culturally relevant practices. We will discuss the formation of the research network, involving more than 50 international collaborators. As part of the Global Pride project, we developed and tested a pilot survey, which was distributed by 18 partners and completed across six global regions (N= 3,885). Key processes and lessons learned include: 1. Establishing an international network of researchers to exchange knowledge and experiences in studying sexuality, gender, longevity, and health holistically; 2. Implementing a collaboratively developed survey across six global regions, taking into consideration differing cultural contexts and methodologies; 3. Employing culturally tailored dissemination strategies across diverse regions and settings. The insights gleaned from this research will deepen an awareness of the diversity of lives across the life course and contribute knowledge about the richness, challenges, and heterogeneity of ageing, as well as best practices for the implementation of global research.
PERSON-CENTERED ONLINE DEMENTIA TRAINING
Authors: Sturdevant Diana , Jackson Kimethria , Broussard Kimetha
Published: January 2025

Nursing education that focuses on care of people living with dementia (PLWD), and training in person-centered dementia care is limited. Person-centered dementia care puts PLWD at the center of the care process. It requires deep knowledge of the individual, as well as empathy and understanding from the nurse. Person-centered dementia care training improves care by correcting misconceptions about dementia and increases confidence in managing behavioral-psychological symptoms of dementia. In this session we will report outcomes from an on-line training focused on improving nursing care of people living with dementia (PLWD). The training consisted of 4 modules that included multimedia, discussion boards, and interactive exercises to stimulate student engagement and interaction. Undergraduate nursing students were recruited via email announcements of the volunteer opportunity. A total of (n=31) participants were recruited from 4 baccalaureate nursing programs including Traditional Junior, Traditional Senior, Degree Completion LPN to BSN, and Accelerated BSN. Pre/post assessments included the Dementia Attitudes Scale, the ADRC Staff Dementia Knowledge Assessment Tool, and the Confidence in Dementia Scale. A 5pt-likert scale was used to evaluate course structure and content, and open-ended questions provided prompts for additional participant comments. Common themes from evaluations included: need for additional content, more interactive activities, and inclusion as a required course for all nursing students.
SOCIAL INTEGRATION IN TEMPORARY HOUSING: PERSPECTIVES OF OLDER PERSONS EXPERIENCING HOMELESSNESS
Authors: Weldrick Rachel , Canham Sarah , Mahmood Atiya , Patille Rachelle , Gurung Shreemouna
Published: January 2025

The prevalence of homelessness among older persons in North America is rising. Accordingly, age-supportive housing and service models are needed to adequately support older persons experiencing homelessness to secure permanent housing. Within permanent supportive housing models, achieving and maintaining social integration (i.e., strong social connection and engagement) is recognized as a programmatic goal. Previous research has identified strategies to promote social integration in permanent supportive housing models, such as Housing First models. However, minimal research has considered strategies to promote social integration in temporary housing programs (THPs) and transitional housing models. This study addresses this knowledge gap by examining experiences of social integration, connection, and support in a THP program for older persons experiencing homelessness in Vancouver, Canada. We conducted semi-structured qualitative photovoice interviews with 11 current or former THP clients (Mean age = 65 years; 6 female, 5 male) across three sessions. Data were analyzed using a critical realist-informed thematic analysis method. We identified three themes: 1) technology access and programming can facilitate social connection; 2) consistent communication with program staff can enhance perceived social support; and 3) accessible built environments can promote social participation among clients. Findings offer insights for the development of age-supportive housing and support models for older persons experiencing homelessness. We conclude by offering strategies, such as digital literacy programming and the creation of ‘third spaces’, to support older persons to remain (or become) integrated while in temporary and transitional housing.
DEVELOPING A SUMMER RESEARCH INSTITUTE FOR EARLY CAREER RESEARCHERS
Authors: Kline Chelsea , Zimmerman Sheryl , Bynum Julie , Baumgart Matthew , Fazio Sam
Published: January 2025

Today, there are nearly 7 million Americans living with Alzheimer’s disease and more than 11 million unpaid caregivers. By 2060, the number of Americans living with Alzheimer’s could reach almost 14 million. These statistics highlight the need for early career investigators to join the dementia research workforce and accelerate breakthroughs in the field. To address this need, the Alzheimer’s Association Interdisciplinary Summer Research Institute (AA-ISRI) was created. AA-ISRI was developed as a five-day immersive experience in which 24 competitively-selected, early career investigators attend didactic lectures led by experts in the field, develop research proposals in small groups, and receive one-to-one mentoring. The overall goals of the program include increasing knowledge on the fundamental aspects of dementia and dementia research; increasing connections in the field; and aiding the development of fundable research proposals. This presentation will provide an overview of the AA-ISRI, including information on the goals of the program, how and why the program was developed and structured as it is, session topics, and the recruitment and selection process of AA-ISRI participants.
PSYCHOSOCIAL RESEARCHER PERSPECTIVES OF THE SUMMER RESEARCH INSTITUTE AND TRAINING NEEDS
Authors: Lanzi Alyssa
Published: January 2025

Over 30 public psychosocial early career researchers have participated in the Alzheimer’s Association Interdisciplinary Summer Research Institute (AA-ISRI) across the first three years of the program. During the week spent at AA-ISRI, psychosocial participants attend a variety of sessions, including both full group sessions and track-specific sessions; receive mentoring from peers and expert faculty; and refine their research proposals. Psychosocial track participants gain exposure to a wide range of potential intervention research populations and designs and enhance skills in methods for ADRD research including identifying and developing measures, utilizing mixed methods, and how to initiate and follow through with community-engaged research. The ultimate hope of the psychosocial track of the AA-ISRI is that participants will depart having formed long-term connections and the tools needed to advance their research careers. During this presentation, AA-ISRI psychosocial alum Dr. Alyssa Lanzi will describe the experience of AA-ISRI as a participant, including the highlights and helpfulness of the didactic sessions offered at the program, the mentoring and networking opportunities that were available, and the impact that AA-ISRI had on the short-term career trajectory and research. For example, since AA-ISRI, Dr. Lanzi has received an R01 funded by NIA/NIH to establish an open-access database of connected speech/language samples from older adults at-risk for dementia to study language as a potential biomarker. A key feature of this proposal is its community engagement plan to enroll those from minoritized backgrounds. This includes working with collaborators from across the country including two researchers Dr. Lanzi met at AA-ISRI.
OPTIMIZING A PRAGMATIC TRIAL OF EMERGENCY DEPARTMENT INITIATED CARE FOR PERSONS LIVING WITH DEMENTIA
Authors: Brody Abraham , Shah Manish , Goldfeld Keith , Grudzen Corita , Chodosh Joshua
Published: January 2025

Over 50% of persons living with dementia (PLWD) seek emergency department (ED) care annually. However, the ED is not optimized to care for PLWD; those discharged back to the community experience adverse events. Through a recently-funded NIA Cooperative Award, we will implement an 80-site embedded pragmatic factorial designed trial of three independent, yet potentially synergistic, interventions to improve care and reduce adverse events during care transitions among PLWD and their care partners who visit the ED: Emergency care redesign, nurse-led telephonic care, and community paramedic-led transitions. While each intervention has been previously implemented, they have not been implemented concurrently. Thus, to prepare for the full-scale trial where EDs will implement zero to all three interventions, we performed an optimization study with 40 PLWD who received care and were discharged from two EDs. The optimization program examined how to efficiently implement interventions in tandem while maintaining core functions. We developed and implemented: clinical decision support pathways to identify PLWD eligible for the clinical interventions and nudge clinicians towards effective intervention implementation, modifications for when multiple interventions were utilized, and intra-intervention communication pathways. We evaluated the optimization through implementation metrics and semi-structured interviews with engaged clinicians, PLWD and their care partners. Particular challenges requiring adaptations included time required to implement clinical decision support, creating effective communication pathways between intervention programs, developing staffing flexibility in the nurse telephonic program to allow for coverage at key times while balancing nursing staff needs, and engaging ED staff in performing team huddles at the bedside.
ADVANCED OLD AGE: NARRATIVES, NEEDS, AND NOTIONS
Authors: Eliopoulos Elaine , Gilleard Chris
Published: January 2025

Longevity trends worldwide have highlighted the need to advance theoretical development of advanced old age beyond a singularly focused decline narrative. This narrative contributes to a doomed sense of old age without consideration for the subjectivities which may contribute to a deeper understanding of the experience of advanced old age beyond its bodily capabilities. This paper reports findings from a qualitative study depicting personal narratives elicited from 23 individuals aged 80 to 102 living on the San Juan Islands in the state of Washington. Using a mix of photo-elicitation and semi-structured interviews, participants narratives reflected a specific focus on their needs and interests despite a range of corporeal challenges. Those needs and interests foregrounded a sense of community experienced in diverse ways on their island. The participants’ focus on community and belonging gives rise to the benefits of embracing new models of advanced old age which capture a sense of contented engagement with both nature and community that contrasts with the dominant discourse of decline and offers new notions of advanced old age. These new notions may enhance both quality of life and directly inform policy designed to address quality.
EXPRESSIONS OF INTERSECTIONALITY IN OLD AGE THROUGH NARRATIVE RESEARCH AND PHOTO EXHIBITION
Authors: Shulyaev Ksenya , Band-Winterstein Tova , Dekel Tal , Eisikovits Zvi , Nashef-Hamuda Reem
Published: January 2025

This presentation analyzes the complex experiences of old women navigating multiple marginalized identities, through an intersectional lens. There is relatively limited in-depth representation of older women at the crossroads of multiple social disadvantages. This project addresses this gap through a collaboration with 15 older women in Israel from diverse minority groups (lesbian/transgender, women with disabilities, Israeli Arabs, immigrants from Ethiopia, and former USSR). The project aims to visualize older women’s self from an intersectional perspective by creating a visual documentary – (a photo exposition) with added verbal narrative of their life stories. Utilizing visual narratives and in-depth interviews, the project explores the unique experiences of old women shaped by age and additional marginalized identities. Professional artists guided the photo sessions, ensuring the women’s vision and representation were prioritized. The resulting artwork was exhibited publicly at the University of Haifa library with accompanying small group sessions aimed at increasing awareness of students and the community about discrimination against older women. Visitors to the exhibition will be interviewed for further analysis and understanding of the impact of the exhibition in terms of visibility and attitudinal change. The exhibition will become a permanent online display on the Minerva Center of Intersectionality in Aging website. The presentation of on GSA conference includes photos and citations of the life stories of women who participated in the project. This unique project illuminates the lived reality of aging women intersectionality, offering insights to gerontological researchers and practitioners, challenges stereotypes and empowers women to express their experiences visually
WHO IDENTIFIES WITH AGE-BASED DISCRIMINATION?
Authors: Hanes Douglas
Published: January 2025

Background

Ageism remains a persistent problem that contributes to worse later-life outcomes. Since the COVID-19 pandemic, ageism has received greater attention from activists, researchers, and policymakers. Yet little is known about who identifies with ageism as the basis of their discriminatory experiences, and how people with intersecting marginalized identities endorse ageism as a basis for their discrimination.

Method

Health and Retirement Study (2008–2018, N = 16,250) participants were asked about their experiences of discrimination and the reasons for them, including age and other factors. We analyze which experiences and identities predict endorsement of age as the basis of participants’ discrimination. Multilevel logistic regressions with “discrimination due to age” as the outcome variable were conducted.

Results

Age predicted a small increased likelihood of ageism (OR = 1.08; p < 0.001), but more frequent discrimination decreased it (OR = 0.877, p < 0.001). People of color were less likely to report ageism than non-Hispanic whites (OR = 0.552, p < 0.002), regardless of reporting racist discrimination; whites who reported race-based discrimination had greater odds of also reporting ageism (OR = 1.563, p < 0.001). Women were more likely to report ageism (OR = 1.139; p = 0.002); reporting gender-based discrimination increased ageism probability for both women (OR = 2.318, p < 0.001) and men (OR = 3.037, p < 0.001).

Discussion

Members of certain identity groups and with certain experiences are more likely to understand themselves as subject to ageism than others, which may affect the effectiveness of anti-ageist messaging and interventions.
IT’S RAINING, IT’S POURING, THE OLD MAN IS SNORING: AGE STEREOTYPES IN NURSERY RHYMES
Authors: Ng Reuben , Indran Nicole
Published: January 2025

Ageist beliefs tend to take root in one’s formative years and persist into adulthood. As future older adults, children must be instilled with more positive attitudes towards aging. To gain insight into the ways in which children are being socialized to view old age, this study examines the depictions of old age in nursery rhymes. We built a comprehensive dataset of nursery rhymes by gathering material from four websites. In total, 735 unique rhymes were retrieved. To identify rhymes related to old age, we conducted a search using various age-related terms (e.g., old, elder, grandfather, grandma). This search yielded 85 nursery rhymes. After applying our exclusion criteria (e.g., instances where ‘old’ referred to buildings that have been around for a long time), we were left with 34 rhymes. Both inductive and deductive approaches guided our qualitative content analysis of the rhymes. Overall, old age was mentioned in 5% (N=34) of the 735 nursery rhymes. Of the 34 rhymes, half contained negative age stereotypes (50%; N=17). The remaining rhymes featured about an equal mix of positive (26%; N=9) and neutral age stereotypes (24%; N=9). In the context of an aging population, it is paramount that society is led by people with a realistic outlook of aging. Although nursery rhymes may seem like mere tales not to be taken seriously, they nonetheless remain powerful tools capable of molding thought processes. Our study sets the stage for telling children accurate and nuanced stories about older adults to inculcate healthy attitudes towards aging.
ASSOCIATION BETWEEN PRE-HIP FRACTURE DEPRESSION AND DAYS AT HOME AFTER FRACTURE AMONG MEDICARE BENEFICIARIES
Authors: Mehta Rhea , Orwig Denise , Chen Chixiang , Dong Yu , Shardell Michelle , Yamashita Takashi , Falvey Jason
Published: January 2025

Hip fracture and depression are important public health issues among older adults. Though historically more common in females, hip fracture cases are projected to increase among males, who often experience greater depression severity. Days at home (DAH), a patient-centered metric reflecting fracture recovery, can inform post-surgical treatments for older adults. The association between pre-fracture depression and DAH among hip fracture survivors and potential sex differences remains unexplored. Our cohort included 63,618 community-dwelling Medicare fee-for-service beneficiaries, aged 65+, who underwent hip fracture surgery between 2010 and 2017. Generalized Estimating Equations assessed longitudinal associations between pre-fracture depression at hospital admission and total DAH over 12 months post-discharge, adjusting for covariates. Sex-by-depression interactions were also included, and multiple models were built to identify factors that may explain the primary association. There was no difference in DAH between beneficiaries by depression status in the fully adjusted model. After adjusting for demographic factors (age and sex) and social determinants of health (race, Medicaid dual eligibility, and poverty), those with depression spent 11 fewer average DAH compared to counterparts without depression (incident rate ratio [IRR] = 0.92; 95% CI = 0.91, 0.93; p<.0001). The association was attenuated and not significant after additional adjustment for medical complexities, specifically comorbidities, and facility and geographic factors. The sex-by-depression interaction term was not statistically significant (p=0.38). The association between pre-existing depression and DAH among Medicare beneficiaries with hip fracture underscores the need for early recognition and secondary prevention of depressive symptoms during acute care, which may inform hip fracture treatment.
ATTITUDES AND BELIEFS ON INTERGENERATIONAL FAMILIAL CARE: IMPLICATIONS FOR FUTURE CARE POLICY IN LEBANON
Authors: Bcherraoui Myriam Al , Ajrouch Kristine , Antonucci Toni
Published: January 2025

In a collectivistic society such as Lebanon, familism is a deeply rooted cultural value where family members learn to put the needs of the group over the self. Familial obligation is socially reinforced, and care is perceived as the principal responsibility of the family. In a rapidly aging society accompanied by economic hardships, older adults in Lebanon are living longer, often with health conditions, and family members assume the main responsibility of care. Solidarity in family relationships becomes increasingly important and may lead to many benefits in caregiving when they are positive, but they may also be equally harmful if conflictual. Understanding adults’ attitudes concerning differential care settings becomes an intricate state matter with ethical implications. Drawing on Bengtson’s Solidarity-Conflict Model of Generational Relationships, we assessed data from the Family Ties and Aging study (N=500) collected in Beirut, Lebanon from adults aged 18-91. The study examined 1) the extent to which age, gender, and education level influence beliefs held about elder care, and 2) whether parent-child relationship closeness predicts attitudes on state versus family care. Regression analyses indicated that greater relationship closeness to children predicts stronger beliefs favoring government-led care for personal and household matters. Older age and closeness to children also predicted parents’ disagreement in children’s obligational role in care, both personally and financially. This may relate to parents’ desire to decrease strain on family members and increase solidarity. Results will be discussed in light of the Solidarity-Conflict Model, emphasizing the importance of strengthening family ties through state interventions.
DEEP PROTEOMIC PROFILING OF ACCELERATED KIDNEY AGING AND SENESCENCE BURDEN IN MACACA MULATTA
Authors: King Christina , Burton Jordan , Schaaf George , Kritchevsky Stephen , Cline J , Justice Jamie , Quillen Ellen , Schilling Birgit
Published: January 2025

Whole-body ionizing radiation (IR) is a stressor that causes damage to DNA, lipids, and proteins, and in the latent-phase, may lead to oxidative stress, inflammation, and cellular senescence. Slowly-reproducing tissues, including kidney, are more likely to react to DNA damaging stressors, which may exacerbate aging processes. Quantitative proteomics was employed to gain molecular insights into how IR exposure may drive renal aging processes. For this analysis, kidney cortex tissues (N=38) were obtained from the Wake Forest Non-Human Primate Radiation Late Effects Cohort. Protein lysates (100 µg) were digested and peptides were desalted. Peptides were analyzed on a timsTOF HT mass spectrometer (Bruker), raw data was analyzed using protein-analysis software, and significantly-altered proteins were subjected to bioinformatic analysis. 5,472 protein groups with at least two unique peptides were identified in the kidney cortex. The influence of 1) kidney disease (KD) in irradiated individuals, 2) only kidney disease, and 3) only irradiation was studied. Interestingly, over 75% of significantly-altered proteins are significantly upregulated. This includes extracellular matrix proteins tenascin and periostin, which are potential aging biomarkers. Upon mapping this dataset to homologous human proteins, proteins associated with kidney disease among irradiated animals are related to EGF pathways, integrin signaling, and fibrosis. Significantly-altered proteins related with kidney disease, independent of irradiation, are related to EGF pathways, integrins, and fibrosis whereas significantly-altered proteins related to irradiation exposure are involved in fibrosis. Similarities in biological processes from significantly-altered proteins in either kidney disease or irradiation highlight a potential synergistic effect of irradiation on kidney disease.
FACTORS INFLUENCING PHYSICAL ACTIVITY AMONG COMMUNITY-DWELLING OLDER ADULTS IN BEIJING, CHINA: A PATH ANALYSIS
Authors: Kang Ning , Chen Gong , Wang Dongmin , Wang Yue , Liu Min
Published: January 2025

Background

Previous research underscores the significance of physical activity in enhancing the health of older adults. This study seeks to delineate the pivotal determinants and model the pathways that influence the physical activity levels of older adults residing in community settings.

Methods

Leveraging a cluster sampling strategy, this study surveyed older adults in Beijing, China, employing the International Physical Activity Questionnaire to assess physical activity. We gathered 770 valid responses (173 males and 594 females). The relationship between physical activity and various determinants was examined using ordered logistic regression, and a structural equation model was developed to elucidate the influencing pathways.

Results

Findings reveal that a substantial portion of community-dwelling older adults exhibit low physical activity levels (40.00%), with moderate (28.7%) and high levels (31.30%) less prevalent. Direct influences on physical activity levels were found for exercise support (β=0.168), motivation (β=0.164), and knowledge (β=0.089). Exercise self-efficacy (β=0.21), support (β=0.152), and knowledge (β=0.092) indirectly affected motivation, with self-efficacy further mediated by support (β=0.081) and knowledge (β=-0.128), suggesting the nuanced role of exercise risk awareness. Exercise motivation, particularly achievement motivation, health motivation, and internal pressure motivation, was identified as a key factor affecting their physical activity levels.

Conclusion

This research identifies exercise motivation and support as crucial to older adults’ physical activity. Contrary to expectations, increased self-efficacy does not directly correlate with higher activity levels, underscoring the complexity of factors influencing older adults’ engagement in physical activity.This study advise a community intervention enhancing exercise motivation through social support and health education.
INTERVENTIONS FOR COGNITIVE FRAILTY: DELPHI CONSENSUS WITH RESEARCHERS, CLINICIANS, AND EXPERTS BY EXPERIENCE
Authors: Holland Carol , Dravecz Nikolette , Broughton Susan , Davis Sally Fowler , Dixon Mandy
Published: January 2025

The conjunction of physical frailty and cognitive impairment without dementia is described as Cognitive Frailty (CF). Indications that CF is potentially reversible has led to proposals that addressing risk factors, symptoms or mechanisms of CF would be appropriate targets for interventions for prevention, delay or reversal. However, no study has brought experts together across sectors to determine targeted or structures of interventions, and most resources on interventions are from the perspective of academic or clinical researchers only. We conducted an international Delphi consensus study bringing together experts from academic and clinical research, lay people with lived experience of CF, informal carers, and professional care practitioners/clinicians. Three rounds of the Delphi study were held to discern which factors were agreed upon by the whole sample and on which did people with differing expertise have differing views. A scoping review and Round 1 was used to gather initial statements. In Round 2, 56 people responded to statements and open text boxes, with 7 lab based researchers, 27 researchers working with people, 14 people with lived experience or informal family carers, and 10 professional carers/clinicians. Analysis of quantitative data gave 74 statements on which there was at least 70% agreement and qualitative data gave 24 statements, which were then combined to give 90 statements for Round 3, to which 38 original participants responded. Consensus was found for 88 of the statements. Differences between the groups were observed at both stages. Outcomes can be used to feed into co-creation of interventions for cognitive frailty.