bluuebunny/crossref_metadata_2025 huggingface dataset:
Change of Health and Change of Preferences on Life-Sustaining Treatment: Evidence From a Longitudinal Study
Authors: Lou Yifan , Bern-Klug Mercedes , Liu Jinyu
Published: December 2021

Background: Decision-making for end-of-life (EoL) care is not a one-off choice. Older adults may change their preferences for life-sustaining treatments along their health continuum. Guided by prospect theory, we hypothesize that perceived change in health status is a driver behind preference changes. Method: Health and Retirement Study Wave 2012 to 2018 data. Sample is limited to 5,646 older adults who reported whether they requested to limit treatment in living will during two waves of data. Two possible preference changes were tested: from limited to default care and from default to limited care. Change in health status was indicated by changes (1=same, 2=improve, 3=decline) in physical pain, general health, activities of daily living, instrumental activities of daily living (IADL), and number of diagnoses. Multilevel logistic regression models were used to understand how change of health status was related to changes in EoL preferences. Results: 700 older adults changed their preferences some time in 8 years. Those who changed their preferences are more likely to be older and not married, and to have lower socioeconomic background. Older adults who experienced deteriorated pain levels were more likely to change their preferences from default to limited care (OR=3.77, p<.05) and less likely to change from limited to default care (OR=0.63, p<.05). Change in IADL is also a significant predictor of change of preferences. Implication: The findings highlight the importance of periodic reassessment of EoL care preferences with older adults. We discuss policy and practice implications regarding health changes as underlying mechanisms of preference changes.
Culture Differences in Advance Care Planning and Implications for Social Work Practice
Authors: Ha Jung-Hwa , Lee Changsook , Yoo Jennifer
Published: December 2021

Advance care planning (ACP) is the process of making plans and decisions regarding end-of-life care (EOLC) in advance while one has the physical and cognitive capacity to do so. However, even if health practitioners recognize the importance of ACP, they may be constrained by social and cultural factors in engaging their clients in ACP. This study examined cultural differences in ACP and various strategies that social workers use to initiate conversations on ACP in a range of settings. Using the case study method, we conducted in-depth interviews with 7 social workers who work in South Korea, 2 Korean-American social workers working in the Korean-American communities in the US, and 3 American social workers serving diverse populations in the US. Their practice sites include: university hospitals, day care centers, a community senior center, a nursing home, and a hospice agency. Social workers in both countries emphasized the need to build rapport with their clients early on and to empower them to take the lead in their ACP while they were still healthy. In Korean and Korean-American communities, social workers recognized their clients’ reluctance to speak about EOLC and highlighted the importance of communicating with their family due to their clients’ preference for family-centered decision-making. When doing this, a step-by-step approach in giving relevant information was recommended. We identified relationship-building, empowerment, and culturally sensitive approaches as common strategies in initiating discussions on ACP in both countries.
Strategies Older Adults Used During COVID-19 to Stay Connected
Authors: Doebbeling Brad , Harrelson Haley , Houchins Michelle , Wine Hallie , Pishko Claire , Der Ananian Cheryl , Peckham Allie , Guest M Aaron
Published: December 2021

An unintended consequence of the physical distancing guidelines to prevent the spread of COVID-19 may be increased feelings of social isolation and loneliness in older adults. Purpose: The purpose of this study was to identify successful strategies used in avoiding social isolation and feelings of loneliness in older adults (50+) during the pandemic. Methods: Older adults (n=22) selected from a longitudinal study, Aging In the Time of COVID-19, who did not report loneliness, participated in a semi-structured interview via zoom. Individuals were asked a series of questions about how their lives were impacted by the pandemic and what they did to avoid social isolation and loneliness. Each interview was recorded and transcribed verbatim. transcripts were analyzed and categorized to identify common strategies. Results: Participants were primarily female and white (100%) with a mean age of 64.7 years. Preliminary findings (n=5) suggest older adults developed several effective strategies for combating social isolation and feelings of loneliness, including purposely reaching out and “checking in” on others; engaging in exercise, either alone or with others, and engaging in outdoor activities, such as socially distanced in-person encounters. Other effective strategies included virtual events (e.g. community or local events, museums or concerts, etc.), using technology to communicate with friends and family, and practicing gratitude consistently. Conclusions: Although older adults have been encouraged to stay at home and physically distanced throughout the pandemic, they have found ways to remain socially connected with friends, family, and community, despite not being physically together.
Mobility, Physical Activity, and Social Engagement of Community-Living Older Adults
Authors: Li Wenjun , Quach Lien
Published: December 2021

Mobility, physical activity and social engagement are important to healthy aging and independent living among older adults. This symposium includes four related studies on these issues. Dr. Lien Quach and her team examined racial and ethnic disparities in social engagement among community-living older adults using data from the national Health and Retirement Study. The analysis found that Asians and Hispanics had significantly lower social engagement score compared with non-Hispanic Whites, advocating for further investigations of the causes of racial disparities in social engagement. Dr. Su-I Hou’s study examined the impact of physical activity and social relationship on social engagement. The study found positive impacts of more physical activity, better social relationships and volunteers on social engagement. The results have important implications to promotion of social engagement among older adults participating in aging-in-community programs. Dr. Ladda Thiamwong’s study demonstrated the benefits of using assistive health technology (AHT) to assess the relationships between fall risks, body compositions and objectively measured physical activity in older adults. Dr. Thiamwong’ will discuss the research protocol and preliminary results. Dr. Li’s Health Aging and Neighborhood Study examined variations of older adults’ driving behaviors by sex, age, race, income, health status and housing density of the neighborhoods. The study found substantial differences in mobility and driving patterns by both personal characteristics and neighborhood living environment. The findings have important implications to community programs that support older adults aging in place.
Using Assistive Health Technology to Assess Fall Risk Appraisal, Body Composition, and Physical Activity
Authors: Thiamwong Ladda , Park Joon-Hyuk , Choudhury Renoa , Garcia Oscar , Furtado Maxine , Stallworth Nicole , Stout Jeffrey
Published: December 2021

One-third of older adults have a discrepancy between perceived and physiological fall risks or maladaptive fall risk appraisal (FRA). Older adults who report high fear of falling and overestimate their physiological fall risk are less likely to participate in physical activity (PA). Limited data suggest the interrelation between fall risk appraisal, body composition, and objective measured PA. This cross-sectional study examines the feasibility of recruitment and acceptability of Assistive Health Technology (AHT), including the BTrackS Balance System (BBS), Bioelectrical Impedance Analysis (InBody s10), and ActiGraph GT9X Link wireless activity monitor. This study demonstrates the benefits of using AHT to study the associations among FRA, body composition, and PA in older adults. We hypothesize that rational FRA is associated with higher levels of PA and skeletal muscle mass and lower levels of percent of body fat and body mass index. Topics presentation included research protocol and preliminary results.
We're Still Very Much in Limbo: Providers' Perspectives on Implementing a Person-Centered Project
Authors: Corpora Miranda , Kelley Megan , Heppner Alex , Van Haitsma Kimberly , Abbott Katherine
Published: December 2021

Background: The Preferences for Everyday Living Inventory assists nursing home (NH) providers in assessing residents’ preferences and can be used to make Preferences for Activity and Leisure (PAL) Cards, which are personalized 5x7 laminated cards that reflect a resident’s recreation and leisure preferences. We sought to understand the barriers and facilitators to implementing PAL Cards in NH communities during COVID-19. Methods: NH providers from five states (n=29) were recruited to create PAL Cards in their communities. Monthly coaching calls with project champions assessed the implementation process. Calls were recorded, transcribed verbatim, checked for accuracy, and coded via thematic analysis. Results: Four themes emerged: Adapting to COVID, Preoccupied with COVID, Future Thinking, and PAL Cards Filling the Gaps. Conclusion: Some providers were successful adapting to COVID, while others struggled to implement a new program during the pandemic. Those that were successful expressed how PAL Cards helped promote person-centered care.
Resources and Relationships in Disasters: Differences Among Small and Large Assisted Living Communities
Authors: Peterson Lindsay , Dobbs Debra , June Joseph , Dosa David , Hyer Kathryn
Published: December 2021

Disaster preparedness among assisted living communities (ALCs) has not been widely researched, despite the growth of ALCs and evidence of disability in this population. An additional issue of concern is the way in which ALCs vary, including variation by size. The purpose of this paper was to explore the experiences of ALCs in Florida that experienced Hurricane Irma in 2017 and how experiences varied by ALC size. Qualitative interviews and focus groups were conducted with representatives of small ALCs (<25 beds; n=32) and large ALCs (25+; n=38). Transcripts were analyzed using Atlas.ti version 8, and research team members collaborated to reach consensus on codes and further analyze differences based on ALC size. Results suggest there are differences among ALCs in their disaster preparedness and response, and these differences are related to size (e.g., access to resources, organizational characteristics). Implications for ALC resident wellbeing and future disaster planning will be discussed.
Perceiving More Age-Related Losses? The Role of General Control Beliefs and Daily Disturbance to Plans
Authors: Neupert Shevaun , Zhu Xianghe
Published: December 2021

We examined daily fluctuations in future time perspective within the daily stress and awareness of aging processes. Awareness of age-related change (AARC) focuses on everyday experiences that highlight changes in behavior and functioning as a result of growing older. We integrated individual differences in control beliefs because those with higher control tend to be more resilient to stressors. We conducted a daily diary study of 112 older adults (aged 60-90) who completed measures of control beliefs at baseline and then daily measures of stressor exposure, appraisal (e.g., threats to future plans), and AARC for eight consecutive days. Increases in threats to future plans were associated with increases in AARC losses, and those with low control were especially vulnerable to increases in threats to future plans. With a constricted future time perspective, any threats to future plans may be especially harmful for older adults who are low in control beliefs.
Oral Health and Dental Care Among Older Adults in China: What Are the Risk and Protective Factors?
Authors: Mao Weiyu , Pei Yaolin , Luo Huabin
Published: December 2021

Oral health is a global public health concern. The four papers in this symposium capture various understudied risk and protective factors in oral health and dental care among older adults in China. The first paper examined the relationship between social isolation, loneliness, and tooth loss among Chinese older adults, using the Chinese Longitudinal Healthy Longevity Survey. The findings suggest that higher levels of social isolation, rather than loneliness, were associated with fewer remaining teeth and accelerated tooth loss over time. The second paper investigated urban-rural disparities in dental care utilization among Chinese adults aged 18 to 65 years old, using the 2019 New Era and Living Conditions in Megacities Survey. The findings demonstrate urban residents were more likely to visit dentists than rural residents. Besides socioeconomic status, health attitudes/behaviors, and oral health needs, health insurance coverage was considered an important enabling factor to promote dental care use in this population. The third paper examined the relationship between denture use and cognitive decline among Chinese older adults, using data from the Chinese Longitudinal Healthy Longevity Survey. The findings indicate that denture use is protective against cognitive decline over time in later life. The fourth paper examined the prevalence of self-reported orofacial pain symptoms and their correlates at the last year of life among Chinese older adults. Low socioeconomic status, smoking, chronic conditions, oral hygiene practice, and natural teeth condition were associated with such symptoms. This symposium offers valuable insights to improve oral health and dental care in older adults in China.
Predictors of Physical Activity Among Older Breast Cancer Survivors: Findings From the WHI LILAC Study
Authors: Krok-Schoen Jessica , Pennell Michael , Naughton Michelle , Zhang Xiaochen , Shadyab Aladdin , Kroenke Candyce , Saquib Nazmus , Paskett Electra
Published: December 2021

We examined the factors associated with physical activity following cancer treatment among older breast cancer survivors from the WHI LILAC study. The majority of participants (n=3,710, mean age=78.8±5.9) were white (86%), and had in situ/localized breast cancer (79%). Women who received radiation therapy, were underweight/normal weight, had fewer reported cancer-related symptoms, no lymphedema, higher self-rated health, higher physical functioning, no pain, no depressive symptoms, and higher social support had significantly greater participation and duration of physical activity (all p<0.05). Women aged <75 who received radiation had longer duration of total minutes of physical activity (β=19.7, p<0.05), while women aged 75-85 who received radiation had shorter duration of total minutes of physical activity (β=-3.2, p<0.05). These results indicate that multiple health and social factors are associated with physical activity in this cohort. Interventions to facilitate physical activity among this group should consider body weight, symptom burden, comorbidity status, and social support.
Inspire: A New Effort on Geroscience in Toulouse, France
Authors: Sierra Felipe , Vellas Bruno
Published: December 2021

The Inspire project of the Toulouse Hospital System is a comprehensive approach to health care in older adults, focused on maintenance of health and physical function. At the core of the project are human, mouse and killifish cohorts, which in the case of humans, is comprised of 1,000 subjects of ages 20 and above, which are followed for a total of 10 years, both via visits to the clinic, and electronic follow-up via the ICOPE app. At recruitment they are stratified as robust, pre-frail or frail according to Fried’s criteria, and then followed for loss of Intrinsic Capacities, as defined by WHO. A parallel cohort of Swiss mice with enhanced (exercise) and decreased (high fat diet) health will be used to measure concordant parameters. The project is generating a significant biorepository that is being used to pursue research in several areas where Toulouse has a significant research strength.
Links of Autoimmune Thyroid Disorders to Alzheimer’s Disease for Medicare Beneficiaries Ages 65+
Authors: Nikitin Stanislav Kolpakov , Yashkin Arseniy , Akushevich Igor
Published: December 2021

To explore racial disparities in the interaction between Hashimoto thyroiditis (HT), Graves disease (GD), and Alzheimer’s disease (AD)we used age-adjusted rates for Medicare beneficiaries aged 65+. We investigated race/ethnicity/gender-specific trends of age-adjusted prevalence of HT and GD over 1991-2017 and used the Cox proportional hazards model with propensity score matching to explore the associations between AD and these thyroid disorders. The total age-adjusted prevalence of GD was increasing over the study period reaching a maximum of 0.35% in 2014 followed by a gradual decline. Except for relatively high prevalence rates in Native American Males, no statistically significant sex/race-related differences were identified. GD was found to be associated with an increased risk of AD onset [HR: 1.129; CI: 1.050-1.215]. The mechanism of interaction between thyroiditis and AD could follow several alternative pathways. The primary mechanism involves changes in blood vessel function, mostly arterial wall stiffness, which leads to increased pulse wave velocity and consequently to the higher amplitude of oscillation of the peripheral microcapillary system in the brain leading to cerebral leukoaraiosis and damage in kidney tissue. This, in turn, leads to kidney diseases (themselves associated with AD/ADRD), increased for HT and decreased for GD LDL cholesterol levels and an increased for HT and decreased for GD total/HDL cholesterol ratio, which has an important role in increased common carotid intima-media thickness (CIMT) in hypothyroid patients and is linked to arteriosclerosis. Additionally, both, endothelial dysfunction and arterial stiffness are risk factors for coronary or artery disease and consequently increase risks for AD/ADRD.
Preventable Hospitalizations in Adults With Alzheimer's Disease and Related Dementias: United States, 2016–2018
Authors: Olivari Benjamin , Taylor Christopher , Patel Roshni , Lamb Raza , Baumgart Matthew , McGuire Lisa
Published: December 2021

Alzheimer's disease and related dementias (ADRD) are a significant public health burden. Preventing hospitalizations in adults with ADRD is a public health priority. Data from the 2016–2018 Healthcare Cost Utilization Project National Inpatient Sample, an all-payer representative sample of US hospitalizations, were used to describe potentially preventable hospitalizations in adults ≥45 years with ADRD using International Classification of Disease, Tenth Edition, Clinical Modification (ICD-10-CM) codes. Definitions for principal or any-listed ICD-10-CM codes from the Agency for Healthcare Research and Quality defined potentially preventable hospitalizations where admissions might have been avoided by appropriate outpatient primary care management. Of discharges in adults ≥45 years with a potentially preventable hospitalization diagnosis, 11.4% (N=389,155) had a diagnosis of ADRD listed in any position. Of those discharges with ADRD, a significantly higher proportion (82.6%) with diagnosis related to potentially preventable hospitalizations were aged ≥75 years compared to 78.9% without potentially preventable hospitalizations. Additionally, of those with ADRD and potentially preventable hospitalization diagnoses, a higher proportion died in the hospital (5.7%) compared to those without potentially preventable hospitalization diagnoses (3.4%). The most common potentially preventable hospitalization diagnoses among adults with ADRD were related to sepsis (34.0%), injuries (20.8%), urinary tract infections (14.2%), and heart failure (12.7%). Measures focusing on preventing injuries as well as identifying early signs and symptoms of potentially preventable hospitalizations like urinary tract infections and sepsis in adults with ADRD could reduce the number of preventable hospitalizations in this population.
PRISM 2.0: Technical Challenges
Authors: Charness Neil , Boot Walter , Czaja Sara , Rogers Wendy , Sharit Joseph
Published: December 2021

PRISM 2.0 was designed to run on Android tablets and made use of both customized apps that relied on Google’s browser and e-mail functionality as well as commercial apps, such as Microsoft’s Skype for videoconferencing. We also made use of functionality provided by our partner AT&T, such as their sim cards to provide cell-based internet connectivity to participants who did not have access to Wi-Fi internet services to their home (cable, DSL), as well as tablet management software to deploy updates. The Miami site provided central management and tablet deployment and redeployment services and support as well as coordinating locally provided tech support at the three sites. We discuss some of the technical challenges associated with these arrangements. We focus on how changes to the operating system broke some of our apps necessitating substitution of other apps and provision of new training, and how Covid-19 affected technical support.
The Role of Optimal Dyadic Mental Health in Couples Living With Lung Cancer: Interdependence, Congruence, or Balance?
Authors: Lyons Karen , Miller Lyndsey
Published: December 2021

Optimizing dyadic health is a central goal of dyadic frameworks. Yet, research has focused on interdependent individual health or the transactional nature of health within dyads. Emerging research has explored dyadic health through the lens of congruence and balance. This longitudinal study examined dyadic mental health in 76 couples (M = 67.88 ± 11.54) during the first year of lung cancer. As expected, multilevel modeling found mental and physical health of couples were significantly associated at baseline (p < .05). Congruence in mental health was significantly associated with changes in physical health over time for survivors (p < .05) but not partners, whereas balanced mental health had differential effects on the physical health of survivors and partners (p < .01). Discussion will focus on the implications of congruent versus balanced dyadic health for the couple, evaluation of interventions, and propose ways to define optimal dyadic health.
Reaching Out to Older Adults in Rural Communities by Utilizing Community Health Workers During a Pandemic
Authors: Knecht Jenny
Published: December 2021

Older adults in rural communities have access, isolation, and technology barriers to healthcare that are exacerbated by the COVID- 19 pandemic. A shortage of healthcare professionals combined with limited resources and poor broadband access have limited their ability to benefit from telehealth. The pandemic has further worsened isolation in rural communities. This Age-Friendly Care, PA pilot study uses community health workers (CHW) as a bridge to connect isolated and underserved older adults with their healthcare team. The CHWs facilitate access to telehealth provided by a Federally Qualified Health Center (FQHC), and also provide “check-ins’ to housebound patients. The focus of the intervention is CHW delivered facilitation of telehealth and other supports to better manage their healthcare needs. We will describe the co-design of the project and discuss lessons learned in attempting to bridge the digital divide for rural older adults during and after the pandemic.
Policy Series/ESPO and Social Research, Policy, and Practice Section Symposium: It’s a Practice, Not an End State: Centering Equity in Gerontological Research and Policy
Authors: Dys Sarah , Pendergrast Claire
Published: December 2021

Social, economic, and health inequities shape the experience of aging, reflecting a landscape of unequal resources, opportunities, and stressors that accumulate over the life-course. These inequities are not accidental, but rather reflect systems of power that act through institutions, policies, and people to simultaneously privilege some groups and disadvantage others based on socially constructed categories. These systems include, but are not limited to, racism, ageism, and capitalism. The unequal and unjust distribution of resources and opportunities over the lifespan results in health, social, and economic disparities in older adulthood. For example, Black older adults are at higher risk of experiencing chronic disease burden and shorter life expectancy than white older adults due to greater economic disinvestment, interpersonal and systemic racial discrimination, and lower health services access over the life course. This symposium features three leading scholars whose work centers racial and health equity in later life. The symposium will engage with issues related to long-term services and supports infrastructure, community-engaged and culturally relevant programs and education, and research activities (e.g., recruitment, study design, grant writing, dissemination). Panelists will also discuss their research agendas and recent scholarship, career trajectories, insights, and practices. We hope symposium attendees will identify opportunities and strategies for focusing on elimination of health disparities across the life-course in their own work. We believe this symposium can serve as an opportunity for SRPP members and emerging scholars and practitioners to center equity, highlight intersectionality, and amplify our colleagues at the forefront of addressing inequity through their work.
Cross-Cultural Differences in Caregiving: Investigating the Role of Familism and Social Support
Authors: Falzarano Francesca , Moxley Jerad , Pillemer Karl , Czaja Sara
Published: December 2021

Cultural diversity in the United States (US) reflects a demographic shift, with a growing population of minority older adults and a subsequent increase in minority family caregivers providing care to aging adults. Research has demonstrated heterogeneity in the caregiving experience, with increasing focus placed on examining the impact of cultural values on caregiver (CG) outcomes. Familism has been investigated as a driving mechanism of cross-cultural differences in caregiving outcomes, yet prior work examining this relationship has yielded mixed findings. Using the sociocultural stress and coping model as a guiding framework, we examined, in a sample of 243 CGs who participated in the Caring for the Caregiver Network Study, a randomized controlled trial examining a culturally-tailored technology-based psychosocial intervention, the influence of familism and social support on positive aspects of caregiving, depressive symptoms, and caregiver burden. We also examined how these relationships vary as a function of race/ethnicity, the CG’s relationship to the care-recipient, other sociodemographic characteristics (e.g., SES status), and acculturation. Results showed that African American and Hispanic CGs exhibited higher levels of familism compared to Whites. In African Americans, familism predicted higher positive caregiving appraisals, and social support significantly predicted lower burden and depression. In Hispanics, levels of familism varied as a function of acculturation, with lower levels of familism identified among US Hispanic natives. Our findings highlight that cultural beliefs, such as familism, as well as social support may be adaptive in protecting against adverse CG outcomes and point to directions for future culturally congruent, family-centered intervention approaches.
Device-Measured Sedentary Patterns and Physical Activity Before and During the COVID-19 Pandemic
Authors: Rosenberg Dori , Greenwood-Hickman Mikael Anne , Zhou Jing , Cooper Julie , Arterburn David , Cook Andrea
Published: December 2021

Little is known about objective levels of sitting time (ST), patterns of ST, and physical activity (PA) among older adults before compared to during the COVID -19 pandemic. We used data from the Healthy Aging Resources to Thrive Trial to examine differences in activPAL-assessed ST, standing time, breaks from sitting, and steps in study enrollees prior to March 2020 (N = 97, % female = 60.8, % white = 81.4; Mean BMI = 35.2) compared to post-March 2020 (N = 47, % female = 70.2, % white = 72.3; Mean BMI = 36.1). During the pandemic, participants had higher sitting time (Mean = 11.5 vs. 10.7 hours/day), fewer breaks from sitting (Mean = 40 vs. 44 breaks/day), and fewer steps (Mean = 4441 vs. 5931 steps/day) than prior to the pandemic. Interventions may be needed to support older adults with obesity in recovering losses in time spent physically active.
Accelerometer-Measured Patterns of Sedentary Behavior in Older Women: The OPACH Study
Authors: Schumacher Benjamin , Hyde Eric , Bellettiere John , Anuskiewicz Blake , LaCroix Andrea
Published: December 2021

Excessive sedentary behavior (SB) is related to deleterious health outcomes. Understanding the patterns and contexts in which SB accumulates can promote healthy aging. Daily sitting time and mean sitting bout duration (MBD) were measured by triaxial accelerometers. Participants self-reported how much time they spent sitting while: watching TV, reading, using the computer, driving, working, or taking phone calls. Data were compared across aging-related characteristics. Age-adjusted sitting time (minutes/day) for 5,838 diverse (33.2% Black, 16.9% Hispanic), older women (mean age 78.7±6.7) were 577.2 for Hispanic women, 630.3 for Black women, and 632.0 for White women. Those in the lowest vs. highest physical function category had the longest MBD (16.1 vs. 11.7 minutes/bout). Watching television was the most common self-reported sedentary activity. The highest vs. lowest quartile of MBD spent, on average, 30.6 and 22.3 minutes/day watching television, respectively. This presentation will illuminate critical factors associated with sitting patterns in older adults.
Air Quality Improvement Is Associated With Decreasing Depressive Symptoms in Older Women
Authors: Petkus Andrew , Wang Xinhui , Younan Diana , Beavers Daniel , Espeland Mark , Millstein Joshua , Gatz Margaret , Chen Jiu-Chiuan
Published: December 2021

Air pollution exposure is an environmental risk factor in brain aging and may also be associated with late-life depressive symptoms (DS). It is unknown if air quality (AQ) improvement is associated with reductions in DS in later life. Longitudinal data from 917 cognitively intact women with no prior history of depression (baseline age 66.4 ± 1.6 years old) participating in the Women’s Health Initiative Memory Study of Younger Women (WHIMSY; 2008-2016) were analyzed to examine whether AQ improvement over the 5-years prior to WHIMSY baseline was associated with trajectories of DS (measured by 15-item Geriatric Depression Scale). Annual PM2.5 (fine particulate matter of aerodynamic diameter <2.5) and NO2 were estimated at the participants’ residence using regionalized universal kriging models. Estimates were aggregated to the 3-year average at 5 years (remote) and immediately (recent) before WHIMSY baseline. Associations between AQ improvement (difference between remote to recent exposure) and trajectories of DS were estimated using linear mixed effect models, adjusting for sociodemographic, lifestyle, and clinical covariates. AQ improved prior to baseline (PM2.5: 1.62 ± 1.45 μg/m3 and NO2: 3.70 ± 2.81 ppb). Women residing in locations with greater improvement in NO2 (per IQR = 4.34 ppb) or PM2.5 (per IQR = 2.30 μg/m3) reported significant annual reductions in DS (βNO2=3.1%, p=.046; βPM25=1.6%, p=.046), similar to the effect of engaging in moderate to vigorous physical activity four times or more a week. These findings suggest that improving air quality may reduce depressive symptoms in older women.
Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort
Authors: Atkins Janice , Masoli Jane , Delgado Joao , Pilling Luke , Kuo Chia-Ling , Kuchel George , Melzer David
Published: December 2021

Hospitalized COVID-19 patients tend to be older and frequently have hypertension, diabetes or CHD, but whether these co-morbidities are more common than in the general older population is unclear. We estimated associations between pre-existing diagnoses and hospitalized COVID-19 alone or with mortality (during the first COVID-19 outbreak, tests performed between March 16 and April 26, 2020). In 269,070 UK Biobank participants aged 65+, 507 (0.2%) became COVID-19 hospital inpatients, of which 141 (27.8%) died. Common preexisting co-morbidities in hospitalized inpatients were hypertension (59.6%), history of falls/fragility fractures (29.4%), CHD (21.5%), T2 diabetes (19. 9%) and asthma (17.6%). However, in adjusted models, pre-existing diagnoses of dementia, T2 diabetes, COPD, pneumonia, depression, atrial fibrillation and hypertension emerged as independent risk factors for COVID-19 hospitalization, the first five remaining statistically significant for related mortality. There are specific high risk pre-existing co-morbidities for COVID-19 hospitalization and deaths in community based older men and women.
Visualizing Inclusivity: Aging Lifelong and Worldwide Through the Lens of Gerontology as Social Science
Authors: Holley Lyn
Published: December 2021

A new course actively engages students in applying social science to examine their own prospective aging and the aging of others. This Grand Project begins with self-assessment of their expectations for the “Future Self” at age 67, then conducting two structured interviews each followed by writing a “life story” – one of an US older adult and the other an imagined older adult from a different county. Comparative analysis of these three stories highlights the impacts of society, heredity, and choice on shaping the experience of old age. Each project is presented to the class. Seeing life from this personal “tour” of the “other” informs beliefs about differences. Students gain knowledge about gerontology as a social science and develop personal understanding of their own and others’ aging, a good step toward becoming comfortable with diversity and inclusivity. Ageism is the only “ism” guaranteed to include all who survive long enough.
Addressing Stigma in the Community: A Rights-Based Approach to Community-Building
Authors: O'Connor Deborah
Published: December 2021

Article 12 of the United Nations Convention of Rights of Persons with Disabilities (CRPD) affirms the rights of persons with physical and mental disabilities to be treated as equal, and deserving of state support to realize their full human potential. This focus on a ‘positive’ right to support (as opposed to the ‘negative’ right to non-interference) has established an important set of expectations around societal responses to people living with dementia(PLWD). This presentation examines the contributions of a rights-based approach to build community with and for PLWD. Data is drawn from Participatory Action Research (PAR) and bi-weekly online action groups with N=10 PLWD in urban and rural British Columbia. Two thematic targets were identified. First, it is important to bring together PLWD in ways that create a sense of solidarity and inclusion. Second, fostering community requires addressing the stigma and discrimination which often leave PLWD feeling isolated, excluded, and marginalized.
The Length of Membership and Loneliness of Older Adults in Village Programs
Authors: Cao Qiuchang (Katy) , Happel Christine , White Katie , Dabelko-Schoeny Holly
Published: December 2021

Villages are consumer-driven programs supporting older adults to age in their own homes while staying socially connected through service referrals, coordination, and the organization of social activities. Although previous studies demonstrated an increase of perceived social support among Village members over time, few studies tested how Village membership influence older adults’ loneliness. To address this gap, a total of 112 members from four Village programs in a Midwest Metropolitan area completed a cross-sectional pilot survey on their social well-being between January and March 2020. The age of participants ranged from 51 to 92 years old (M=72.30, SD=8.38), over 74% of participants were female and over 88% of participants identified as White/Caucasian. The relationship between the 20-item UCLA loneliness scale and length of Village membership was roughly linear according to the Loess Curve. The scores of the UCLA scale range from 20-80 and higher scores indicate higher loneliness. The Cronbach’s alpha of the UCLA loneliness scale was 0.86 in the sample, indicating good internal consistency. The average loneliness score of the sample was 38.45, resembling the average of community-living older adults. Regression results suggested that a one-year increase in village membership was associated with approximately two points reduction in loneliness, holding all else constant. Being female, a racial/ethnic minority, retired, a driver, and having higher frequencies of socializing with friends and neighbors were associated with lower levels of loneliness among Village members. This pilot study provides initial support for the social impact of Villages and informs future larger sample longitudinal studies.
Health Disparities Scientific Research in the Division of Geriatrics and Clinical Gerontology
Authors: Joseph Lyndon
Published: December 2021

The Division of Geriatrics and Clinical Gerontology (DGCG) supports clinical and translational research on health and disease in the aged, and research on aging over the human lifespan, including its relationships to health outcomes. Key areas include development of new interventions for age-related conditions and pathologies, prevention and treatment of multiple chronic conditions, geriatric palliative care, factors influencing the progression of chronic diseases over the life span, and predictive markers of aging that may inform potential interventions for extension of health span. Population diversity and health disparities are critical aspects of science that cut across DGCG research areas. This presentation will highlight several examples of DGCG-supported studies related to health disparities and discuss potential future research directions. One potential upcoming research area of interest involves leveraging large data sets to examine disparities in risks and benefits of long-term osteoporosis drug therapy and drug holidays according to racial and ethnic groupings
Examining Social Isolation as a Mediator for the Environmental Influence on Cognitive Functioning
Authors: Yu Kexin
Published: December 2021

Environments serve as one of the most pervasive stimuli to the brain, shaping cognitive functionality through neuroplasticity. Both the physical and social environments of living could affect the cognitive functioning of older adults. Nonetheless, the mechanisms on how the environments “get under the skin” are unknown. This study examines the potential mediating effect of social isolation on the relationships between environment and cognitive health. Wave 9 data from the National Healthy Aging Trend Study was employed. The working sample includes 2,313 older adults. Path analysis results showed that in-home disorder was positively related to social isolation. A more cohesive social environment was negatively related to social isolation. Higher social isolation scores were associated with worsen global cognitive functioning. In-home disorder, community disorder, and social environment had significant direct effects on cognitive health after adjusting for the mediating effect. Social Isolation partially mediates the environmental influence on cognitive functioning.
COVID-19 Outbreaks and Control Measures Are Associated With Depression Risk Among Older Adults
Authors: Peng Man-Man , Liu Tianyin , Au Walker Siu Hong , Lum Terry Y S , Wong Gloria H Y
Published: December 2021

Local COVID-19 outbreaks and infection control measures may affect mental health in older persons. This study aims to investigate the effects of COVID-19 outbreaks and control measures on depression risk in community-dwelling older adults in Hong Kong. With rolling cross-sectional design, telephone screenings for depressive risk were conducted among 8163 older people using Patient Health Questionnaire-2 (PHQ-2) from February to September 2020. COVID-19 outbreaks across thirty weeks were measured using real-time effective reproductive number (Rt), infected new cases, and change of infected new cases by week. Infection control measures were assessed using four policy indices, including government response, government stringency, containment and health, and economic support. Linear regressions were used to test the associations of depression risk with COVID-19 outbreaks and control measures. We found that being female and higher Rt were associated with higher depression risk in the overall sample. In older adults without pre-existing mental health issues, higher depression risk were related to older age (t=-1.974, 95%CI[-0.006, 0.000], p<0.05), a higher level of government stringency (t=2.954, 95%CI[0.007, 0.033], p<0.01), and less stringent containment and health-related policy (t=-2.599, 95%CI[-0.041, -0.006], p<0.01). In older adults with pre-existing mental health issues, greater changes in newly infected cases were related to higher depression risk (t=2.813, 95%CI[0.002, 0.010], p<0.01). In conclusion, the effects of COVID-19 infection risk and control measures on depression risk differ among older Chinese by pre-existing mental health issues. Future public health communication could build on resilience to balance awareness of infection risks and mental health risks in older persons.
Validation of a Frailty Ladder Using Rasch Analysis: If the Shoe Fits
Authors: Mayo Nancy , Aubertin-Leheudre Mylène , Mate Kedar , Figueiredo Sabrina , Fiore Julio , Auais Mohammad , Scott Susan , Morais José
Published: December 2021

The current measurement approach to frailty is to classify people on frailty status, rather than measure the degree to which they are frail. Here, we test the extent to which a set of items identified within the frailty concept fits a hierarchical linear model (Rasch model) and form a true measure reflective of the frailty construct and confirm the model using the NuAge dataset. The development sample included 234 individuals (aged 57 to 97) drawn from three sources: at-risk seniors (n=141); post-colorectal surgery (n=47); and post-rehabilitation hip fracture (n=46). We defined our frailty construct based on items commonly used in frailty indices, self-report measures, and performance tests. Of the 68 items, 29 fit the Rasch Model: 19 self-report items on physical function and 10 performance tests including one for cognition. Items typically identified as reflecting the frailty concept fit the Rasch model. The Frailty Ladder would facilitate personalized intervention.
Doing Aging Research Together: Innovative Perspectives on Participatory Approaches
Authors: Wanka Anna , Urbaniak Anna
Published: December 2021

The symposium aims to take a closer look at what it means to involve older participants in ageing research - beyond the role of research subjects. By discussing projects that deploy different participatory approaches we investigate the manifold ways in which older adults can become co-creators of the research process. We do so comparing such approaches in different domains, with different outcomes and in different stages of the research process. Consequently, this symposium (1) looks at the research process through the lens of benefits and challenges resulting from involving older adults as co-creators; (2) showcases projects across different domains and different jurisdictions that applied participatory approach in ageing research to discuss benefits and challenges, and (3) advances scientific insights into participatory approaches involving older adults. After an introductory contribution outlining theories, concepts and developments of participatory approaches in ageing research, we present insights from three empirical studies in different cultural and thematic settings. In our first presentation, Anna Wanka and Anna Urbaniak open the symposium by presenting an overview of participatory approaches that involve older adults. In the first empirical presentation, Julia Nolte and Hamid Turker discuss the process of involving older adults in data analysis and therefor present data from the US. In the third presentation, Lillian Hunn highlights how the recent COVID-19 pandemic impacted patient involvement in research in Canada. Finally, Anna Urbaniak discusses the process of planning participatory research with hard to reach population among older adults in Austria, namely those who are socially excluded.
Evaluating How and Why the Environmental Context Shapes the Course of Development Across the Adult Lifespan
Authors: Staben Omar , Infurna Frank , Crimmins Eileen
Published: December 2021

There is a long-standing literature that has documented the importance of both the immediate and distal context in impacting mental and physical health across the adult lifespan. The goal of this symposium is to bring together a collection of papers that target the extent to which the immediate and distal context as measured through objective and subjective indicators relate to pertinent outcomes of mental and physical health. Staben and colleagues use an intensive longitudinal design in middle-aged adults to show that objective and subjective indicators of the neighborhood are associated with higher levels of and are protective against the impact of monthly adversity on mental health and well-being. Munoz and colleagues evaluate associations between objective and subjective early-life neighborhood contexts and whether they play a role in cognitive function at midlife. They find that poorer age-five self-report conditions were associated with lower working memory. Osuna and colleagues examine how both neighborhood and housing conditions play a role on psychological well-being. They find that housing and neighborhood safety conditions are associated with depressive symptoms over time. Piazza and colleagues examine associations between daily financial thoughts, SES, and indices of emotional and physical health. They find that individuals who reported more daily financial thoughts also reported more negative affect and physical symptoms. The discussion by Crimmins will integrate the four papers by highlighting the importance of how different forms of context can impact development in adulthood and old age, particularly in relation to health and well-being and consider future routes of inquiry.