bluuebunny/crossref_metadata_2025 huggingface dataset:
RECRUITING THE ULTRA-INVISIBLE: COMMUNITY RECOMMENDATIONS FOR FORMER DEMENTIA CAREGIVER RECRUITMENT
Authors: Baker Zachary
Published: December 2022

Bereaved dementia caregivers often refer to themselves as “Ultra-Invisible” (contrasting with caregivers’ “Invisibility”). We report on a series of open-ended discussions with the “Supporting Dementia Caregivers After Death” community advisory board (CAB) about how best to recruit bereaved dementia caregivers for research. The 12-member CAB includes current and former caregivers of PLWD due to early- and normal-onset Alzheimer’s, Lewy body, and Parkinson’s, an Alzheimer’s Association senior program manager, the Indian Health Board of Minneapolis Spiritual Health leader, the Engaging communities of Hispanics/Latinos for Aging Research Network leader, and a Federally Qualified Healthcare Center Equity Director. Strategies included: partnering with local religious institutions who may be primary source of bereavement services across cultures, multiple survey formats (e.g., recruiting Latino caregivers by phone; written surveys for Indians on rural reservations with limited phone/internet access). 3) Broadened age group considerations (e.g., one African American CAB-member’s young children contribute meaningfully to caregiving).
IRVING S. WRIGHT AWARD, VINCENT CRISTOFALO AWARD, AND TERRIE FOX WETLE AWARD PRESENTATIONS AND LECTURES
Authors: Kirkland James
Published: December 2022

The Irving S. Wright Award of Distinction Lecture will feature an address by the 2022 recipient Thomas M. Gill, MD of Yale University. The Vincent Cristofalo Rising Star Award in Aging Research lecture will feature an address by the 2022 recipient Jamie Nicole Justice, PhD, of Wake Forest University. The Terrie Fox Wetle Award lecture will feature an address by the 2022 recipient Benjamin H. Han, MD, MPH, of the University of California San Diego. These awards are given by the American Federation for Aging Research, Inc.
CONSUMERS AND PROVIDERS ON THE NEEDS OF LONG-TERM SURVIVORS AND PEOPLE AGING WITH HIV IN NEW YORK STATE
Authors: Brown Maria , Siegler Eugenia , Albarran Marz , Wikiera John , Partap Angie , Ahmed Courtney , Beard Sheriden , Heslop Thomas
Published: December 2022

Objectives

To document the practical needs, and develop quality initiatives to address those needs, of the growing population of long-term survivors (LTS) and older people with HIV (OPH) in New York State.

Methods

The HIV+ Aging/LTS/Perinatally Diagnosed Subcommittee of the NYS Quality of Care Consumer Advisory Council used community based participatory research methods to design a statewide survey based on categories identified in August 2020 virtual town halls with consumers and providers across New York. Syracuse University launched the survey, open to consumers aged 18 and over who were LTS or OPH, clinicians, and social services providers, in June 2021 using Qualtrics™. Participants chose the three most important barriers and recommendations for each category. Responses were characterized using basic descriptive statistics.

Results

Participants included 124 consumers from 26 counties, 20 clinicians, and 24 social service providers. Two thirds of participants were cisgender men (67%), 27% were African American, 80% identified as both LTS and OPH. On average, consumers were 58 years old, had been living with their HIV+ diagnosis for 27 years, and reported 4 additional conditions, most commonly depression (30%). LTS and OPH were concerned about clinical and financial needs, particularly coordination of clinical care, unmet housing needs, cultural representation in mental health services, and financial support of LTS and OPH. Implications: Community based participatory research can inform and stimulate changes in clinical care for LTS and OPH. Survey results are informing a plan for functional screening of OPH and LTS that can be performed by certified peer workers.
MODE EFFECTS ON COGNITIVE FUNCTIONING ASSESSMENTS IN THE HEALTH AND RETIREMENT STUDY
Authors: Faul Jessica , Domingue Ben , Stenhaug Ben , West Brady , Langa Kenneth , Weir David
Published: December 2022

As the population of the US ages, there is interest in assessing health conditions associated with age and longevity, such as age-related decline in cognitive functioning. As a result, there is an increased focus on measuring cognitive functioning in surveys of older populations. One challenge relates to conducting comparable measurement across survey modes (e.g., phone vs. web). Compounding this is that mode of survey administration is often not assigned randomly making inter-group comparison more difficult. This paper addresses these issues using a novel experiment embedded within the Health and Retirement Study (HRS). The HRS, a US-based cohort of people over 50, has measured cognition since its inception using both in-person and telephone modes. In 2018, a sample of approximately 3700 respondents was identified as web-eligible based on a prior report of internet access along with other selection criteria. Of these, 60% were randomly selected for the web sample with the remainder serving as controls, assigned to telephone mode for comparison purposes. We deploy techniques from item response theory (IRT) and differential item functioning (DIF) to estimate the difference in cognitive functioning between web and phone respondents in 2018 based on longitudinal cognition data collected prior to 2018. Second, we estimate the overall effect of taking the survey via the web as compared to the phone. Third, we examine item-level variation in the magnitude of the mode effect and suggest possible methods for adjustment to support longitudinal consistency. These results are important in guiding future research that utilizes web-based cognitive measures.
GUIDELINES FOR DEVELOPING EVIDENCE-BASED RISKY DRIVING COUNTERMEASURES THAT INCLUDE OLDER DRIVERS
Authors: Zakrajsek Jennifer , Molnar Lisa , Eby David , Kostyniuk Lidia , Zanier Nicole , LeBlanc David J , Sayer Tina B
Published: December 2022

Driver behavior will continue to play a critical role in driving safety for the foreseeable future. Utilizing behavior change theory appropriately presents opportunities to improve the effectiveness of risky driving countermeasures that have been under-utilized to date. Older drivers should not be excluded from consideration of risky behaviors. Forty-six drivers (33% age 65+) completed surveys, then drove for three weeks with data collection during all trips. The Theory of Planned Behavior guided a two-phased regression analysis approach: 1) behavioral intentions were predicted using attitudes about behaviors and demographics; 2) observed risky behavior was predicted using behavioral intentions, theory constructs, personality/psychosocial characteristics, demographics, and driving exposure. Results were synthesized and the emergent themes were used to formulate guidelines for developing theory-based education and communication risky driving countermeasures. Guidelines focused on four risky driving behaviors observed in a large proportion of participants (72% - 96%): holding/using a cellphone; eating/drinking; speeding; and tailgating. Twenty-six guidelines were developed across four categories: 1) relationships among risky behaviors; 2) characteristics or underlying dimensions of risky driving (e.g., time, location, emotion); 3) behavior change theory constructs; 4) audience and message factors. While older drivers self-reported low frequencies of risky behaviors, low intentions for future risky behaviors, and less favorable attitudes toward risky behaviors than younger drivers they were regularly observed engaging in risky behaviors: distracted behaviors in 79% of trips and 2.1 speeding events per trip. Risky driving countermeasures are appropriate for older drivers and the emergent guidelines will be presented with recommended variations for older drivers.
THE ROLE OF MITOCHONDRIAL-NUCLEAR INTERACTIONS IN SEX DIFFERENCES IN AGING
Authors: Austad Steven
Published: December 2022

Sex differences in longevity and the aging phenotype are rampant if not ubiquitous. They are also highly variable and content dependent. That is, although there appears to be an overall female longevity bias in many species, that pattern has many exceptions. In virtually all of the best-studied species, with humans being a notable exception, longevity sex bias is context-dependent. To try to understand sex differences in aging, it is useful to consider the impact of mitochondria, which are exclusively inherited through the female lineage. Mitochondria are endosymbiotic bacteria that have given away most of their genes to the nucleus. Therefore, mitochondrial function depends on compatibility and coordination of the mitochondrial genome with the nuclear genome. The evolutionary success of mitochondrial genomes, specifically, will depend on how effectively they interact with female nuclear genomes, male nuclear genomes being evolutionary dead-ends for them. This talk will employ this logic to examine observations of sex differences in the aging phenotype.
PATHWAYS OF CARE: THE EXPERIENCE AND COSTS OF CARING FOR FAMILY MEMBERS LIVING WITH DEMENTIA IN MEXICO
Authors: López-Ortega Mariana
Published: December 2022

Introduction

Formal health and social security institutions are not unequipped to respond to significant dementia prevalence, and currently, no publicly funded national level dementia care policies are in place. However, little is known about the economic, social and health consequences for those providing care.

Methods

This paper presents families’ health and social dementia care seeking trajectories and the structural factors that shape them. It is based on results of almost 2 years of highly inductive fieldwork, carried out before and during the ongoing COVID-19 pandemic, and includes 50 in-depth interviews with 23 unpaid family caregivers.

Results

Lack of awareness and knowledge about dementia and normalization of cognitive impairment as part of aging result in long delays in seeking care. When there is a diagnosis, health professionals concentrate on clinical aspects of illness, but seldom explain possible changes, behaviours, symptoms, or provide care strategies. For most carers, high opportunity costs are reported with high impact as they stop or change to more flexible employment, change living arrangements, in addition to the large economic impact of paying for most care inputs such as medicines or home adaptations.

Conclusions

In Mexico, these unpaid family carers struggle to navigate complicated care pathways, with little or no government or public support. Health system institutions should increase awareness and knowledge about dementia and prioritize developing and coordinating programs that provide timely diagnosis within primary care services and support strategies for people living with dementia and their carers, using person centred care.
FULL CIRCLE: MENTORING IN GERONTOLOGY AND GERIATRICS EDUCATION
Authors: Karasik Rona
Published: December 2022

More than just a buzzword in business and education, mentoring is a complex interactional process that, at its best, fosters personal and professional development for all involved. In other words, a good mentoring relationship can be both transformative and reciprocal. This raises the question of what is (and is not) a good mentoring relationship? Moreover, how does one enter into and capitalize on the benefits of mentorship? While some mentoring relationships are intentionally created, others seem to evolve so organically that participants are not immediately aware of mentoring’s presence. The current presentation looks at the nature of mentoring relationships within the context of gerontology and geriatrics education from both the mentor and mentee perspectives.
FOOD INSECURITY ACROSS THE LIFE COURSE AND COGNITIVE FUNCTION AMONG OLDER MEXICAN ADULTS
Authors: Saenz Joseph , Kessler Jamie , Nelson Ehlana
Published: December 2022

Food insecurity is a global public health problem and is related with poorer cognition among older adults. Few have examined how food insecurity, throughout life, relates with cognition among older Mexican adults. Data came from the 2015 Mexican Health and Aging Study (n=11,507, aged 50+). Early- and late-life food insecurity were self-reported. We evaluated how food insecurity related with cognition (Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency), controlling for health and sociodemographic confounders. In descriptive analyses, respondents who experienced food insecurity in early- or late-life performed worse on all cognitive tasks compared to the food secure. When adjusting for health and sociodemographic confounders, early-life food insecurity predicted worse Verbal Learning performance and late-life food insecurity related with poorer Visual Scanning. Food insecurity negatively related with cognition among older Mexican adults. The significance of effects depended on cognitive task and when in life food insecurity was experienced
DIRECT AND INDIRECT PATHWAYS FROM EDUCATION TO COGNITIVE FUNCTIONING AMONG OLDER BRAZILIANS
Authors: Farina Mateo
Published: December 2022

Cognitive impairment in Brazil is a growing population health concern. Studies suggest that Brazil may have one of the highest age-standardized prevalence of Alzheimer’s disease and related dementias (ADRD) in the world. However, improving education attainment among older adults may lead to a decline in cognitive impairment across the population in the coming years. The purpose of this study is to examine the pathways that link educational attainment to cognitive functioning in Brazil, a highly unequal, resource rich society. I use the 2016 Brazilian Longitudinal Study of Aging, a nationally representative study of Brazilian older adults 50+. I use linear regression models to predict overall cognitive functioning as well as specific domains of cognition (memory vs. non-memory). Preliminary findings provide evidence of both indirect and direct pathways from education to cognitive functioning. The indirect pathways, however, were only found for adults with 8+ years of education.
DEMENTIA CARE REIMAGINED: THE MULTIMODAL PREVENTING LOSS OF INDEPENDENCE THROUGH EXERCISE (PLIÉ) PROGRAM
Authors: Barnes Deborah , Nicosia Francesca , Allison Theresa
Published: December 2022

Over 6 million people in the United States and 50 million people worldwide are living with some form of dementia. Current pharmacotherapies for people living with dementia (PLWD) can provide some symptomatic relief but do not alter the disease course, have numerous side effects, and do not improve quality of life. Non-pharmacologic and behavioral interventions are increasingly recognized as inexpensive and effective ways to improve a wide range of outcomes for PLWD. Yet few interventions target multiple domains related to dementia quality of life. This symposium overviews the Preventing Loss of Independence through Exercise (PLIÉ) program, an evidence-based, integrative mind-body group movement program that targets key domains associated with better quality of life in PLWD: physical function, cognitive function, well-being, social connection, and self-esteem. This symposium provides an overview of the broad impact of this novel, non-pharmacologic, multimodal intervention on quality-of-life outcomes for PLWD, including expansion to include care partners and people with mild cognitive impairment and implementation in varied settings including adult day programs, nursing homes, and online delivery. It includes a participatory component for attendees to experience PLIÉ in action. Discussion focuses on the need for programs that support dementia quality of life through engagement in mind-body movement and social connection.
DEVELOPMENT AND TESTING AN INTERPROFESSIONAL PLIÉ TRAINING PROGRAM FOR VA NURSING HOME STAFF
Authors: Lee Jennifer , Nicosia Francesca , Pham Catherine , Shirsat Nikita , Miller Matthew , Chesney Margaret , Barnes Deborah
Published: December 2022

In this study, we collected formative data from key stakeholders (nursing home staff and leadership, dementia care experts), developed, pilot tested, and refined a 10-week remote training program at 2 VA nursing homes with 15 interprofessional staff (e.g., recreation therapists, social workers, registered nurses). Training components included weekly livestreaming didactic sessions for staff that demonstrated PLIÉ guiding principles and themes. Weekly experiential sessions, facilitated by the lead PLIÉ instructor, included staff and residents with dementia participating together online. All training sessions were video recorded and available for review along with a training manual. Staff completed weekly surveys, post-training focus groups, and expressed high confidence using 6 of 8 PLIÉ principles; 100% rated their overall training satisfaction as “very good” or “excellent.” The remote PLIÉ training was an efficient model for staff training that leveraged interprofessional knowledge and skills. This presentation includes an experiential demonstration of PLIÉ in action.
OPPORTUNITIES FOR MHEALTH IN DEMENTIA CARE/CARE MANAGEMENT: LESSONS LEARNED FROM OTHER CLINICAL DISCIPLINES
Authors: Belli Hayley
Published: December 2022

The use of mHealth applications in dementia care/care management has recently become of increasing interest to patient stakeholders, clinicians, and researchers working in the field. However, there exists a rich literature of successful examples of the development, implementation, and efficacy of mHealth applications across a variety of health care disciplines. Thus there is high potential to take these lessons learned from other clinical fields and apply such successes to dementia care/care management. We will walk through several examples of mHealth tools used for managing hypertension, diabetes, migraines, and weight loss, while highlighting specific opportunities for dementia care/care management. Points of discussion will include optimizing the user-centered design process during the development phase of mHealth applications, increasing patient engagement with mHealth applications – especially among underrepresented individuals in research, promoting adherence to mHealth interventions via principles from behavioral economics, and scaling up mHealth interventions to test for efficacy at a population-level.
EXPLORATORY STRUCTURAL PROCEDURES IN HEALTH SERVICES RESEARCH
Authors: Roes Martina , Resnick Barbara
Published: December 2022

When analysing data where little knowledge of relationships is available, exploratory structuring techniques, e.g., clustering and scaling techniques, are applied, using an inductive approach to construct analogies and thus suggest how to organize the data. These procedures in Health Service Research mainly focus on latent variables and are particularly used in the development of instruments or theories. Our symposium includes three presentations on research studies in which exploratory structural procedures were used for data analysis, that were considered appropriate for Health Service Research. Dr. Johannes Bergmann will present a concept mapping technique of the German Preferences for Everyday Living Inventory (PELI-D), for structuring the questionnaire from the perspective of professional nurses. This is a mixed methods participatory approach that combines interpretation and decisions by the researchers with a sequence of multivariate statistical analyses (multidimensional scaling, cluster analysis).. Jan Dreyer will present a Multiple Correspondence Analysis and Hierarchical Cluster Analysis as exploratory data reduction procedures. His aim was to identify types of home-based care arrangements for people living with dementia. To analyse the relationships between care arrangement variables, he performed Multiple Correspondence Analysis. To cluster the care arrangements, he performed Hierarchical Cluster Analysis. Anna Louisa Hoffmann will present an alternative, modified procedure of Multiple Correspondence analysis. Since Multiple Correspondence Analysis underestimates the true quality of data representation, she used Adjusted Multiple Correspondence Analysis to explore construct validity of the Dementia Policy Questionnaire (DemPol-Q). This procedure was considered appropriate to assign categorical variables to latent variables.
THE FUTURE OF PARATRANSIT: A STUDY OF PROVIDER EXPERIENCES AND HOPES FOR CHANGE
Authors: Gleason Shayna , Silverstein Nina
Published: December 2022

The present study examined paratransit managers’ perceptions of a changing transportation market, and what resources or supports they might need to adapt to evolving market expectations. As transportation network companies (e.g., Uber, Lyft) have emerged, the landscape of demand-responsive transportation has changed. However, the experiences of those closest to the operations of paratransit programs have been largely neglected in research. In-depth, semi-structured interviews were conducted with 16 managers of paratransit services. The resulting transcripts were coded iteratively using NVivo software, using both inductive and deductive approaches. We found that participants were already innovating and often wanted to be even more creative with their services, but were hampered by inadequate funding, driver shortages, regulatory or policy challenges, and other barriers. This study’s findings advance the literature toward greater understanding of how policymakers can leverage existing paratransit infrastructure to better serve the transportation needs of older adults and other transportation disadvantaged groups.
FINDING YOURSELF: PERSONALIZED MEDICINE, DATA SCIENCE, AND INTERACTIVE VISUALIZATIONS
Authors: Griswold Michael , Henegan James , Blackshear Chad , Windham Beverly Gwen , Mosley Thomas
Published: December 2022

Personalized medicine is care that is tailored to an individual patient. In contrast, randomized trials are designed to report evidence of benefits and harms “on average”. The average trial participant though, is often healthier than older patients seen in clinical practice. A variety of methods have been proposed which offer improvements to traditional (but questionable) practices of one-subgroup-at-a-time examinations of treatment effect heterogeneity, but translating evidence from these advancements has received less attention. Data Science initiatives have allowed broader data sharing, data harmonization and data synthesizing approaches, as well as an enormous maturing of interactive visualization techniques. Motivated by the SPRINT study and using advanced approaches of marginalized standardization and the Predictive Approaches to Treatment effect Heterogeneity (PATH) statement, we show how researchers, regulators, clinicians and patients can "find themselves" on the treatment effect continuum and be better informed of potential individualized evidence through interactive visualizations.
SIGNAL DETECTION AND VALIDATION IN AN ERA OF BIG GERONTOLOGICAL DATA
Authors: Bandeen-Roche Karen
Published: December 2022

Older adult health assessment long has posed measurement challenges—multidimensionality of sentinel outcomes like functioning and frailty, for example. This presentation discusses three developments creating opportunities for gerontologic biostatistics (GBS) over the past 10 years. Firstly, modeling to internally validate measurements or to quantify systematic heterogeneity in assessing older adult health has become considerably more widespread. Confirmatory latent variable modeling, harmonization, and mixture models will be addressed. Secondly, signal intensive behavioral phenotypes are proliferating, e.g. accelerometry, sleep actigraphy, and ecological momentary assessment. Functional data analysis is described as a data analytic technique to extract signal capturing main behavioral features or most relevant for health outcomes. Thirdly, “deep” characterization is under hot pursuit—whether by single- or multi-‘omics studies, or by multi-modal phenotyping as is increasingly common in the study of cognition. Techniques to accomplish this replicably are discussed. Throughout, potential pitfalls and implications for gerontologic data science development are identified.
HEALTHY PEOPLE 2030 AND HEALTHY AGING
Authors: Lin Yen
Published: December 2022

The US Department of Health and Human Services, Office of Disease Prevention and Health Promotion (ODPHP) sets science-based health promotion and disease prevention objectives for the nation with 10-year targets through the Healthy People Initiative. In addition to objectives specific to older adults, many of our population-based objectives in other condition-specific topics also contain data for older adults. Healthy People also developed the Department of Health and Human Service's Social Determinants of Health model. This presentation will highlight ODPHP's policy initiatives and campaigns specifically for older adults, including the Dietary Guidelines for Americans 2020-2025, Move Your Way © for Older Adults and provide an update on the Physical Activity Guidelines Midcourse Report on Older Adults.
SOCIAL DETERMINANTS OF HOSPITAL READMISSION FOR OLDER VETERANS
Authors: Cornell Portia , Halladay Christopher , Chmelka Gina , Celardo Caitlin , Burke Robert , Silva Jennifer , Rudolph James , Thomas Kali
Published: December 2022

The objective of this study was to estimate the effect of social risk on the likelihood of hospital readmission. Our study sample included 156,690 hospitalizations from 2016 - 2019 at one of 36 VA medical centers that participated in a national social-work staffing program. Using information from outpatient screenings, social workers’ assessments, and diagnosis codes, We identified Veterans’ social risks categorized into nine specific categories: intimate partner violence, financial need, housing instability, legal problems, social isolation, mental health, transportation, food insecurity, and functional need; and two general categories: nonspecific psychosocial and neighborhood deprivation. We estimated linear probability models of unplanned hospital readmission to a VA or a community hospital within 30 days of discharge, adjusted for demographics, clinical characteristics known to predict readmission (length of stay, primary diagnosis, admission from emergency department, chronic comorbidities, previous hospitalizations), and year and hospital fixed effects. 15.3 percent of hospital stays were followed by an unplanned readmission within 30 days. The prevalence of specific social risks ranged from 1.2% (food insecurity) to 13.9% (financial need). Social risk factors are important predictors of unplanned hospital readmission among Veterans after adjusting for medical risk. The risk categories with the strongest adjusted association with 30-day readmission were legal need, risk difference .033 (p=.015); interpersonal violence (r.d.=.022, p<.001); mental health (r.d.=.022, p=.002); social isolation (r.d.=.010, p<.001); and nonspecific psychosocial (r.d.=.017, p<.001). These social risk indicators could be used to target care-transition intervention and follow-up by a social worker to address social needs and avert unplanned hospital readmission.
HEALTHCARE-SEEKING BEHAVIORS AMONG OLDER AMERICANS WITH SUBJECTIVE COGNITIVE DECLINE
Authors: Kim Seoyoun , Yoon Hyun Woo , Jang Yuri
Published: December 2022

Subjective cognitive decline (SCD) in older adults is increasingly recognized as a harbinger of dementia. However, since SCD is, by definition, based on self-reports, it is unclear whether those who experience memory loss discuss these issues with physicians. Access to regular healthcare can be a catalyst for early detection of SCD because asymptomatic cognitive changes may not be apparent unless directly addressed with primary care physicians (PCP). Further, given the widely-known racial/ethnic disparities in healthcare access, minority adults might be further disadvantaged in healthcare seeking for SCD. Using a large national dataset, Behavioral Risk Factor Surveillance System (BRFSS) in 2019, the goals of the study are to a) examine the link between having a PCP and discussing memory issues with physicians and b) examine how race and ethnicity and the availability of PCPs are associated with discussion of SCD. The sample included 7,900 individuals 50 and older who reported SCD in the past year. We conducted a logistic regression adjusting for BRFSS survey weights, missing data, state-level clustering, and a set of covariates. Among those with SCD, those with a PCP were almost twice as likely to discuss their cognitive decline (OR=1.98, p<.001). There was also a significant interaction between Hispanic ethnicity and having a PCP (OR=0.25, p<.05, F=4.65, p=.03). Surprisingly, Hispanics with a PCP were less likely to discuss memory issues compared to Hispanics without one. The findings highlight the significance of routine healthcare service utilization for adults with SCD while providing a nuanced understanding of ethnic differences.
ADDRESSING UNMET LONG-TERM SERVICES AND SUPPORTS NEEDS FOR RACIAL/ETHNIC MINORITY OLDER ADULTS
Authors: Travers Jasmine
Published: December 2022

The COVID-19 pandemic magnified several long-standing problems with the delivery of long-term services and supports, including access to care in the community setting. A disproportionate rise in nursing home use among Black and Latino older adults reflects the inadequacy of existing programs and policies to support aging in place for these most at-risk populations. Enabling aging in the community and preventing avoidable nursing home placements is widely considered a priority by federal, state, and local entities along with families and older adults. Yet, it is unclear what is needed to support Black and Latino older adults to remain in the community. In this presentation, Dr. Travers will discuss unmet long-term services and supports needs among the Black and Latino population, issues particularly faced by these populations during COVID-19, and opportunities to move forward as we transition to an 'endemic' COVID-19 landscape.
A LOOK INSIDE THE MISSOURI NURSING HOME COVID-19 EXPERIENCE
Authors: Vogelsmeier Amy , Popejoy Lori
Published: December 2022

The COVID-19 pandemic exposed the vulnerabilities of US nursing homes to manage widespread viral outbreaks including an ill prepared/under-resourced workforce, a physical environment not conducive to infection prevention or management, and isolation from community emergency response planning. In this session, we will share real-life, real-time experiences of diverse Missouri nursing homes as they responded to the COVID-19 pandemic. We will also report on emerging data about the impact of nursing homes’ pandemic response on resident outcomes. Strategies such as community-based efforts to respond to resource scarcity, and creative workforce solutions to address staffing needs, will be shared. Critical next steps should focus on the implementation of community coalitions to create sustainable healthcare partnerships at the local and state level and enhanced workforce solutions that include registered nurses and advanced practice registered nurses working within nursing homes to guide clinical care and infection prevention and management strategies.
READY, FIRE, AIM: DOES INTEGRATING ACUTE AND LONG-TERM SERVICES WORK?
Authors: Applebaum Robert , Browdie Richard
Published: December 2022

Due to the increasing costs of Medicaid and Medicare and concerns about how these two programs fail to work together to deliver quality care, there has been a growing enthusiasm for integrated care programs. The Financial Alignment Initiatives (FAI), implemented by the Centers for Medicare and Medicaid Services (CMS) in 2011 and tested in 13 states were designed to test the impacts of a program that offers Medicare and Medicaid services under one organization to individuals who are dually eligible for both programs. Previous studies of the expansion of managed long-term services have generated considerable interest over the last two decades however, research results have been mixed. There is also limited information about the implementation of these efforts, as demonstrations have served varying target populations with very different intervention strategies. The lack of conclusive results means that states, now faced with decisions about continued implementation of these initiatives do not have good information to make sound policy decisions. The national evaluation of the FAI states did not include Medicaid costs. Our study is designed to gain a better understanding of Ohio’s FAI MyCare Demonstration. This symposium provides data from a comprehensive impact analysis that examined both Medicaid and Medicare claims data using a difference- in- differences treatment and comparison analysis (n= 390,000) and an in-depth process evaluation (using interviews with 487 participants) to gain an understanding of program effects. After reviewing results the symposium will discuss the future of these and other reform efforts to integrate Medicaid and Medicare services.
LIMITED FUTURE TIME PERSPECTIVE IS ASSOCIATED WITH LOWER EMOTIONAL WELL-BEING DURING THE COVID-19 PANDEMIC
Authors: Shavit Yochai , Barnes Jessica , Carstensen Laura
Published: December 2022

Socioemotional selectivity theory postulates that limited future time perspective (FTP) motivates older adults to prioritize emotionally meaningful goals, explaining documented age advantages in emotional well-being. During the early months of the COVID-19 pandemic, we collected data from 945 community dwelling adults and 156 assisted living facilities residents living in the United States (N= 1101, age-range: 18-98). Participants reported their FTP using the scale developed by Carstensen and Lang (1996), as well as the frequency and intensity of sixteen positive and thirteen negative emotions. Age association with limited FTP was comparable to past studies. Contrary to our hypotheses, limited FTP was associated with lower emotional well-being across ages and suppressed (rather than mediated) a general trend towards higher emotional well-being in older ages. Findings suggest that there may be conditions under which perceptions of limited time horizons have negative implications. Theoretical implications are discussed.
EXAMINING THE RELATIONSHIP BETWEEN FUTURE TIME PERSPECTIVE AND POSITIVITY EFFECTS
Authors: Barber Sarah , Kim Hyunji , Lopez Noelle
Published: December 2022

When compared to younger adults, older adults favor positive over negative information in attention and memory. This positivity effect is typically interpreted through the lens of socioemotional selectivity theory. According to this view, older adults often have a limited future time perspective (FTP), which leads them to prioritize emotional well-being goals. However, data from our lab suggest that a limited FTP is actually associated with increased negativity, rather than with increased positivity. More specifically, we found that older adults with a limited FTP (self-reported on the Carstensen and Lang FTP scale) rated their autobiographical memories more negatively. We also found that among older adults with high executive function abilities, a limited FTP was associated with reduced positivity in an episodic memory task. In discussing why these counterintuitive relationships occurred, we will also present data showing that a limited FTP is associated with negative attitudes about the future and the present.
MENTAL HEALTH AND FINANCIAL HARDSHIP AMONG OLDER ADULTS WITH PROBABLE COVID-19 INFECTION
Authors: Zaninotto Paola , Iob Eleonora , Steptoe Andrew
Published: December 2022

We investigated the immediate and longer-term impact of probable COVID-19 infection on mental health, wellbeing, and financial hardship among older people living in England. Data were analysed from 5146 older adults participating in the English Longitudinal Study of Ageing who provided data before the pandemic (2018-19) and at two COVID-19 assessments in 2020 (June-July and November-December). The associations of probable COVID-19 infection (first COVID-19 assessment) with depression, anxiety, poor quality of life (QoL), loneliness, and financial hardship at the first and second COVID-19 assessments were tested using linear/logistic regression and were adjusted for pre-pandemic outcome measures. Participants with probable infection had higher levels of depression and anxiety, poorer QoL, and greater loneliness scores compared with those without probable infection at both the first (ORdepression=1·62[95%CI:1·16,2·26];ORanxiety=1·59[95%CI:1·00,2·51]; bpoorQoL=1·34[95%CI:0·66,2·02]; bloneliness=0·49[95%CI:0·25,0·74]) and second (ORdepression =1·56[95%CI:1·17,2·09];ORanxiety=1·55[95%CI:1·02,2·37];bpoorQoL=1·38[95%CI:0·74,2·03]; bloneliness=0·31[95%CI:0·04;0·58]) assessments. Participants with probable infection also experienced greater financial difficulties than those without infection at the first assessment (OR=1·50[95%CI:1·10,2·05]).
RACIAL AND ETHNIC DISPARITIES IN COVID-19 DISRUPTIONS TO SOCIAL ACTIVITIES AMONG OLDER ADULTS IN THE UNITED STATES
Authors: Wheaton Felicia , Islam Farhana , Johnson Matilda , Kappari Sai Raj
Published: December 2022

Racial disparities in COVID-19 exposure, illness, hospitalization and mortality have been well-documented, however, less is known about potential disparities in the pandemic’s effect on social activities. Data from the early release of the 2020 Health and Retirement Study (HRS) were used to examine the relationship between race (White/African American/other) and ethnicity (Hispanic/Non-Hispanic) and COVID-19 disruptions to social activities (N=4,500). Participants were asked, “due to the coronavirus pandemic, did you experience any of these changes in activities: 1) unable to visit a family member in a care facility, nursing home or group home, 2) family celebrations canceled/restricted, 3) unable to visit a close family member in the hospital, 4) unable to attend in-person funeral or religious service for a family member or friend, 5) unable to visit family after birth of a baby (1=yes, 0=no/not relevant) and, “overall, how stressful have changes in contacts with family and friends been for you?” (1=not at all stressful, 5=extremely stressful). Results from logistic regression controlling for age and gender showed that relative to Whites, African Americans had significantly higher odds of all disruptions except for family celebrations and relative to non-Hispanics, Hispanics had significantly higher odds of three types of disruptions. OLS regression results showed that only Hispanics had higher average stress due to these changes. These findings indicate that in addition to the previously documented disparities in COVID-19, older African Americans and Hispanics experienced greater disruptions to social activities. These impacts could further influence both short and long-term physical and mental health.
FACILITATORS AND CONSTRAINTS TO SPORT ACTIVITY AMONG ADULTS WITH ARTHRITIS
Authors: Juris Jill , Son Julie , Wong Jen , Chen Guangzhou , Liechty Toni , West Stephanie , Janke Megan
Published: December 2022

This study examines types of facilitators, constraints, and constraint negotiation strategies and their associations with self-reported physical activity levels for older adults with arthritis. A national sample of U.S. adults (N=288; age range =50-85, M=64.8) who participated in a larger study of sport participation completed an online questionnaire on their involvement in leisure activities. The sample was predominantly White (91.3%), female (65.2%), and unmarried (55.6%). As expected, individuals reporting more constraints engaged in significantly less physical activity (β=-.19, p=.01) while those using greater constraint negotiation strategies reported significantly more activity engagement (β =.18, p=.03). Facilitators were examined (intrapersonal, interpersonal, and structural), but only interpersonal facilitators significantly predicted greater levels of physical activity (β =-.07, p=.03). Adults reporting sport engagement during the past year were also more active (β =.24, p<.001). The discussion will focus on the implications of findings and how barriers to activity in this population can be addressed.
THE IMPACT OF THE R3 PROGRAM ON HEALTH SERVICES UTILIZATION AND COSTS
Authors: Tavares Jane , Simpson Elizabeth , Miller Edward , Nadash Pamela , Cohen Marc
Published: December 2022

Relatively few housing with services evaluations use rigorous designs when assessing program impacts on health services utilization. This study thus employed a pre/post difference-in-difference quasi-experimental design, including building-level comparisons using Medicare fee-for-service claims data across two stages of the R3 intervention. Intervention sites included seven buildings with roughly 1,200 individuals. Key outcomes included hospital admissions, 30-day hospital readmission, and emergency department admissions. Results indicate that adding the R3 intervention to low-income housing sites led to meaningful reductions in service utilization and costs when compared to buildings where the program was not operating. The introduction of risk-targeting in the second stage of the intervention further strengthened this effect. Findings demonstrate that residents of affordable senior housing communities, who tend to be in poorer health than their counterparts in the community, benefit from the R3 program and that additional investment in this type of initiative would benefit the health care system.
WEB-ENABLED RECRUITMENT STRATEGIES FOR COMMUNITY-DWELLING OLDER ADULTS
Authors: Min Deborah , Gray Ja'Lynn , Parslow Chad , Jajodia Anushka , Yun Ji-Young , Han Hae-Ra
Published: December 2022

Older adults are vulnerable to experiencing the digital divide. Identifying effective web-enabled recruitment strategies to target older adults is an important research focus. Web-enabled recruitment strategies have become increasingly popular amidst virtual working environments due to unprecedented challenges of the COVID-19 pandemic. Yet, it is unclear which web-enabled recruitment strategies have been successful among older adults in community-based intervention trials. We describe lessons learned in using web-enabled strategies to recruit Korean American older adults with probable dementia and their caregivers in a community-based intervention trial and compare our findings with the web-enabled recruitment strategies targeting older adults reported in relevant published studies. Data sources included: study team meeting minutes, community consultant interviews, and a PubMed search. Five themes emerged: unfamiliarity with technology, differences in internet access across older age groups, providing technological support to promote recruitment, successful and unsuccessful recruitment using social media, and other diverse online methods of recruitment.
INTRODUCTION TO SOMMA: CONCEPTUAL CONSTRUCT AND PARTICIPANT CHARACTERISTICS
Authors: Cummings Steven , Cawthon Peggy , Mau Theresa , Kritchevsky Stephen , Hepple Russell T , Coen Paul , Goodpaster Bret , Newman Anne
Published: December 2022

SOMMA aims to characterize key muscle characteristics and their longitudinal association with declines in mobility. To assess mitochondrial energetics in muscle, respiration assays were performed on biopsies of the vastus lateralis and the capacity to generate ATP (ATPmax) was determined by 31P MR spectroscopy. Other properties examined in biopsies include denervation, fiber type and size, capillary density and oxidative damage. We archive ~150mg for ancillary science. In a subset, we obtained biopsies of subcutaneous adipose for measurements including cell senescence and for archiving. To assess body composition, SOMMA used whole body MR for quadriceps volume and D3 Creatine dilution for total skeletal muscle mass. We measured fitness by cardiopulmonary exercise testing. Participants also had many other assessments of physical and cognitive performance including chair stands, balance, gait speed, leg power, stair climbing, Trails B, MOCA, and patterns of physical activity by actigraphy.
MEET THE END-OF-LIFE CARE EXPERTS: INSIGHTS FROM FORMER CAREGIVERS OF OLDER ADULTS LIVING WITH SERIOUS ILLNESS
Authors: Mroz Emily , Miller Emika , Moss Karen
Published: December 2022

High-quality end-of-life care relies on the collective efforts of professional care providers and family caregivers; however, care practice development is rarely guided by experiential perspectives of former family caregivers (i.e., those whose care recipient has died). Former family caregivers typically carry rich, untapped insight into what works well, and what still does not, in end-of-life care. While current caregivers sometimes describe being over-burdened and unable to engage meaningfully in research, former caregivers express the desire to share insights and lessons learned to improve the experiences of future caregivers. Grounded in research methodologies which leverage insights from participants (e.g., qualitative analysis, community-based participatory research), this symposium draws on perspectives of former caregivers of seriously ill older adults to enhance end-of-life care practices, improve intervention designs, and enrich research agendas. First, Dr. Emily Mroz will describe the pathways by which recent caregiving experiences for parents living with dementia shape former caregivers’ perspectives on, and engagement in, their own end-of-life care planning. Next, Emika Miller will characterize the advance care planning perspectives of former family caregivers of African Americans who lived with dementia, highlighting areas for improvement in culturally-tailored interventions. Lastly, Jennifer Dickman Portz will present on caregivers’ use of patient portals near their care recipient’s end-of-life. Our discussant, Karen Moss, will lead us in conversation by outlining the unique value added to end-of-life care research when incorporating perspectives of former caregivers from diverse backgrounds. She will also describe future directions in caregiver-informed end-of-life interventions, practices, and policies to improve end-of-life care outcomes.
WE'RE ALL MAKERS NOW: ARTS AND CRAFT PARTICIPATION IN MIDLIFE
Authors: Adams-Price Carolyn
Published: December 2022

Recent research has focused on the benefits of participation in creative activities for older adults, even those who experiencing cognitive deficits. However, many people begin participating in creative activities in midlife, and continue their participation into later life. Research in my lab suggests that middle aged people turn to crafts that involve making things to reduce stress and increase feelings of productivity. Glaveanu’s sociocultural theory will be introduced to explain the benefits middle aged people get from creating crafts, and how those benefits are accrued from the beginner stage through the development of expertise.