bluuebunny/crossref_metadata_2025 huggingface dataset:
Increasing Physical Activity and Reducing Dementia Risk in Older African American Residents of Public Housing
Authors: Fausto Bernadette , Duberstein Paul , Lu Shou-En , Gluck Mark
Published: December 2020

Older African Americans—especially those with lower income and those living in urban public housing—have a greater risk of Alzheimer’s disease (AD) compared to the general population. Inadequate levels of physical activity and aerobic exercise are thought to be among the probable causes for increased AD risk. Based on our preliminary data, we hypothesize that a cluster-randomized multi-level intervention in low-income public housing, focused on heart and brain health, can produce participant-level increases in physical activity among participants enrolled in an aerobic exercise class after six months (primary outcome) that are maintained at one year, as well as housing-level changes in attitudes and beliefs about physical activity and exercise participation among housing residents, both exposed and not exposed to the participant-level intervention as well as participant-level improvements in cognition and brain health evincive of decreased risk for AD.
Using Technology to Support Self-Managing Hypertension in African Americans
Authors: Still Carolyn , Dang Phuong , Sattar Abdus
Published: December 2020

The purpose of this study was to examine the effects of a community and technology-based intervention to support self-managing hypertension in African American (AA). Sixty AA with hypertension were randomly assigned to Coachman (a technology-based intervention) or Enhanced Usual Care. COACHMAN is comprised of blood pressure (BP) monitoring with study issued monitor, six-weeks of web-based education, training to use a medication management application, and nurse counseling. Data were collected on contextual factors (demographics, perceived social support), process factors (hypertension knowledge, self-efficacy, technology use/adoption), and proximal health behaviors (medication adherence, diet, exercise) at baseline, and 8 and 12 weeks. While mean difference in BP reduction was not statistically significant, we found that half of the subjects randomized to the intervention group had an average systolic BP reduction of 13.5 mmHg that we would regard as clinically significant. Interventions that incorporate mHealth can support self-managing hypertension in AA, and improve BP.
Factors Associated With Aging Biomarkers: Findings From the National Health and Aging Trends Study
Authors: Samuel Laura , Cudjoe Thomas K M , Crimmins Eileen
Published: December 2020

Few studies have examined associations between socioeconomic, psychosocial and environmental characteristics with biological markers of aging among nationally representative older adult samples. This symposium will present results from four studies that examine the associations between 1) socioeconomic factors (i.e. financial strain and income to poverty ratio), 2) environmental characteristics (i.e. home disorder, street block disorder and community social cohesion) 3) social isolation (i.e. household size and social network),and 4) subjective well-being (i.e. positive affect, self-realization and personal mastery) as they relate to biomarkers of aging (hemoglobin A1c, IL-6, high-sensitivity CRP, and cytomegalovirus). Biomarker samples were obtained in 2017 via dried blood spots from 4,648 (88%) of the 5,265 self-responding participants of the National Health and Aging Trends Study (NHATS). NHATS is an ongoing study that conducts annual in-home interviews, which recruited a nationally representative cohort of Medicare beneficiaries aged 65+ residing in the contiguous United States in 2011 and replenished the sample in 2015. All analyses for the four studies presented in this symposium adjusted for demographic and socioeconomic characteristics and other potential confounders. Sampling weights were applied to account for study design and non-response so that inferences can be generalized to US adults aged ≥67 in 2017. Sessions of this symposium will highlight the socioeconomic, psychosocial and environmental characteristics that are associated with aging biomarkers. These results have clinical, policy and public health implications. These results can inform the development of interventions and policies aimed at improving biologic aging across the lifespan and reducing disparities in biologic aging.
Temporal Relationship Between Activity Engagement and Cognition
Authors: Jung Seojung , Siedlecki Karen
Published: December 2020

Previous studies have shown that activity engagement is related to cognitive function. However, few studies have examined the temporal order between activity engagement and various domains of cognition. Using data from the Virginia Cognitive Aging Project (baseline N =5430, Mage =51.28, SD =18.12), we examined the temporal relationships between engagement in physical and cognitive activity and different cognitive domains (reasoning, spatial visualization, episodic memory, processing speed, vocabulary) after controlling for age, education, self-rated health and depression. Cross-lagged panel analyses indicate that very few of the temporal relationships between activity level and cognition were significant except higher levels of cognitive activity significantly predicted better future processing speed, but not the reverse. Findings suggest the importance of engaging in cognitively stimulating activities, which help adults preserve processing speed over time. This study also highlights the importance of longitudinal design on various domains of cognition to help develop domain-specific interventions.
Ageism Across Cultures and Interest in Geropsychology Among International Students
Authors: Strong Jessica , Graham Kirsten
Published: December 2020

Ageist attitudes are concerning when considering who will enter the geriatric workforce. The impact of ageism on intent to work with older adults (OAs) between North American and non-North American individuals is unclear. We collected data from N=186 students (n=153 N. American, n=33 non-N. American), examining ageist attitudes and intent to work with OAs. We found significant differences between groups in ageist attitudes; North American students had more positive views of aging (M=88.64, SE=0.72) than non-North American students (M=85.33, SE = 1.42; t (167) = 2.04, p = 0.04, d=0.39), but there were no differences between groups for intent to work with OAs (t (174) = 0.09, p = 0.93). Ageist attitudes predicted intent to work with OAs for North American students only (F (2, 112) = 8.82, p < 0.001, R2 = 0.14). We discuss implications of ageism and intent to work with OAs from a cross-cultural lens.
Capacity Assessment Training and Competency Evaluation Tool
Authors: Jacobs Lindsey , Bamonti Patricia , Strong Jessica , Page Kyle , Edelstein Barry , Allen Rebecca , Bush Shane
Published: December 2020

Given the complex interplay of ethical, clinical, and legal factors, evaluating capacities in older adults is an important competency for geropsychologists. However, the amount of quality of training in this area varies, and geropsychology trainees report less confidence in their capacity evaluation skills. To date, only the Pikes Peak Self-Assessment Tool includes items measuring competency and growth in decisional capacity evaluations. However, it is a broad self-report measure assessing general geropsychology competencies. We developed a performance-based measure of decision-making capacity evaluations, the “Capacity Assessment Training and Competency Evaluation Tool (CATCET).” Using the ABA/APA Assessment of Older Adults with Diminished Capacity as a guide, expert panels created two clinical cases across 5 capacity domains. This presentation will discuss the creation of the CATCET, its application as a training and evaluation tool, and initial performance data among psychology graduate students, intern, and fellows across settings.
Life-Course Transitions to Precarious Housing in Older Age
Authors: Barrie Helen , Faulkner Debbie , Lester Laurence
Published: December 2020

Home is central to health and wellbeing; yet the changing nature of work, household dynamics and especially housing markets, with scant policy attention and action around this, means low-middle income households are struggling in many countries. In Australia, while older people are considered to be at less risk because of higher levels of home ownership, there is a growing body of evidence about the living situations of older people who have not attained or retained home ownership over the life course and have limited wealth and savings moving into later life. This paper presents the findings of multivariate regression modelling using HILDA, a national longitudinal panel survey, to identify the profile(s) of older people at risk of homelessness in Australia. The data makes it clear a range of structural and individual factors across the life course are increasingly impacting on the ability to live a good life in older age.
Positive Age Beliefs Lead to Lower Dementia Risk Even Among Older Persons With High-Risk Gene
Authors: Levy Becca , Slade Martin , Pietrzak Robert , Ferrucci Luigi
Published: December 2020

One of the strongest risk factors for dementia is the ε4 variant of the APOE gene. Yet, many who carry it never develop dementia. The current study examined whether positive age beliefs that are acquired from the culture may reduce the risk of developing dementia among older individuals, including those who are APOE ε4 carriers. The cohort consisted of 4,765 Health and Retirement Study participants who were aged 60 or older and dementia-free at baseline. As predicted, in the total sample those with positive age beliefs at baseline were significantly less likely to develop dementia, after adjusting for relevant covariates. Among those with APOE ε4, those with positive age beliefs were 49.8% less likely to develop dementia than those with negative age beliefs. The results of this study suggest that positive age beliefs, which are modifiable and have been found to reduce stress, can act as a protective factor, even for older individuals at high risk of dementia.
Higher Awareness of Positive and Negative Age-Related Changes Relate to Lower Objective Cognitive Scores
Authors: Sabatini Serena , Ukoumunne Obioha , Ballard Clive , Anstey Kaarin , Diehl Manfred , Brothers Allyson , Wahl Hans-Werner , Clare Linda
Published: December 2020

Existing evidence suggests that individuals’ subjective experience of cognitive decline may be a risk state for dementia. However, whether self-awareness of positive changes confer cognitive protection is unknown. We examined the extent to which awareness of positive (AARC gains) and negative (AARC losses) age-related changes explains variability in objective cognitive performance in a sample of 6,231 UK residents (Mean age= 66.1 years, 75.9% women) without cognitive impairment. We tested a structural equation model with AARC gains and losses as predictors of cognitive performance and depressive symptoms as a mediator of the association of AARC losses with cognitive performance. The model fit the data well. The correlation between AARC gains and losses was negligible, yet higher levels of both AARC gains and losses predicted poorer cognitive scores. Hence, higher AARC gains did not confer cognitive protection. This unexpected pattern of results underscores the complexity of mapping individuals’ awareness onto objective outcomes.
The Role of Daily Social Interactions in Detecting Mild Cognitive Impairment
Authors: Zhaoyang Ruixue , Scott Stacey , Cerino Eric , Sliwinski Martin
Published: December 2020

Social relationships play an important role in cognitive health and aging. However, it is unclear how older adult’s cognitive function affects their everyday social interactions, especially for those with mild cognitive impairment (MCI). This study examined whether older adults with intact cognition vs. MCI differed in their daily social interactions. Community-dwelling older adults from the Einstein Aging Study (N=244, 70-91 yrs) reported their social interactions five times daily for 14 consecutive days using smartphones. Compared to those with normal cognitive function, older adults with MCI reported less frequent positive social interactions (p=0.012) and in-person social activities (p=0.006) on a daily basis. These two groups, however, did not show significant differences in their social relationships assessed by a conventional global questionnaire. The results support that, relative to global social relationships, daily social interactions are more sensitive, ecologically valid social markers that can facilitate the early detection of MCI.
Digital Home Assistant Health Applications for Older Adults With Long-Term Mobility Disabilities
Authors: Kadylak Travis , Khaleghi Roshanak , Blocker Kenneth , Gowrishankar Saahithya , Ramadhani Widya , Koon Lyndsie , Sreenivas Ramavarapu , Rogers Wendy
Published: December 2020

The aim of the current study was to evaluate the feasibility, usability, safety, and efficacy of digital home assistant health applications (e.g., meditation applications, medication reminders, hydration management) for older adults with mobility disabilities. We used a multi-pronged approach. First, we compiled, categorized, and assessed a list of commercially available health applications compatible with Amazon Alexa devices. We reviewed data from the National Health and Aging Trends Study and the ACCESS study to identify challenges that older adults with mobility disabilities face within the home. We also reviewed the literature on the acceptance and use of digital home assistant health applications by older adults. Lastly, we conducted user testing in a laboratory and in a home-simulation environment to assess usability of different health applications. Our results provide guidance for the implementation of digital home assistant health applications to support older adults with long-term mobility disabilities.
Adults With Neurocognitive Disorders Who Reside Alone: Exploration of Nontraditional and Absent Support Systems
Authors: Girling Laura , de Medeiros Kate
Published: December 2020

Research steadily demonstrates that family functions as the central component in the provision of care for persons with neurocognitive disorders. While it is clear family plays a critical role in the lives of adults with neurocognitive disorders, overlooked is the subpopulation who reside alone, but have no identifiable family to provide care. To address this gap, data were drawn from an interview-based NIA-funded study that focused on community-dwelling live-alone persons with dementia. Subanalyses were conducted on the interviews and field notes of live-alone adults with neurocognitive disorders who had no identifiable family (N=19) and their collaterals (e.g., neighbor, N=20). Using data-derived coding in ATLAS.ti., several themes emerged including transient informal care, consequential peripheral ties, and strained/traumatic nuclear relations. Themes will be discussed in detail. The present study expands the limited information on community-dwelling persons with dementia, providing a lens for understanding the complex intersection of aging and non-traditional/absent support networks.
Precarious Work, Marital Quality, and Divorce: A Gendered Dyadic Analysis of Aging Couples
Authors: Donnelly Rachel
Published: December 2020

Precarious work – work that is unstable and insecure – is often stressful and may contribute to marital strain and dissolution among midlife adults. However, prior research has not considered how precarious work spills over to spouses. Using longitudinal dyadic data of midlife couples from the Health and Retirement Study, I examine whether having a spouse in precarious work is associated with marital strain and dissolution, with attention to differences by gender. I find that indicators of precarious work (job insecurity, schedule variability) are associated with a heightened risk of marital strain and divorce in midlife. These patterns depend on the gender of the spouse experiencing precarious work. Understanding the implications of precarious work for marriage is important because poor marital quality and divorce hasten health declines at older ages. Thus, this study suggests that precarious work may be a risk factor for divorce and poor health among aging adults.
Memories of Lost Loved Ones
Authors: Mroz Emily , Bluck Susan , Carr Deborah
Published: December 2020

The death of a loved one is a challenging but also normative occurrence in later life (e.g., Thomson et al, 2018). Experiencing the death of others typically increases with age, so personal reaction to loss becomes an ongoing process (Harrop et al., 2016). When adults lose someone, the deceased person is often ‘gone but not forgotten.’ That is, they are remembered over time (Klass & Steffen, 2017). The way one remembers their lost loved one’s life and their death (e.g., Mroz et al., 2019) may influence post-loss emotional adjustment and personal views. This symposium brings together Psychology and Sociology researchers with data from Germany, the US, and China whose work elucidates the complex relation between loss and memory: we identify how remembering lost loved ones relates to both adaptive and difficult outcomes. In this symposium, Wolf et al. examine beneficial and harmful ways of using autobiographical memories after a personal loss. Mroz and Bluck identify how grief responses in older adult widows lead to functional use of memories from the very end of the spouse’s life. Fu and Idler focus on the directive function of autobiographical memory, examining how memory for end-of-life experience with loved ones influences current choices for aggressive end-of-life care. Bolkan and Weaver examine how early life experiences with loss influence later personal views and advance care planning. Our Discussant, Debby Carr, integrates these talks to elucidate how remembering loss experiences relate to not only current grief, but also to people’s preparations for the future.
Diverse Needs of Grandparents Raising Grandchildren: Qualitative Research in Malawi, South Korea, and the United States
Authors: Lee Youjung
Published: December 2020

Despite custodial grandparents’ significant contributions to their grandchildren’s healthy development, unique needs of older adults often remain unmet with a limited cultural understanding of intergenerational caregiving. Using a phenomenological approach, interviews and focus groups were conducted with 75 custodial grandparents in Malawi (n=29), South Korea (n=23), and the U.S. (n=23). Malawian grandparents presented financial and physical hardships; however, they experienced strong support from community. Korean grandparents reported similar needs as Malawian grandparents while additionally experiencing cultural biases toward grandparent-headed families (maternal grandparenting and adult child’s divorce). The U.S. grandparents disclosed increased needs for social support as well as family trauma with intergenerational impacts. The increase in custodial grandparent population across the world and findings from this comparative transnational research highlight the need for development of a model for culturally responsive practice with grandparent-headed families in a global context. Part of a symposium sponsored by the Grandparents as Caregivers Interest Group.
How the Lifestyle Leaders View and Manage Medications
Authors: Patskanick Taylor , Miller Julie
Published: December 2020

Medication management is an ongoing consideration for adults ages 85 and older, their caregivers, and healthcare providers. When asked about their attitudes and behaviors regarding medication management, over 73% of the Lifestyle Leaders reported taking 3+ prescription medications daily and managing their own medication regimes. 61.9% of participants had taken over-the-counter, non-prescription medication for pain over the past five years. When asked why some participants didn’t currently take prescription medications to manage pain, the most frequently-reported responses were: “I don’t feel that my pain warrants a prescription medication,” (19%, n=8), “I don’t want to deal with the side effects,” and “I don’t trust drug companies,” (9.5%, n=4, respectively). The Lifestyle Leaders reported they would be most likely to go to the internet (over their local pharmacist) to ask for advice about their medication(s). Meanwhile, 39% of Lifestyle Leaders would trust a robot to manage their medication(s) for them.
An Exploratory Study of Civic Engagement and Participation Among a Panel of Adults Ages 85+
Authors: Rudnik John , Patskanick Taylor , Miller Julie , D’Ambrosio Lisa , Coughlin Joseph
Published: December 2020

The past twenty years have seen a surge in public attention devoted to increasing civic participation opportunities for older adults in the United States. At the same time, technology has transformed the way that information related to political and social issues is shared. A relatively small body of research has explored how older adults use technology-mediated platforms for political participation. In this study, the 85+ Lifestyle Leaders were surveyed to understand their experiences of civic engagement and participation. Responses to a questionnaire (N = 24) and focus groups (N = 22) indicate that participants are interested in and feel knowledgeable about social and political issues, but some forms of participation have decreased. Findings also suggest that there are opportunities for technology to facilitate engagement with and participation in social and political issues, for adults ages 85 and over. Issues of equity and accessibility will be highlighted in this presentation.
Rural Aging: Multidisciplinary, Multinational Innovations That Support New Approaches to Address Unmet Needs
Authors: O’Sullivan Roger , Holley Lyn , Bond Megan
Published: December 2020

The meaning of aging in rural areas is not well explored in the literature. To address this gap each presenter in this multidisciplinary and international group of researchers will address different components of rural ageing. An exact definition of “rural” is essential to forming, implementing or evaluating policies and programs impacting rural populations; however there is no universal definition. Cohen introduces definitional issues, and underscores the heterogeneity and regional variability of “rurality” and how such factors drive rural-urban disparities. Pendergrast, an early career researcher, reports results of in-depth semi-structured interviews that examined institutional influences of social networks on health of rural older adults, with specific focus on support services. Leavey describes lessons learned from the activities of PLACE-EE, a transnational partnership of public health agencies, local authorities, academics and ICT experts dedicated to improving the quality of life for older people. He describes the impacts on relationships of a program of community engagement and intergenerational exchange between younger and older citizens that used an assets-based approach. Żurek explores the potential for reward structures that can be embedded in ‘social games’ to motivate older adults to exercise in the context of research conducted in the rural US (Appalachia) and urban Poland (Krakow), and suggests a new direction that can inform services intended to improve health and happiness of rural adults. Our discussant will reflect on the major themes that emerge from these multidisciplinary perspectives, especially the potential for intersection of rural community-based innovations and learning from different regions of the world. Rural Aging Interest Group Sponsored Symposium.
Exploring How Hearing, Vision, and Cognition Affect Older Adults’ Driving Exposure Patterns
Authors: Vivoda Jonathon , Molnar Lisa , Eby David , Zakrajsek Jennifer , Zanier Nicole , DiGuiseppi Carolyn , Li Guohua , Strogatz David
Published: December 2020

Better information is needed about how declines in sensory and cognitive function affect older drivers. This study assessed how hearing loss affects engagement in four challenging driving patterns. Data from the AAA Longitudinal Research on Aging Drivers study was used, including objectively-measured driving; three measures of hearing: reported hearing aid use, self-rated hearing, and the Whisper Test; visual acuity (Tumbling E); and cognition (Trail Making B). Failing the Whisper Test in both ears was related to significantly lower percentage of trips (%trips) at night, on freeways, and during rush hour, but a higher %trips >15 miles. Hearing aid use and self-rated hearing were not associated with any driving differences. Worse vision was related to a lower %trips >15 miles, while worse cognition was associated with a lower %trips at night, on freeways, and during rush hour. The Whisper Test interacted with cognition for rush hour trips.
Evidence-Based Approaches to Suicide in Older Adults—Collaborative Care
Authors: Schoenbaum Michael
Published: December 2020

This individual symposium abstract will focus another evidence-based approach to mental health treatment and in older adults, the collaborative care model. Collaborative care is a consultation-based approach in primary care that has been described with multiple clinical trials, with significant benefit for access and treatment. The Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) using the collaborative care model found that those older adults receiving the intervention had a higher utilization of mental health treatment (psychotherapy and/or antidepressant treatment) and had a 2.2 times greater decline in suicidal ideation over 24 months. The authors will describe the utility of using the collaborative care model on the identification of suicidal ideation and subsequent mental health treatment for older adults. The authors will also share about challenges and successes related to collaborative care implementation in healthcare settings for older adults, and relevant policy and financing components for the model.
Adapting the SHARE Program for Use With Families Facing the Challenges of Chronic Illness
Authors: Orsulic-Jeras Silvia , Whitlatch Carol
Published: December 2020

Advances in diagnostic procedures have helped to make diagnosing Alzheimer’s disease and other dementias more accurate and to occur earlier in the disease progression. For persons living with dementia and their family care partners, finding programs that meet their needs for support post diagnosis can be challenging. Likewise, for persons with chronic conditions, few programs exist which help care dyads to create a manageable plan of care that addresses each person’s concerns and fears. SHARE, (Support, Health, Activities, Resources, and Education), originally designed for dementia care partners, has shown positive outcomes for both members of the care partnership. This presentation describes the development of the six-session SHARE intervention, its implementation in community settings, and its current standing as an evidence-based program and product that has been commercialized. Discussion will also focus on adapting SHARE for use with chronic illness families, highlighting revisions to program procedures, materials, recruitment, and evaluation.
A Training Program for Professionals to Encourage Independence of Home-Living Older Adults: A Process Evaluation
Authors: Rooijackers Teuni , Zijlstra G A , van Rossum Erik , Vogel Ruth G , Veenstra Marja , Kempen Gertrudis I J , Metzelthin Silke
Published: December 2020

Stay Active at Home (SAaH) was developed to change homecare professionals’ behavior towards encouraging older adults’ independence in daily activities. This mixed-methods study evaluated SAaH regarding implementation, mechanisms of impact, and context. SAaH was implemented in five Dutch homecare teams (162 professionals). Quantitative data were collected from all professionals, and five focus groups with 23 professionals and 4 interventionists were performed. Data were analyzed using descriptive statistics and qualitative content analysis. SAaH was feasible to implement. Professionals visited on average 73% of the programme meetings. They reported positive changes in their knowledge, attitude, and skills, and perceived social and organizational support regarding the new way of working. The extent to which professionals applied SAaH in practice varied. SAaH was easier to apply among new clients. Perceived barriers were time pressure and staff shortages, and people’s resistance to change. Tailoring the intervention to professionals’ needs and wishes could improve their compliance. Part of a symposium sponsored by Nursing Care of Older Adults Interest Group.
Assisted Living Administrators’ Approaches to Advance Care Planning
Authors: Abken Elise , Bender Alexis , Vandenberg Ann , Kemp Candace , Perkins Molly
Published: December 2020

Assisted living (AL) communities are increasingly home to frail, chronically ill older adults who remain until death. State laws mandate that AL facilities request copies of any advance care planning documents residents have and make forms available upon request. Using secondary data from a larger study funded by the National Institute on Aging (R01AG047408) that focuses on end-of-life (EOL) care in AL, this project investigated barriers and facilitators to conducting advance care planning in AL. Data included in-depth interviews (of 86 minute average length) with 20 administrators from 7 facilities around the Atlanta metropolitan area and aggregate data collected from each facility regarding facility, staff, and resident characteristics. Findings from thematic analysis of qualitative data showed that key barriers to planning in AL included lack of staff training and reluctance among administrators and families to discuss advance care planning and EOL care. Important facilitators included periodic follow-up discussions of residents’ wishes, often during care plan meetings, educating families about the importance of planning, and external support for staff training and family education from agencies such as hospice and home health. Three study facilities exceeded state requirements to request and store documents by systematically encouraging residents to complete documentation. These facilities, whose administrators discuss advance care planning and residents’ EOL wishes with residents and families during regular care plan meetings, were more likely to have planning documents on file, demonstrating the potential of long-term care communities, such as AL, to successfully promote advance care planning among residents and their family members.
Health Personality and Well-Being: An Overview
Authors: Martin Peter , Kim Joseph , Arieli Rotem , Cone Nicholas
Published: December 2020

It is well established that there are interindividual differences in many areas of well-being. Based on previous segmentation research and work connecting personality traits to health outcomes, we developed the health personality segmentation model. The health personality segmentation model takes a person-centered approach to provide optimal health care based on segmenting individuals through health personality factors. The presentation provides an overview of health personality, defined as a set of individual dispositions that are directly related to health. We introduce the Health Personality Assessment based on our health personality segmentation model, and we link health personality with resilience, activation, as well as with physical and emotional well-being. Future research should evaluate the usefulness of this assessment in applied healthcare settings.
Examining Associations Between Legal Frameworks for Medical Planning and Intensity of End-of-Life Care
Authors: Berkowitz Melissa , Hoffman Allison , Sacco Anthony , Coe Norma
Published: December 2020

This study aims to understand the correlation between the legal framework around planning for medical treatment and the intensity of care received at the end of life. Advance directives (AD) allow an individual to legally document their wishes for medical treatment and end-of-life care, and durable powers of attorney (DPOA) allow them to identify an individual to make medical decisions on their behalf in the event they are no longer able. These laws vary greatly across time, place, and in their complexity. We estimated fixed effects model, which controls for time-invariant and state-specific factors affecting end-of-life care. Our primary outcome variable is the number of inpatient hospital days during the last six months of life, sourced from the Dartmouth Atlas Project. Our explanatory variables are hand-collected state-level legal statutes including whether the state (a) has default surrogate laws, (b) recognizes the ability to create a DPOA and/or AD, (c) permits oral directives, (d) authorizes a combined AD/DPOA, and (e) provides an official registry for ADs. Preliminary findings show recognizing DPOA and AD are negatively correlated with our outcome variable (-2.6 days; Std err 0.272) as are having default surrogate laws (-0.36 days; std err 0.157). However, allowing oral directives had an opposite effect (-.46 days; std err 0.157). Neither authorized combined AD/DPOAs nor AD registries resulted with significant correlations. These findings indicate that the existence of a basic framework such as default surrogate laws and a law governing ADs are key policy features correlated with reduced intensity in end-of-life care.
Risk Aversion Among Male Older Adults: Does Veteran Status Matter?
Authors: Cheng Kent Jason , Landes Scott , Wilmoth Janet
Published: December 2020

Risk aversion determines how people make decisions and is known to predict a wide array of economic outcomes. This study assessed whether there are veteran status differences in risk aversion utilizing the Health and Retirement Study. Risk aversion is based on hypothetical financial gambles (N=2,121; 2006 wave) and self-reported risk attitudes on selected topics (N= 4,980; pooled 2014 and 2016 waves of the Leave-Behind Survey). Results from multivariate analyses reveal that veterans were more likely to be risk averse than nonveterans in financial matters, occupation, and health, but veteran status is not statistically significant in explaining risk taking in driving and leisure, and sport risk. Further research is needed to discern the role of military service-related experiences in determining levels of risk aversion among veterans and the extent to which risk aversion accounts for veteran status differences in later-life economic outcomes. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.
Empathy and Coping: Older Adults’ Social Encounters and Mood Throughout the Day
Authors: Huo Meng , Ng Yee To , Birditt Kira , Fingerman Karen
Published: December 2020

Scholars have proposed empathy as a key characteristic of strong social ties, but little is known about the role empathy plays when tensions occur in these ties. We examined whether older adults’ empathy was associated with their (a) coping strategies for interpersonal tensions, and (b) momentary mood when tensions occurred throughout the day. Data were from the Daily Experiences and Well-being Study. Older adults (n = 302) rated empathy, reported avoidant, constructive, and destructive coping strategies, and indicated tensions and mood every 3 hours each day over 5 to 6 days. More empathic older adults used constructive strategies more often and destructive strategies less often than less empathic older adults. Interpersonal tensions were associated with reduced positive mood throughout the day, but this link was attenuated by older adults’ empathy. This study advances our understanding of empathy and social experiences in later life with a focus on the negative moments.
Why Are Inequalities in Disability-Free Life Expectancy by Socioeconomic Position Widening?
Authors: Jagger Carol
Published: December 2020

Life expectancy has increased over previous decades, but several countries are seeing widening inequalities in disability-free life expectancy (DFLE) by socioeconomic position (SEP). In this symposium we address three unanswered questions.1. Do DFLE trends differ for SEP groups, and which of the underlying transitions (incidence, recovery, death when disability-free, death when already disabled) explains the differences?2. Do DFLE trends by SEP depend on when in the life-course SEP is measured (early life - education, mid-life - occupational status or late-life - material disadvantage)?3. How much does multi-morbidity contribute to differing trends in DFLE by SEP, since multi-morbidity is more prevalent in low SEP groups? To answer these questions, we use unique longitudinal studies of older people across different generations in two countries: the UK (Cognitive Function and Ageing Studies – CFAS I and II) and Australia (Household, Income and Labour Dynamics in Australia – HILDA). The first presentation sets the scene with findings from a systematic review of worldwide trends in life and healthy life expectancy by SEP. Presentations two and three examine the first question using DFLE at age65 by SEP defined by late-life disadvantage in CFAS (1991-2011), followed by HILDA (2001-2017). The fourth presentation investigates the effect of different life-course measures of SEP using HILDA. The final presentation from CFAS examines the third question. This symposium increases our understanding of how and why inequalities in DFLE by SEP are changing with the goal of achieving healthy ageing for all.
Building the Science: Current Studies on the Impact of Arts Engagement on the Health of Older Adults
Authors: Bernard Marie , Iyengar Sunil
Published: December 2020

Nearly a decade ago, a federal interagency task force on the arts and human development was launched as the result of a research summit held by the National Endowment for the Arts and the U.S. Department of Health and Human Services to investigate the arts’ relationships to health and well-being across the lifespan. Soon afterward, the National Institute on Aging partnered with the Arts Endowment and the National Academy of Sciences to identify research recommendations to benefit healthy aging and the treatment of neurodegenerative diseases in older-adult populations. While this session will revisit some of those findings, it also will share more recent advances in biomedical and behavioral research being conducted by a growing network of “Sound Health” researchers at the nexus of neuroscience, music, and health==with direct implications for the future of research on the arts and aging.
The Science of Ageism: Two Steps Forward, One Step Back
Authors: Lee Jerin , Shook Natalie
Published: December 2020

The past two decades have been marked by a rapidly aging population in the U.S. (U.S. Census Bureau, 2018), making prejudicial attitudes toward older adults (i.e., ageism) and the impact of such attitudes more relevant. As such, ageism researchers have worked tirelessly to not only understand this normalized and insidious form of bias, but also develop efforts to combat it. This symposium will feature four ageism researchers who will showcase both the growing pains and novel contributions of ageism research, ranging from the impact of ageism on psychological health to ageism interventions to issues related to the measurement of ageism. Specifically, Dr. Ayalon will present findings regarding difficulties with the assessment of exposure to ageism and the consequences of ageism for psychological well-being. Dr. Horhota will share research demonstrating challenges associated with confronting ageism. Dr. Levy will present a model showcasing factors associated with the reduction of ageism. Ms. Lee will discuss research findings examining the construct validity of several ageism measures. These talks highlight theoretical and real-world implications associated with the complex nature of ageism, providing important directions for enriching ageism research going forward.
What Is Ageism? Do Our Measures Tell Us?
Authors: Lee Jerin , Wilson Jenna , Ebert Alexandria , Shook Natalie
Published: December 2020

Ageism has been operationalized in a number of ways over the past half century, and several measures of ageism have been developed to reflect these conceptualizations. This presentation evaluates the extent to which existing ageism measures capture similar or different aspects of ageism. We examined the construct validity of several ageism measures in a sample of 473 undergraduate students (Mage = 19.5 years). Participants completed an online survey of ageism measures, as well as measures of convergent (e.g., aging semantic differentials, attitudes toward various age groups) and discriminant validity (e.g., social dominance orientation, attitudes toward other social groups, sexism). Ageism measures were generally positively associated with one another, though correlations were mostly weak to moderate in magnitude. There was also weak evidence of convergent and discriminant validity. These findings demonstrate conceptual problems with current ageism measures as they do not appear to reflect a common construct.
Challenges Associated With the Assessment of Exposure to Ageism
Authors: Ayalon Liat
Published: December 2020

Ageism is defined as stereotypes, prejudice and discrimination towards people of any age. Ageism can be both positive and negative. In order for an individual to report exposure to ageism, several steps should occur: the individual has to notice the events, interpret them as ageist and report exposure to ageism. Any of these steps may go awry along the way. This presentation uses data from the European Social Survey and the Health and Retirement Study to illustrate the importance of item placement, item phrasing and respondent’s mood in responding to items concerning perceived exposure to ageism. A strong priming effect demonstrated a gap between reports of perceived exposure within the ageism module (33.7%) vs. reports within the neutral context (1.1%). A cross-lagged analyses revealed that one’s depressive symptoms are predictive of perceived exposure to ageism and not the other way around. Findings illustrate the importance of the context effect.
Diversity Matters for Health: Activity Diversity, Emodiversity, Stressor Diversity, and Happyversity
Authors: Lee Soomi , Urban-Wojcik Emily , Almeida David
Published: December 2020

Aging theories suggest that diversity of experiences relates to social integration, cognitive reserve, and more psychological resources, all of which are important for successful aging. However, age-related declines may contribute to a monotonous daily life. Emerging studies suggest that activity diversity and positive emotional diversity are associated with better health; yet, we still know little about how a variety of diverse lifestyle indicators are associated with health in adulthood. This symposium showcases contemporary endeavors towards understanding how multiple diversity indicators of adult lifestyle relate to health. Paper 1 examines activity diversity (breadth and evenness of daily activity participation) and tests its associations with overall and nightly sleep health. Paper 2 investigates the relationship between activity diversity and hippocampus volume. Paper 3 examines whether there are age-related differences in the extent to which positive emodiversity attenuates the association between stress and depressive symptoms. Paper 4 examines stressor diversity and how it is associated with blood pressure across age and SES. Paper 5 introduces a novel concept of happyversity (diversity in life satisfaction across different domains) and tests its association with terminal decline. These papers use different project datasets that include different populations of middle-aged and older adults, such as the Midlife in the United States Study, Intraindividual Study of Affect, Health and Interpersonal Behavior, Study of Health and Interactions in the Natural Environment, and German Socioeconomic Panel Study. At the end of these presentations, Dr. Almeida will discuss their theoretical and methodological contributions, and consider challenges and opportunities for future research.
Characteristics of the True Believer in Later Life
Authors: Jones Shannon , Prusak Austin , Wigton Rennae , Futterman Andrew
Published: December 2020

This study describes the nature, causes, and outcomes of steadfast, unquestioned “true” belief in later life (Hoffer, 1950). According to some theorists, such “true” belief develops from more childish, extrinsically-motivated, compartmentalized beliefs and behaviors to become more mature, intrinsically-motivated, comprehensive and integrated beliefs and behaviors (e.g., Allport, 1950). Research, however, is equivocal regarding the validity of this position. From “grounded-theory” analysis of a sample of 278 semi-structured interviews of older adults from six New England states and New York (aged 55-101 years-old.), we demonstrate the need for a more nuanced definition of a “true” belief as a form of religiousness without commitment to rigid orthodoxy. For example, a sizable segment of this sample changed religious denominations over the course of their lives without ever doubting the presence of a diety (i.e., a God, a Higher Power, etc.), but who dramatically changed the way they expressed this belief. This prompts a reconceptualization of “true” belief by Hoffer and a more nuanced understanding of religious development than implied by Allport, one that more adequately accounts for individual differences in life experiences, personality, religious upbringing, and religious cultural expectations. We discuss these findings in light of recent research by Wink and Dillon (2002, 2008).
Longitudinal Effects of Becoming a Family Caregiver: The Caregiving Transitions Study
Authors: Roth David , Zarit Steven
Published: December 2020

Taking on caregiving responsibilities for older adult family members with disabilities is often considered to be a highly stressful experience that may adversely affect the health of caregivers. However, the vast majority of studies in this area compare existing samples of caregivers with questionably matched non-caregiving controls. In this symposium, we will present findings for a population-based sample of persons who became family caregivers while participating in a longitudinal epidemiological study. Changes in health and well-being are compared between these caregivers and non-caregiving control participants who were matched on multiple demographic and pre-caregiving health history variables. All persons enrolled as caregivers were providing sustained and substantial caregiving assistance. Presentations will include 1) a descriptive overview of the screening, eligibility, and enrollment methods used to construct these unique, population-based samples; 2) comparisons of within-person changes on measures of self-reported health and well-being for dementia and non-dementia caregivers; 3) changes in the caregivers’ social networks, social engagement, and leisure time activities; 4) comparisons of longitudinal changes on circulating inflammatory biomarkers (e.g., IL-6, CRP, TNF alpha receptor 1) and cellular aging (telomere length); and 5) examinations of individual differences in caregiver outcomes using a stress process model. Becoming a family caregiver can be stressful, but the opportunity to help a loved one and the related feelings of purpose and deepening family connections may also promote resilience and enhance health. These questions are far from resolved, and rigorous, prospective, population-based studies like the Caregiving Transitions Study promise to provide compelling new insights.