bluuebunny/crossref_metadata_2025 huggingface dataset:
EXPLORING TECHNOLOGY-ENABLED ASSESSMENTS OF SYMPTOMS EXPERIENCE BY INFORMAL CAREGIVERS
Authors: Schulman Daniel J , Singh Portia , Milosevic Mladen , Samadani Ali
Published: November 2019

For community-dwelling older adults with chronic conditions, effective symptom management is a determinant of quality of life. Providers often have poor knowledge of an individual’s symptoms experience, especially when contact is infrequent, leading to suboptimal symptom management. Many older adults receive frequent care and contact from family, friends, and other informal caregivers (ICGs). Subjective observation by ICGs is an underexplored information source, but faces barriers including ICG burden and lack of ICG knowledge. It is unclear what relevant information might be collected by ICG observations. We conducted a pilot evaluation of Philips CarePartners Mobile (CPM), a prototype smartphone application that provides communication and coordination support to a “circle” of ICGs assisting an older adult. CPM includes features enabling ICGs to share semi-structured observations. 19 caregivers (in 8 circles) used CPM for 12 weeks, contributing 397 observations and participating in interviews and other assessments. We performed a qualitative analysis of the observations, coding for presence of content relevant to dimensions in the UCSF Symptom Management Theory (perception of, evaluation of, and response to symptoms). Relevant content was found in 150 observations, with perception and assessment more common (141) than response (32). Common symptoms included mobility difficulty (31), fatigue (23), dizziness (21), pain (19), and confusion (18). Among observations without symptom-relevant content, many reported on overall mood (92), and reference to social activities was frequent. These results demonstrate that symptoms experience can be assessed using caregiver observations, although further work may be needed to enable caregivers to provide a comprehensive assessment.
EHEALTH ON FRAILTY: FRAILSURVEY, A RELIABLE SMARTPHONE APPLICATION FOR SELF-ASSESSMENT OF FRAILTY
Authors: Midão Luís , Sá Carla , Marques Elisa , Duarte Mafalda , Paúl Constança , Viana João , Costa Elísio
Published: November 2019

Frailty is a clinical syndrome whose signs and symptoms are predictors of health complications, making this a major public health problem. FRAILSURVEY, which was considered a good practice by several entities, is a smartphone application that allows an easy assessment of frailty, available in Portuguese, English and Italian, on both iOS and Android stores. Smartphone-based assessment has been proven to be a useful diagnostic tool for patients, although few applications have demonstrated reliability. With this work we aimed to test the reliability of FRAILSURVEY as a tool to assess frailty, and to study people’s preference on which way to assess frailty. FRAILSURVEY is a questionnaire that comprises two sets of questions: 19 about sociodemographic data, social resources, self-perception of health, nutrition, medication, psycho-social and cognitive status, and time occupation, plus a set of 15 used to assess frailty status, the Groningen Frailty Indicator (GFI). Including 427 older adults in this study, a randomized repeated measures crossover design was employed using the FRAILSURVEY questionnaire both in paper and in application, with a week of interval to reduce carryover effects. Reliability was assessed through the GFI scores obtained by the same person between the paper and application. There were no significant differences between the results on frailty assessment using the questionnaire on both paper and application. A significant correlation was noted in the total group (ICC=.794, P<0.01). Our work shows that FRAILSURVEY is a reliable mobile application for frailty assessment, that can be used by older adults, caregivers, and health professionals.
#GERIATRICS: AN ANALYSIS OF THE IMPACT OF THE GERIATRICS TWITTER NETWORK
Authors: Ayyaswami Varun , Prabhu Arpan , Gambert Steven
Published: November 2019

Twitter connects an international community of healthcare stakeholders, potentially augmenting access to information related to geriatric medicine. The purpose of this study is to analyze the geriatric medicine Twitter network, and we hypothesize this community has substantially grown in the last six years. We analyzed all publicly available tweets including the hashtag #geriatrics from January 1, 2013-January 1, 2019 using Symplur Signals, a health care social media analytics platform. We evaluated #geriatrics metrics over time related to activity, content analysis, user characteristics, engagement, and network analysis. A total of 159,008 tweets (containing 42.8% re-tweets) with the hashtag #geriatrics were written by 29,443 users, resulting in 393.6 million impressions. The number of tweets increased from 9,705 in 2013 to 39,151 in 2018 (32.2% compound annual growth); users increased from 3,366 in 2013 to 29,443 in 2018 (55.3% compound annual growth). Users were primarily found in the United States, United Kingdom, and Canada. The most commonly trending topic from 2013-2015 and from 2016-2018 was ‘older adults’. The top hashtags included in tweets with #geriatrics were #job, #aging, and #hpm (hospice and palliative medicine). Network analysis showed central hubs to be medical journals, provider organizations, individual physicians, and individual advocates. The top 150 influencers consisted primarily of physicians (49.1%), advocate/support organizations (13.8%), and media organizations (6.3%). The use of Twitter to promote geriatric medicine using #geriatrics has matured into an international digital community of interest. Future studies should examine hashtags related to age prevalent illnesses and hashtags likely to be used by patients.
HOME-BASED TRANSCRANIAL DIRECT-CURRENT STIMULATION AND EXPERIMENTAL PAIN SENSITIVITY
Authors: Ahn Hyochol , Zhong Chengxue , Sorkpor Setor , Miao Hongyu
Published: November 2019

Osteoarthritis (OA) of the knee is one of the most common causes of pain in older adults. Clinic-based transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that has been shown to reduce pain, but no published studies have reported using home-based self-administered tDCS in older adults with knee OA. Thus, the purpose of this study was to examine the effect of home-based tDCS on experimental pain sensitivity in older adults with knee OA. Twenty community-dwelling participants aged 50–85 years with knee OA pain received ten daily sessions of 2 mA tDCS for 20 minutes at home. A multimodal quantitative sensory testing battery was completed, including heat pain tolerance, pressure pain threshold, and punctate mechanical pain. Participants (75% female) had a mean age of 61 years, and a mean body mass index in the sample was 28.33 kg/m2. All 20 participants completed all ten home-based tDCS sessions without serious adverse effects. The Wilcoxon Signed-Rank test showed that all the differences between the baseline measurements and experimental pain sensitivity measurements after 10 sessions were statistically significant. Effect sizes (Rosenthal’s R) were R = 0.35 for heat pain tolerance (P = 0.02), R = 0.40 for pressure pain threshold (P < 0.01), and R = 0.32 for punctate mechanical pain (P = 0.02). We demonstrated that home-based self-administered tDCS was feasible and reduced experimental pain sensitivity in older adults with knee OA. Future studies with well-designed randomized controlled trials are needed to validate our findings.
BUILDING DISASTER RESILIENCE FOR OLDER ADULTS AGING IN PLACE: THE ROLE OF COMMUNITY-BASED ORGANIZATIONS
Authors: Pendergrast Claire , Belza Basia , Bostrom Ann , Errett Nicole
Published: November 2019

Older adults are more susceptible to adverse health outcomes during and after a disaster compared with their younger counterparts. Developing community resilience, or strengthening communities to reduce the negative impacts of disasters, has the potential support older adults’ health and well-being. Community-based organizations (CBOs), such as senior centers and Villages, provide social services and programming that support aging in place and may support older adults’ resilience to disasters. This study examines CBO leadership perspectives on the role of CBOs in building disaster resilience for older adults aging in place, as well as perceived barriers and facilitators to incorporating disaster resilience activities into organizational programming. In-depth interviews were conducted with a purposive sample of staff-members of CBOs serving older adults aging in place in King County, Washington. Participants included representatives from 14 organizations that varied in size, geographic setting, organizational structure, and ethnic, linguistic, and socio-economic backgrounds of organizational members. The sample included five government-run senior centers, seven non-profit senior centers, and two Villages. Interviews were audio-recorded and transcribed verbatim. We used a combined inductive and deductive approach to code and thematically analyze the data. Results indicate that local context, leadership risk perception, collaborations, and existing services and programming influence CBOs’ willingness to engage in activities supporting disaster resilience for older adults aging in place. Findings suggest that CBOs supporting aging in place may support disaster resilience for older adults by serving as a trusted source of disaster preparedness information and tailoring disaster-related messages for an older adult audience.
DRIVING CESSATION IS ASSOCIATED WITH POORER MENTAL HEALTH
Authors: Stinchcombe Arne , Marchese Carlina , Fossum Shauna , Gagnon Sylvain , Naglie Gary , Rapoport Mark , Weaver Bruce , Bédard Michel
Published: November 2019

The Canadian Longitudinal Study on Aging (CLSA) is a longitudinal health study that will follow individuals aged 45 to 85 for 20 years. At baseline, participants completed measures related to driving status and mental health outcomes (e.g., Center for Epidemiologic Studies Depression Scale; CES-D). In this study we examined the associations between driving status and mental health outcomes. In the baseline sample, 1,415 participants reported being former drivers and 44,694 reported being current drivers. A greater proportion of former drivers were female, older, and urban-dwelling. Compared to current drivers, former drivers had lower levels of social support, poorer self-rated physical health, and less community participation. After controlling for these covariates as well as age and sex, former drivers had greater odds than current drivers of being classified as depressed (OR=2.48, 95% CI=2.21-2.79), and of reporting psychological distress (OR=2.22, 95% CI=1.87-2.62). Using data from former drivers only, we also examined associations between variables that contributed to driving cessation and depression symptoms. Former drivers had greater odds of being depressed if they reported feeling nervous or intimidated behind the wheel (OR=1.77, 95% CI= 1.11 - 2.80), or if they experienced difficulties with the licensing process (OR=1.62, 95% CI=1.07 - 2.54), before they stopped driving. As a next step we will search for factors that may modify the relationship between driving status and mental health. The identification of factors that modify the impact of driving cessation on mental health is critical to the development of interventions that will support smoother transitions to non-driving.
SCANNING FOR CRITICAL EVENTS DURING DRIVING: VISUAL SCANNING USING EYE TRACKING TECHNOLOGY ON A DRIVING SIMULATOR
Authors: Dickerson Anne E , Gartz Rachel , Eaker Megan , Clark Brittany
Published: November 2019

This study explored age differences and scanning strategies for critical events using a driving simulator with eye-tracking technology. One critical skill in driving is to efficiently scan the environment. Ten young(M=26y) and 10 old(M=65y) healthy adults drove a wearing Tobii-Pro Glasses. The software analyzes areas of interest (AOI) for “percent time of fixation” as well as illustrative “heat maps” of duration of fixation. At a four-way-stop, the young fixated at the road ahead (25% fixation time), dashboard (29%), more often than left/right of their car (15%). The old fixed on the road ahead (21%) but spent more time outside the car (23%). At the hidden sign, older drivers fixated on the environment outside the road ahead more than younger drivers (26% versus 20%), but both had increased fixation to the right side of the vehicle (Y-23%, O-24%) with this event, likely looking for the sign. Heat maps of the hidden sign illustrate this, suggesting older drivers may more efficiently scan their environment. Other possibilities include the young trusting the simulator, young/old scan differently, or interference of previous simulator experience. Simulator outcomes showed age differences on gas-pedal-reaction times suggesting that older adults are more cautious, slowing down faster with critical events. Limitations include small sample and limited studies have used eye-tracking technology in driving. This study raises interesting questions, especially for medically-at-risk drivers with visual impairments. Using the eye-tracking may enhance targeting specific strategies for a variety of impairments as well as establishing a baseline of typical drivers’ visual scanning habits.
THE RELATIONSHIP BETWEEN OLDER DRIVERS’ RESILIENCE AND SELF-REPORTED DRIVING MEASURES OVER 5 YEARS
Authors: Louis Renée M St , Charlton Judith , Koppel Sjaan , Molnar Lisa J , Stefano Marilyn Di , Darzins Peteris , Bédard Michel , Marshall Shawn
Published: November 2019

As people age into older adulthood, they are more likely to experience events that impact their driving, such as age-related cognitive and functional declines, serious illness, or disability. The ability to demonstrate resilience following such adversity may influence one’s decisions and feelings about driving. This study investigated whether resilience of older drivers changes over time, and if relationships between resilience, gender, and self-reported driving-related abilities, perceptions and practices remain stable or change. Participants were from the Candrive/Ozcandrive study, a prospective cohort study of older drivers from Canada, Australia and New Zealand. Analyses are presented from a subset of Ozcandrive participants (n=125) from Australia who completed a resilience scale at two time points approximately five years apart, as well as measures of driving comfort during the day and night, perceived driving abilities, and driving frequency. Participants were primarily male (67.2%) with a mean age of 81.6 years (SD=3.3, Range=76.0-90.0) at Time 1. Resilience increased significantly from Time 1 to Time 2 (Median=82.0/84.00, z=-2.9, p<.01). Although females had significantly higher resilience than males at both Time 1 (Median=84.0/81.0, U=2.3, p=.02) and Time 2 (Median=86.5/82.0, U=2.1, p=.03), there was a statistically significant increase in resilience of males over five years (p<.01) and no statistical change for females. Results show small but significant positive correlations, and increasingly stronger relationships over time between older drivers’ resilience and driving comfort as well as perceived driving abilities. Future research will use modelling to examine the association of various factors on the change in resilience and driving-related measures.
INTEREST GROUP SESSION—RAINBOW RESEARCH GROUP: ADAPTING AN EVIDENCE-BASED INTERVENTION TO LGBT ADULTS WITH DEMENTIA AND CARE PARTNERS: MOBILIZING SUPPORT NETWORKS
Authors: Goldsen Karen Fredriksen , Teri Linda
Published: November 2019

LGBT (lesbian, gay, bisexual, and transgender) older adults have been found to have elevated risks of cognitive impairment. Maintaining quality of life is a challenge for those experiencing cognitive decline and their caregivers. Whereas support networks are essential for quality of life, LGBT older adults with dementia may face unique risks, such as stigma, social isolation, lack of family support, and barriers to healthcare. Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), is the first federally funded clinical trial to test an intervention designed to improve quality of life of LGBT older adults with dementia and caregivers adapting a preexisting program teaching behavioral strategies and physical exercises. The intervention incorporated empirical findings from a longitudinal study, Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) and developed innovative and culturally responsive approaches. Kim and colleagues examine predictors of longitudinal changes in physical functioning among LGBT older adults with cognitive impairment focusing on physical, social, and recreational activities as well as stigma. Emlet and colleagues investigate caregiving experiences among LGBT older adults and identify factors that are associated with their physical and mental health. Lastly, Fredriksen Goldsen and colleagues introduce how the modifiable factors identified from the Aging with Pride: NHAS were incorporated in the IDEA intervention and evaluate the processes of the culturally-responsive approaches implemented in the study. The presentations in this symposium illustrate the importance of tailoring clinical trial studies for hard-to-reach and underserved populations with dementia responding to their unique health needs.
LESSONS LEARNED FROM THE FIRST INTERVENTION STUDY ADDRESSING DEMENTIA IN THE LGBT COMMUNITY
Authors: Goldsen Karen Fredriksen , Fredriksen-Goldsen Karen , Teri Linda , Kim Hyun-Jun , McKenzie Glenise , Fazia David La , Emlet Charles , Petros Ryan
Published: November 2019

The cognitive health needs of LGBT older adults have not been adequately addressed in mainstream clinical trials. Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), is an intervention designed to improve physical functioning and quality of life of LGBT adults with dementia and caregivers. We evaluate the processes and effectiveness of culturally-responsive recruitment approaches implemented in this study. A strong research-community partnership was necessary for the development and implementation of the intervention. LGBT participants with dementia made the first contact to research team as often as caregivers did and showed a higher rate of living alone and having a friend-based care network. The most common reason for ineligibility was not having a caregiver. Participants learned about the study via multiple venues including community events, newsletters, and social media. This study illustrates important new ways to sustain collaborations with disadvantaged communities and conduct a clinical trial with hard-to-reach participants.
THE POTENTIAL AND PITFALLS OF GAMIFICATION TO SUPPORT OLDER ADULTS' ADHERENCE TO HEALTHCARE INTERVENTIONS
Authors: Boot Walter R , Charness Neil
Published: November 2019

The addition of video game-like elements to non-game activities, known as gamification, holds promise with respect to encouraging engagement with, and adherence to, health behaviors and healthcare interventions. Elements of gamification include the introduction of points systems, leaderboards, achievement badges, stories and themes, rewards, progress tracking, and challenges. However, a lack of enthusiasm for, and experience with, video game play by older adults has important implications for the effectiveness of these techniques across the lifespan. Specifically, the age-related “digital divide” must be considered before applying these approaches to improving the wellbeing, cognition, and health of older adults. This talk will build on the body of research conducted by the Center for Research and Education on Aging and Technology Enhancement (CREATE) focused on gaming and interventions to present best practice guidelines for implementing gamification with older adults.
A CASE ARGUMENT FOR AGE DIVERSITY ON CAMPUS
Authors: Morrow-Howell Nancy , Lawlor Edward , Macias Ed , Swinford Emma , Brandt Jeffrey
Published: November 2019

Washington University for Life is an initiative to increase age-diversity on campus, especially in degree and certificate programs. We have developed a case argument for educating people across the longer life course; and we identify positive outcomes for society, younger students, the institution, and for older adults themselves. These arguments do not include the reality that the supply of young students will be constrained, as this demographic press is not viewed as threatening by many U.S. universities. This argument is being presented to administrators, admission and career service personnel, and classroom instructors, who do not universally accept the benefits, much less the necessity, of increased age-diversity; and they often express resistance to disrupting traditional practices with only the well-being of older adults in mind. A full discussion of reasons that Washington University should move purposively toward age inclusivity is important to build consensus and identify opportunities for new practices.
BUILDING RECOGNITION ACROSS CAMPUS AND TOWN FOR USC’S AGE-FRIENDLY UNIVERSITY INITIATIVE
Authors: Nash Paul , Nash Paul , Cicero Caroline
Published: November 2019

Details of efforts to highlight existing age-related programming on campus, create a new intergenerational experiential learning program, build a social media presence, and include ‘age’ in the university’s diversity efforts will be discussed. Best practices in community engagement will be emphasized including successes with retired employees, alumni, activities programming, and local age-friendly efforts. Discussion includes the benefits of developing a multidisciplinary working group to ensure the Initiative is a university wide effort and the challenges of working in a large, multi-campus research university located in multilayered bureaucratic local jurisdictions. Future goals and collaboration with AFU Global Network partners and aspirations for addressing societal ageism will be addressed.
A NOVEL METABOLITE COMPOSITE SCORE EXPLAINS THE HIGHER MORTALITY ASSOCIATED WITH FRAILTY AMONG OLDER BLACK MEN
Authors: Marron Megan M , Harris Tamara B , Boudreau Robert M , Moore Steven C , Sanders Jason L , Wendell Stacy G , Zmuda Joseph M , Newman Anne B
Published: November 2019

Frailty is more prevalent among black versus white older Americans. We previously sought to better characterize frailty among 287 black men ages 70-81 by identifying 37 plasma metabolites associated with vigor to frailty using the scale of aging vigor in epidemiology (SAVE). Using this information, we developed a metabolite score to determine if it explained the frailty-associated higher mortality. The Human Metabolome Database classified the metabolites as organic acids/derivatives (m=14), lipids/lipid-like molecules (m=12), organoheterocyclic compounds (m=4), benzenoids (m=3), organic nitrogen compounds (m=2), organic oxygen compounds (m=1), and nucleosides/nucleotides/analogues (m=1). Values for each were ranked into tertiles. The metabolite tertile associated with more vigorous SAVE scores was given a score of 0, the metabolite mid-tertile a score of 1, and the metabolite tertile associated with frailer SAVE scores a score of 2. The metabolite composite score was calculated as the sum of the metabolite tertile scores. One standard deviation frailer SAVE was associated with 30% higher mortality (p=0.0002), adjusting for age and study site. The association between frailty and mortality was attenuated by 56% after additionally adjusting for the metabolite score, where organic acids/derivatives and lipids/lipid-like molecules (mostly amino acids, glycerophospholipids, sphingolipids) accounted for most of the attenuation. In this model, one standard deviation higher metabolite score was associated with 46% higher mortality (p<0.0001). The metabolite score also predicted mortality among 48 community-dwelling (96% white) older men (p=0.03). These metabolites provide a deeper characterization of frailty that reproducibly explains a substantial portion of the vulnerability to death in these older men.
LINKAGES BETWEEN INDIGENOUS CULTURAL GENERATIVITY AND SOBRIETY TO PROMOTE ALASKA NATIVE SUCCESSFUL AGING
Authors: Lewis Jordan P
Published: November 2019

The aim of this study was to explore motivating and maintenance factors for sobriety among older AN adult participants (age 50+) from across Alaska. Ten life history narratives of Alaska Native older adults, representing Alutiiq, Athabascan, Tlingit, Yup’ik/Cup’ik Eskimos, from the PA sample were explored using thematic analysis. AN older adults are motivated to abstain from, or to quit drinking alcohol through spirituality, family influence, role socialization and others’ role modeling, and a desire to engage in indigenous cultural generative activities with their family and community. A desire to pass on their accumulated wisdom to a younger generation through engagement and sharing of culturally grounded activities and values, or indigenous cultural generativity, is a central unifying motivational and maintenance factor for sobriety. The implications of this research indicate that family, role expectations and socialization, desire for community and culture engagement, and spirituality are central features to both AN Elders’ understanding of sobriety and more broadly, to their successful aging. Future research is needed to test these findings in population-based studies and to explore incorpo- ration of these findings into alcohol treatment programs to support older AN adults’ desire to quit drinking and attain long-term sobriety. Sobriety can put older AN adults on a pathway to successful aging, in positions to serve as role models for their family and community, where they are provided opportunities to engage in meaningful indigenous cultural generative acts.
SENSE OF PURPOSE IN LIFE AND REDUCED LIKELIHOOD OF FUTURE DRUG MISUSE
Authors: Kim Eric S , Ryff Carol , Hassett Afton , Brummett Chad , Yeh Charlotte , Strecher Victor
Published: November 2019

A stronger sense of purpose in life is hypothesized to reduce the likelihood of drug misuse because it has been linked with several protective factors including: increased ability to handle stress and pain tolerance, decreased impulsivity, and reduced risk of depression and chronic conditions. However, the association between purpose in life and drug misuse has been understudied. We tested whether people with a stronger sense of purpose in life had a decreased likelihood of incident drug misuse 9-10 years later. We also tested whether people with a stronger sense of purpose were less likely to cope with stress by misusing drugs. Participants were drawn from the Midlife in the United States Study (MIDUS; n=3,483) and from a stress coping module of the Health and Retirement Study (HRS; n=498). Among MIDUS respondents not misusing drugs at baseline, people in the highest quartile of purpose (compared to people in the lowest quartile) had 42% reduced odds (95% CI: 0.37-0.92) of incident drug misuse 9-10 years later in the fully-adjusted model (e.g., sociodemographic factors, depression, chronic conditions, and chronic pain). Among HRS respondents, people in the highest purpose quartile had 65% decreased odds (95% CI: 0.14-0.89) of misusing drugs to cope with stress in the fully-adjusted model. A growing number of intervention studies show that purpose in life can be raised. With additional research, these data suggest that sensitively tailored and administered purpose in life may reduce the likelihood of drug misuse and help stem the tide of our nation’s growing drug epidemic.
INTEGRATIVE ANALYSIS OF ALZHEIMER’S DISEASE GWAS TO DEVELOP A NEW POLYGENIC PREDICTOR AND TEST BIOSOCIAL ETIOLOGY
Authors: Harrati Amal
Published: November 2019

Alzheimer’s disease (AD) has genetic and environmental causes and etiology is thought to reflect interplay among these factors. A barrier to integration of genetic and environmental etiologic factors in research to inform prevention and intervention is poor understanding of AD genetics beyond APOE4. We used the new Genomic SEM methodology to conduct integrative analysis of results from several AD genome-wide association studies (GWAS), including brain-imaging and autopsy AD GWAS, to derive a novel, polygenic genetic predictor of AD. We applied this polygenic predictor in the US Health and Retirement Study to test associations with (1) cognitive aging measured from repeated-measures longitudinal cognitive-test data; and (2) blood-chemistry-based biological age algorithms. In further exploratory analysis, we tested if risk measured by the novel AD polygenic predictor was correlated with and/or buffered by a known environmental factor influencing AD etiology, life-course socioeconomic position. Results map new directions for biosocial AD research.
REVERSE TRANSLATION OF HUMAN BIO-AGING MEASURES TO CYNOMOLGUS MONKEYS TO TEST ASSOCIATIONS WITH DOMINANCE RANK
Authors: Snyder-Mackler Noah , Shively Carol , Register Tom , Belsky Daniel W
Published: November 2019

Social status is a powerful correlate of aging-related health decline. Observational data in humans suggest that disadvantaged social status may be associated with accelerated biological aging. But establishing causality in this relationship poses challenges; experimental manipulation of human social status is not possible. In contrast, social status can be experimentally manipulated non-human primates (e.g. Snyder-Mackler 2016 Science). We conducted analysis to reverse-translate blood-chemistry of biological aging to cynomolgus monkeys using data from several hundred animals in the Wake Primate Center breeding colony. We are applying these measures in an independent sample of monkeys with ascertained dominance rank to test replication in the non-human primate model of the human social gradient in biological aging. Parallel analysis of DNA methylation-based measures of biological aging are ongoing and should be available to present by Fall 2019. Results will inform potential to use this non-human primate model to study social determinants of biological aging.
IS SELF-RATED HEALTH A WINDOW ONTO THE BIOLOGY OF HEALTH AND AGING?
Authors: Belsky Daniel W
Published: November 2019

Self-ratings of health predict survival in older adults, suggesting that they capture important information about system integrity. We analyzed epigenetic clock, blood biochemistry, and functional test data alongside participant reports of disability, morbidity, and self-rated health in population-based cross-sectional and longitudinal datasets from the US and UK (total N>50,000) and in a randomized trial of caloric restriction (N=220). We (1) profiled cross-sectional biomarker correlates of self-rated health; (2) quantified residual biomarker associations with self-rated health after accounting for research-participant reports of morbidity and disability and evaluated variation in associations across strata of age, birth-cohort cohort, socioeconomic status, and cognitive functioning; and (3) tested coordinated change in biomarker indices of system integrity and self-ratings of health in response to caloric restriction. Results develop an understanding of self-rated health as a window onto biological processes of aging and highlight important design considerations for future research to illuminate the biological basis of health.
INTEREST GROUP SESSION—ORAL HEALTH: COGNITIVE FUNCTION, SOCIAL SUPPORT, AND ORAL HEALTH STATUS AMONG OLDER ADULTS IN THE U.S. AND ABROAD
Authors: Wu Bei , Shuman Stephen K , Saunders Michele
Published: November 2019

There is an increasing awareness of the importance of oral health and its associated risk factors among older adults. This symposium includes four papers that address cognitive function, social support and oral health problems and symptoms among older adults in the U.S. and China. Lu and his colleagues examined the reciprocal relationship between cognitive function and complete tooth loss Chinese adults age 50+ using the China Health and Retirement Longitudinal study. The results show that there is a reciprocal relationship between these two indicators. The second paper used the Population Study of Chinese Elderly in Chicago (PINE) and examined the associations between tooth/gums symptoms and changes in cognitive function in Chinese older immigrants. The results reveal that having teeth symptoms was associated with a decline in cognitive function. Using the same PINE data, the third paper examined the association between different characteristics of social relationships and the number of oral health problems among U.S. older Chinese adults. Wu and her colleagues conducted a partner-assisted pilot intervention to improve oral health for community-dwelling older adults with either mild cognitive impairment or mild dementia. The results of this 6-month intervention show that persons in the treatment group had more improvement in oral hygiene than those in the control group. Findings from these four papers illustrate that cognitive function, social support, and oral health are interrelated. This symposium highlights the importance of improving cognitive health, social support, and oral health for middle-aged and older adults.
LATENT CLASS ANALYSIS OF RE-EXPERIENCING VIOLENCE ACROSS THE LIFE COURSE
Authors: Kong Jooyoung , Easton Scott
Published: November 2019

Guided by the cumulative disadvantage hypothesis, the present study examines recurrent victimization experiences across the life course and their impact on psychological health in later life. Using data from the 2010-2011 Wisconsin Longitudinal Study, we explored the latent structure of histories of childhood maltreatment (i.e., neglect, emotional/physical abuse, witness of domestic violence) and elder abuse victimization among 5,968 older adults (average age of 71 years). We also investigated whether membership in specific latent classes, particularly experiencing both childhood and elder victimization, would be associated with psychological functioning in late life. We identified five latent classes: “Never victimized” (66% of respondents), “Abused as child” (16%), “Abused and neglected as child” (9%), “Abused as elder” (6%), and “Abused as child and elder” (2%). Also, the “abused as child and elder” class consistently was associated with negative psychological outcomes (i.e., distress and somatic symptom severity) and lower levels of psychological well-being.
LIFE COURSE PATHWAYS OF CHILDHOOD SOCIOECONOMIC STATUS TOWARD CLINICAL RISK FACTORS FOR WORSE KIDNEY FUNCTION
Authors: Surachman Agus , Santos Alexis , Rush Jonathan , Alexander Lacy , Coe Christopher , Almeida David M
Published: November 2019

This study examines the roles of daily stress processes as a possible mediator of how life course socioeconomic inequality is reproduced in day-to-day experiences and creates disparities in clinical risk for rapid kidney function declines in adulthood. Data are from 1174 middle and older adults (56% female; ages 40–84, Mage = 56.2) who participated in the MIDUS study wave 2 and Refresher. We found significant pathways that childhood SES was associated with education and adult SES, adult SES was associated with exposure to daily stressors and daily stressor reactivity to negative affect, positive affect, and somatic symptom. In turn, higher report of daily somatic symptom and lower report of daily positive affect were associated with higher CKD risk factors. Finally, childhood SES was directly associated with CKD risk factors. Childhood SES is associated with clinical risks for rapid kidney function decline through direct association and life course accumulation.
COMPARISON OF AGE AND BIOLOGICAL SEX MORTALITY TRENDS BETWEEN ADULTS WITH AND WITHOUT DOWN SYNDROME
Authors: Stevens James D , Stevens James D , Landes Scott D , Turk Margaret A
Published: November 2019

Distinct mortality trends emerge from comparisons of mean and median age at death and specific causes of death between adults with and without cerebral palsy. We compare standardized mortality odds ratios (SMORs) for 20 leading causes of death for 11,895 adults with cerebral palsy and 13,047,988 without cerebral palsy in the US between 2012 and 2016. Male and female decadents with cerebral palsy died significantly younger than male and female decadents without cerebral palsy, and were more likely to die from respiratory diseases, choking, and unknown causes. Public health and preventive care efforts should account for respiratory, swallowing, and nutrition risks, as well as mortality trends’ variation across age and biological sex. The CDC and WHO could better surveil this population’s health and mortality by disallowing certifiers from using cerebral palsy as the underlying cause of death as the practice leads to high rates of unknown causes of death.
INCREASED CARDIOVASCULAR DISEASE RISK FACTORS IN PERSONS WITH CEREBRAL PALSY
Authors: Heyn Patricia C
Published: November 2019

Cardiovascular disease (CVD) remains the leading cause of global mortality. Individuals with disabilities are at increased risk of CVD in part due to their musculoskeletal and/or cognitive impairments that can challenge their participation in physical activities. Gait ability has been associated to several key health outcomes including morbidity. Unfortunately, there is little research done to understand how individuals with obstructed mobility (i.e. developmental or injury condition) grow older. Our research team (Heyn et al 2019), evaluated the prevalence of CVD risk factors and age-related health outcomes associated to aging on a cohort of adults with cerebral palsy with obstructed mobility. Metabolic syndrome was identified in 17.1% of the cohort, higher than the 10% in the NHANES sample. CVD risk factors were much higher in this cohort as compared to normative population data. There was a positive correlation between mobility level, waist circumference (r=0.28, p=0.02), and waist-to-hip ratio (r=0.28, p=0.02).
COMPARISON OF AGE AND BIOLOGICAL SEX MORTALITY TRENDS BETWEEN ADULTS WITH AND WITHOUT DOWN SYNDROME
Authors: Landes Scott D , Landes Scott D , Stevens James D , Turk Margaret D
Published: November 2019

Age at death and cause of death comparisons between adults with and without Down syndrome reveal distinct mortality trends that can be utilized to inform preventive care efforts to reduce premature mortality in this population. We compare mean and median age at death, and standardized mortality odds ratios (SMORs) for 20 leading causes of death for 9,564 decedents with and 13,050,319 without Down syndrome in the U.S. between 2012 and 2016. Decedents with Down syndrome, on average, were substantially younger than those without Down syndrome, and were more likely to die from Alzheimer disease and dementia at younger ages. In addition, adults with Down syndrome also had higher risk of choking related deaths. Efforts to reduce premature mortality through public health and preventive care interventions for this population should be cognizant of these increased risk factors, as well as variation in age and biological sex mortality trends.
ESPO AND NIA BUTLER-WILLIAMS SCIENTIFIC SYMPOSIUM: INFLUENCE OF RACE, ETHNICITY, AND EXPERIENCE ON HEALTH IN AGING
Authors: Justice Jamie N , Hill Carl V , Thorpe Roland J
Published: November 2019

The NIA’s Butler-Williams Scholars Program and GSA’s Emerging Scholars and Professional Organization are united in providing career development opportunities for early career scholars in a manner that promotes leadership, diversity, and inclusivity. This provides a foundation to develop a network of next generation of scientists, clinicians, and policy makers capable of shaping health in aging. Among the chief concerns of our aging population are disparities in health associated with race/ethnicity, experience, environment, access to health care, and sociocultural and socioeconomic factors. GSA’s early career professionals and alumni of the prestigious NIA Butler-Williams Scholars Program have tackled these issues directly and the scientific scholarship that results is astounding in its breadth and depth. Dr. Vicki Johnson-Lawrence, Ph.D. (Butler-Williams class of 2014), will present on the interacting effects of education and race/ethnicity on multi-morbidity, highlighting lessons learned from the National Health Interview Study. Dr. Lauren Parker (Butler-Williams class of 2018) will review efforts to develop culturally competent content for recruitment of Hispanic and black/African American persons to NIA-supported dementia-caregiving studies. Dr. Ryon Cobb (Butler-Williams class of 2016) will discuss the impact of race/ethnicity on kidney function among older adults, with evidence from the Health and Retirement Study. The final speaker, Dr. Ana Quiñones (Butler-Williams class of 2012), will present on longitudinal tracking of multi-morbidity in racially/ethnically diverse older adults. In sum, the featured talks by rising stars in aging research deepen our understanding of the influence of race, ethnicity, and experience on health and chronic disease in diverse aging populations.
EDUCATION, RACE-ETHNICITY, AND MULTI-MORBIDITY AMONG ADULTS AGES 30-64 IN THE NATIONAL HEALTH INTERVIEW STUDY
Authors: Johnson-Lawrence Vicki , Zajacova Anna , Sneed Rodlescia
Published: November 2019

Demographic risk factors for multimorbidity (living with 2+ chronic conditions) have been identified in numerous population-based studies of older adults; however, there is less data on younger populations, despite the fact that approximately 24% of US adults age 18+ have multimorbidity. To examine the associations of education and race/ethnicity with mutimorbidity among adults aged 30-64 using cross-sectional data from the 2002-2014 National Health Interview Surveys. Compared to having a bachelor’s degree or higher, completing less than HS (OR=1.58, 95% CI = 1.50-1.66) or HS/some college (OR=1.32, 95% CI = 1.27-1.37) were both associated with increased odds of multimorbidity. Non-Hispanic Blacks had greater odds of multimorbidity (OR=1.07, 95% CI = 1.02-1.11) compared to Non-Hispanic Whites with comparable characteristics. Reducing multimorbidity through health promotion efforts across the socioeconomic spectrum and earlier in the life course will be a requirement to age successfully and support overall well-being in the aging US population.
RACE BY AGE PATTERNS IN KIDNEY FUNCTIONING AMONG OLDER ADULTS: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: Cobb Ryon J
Published: November 2019

The present study considers how race combines with chronological age to shape kidney function among older adults. We analyzed cross-sectional data from a nationally representative study of older adults. Our measure of kidney function derived from the cystatin C-based estimated glomerular filtration rate. We use a pattern variable to divide White and Black respondents into four groups based on their age group membership: early midlife (age 52–59), late midlife (age 60–69), young old (age 70–79), and oldest old (80s+ years). Results from our ordinary least squares models reveal that Blacks and Whites in late midlife, young old, and oldest old exhibited poorer kidney function than Whites in early midlife. Our study uncovers evidence of race by age disparities in kidney function among older adults. Future longitudinal studies will provide further insight into how and why race combines with age to pattern kidney function over time.
TRACKING CHANGES IN MULTIMORBIDITY AMONG RACIALLY AND ETHNICALLY DIVERSE POPULATIONS
Authors: Quiñones Ana R , Botoseneanu Anda , Markwardt Sheila , Nagel Corey , Newsom Jason T , Dorr David A , Allore Heather G
Published: November 2019

Multimorbidity is widely recognized as having adverse effects on health and wellbeing above and beyond the risk attributable to individual chronic disease. Much of what is known about multimorbidity rests on research that has largely focused on one point-in-time, or from a static perspective, with little consideration to issues involved in assessing longitudinal changes in multimorbidity. In addition, less focus has been placed on assessing racial and ethnic variations in longitudinal changes of multimorbidity. Addressing this knowledge gap, we highlight important issues and considerations in addressing multimorbidity research from a longitudinal perspective and present findings from longitudinal models that examine differences in the rate of chronic disease accumulation and multimorbidity onset between non-Hispanic white (white), non-Hispanic black (black), and Hispanic study participants in the Health and Retirement Study starting in middle-age and followed for up to 16 years.
THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION (SWAN): FROM MIDLIFE ONWARD
Authors: Avis Nancy E , Avis Nancy E , Crawford Sybil , Colvin Alicia , Derby Carol A , Karvonen-Gutierrez Carrie , Brooks Maria M
Published: November 2019

The Study of Women’s Health Across the Nation (SWAN) is a multisite, multiracial/ethnic longitudinal study of women initially aged 42-52 (N=3302) designed to characterize the physiological and psychosocial changes that occur during the menopause transition and to assess their relations to subsequent health and age-related diseases. Each of seven clinical sites recruited non-Hispanic white women and women belonging to a predetermined racial/ethnic minority (African American, Hispanic, Chinese, or Japanese). Cohort eligibility was determined from a cross-sectional survey of 16,065 women in 1996-97 aged 40-55 who were aged 42-52, had an intact uterus and at least one ovary, and not using hormone therapy. Cohort participants have been assessed in-person approximately annually through follow-up visit 15 in 2017 using a standardized protocol of detailed questions about medical, reproductive and menstrual history; lifestyle and psychosocial factors; physical and psychological symptoms; and anthropometric measurements, reproductive hormones, bone and body composition, and cardiovascular health.
THE WOMEN'S HEALTH INITIATIVE (WHI): STILL LEARNING FROM 161,808 POSTMENOPAUSAL WOMEN
Authors: LaCroix Andrea Z , LaCroix Andrea Z
Published: November 2019

The WHI enrolled 161,808 women ages 50-79 into 1-3 Clinical Trials (n=68,132) or the Observational Study (n=93,676) from 1993-1998. As of March 31, 2018, 70,812 women are alive and continue to be enrolled including 10,179 over the age of 90, 4588 Black/African American, and 1998 Hispanic/Latina women. 54,877 women have died, including 17,010 from cardiovascular disease and 14,553 from cancer. 64,344 reported a fracture during follow-up. Between 2012-2014, 7875 women completed a brief in-person visit as part of The Long Life Study. This examination included the Short Physical Performance Battery, grip strength, height, weight, blood pressure, heart rate and a blood draw. Genetic data of various types have been collected for over 30,000 WHI participants. Whole genome sequencing data is available for over 11,000 WHI participants. Over 1700 manuscripts have been published. The WHI biospecimen repository contains millions of stored biospecimens. CMS (Medicare) data is available and regularly updated.
THE RANCHO BERNARDO STUDY (RBS) OF HEALTHY AGING: A RICH RESOURCE FOR STUDYING AGING IN WOMEN
Authors: McEvoy Linda , McEvoy Linda K , Laughlin Gail A , Kritz-Silverstein Donna , Bettencourt Richelle , Bergstrom Jaclyn
Published: November 2019

RBS is an ideal cohort to study healthy aging in women and to examine sex differences in aging. Initiated in 1972, RBS enrolled 82% of adult residents of Rancho Bernardo, a suburb of San Diego. Residents were white, and middle to upper-middle class. Participants have been followed via 12 research clinic visits at ~4 year intervals and 32 mailed surveys. RBS contains detailed assessment of cardiometabolic disease risk factors, bone health, biomarkers, physical ability, cognitive function, health and reproductive history, medications, behaviors (smoking, drinking, diet, exercise) and psychosocial measures. Of the 6726 participants, 54% are women and 65% were aged ≥50 at enrollment. Vital status is known for 91% of the cohort; overall mortality is 71%. Death certificates have been coded for cause of death for 91% of decedents. We will discuss contributors to healthy longevity in RBS women (average age of death 86.4 yrs; 29% lived to age ≥90).