bluuebunny/crossref_metadata_2025 huggingface dataset:
PATIENT PERCEPTIONS OF USING VOICE-BASED DIETARY ASSESSMENT TOOLS AMONG OLDER ADULTS
Authors: Driesse Tiffany , Liang Xiaohui , Fowler Michael , Yuan Jing , Spangler Hillary , Lynch David , Batsis John
Published: December 2022

Poor diet among older adults is a risk factor for developing multiple chronic diseases. Dietary recall comprises an important component in intervention research and clinical care. Commonly used tools include the web-based automated self-administered 24-hour assessment (ASA-24). Yet voice assistant (VAS) systems (i.e., Amazon Alexa) have not been developed for this purpose. Hence, we evaluated patient perceptions on performing a VAS-based dietary assessment among older adults. Community-dwelling adults (age 65+ years) participated in two virtual sessions who reported their past 24-hour intake, first using ASA-24, and then using a VAS. All completed a Likert questionnaire (binary, % strongly agree/strongly disagree reported) regarding the simplicity of using both systems, completion time, and user satisfaction. Semi-structured interviews allowed us to ask about technology use. Of the 40 participants (100% enrolled), mean age was 69±1.0 years (85% female, 100% white, 5% Latinx). Only 40% owned a VAS; 60% reported having VAS experience prior to the study. After completing both sessions, 80% preferred a VAS over the ASA-24. Participants reported that web-based recalls were unnecessarily complex (60%), time-consuming (50%), and 60% did not wish to use them. Comparatively, VAS recalls were intuitive (75%), easily reportable (85%), and there was willingness to report food while preparing meals (85%). In 16 participants, we evaluated themes of VAS use including easier navigation, less time, and ability to have a natural conversation. A VAS provides a more convenient, conversational, and computerless interaction to report meals over web-based solutions suggesting they hold promise for dietary recall in older adults.
EMBRACING COMMUNITY: ADVANCE CARE PLANNING FOR AFRICAN AMERICAN OLDER ADULTS LIVING WITH DEMENTIA
Authors: Moss Karen , Wright Kathy , Miller Emika , Lawson Kimberly , Rose Karen , Monroe Todd , Wills Celia
Published: December 2022

Lower socioeconomic status African American older adults living with dementia and their family caregivers face unique advance care planning challenges, including achieving appropriate preference-consistent healthcare near the end of life. The purpose of this project within a larger multi-stakeholder study is to assess community stakeholder perspectives on the needs of African American older adults living with dementia and their family caregivers. Diverse community-based organization leaders (n=9) were interviewed and identified the following thematic needs: Reframing of Advance Care Planning, Clarification of Misinformation, and Expansion of Available Resources. Community leaders expressed strong desires to assist families with advance care planning. The use of creative, culturally-tailored, non-traditional approaches to this process offers innovative ways to promote advance care planning through community engagement. This will change the narrative on advance care planning from a cultural perspective while embracing diversity, enriching discovery, and reimaging aging in the community
VITAL INVOLVEMENT IN LATE LIFE: HELEN KIVNICK'S VITAL CONCEPT FOR GERONTOLOGY+
Authors: Adams-Price Carolyn
Published: December 2022

Carolyn Adams-Price will lead off the symposium with a discussion of Kivnick’s impact on gerontology and the arts. Her various arts interests will be discussed, including her interests in choral and African music. Much of the talk will focus on the concept of vital involvement, why it was revolutionary, and how it connects to current research on positive gerontology, creativity, and adaptation in late life. Adams-Price will address in detail the benefits that participation in creative activities can impart to older adults, based on her own research on creative benefits, and will provide a framework for studying those benefits in the future.
ASSOCIATIONS BETWEEN CUMULATIVE STRESS AND COGNITIVE FUNCTION IN HRS AND ELSA
Authors: Chen Ruijia , Lee Harold , Okuzono Sakurako , Kubzansky Laura
Published: December 2022

Despite growing research linking stressors with poorer cognition, less research explicitly considers stress from several sources, which often co-occurs and accumulate to influence health. We used the Global Gateway Harmonized data (HRS: n=8,888; mean age: 74 years; ELSA: n=6,715; mean age: 65 years) to examine whether higher cumulative stress is associated with lower levels of and faster decline in cognitive function. We fit linear mixed effect models to assess the stress-cognition associations. After adjusting for all covariates, baseline cumulative stress was associated with lower baseline cognitive function in both HRS (β=-0.02, 95%CI -0.04, -0.01) and ELSA (β=-0.03, 95%CI -0.05, -0.01). Unexpectedly, higher baseline cumulative stress was associated with slower cognitive decline in HRS (βtime*stress=0.001, 95%CI 0.002,0.01) but not in ELSA. The stress-cognition associations may differ among adults in the US and the UK. Future research should investigate how cumulative stress may operate differently to influence cognitive function across different populations.
UNPARTNERED AND CHILDLESS OLDER ADULTS' RISK OF LONELINESS DURING COVID-19 BY COUNTRY CONTEXT
Authors: Mair Christine , Arpino Bruno , Quashie Nekehia , Antczak Radoslaw
Published: December 2022

Older adults with non-traditional family structures (unpartnered and childless) may be at higher risk for loneliness. Yet, experiences of loneliness during COVID-19 can vary depending on a country’s context (e.g., culture, demography, COVID-19 mitigation policies, severity of the pandemic). We explore associations between older Europeans’ family structure and loneliness to assess risks for those with non-traditional family structures (e.g., unpartnered vs partnered, childless vs parents) during the pandemic across a variety of country contexts. We analyze data from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected before (2019/2020) and twice during (2020, 2021) the pandemic to examine if unpartnered and childless older adults are at higher risk of loneliness, and compare results by multiple indicators of country context (fertility and partnership rates, stringency of COVID mitigation policies, population age composition, and COVID fatality rates). Results of this study can potentially inform current and future pandemic mitigation strategies.
PUBLIC HEALTH POLICY IN AN AGING POPULATION
Authors: Flores Eileen , Llaneza Danielle , Skoblow Hanamori , Azer Lilian , D’Antonio Patricia
Published: December 2022

In the U.S., cancer and its related issues have an impact on public health, such as increased death rates and economic burdens due to lost productivity and associated treatment costs. Along the cancer control continuum, there are ample opportunities to enact policies that can improve cancer prevention, detection, and survivorship. As the US population ages, health policies that address barriers to cancer prevention and optimal survivorship care for older adults will be key. The intersection of policy and public health has gained momentum in the last decade. Changes resulting from the Affordable Care Act and President Biden’s recently set goals (i.e. reduce age-adjusted death rates from cancer by at least 50% and improving the experience of people and their families living with and surviving cancer) for the Cancer Moonshot program have ignited the role of public health policy and its implications among the US population. As a policy intern, I had the opportunity to advocate on behalf of GSA, the nation’s largest aging organization, for research initiatives (e.g. ARPA-H) that amplify opportunities to address policies in public health. Advocating for initiatives that accelerate the government’s biomedical and health research to embrace a geroscience approach will continue to spearhead much needed opportunities to directly impact policies surrounding aging and cancer.
DEVELOPMENT OF SOCIAL CONVOYS: TRAJECTORIES OF CONVOY STRUCTURE AND COMPOSITION FROM CHILDHOOD THROUGH ADULTHOOD
Authors: Manalel Jasmine , Cleary Jennifer , Antonucci Toni
Published: December 2022

This study examines stability and change in social convoys from childhood to adulthood and variation in trajectories of convoy characteristics by gender and race. Multilevel models for convoy structure and composition were estimated using longitudinal data spanning 23 years. Respondents included a sample of 193 children aged 8 to 12 in Wave 1 (1992) who were surveyed again in their 20s (Wave 2) and 30s (Wave 3). Changes in composition, proximity, and contact frequency were observed at each wave. Between Waves 1 and 2, changes reflected age-normative trends toward network diversification typical of the transition to adulthood. Between Waves 2 and 3, changes were consistent with those expected as young adults settle into stable roles. We also identified convoy characteristics that differed between men and women and between Black and White individuals, emphasizing the importance of personal characteristics to fully understand form and function of social relations across the lifespan.
URBAN ENGAGEMENT STRATEGIES FOR ALASKA NATIVE ELDER PARTICIPATION IN RESEARCH
Authors: Kim Steffi
Published: December 2022

Given the current threats to health for older Indigenous people, it is important to understand the health needs and perceptions of older Indigenous people who play a pivotal role in the health and wellbeing of their communities. The underrepresentation of Indigenous voices has led to research, health promotion efforts, and community engagement that has largely been unsuccessful in facilitating culturally grounded and effective health promotion. Engaging Indigenous Elders in research has often been a challenge for researchers – Indigenous and non-Indigenous. Reaching Indigenous Elders within the urban environment can even be more challenging at times based on dispersed communities due to challenging historical contexts, experiences of racism, and mistrust. This presentation is based on the employed engagement strategies of urban-based Alaska Native Elders. Developing policies and programs to promote healthy aging in Indigenous communities requires the voices of those living within their communities.
LINC TOOL: USING QUALITY DATA, COACHING, AND AN IMPROVEMENT CYCLE FOR LEARNING AND IMPROVEMENT IN LONG-TERM CARE
Authors: Van Lierop Merel (E A ) , Meijers Judith , van Rossum Erik , Zwakhalen Sandra
Published: December 2022

Providing high quality of care can be challenging for nursing staff because of the continuous changes in healthcare. Nursing staff needs to learn continuously to remain employable and deal with these challenges. Therefore, availability of a continuous learning and improvement tool (LINC tool) using nursing quality data and an improvement cycle to maintain high quality of care in long-term care is important. The development of this tool took place in co-creation with researchers, experts, educational staff and nursing staff working in long-term care. Taskforces with researchers and experts on quality data and education were established to develop the main steps of the tool. Nursing staff was involved in the development and testing of the tool. The LINC tool consists of 1) Assessment of the current learning climate and preferred quality data for nursing staff to work with, 2) Discussing findings from step 1 with the nursing staff team and formulate learning topics, 3) Start improvement cycle (PDCA cycle) using one learning climate topic and one quality data topic as a case to improve quality of care and improve the learning climate. During this cycle, nurse coaches are available to help nursing staff use the LINC tool materials. The LINC tool can be used to improve long-term care and has proven to be feasible. However, the LINC tool is currently tested in more nursing staff teams to increase its usability and effectiveness. Further development of the LINC tool is therefore a constant cycle of developing, implementing, testing, and evaluating, all in cooperation with stakeholders.
"DID I ASK FOR YOUR ADVICE?”: EFFECTS OF ADVICE FROM PARENTS ON ADULT CHILDREN'S DEPRESSIVE SYMPTOMS
Authors: Suitor J Jill , Gilligan Megan , Frase Robert , Stepniak Catherine
Published: December 2022

Studies of intergenerational relations typically conceptualize advice as a positive dimension of exchanges between parents and adult children. In contrast, we suggest that advice may often be a source of interpersonal stress and thus have detrimental effects on psychological well-being. Further, we suggest that these effects vary by race and gender. To address these questions, we use data from 725 adult children regarding advice from mothers, collected as part of the Within-Family Differences Study. Multilevel regression analyses revealed that the impact of receiving advice varied by the combination of gender and race. Among sons, receiving advice predicted higher depressive symptoms, regardless of race. However, receiving advice predicted depressive symptoms among Black but not White daughters. Taken together, these findings question whether advice is a positive dimension of intergenerational interaction and suggest that mothers’ advice may have a negative impact on adult children’s depressive symptoms, particularly for sons and Black daughters.
CORRELATES OF RACIAL DISCRIMINATION TRAJECTORIES AMONG BLACK MIDDLE-AGED AND OLDER ADULTS
Authors: White Kellee , Huang Shuo , Bell Bethany
Published: December 2022

Single cross-sectional measures of racial discrimination may mask the dynamic nature and cumulative impact of repeated exposures to discrimination. Characterizing racial discrimination trajectories, patterns of repeated exposure, may provide insight on age-related patterns of health risk and resilience. However, there is a dearth of research exploring racial discrimination trajectories. This study characterizes racial discrimination trajectories and identifies trajectory correlates among a nationally representative sample of middle-aged and older black adults who participated in the Health and Retirement Study (2006-2018). Repeated measures latent profile analysis was employed to identify racial discrimination trajectories. Logistic regression models, estimating odds ratios (ORs) and 95% confidence intervals (CIs), were conducted to investigate sociodemographic and neighborhood-level predictors of racial discrimination trajectories. Two racial discrimination trajectories were identified: low to moderate (82%) and persistently high (18%). Individuals 65+ (OR: 0.45; 95% CI: 0.32, 0.64) and female sex (OR: 0.59; 95% CI: 0.45, 0.76) were associated with a lower odds of belonging to the persistently high racial discrimination trajectory class. Individuals reporting higher levels of major lifetime experiences of discrimination (OR: 1.47; 95% CI: 1.33, 1.63) and greater neighborhood social cohesion (OR: 1.30; 95% CI: 1.1, 1.50) predicted membership in the persistently high racial discrimination trajectory class. These findings suggest heterogeneity in the cumulative patterning of discrimination among black middle-aged and older adults. Discrimination trajectories may enable greater precision in estimating the health consequences of cumulative exposure to discrimination. Future studies are warranted to determine whether membership in specific trajectory classes confers differential risk to age-related conditions.
QUALITATIVE COMPARISON OF TWO INTERGENERATIONAL SERVICE-LEARNING PROGRAMS
Authors: Bartlett Sara , Bergman Sky , Solomon Phyllis , Gellis Zvi
Published: December 2022

Intergenerational service-learning programs are an effective and frequently used training modality in undergraduate education and are often examined using qualitative methods. It is less common to qualitatively examine two such programs to compare their outcomes. This study reports qualitative findings from a mixed-methods study comparing two intergenerational service-learning programs in an undergraduate Psychology of Aging class. The longer, more relational intervention, the Lives Well Lived program, matched students and older adults exemplifying “successful aging” in a mutual interviewing, life review project utilizing documentary film, photography, and memoir creation. The comparison intervention, the Meals That Connect/Lunch Bunch program, also exposed students to older adults exemplifying successful aging, but in a shorter, less relational way. A convenience sample of 128 students (65 in the intervention group and 63 in the comparison group) answered post-intervention open-ended questions about what they liked/disliked about the program in which they participated, as well as any viewpoints about aging they felt changed or were reinforced by the project. Thematic analysis revealed students in both groups experienced decreased ageism and improved attitudes about aging. However, those participating in the Lives Well Lived program had closer relationships with the older adults participating in the project, expressed more positivity about their own aging process, and indicated more willingness to engage in future intergenerational relationships. Use of a comparison project in qualitative examination of intergenerational service-learning adds greater insight into such programs’ outcomes, enhancing quantitative effectiveness examinations.
IMPLEMENTING FUNCTION-FOCUSED CARE IN THE HOSPITAL: LESSONS LEARNED
Authors: Boltz Marie
Published: December 2022

The mentorship provided by the nurse interventionist is an important implementation strategy to support Function-focused care adoption in hospitalized older adults with dementia. The nurse interventionist works with unit champions and interdisciplinary stakeholder teams over a 12 month period. The first interaction includes using a brainstorming approach to develop unit-specific goals to support the integration of function-focused care into routine care delivery. Implementation strategies at the unit level include flexible staff training, involving staff in evaluations of care interactions, targeting pragmatic measures, and a feedback loop. Based on content analysis of field notes we will describe stakeholder goals established, action plans, and barriers and facilitators to meet goals in four hospital units. Key findings include the influence of leadership support, communication strategies, engagement of direct care staff, interdisciplinary collaboration, access to human and material resources, and contextual factors within the hospital setting (including pandemic-related challenges).
THE EXISTENTIAL CONTEXT OF GRAY DIVORCE
Authors: Bildtgård Torbjörn , Öberg Peter
Published: December 2022

In later years divorce rates for older people has increased in many parts of the Western world in what has been described as a “grey divorce revolution”. In Sweden divorce rates for people 60+ have more than doubled since the millennium. The purpose of this paper is to study the reasons older people attribute to their late life divorce. Qualitative interviews were carried out with Swedish men and women aged 62–82 who after the age of 60 had divorced from a cross-gender marital or non-marital cohabiting union (n=37). The interviews covered themes regarding the divorce process, including reasons for divorce, experiences of divorce and life as a grey divorcee. The results were analysed using principles from Grounded Theory. The results revealed four different types of divorce narratives: 1) Incompatible goals for the third age, 2) Personality change caused by age related disease, 3) A last chance for romance, and 4) Enough of inequality and abuse. A central insight generated by the study was the importance attributed to the particular existential conditions of later life in the divorce decisions. The results are discussed in relation to theories of the third age as a time of self-fulfillment, where the partner can either be part of or an obstacle to that project.
THE IMPACT OF PUBLIC REPORTING ON INEQUITIES IN HIGH-QUALITY HOME HEALTH UTILIZATION
Authors: Fashaw-Walters Shekinah , Rahman Momotazur , Gee Gilbert , Mor Vincent , Thomas Kali
Published: December 2022

Literature suggests that public reporting of quality may exacerbate disparities in access to high-quality post-acute and long-term care for older adults. The objective of this study was to evaluate the impact of the home health (HH) 5-star ratings on changes in high-quality HH agency (HHA) use, by race, ethnicity, income level, and place-based factors. Using a difference-in-differences framework, we found that after introduction of 5-star ratings adjusted rates of high-quality HHA use increased for all HH users, except for Latinx, Asian American/Pacific Islander, and low-income HH users, and disparities in access to high-quality HHAs were exacerbated for each of these groups. Last, we found that users within predominantly Latinx and lower income neighborhoods had a significantly greater decrease in their use of high-quality HHAs. Policymakers should be aware of the potential unintended consequences of public reporting and should consider adding measures of equity to the publicly reported information.
EFFECT OF A 6-MONTH HOME-BASED WALKING PROGRAM ON COGNITIVE FITNESS IN OLDER ADULTS WITH CHRONIC KIDNEY DISEASE
Authors: Bronas Ulf
Published: December 2022

We have previously demonstrated that cognitive status and white matter integrity are highly associated with physical fitness in older adult patients with chronic kidney disease (CKD). We present data from a two group RCT determining effect of a 6-month home-based walking intervention on physical and cognitive fitness compared to usual care. The intervention included use of a wearable activity monitor, weekly didactic phone meetings, interactive tools and monthly coach-delivered feedback. The intervention group had a 78% compliance rate to the 6-month exercise program (159.9 (149.2) minutes/week). Executive function composite score and global cognitive for intervention group > than control group. Additionally, global white matter integrity and functional connectivity improved in the intervention group and declined in the usual care group. We conclude that a home-based physical activity intervention can have significant improvement on cognitive health and neuroplasticity in older adults with CKD and lowering their risk of developing AD/ADRD
NOVEL GENOMIC AND EXCEPTIONAL LONGEVITY FINDINGS FROM THE LONG LIFE FAMILY STUDY
Authors: Wojczynski Mary , Glynn Nancy W , Hadley Evan
Published: December 2022

The Long Life Family Study (LLFS), funded by the National Institute on Aging, is an international collaborative study of the genetics and familial components of exceptional longevity and healthy aging. We phenotyped 4,953 individuals from 539 two-generational families (1,727 proband; 3,226 offspring) at baseline (2006-2009). A second visit (2014-2017) was conducted for 2,904 (478 proband; 2,426 offspring) participants. The longitudinal, comprehensive in-person visits measured domains of healthy aging, including physical performance, cognition, and blood markers. Extensive genetic analyses were performed using the baseline blood draw, including genotyping with the Illumina 2.5M Human Omni array, linkage analyses with the families, whole genome sequencing using the TopMED protocol, and metabolomic assays. Collectively, this symposium will present novel findings that examined differences in end of life events and cause of death between non-exceptional and exceptional long-lived women, elucidate potential rare variants associated with exceptional longevity, and examine new potential metabolomics pathways involved in gait speed and cardiovascular disease. Specifically, Dr. Galvin will share results from three Danish nationwide studies (including LLFS) on different end of life events in long-lived female siblings. Then, Dr. Gurinovich will share findings on new uncommon variants associated with extreme longevity. Next, Dr. Kuipers will discuss associations between lipid metabolomics and vascular health. Lastly, Dr. Santanasto will discuss lipid metabolomics associated with lower odds of slow gait speed. Dr. Evan Hadley, NIA, will be the discussant and will share insights and propose future directions for LLFS.
LIPIDOMIC ANALYSIS OF GAIT SPEED IN THE LONG LIFE FAMILY STUDY
Authors: Santanasto Adam , Fiestosa Mary , Lustgarten Michael , Christensen Kaare , Patti Gary , Zmuda Joseph , Cvejkus Ryan , Wojczynski Mary
Published: December 2022

Gait speed is a predictor of overall health and mortality in older adults. Metabolomics may provide insights into biological mechanisms underlying gait speed. Herein, we examined the association between 193 lipid metabolites with gait speed in 1,717 adults (52.1% women) aged 82.0 ± 14.5. Lipidomic analysis was performed using liquid chromatography-mass spectrometry. Gait speed was measured over 4-meters and slowness was defined as <0.8m/s. Logistic regression, adjusted for age, sex, field center, height, fasting-duration and familial-relatedness, were used to examine the association between log-transformed metabolites with slowness. A false discovery rate (FDR) of p<0.05 was employed to account for multiple comparisons. Gait speed was 0.83 ± 0.32 and 53.4% had slowness. Three lipid metabolites were significantly associated with lower odds of slowness: an acylcarnitine, sphingomyelin and a ceramide non-hydroxy fatty acid-sphingosine. Our results potentially link lipids involved with mitochondrial beta-oxidation and nerve signal transduction to gait speed in older adults.
ADULT CHILD PROXIMITY AND REPARTNERING AMONG PARENTS AFTER GRAY DIVORCE
Authors: Brown Susan , Lin I-Fen , Mellencamp Kagan
Published: December 2022

The rise in gray divorce is spurring growth in repartnering, which occurs more frequently after divorce than widowhood. Roughly 40% of men and 25% of women form a co-residential union following gray divorce. Drawing on the 1998-2014 Health and Retirement Study, we assessed whether parent-adult child proximity (living within 10 miles) was associated with men’s and women’s repartnering after gray divorce. Men’s relationships with their children tend to erode following gray divorce, and thus we anticipated that the association between proximity and repartnering was negligible. In contrast, women’s ties to adult children are largely resilient following gray divorce, which led us to expect that having a child nearby reduced chances of repartnering. Our analyses revealed that both men and women with a proximate child less often repartnered than those with no children nearby. Repartnering seemingly functions as an alternative means to “doing family” for those lacking nearby children.
HOSPICE UTILIZATION AMONG LONG-STAY NURSING HOME RESIDENTS DURING THE COVID-19 PANDEMIC
Authors: Wang Xiao (Joyce) , Belanger Emma , Thomas Kali , Dobbs Debra , Dosa David
Published: December 2022

Background

The COVID-19 pandemic has had significant impacts on nursing home residents. This study aims to examine how hospice utilization changed among long-stay nursing home residents between January and September in 2020, as compared with the same period in 2019, nationally. Design: A retrospective cohort study of residents present in US nursing homes as long-stay as of January 1st, 2019 and 2020, respectively. A subgroup of residents who died from January to September in each year was also examined. We utilized the Minimum Data and multiple administrative claims data. We compared hospice utilization rate between 2019 and 2020 nationally and by state.Outcomes: This study examined: 1) any hospice utilization among long-stay residents from January to September in 2019 and 2020 respectively, and 2) hospice utilization in the last 30 days of life among the decedent subgroup, which we also tracked as a factor of percent change in mortality rate at the state level.

Results

The hospice utilization rate among long-stay residents was 19.4% in 2019 and 19.7% in 2020. The rate was 27.5% in 2019 and 24.2% in 2020 among the decedent subgroup (χ2=553.1, p< 0.001), although the absolute number of decedents using hospice in the last 30 days of life was higher in 2020 than 2019. Substantial state variation in hospice utilization was observed, mostly following patterns in community-level infections.

Conclusions

Hospice managed to continue service delivery despite many challenges. The pandemic highlights the importance of integrating hospice and palliative care into emergency preparedness planning.
ELDER ABUSE TRAINING NEEDS AMONG NURSING HOME SOCIAL SERVICES DIRECTORS
Authors: Roberts Amy , Anetzberger Georgia , Smith Kevin , Bern-Klug Mercedes
Published: December 2022

This study aims to identify elder abuse training needs among social services directors. Using nationally representative data from the 2019 National Nursing Home Social Services Directors Survey, we found that approximately three-quarters of directors reported either a moderate or strong interest in receiving training in the following areas: (1) the types of abuse, neglect, and/or exploitation by staff, residents, family and/or other visitors…; (2) establishing trust with a resident and/or family member who feels mistreated by the nursing home or a staff member…; and (3) interacting with visitors whose behaviors are perceived as threatening to residents or staff. Hierarchical logistic regressions found significant associations between strong interest in each training topic and facility, department, and director characteristics. Additional training may enhance directors’ skills in explaining basic information about elder abuse and supporting other staff with strategies to address elder abuse and difficult interpersonal dynamics among staff, residents, families, and visitors.
A DEGREE IN SOCIAL WORK INCREASES FAMILY ENGAGEMENT WITH THE SOCIAL SERVICES DEPARTMENT
Authors: Roberts Amy , Kusmaul Nancy , Alaniz Amber , Bern-Klug Mercedes
Published: December 2022

This mixed-methods presentation will examine the role of social services directors in supporting the family members of nursing home residents. A logistic, hierarchical regression (n= 924) found a positive association between the social services director having a degree in social work and strong agreement with "family members regularly engage the expertise of the social services department." A qualitative analysis of written-in comments to the question, “What do you like about your job?” identified 234 comments that described directors’ view of the importance of working with and supporting families. A content analysis revealed that two types of support are provided to families, instrumental and emotional. Instrumental support includes connection to resources for adjustment, financial needs, and discharge planning. Emotional support includes activities such as helping people through transitions, and coping with grief and loss. Appropriately trained social services directors can offer different types of support and be valued resources for families.
IMPACT OF UNINTENTIONAL WEIGHT LOSS AND EXHAUSTION ON CLINICAL OUTCOMES FOLLOWING SURGERY
Authors: Kaufmann Christopher , Mardini Mamoun , Smail Emily , Tighe Patrick , Price Catherine , Manini Todd
Published: December 2022

For patients undergoing surgery, unintentional weight loss and exhaustion, two hallmarks of frailty, may be salient markers for identifying patients at risk for adverse postsurgical outcomes. This study examined how these frailty components impact postsurgical outcomes including length of stay, 30-day mortality, and discharge disposition. Patients with weight loss and exhaustion pre-surgery experienced greater length of stay, and higher odds of 30-day mortality as well as lower likelihood of being discharged home. After adjustment for confounders including age, sex, race, and disease history, the above results for the most part remained significant, although statistical significance was lost for 30-day mortality and some discharge dispositions. Results highlight importance of assessing frailty components to enhance surgical care in older adults.
LOW PHYSICAL ACTIVITY AND SLOW GAIT AS PREDICTORS OF POSTSURGICAL CLINICAL OUTCOMES
Authors: Smail Emily , Mardini Mamoun , Tighe Patrick , Price Catherine , Kaufmann Christopher , Manini Todd
Published: December 2022

Low physical activity and slow gait are independently associated with adverse health outcomes of aging (e.g., hospital readmission and mortality). The objective of this study was to build on current knowledge using presurgical indicators of frailty to predict postsurgical outcomes (i.e., length of stay, 30-day mortality, and discharge disposition). In a sample of over 8,900 patients, low physical activity and slow gait were both associated with a greater length of stay, higher odds of mortality, and lower odds of being discharged to home (vs. more intensive care). Associations remained significant for 30-day mortality and discharge disposition in fully adjusted models (adjusting for age, sex, race, and disease history). These results suggest that measuring movement-based presurgical markers of physical activity and slow gait may be useful for identifying patients at risk for poor postsurgical outcomes.
POSITIVE EMOTIONAL CONNECTION AND CAREGIVER WELL-BEING IN BEHAVIORAL-VARIANT FRONTOTEMPORAL DEMENTIA
Authors: Chen Kuan-Hua , Yee Claire , Brown Casey , Sapozhnikova Anna , Pressman Peter , Merrilees Jennifer , Fredrickson Barbara , Levenson Robert
Published: December 2022

Behavioral-variant frontotemporal dementia (bvFTD) is characterized by impairment in socioemotional functioning. Spouses caring for individuals with bvFTD often experience profound health/well-being declines, compared to Alzheimer’s disease (AD) caregivers and non-caregiving older adults. We hypothesized that disrupted positive emotional connections between spousal caregivers and individuals with bvFTD contribute to caregivers’ lower emotional well-being. 23 bvFTD-caregiver, 23 AD-caregiver, and 17 control dyads had a 10-minute conflict conversation in the laboratory. Positive emotional connections were measured as the covariation of partners’ positive emotional behaviors during the conversation. Caregiver emotional well-being was assessed via questionnaire (SF-36). We found that bvFTD caregivers had lower emotional well-being than AD caregivers and controls (who did not differ from each other, t=.80, p=.43), c=-.70, p<.01. Importantly, this effect was fully mediated by bvFTD caregivers' lower positive emotional connections, c’=-.38, n.s. We speculate that lower positive emotional connections can cause social isolation and contribute to bvFTD caregivers’ health/well-being declines.
FLIPPING STIGMA ON ITS EAR: A TOOLKIT FROM PARTICIPATORY ACTION RESEARCH
Authors: Sakamoto Mariko , Mann Jim , O'Connor Deborah , Phinney Alison
Published: December 2022

People living with dementia face persistent stigma, discrimination and social exclusion, with significant emotional, physical and social consequences. Addressing this requires changing attitudes and fostering actions for communities to include people with dementia as citizens with agency and self-determination. This presentation highlights the work of an Action Group (AG) of people living with dementia. As part of a four-year Participatory Action Research study aimed at addressing the stigma, discrimination and social exclusion that is so common to the dementia experience, members of the AG in partnership with the research team developed the Flipping Stigma on its Ear Toolkit. Focus will be on the action-oriented nature of this research project, an overview of the toolkit, and exploration of the communal space that was created by AG members in the process of working together, learning from one another, and making a collective contribution towards addressing stigma, discrimination and social exclusion.
THE ELDER MISTREATMENT EMERGENCY DEPARTMENT TOOLKIT: ADDRESSING ELDER MISTREATMENT DURING COVID-19 AND BEYOND
Authors: Stoeckle Rebecca , Haggerty Kristin Lees , Fulmer Terry
Published: December 2022

Elder Mistreatment (EM) is a prevalent problem that too often goes undetected. Hospital emergency departments (ED) offer a unique opportunity to screen for elder mistreatment and connect patients at risk with needed services but most do not have training and protocols in place to help staff screen for and respond to EM. In 2020, the National Collaboratory to Address Elder Mistreatment partnered with five hospitals to test the feasibility of implementing a streamlined set of tools and training known as the Elder Mistreatment Emergency Department Toolkit, and conducted two qualitative studies to better understand related barriers and facilitators to addressing EM. The presentations in this symposium share results from case studies at two feasibility test sites: Heywood Hospital, a small community hospital in central Massachusetts, and Lyndon B. Johnson Hospital, the busiest Level III Trauma Center in Texas, each presented by the respective site’s local clinical champion. Following presentations by the clinical champions, National Collaboratory expert core faculty will report results from two related qualitative studies. The first explores barriers and facilitators to communication between EDs and Adult Protective Services (APS) and the second explores older adult survivors’ own perspectives on the screening and response tools used in the feasibility study. The results of these studies highlight the need for streamlined and easy-to-use tools for identifying and responding to EM in busy EDs, the need for a personalized and trauma-informed approach to screening, and the importance of a personalized approach to connecting the ED and APS.
ADULT MALTREATMENT OUTCOMES OF A TARGETED CASE MANAGEMENT INTERVENTION FOR SELF-NEGLECT
Authors: Reynolds Courtney , Ejaz Farida , Rose Miriam
Published: December 2022

A longitudinal study to prevent self-neglect among at-risk, older (age 60+) or disabled (age 18+) healthcare patients was conducted collaboratively by a gerontological research institute, a health care system, and Texas Adult Protective Services (APS). Selected patients (n = 285) from 19 primary care clinics received targeted case management services for four months by a trained social worker. Their median age was 70, 72% were Hispanic/Latino, 79% had a high school education or less, and 73% had monthly income less than $1,361. A screening tool was used to identify adult maltreatment during baseline and posttest interviews. Consistent with national prevalence rates, 86% of participants at baseline, and 90% at posttest, reported they had not recently experienced abuse. In this sample, we found a significant decrease in mean scores on the screening tool from baseline (M = 0.24, SD = 0.63) to posttest (M = 0.14, SD = 0.48); t(241), p < 0.05. Six of the seven participants reported by project social workers to APS had at least one allegation of self-neglect. APS administrative data were also examined and included another 10 study participants reported to APS during the study. In total, 21 reports were made, with 26 allegations of maltreatment, of which 35% were validated, all for self-neglect; 70% of self-neglect allegations reported by project social workers were validated. Results suggest that targeted case management services could reduce the incidence of self-neglect. Similar targeted interventions may help to identify, report, and address other forms of adult maltreatment.
ASSOCIATIONS BETWEEN MEDIA CONSUMPTION AND AGEIST ATTITUDES: A CROSS-NATIONAL ANALYSIS
Authors: Zhao Erfei , Crimmins Eileen , Zelinski Elizabeth , Choi Eunyoung
Published: December 2022

The mass media has been thought to be associated with public opinion, often creating and sustaining stereotypes. However, little is known about the role of media exposure in people’s ageist attitudes, particularly at a cross-national level. This study examines whether the daily use of different media types is associated with personal attitudes towards older people. We analyzed data from 59,103 adults across 54 countries, using the World Value Survey wave 6 (2010-2014). Personal ageist attitudes were assessed by whether participants agree that older people are a burden on society. We used logistic regression, controlling for individual- and country-level factors. Our findings suggest that people’s exposure to media is significantly associated with their attitudes towards older adults, but differently by the platform and respondents’ age. Those who used newspaper (OR:1.66, CI:1.38-1.98), magazines (OR:1.67, CI:1.27-2.20), and radio (OR:1.42, CI:1.23-1.65) were more likely to have negative attitudes toward older people, whereas those who used TV (OR:0.62, CI:0.53-0.72) and internet (OR:0.76, CI:0.65-0.89) were less likely to. Further, the effects of newspaper and radio consumption on people’s attitudes were moderated by respondents’ age. Younger adults’ ageist attitudes had a stronger negative relationship with these media types compared to those that are older. For the older age group, in contrast, more consumption of newspapers and radio are associated with less ageist attitudes. Future studies may focus on the content of each platform and assess their effect on people’s ageist attitudes by age groups in order to understand how to foster a more age-friendly media environment.
DO BELIEFS THAT OLDER ADULTS ARE INFLEXIBLE SERVE AS A BARRIER TO RACIAL EQUITY?
Authors: Chaney Kimberly , Chasteen Alison
Published: December 2022

Past research has demonstrated that older adults are stereotyped as less malleable than younger adults, such that older adults are perceived to be less capable of changing their beliefs and learning new things. Moreover, beliefs that people are less malleable are associated with lower confrontations of prejudice, as perpetrators are seen as less capable of changing their (prejudiced) behavior. The aim of the present research was to integrate these lines of research to demonstrate that endorsement of ageist beliefs that older adults are less malleable will lead to lower confrontation of anti-Black prejudice espoused by older adults. Across four experimental studies (N = 1,310), people were less likely to confront anti-Black prejudice espoused by an 82 year-old compared to a 62, 42, or 20 year-old, due, in part, to beliefs that older adults are less malleable. Further exploration demonstrated that malleability beliefs about older adults were held across young, middle-aged, and older adult samples, though older participants were the least likely to confront prejudice, regardless of perpetrator age. Alternative mechanisms are explored, including respect, perceived social influence, and perceived awareness of egalitarian norms. These findings demonstrate how stereotypes about older adults can impede racial equality and highlight that interventions geared towards reducing ageism could, in turn, lead to greater racial equality.
THE ROLE OF PPARδ-DRIVEN β-OXIDATION IN BONE HEALTH DURING AGING
Authors: Prideaux Matt , O'Connell Tom , Kitase Yukiko
Published: December 2022

Musculoskeletal disorders are a significant complication of aging, leading to increased morbidity and mortality. However, current understanding of the mechanisms by which aging affects skeletal health is limited. Osteocytes are the most numerous and long-lived bone cells and play key roles in maintaining bone mass by responding to anabolic signals such as mechanical loading. Energy metabolism is dysregulated in many cells with aging, however regulation of energy metabolism in osteocytes and how this is affected during aging and by mechanical loading remains undefined. To investigate this, we first used IDG-SW3 osteocyte cells to determine the effects of mechanical loading on osteocytes in vitro by applying fluid flow shear stress (FFSS). FFSS increased Pparδ and Cpt1 expression, key promoters of fatty acid β-oxidation (FAO). Pharmacological antagonism of PPARδ or CPT1 resulted in dysregulated expression of key bone remodeling genes and impaired ATP release in response to FFSS. In vivo, mechanical loading significantly increased FAO in tibia cortical bone. However, FAO was impaired in the bones from aged mice. To further elucidate the role of osteocyte FAO, we deleted PPARδ specifically in osteocytes (PPARδ cKO), which resulted in decreased FAO and bone volume in female PPARδ cKO mice. Lastly, treatment of aging mice with the PPARδ activator GW0742 resulted in significantly increased bone mineral content, density and trabecular bone volume. These findings suggest important functions of osteocyte energy metabolism during aging and with mechanical loading on bone and identify PPARδ-driven FAO as a novel therapeutic target for improving skeletal health with aging.
NUTRITION, INFLAMMATION, AND PHYSICAL AND MENTAL HEALTH IN AGING ADULTS WITH CHRONIC WOUNDS
Authors: Hwang Yeji , Hathaway Zachary , Stoll Isabella , Hufnal Shelby , Lewin Peter , DiMaria-Ghalili Rose Ann
Published: December 2022

Nutritional status can impact the healing of chronic leg wounds (CLW). This secondary data analysis examined characteristics associated with nutritional status among aging adults (N=62, M= 57.5, SD 12.1 years of age) living with a CLW who were enrolled in a randomized control trial to test a novel ultrasound intervention on wound healing. Nutritional status (Mini-Nutrition Assessment, [MNA]), physical and mental health (36-Item Short-Form Health Status Survey), and inflammation (high-sensitivity C-Reactive Protein [CRP]) were measured at baseline. Majority of the participants were male (54.8%), non-Hispanic Black (67.7%) and either malnourished or at risk of malnutrition (64.5%). Compared to individuals with normal nutrition, individuals with malnutrition or risk for malnutrition had on average poorer physical health (38.7 vs 33.4, p <0.01), mental health (52.4 vs 45.8, p=0.03) and greater inflammation (CRP=13.4 vs 24.0, p=0.05). Tailored interventions targeting nutritional status, inflammation, physical and mental health are needed in aging adults with CLW.
RACIAL AND ETHNIC DIFFERENCES IN THE LIFE COURSE INFLUENCES OF SOCIOECONOMIC STATUS ON ADULT SYSTEMIC INFLAMMATION
Authors: Kelly Amber , Morton Patricia , Eid Fatima , Ferraro Kenneth
Published: December 2022

Two fundamental causes of health disparities in the U.S. are race and socioeconomic status (SES). Although these disparities emerge early in the life course, there is limited research on how race/ethnicity intersects with SES over the life course to influence later-life systemic inflammation—a key pathogenic process of health for older adults. Moreover, life course studies on systemic inflammation often focus on Black/White differences. Analyzing a sample of Black, White, and Hispanic Americans, this study examined the intersecting influences of childhood SES, race/ethnicity, and adult education on three time points of later-life inflammation levels (measured using C-reactive protein [CRP]). Longitudinal mixed-effects models were estimated using a sample of U.S. men (n=4,137) and women (n=6,187) over age 50 from the Health and Retirement Study during a decade of observation (2006-2016). Black men who experienced low childhood SES had higher levels of CRP than White men with low childhood SES; education did not moderate these associations. Education had a stronger protective effect against systemic inflammation for Hispanic men who experienced childhood socioeconomic disadvantage compared to their White counterparts. For women, the protective effect of education on systemic inflammation was stronger for White women compared to Black and Hispanic women. There were no significant childhood SES interactions for women. Findings indicate that the effects of SES on later-life systemic inflammation are contingent upon race/ethnicity, suggesting that intersectionality operates over the life course to produce health disparities in later-life. However, adult education acts as a leveler of life course inequality for Hispanic men.