bluuebunny/crossref_metadata_2025 huggingface dataset:
Launching the Living Alone With Cognitive Impairment (LACI) Project: Bridging Research and Policy
Authors: Portacolone Elena , Johnson Julene , Torres Jacqueline , Glymour M Maria , Keiser Sahru , Tran Thi
Published: December 2021

The Living Alone with Cognitive Impairment (LACI) Project bridges research and policy to develop policy recommendations to address the needs of people living alone with cognitive impairment (PLACI) through new expansions of long-term services and supports. There are an estimated 4.3 million PLACI in the United States. Access to formal LTSS is critical to them because they lack cohabitants to assist with activities of daily living and navigating LTSS, especially during the COVID-19 pandemic. To bridge research with policy, seventeen Policy Advisory Group (PAG) members were recruited, including representatives from state and local government, and LTSS policy experts. Between November 2020-January 2021, a total of 17 individual meetings were conducted with PAG members and one webinar convening of the group. The PAG identified preliminary recommendations in three areas, including: 1) important areas of inquiry for qualitative and quantitative research, 2) best practices for addressing equity across diverse racial/ethnic minority groups, and 3) preliminary policy recommendations that leverage existing innovations. The LACI Project team is actively incorporating the PAG feedback by: a) modifying research questions for the quantitative and qualitative research, b) convening a diverse Community Advisory Group, and c) crafting preliminary policy recommendations based on PAG input. To conclude, engaging the expertise of the PAG to develop policy recommendations to increase LTSS for PLACI is a promising method of bridging research and policy. The engagement of policy experts ensures that fore-coming research is designed to address the most important policy gaps and all policy recommendations are actionable and timely.
Transfers among Long-term Nursing Home Residents during the COVID-19 Pandemic
Authors: Montoya Ana , Chang Chiang-Hua , Park Pil , Bynum Julie
Published: December 2021

Transferring long-term nursing home residents between facilities can compromise the quality of life and be associated with functional decline, hospitalizations, and even death. This study aimed to examine transfer rates and identify risk factors associated with transfers among long-term nursing home residents before (2018-2019) and during the COVID-19 pandemic (2020). Using the Michigan state Minimum Data Set data 2018-2020, we identified long-term residents as those who stayed in nursing homes for at least 100 days each year (N=39,693, 39,454, and 35,575, respectively). We defined a facility-to-facility transfer as a direct transfer between two nursing homes. We first examined the likelihood of transfer by year using logistic regression models, adjusting for residents’ age, sex, race, and marital status. We then examined two health statuses that could be associated with a transfer: activities of daily living (ADL) and cognitive impairment. Finally, we compared transfers that occurred before COVID-19 (2018-2019) and during COVID-19 (2020), adjusting for residents’ demographic characteristics and health statuses. After adjustment, age was the only factor associated with transfers for all three years (Age>=80: AOR=0.61, 95% CI: 0.54-0.69; AOR=0.63, 95% CI: 0.55-0.72; AOR=0.71, 95% CI: 0.63-0.80, respectively). New risk factors in 2020 were Black race (AOR=1.22, 95% CI: 1.07-1.40) and requiring ADL assistance (AOR=1.24, 95% CI: 1.03-1.49). The COVID-19 period had higher transfer rate (unadjusted rates 2.9%, 2.7%, 3.5%, respectively) with 10% higher odds of transfer compared to before COVID-19 (AOR=1.10, 95% CI: 1.01-1.20). This finding suggests that COVID-19 has an impact on how nursing home transferred their long-term residents.
Variables Impacting Nursing Home Goals of Care Discussions and Order Implementation During COVID-19
Authors: Burack Orah , Reinhardt Joann , Mak Wingyun , Weerahandi Himali , Canter Benjamin , Boockvar Kenneth
Published: December 2021

Nursing home (NH) residents are especially vulnerable to COVID-19, disproportionately suffering from severe illness and death. As such, resident Goals of Care (GOC) often had to be quickly established to ensure treatment preferences were known and respected. This study examined variables related to the occurrence of GOC discussions and added orders (Do Not Resuscitate, Do Not Intubate, and Do Not Hospitalize), including demographic, physical functioning, cognitive impairment, depression, number of diagnoses, and Optum participation (Optum provided added specialized care by nurse practitioners who routinely address GOC preferences). Subjects were 286 COVID positive residents from a large NYC NH. All data were obtained from the NH’s electronic medical records. Patient median age was 81 n (interquartile range 71-88), 59% were female, 61% were long stay (stay >100 days) and 39% were short stay. Using bivariate correlations we found that older short stay residents were more likely to have GOC conversations. Additionally, older, cognitively impaired, Optum participants were more likely to have orders added. When all independent variables were entered into binary logistic regressions, only older age and being a primary English speaker were significantly related to the occurrence of GOC conversations (□2= 21.76**; N=278; Nagelkerke R2 = .10), while older age and being an Optum participant were related to added orders (□2=32.18**; N=164; Nagelkerke R2 = .24). Results have implications for (1) ensuring the GOC wishes of diverse populations are known and abided by and (2) improving the quality of clinician – resident GOC discussions.
The Seasons of COVID-19: understanding the mood of older adults in the UK through a barometer survey spanning 12 months
Authors: Palmarini Nicola , Mitchell Alex , Hall Lesley , McNaughton James , Nixon Charlotte
Published: December 2021

The impact of COVID-19 on older adults has been analysed through different research approaches. However, with its sudden global spread, combined with uncertainty about which countermeasures would be employed, there was a lack of opportunity to systematically and continuously engage in a system of observing the moods of older adults forced to live in unexpected conditions. Ageist narratives, social distancing, the unending barrage of real and fake news, and the lockdowns, have given rise to what we define as a series of “seasons” of life, characterised not by the weather barometer, but by moods of people. How much did these external events, like the impact of weather, affect the mood of older adults? We immediately recognised the pandemic’s long-term nature, and thanks to our position as an "observatory" of social dynamics, and because of our existing community of older adults (VOICE), we could involve our members to provide valuable insights about mood and wellbeing during the pandemic. We initiated a weekly pulse survey, based on the two same questions, starting in week 13 of 2020. Across the 50 weeks which followed, we received 2577 responses. They rated their mood on a scale of 1 (extra-stormy) to 5 (all sunshine), before we collated the data and mapped on key events related to media announcements and political decisions. Our research showed the impact of these events on the mood of participants, and the potential of this approach to identify trends in mood to help policy makers with informed decision-making during unprecedented times.
Type 2 Diabetes Management Among Older Black American Men During the COVID-19 Pandemic: A Qualitative Investigation
Authors: Sherman Ledric , Comer-HaGans DeLawnia , Vera Sara
Published: December 2021

As COVID-19 swept across the globe in 2020, it appeared to have infected and killed Black Americans at a disproportionately higher rate. However, few studies have focused specifically on the complications of managing diabetes, expressly type 2 diabetes (T2D), among Black men during the global pandemic. Therefore, the purpose of this qualitative study was to seek understanding of the experiences in managing T2D among Black men during the COVID-19 pandemic. One on one interviews were conducted via Zoom video conferencing with twenty-two (n=22) Black men regarding their experience of managing type 2 diabetes (T2D) in a pandemic environment. Four main themes emerged from the study, which are: (1) stress levels during the pandemic, (2) barriers to managing my diabetes, (3) who/what is helping the most, and (4) communication with health-care provider. As more information becomes available, it is apparent that having diabetes increases the risk for detrimental COVID-19 outcomes (i.e. increased lengths of hospital stays, the need for mechanical ventilation, and mortality. Future research efforts are crucially needed to provide an improved understanding of how individuals across all racial groups are managing diabetes during the COVID-19 pandemic.
Loneliness and Neuropsychiatric Symptoms in Cognitively Impaired Older Adults during COVID-19 Pandemic
Authors: Padala Prasad , Jendro Ashlyn , Gauss Clinton , Wilson Kerrie , Das Aparna , House Samuel , Mooney Scott , Padala Kalpana
Published: December 2021

Background: Cognitively impaired older adults living in the community have been vulnerable to the effects of COVID-19 confinement. The current study’s objectives were to examine the prevalence of loneliness in such adults along with impact of COVID-19 on neuropsychiatric symptoms and functional status. Methods: A cross-sectional study was conducted in community dwelling cognitively impaired older Veterans (N=41). Demographic data such as age, gender, race, and rurality were collected. Loneliness data were collected with the 3-item Loneliness Questionnaire. Cognition was assessed with the Tele-Montreal Cognitive Assessment (T-MoCA) and functional status of instrumental activities of daily living was assessed with the Functional Activities Questionnaire (FAQ). Neuropsychiatry symptoms including severity and distress were collected using the Neuropsychiatric Inventory (NPI), and change during COVID was also recorded for each symptom. Results: Demographic characteristics included: mean age of 71.9 (±8.6) years, 95.1% male, 46.3% rural, 75.6% Caucasian, and 19.5% African American. Loneliness was prevalent in most participants (62.5%). T-MoCA and FAQ mean scores were 15.1 (±4.5) and 10.0 (±8.6), respectively. Mean NPI total severity and total distress were 8.4 (±5.9) and 11.4 (±8.5), respectively. Irritability was most frequently reported symptom (65%), followed by agitation (57.5%), anxiety (55%), depression (50%), and night-time behavior (50%). A majority of the participants reported worsening of neuropsychiatric symptoms during COVID (71.1%). Among those that reported worsening neuropsychiatric symptoms, 70.4% noted an increase in ≥ two symptoms. Conclusion: Older adults with pre-existent cognitive impairment may be at high risk for loneliness and worsening of neuropsychiatric symptoms during the COVID pandemic.
Social Determinants of Health And The Onset of Dementia in Later Life
Authors: Liu Darren , Yamashita Takashi , Burston Betty , Guthikonda Chetana
Published: December 2021

Dementia is a debilitating neurodegenerative syndrome characterized by deterioration in memory, cognitive, behavioral, and physical capacity. Recent research has indicated that some early-life social determinants of health (SDH), which vary by race/ethnicity may hold clues to the onset of dementia. Although early life clinical risk factors of dementia have been identified, early-life SDH such as education, sociodemographic and socioeconomic characteristics are yet to be collated. This review study focused on early-life (less than18 years of age) SDH in relation to cognitive decline in later life and differences across racial/ethnic groups in the U.S. A systematic review of articles in and after January of 1999 was conducted using Scoping Reviews - an approach for evidence synthesis to determine the coverage of a body of literature. Studies that report the impact of early-life social determinants on late-life cognitive decline were identified through the searches of CINAHL, Global Health, PsycINFO, PubMed and Scopus databases. Our initial database search resulted in 823 studies, and of those, 102 studies satisfied the inclusion criteria. The systematic review identified the following risk factors: lower education (34%), lower socioeconomic status (25%), Adverse Childhood Experiences (ACEs) (14%), exposure to environmental toxins (11%), food insecurity (6.8%), and rural residence (4%). Although education and socioeconomic status are well-known risk factors of cognitive decline in later life, other understudied factors such as food insecurity and residing in rural areas are yet to be explored. Implications in terms of understanding the link between early life SDH and dementia in later life are discussed.
Does Useful Field of Vision Predict Attention While Driving Between Young and Older Adults?
Authors: Dunterman Rebecca , INTRIERI R
Published: December 2021

The Insurance Information Institute (2017) reports drivers aged 65 and up are involved in the second highest rate of fatal car crashes. It is important that there is a fair and standardized assessment to test driving fitness. The prime objective was to assess the utility of the Useful Field of View (UFOV) across young and old groups to predict performance on a simulated driving exercise. Community-dwelling adults aged 65 and older (n=48) and students (n=48) recruited from an undergraduate research pool served as participants. They completed a series of demographic, health and cognitive measures, besides a Useful Field of Vison (UFOV) task and a driving simulation exercise. Results showed that collision avoidance and braking varied between age groups, with older adults appearing to be less likely to avoid collision (Older M = 12.46, SD = 10.25, Younger (M = 7.96, SD =4.92; n = 47), but quicker to brake (Older M = 3.64, SD = 3.41, Younger M = 9.79, SD =7.91). There were group differences for driving simulator performance, predicted by cognitive measures (Young; R2 = .099, p = 0.005; Old; R2 = 0.094, p = 0.038). UFOV scores did not predict group differences in driving simulator performance (Young; R2 = 0.009, p = 0.664; β = 0.089, p = 0.437) , (Older; R2 = 0.061, p = 0.522; UFOV-DA β = -0.074, p = 0.555; UFOV_SA β = 0.289, p = 0.194). These findings have implication for the development of pragmatic capacity to drive assessments.
Not Seeing Double: Discordance in Disease, Function, and Their Longitudinal Associations in Monozygotic Twins
Authors: Teas Elizabeth , Robertson Olivia , Marceau Kristine , Friedman Elliot
Published: December 2021

Prior research on the causality and directionality between disease and functional limitations is ambiguous. The current study used longitudinal monozygotic twin data to test both directions linking disease burden and functional limitations in middle-aged and older adults, controlling for genetic and familial factors. We also examined potential moderation by psychological well-being. The Twins sub-sample from the first two waves of the longitudinal Midlife in the United States (MIDUS) study was used (Wave 1: 1995-1996, Wave 2: 2004-2006). Only monozygotic twins (N = 713) were included in analyses. In separate multi-level models, we examined disease burden at MIDUS 2 predicted by functional limitations at MIDUS 1 and MIDUS 2 functional limitations predicted by disease burden at MIDUS 1. Disease burden and functional limitations at MIDUS 2 varied substantially within families. There was no within-family association of earlier functional limitations with change in later disease burden (b = .40, p = .39), but there was a within-family association such that the twin with higher baseline disease burden had a greater increase in functional limitations than his/her co-twin (b = .06, p = .02). Well-being was not a moderator in either model. We found support for a potentially causal association between earlier disease burden and later increases in functional limitations, consistent with the Disablement Process Model. Sensitivity analyses confirm the detected within-family effect. Possible mechanisms linking disease burden and functional limitations are discussed as potential targets for future research.
Evaluating a Geriatric Educational Program: Exploring Opportunities for Increasing Impact and Scale
Authors: Hosseini Shera , Howard Michelle , Ward Allison
Published: December 2021

The geriatric population is rapidly growing, and this growth is beyond the pace of increase in the number of healthcare professionals who are qualified to care for and tend to the various needs of this significant subgroup of the population. The current university curricula have not been sufficient in terms of quantity as well as their ability to address the ageism inherent in the perspectives of students from across the educational spectrum. In recognition of the absence of standardized geriatric guidelines, medical associations across Canada and the United States have established geriatric learning competencies for medical programs. Nevertheless, there are exiting gaps regarding the development and evaluation of geriatric-focused didactic programs that adequately train and build competency among the students interested in pursuing careers with geriatric-specific elements. A university-wide program was developed to enhance aging education and build competency through sparking interest, providing better education related to aging, and building better relationships between future healthcare professionals and older adults. To evaluate the impact of this program, a logical framework was developed a-priori and revised through constant iterations and following discussion with the program’s multidisciplinary stakeholder group. Quantitative measures are being augmented with in-depth qualitative interviews to explore elements influencing students’ experiences with the program and the effect on their interests in and attitudes towards geriatrics. The results will inform our conclusions regarding program effectiveness in enhancing interest in geriatric-focused education among the students and trainees and assist with recommending future directions regarding impact and large-scale dissemination and implementation.
The 4Ms Provide A Structural Framework For Organizing Educational Materials
Authors: Duthie Edmund , Simpson Deborah , Szymkowski Amanda , Denson Kathryn , Denson Steven
Published: December 2021

The John A Hartford Foundation and the Institute for Healthcare Improvement (IHI)’s 4Ms of mentation, mobility, medications and (what) matters most provide a much-needed framework for helping system leaders and frontline teams consistently deliver high-quality, age-friendly care. Geriatric Fast Facts (GFFs) is a virtual resource providing teachers/learners with peer-reviewed, evidence-based summaries on topics essential to older adult care via a searchable website [www.geriatricfastfacts.com]. To determine if GFFs can be classified by the 4Ms we initially did a free text search of all GFFs. That revealed GFFs whose foci were unrelated to the 4Ms (e.g., mobility emerged in a fluoroscopy GFF as a minor element related to patient positioning). Therefore, all GFFs were independently reviewed by a geriatrician and the website manager and classified according to the 4M rubric (a single GFF can be classified in multiple M’s such as #93 on Age Friendly Health Systems). Any differences were adjudicated by the GFF editor. 64% (60/ 93) of GFFs strongly linked to one of the 4Ms. The number of GFFs dedicated to the 4Ms are as follows: 20 what matters most, 18 medications, 13 mentation, and 9 mobility. Those that were not coded within 4Ms were often very disease/specialty oriented. A total of 36 were not classified. For example, GGF #39 focuses on the etiologies of anemia among older adults. The 4M framework can be easily applied to educational materials to support consistent and clear conceptual model across learning conditions and materials.
Applying the New World Kirkpatrick Model to evaluate an online training course introducing a multi-sensory device
Authors: Perion Jennifer , Steiner Victoria , Kinney Jennifer , McBride Kimberly , Saltzman Barbara
Published: December 2021

Online education offers care providers flexibility and convenience. Applying the New World Kirkpatrick Model of training evaluation, this descriptive study evaluated the design and content of a 30-40 minute online training course that introduces direct-care workers to a multi-sensory device to help manage dementia symptoms in older adults. Following course completion, an online survey obtained ratings of engagement (i.e., aesthetics, ease of use, novelty, and involvement), relevance, and knowledge/skills gained from the training using a 5-point Likert scale. A convenience sample of 72 undergraduate students enrolled in health science and human service programs at a Midwestern university participated. The majority were white (83.3%), non-Hispanic (81.9%) females (88.9%). Most participants agreed or strongly agreed (median=4) with positive statements related to engagement with the course. Statements about relevance to their intended career were rated even higher (median=5). Wilcoxon signed-rank tests for matched pairs revealed statistically significant improvements on self-reported pre-post knowledge/skills scores (p<0.005). The results indicated that participants found the training aesthetically pleasing, easy to use, novel, and that it encouraged user involvement. Participants thought the topics covered were relevant to the professional career they are pursing, and they learned new knowledge/skills. Responses to open-ended questions suggested improvements to the design (e.g., color choice) and content (e.g., expanded topics and resources). Future research will evaluate a revised course with direct-care workers who will use the multi-sensory device in long term care facilities. Subsequently, an intervention study will determine the effectiveness of the device in increasing the well-being of people with dementia.
Aging in the Aftermath of Adversity: Later-Life Impact of Institutional Child Abuse and Disclosure
Authors: Rohner Shauna , Maercker Andreas , Carr Alan , Thoma Myriam
Published: December 2021

Until the 1990’s in Ireland, many children in institutional care experienced abuse and neglect, with lasting negative effects, including trauma symptoms and psychopathology. While trauma disclosure can be important for recovery, findings are inconsistent and often lack consideration of wider social and interpersonal contexts. As survivors of this historical adversity enter later-life stages, research is needed on the long-term impact and to clarify the role of disclosure. Therefore, this study aimed to examine the later-life impact of institutional child abuse on health and well-being, and the role of trauma disclosure and socio-interpersonal contexts in an older adult sample. Qualitative semi-structured interviews (60-120 minutes) were conducted with 17 Irish older adults, aged 50-77 years (mean age=60.7 years), who experienced childhood institutional abuse. Audio-recorded interviews were transcribed and analysed using Framework Analysis. Themes for ‘childhood and related later-life adversity’ included detrimental perceptions and interactions, re-exposure and reminders, failure of system and society, and cycle of abuse. Disclosure themes included successful, unsuccessful, and non-disclosure, as well as evidence of socio-interpersonal interactions (e.g., non-disclosure influenced by shame or fear, compounded by socio-cultural values, (lack of) social acknowledgment, or the power of the church in society). Results suggest that childhood institutional abuse can have long-term negative impacts into later life, including social, psychological, physical health, and socio-economic aspects. Disclosure results emphasize the need to consider the complex social, cultural, and interpersonal contexts within which an individual is embedded. This may enhance understanding and facilitate targeted health and social care services for this older adult population.
Age Differences in Awe Among Young, Middle-aged, and Older Adults: Extensions of Socioemotional Selectivity Theory
Authors: Ebert Alexandria , Patrick Julie Hicks , Huggins Maya , Yadava Aradhita , Collett Sarah
Published: December 2021

Increases in motivation for the pursuit of emotionally meaningful goals and activities as people age (socioemotional selectivity theory; SST) necessitates the investigation of means in which these goals and activities can be realized. In the present study adults (N = 130) aged 25 to 78 (M = 53.32; SD = 15.181) watched awe-inducing (view of space) and happiness-inducing (comedian Robin Williams interacting with Koko the “talking gorilla”) videos and then completed measures associated with awe, affect, and well-being (measured via PGC Positive and Negative Affect Scales). Analyses of Variance (ANOVAs) were conducted to examine the effect of age (split by young, middle-aged, and older) on experiences of awe and positive affect in response to watching each video. There was a main effect of age on experiences of awe for both videos (ps < 05). Specifically, older adults experienced significantly higher levels of awe than young adults (p < .05) in response to video 1. They also experienced significantly higher levels of awe than young adults (p < .01) in response to video 2. Bivariate correlations among awe, well-being, and happiness were similar in strength and magnitude in each age group (ps < .05). Overall, consistent with Socioemotional Selectivity Theory, our findings suggest that affective reactions of awe and happiness, induced by videos, relate to well-being across age-groups. Future work should test whether the use of these awe-inducing videos can improve well-being.
Interpersonal Interactions and Affect in Daily Life Among Midlife and Older Adults
Authors: Stawski Robert , Witzel Dakota , Nichols Madeline , Charles Susan
Published: December 2021

Theories of age and emotional wellbeing posit that older age is associated with better affective well-being through avoidance or minimization of distressing experiences and prioritizing positive experiences and emotions. To test these theories, researchers have examined change in affect (i.e., reactivity) associated with negative interpersonal experiences in daily diary studies, given the compromising effects these interpersonal stressors exert on daily affect. In contrast, age differences in the potential affect-enhancing effects of positive interpersonal experiences have been comparatively neglected. Using the second wave of the National Study of Daily Experiences, we evaluated age differences in the frequency of daily negative and positive interpersonal interactions, as well as the affective responses to these interpersonal interactions. Positive and negative affect, as well as negative and positive interpersonal interactions were assessed on eight consecutive evenings. Analyses included 818 participants (Mage=53.3, SD=11.8, Range=34-83; 60% female) who experienced both negative and positive interpersonal interactions during the 8-day protocol. Preliminary results revealed increased frequency of negative interpersonal interactions and decreased frequency of positive interpersonal interactions with age (ps<.01). Further, negative interpersonal interactions were associated with increases in negative affect and decreases in positive affect (ps<.01), while positive interpersonal interactions were associated only with increased positive affect (p<.01). Finally, modest evidence of age-related reductions in the affective impact of negative, but not positive, interpersonal interactions emerged (p=.03). Discussion will focus on how studies of interpersonal interactions in daily life can inform theories of aging and promote emotional wellbeing throughout adulthood and later life.
Socioemotional Goals and Definitions of Emotion Terms: A Qualitative Analysis Across Age
Authors: Orlovsky Irina , Ready Rebecca , Martins-Klein Bruna
Published: December 2021

Major theories of adult development posit that knowledge about emotion might evolve across the lifespan. Socioemotional Selectivity Theory (SST) and the Strength and Vulnerability Integration (SAVI) models imply that the manner in which older (OA) and younger adults (YA) conceptualize emotions may differ in valence, arousal, reference to social partners, time perspective, and the self. Quantitative accounts of age differences in conceptualizations of emotion-terms offer mixed support for theoretical expectations, but many predictions have yet to be tested qualitatively. In this study, 90 OA and 210 YA provided narrative descriptions of 11 (5 positive, 6 negative) emotion-terms. Responses were coded on valence, reference to self/others, and arousal. O/YA used similar synonyms to define emotion-terms. As predicted, YA used high arousal language in their definitions of negative (OR = 10.29, p = 0.018) and positive terms more than OA (i.e. Happy: OR = 1.27, p<0.001); OA referenced other persons such as family and friends (pos: OR = 0.13, p<0.001; neg: OA = 0.32, p=0.002) more than YA. Contrary to predictions, OA self-referenced more often than YA in positive (OR = 0.12, p=0.001) and negative definitions (OR= 0.11, p=0.004); this may be attributed to OA providing more situational examples in their responses than YA. Somewhat consistent with SAVI and SST, OA may reference high-arousal states less when conceptualizing emotions and associate their definitions more with social partners than YA. Future research should address OA greater use of situational examples when defining emotion terms, motivational factors and emotional impact of these age differences.
Aesthetics and Environment: What is the Role of Beauty in Supporting Ageing Well?
Authors: Nelson-Becker Holly , van den Heuvel Eleanor
Published: December 2021

Access to beauty is intrinsic to psychological, social, and spiritual health. Aesthetic sensibility includes awareness initiated in both mind and emotion accessed through nurturing environments (Caspari, Eriksson, & Naden, 2011). While individual tastes vary and aesthetic preferences are culturally conditioned, an appreciation of natural and constructed beauty is fundamental to human meaning-making, creativity, and innovation (Hillman 1998). Beauty is thus an instrumental tool that may support ageing well. We investigated the question of what aesthetics/beauty meant to older adults in England, how they experienced it, and whether experiencing beauty sustained them. Three focus groups were conducted with community dwelling participants aged between 60 and 93 (median age 75) for a total N of 14. Five themes emerged related to experience: an unexpected recognition; an evolving openness to experience; a universal perception available in micro and macro environments; a force that can alleviate depression; and a relational quality of some interactions. The value of beauty was identified through all groups: participants found it difficult to imagine a world with no beauty in it. They wondered if age made discernment capacity greater. Appreciation of beauty in unexpected places like a cracked pot led participants to identify happiness and wellbeing as outcomes of perception. This study suggests that beauty is essential for wellbeing and human flourishing and can emerge in unlikely ways. Implications are that professionals should assist older people to consider the role of beauty in life and develop interventions to consciously keep beauty awakened in normal and aesthetically-deprived environments.
Multi-Sector Collaboration for Improving Home-Based Nutrition Supports: Process Findings from a Clinical Trial
Authors: Wihry David , Jain Jennifer , Crittenden Jennifer
Published: December 2021

In-home supports and proper nutrition are critical to post-acute recovery and long-term health management for adults 60 and older. At the same time, such supports are often difficult to deploy in rural settings. To address these challenges, a unique multi-sector consortia was formed between a local Area Agency on Aging, a healthcare system, a health technology company, and a university to conduct a clinical trial of a novel in-home health technology program coupled with customized chronic care nutrition support. Early stage clinical trial development required coordination across health and community-based organizations to develop a pathway for older adults to access the in-home project supports. At the conclusion of the year one, six project partners were interviewed using a semi-structured interview protocol examining the strengths of early project design and challenges inherent in the early phases of a community-based clinical trial. Thematic analysis uncovered six themes instructive in formulating efficacious clinical trial methodologies: 1) Logistical challenges related to the pandemic, including reduced patient numbers and the curtailing of in-hospital recruitment; 2) Partner collaboration as essential to designing preferred project modifications; 3) The challenge of converting project referrals into project enrollees; 4) A new appreciation among community partners regarding institutional review board requirements; 5) Recommendations for addressing emerging staffing challenges; and 6) The overriding importance of engaging older adults in their own care and health promotion post-discharge. Results will inform construction of a replicable model for establishing novel research partnerships that span healthcare, social services, the business sector, and higher education.
“All they do is walk”: Successful aging and symbolic boundaries among a self-organized mall walkers club
Authors: Pagaduan Jason
Published: December 2021

Objectives: This study examines how successful aging discourse manifests through physical and social participation among members of a self-organized mall walkers club. There is a paucity of research investigating successful aging in situ and theorizing the relationship between successful aging discourse and community participation. I draw on symbolic boundaries—a concept from cultural sociology—as a way to make sense of what mall walkers say and do. Methods: I draw on data from 15 months of participant observations and interviews of mall walkers, all of whom are over 65 and predominantly Caribbean-Canadian women Results: I identify three common boundaries: personal, interpersonal, and community, that mall walkers draw on to challenge narratives of decline and internalize dimensions of successful aging. Discussion: These findings uncover the ways members in a self-organized community reinforce boundaries that highlight how certain dimensions of successful aging as something to be proud of and desirable. This article contributes to research on intersubjective experiences of aging by revealing how successful aging is rooted in community participation, rather than individual achievement.
Actigraphy-Based Associations Between Chronotype and Physical Activity in Older Adults
Authors: Hicks Hilary , Losinski Genna , Laffer Alexandra , Watts Amber
Published: December 2021

Chronotype is a measure of the time of day people prefer to be most active or to sleep. There is a known relationship between chronotype and engagement in physical activity in young and middle-aged adults, such that individuals with a morning chronotype engage in more physical activity compared to those with an evening chronotype. Our study aimed to replicate this finding in an older adult sample. Actigraphy can be used to measure both physical activity and sleep. Because of its ability to capture information about bedtime and arise time, actigraphy can serve as an objective measurement of chronotype. Participants were 159 older adults (ages 60-89, M = 74.73) who wore an ActiGraph GT9X on their non-dominant wrist for 7 days in a free-living environment. Chronotype was measured continuously using the midpoint of the ActiGraph-calculated sleep interval. We used multiple regression to determine the relationship between physical activity and chronotype adjusting for sex, age, and body mass index. Results suggest that while these variables explain a significant amount of variance in physical activity, R2 = 19.0%, F (4, 152) = 8.921, p < .001, there is no significant relationship between chronotype and total physical activity in our sample, ß= -.117, p = .114. These findings are inconsistent with what has been shown in younger samples and suggest that the relationship between chronotype and physical activity may change as one ages. Future research should consider whether particular physical activity intensities (vs. total activity) may have a relationship with chronotype in older adults.
Get up and go! An Evaluation of Fitness and Memory.
Authors: Nunez Christina , Nuccio Alexandria , Perez Sophia , Golden Charles
Published: December 2021

As we age, exercise is increasingly important for physical health and well-being. Recent studies have shown that exercise is associated with cognitive performance across multiple domains, specifically memory, a common complaint for older adults. Data included a ten-word list of delayed recall, a clock drawing activity, and a sit-to-stand task (i.e., a low impact sub-maximal test of functional fitness) derived from the National Health & Aging Trends Study Database (NHATS Round 9). A total of 4977 participants were included in the analysis which was predominantly white (69.7%), non-Hispanic (94.5%), female (59.2%), and between the ages of 70-84 (62.7%). A hierarchical linear regression revealed that performance on the sit-to-stand task positively predicted performance on delayed recall, F(4,3914)=245.141, p<.001, and on the clock drawing activity, a common screening task for cognitive decline, F(4,2893)=115.470, p<.001; accounting for 20.1% and 10.6% of the variability, respectively, over and above known demographic variables. These findings indicate that exercise may be one of many factors that is associated with memory and cognitive decline. Given the continuation of quarantine procedures, these findings come at a time of significant clinical relevance. Research shows that many individuals slowed down because of the COVID-19 pandemic, and current findings suggest that not being physically active may be related to poorer physical and cognitive health, with specific concerns surrounding memory. Future research is essential in this area to tease out of other factor that may be contributing to this relationship and to develop new and innovated modalities for older adults to safely exercise.
Adult Children’s Monitoring, Knowledge, and Intergenerational Ambivalence
Authors: Toyokawa Noriko , Darling Nancy , Toyokawa Teru
Published: December 2021

Monitoring aging parents' daily life is an essential task for adult children to ensure their parents’ health and safety. The current study examined domains of parents' lives that adult children monitored as caregivers. Based on social domain theory (Smetana, 1999), we hypothesized that adult children would monitor parents’ health and safety issues as respecting parents’ autonomy in other issues. The study also examined how adult children’s belief in need for monitoring and their perception of having actual knowledge of their parents’ behaviors and thoughts would relate to the intensity of their intergenerational ambivalence. Adults who had at least one living parent (N=398, Mage=60, SD=7.7, range 45-77) participated in online surveys. Issues of parents' lives that adult children monitored were categorized into four domains by factor analysis: parents' financial safety, health and physical safety, substance use, and plans with other adult children. A series of regression analyses revealed that adult children's sense of need to know about parents' financial safety was associated with lower ambivalence, B=-.60, SE=.18, β=-.23, p=.001, whereas parents’ physical safety was associated with greater ambivalence, B=.42, SE=.19, β =.17, p=.03. Adult children's perception of their knowledge about parents' financial safety was positively associated with their ambivalence, B=.58, SE=.20, β=.22, p=.004, whereas adult children's perception of parents' physical safety was negatively associated with their ambivalence, B=-.42, SE=.21, β=-.14, p=.05. Different meanings of different types of parents' safety issues for adult children as their caregivers and suggestions for future research will be discussed.
Subjective Well-being, Status Identity, and Intergenerational Relations among the Elderly
Authors: Chen Jieming
Published: December 2021

This study investigates the influences of intergenerational relations on the subjective wellbeing and status identity of the elderly population in China. The project draws insights from the studies of social mobility and stratification, and that of family relations and old age support. Because of widespread exchange of economic resources across generations and strong sense of connectedness among parent and adult children families that continue to exist in Chinese society today, we hypothesize that older parents’ subjective sense of well-being and evaluation of their socioeconomic statuses are positively related with the socioeconomic conditions of their grown children, and the strength of the such relations with them. The study used the data from the 2013 China General Social Survey (CGSS), and the results provide fairly strong support to the hypotheses. The implications of the results on age-based stratification are discussed.
Support Exchanges Among Very Old Parents and Their Children: Findings From the Boston Aging Together Study
Authors: Kim Kyungmin , Boerner Kathrin , Kim Yijung , Jopp Daniela
Published: December 2021

Very old parents and their “old” children are a growing group in industrialized countries worldwide. Care needs of very old parents can be substantial, while children may also face their own age-related issues. However, little is known about support exchanges within very-old parent-child dyads. This study aimed to identify patterns of support exchanges occurring in these dyads, as well as to ascertain individual and relationship factors associated with these patterns. Participants were 114 very old parents (age ≥ 90) and their children (age ≥ 65) from the Boston Aging Together Study. Data were collected using comprehensive, semistructured in-person interviews with both dyad members, including standardized assessments of support exchanges, relationship quality, health, and perceptions of family norms. Actor-Partner Interdependence Models (APIM) were used to predict upward and downward support reported by children and parents. Both dyad members not only reported substantial upward support (given to parents by children) in all domains but also notable amounts of downward support (given to children by parents) in the domains of emotional support, listening, and socializing. Findings showed significant associations of parent functional impairment, parent and child relationship quality, and child perceptions of family obligation with upward support, and of relationship quality with downward support. Continued support exchanges among very old parents and their children indicated that intergenerational theories still hold up in very late life relationships. Healthcare professionals should be aware that attention to relationship quality and family norms might be vital to ensure that support needs are met.
The Connection Between Social Inequality And Intergenerational Transfers Between Three Generations In Europe
Authors: Deindl Christian
Published: December 2021

Family members support each other across the entire family cycle. Parents help their adult children with financial transfers and hands-on-support and childcare, while children in mid-life often support their older parents with help and care. However, there is profound social inequalities linked to intergenerational transfers. While there is some research on inequality for some types of intergenerational transfers and some transfer directions, there is still no conclusive study bringing together all different support types between multiple generations from different social backgrounds over time. In our view, taking a longitudinal multi-generational perspective is essential to capture dependencies and negotiations within families from different socio-economic backgrounds within different regional contexts. If middle-aged parents have to take care of their own older parents, they have fewer resources for their(grand-)children, who might then receive less attention and support from them. This may differ according to access to support from public or private institutions. Here, country and regional specifics have a huge impact on support patterns within the family, which can only be captured when looking into developments and change. Using six waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), we look at intergenerational transfers between multiple generations over time across European regions, considering mid-aged Europeans in the “sandwich” position between older parents and children and include multiple transfer directions and types over time to assess the links between social inequality and intergenerational solidarity in Europe’s ageing societies. The impact of Covid 19 on this issue will also be considered.
An integrative theoretical model to predict positive aspects of caregiving in dementia
Authors: Yu Doris , Cheng Sheung-Tak , Kwok Timothy
Published: December 2021

Family caregiving for dementia is the crucial informal care resource to buffer the associated disease burden. Whereas substantial research focused on ameliorating the caregiving burden through increasing their coping resources, least attention is placed on how to promotive their positive aspects of caregiving (PAC). This longitudinal exploratory study aimed at testingWhereas the perceived self-efficacy was further enriched in the context of good social sup an integrative theoretical model which attempts to explain the evolvement of PAC from the paradigm of stress and coping and existentialism. From to June 2017 to April 2020, we have recruited a total of 403 dementia caregivers from the a geriatric clinic in Hong Kong (mean age = 56.2, SD = 12.2; child-caregiver: 73.9%). About 61% of them were taking care of PwD of moderate to severe dementia. Validated instruments were used to measure the hypothesized model constructs. By using path analysis, it was found that PAC was evolved from two conditions, including i) perceived self-efficacy developed through active coping strategies for carers with good to moderate social support and ii) meaning-focused coping in the context of high religiosity, better social support and active coping. Data-model fit was evident by RMSEA = 0.023, CFI = 0.994, NFI = 0.968 and AIC = 97.762. The findings suggested that PAC was evolved from the interaction of the stress-coping and meaning-making process. Empowering carers for successful caregiving experience, facilitating them to make meaning in the process, enhancing good dyadic relationship and social support are crucial to cultivate PAC.