bluuebunny/crossref_metadata_2025 huggingface dataset:
THE POTENTIAL OF CROWDSOURCED ASSET MAPPING TECHNOLOGIES FOR SUPPORTING DEMENTIA CAREGIVERS
Authors: Ruggiano Nicole , Winton Tish , Daquin Jane , Jiang Zhe , Herzog Monica , Gray Jeff
Published: December 2023

It is well-established that caregivers of people living with dementia (PLWD) often report having difficulty finding information about education and support that is available to them in their community. Caregiver support groups have demonstrated to be an effective approach to caregiver education through mutual support, though many caregivers are unable to participate in caregiver support groups due to time and geographic constraints. Crowdsourced technologies that rely on volunteered geographic information (VGI) are a viable way of community members to provide mutual support on a variety of issues, including disaster response, traffic conditions, health, and travel. These technologies often rely on a mobile app where users upload VGI that are of interest to others who use the app. There are benefits and drawbacks of crowdsourced technologies. For example, they may be an easy way for community members to share needed information, though there may be challenges in the quality of data that users provide. This presentation will report findings from a project that examined dementia caregivers’ interest in using crowdsourced mapping technologies to share information about services and resources in their community that they have found helpful. Data were collected from a diverse sample of dementia caregivers living in Alabama through an online survey that was administered between June and November of 2022. Overall, it was found that caregivers were interested in using a crowdsourcing technology for support and education. Additional findings provide guidance for developing a crowdsourcing protocol that is based on caregivers’ reported information needs.
THREE DECADES OF RESEARCH GUIDING POLICY AND POLICY GUIDING RESEARCH IN AGING AT THE UNIVERSITY OF SOUTH FLORIDA
Authors: Peterson Lindsay
Published: December 2023

The Florida Legislature created the Florida Policy Exchange Center on Aging more than 30 years ago to conduct independent research and policy analyses on critical topics in aging. Housed at the University of South Florida (USF), the center brought together students and faculty to examine public policies that directly affect the health and well-being of older adults (e.g., the role of Medicaid funding in home- and community-based care and the effects of nurse staffing levels in nursing homes). As new policy questions emerge, the foundational work of the policy center continues to guide undergraduate and graduate education at the USF School of Aging Studies. This presentation describes the multiple opportunities to incorporate policy instruction into an interdisciplinary gerontology program. These opportunities depend on having faculty who maintain ties with the organizations that provide direct care and services to the public and who connect the policy lessons they learn through these relationships to their teaching and research. Another key element is access to health services data needed to answer critical policy questions. The goal of such an approach is to enable gerontology students to engage in policy analysis and development and to understand the essential links between research, public policy, and practice that improves the lives of older adults.
UTILIZING PALLIATIVE LEADERS IN FACILITIES TO TRANSFORM CARE: THE UPLIFT CLINICAL TRIAL IMPLEMENTATION
Authors: Unroe Kathleen , Cagle John , Ersek Mary
Published: December 2023

UPLIFT is an NIH funded clinical trial with a goal of improving quality of care for people with moderate to advanced dementia in nursing homes. The UPLIFT intervention consists of specialized training in palliative care and dementia care for two nursing facility staff who are identified as Palliative Care Leads. All staff training on the fundamentals of palliative care is also delivered. In addition to this internal capacity building, UPLIFT integrates specialty medical palliative care consultants into the care team. Palliative Care Leads screen residents for palliative care needs which prompt clinical consultations. Outcomes include surrogate (both nursing facility staff and family) reported symptoms of eligible residents. A total of 16 nursing facilities are enrolled in this stepped wedge trial, which concludes in 2025. Numerous implementation challenges have been identified and navigated throughout the trial. These include Palliative Care Lead turnover, nursing facility leadership turnover, communication with primary medical teams, and integration of palliative care NPs and MDs into the clinical care of the residents. Data on challenges is captured on regular fidelity check-ins with nursing home staff and interviews with Leads and palliative care providers. A description of these challenges and strategies the team is using to navigate them will be presented, including adaptations to study design and the intervention.
THE ROLE OF CASTRATION BEFORE OR AFTER PUBERTY ON SEX DIFFERENCES IN GROWTH AND LONGEVITY IN UM-HET3 MICE
Authors: Jiang Nisi , Cheng Catherine , Nelson James
Published: December 2023

Sex differences in human aging and longevity are well known. Mortality rates of males are higher throughout life with no definitive mechanisms identified. Previously, we reported that genetically heterogeneous mice have sex differences in longevity like those of humans. Here, we report that prepubertal castration significantly reduced early adulthood mortality and increased median lifespan by 12.6% (n=236/group) to match female levels. It also shifted growth trajectories toward the female pattern, including a reduced rate of body weight gain and a prolonged growth period. Our findings suggest that testicular hormones are critical for these sex differences. We next tested whether a) exposure to gonadal hormones from puberty throughout life is required or b) only hormone exposure during the short period of pubertal development is sufficient to cause these sex differences. We castrated or sham-operated mice (n = 60/group) prepubertally at 20 days, or after puberty at 60 or 240 days. Prepubertal castration prolonged the period of growth as before, with dramatically increased fat mass and reduced lean mass, which reduced the lean/body mass ratio to a level indistinguishable from that of females. Although post-pubertal castrated groups also had reduced lean/body mass ratios, they were significantly higher than prepubertally castrated mice, but were unchanged between 60d and 240d groups. These results suggest that the narrow window of testicular hormone exposure during puberty is necessary for the full expression of sex differences in body composition trajectories. Its effect on lifespan will be presented at the meeting when mice are old enough for assessment.
IDENTIFYING PREDICTORS OF RESILIENCE IN SINGLE-ARM STUDIES OF PRE–POST CHANGE
Authors: Varadhan Ravi , Zhu Jiafeng , Bandeen-Roche Karen
Published: December 2023

With advancing age, older adults are at a greater risk of experiencing significant stressors. While frailty is the increased vulnerability to stressors, resilience is the ability to respond well to a major stressor. An important goal of geriatric research is to identify factors which influence resilience to stressors. Studies of resilience in older adults are typically conducted using a single-arm design where everyone experiences the stressor. In such designs, resilience is typically quantified as the degree of recovery in physical/cognitive/psychological functions after the stressor. The simplistic approach of regressing change versus baseline yields biased estimates due to mathematical coupling and regression-to-the-mean. Correction is necessary for eliminating the bias and drawing valid inferences regarding the effect of covariates and baseline status on pre-post change. We present a simple method to correct this bias. We extend the method to include covariates. Our approach considers a counterfactual control group and involves sensitivity analyses to evaluate different settings of control group parameters. We illustrate the method using a large, registry of older adults (N=7,239) who underwent total knee replacement (TKR). We demonstrate how external data can be utilized to constrain the sensitivity analysis. Our analysis indicates that baseline (pre-stressor) function was not strongly linked to recovery after TKR. Among the covariates, only age had a consistent effect on post-stressor recovery. A main takeaway of our work is that studies of resilience should consider, either directly or indirectly, the use of an appropriate control group.
GENDER DISPARITIES IN THE MENTAL HEALTH OF CAREGIVERS BEFORE AND DURING THE COVID-19 PANDEMIC
Authors: Kalousova Lucie , Ratangee Brina
Published: December 2023

Prior research has shown that many have experienced worsened mental health during the COVID-19 pandemic. This study uses a large, nationally representative sample of caregivers interviewed by the Behavioral Risk Factor Surveillance System (BRFSS). It implements regression models to examine the changes in mental health among informal caregivers for older adults, who are a high-risk group for COVID-19 infection. We ask: (1) has the average number of poor mental health days among caregivers increased during the pandemic; (2) has the increase varied by gender; (3) the condition of the person receiving care? Our results indicate that caregivers experienced a sharp increase in poor mental health outcomes at the onset of the pandemic, much sharper than non-caregivers. In 2021 and 2022, male caregivers’ mental health returned to pre-pandemic levels, while women’s caregivers did not. We hypothesize that gender disparity in mental health outcomes could be attributed to differences in the types of caregiving responsibilities, the level of stress experienced, and the social support available. Furthermore, our study also shows that caregivers providing care to Alzheimer’s disease (AD) patients have worse mental health outcomes than other caregivers. Women who care for AD patients have worse mental health than male AD caregivers, whose mental health did not significantly differ from other caregivers. The findings could inform policy decisions and support the development of interventions that aim to mitigate the negative impact of the pandemic on caregivers’ mental health.
EARLY PANDEMIC INTERGENERATIONAL RELATIONSHIP TYPOLOGIES AND WELL-BEING AMONG OLDER ADULTS
Authors: Chan Athena Chung Yin , Sneed Rodlescia
Published: December 2023

The COVID-19 pandemic necessitated numerous changes in older adults’ social interactions; however, there has been limited inquiry into the structure and function of early pandemic intergenerational relationships and consequent implications for well-being. Informed by intergenerational solidarity theory, we explored typologies of older adults’ intergenerational relationships early in the pandemic, examining factors associated with each typology and associations between typologies and well-being. Participants were 7,840 adults aged ≥ 50 from the 2020 and 2021 waves of the Health and Retirement Study. We conducted latent class analysis using 12 indicators: associational (time with pets, frequency of in-person and virtual contact), structural (pet ownership and living arrangement), functional (receiving/providing support), and affectual (better relations). We used analysis of variance and post hoc analyses to determine whether individual differences (i.e., demographics, health status, and pandemic-related stressors), and well-being differed across typologies. Five latent classes were identified: low intergenerational relations (48%), pet owner with low intergenerational relations (15%), high contact and good relationship quality (tightknit, 11%), support provider (15%) and support recipient (12%). Older adults’ age, gender, marital status, and health status were related to their relation typologies. Low intergenerational relations and tightknit typologies reported greater well-being. Support recipients reported the most distress, while support providers reported higher growth and resilience. Pet owners with low intergenerational relations reported the lowest positive emotions. Overall, results encourage careful attention to the multifaceted nature of intergenerational relationships when understanding coping of older adults in the pandemic.
IS LIFETIME ABUSE FORGIVABLE IN OLD AGE?
Authors: Band-Winterstein Tova , Shulyaev Ksenya , Eisikovits Zvi
Published: December 2023

Old age is characterized by reflection and retrospective examination of the multiple meanings of various life experiences including lifetime abuse. Forgiveness was found to have salutary effects on older adults’ wellbeing. To enhance understanding concerning the place and role of forgiveness in the reflective process in later life we performed a secondary analysis of data from four previous studies using in in-depth, semi-structured interviews (N=78) with older women who survived abuse. Concepts developed deductively from reviewing the literature contributed to an inductive thematic analysis of the interviews. Three major themes emerged from this procedure: (1) The dimensions of forgiving: The victim as subject. Movement towards forgiveness occurs along three dimensions: painful memories with negative emotions, commitment to social obligations and life circumstances. (2) Being forgiven: Between lost forgiveness and hope. This theme related to the boundaries between the roles of being a victim and a victimizer simultaneously and describes the hope and willingness of survivors to be forgiven by closely related persons. (3) Self-forgiveness and the aging self. Forgiving self can be conceptualized from total renunciation due to exhaustion from lifetime abuse to full recognition of self-accepting forgiveness resulting from decision-making based on strength. While recognizing the salutary effects of forgiveness, we cannot disregard that this is not a universally desirable process. The dimension of forgiveness needs to be included in the study of abuse throughout the old person’s life-course to better understand its complexity Such view should substitute the either/or approach based on the dichotomy of “forgiveness” or “unforgiveness”.
LIFE COURSE PATTERNS AND PREDICTORS OF THE RELATIONSHIP BETWEEN ADULT CHILDREN AND THEIR MOTHERS
Authors: Thomeer Mieke Beth , Reczek Rin
Published: December 2023

Studies demonstrate that the content and quality of the parent-child tie is highly variable across the life course and that multiple social factors predict different aspects of that relationship. Separate research shows that childbirth experiences (e.g., age at birth) matter for the well-being of both the mother and child. However, limited research considers how the mother’s childbearing history is associated with adult child relationships at mid-life and beyond—namely contact and emotional closeness. We use Sequence Analysis on two linked datasets—the 1979 National Longitudinal Survey of Youth (NLSY79) and the National Longitudinal Survey of Youth-Young Adults (NLSY79YA) (N=1,953) to identify life course patterns of closeness and contact between adult children and their mothers. We identify six unique sequences: (1) mixed quality/contact (9.9%), (2) distant (10.0%), (3) close with decreasing contact (13.2%), (4) increasing emotional closeness with high contact (16.4%), (5) mostly close with high contact (23.2%), and (6) always close with high contact (27.3%). We use regression analysis to estimate how different aspects of the childbearing biography are associated with each category. Relationships characterized by “always close with high contact” were associated with more siblings/childbirths and older age at birth. Relationships associated with “emotionally distance” were associated with births characterized as “mistimed,” being a middle or older child, and younger age at birth. Future analysis will consider selection factors such as family histories. This project demonstrates the need for life course perspectives on the child-mother relationship, recognizing the role of childbearing histories and the important diversity within and between individuals.
PROMOTING PROVIDER ADHERENCE TO THE MEDICATION M OF THE AGE-FRIENDLY 4MS FRAMEWORK
Authors: Ohuabunwa Ugochi , Kantamneni Leela
Published: December 2023

BACKGROUND

The Age Friendly Health Systems (AFHS) initiative promotes use of the 4Ms Framework: We sought to evaluate provider adherence to protocols addressing the medication M of the framework.

METHODS

The project was conducted among patients > 65years treated in the inpatient (IP), outpatient (OP) and emergency departments (ED) of Grady Memorial Hospital (GMH). We implemented 2 approaches to improve provider prescribing among older adults 1) Using a clinical decision support tool via the electronic health record Epic Systems®, a best practice advisory (BPA) offered individual provider feedback regarding potentially inappropriate medications (PIMs) ordered and offered safer alternative medications. 2)A pharmacist-led daily medication review with provider feedback on PIMs in the Acute Care for Elderly (ACE) Unit. Primary outcome: Percentage of PIMs discontinued. Secondary outcomes: Percentage of BPA vs pharmacist recommendations accepted, discharge PIMs, Length of Stay (LOS), mobility, delirium and Katz scores, 30-day readmission rate. RESULTS: 8270 BPA alerts fired for 3291 patients, mean age 73.7, with 5709 BPAs in IP, 1462 in ED & 1083 in OP settings. Providers responded to alerts by overriding BPA (10.2%), canceling BPA (60.4%), removing alerted PIM (20.6%), ordering alternative medication (3.5%).. With the pharmacist led intervention, ACE Unit providers accepted 47.2% recommendations, discontinued 17.9% PIMs . 19% of ACE and 1.1% of GMU patients were discharged without PIMs. 30-day readmission rate was 19.1% (ACE) vs 27% (GMU) (P = 0.31).

Conclusion

There was a higher provider acceptance rate with the pharmacist led intervention but no significant difference in PIM discontinuation rate
OLDER-ADULT PERSONAL SUPPORT WORKERS’ CONTRIBUTIONS DURING THE COVID-19 EMERGENCY RESPONSE
Authors: Wu Haorui
Published: December 2023

When COVID-19 devastated long-term care facilities across Canada, most public attention was turned to older adult residents/clients, rather than their service providers, especially the personal support workers (PSWs). Some PSWs are over 55 age and above; they featured dual roles in the COVID-19 settings: (1) they were a vulnerable group disproportionately impacted by COVID-19 and (2) they were essential workers providing support in the older-adult care facilities. Since current older-adult-driven research, practice, and policy have primarily focused on generalized assumptions of older adults as a vulnerable, passive, and dependent group rather than recognizing their diversity, expertise, assets, and experiences, this project aims to identify these older-adult PSWs’ contributions. This qualitative study invited 13 PSWs from older-adult care organizations in the Greater Toronto area of Canada to participate in in-depth interviews. This study uncovered three major contributions of older-adult PSWs within the individual-work-family triangulation. At the individual level, they bear the potentially high health risks of COVID-19, while supporting people around them. At the workplace level, they took on extra responsibilities to reduce the spread of the virus, dealing with the client’s/residents’ unfavourable behaviours and stress, and supporting their co-workers to maintain their organizations’ operations. At the family level, they worked overtime to compensate for their family members’ income loss and kept their family members at home to avoid infections. These outcomes inform the older adult research, practice, and policy by enhancing the appreciation of older adults’ diverse strengths and promoting older adults’ contributions in disaster settings.
ADDRESSING CO-OCCURRING ALCOHOL AND MENTAL HEALTH PROBLEMS IN OLDER ADULTS: CO-DESIGNED DIRECTIONS FOR PRACTICE
Authors: Bareham Bethany , John Deepti , O’Donnell Amy , Liddle Jennifer , Hanratty Barbara
Published: December 2023

Older people in the UK experience the highest rates of alcohol-related harm of all age groups, due to reduced tolerance to alcohol with age. Most older people drinking at harmful levels have co-occurring mental health problems. This population fall between services, which are ill-equipped to address their complex and multifaceted needs. This study aimed to co-design directions for integrated services to support this group in North East/North Cumbria, England. Co-design was guided by Intervention Mapping, and was informed by four workshops with older people with co-occurring alcohol/mental health problems; informal caregivers and supporting practitioners. Workshops built on evidence from i) a preceding qualitative study with these groups examining lived experience, support needs, and challenges in supporting this group and ii) a literature review of existing interventions/services for older people with alcohol or mental health problems. Findings highlight the importance of availability, accessibility and flexibility of support for older people, who often present in crisis, and can face additional barriers to accessing services such as hearing/mobility issues. Mental health practitioners should be trained in identifying and addressing harmful drinking in older people. Practitioners must be knowledgeable of relevant, local services and prepared to signpost appropriately. Care should encompass peer support, and support and advocacy to address wider issues that impact mental health and alcohol use including finances, social isolation and illness. This study informs the development of integrated community alcohol/mental health support for this patient group. Applicability of directions to other care systems is considered.
MEASURING IMPLEMENTATION FIDELITY OF THE TRANSITIONAL CARE MODEL IN THE MIRROR-TCM TRIAL
Authors: Hanlon Alexandra , Ahrens Monica , Hirschman Karen , Mccauley Kathleen , Shaid Elizabeth , Osokpo Onome , Pauly Mark , Naylor Mary
Published: December 2023

Examining the fidelity to the implementation of multi-component evidence-based interventions is essential but challenging. To capture the application of the Transitional Care Model (TCM) as designed, an advanced practice registered nurse (APRN)-led, team-based, care management strategy in a replication RCT conducted in three diverse health systems, an innovative method was utilized. This session describes the procedures, challenges, and decision-making processes associated with measuring the fidelity of the implementation of TCM’s core components over the trial. Standardized data collection forms were created for the APRNs to document the TCM elements addressed during each contact with and on behalf of the hospitalized older adults and their caregivers who had been randomly assigned to the TCM group (N=480). Measurable performance expectations for each element were established a priori (e.g., a minimum of 9 in-person visits). A dichotomous variable was created for each of the 38 elements making up the 10 TCM components which were provided monthly to each site to monitor their intervention implementation. Since not all elements were applicable to all older adults, the overall patient-level fidelity score required scaling to standardize the maximum fidelity score to 38. The individual components were inherently weighted according to their complexity as reflected by their respective number of elements. The average overall patient-level fidelity score was 34.2 (standard deviation: 3.5), median = 34.7. Higher fidelity scores indicated implementation of the minimum dose of the intervention elements. The findings provide critical insight into how to develop measures of implementation fidelity for complex multi-component evidence-based interventions.
DEVELOPMENTAL CHANGE IN PROBLEM DRINKING ACROSS THE LIFESPAN: BETWEEN- VERSUS WITHIN-PERSON AGE EFFECTS IN NATIONAL DATA
Authors: Lee Matthew , Yeung Ellen
Published: December 2023

When considering problem drinking from a lifespan developmental perspective, an often-stated underlying premise is that problem drinking peaks around early young adulthood and then declines throughout the remainder of the lifespan. However, relative to adolescence and young adulthood, the supposed later declines in midlife and older adulthood are less firmly established and based primarily on cross-sectional data. Thus, this study contrasted cross-sectional versus longitudinal age effects on problem-drinking changes across the adult lifespan. Analyses used two waves of longitudinal data from a U.S.-representative sample. We generated descriptive “porcupine figures” graphically depicting both cross-sectional and longitudinal age effects simultaneously. In addition, we used multilevel models to partition, test, and contrast cross-sectional versus longitudinal age effects on problem drinking in different age periods of the adult lifespan. While age effects were consistent in young adulthood across the cross-sectional and longitudinal tests, key discrepancies were shown in midlife and older adulthood. Specifically, the supposed continuation of problem-drinking reductions throughout midlife and older adulthood was observed cross-sectionally but not longitudinally. These findings call into question the notion of normative drinking-related declines that continue beyond young adulthood and throughout the remainder of the adult lifespan. We will discuss plausible alternative explanation for how cross-sectional data can lead to spurious conclusion about developmental change (e.g., age-confounded cohort effects). If replicated in future research, our evidence for relative stability or even increases in problem drinking in midlife and older adulthood can contribute to a more lifespan-developmentally-informed understanding of risky behaviors and thereby guide lifespan-developmental tailoring of interventions.
EXPLORING CONGRUENCY OF DEATH LOCATION PREFERENCES VERSUS EXPECTATIONS: FINDINGS FROM BRAZIL, ITALY, JAPAN, AND THE US
Authors: Clem Sarah , Zhang Peiyuan , Cagle John
Published: December 2023

Dying in one’s preferred death location is a common indicator of a good death. Previous studies exploring the congruency between individuals’ death location wishes and their actual death locations relied on samples of patients with terminal diagnoses. Data for this study came from the Four-Country Survey on Aging and End-of-Life Medical Care 2017 from which nationally representative samples of the general public were collected in the U.S., Italy, Japan, and Brazil. Bivariate analyses of the total sample (n=4,239) identified that 45% of participants reported expected death locations that differed from their preferred place of death. Among the majority of participants reporting a preference for a home death, 61% of these individuals in Japan (p<.001) and 43% from Brazil (p<.001) reported they were more likely to die in a hospital. Whereas, in both Italy and the U.S., the majority of participants within each death location category reported the same location for their preferred and most likely death location. Logistic regression models identified unique predictors of congruency for each country. Noteworthy, in the Italy model, females were 43% lower odds of having congruent death location perceptions compared to men (OR=0.57, p=0.02). In the U.S. model, racial differences were also notable, as Black participants had over 2 times greater odds of congruent death location perceptions compared to White participants (OR=2.18, p=0.02). By further understanding the congruency of death location perceptions among the general public, we can gain insight into the perception of whether individuals feel that a quality death experience is attainable.
FACTORS ASSOCIATED WITH WANDERING AMONG PERSONS WITH DEMENTIA: A RETROSPECTIVE STUDY
Authors: Miguel-Cruz Antonio , Perez Hector , Rutledge Emily , Daum Christine , Liu Lili
Published: December 2023

Persons living with dementia are at increased risk of getting lost and going missing due to critical wandering. Risk factors associated with critical wandering within this population are underexplored, thus prompting this study. In this retrospective observational study, we examined anonymized data from 25,785 MedicAlert® subscribers. We used a logistic regression model with a self-reported critical wandering incident as the outcome variable (p< 0.05). The average age of our sample was 75.42 (SD 14.34). Fifty-one percent (13,064/25,785) of cases had dementia and almost 22% (5,561/25,785) were involved in a critical wandering incident at least once. People living with dementia were two and a half times more likely to be involved in a missing incident compared to people without dementia (OR=2.56, 95% CI [2.39, 2.73], p< 0.001). The likelihood of being involved in a lost incident increased with advancing age; people 95-104 years old were seven times more likely to wander than those under age 65 (OR=7.11, 95% CI [5.96, 8.47], p< 0.001). Sex at birth, official Canadian languages spoken, ethnic background, population density, living arrangement, and medication were associated with increased dementia-related missing incidents. Numerous risk factors for missing incidents were identified. Our study paves the way for implementing preventative strategies to ultimately decrease the risk of going missing for person living with dementia.
THE PROMISE AND CHALLENGES OF GERONTOLOGISTS WHO ADVANCE THE SCIENCE OF COMMUNITY-ENGAGED RESEARCH
Authors: Leach Carrie , Gan Daniel , Brothers Allyson , Sargent Lana , Dys Sarah
Published: December 2023

Our aging population demands more responsive policies and services and calls for a shift from involving older adults as individual participants toward collaborating with or empowering their communities as research partners. Knowing how to build capacity for community-engaged research (CEnR) among gerontologists requires understanding the challenges of such endeavors. A survey was distributed to gerontologists in March 2021 to December 2022, and was supplemented by a brainstorming focus group. We received responses from academic faculty, staff, students, and trainees (n=98) representing multiple academic disciplines from community health and implementation science to behavioral and social sciences. Many identified as a minoritized person (57.7%) and used mixed methods (55.1%). Focus group findings revealed challenges around community and participant recruitment, sustaining relationships, low-resource contexts and recognition. These reflected concerns around time, work, and funding – three most commonly-occurring words in survey responses. Barriers articulated include, “the time it takes to cultivate real relationships with community partners to design and carry out research together,” “confusion among academic colleagues on how this work is scholarship,” and a “lack of understanding and recognition from universities and funding agencies.” To more effectively mobilize knowledge and remain relevant, institutions would do well to heed calls for training on involving community members as co-researchers (78.6%), learning about rapidly developing CEnR methodologies (75.3%), and sustaining successful intervention programs after grant funding has ended (70.4%) among other priorities. This study provides critical insight into the landscape of CEnR among gerontologists and may be used to develop more supportive programs and structures.
TOBACCO IN HOTELS: A STUDY OF NICOTINE EXPOSURE AND RESIDENT RISK
Authors: Lewinson Terri , Dasgupta Abhirupta , Murphey James
Published: December 2023

Secondhand smoke (SHS) exposure exacts considerable health and financial impact on thousands of Americans yearly. One in four nonsmokers (about 58 million people) is routinely exposed to SHS, primarily at home. There is wide variability in smoke-free home policy adoption, leading to sociodemographic disparities in tobacco exposure and adverse health effects among low-income renters. Although there is no safe level of tobacco smoke exposure, varying perceptions about exposure effects and risks contribute to inconsistent use of harm-reduction strategies such as smoke-free home policies in private dwellings. Therefore, we surveyed and interviewed low-income extended-stay hotel renters (n=77) to learn about their perceptions of tobacco exposure. We also measured participants’ willingness to self-monitor these risks and adopt at-home smoke-free interventions. Most survey participants identified as nonsmokers (56.8%) exposed to tobacco smoke regularly. However, both nonsmokers and smokers preferred smoke-free rooms and indicated they would likely participate in personal health research by sharing air and biosamples to measure their exposure. We will present survey results of tobacco exposure knowledge and attitudes among long-term renters in Metropolitan Atlanta extended-stay hotels, perceptions of exposure risk, and self-efficacy beliefs. From our interview findings, we share renter and hotel manager readiness perceptions for implementing at-home smoke-free interventions. Lastly, we will share the results of integrating community-engaged partnerships with local organizations and respondent-driven sampling methods to build trust and aid renter recruitment.
ACCESS TO LOCAL ESTABLISHMENTS AND NEIGHBORHOOD PERCEPTIONS: A FOCUS ON THE ROLE OF LOCAL BANKING
Authors: Goldman Alyssa , Bea Megan Doherty
Published: December 2023

As an increasing number of older adults are aging-in-place, individuals’ perceptions of their neighborhood environments have emerged as significant social-contextual issues for healthy aging. Prior studies have focused on how neighborhood characteristics shape perceptions of residential neighborhoods. Far less research has focused on the role of local banking, despite the intersections between local banking establishments and a host of key community social and economic resources, particularly for the older adult population. We use nationally representative data from older adults interviewed at Rounds 2 and 3 of the National Social Life, Health, and Aging Project (N=4,589) linked with the National Establishment Time Series database to examine neighborhood perceptions as a function of local banking establishment density. We find that older adults who live in areas with higher rates of banking establishments report significantly higher levels of neighborhood safety, even when adjusting for a host of individual and neighborhood characteristics. Importantly, other types of establishments also shape perceived neighborhood safety, however, the significance of certain associations only emerges when we adjust for the presence of local banking. We suggest that local banks may be a lynchpin in catalyzing the broader socioeconomic vitality of a place, supporting older residents’ favorable perceptions of neighborhood safety. We discuss the implications of our findings for inequality in aging in light of unequal access to local banking across social groups, potentially increasing the vulnerability of older adults who are less likely to adopt mobile banking solutions and who are more likely to be susceptible to financial exploitation.
NURSING HOME EXPECTATIONS AND MENTAL HEALTH AMONG OLDER ADULTS IN THE HEALTH AND RETIREMENT STUDY
Authors: Lane Annalise , Dang Linh , Mezuk Briana
Published: December 2023

Three million older adults live in long-term care facilities. Transitioning into a nursing home is a major life event that can worsen mental health. Expectedness of nursing home transitions may have implications for mental health; however, this area is understudied. This study examined the relationship between expectations of transitioning into a nursing home in the next five years and depressive symptoms and passive suicidal ideation, and how social integration modified these relationships. Sample included respondents aged 65+ from the 2018 Health and Retirement Study (n=7,944, mean age=73.9, 55.4% female, 80.5% Non-Hispanic White). Nursing home transition expectations were modeled continuously (range: 0-100%). Mental health outcomes were assessed by the Composite International Diagnostic Interview-Short Form. Social integration measured composition, frequency of contact, and closeness with spouses/partners, children, other family members, and friends. Multivariate logistic regressions were fit for depressive symptoms and passive suicidal ideation separately, adjusting for demographic, health characteristics, and health-related reasons for moving. Additional models simultaneously adjusted for all social integration measures. Higher nursing home expectations were associated with elevated depressive symptoms (OR: 1.06, 95% CI: 1.01-1.11), major depressive episode (OR: 1.08, 95% CI: 1.02-1.15), and suicidal ideation (OR: 1.10, 95% CI: 1.03-1.16). These relationships persisted even after accounting for social integration. Future research can explore modifiable factors salient to these relationships, such as perceived social support and family care, to inform mental health-targeted interventions as older adults transition into long-term care.
THE IMPACT OF LIVING IN MULTIGENERATIONAL NEIGHBOURHOODS ON LONELINESS IN LATER LIFE
Authors: Hyde Martin , Evans Elizabeth
Published: December 2023

Intergenerational solidarity has been identified as a key factor for effective social functioning. However, evidence suggests that divisions between younger and older generations within Great Britain (GB) have never been greater. Growing residential age segregation is thought to be driving intergenerational division. This, in turn, is assumed to lead to an increased risk of loneliness among older adults. However, to date, this has not been empirically tested. To examine this issue, we created a new measure of multigenerational neighbourhoods, for all lower super output areas in England and Wales. These were linked to individuals aged 50 and over living in England and Wales in 2018/2019 in the UK Household Longitudinal Survey (N = 14,196). Loneliness was measured using the UCLA-3 scale. Multilevel regression analyses were performed. Covariates included, area level deprivation, urban/rural, residential tax band, home ownership, individual age, sex, marital status and financial situation. The results show that the mix of generations within a neighbourhood has a weak (r = 0.33) and non-significant (p=.493) association with loneliness among older adults. To the best of our knowledge this is the first study to directly examine the impact of neighbourhood age diversity on loneliness in later life. Our findings suggest that the mere presence of different generations within a neighbourhood is not a sufficient condition to combat loneliness in later life
ENGAGING STRATEGIES IN CLASSES, COMMUNITIES, AND RESEARCH
Authors: Kemeny Betsy
Published: December 2023

Educators can use community engaged learning (CEL), also known as service learning, to empower all ages, bridging both college students and older adults needs. With the wrong approach, service just attached to a course may reinforce negative stereotypes. To assure best practice, educators benefit from CEL competencies to promote positive learning and avoid reinforcing ageism. Competencies, based on a community-engaged taxonomy, include: Reciprocal partnerships, Diversity of interactions and dialogue,​ Community activities, Civic competencies, Critical reflection, and Assessment (Rathlef, 2022; Kecskes, 2015). A complete explanation of each competency will be explained and illustrated. Using the competencies as a framework, two specific programs with college students and older adults were evaluated using both formative and summative measures. One program, a virtual intergenerational interaction, lasted seven weeks. The second program, an in-person program at the University’s equestrian and nature center, spanned five weeks. Pre and post comparisons of civic learning outcomes using CLEO, written reflections, focus group discussion, and partner perspectives were analyzed. Older adults reported some improvement in social interaction and companionship with some expansion in social networks. Students significantly improved civic knowledge outcomes. The students’ written reflections revealed a self-reported change in attitude toward older adults. Students also expressed a shift in their perceptions of future work in a health setting with older adults. Community-engaged learning can empower all ages, but an educator’s attention to the competencies supporting best practice can make a significant difference to the outcome of these efforts.
SENSITIVITY AND SPECIFICITY OF THE MCDR FOR MCI DIAGNOSIS AMONG HISPANIC AND WHITE NON-HISPANIC OLDER ADULTS
Authors: Garcia Patricia , Mendoza Lisandra , Duarte Andres , Padron Dilianna , Marsiske Michael , Fiala Jacob , Duara Ranjan , Rodriguez Miriam
Published: December 2023

Objective

Greater functional impairment has been associated with higher rates of progression to dementia. Identifying sensitive functional measures that can detect early ADRD have immediate implications for prognosis, especially among ethnically diverse groups who are disproportionately affected. The modified Clinical Dementia Rating scale (mCDR) is a multiple-choice format assessment that assesses the five domains of the Clinical Dementia Rating scale. The current study aimed to compare sensitivity and specificity of the mCDR between White non-Hispanic (WNH) and Hispanic participants.

Methods

The mCDR was administered in the patient’s primary language (English or Spanish) to 101 WNH Cognitively Normal (CN, n=20) and with MCI (n=81) and 159 Hispanic CN (n=32) and MCI (n=127) participants. Sensitivity to MCI diagnosis and Specificity to CN, using the mCDR “mean of means” total score, was quantified via Area under the Curve (AUC) calculated from a Receiver Operating Characteristic analysis.

Results

Among WNH participants, the mCDR score demonstrated 78% Sensitivity and 90% Specificity (AUC = .88; CI95%= .81, .94). Among Hispanics, the mCDR showed 61% Sensitivity and 78% specificity (AUC = .73; CI95%= .64, .83). AUC was significantly worse for Hispanic participants.

Conclusion

The mCDR is a tool that can be used by a trained psychometrist to facilitate focused answers and reduce administration time when assessing clinical functioning among dementia populations. It demonstrated excellent discrimination between CN and MCI among WNHs and acceptable discrimination among Hispanic individuals. Future research should further examine the utility of this tool for Hispanic older adults in early diagnosis of ADRD.
BODY COMPOSITION AND FALL RISK IN MUTUALLY EXCLUSIVE CATEGORIES OF PHYSICAL ACTIVITY IN OLDER WOMEN
Authors: Choudhury Renoa , Park Joon-Hyuk , Banarjee Chitra , Thiamwong Ladda , Xie Rui , Stout Jeffrey
Published: December 2023

Both physical activity (PA) and sedentary behavior (SB) have been independently linked with health outcomes in older adults. However, limited research has been done to investigate how different combinations of these behaviors influence their body composition and functional balance. This cross-sectional study examined the associations of mutually exclusive categories of PA and SB with body composition and fall risk in older women. Accelerometer-measured PA (ActiGraph GT9X), body composition (Bioelectrical Impedance Analysis) and fall risk data (BTrackS Balance & sit-to-stand) were collected from 91 community-dwelling older women. Participants were grouped into four behavioral categories: active-low sedentary, active-high sedentary, inactive-low sedentary and inactive-high sedentary. Active was defined as ≥150 minutes of moderate-to-vigorous PA (MVPA) per week (inactive: < 150 minutes/week of MVPA) and low sedentary was denoted as residing in the first tertile of sedentary-to-light PA time ratio (high sedentary: residing in the remaining tertiles). Results from linear regression analysis showed that, compared to inactive-high sedentary group, lower body fat mass index (BFMI), higher skeletal muscle mass index (SMMI), lower appendicular fat mass index (AFMI) and higher sit-to-stand (STS) scores were found in both active-low sedentary (BFMI: p=.002; SMMI: p=.017; AFMI: p=.003; STS: p=.014) and inactive-low sedentary participants (BFMI: p=.007; SMMI: p=.014; AFMI: p=.005; STS: p=.031), while active-high sedentary participants only showed lower AFMI (p=.037). Our findings suggest PA interventions integrating approaches for achieving sufficient MVPA and reducing SB concurrently might promote healthy body composition and reduce fall risk among older adults.
TRANSCRIPTOMIC SIGNATURES OF AGING, GENETICS, AND MORTALITY RISK: FINDINGS FROM THE LONG LIFE FAMILY STUDY
Authors: Wojczynski Mary , Glynn Nancy , Raghavachari Nalini
Published: December 2023

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, with a third visit ongoing. 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, metabolomic assays, and trascriptomics (RNA-seq). Collectively, this symposium will present novel findings that examined differences in gene expression between those of extreme old age compared to younger participants, elucidate potential new genomic regions and variants associated with ankle brachial index, examine rare variants under linkage peaks for perceived physical fatigability, and compare mortality and cause of death between LLFS and the US population. Specifically, Ms. Li will share results on gene expression profiles in aging. Then, Ms. Ressler will share findings on the genetics of ankle brachial index with linkage and association results. Next, Ms. Gay will discuss associations under the linkage peak for perceived physical fatigability. Lastly, Ms. Yao will present mortality and patterns of death in the LLFS. As Discussant, Dr. Nalini Raghavachari from the NIA will provide insights and propose future directions for LLFS.
LINKAGE ANALYSIS OF PERCEIVED PHYSICAL FATIGABILITY IN THE LONG LIFE FAMILY STUDY
Authors: Gay Emma , Santanasto Adam , Lin Shiow (Rosa) , Wojczynski Mary , Glynn Nancy
Published: December 2023

Fatigability, whole-body fatigue anchored to specific tasks, is a highly prevalent characteristic in older adults, but the biological mechanisms underlying perceived physical fatigability are unclear. Genetic studies may identify potential biological pathways contributing to physical fatigability. The family study design of the LLFS provides a unique opportunity to explore variants associated with fatigability using whole-genome linkage analysis. Whole genome sequencing (WGS) was available for N=2462, 496 families (age 73.6±10.5 years, 54.8% women, 99% white. Perceived physical fatigability was measured with the Pittsburgh Fatigability Scale (PFS, 0-50, lower=less severe). Prevalence of lower PFS scores (<15) was 57.9%. Multipoint linkage analysis employing likelihood-based variance components analyses were performed to identify families and genetic loci showing strong evidence for linkage. Based on linkage analysis results, a series of association analyses were performed in the subsets of linked families for PFS Physical scores. Association analyses were conducted using linear mixed models adjusted for age, field center, principal components and familial relatedness. For all families the LOD was 2.13 at chr17:79,549,108. The HLOD of the top 27 families (n=225) was 8.97. There were 8 single nucleotide polymorphisms (SNPs) identified under the linkage peak on chromosome 17. These variants were mapped to 8 different genes involved in regulation of transcription and metabolism, cellular proliferation, signal transduction, protein trafficking, and membrane structure; all important in maintenance of cellular health. Results suggest fatigability in older adults may have multiple molecular etiologies and identified variants may allude to molecular mechanisms to target in future interventions to promote healthy aging.