bluuebunny/crossref_metadata_2025 huggingface dataset:
PILOT STUDY OF A SELF-ADMINISTERED ADVANCE PLANNING TOOL FOR TECHNOLOGY USE WITH DEMENTIA CARE DYADS
Authors: Berridge Clara , Turner Natalie , Liu Liu
Published: December 2022

We present feasibility and preliminary efficacy findings from a novel web-app intervention to educate and facilitate dyadic communication about four categories of technologies used in dementia care and to document preferences of people living with mild AD regarding these technologies. A pre/post-test design was conducted. Eighty-eight percent of the 66 enrolled participants completed the study for a total of 29 dyads. Participants gave favorable ratings of satisfaction, helpfulness, clarity, and other usability measures. While improvements on multiple measures were of greater magnitude for care partners than for people living with dementia (PLWD), paired t-tests showed statistically significant improvement with medium and large effect sizes in PLWD (p<.001) and care partners’ ( p<.001) self-reported understanding of the technologies, as well as care partners’ perceptions of the PLWD’s understanding (p<.01). After completing the web-app together, care partners felt significantly more prepared to make decisions about these technologies (p<.01).
MECHANISMS OF DEVELOPMENT AND REGENERATION IN HYDRA
Authors: Juliano Celina , Cazet Jack , Primack Abby
Published: December 2022

Hydra vulgaris is a small and simple aquatic animal capable of whole-body regeneration and has negligible senescence. The entire animal, including the nervous system, is composed of about 25 cell types, and can regenerate from a fragment of tissue as small as ~300 cells. In addition, all cell types are continually renewed in the uninjured adult as part of normal homeostasis; every differentiated cell type is replaced approximately every 20 days, which likely contributes to its lack of aging. The remarkable features of Hydra are enabled by three distinct populations of stem cells that support the three lineages that make up the adult Hydra – the ectodermal epithelial lineage, the endodermal epithelial lineage, and the interstitial lineage (includes the neurons). A major goal of our laboratory is to understand the gene regulatory networks that control the specification of all Hydra cell types in the uninjured (homeostatic) state and then understand how injury triggers these differentiation pathways at unexpected locations during regeneration. Using high throughput genomics approaches such as scRNA-seq, ATAC-seq, and Cut&Tag, we have transcriptionally defined every cell type in Hydra and identified putative transcriptional regulators for each cell type. This includes the 11 neuronal subtypes that comprise the nerve net that spans the entire length of the Hydra body. We are currently leveraging these data to conduct functional testing of key putative regulators and to identify injury inputs into cell specification events during regeneration.
NEIGHBORHOOD CHARACTERISTICS INFLUENCE OLDER ADULTS' HEALTH AND MENTAL HEALTH OUTCOMES
Authors: Qin Weidi , Qin Weidi
Published: December 2022

Both social and physical aspects of neighborhood characteristics are related to a wide range of health and mental health outcomes. There has been increasing evidence pointing to the link between neighborhood-level factors and health among older adults. Specifically, older adults living in disadvantaged neighborhoods with under-resourced infrastructure may experience more daily activity limitations, mental health symptoms, and increased morbidity and mortality. Positive aspects of the neighborhood, such as social cohesion, may serve as a social capital resource and protect against adverse health outcomes. On the contrary, negative aspects of the neighborhood, such as physical disorder, can be a substantial stressor leading to poor health. The neighborhood environment also disproportionally affects racial and ethnic minorities in the US. This symposium session will present four studies exploring important topics related to neighborhood factors of health among older adults. Collectively, the findings will inform neighborhood-level interventions to promote health and well-being among community-dwelling older adults. This session will start with a talk by Dr. Chan on the link between neighborhood and disability across six ethnic groups of older Asian Americans residing in New York City. Dr. Perry will present a qualitative study to explore the environmental and infrastructure challenges in the neighborhood from the perspective of older adults in Detroit. This will be followed by Dr. Jiang’s talk on the relationship between neighborhood cohesion and mortality among a sample of older Chinese in Chicago. Finally, the session will conclude with Dr. Qin’s presentation on how neighborhood characteristics affect older adults’ mental health trajectories.
CORRELATES OF SOCIAL COHESION AMONG COMMUNITY-DWELLING OLDER PERSONS IN SOUTH-WESTERN NIGERIA
Authors: Cadmus Eniola , Adebusoye Lawrence , Owoaje Eme
Published: December 2022

Existing research shows that older persons prefer to ‘Age in Place’ in their homes or community for as long as possible and are attached to both the physical space as well as the social environment. Despite growing attention to the relationship between social cohesion and health outcomes, few studies have focused on its correlates, especially in low- and middle-income countries, including Nigeria. This study identified the factors related to neighbourhood social cohesion among older adults aged >60years dwelling in a selected rural and urban community in Oyo State, southwestern Nigeria. Data were collected using a semi-structured, interviewer-administered questionnaire and analysed using Stata version 15. Overall, 1180 (588 rural and 592 urban) respondents were interviewed (mean age 74.2 ± 9.5 years). Over half (55.3%) of the respondents had an adequate level of social cohesion. In the rural environment, positive predictors of social cohesion were male gender [OR: 1.73 (95%CI: 1.10-2.73)], formal education [OR:2.70 (95%CI: 1.52-4.81)] being employed [OR:3.68 (95%CI: 2.50-5.42)], homeownership [OR: 1.82 (95%CI: 1.22-2.71)] and good self-rated health (SRH) [OR:2.73 (95%CI: 1.78-4.20)]. Among the urban respondents, factors predictive of good social cohesion were male sex [OR:1.68 (95%CI: 1.06-2.68)], being employed [OR:2.38 (95%CI: 1.67-3.41) and reporting good SRH [OR:2.13 (95%CI: 1.45-3.11)]. Older respondents were less likely to have good social cohesion compared with the younger respondents in the rural [OR:0.54 (95%CI: 0.35-0.84)] and urban setting [OR:0.68 (95%CI: 0.47-1.00)]. The study findings underscore the importance of socio-economic status and homeownership on older adults’ social cohesion and areas for targeted policy and intervention
WITHIN-FAMILY DIFFERENCES IN INTERGENERATIONAL CONTACT: THE ROLE OF GENDER NORMS IN A PATRILINEAL SOCIETY
Authors: Lim-Soh Jeremy , Kim Dahye , Kim Kyungmin
Published: December 2022

Intergenerational contact is important for older adults’ quality of life. However, few studies have examined older adults’ patterns of intergenerational contact across multiple children and whether these patterns are gendered within families, which has been a distinct characteristic in countries with patrilineal traditions. A sample of older adults aged 65 and above with mixed-gender children (N = 3,228) from the 2006 Korean Longitudinal Study of Ageing reported the frequency of meeting and communication with each of their children (N = 14,110). To identify “within-family” patterns of contact, we applied latent profile analysis to three family-level indicators of contact across children: (a) family means, (b) family standard deviations, and (c) gender differences between sons and daughters. Multinomial logit regression was estimated to examine differences in parents’ characteristics between the derived patterns. Nearly half of parents exhibited gender-balanced patterns of meeting across children: “equally high contact” (14%) and “equally low contact” (34%). We also found two gendered patterns of contact: “more frequent contact with daughters” (13%) and “more frequent contact with sons” (39%). Communication also exhibited similar four patterns across children with a higher proportion of “equally high contact” (77%). The derived patterns of contact differed by parents’ age, education, marital status, employment situation, and depressive symptoms. The results highlighted substantial within-family differences in older parents’ contact with their children, revealing more frequent contact with sons. This points to the enduring nature of patrilineal traditions as well as the lack of frequent physical contact in some Korean families.
SHORT SLEEP AND INSOMNIA ARE ASSOCIATED WITH ACCELERATED EPIGENETIC AGE
Authors: Kusters Cynthia , Klopack Eric , Crimmins Eileen , Seeman Teresa , Cole Steve , Carroll Judith
Published: December 2022

Short sleep (<6 hours) and insomnia are independently associated with greater risk for age-related disease suggesting that insufficient sleep may accelerate biological aging. Epigenetic age acceleration is an estimate of biological aging that predicts morbidity and mortality. We tested whether insomnia symptoms and short sleep duration relates to epigenetic age in 2783 participants in the Health and Retirement Study. Insomnia and short sleep were associated with an 0.70(95%CI:0.23-1.17;P: 0.005) and 1.45(95%CI:0.67-2.24;P:0.001) years acceleration of GrimAge, respectively, as well as a faster pace of aging (DunedinPoAm; 0.015(95%CI: 0.005-0.024; P:0.006); 0.021(95%CI: 0.006-0.037; P:0.009)). Compared to healthy sleepers, Individuals with the combination of short sleep and insomnia had an accelerated GrimAge (1.34;95%CI: 0.49-02.19; P:0.003) and a greater DunedinPoAm (0.025; 95%CI: 0.009-0.041; P:0.004). Our findings indicate short sleep and insomnia are linked to epigenetic age acceleration, suggesting that these individuals have an older biological age that may contribute to risk for comorbidity and mortality.
RISK AND RESILIENCE: HIGHLIGHTING MINORITY STRESS IN A LIFESPAN SAMPLE OF SEXUAL MINORITIES
Authors: Vale Michael , Bisconti Toni
Published: December 2022

Older sexual minorities (OSM), or those older adults sexually attracted to the same sex, are at risk for poorer well-being, which is rooted in the stresses of being marginalized. There is limited knowledge on how older age contextualizes the minority stress process. OSM have witnessed more stigmatized sociopolitical climates, yet report less minority stress compared with younger adults, which may be due to having accrued lifetime practice with stigma. The current study explores age differences in the daily experiences of minority stress in a sample of sexual minorities stratified across the lifespan. Data from a baseline sample of 355 sexual minorities (ages 18-90) confirmed previous research that OSM experienced lower minority stress compared with their younger counterparts (p<.05). Additionally, an age-stratified subset of this sample (N=112; ages 19-79) answered daily surveys for 3 weeks (N=1,923). Using multilevel modeling, we found that older age moderated the daily stress-distress relationships between outness disclosure and positive affect (B=-.005, p<.05); internalized homonegativity and positive affect (B=.004, p <.05) and negative affect (B=-.005, p<.05), and experienced microaggressions and negative affect (B=.007, p<.05). OSM had weaker relationships among four different daily minority stressors and worse daily well-being. There also was support that the associations between age and minority stress were partially mediated by lifelong exposure with marginalization. This project highlights the intersection of sexuality and aging and emphasizes the unique resilience of OSM. The results of this study inform both theory and practice and contribute to a better understanding of how to address OSM’ health disparities.
UPDATING ESTIMATES OF DRIVING LIFE EXPECTANCY
Authors: Vivoda Jonathon
Published: December 2022

Information is limited about driving life expectancy, and the amount of time between loss of driving ability and death. The most often cited study (by Foley and colleagues, 2002) analyzed data collected in the mid-1990s and used life expectancy estimates to determine survival probabilities. Although that study was well designed, longitudinal data from the Health and Retirement Study (HRS) are now available to use participants’ actual date of death to assess issues related to driving life expectancy. HRS data from 1996-2018 were assessed; only participants who had answered the driving ability question for at least one wave, and had a reported death date were included. The percentages of participants were determined who never reported the ability to drive, always reported the ability to drive, and those who transitioned from driving to non-driving. Time between loss of driving ability and death was calculated among former drivers by subtracting the interview date when respondents reported an inability to drive (after having previously reported being able to drive) from the participants’ date of death. Only about 3% reported never driving, with a nearly even split between those who stopped driving (49%) and those who always drove (48%). Women were more likely to report being a never/former driver (65%) compared to men (36%). Among former drivers, the average time between inability to drive and death was 1312 days (3.59 years), and was significantly longer for women (437 days). Among former drivers, the average age for reporting inability to drive was about 83 years old.
AGITATION IN ALZHEIMER'S DISEASE: A DECISION TREE FOR HEALTHCARE PROVIDERS
Authors: Grossberg George , Sanford Angela , Scanland Susan , Tracy Karen , Stefanacci Richard G
Published: December 2022

Agitation in Alzheimer's Disease (AAD) impacts nearly 80% of persons with Alzheimer's Disease and is a cause of significant distress for patients and family/professional caregivers.Clinicians need guidance relative to assessment as well as non-pharmacologic and pharmacologic treatment approaches to AAD. To this end, the Gerontological Society of America (GSA) convened a group of experts representing Geriatric Psychiatry, Gerontological Nursing, Geriatric Medicine, and Long-Term Care to develop a "Decision Tree for Healthcare Providers" in the evaluation and management of AAD. The "Decision Tree" is a practical, user-friendly template for clinicians which provides a step-by-step approach to differential diagnosis of AAD, including conditions such as delirium, pain/discomfort, environmental and psycho-social stressors. The "Decision Tree" also walks the clinician through a range of non-pharmacologic treatment options such as music therapy; activities therapy, environmental modification and de-prescribing. The "Decision Tree" highlights rational use of pharmacotherapies as well as their hazards in this vulnerable population.
NURSE PRACTITIONER–LED IMPLEMENTATION OF HUDDLES TO SUPPORT STAFF IN LONG-TERM CARE HOMES
Authors: McGilton Katherine , Krassikova Alexandra , Wills Aria , Keatings Margaret , Bethell Jennifer , Boscart Veronique , Sidani Souraya
Published: December 2022

Staff working in long-term care (LTC) homes frequently report experiencing moral distress related to lack of autonomy and not being able to provide quality care. Huddles have been used as a communication tool for many years in acute care settings to improve collaboration and safety culture. In LTC homes, huddles are implemented less often, despite evidence of their benefits in improving support and teamwork. In this pre-test post-test implementation study, huddles led by a nurse practitioner (NP) were introduced in a privately-owned not-for-profit LTC home with < 150 beds, located in a medium urban centre in Ontario, Canada. Objectives of the study were to 1) examine fidelity of huddle implementation; 2) examine the extent to which the huddles improved staff’ outcomes of moral distress, job satisfaction, and support provided by the NP estimated with Bayesian proportional odds model. A total of 48 huddles were carried out by the NP over 15 weeks. Huddles were most commonly attended by personal support workers (98%) and registered practical nurses (96%), with an average of 7 individuals per huddle. Topics most often addressed at huddles were related to resident care (46%) and staff concerns (34%). Strong statistical evidence of a reduction in overall moral distress was evident for staff attending the huddles, when compared to staff who did not (posterior probability =.9933). No changes in job satisfaction and support provided by the NP were observed. Introducing huddles in LTC homes may be effective at reducing moral distress experienced by staff.
ARE CAREGIVERS HEALTHIER?: ASSESSING CAREGIVERS' EPISODIC MEMORY IN A MATCHED AND UNMATCHED SAMPLE
Authors: Veal Britney , Yauk Jessica , Meng Hongdao
Published: December 2022

Recent findings using an advanced methodological technique of propensity matching have found that caregivers may have better cognitive health compared to non-caregivers. However, there are limited studies assessing how personality and other psychosocial variables may affect the relationship between caregiver status and cognition. Utilizing the healthy caregiver hypothesis (HCH), the current study examined the association between caregiving and episodic memory in a matched (N= 1,246) and unmatched (N=3,112) sample of caregivers from the 2016 wave of the Health and Retirement Study. The interaction between caregiving status and personality was also examined. Unadjusted models showed no difference between caregiver status and episodic memory in the samples; however, depression was significantly (p=<.0001) related to cognition in the unmatched sample. In adjusted models for the unmatched sample, conscientiousness (p=0.043), pessimism (p=0.006), and feeling constrained (p=0.028) were found to be significantly associated with episodic memory. In the matched adjusted models, conscientiousness was no longer a significant predictor, but number of chronic conditions was significantly related to episodic memory (p=0.001). The interaction between caregiving and extraversion also approached significance (p=0.076). Findings suggest extraverted caregivers may have better episodic memory performance. These findings highlight the importance of implementing propensity matching in caregiving research. Future research is needed to examine the relationship between coping style and personality specific domains in relation to the HCH.
MERGING AN AGE FRIENDLY UNIVERSITY WITH AN AGE FRIENDLY HEALTH CARE SYSTEM: CASE STUDY FINDINGS
Authors: Schumacher John , Brandt Nicole , Resnick Barbara , Nahabedian Anissa , Heavner Mojdeh , Netzer Giora , Wilson Lara , Kheirbek Raya E
Published: December 2022

Age Friendly Health Systems (AFHSs) and Age Friendly Universities (AFUs) are distinct entities in the “Age Friendly” ecosystem. While Age Friendly entities function independently, they typically exist in close proximity (e.g., universities and community hospitals); yet they remain isolated in their Age Friendly efforts. We report on a collaboration between a mid-Atlantic Age Friendly University and a new AFHS using case study methodology. Our goal is to inform and inspire key stakeholders responsible for creating innovative healthy aging communities. The collaboration began with a shared stakeholder team who articulated focus areas and overlapping goals. A charter document was developed articulating commitments and responsibilities. Using a Quality Improvement (QI) approach, projects targeted the hospital’s older patient needs that linked to the AFHS 4 M’s of Matters, Medications, Mobility, and Mentation. University graduate students and faculty volunteered to teach and mentor hospital staff on the QI projects: 1) Get to Know Me Boards filled by staff caring for hospitalized older adults (Matters); 2) Medical Intensive Care Unit discharge opioid medication deprescribing (Medication); 3) UMove Mobility Screening addressing functional status (Mobility); 4) UB-2 Delirium Screening (Mentation). Data collection across projects demonstrated proof-of-concept and identified implementation challenges around communication, screening, data entry, and data extraction from electronic medical records. During Covid-19 pandemic, the collaboration allowed QI projects to conduct multiple Plan-Do-Check-Act cycles while contributing to the Age Friendly goals of both organizations. Partnerships between academic institutions and hospitals foster development of evidence- based healthy aging communities and provide opportunities for continuing education and research.
THE ASSOCIATION BETWEEN SMARTPHONE USE AND HEALTH BEHAVIORS AMONG OLDER ADULTS WITH DISABILITIES
Authors: Yang Eunjin
Published: December 2022

People actively use smartphones to maintain and improve their health in the digital era. With this, evidence exists of the positive effect of smartphone use on the well-being of people with disabilities. This study aimed to examine the preferred sources of health information among older adults with disabilities and the association between smartphone use and healthy behaviors. This study is based on data from the 2017 national survey on persons with disabilities carried out in South Korea. A total of 4,014 participants aged 60 and above were included. Logistic regression analysis was carried out to verify the association between smartphone use and health behaviors. As the study reports, 37.7% were smartphone users and 62.3% were non-smartphone users. Among health information resources, participants identified mass media, medical institutions, and acquaintances as the first, second, and third preferred sources, regardless of smartphone use. However, a higher proportion of non-smartphone users reported having no health information available to them compared to smartphone users (5.7% vs. 1.3%, respectively). Regarding health behaviors, older adults with disabilities who use smartphones are more likely to have regular health checkups (Odd Ratio [OR], 1.51), cancer screenings (OR 1.33), dental examinations (OR 1.26), and exercise (OR 1.47), and to consume a balanced diet (OR 1.23) compared to non-smartphone users. Although these results do not prove causal relationship, smartphone use is associated with healthy behaviors in this population. Considering that healthy lifestyles are crucial to achieving active aging, resolving the disability digital divide is needed for older adults with disabilities.
USING COMMUNITY-BASED PARTICIPATORY RESEARCH TO PROMOTE MENTAL HEALTH LITERACY IN OLDER CHINESE
Authors: Yau Jessie Ho-Yin , Lok Edwin , Wong Yan , Kanagawa Hotinpo Sky , Wong Nicole H L , Liu Tianyin , Wong Gloria H Y , Lum Terry
Published: December 2022

Whilst traditional mental health literacy programmes utilized a top-down approach, no bottom-up community-based participatory research (CBPR) model had been used to promote mental health literacy among older adults. Moreover, the existing CBPR model was developed in the West and might not be applicable in Chinese communities given different socio-cultural contexts. This research aimed to fill the gap by implementing a CBPR project to promote mental health literacy among older adults and developing a CBPR model in Chinese context. A year-long CBPR project was conducted in five Hong Kong districts from May 2021 to August 2022. A district advisory group was formed in each district, which comprised 50 community older adults, 2 NGO social workers, and 2 researchers. Each district had their own promotional activities that were initiated and designed by older adults, including street booths, art workshops, videos and photos to promote mental health and introduce relevant information and resources. Researchers recorded field observations in each district activity and conducted focus group discussions with stakeholders. Collected data suggested that specific elements are important for a CBPR model in Chinese context, including participant empowerment, technical support, stakeholder expectation management and potential community contribution. Following the implementation of district promotional activities, a territory-wide advisory group was formed to promote mental health literacy on a territory level in the coming year. This is the first large-scale CBPR project that promoted mental health literacy among older adults in Chinese context. Implications for future research and practice will be discussed.
SUPPORTING DEMENTIA CAREGIVERS DURING COVID-19 WITH CAREHEROES IT: USAGE PATTERNS AND OUTCOMES
Authors: Ruggiano Nicole , Brown Ellen , Framil C Victoria , Hurley Shannon , Roberts Lisa , Clarke Peter , Allala Sai Chaithra , Daquin Jane
Published: December 2022

Caregivers of people with dementia often experience negative physical and mental health outcomes due to the complex challenges posed by dementia symptoms and navigating care systems. The COVID-19 pandemic posed even greater hurdles for caregivers as many health care and support services transferred to virtual formats and required increased use of information technologies (IT). This research examined usage data and psychosocial outcomes of dementia caregivers who used a new mobile-enabled web-based app that was offered as an adjunct to clinical care at two memory clinics (Birmingham, AL; Miami, FL) during the pandemic. This app, called CareHeroes: (1) allows caregivers to self-assess their emotional and mental health; (2) offers a secure platform for tracking and communicating patient-related information among caregivers and providers; and (3) offers caregiver education. CareHeroes is also available in Spanish. Effort was made to recruit digitally underserved populations of caregivers (e.g., rural dwelling, underserved racial/ethnic groups). This presentation will review caregiver outcomes (e.g., burden, depression, user data) at baseline and 3-month follow-up. Among the 22 caregivers who enrolled in the study, 17 completed baseline and 3-month follow-up interviews. Over a 14-month period, participants logged onto CareHeroes 131 times, which varied by month. Caregivers most often used CareHeroes to complete assessment tools. Findings indicate that depression and burden were lower at 3-month follow-up compared to baseline, though this reduction was not statistically significant. The presentation will also review challenges of integrating a new technology intervention designed to promote telehealth during the COVID-19 pandemic.
VALIDITY EVIDENCE FOR THE MALE DEPRESSION RISK SCALE-22 (MDRS-22) IN YOUNGER AND OLDER ADULT MALES
Authors: Owsiany Montgomery , Fiske Amy
Published: December 2022

Men are two times less likely to be diagnosed with major depressive disorder (MDD) than women. However, suicide rates are nearly four times higher in men than women, increasing to six times or more when comparing older men to older women. Masculine depression is characterized by symptoms that are not usually assessed by diagnostic criteria for MDD, including drug and alcohol abuse, anger and aggression, and risk-taking. Previous studies have largely neglected to consider the possibility of age-related differences in the presentation of masculine depression. Given research on age-related differences in MDD, there may be age-related differences in the presentation of masculine depression as well. The present study assessed age invariance of the MDRS-22 through a multi-group confirmatory factor analysis (CFA), evaluated validity evidence of the MDRS-22, and tested the MDRS-22’s ability to assess suicidal ideation and behaviors. There was a significant difference between the configural and first-order metric models of the CFA showing that the MDRS-22 was not age invariant (ΔX2 = 451.47, Δdf = 16, p < .001). The MDRS-22 showed convergent validity evidence with assessments of MDD, alignment with masculine norms, suicidal behaviors, problematic alcohol use, and aggression. The MDRS-22 showed concurrent validity evidence with another assessment of masculine depression. Finally, MDRS-22 scores significantly predicted suicide risk above PHQ-9 scores (F(2,440) = 138.774, p < .001, R2 = .385). Overall, the study highlights the importance of screening males for masculine depression. Further research is needed to determine if masculine depression presents differently in younger and older males.
THE DYNAMIC RELATIONSHIP BETWEEN MULTIDIMENTIONAL ENVIRONMENT AND PHYSICAL ACTIVITY PARTICIPATION
Authors: Zhang Yalu , Mei Donghui , Pei Heming , Chen Gong
Published: December 2022

Objectives

Physical activity participation is a preventive factor in improving physical and cognitive functions. Both physical and social environments are essential in evaluating older adults’ opportunities to participate in physical activities. This study aims at assessing the multidimensional environment in physical activity participation and examining how the change in the multidimensional environments could affect their participation in physical activities.

Methods

This paper combined the nationally representative data, the China Longitudinal Aging Social Survey data 2014–2018, and the county-level administrative data extracted from various statistical yearbooks. It used the latent variable cross-lagged panel model to capture the dynamic relationship between environment and physical activities. Additionally, the dynamic analytical model considers a multidimensional environment, including indoor-, outdoor-, human-, social-environment, etc., by adding the latent variables.

Results

The descriptive statistics show that older adults who are in a better environment (.147 in the indoor environment, p < 0.001; .389 in the outdoor environment, p < 0.01; .571 in family support, p < 0.05; .346 in childhood activity experience, p < 0.001) are more likely to frequently participate in physical activities (three times or more per week). The results of the latent cross-lagged panel models indicate that every one percent increase in the multidimensional environmental index is expected to cause a 4.1% increase in the likelihood of participating in physical activities among Chinese older adults. Discussion: In addition to the continuous efforts to improve the physical environment, policymakers and researchers should pay more attention to the social environment to encourage more older adults to participate in physical activities.
BIOPHYTIS BIO101 IN SARCOPENIA: UPDATE ON THE SARA PROGRAM: FROM SARA-INT TOWARDS THE PHASE 3 STUDY
Authors: Tourette Cendrine , Dioh Waly , Margalef Carole , Mariani Jean , Agus Sam , Van Maanen Rob , Veillet Stanislas
Published: December 2022

Sarcopenia is a progressive muscle disorder increasing with age that may lead to mobility disability. SARA program strives to develop a viable option to treat community dwelling older adults suffering from sarcopenia. SARA-INT is a randomized three-arm interventional study (BIO101 175 mg bid / BIO101 350 mg bid / placebo) with treatment duration of 6 months. Eligibility criteria for sarcopenia were meeting FNIH criteria and Short Physical Performance Battery (SPPB) score ≤ 8/12 in men and women aged ≥ 65 years; primary endpoint was the 400-meter walking test (400MWT). 233 participants aged 65 years and older were randomized, 232 and 156 participants were included in the Full Analysis Set (FAS) and Per-Protocol (PP) populations, respectively. Due to COVID-19 pandemic, most end-of-treatment efficacy assessments are missing for 55% of the participants, reducing the studies’ power. BIO101 350 mg bid treatment led to an improvement in the primary endpoint, the gait speed from the 400MWT of 0.07 m/s in the FAS population (not statistically significant) and of 0.09 m/s in the PP population (nominally statistically significant, p=0.008) after 6 months; this is close to MCID in sarcopenia (0.1 m/s). BIO101 350mg bid treatment effect on the 400MWT is confirmed in PP sub-populations at high risk of mobility disability. Trends were observed with other endpoints. BIO101 showed a very good safety profile at both doses. Biophytis will initiate the phase 3 program by end 2022, targeting a severe sarcopenic population. Outcomes of the interactions with regulatory agencies on study design will be presented.
OPTIMIZING MEDICATION RECONCILIATION AMONG OLDER ADULTS DURING COVID-19 INFECTION TREATMENT WITH PAXLOVID
Authors: Chen John , Browne Tarah
Published: December 2022

COVID-19 infection treatment (CIT) has reframed optimizing medication reconciliation in older adults. In December 2021, FDA authorized Emergency Use Authorization of Paxlovid (Nirmatrelvir/Ritonavir), protease inhibitor blocking SARS-CoV-2 replication, to reduce severe COVID-19 and mortality in high-risk patients1. Pharmacodynamic and pharmacokinetic changes in geriatric population warrant a stepwise, patient-centered approach for prescribing Paxlovid by reviewing - 1) drug-drug interactions with current medications2, 2) renal dosing, 3) risks-benefits-alternatives, 4) adverse drug events (ADE), i.e. polypharmacy and prescribing cascade. Case A – Community-dwelling 65-year-old Hispanic male history of paroxysmal ventricular tachycardia and end-stage renal disease (ESRD) requiring CIT- 1) Paxlovid contraindication with Amiodarone2 2) ESRD – not candidate 3) risks outweigh benefits, 4) safer alternatives with less ADE. Case B – Long term care 80-year-old Hispanic female history of stroke, type 2 diabetes mellitus and dementia requiring CIT -1) Paxlovid contraindication with Atorvastatin2 (Atorvastatin held during Paxlovid treatment then restarted at lower dose “deprescribing”), 2) estimated glomerular filtration rate 46 with renal dosing – Paxlovid 150mg/100mg, 3) benefits outweigh risks, 4) monitored ADE in controlled setting. Optimizing medication reconciliation during CIT in older patients can decrease preventable ADE. Further research is essential to align CIT efficacy with the fundamental geriatric principles, including shared decision-making, long-term prognosis, and life care planning. 1Najjar-Debbiny R, Gronich N, Weber G, Khoury J, Amar M, Stein N, Goldstein LH, Saliba W. Effectiveness of Paxlovid in Reducing Severe COVID-19 and Mortality in High Risk Patients. Clin Infect Dis. 2022 Jun 2:ciac443. 2Lexicomp Drug Interaction Checker. Accessed August 6, 2022.
RACE AND ETHNIC DIFFERENCES IN PHYSICAL ACTIVITY, OSTEOPENIA, AND OSTEOPOROSIS: RESULTS FROM NHANES
Authors: Vasquez Elizabeth , Alam Md Towfiqul , Murillo Rosenda
Published: December 2022

Introduction

Osteopenia and osteoporosis are common age-related disorders with enormous health and economic consequences to older adults and society. Physical activity (PA) is an important modifiable risk factor for bone mineral density (BMD). This study aims to determine whether current physical activity is related to osteopenia and osteoporosis (based on BMD) in a racial/ethnically diverse sample of older adults.

Methods

Femoral bone BMD data from the National Health and Nutrition Examination Survey (NHANES 2009-2010, 2013-2014, 2017-2018) was obtained for 3,331 adults 60-80 years old. Self-reported PA was categorized into high, moderate, and low. Linear regression models that accounted for the complex survey design of NHANES examined the association between PA and BMD for each race/ethnic group.

Results

Non-Latino blacks (blacks) and Latinos reported low levels of PA when compared to Non-Latino whites (whites) (40.7%, 38.2% and 32.4% respectively; p< 0.0001). Further, blacks and Latinos had a lower prevalence of osteoporosis (5.6%, 6.4% and 9.0% respectively; p< 0.0001), but have similar prevalence of normal BMD and osteopenia categories when compared to whites. There was a 0.03 g/cm2 difference in BMD between those in the high PA versus the low PA (p< 0.0001).

Conclusion

Our findings indicate that despite lower levels of activity, black and Latino older adults were less likely to have osteoporosis. High levels of activity were significantly associated with higher BMD after controlling for confounders. Considering the prevalence and burden of osteopenia and osteoporosis and projected increases of the older population we need more research evidence supporting the role of PA.
EXAMINING THE NURSING HOME INNER SETTING CHARACTERISTICS THAT LEAD TO THE SUCCESSFUL IMPLEMENTATION OF PAL CARDS
Authors: Kasler Kamryn , Kelley Megan , Kunkel Miranda , Moore Reese , DeVengencie Faith , Heppner Alexandra , Van Haitsma Kimberly , Abbott Katherine
Published: December 2022

Implementation efforts of evidence-based practices focusing on the nursing home setting remain understudied. The purpose of this study was to explore the role of the Consolidated Framework for Implementation Research (CFIR) inner setting domain on the implementation of PAL Cards. Monthly qualitative interviews (n=50) with project champions (n=16) were audio-recorded, transcribed, checked for accuracy, and coded using the domain “Inner Setting” from the CFIR in Dedoose. Major themes emerging from the data included networks and communication (e.g., including PAL Card information in employee newsletter) among staff, compatibility of the PAL Cards (e.g., aligns with community values and fits into existing workflows), and available resources (e.g., adequate time and staff to implement the QIP). High-quality communication channels to educate and collaborate were shown to be an integral component of successful implementation. Implications for policy and practice will be discussed.
USING FOUND POETRY TO EXPLORE SEXUAL AND GENDER MINORITY COUPLES' EXPERIENCES FACING CANCER
Authors: Bybee Sara , Cloyes Kristin , Mooney Kathi , Supiano Katherine , Baucom Brian , Ellington Lee
Published: December 2022

This study explored how relationships of sexual and gender minority (SGM) couples change through the cancer experience. Twelve couples (N = 24) completed surveys assessing demographics and dyadic semi-structured interviews. Thematic analysis was used to analyze interview transcripts. Participants had been together for 19.1 years on average (SD = 9.9, R = 9-44) and commonly described dyadic strength and durability as a result of cancer. Using in-vivo language extracted from the theme dyadic strength and durability, a found poem was constructed depicting how couples saw themselves as two-person teams united against any external stressors. When SGM couples experienced cancer together, it resulted in feeling closer to one another, like they could handle anything that came their way, and assured them that they would stay together regardless of any future hardships experienced. Creative qualitative methods revealed SGM couples facing cancer felt like unyielding, impenetrable, eternal duos with which to be contended.
ADDRESSING TRAUMA IN OLDER VETERANS IN HOME-BASED PRIMARY CARE
Authors: Moye Jennifer , Bashian Hannah , Heintz Hannah , Daks Jennifer , Baird Lola , Kaiser Anica Pless , O'Malley Kelly , Etchin Anna
Published: December 2022

As Veterans age, confronting illness and role changes, they may experience later adulthood trauma reengagement (LATR). To better understand this process in medically ill Veterans, we completed six focus groups with 21 VA Home Based Primary Care (HBPC) mental health clinicians in rural and urban settings; 14 completed a follow-up survey. Thematic analysis of focus groups confirmed the LATR model with unique presentation and treatment challenges related to medical, physical, and cognitive changes. In surveys, the most challenging symptoms were: intrusive symptoms, dissociative reactions, and psychological/physiological reactivity (79%). In addition to focus group themes, surveys described challenges related limited social engagement, Veteran ambivalence, and lack of empirically supported treatments appropriate to HBPC. Results of these focus group and survey data provide key insights into the unique presentation of trauma in aging medically ill Veterans. Ongoing efforts to adapt materials and resources for this population will be described.
HEALTHY AGING IN PLACE REQUIRES A HEALTHY HOME CARE WORKFORCE: THE SAFETY AND HEALTH OF PAID CAREGIVERS
Authors: Quinn Margaret , Markkanen Pia , Sama Susan , Galligan Catherine , Lindberg John , Gore Rebecca
Published: December 2022

Home care (HC) aides provide health and personal care services that enable older adults to live at home as they age. Aides are increasingly in demand as our population ages rapidly. Yet there is an aide shortage due in part to instabilities in HC work organization and to occupational safety and health (OSH) hazards, resulting in aides losing work time or leaving their jobs. Aide injuries and illness interrupt the continuity of care delivery and HC hazards can put clients and family caregivers at risk. This research synthesizes recent findings of aide OSH studies in order to identify risks and preventive interventions to improve both HC aide and client safety. Mixed methods were used to characterize aide OSH hazards including needlesticks, musculoskeletal strain, experiences of violence, COVID-19 and other infections and harmful disinfection practices. Improving aide OSH can contribute to improved care services enabling older adults to live at home.
OLDER ADULT PREFERENCES FOR THE FORMAT AND CONTENT OF PRESCRIPTION MEDICATION LABELS
Authors: Malhotra Rahul , Suppiah Sumithra , Tan Yi Wen , Van Dyk Semra Ozdemir , Sung Pildoo , Tay Sarah Siew Cheng , Tan Ngiap Chuan ,   PROMISE Study Group PROMISE Study Group
Published: December 2022

The risk of misinterpreting prescription medicine labels (PMLs) is higher among older adults. Given the limited space on PMLs, their format and content should cater to older adults’ medication information and legibility needs. We established the ranking of seven medication-related content variables (indication, precautions, interaction or paired medicines, food instructions, side effects, expiry date, and missed dose action; provision of these content is currently not legally mandated) to be prioritised on PMLs using best-worst scaling (BWS), and determined the relative utilities of five format attributes (presentation of dose-frequency instructions, font size, presentation of dose, presentation and colour of precautions) when incorporated onto PMLs using discrete choice experiment (DCE), from the perspective of older Singaporeans. The variables and attributes were informed by our prior qualitative study and best practices guidelines for PMLs. We recruited 280 older adults (mean age: 68.8±5.4 years). A BWS object case was used to evaluate the relative importance of medication-related content variables (range: 0 to 1). A mixed logit model estimated the relative utilities of attribute levels, which enabled calculation of importance scores for ranking the format attributes (range: 0% to 100%). The three most-preferred content variables were indication (1.000), precautions (0.853) and interaction or paired medicines (0.845). The top three format preferences were tabular presentation of dose-frequency instructions (43.7%), large font size (22.3%) and precautions in red colour (13.6%). The findings inform an actionable way to improve the content and format of PMLs in the real-world, which is aligned with the stated priorities of older adults.
DEPRESSIVE SYMPTOM TRAJECTORIES AND COGNITIVE FUNCTION AMONG OLDER COUPLES: A DYADIC PERSPECTIVE
Authors: Kong Dexia , Lu Peiyi , Woo Jean , Shelley Mack
Published: December 2022

Despite the well-documented health interdependence in the spousal context, empirical evidence on how psychological wellbeing of one’s partner might affect one’s cognitive function remains limited. Using dyadic data, the objective of this study is to examine trajectories of depressive symptoms and associated cognitive function outcomes among U.S. older married couples. Longitudinal Health and Retirement Study data (2004-2016) were used (N=6,289 heterosexual couples). Latent class growth analysis characterized depressive symptom trajectories for wives and husbands, separately. Structural equation models examined the actor and partner effects of depressive symptom trajectories on cognitive function in 2016 after adjusting for covariates. Four distinct depressive symptom trajectories were identified, including persistently low (wives: 73.61%; husbands: 79.59%), increasing (wives: 8.60%; husbands: 8.27%), decreasing (wives: 12.80%; husbands: 8.32%), and persistently high (wives: 4.99%; husbands: 3.81%). Compared to the low trajectory, increasing and high depressive symptom trajectories were associated with poorer cognitive function for wives and husbands (β_(wife,increasing,actor)=-0.92,95%CI=-1.30,-0.54; β_(wife,high,actor)=-0.71,95%CI=-1.19,-0.23; β_(husband,increasing,actor)=-0.81,95%CI=-1.16,-0.45; β_(husband,high,actor)=-1.20,95%CI=-1.78,-0.63). Notable gender discrepancies in partner effects were observed. Specifically, wife’s depressive symptom trajectories were not associated with husband’s cognitive function (P>0.05). However, husband’s decreasing depressive symptom trajectory was linked to wife’s better cognitive function. One’s own depressive symptom trajectories predicts his/her own cognitive function. Specifically, older adults with increasing and persistently high depressive symptoms over time may experience poorer cognitive function, and thereby warrant additional policy and clinical attention. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses’ cognitive function. Future studies need to validate such gender differences.
FOXO3-MEDIATED PROTECTION AGAINST VASCULAR DEMENTIA RISK IN A CASE-CONTROL STUDY OF ASIAN AMERICAN MEN
Authors: Davy Philip , Kallianpur Kalpana , Chen Randi , Donlon Timothy , Morris Brian , Allsopp Richard , Willcox Bradley , Masaki Kamal
Published: December 2022

The longevity-associated allele of FOXO3 is associated with a significant reduction in cardiovascular disease (CVD) risk in older adults. We hypothesized that dementia, which shares several risk factors with CVD, might also be related to FOXO3 genotype, particularly vascular dementia (VaD). Therefore, we utilized the Kuakini Honolulu Heart Program/Honolulu Asia Aging Study dataset to assess the relation of FOXO3 genotype to dementia risk. Preliminary analyses suggested that VaD had the strongest relation to FOXO3 genotype. Therefore, we performed larger, more detailed study of FOXO3 genotype and VaD risk in a 9-year nest case-control study. Chi-Square test was used to assess the association of dementia with FOXO3 genotype in a sample of 1504 Japanese-American male study participants, aged 71-93 years, at the baseline exam. General Linear Model was utilized to compare VaD risk factors between VaD cases and controls. Multivariate Logistic Regression was used to assess the association of VaD with FOXO3 genotype adjusting for birth year, education, APOE4 and other vascular risk factors. We found a significant protective association for carriers of the principal FOXO3 longevity-associated allele (SNP rs2802292 G allele-carriers) against VaD risk (OR = 0.66, 95% CI = 0.44-0.98, p = 0.0388). The protective association retained significance when controlling for common risk factors for VaD in a multivariate model. These data indicate a potential neuroprotective role for the FOXO3 longevity-associated genotype against vascular dementia. This finding merits validation studies in other cohort studies.