bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-Related Difference in the Relationship Between Age Stereotypes and Health Behavior in Midlife Koreans
Authors: Yeom Hyun-E , Park Eunyoung , Jung Misook
Published: December 2020

Aging stereotypes about health may affect the interpretation of health-related changes in midlife. The purposes of this study were to examine the influence of age-related stereotypic beliefs on health behavior linked to health status and stress and to investigate whether the relationship differs by age. This is a cross-sectional study using a convenience sample of 446 Korean middle-aged adults (mean age=50.7). Data were analyzed using the PROCESS macro approach of SPSS. Age-related stereotypic beliefs affected health behavior through the evaluation of health status (Index=-.006, 95% CI [-.002, -.001]) and related stress (Index=-.002, 95% CI [-.004, -.001]). The relationship between age-related stereotypic beliefs and health status significantly differed by age (β= -.02, p=.004), indicating that individuals with stronger age-related stereotypic beliefs tended to report poorer health status as they aged. With regard to the age difference, the influence of age-related stereotypic beliefs affecting health behavior through health status and related stress became relatively stronger when midlife individuals became older. The findings of this study highlight the importance of carefully assessing age-related beliefs based on consideration of age-related differences in middle-aged individuals. Developing psychoeducational strategies to modify the negative and erroneous aging-related beliefs and to improve health behavior is warranted.
Sociodemographic and Marital Differences in Spousal Involvement in a Partner’s Diabetes Diet
Authors: Castro Paulene , August Kristin , Sorkin Dara
Published: December 2020

Spouses are commonly involved in their partners’ diabetes management by supporting and regulating (i.e., controlling) their diet. Little is known, however, about what characteristics are associated with how and how often spouses are involved in this context. This study examined whether sociodemographic and marital characteristics helped explain some of the variability in diet-related spousal involvement in promoting a partner’s adherence to a diabetes diet; specifically, whether gender, race/ethnicity, marital quality, and marital length were related to the frequency of spousal engagement in health-related social support and two types of health-related social control. Gender and race/ethnicity were examined as exploratory moderators of the associations between marital characteristics and spousal involvement. Data from two different data sets of older adults (55+ years) whose partners had type 2 diabetes were examined among four racial/ethnic groups (study 1 n = 205; study 2 n = 155). Regression analyses that controlled for patients’ co-morbid health conditions revealed gender and racial/ethnic differences in the frequency of spousal involvement. In addition, marital quality was related to the frequency of support and positive forms of social control among most participants, particularly African American spouses. No associations between marital length and any type of spousal involvement were found, nor were there any gender differences in any of these associations. These findings provide insight into the importance of sociodemographic characteristics and marital quality in understanding spousal involvement in a partner’s diabetes management.
Strategies to Support Physical Activity Participation in Older Adults With Heart Failure
Authors: Hall Katherine , Pastva Amy , King Heather , Lowers Sean , Miller Julie , Riley Jennie
Published: December 2020

Physical activity (PA) is recommended for people living with heart failure (HF). Despite evidence of its benefits, participation in PA is low in this population, putting them at risk for loss of functional independence and additional health burdens. The aim of this pilot study was to ask older adults living with stable, chronic HF to identify strategies to support regular PA. Patients in an outpatient HF rehabilitation program were recruited to participate in focus groups about their PA knowledge, attitudes, and preferences as part of a stakeholder engagement project. At the beginning of the focus group, participants completed a questionnaire listing 8 potential strategies to optimize PA, and were asked to identify the top 4 strategies that they thought would be most beneficial to support regular PA participation. This was the focus of the current analysis. Thirteen adults with HF (M age=65; 46% female; 62% African American; M BMI=32.6 kg/m2) were enrolled. Top-rated strategies endorsed by participants to support long-term adherence to PA included provision of an exercise guide to support home-based exercise and supplement health provider-supervised exercise sessions (69%), group education classes (64%), completion of fitness assessments at regular intervals (62%), and provision of a transition pathway from an exercise rehabilitation program to a community-based exercise program (62%). The remaining strategies were endorsed by fewer than 50% of participants, and included remote delivery and support options. These results have important implications for future program development and implementation efforts to support PA among older adults with stable, chronic HF.
Applying Evidence-Based Violence Prevention Strategies to Elder Abuse in Public Health
Authors: Ham Carolyn , Bolkan Cory
Published: December 2020

Elder abuse is a growing problem with significant public health implications. Because elder abuse shares root causes with other types of violence (e.g., suicidal behavior, intimate partner violence), awareness of elder abuse as a violence prevention priority is rising among public health professionals. Major limitations, however, affect delivery of effective population-level primary prevention for elder abuse, necessitating increased community partnerships. In Washington State, the Department of Health’s Injury and Violence Prevention Section and the Department of Social and Health Services Adult Protective Services Division are leveraging existing strategies to increase identification and reporting of potential elder abuse from falls and injury prevention partners (i.e., opioids, suicide). We describe: (1) challenges and opportunities in creating unique cross-program collaborations, (2) the combined education and outreach efforts of this partnership, and (3) strategies for sustained collaboration. Additionally, we share results of a scoping literature review on evidence-based violence prevention strategies applicable to elder abuse between 2015 – 2019. In the Pubmed and Academic Search Complete databases, the following terms were searched: elder abuse prevention, primary prevention, shared risk and protective factors. Only six articles were identified that addressed primary prevention efforts. Researchers note that primary prevention of elder abuse is poorly understood and challenges exist in applying methods from other types of violence. Education for key community members on identification of abuse is a promising intervention targeting shared risk and protective factors for public health to pursue. Cross-sector community partnerships and rigorous evaluation of primary prevention approaches are needed.
Health and Labor Market Outcomes Among Older Adults: Causal Evidence From Korean Panel Data and Dynamic Modeling
Authors: Kim Hoolda , Mitra Sophie
Published: December 2020

Health and work are two key determinants of economic insecurity and wellbeing. Since economic insecurity may rise with age due to the deterioration of health and work ability, it is essential to study the causal relationship between health and labor market outcomes among older people. In Korea, the size of the older population has grown rapidly in recent decades but the pension system remains limited in terms of its reach and generosity, leaving a considerable number of older people suffering from economic insecurity. To investigate the two-way causal links between health and labor market outcomes, we use unique data on middle-aged and older Koreans from 12 waves of the Korea Welfare Panel Study (2006-2017) and two dynamic modeling approaches: the Arellano-Bond Generalized Method of Moment Model (AB-GMM) and the Maximum Likelihood Structural Equation Model (ML-SEM). Results point at gender differences regarding the direction of the causal link between health and labor market outcomes. Men are more likely to be in good health due to higher income or paid work. Women are more likely to earn a higher income and to work as paid employees because of good health. These effects particularly hold for Koreans aged 55-74 in urban areas.
Historical Differences in Retirement Adjustment in Germany
Authors: Henning Georg , Huxhold Oliver
Published: December 2020

The nature of retirement has been constantly changing over the last decades. Retirement transitions of later-born cohorts differ from those of earlier-born cohorts in terms of sociocultural context and timing. In addition, today’s retirees differ from those who retired earlier in historical time, for example with respect to gender composition, social resources and health status. Gerontological research has rarely addressed the question whether such developments translate into historical differences in retirement adjustment quality. In the current study, we investigated historical differences in perceived retirement adjustment. We distinguished developments for blue-collar and white-collar workers to detect potentially increasing social inequalities. Our pre-registered analyses were based on data from four waves of the German Ageing Survey. The sample included n = 990 participants interviewed either 1996, 2002, 2008 or 2014, who retired in a five-year period before the respective interview (1991-1996, 1997-2002, 2003-2008 and 2009-2014, respectively). Retirement adjustment was measured with three self-report items. Our preliminary results, based on multi-group structural equation modeling, do not provide evidence for a linear improvement or decline of retirement adjustment quality over historical time. White-collar worker reported better adjustment, but this effect was constant over historical time. Our results do not support ideas of fundamental historical differences or growing social inequalities in the individual experience of retirement.
Support for a Lower State Pension Age for Disadvantaged Older Workers
Authors: Mulders Jaap Oude , Van Dalen Hendrik , Henkens Kène
Published: December 2020

Due to policy reforms, early exit from the labor market has decreased substantially and people are participating in the labor market until much higher ages than before. As a result, there are increasingly many people that struggle to continue working until they can comfortably retire, for example due to chronic health conditions or having to provide informal care. A potential solution would be to grant earlier access to state pension benefits (such as Social Security) for disadvantaged older workers. While it is known that many people are supportive of such a policy, the question remains how much earlier access would be granted under which circumstances. Here, using a quasi-experimental vignette design (10,350 observations nested in 2,070 respondents), we study how much earlier Dutch people would like to grant access to disadvantaged older workers. Relevant characteristics of older workers that are judged are the age at which they started working, the level of physical strain in their job, whether they have chronic health conditions, and whether they provide informal care to a loved one. The result show that, on average, people would grant older workers with chronic muscoskeletal conditions or cardiovascular disease one year earlier access to the state pension than normal, while older workers that provide daily informal care would be granted 10 months earlier access. Cumulative disadvantage could lead to a maximum of three years earlier access to pension benefits. This study provides important insights into fairness considerations surrounding state pension provisions, and implications for practice will be discussed.
Balancing Mobility and Driving Safety: Facilitators and Barriers for Driving Frequency Among Older Drivers
Authors: Cao Jiawei , Vivoda Jonathon
Published: December 2020

Being able to drive safely ensures older adults’ transportation mobility and independence. It is also a key element for social participation and to achieve productive aging. However, when accounting for driving exposure, crash risk and crashed-related deaths increase for older drivers aged 70 years and plus. By analyzing data from NHATS, this study aimed to assess factors that might affect driving frequency (a five-category ordinal variable that measured how often people drove places). I examined whether productive aging activities (e.g., working, volunteering, caregiving, leisure, religious participation, civic engagement), perceived importance of social participation, mental wellbeing, physical capacity, cognition, sensory function, and community environment were either positively or negatively related to driving frequency. Age, gender, race, household size, marital status, and self-rated health were controlled for in this study. Results from ordinal regression showed that higher driving frequency was observed among older adults who reported that they worked for pay, provided care, visited friends and family, and went out for enjoyment. Higher driving frequency was also related to a higher perception of social participation importance. Inability to walk six blocks, lower scores on delayed word recall, and poorer vision were associated with lower driving frequency. Lower driving frequency was also found among women, married couples, and people with worth health and advanced age (80 years and older). These results suggest that higher driving frequency is associated with active social engagement and participation. New vehicle technologies or alternative transportation services and programs could be implemented to ensure safety, mobility, and social participation.
A Novel Method for Assessing and Training Everyday Functional Skills
Authors: Czaja Sara , Harvey Philp , Kallestrup Peter
Published: December 2020

Older adults, especially those with cognitive impairments often experience difficulty performing everyday tasks such as medication management, which threatens independence. Thus, there is an interest in developing treatment approaches for those who are experiencing or at risk for cognitive problems. Cognitive remediation training (CRT) programs have shown to be effective in improving cognitive abilities, but there is limited evidence to suggest that CRT results in everyday task performance gains. This presentation will discuss findings from a trial evaluating an innovative computer -based functional skills assessment and skills training program (CFSAT), which includes ecologically valid simulations of everyday tasks (e.g., shopping, money and medication management). The sample includes non-cognitively impaired (NC) older adults (n=50) and those with mild cognitive impairment (MCI) (n = 40), ranging in age from 60 -86 years (M= 73.10; SD = 6.06), is primarily female (90%), and ethnically diverse (69% minority). Participants were randomized into the CFSAT condition or a CFSAT + CRT condition. Performance data includes real time measures of accuracy, response time and efficiency. The findings indicate that the assessment component of the CFSAT program differentiated between the NC and MCI groups at the baseline assessment. Both NC and MCI participants demonstrated improvements in performance following training across all tasks; though the MCI participants required more training. Participants who received CFSAT + CRT training demonstrated increased efficiency in skill acquisition. The results indicate that the CFSAT program is an efficacious tool for assessing and training functional performance in both non-cognitively and cognitively impaired older adults.
Social and Health Disparities Among Relocated Public Housing Residents by Age: Implications for Aging in Place
Authors: Reed Nia , Young Tiffany
Published: December 2020

Research illustrates that neighborhood outcomes (including the built environment) influence the mental and physical health of vulnerable older adults (OA). Many OA aim to age-in-place but aging-in-place is less realistic for low-income OA because of gentrification and forced relocation. Examining neighborhood context is vital to understanding how the places we live contribute to well-being, yet, there is insufficient research on the biopsychosocial effects of forced relocation on low-income OA. To address this gap, our study uses aging-in-place theory to understand the association of neighborhood and health outcomes of relocated and nonrelocated low-income OA in public housing. This study includes three waves of data from Georgia State University’s Urban Health Initiative Study. Participants (n=225) were categorized by age (young-old = 50-64; old-old = 65-74; and oldest-old = 75+). We conducted multivariate regression analyses to highlight relationships between neighborhood and health outcomes, and relocation. We used geocoding to provide within-group analysis of relocated residents to determine if geographic proximity to former public housing communities affected neighborhood and health outcomes. Results show that relocated OA have worse informal social control and neighborhood satisfaction outcomes, but better built environment conditions than those who aged-in-place. Mental health and physical functioning worsened for relocated OA. Relocation was associated with reduced social cohesion and worse built environment conditions for the oldest-old. Moderation analysis illustrated that OA who relocated farther away had worse neighborhood outcomes. Considering the importance of aging-in-place to OA well-being, policymakers may reconsider forced relocation and allocating funds to enhance neighborhoods.
Using the Life Story Book With Mentally Alert Residents of Nursing Homes
Authors: Chrisman Theresa
Published: December 2020

Depression and lack of meaning in life (MIL) are common among residents of nursing homes (NHs) and contribute to a reduction in overall health and well-being. Life Story Book (LSB), a reminiscence intervention, is designed to provide a person with the opportunity to review their past and capture their life stories and photographs into a book. LSB has demonstrated positive outcomes for residents of NHs with dementia, yet little is known for residents without dementia. A switching replication design was used to examine the effects of LSB among 21 mentally alert residents from two NHs (NH-A and NH-B) in Houston, Texas. Participants in NH-A received three weeks of the LSB intervention, while NH-B received three weeks of care-as-usual; the intervention was then switched. The GDS-12R and the MIL questionnaire (MLQ) were used to measure depressive symptoms and MIL respectively. Participants from NH-A (n =11) and NH-B (n = 10) had a mean age of 75 years (SD =11.34); 81% female; 52% non-Hispanic white and 33% African American. Results from a one-way MANCOVA found no statistically significant difference on the GDS-12R and MLQ (F(3, 14) = 2.50, p = .102; Wilks’ Lambda = .652; η2 = .35). Further analyses comparing the pre-intervention and post-intervention scores for the entire sample (N =21) found a significant reduction in depressive symptoms (M = 2.67; SD = 2.52) and (M =1.67, SD = 2.29); (t (20) = 2.21, p = 0.039). The potential benefits of LSB for mentally alert residents of NHs warrants further research.
Whole Genome Linkage Scan Identifies a Novel Locus on 3q28 for TG/HDL-C Ratio Change Over Time
Authors: An Ping , Kuipers Allison , Miljkovic Iva , Zmuda Joseph , Province Michael
Published: December 2020

TG/HDL-C ratio (THR) represents a single inherited surrogate predictor of hyperinsulinemia or insulin resistance that is associated with premature aging processes, risk of diabetes and increased mortality. To identify genetic loci for THR change over time (ΔTHR), we conducted a whole genome linkage scan among subjects of European ancestry who had complete data from two exams collected about seven years apart from the Long Life Family Study (LLFS, n=3091), a study with familial clustering of exceptional longevity in the US and Denmark. Subjects with diabetes or using medications for dyslipidemia were excluded from this analysis. ΔTHR was derived using growth curve modeling, and adjusted for age, sex, PCs, familial membership, and then log-transformed to approximate normality. Our linkage scan was built on haplotype-based IBD estimation with 0.5 cM average spacing. Heritability of ΔTHR was moderate (46%), and evidence for significant linkage (LOD>3) was identified on 3q28 (LOD=4.1). This locus harbors ADIPOQ among several other promising candidate genes. Interestingly, several studies previously reported suggestive evidence of linkage at this locus for relevant traits including adiponectin, dementia, AD and SBP. This linkage signal was not explained by significant GWAS SNPs for LPL or those under the peak (LOD attenuated to 3.7). In conclusion, we found a novel genetic locus on 3q28 for ΔTHR in subjects without diabetes selected for exceptional survival and healthy aging. Further query of sequence elements including rare functional and regulatory variants at this locus is underway which may reveal novel insights on insulin resistance mechanisms for aging.
An Experimental Program for Effective Communication of Middle-Aged and Older Adults With Pharmacists in Taiwan
Authors: Sun Yi-Wei , Weng Hui-Ching
Published: December 2020

Plenty of potential drug-related problems was noted in the middle-aged and older adults. Effective communication is essential for pharmacists to coordinate their opinions with patients to improve the effectiveness of drug treatment and reduce drug-related problems. However, few studies focused on patients’ own abilities to communicate with pharmacists even though it is vital for the effectiveness of medical treatment. The purpose of this study was to design a communication training program for middle-age and older adults not only to enhance their understanding of pharmacists’ responsibilities and the importance to communicate with pharmacists, but also to improve their self-efficacy about drug-related communication and the ability to list their latest medication. A non-randomized control-group pretest-posttest design was conducted in Tainan City. Through individual interviews of five pharmacists and a focus group interview, we ensured the appropriateness and expertise of the training program. 179 adults over 55 years old were distributed into experimental group or control group. The experimental group underwent the training program after the pretest, while no intervention was provided to the control group. Face-to-face and role-playing sessions were in process with a training booklet in the courses. Both groups completed the posttest four weeks after the pretest. This communication training program appears to be effective since the knowledge of pharmacists’ responsibilities and self-efficacy of drug-related communication were significantly improved in the experimental group (p<.05) rather than control group. Completion of the recent medication list was also improved from 40.3% to 80.6% and was significantly higher than the control group.
Do Social Support and Strain Mediate the Relationship Between Childhood Exposures and Frailty in Later Life?
Authors: Williams-Farrelly Monica , Ferraro Kenneth
Published: December 2020

Previous studies have identified the early origins of physical frailty, notably poor childhood health and socioeconomic status, but relatively few studies examine whether social support in later life mitigates the influence of early noxious exposures on frailty. Given the established relationship between health and social relationships in older adults, this research uses data from the Health and Retirement study (2004-2016) to examine whether social support and strain mediate the effect of childhood exposures on frailty in later life. A series of linear regression and pathway models were estimated to test whether childhood exposures, including socioeconomic status, infectious and chronic diseases, impairments, and risky adolescent parental behaviors, were associated with phenotypic frailty (Fried et al. 2001). After adjusting for demographic and adult factors, accumulated childhood misfortune was directly (b=0.015, p<.01) and indirectly (b=0.007, p<.001) associated with more frailty. Average social support, but not strain, from one’s spouse, children, family and friends significantly mediated the relationship between accumulated misfortune and frailty (b= -.002, p<.01). Path analysis revealed that social support reduces later life frailty directly (b=-0.106 ,p<.001) and indirectly through a reduction in adult morbidity (b=-0.031, p<.001). However, counterintuitively we found that accumulated misfortune was associated with more social support. Supplemental analyses reveal that one or more infectious diseases in childhood were responsible for the positive relationship (b= 0.393, p<.001). These results have implications for how we may reduce the burden of frailty on those who have experienced misfortune early in life.
It’s What We Do: Māori Carers Talk About Roles, Challenges, and Coordination in Caring for Older Family Members
Authors: Simpson Mary , McAllum Kirstie , Unson Christine , Fox Stéphanie , Hancock Te Oha
Published: December 2020

As the population of Aotearoa/New Zealand heads towards one-in-four being aged over 65-years-and-over by 2040, it is anticipated that family members will play an increasingly important role in caring for older relatives with chronic and age-related health issues. Multi-generational, and in particular three-generational living arrangements, combined with family care of older relatives are a growing trend; a trend already even evident among Māori communities. This paper reports on a study that explored the care experiences and expectations of 14 past and current Māori carers (aged 23 to 72-years) of older relatives. Interviews were audio-recorded, transcribed verbatim, and coded independently. The initial thematic analysis revealed nine themes and participants were invited to feedback on the summary in person or in writing. The feedback resulted in the original themes being collapsed into four (with subthemes): “Care is Normal”; “Collective Coordination of Care”; “Insider-Carer—Outsider Perspectives on Caring”; and “Societal Influences on Family Care/Carers”. Firstly, these themes highlight how Māori cultural norms infuse direct care, support, and coordination roles within family care of the older family member. Secondly, they reveal the challenges for family carers in talking about their work with others, especially (thirdly) in the face of negative attitudes towards care and carers of an older family member within wider society. These findings have implications for cultural and wider socio-political influences in socialising different groups to carer role expectations. If society is to better prepare future caregivers for their role, ongoing research is needed with the various cultural groups in Aotearoa/New Zealand.
The Effect of Long-Term Changes in Daily Stress Processes on Prospective Health: An Application of Three-Level SEM
Authors: Rush Jonathan , Willroth Emily , Graham Eileen , Mroczek Daniel , Almeida David
Published: December 2020

The study of change over time, contexts, cohorts, and people is influenced by the sampling of observations within longitudinal studies. Intensive measurement designs, embedded within long-term longitudinal studies, provide new opportunities to understand changes in dynamic processes, as well as determinants and consequences of these changes over time. The present investigation examined whether short-term dynamic associations accounted for individual differences in prospective health functioning. We used measurement burst data from the National Study of Daily Experiences subsample (N = 2485) embedded within the Midlife in the United States longitudinal study. Two measurement bursts were separated by ten years, with each containing daily measures of stress and affect across eight consecutive days. Functional health was measured by basic and instrumental activities of daily living at three measurement waves spanning 20 years. Three-level structural equation models were fit to simultaneously model short-term within-person associations between stress and affect (i.e., stress reactivity) and long-term changes in these associations over the ten year period. Individual differences in long-term changes of the short-term dynamic association predicted both basic and instrumental activities of daily living at 20 year follow-up (estimate = 5.26, SE = 2.54, p < .01; and estimate = 5.48, SE = 2.81, p < .01, respectively). These effects were present after adjusting for mean levels of both stress and affect. We highlight how characterizing individuals based on the strength of their within-person associations across multiple time scales can be informative in predicting distal health outcomes.
Gender and the Grandfather Caregiver Experience
Authors: Raymore AviElle
Published: December 2020

In the United States, 2.7 million grandparents are responsible for a grandchild in their home. Grandfathers are present in the majority of grandparent caregiver households, but their contributions and voices are often overlooked. The aim of this study was to explore how grandfathers experience caregiving as men. Twelve grandfathers from the age of 50-76 years participated in the study. Two face-to-face, semi-structured interviews were conducted with eleven grandfather caregivers while a telephone interview was conducted with one grandfather. Interviews focused on their life story, experiences as grandfather caregivers, and views on male caregiving. Data were analyzed using coding and thematic analysis. Gender was important throughout grandfather’s caregiving experiences. Grandfathers discussed their attitudes towards caregiving using language that reflected traditional gender norms. To them, women were nurturing caregivers while men were supposed to provide for their families as caregivers. Grandfathers appeared to stay connected to notions of traditional masculinities through participation in sports and physical play with their grandchildren and through their emphasis on men as responsible and providers. Grandfathers were aware that others may view them as incompetent caregivers, but they did not allow these stereotypes to affect how they viewed themselves as caregivers. These findings can improve the understanding of this population for service providers who work with grandparent caregivers. Providing better outreach for grandfather caregivers, strengthening programs and supports for them, and confronting attitudes or views towards male caregiving are important practice implications.
Island Aging in the Ninth Decade and Beyond
Authors: Eliopoulos Elaine
Published: December 2020

This novel research was designed to explore the lived experience of the aging body and its impact on social exclusion in remote island environments. Twenty three participants, aged 80 to 102 years old, in the Pacific Northwest, USA, were interviewed to explore the role their bodies played in everyday life. Despite presenting limited choices and lifestyle options, the island communities appeared to foster rather than impede a sense of competency and autonomy in the lives of these later life participants. Their ability to navigate their worlds, despite their physical limitations, was apparent in their reports of inclusion in the manner they desired. The island community context, characterized by low technology and mostly face to face encounters for goods and services, presented the participants with the possibility of accessible and meaningful engagement. Their sense of self and inclusion casts doubt on the dominant narrative of decline typically used to describe these late years. New narratives of corporeal being emerged from the data, demonstrating a complexity not captured by the singularity of the decline narrative. The visual methodology utilized enriched the depth and range of the semi-structured interviews, encouraging participants to think critically about their bodies. Possibilities for further research could explore the nuances of these new narratives and whether a different understanding of the older body may be useful.
The Impact of Caregiving Intensity and Religiosity on Spouse Caregivers’ Health and Mortality in the United States (2004–2014)
Authors: Koumoutzis Athena , Mehri Nader
Published: December 2020

Prior research has indicated that religiosity may buffer against the deleterious effects of caregiving. However, research is lacking in examining the role of religiosity and caregiving intensity in the context of caregiver wellbeing and mortality. Data come from the Health and Retirement Study (2004-2014 waves) and consisted of spousal caregivers and noncaregivers (n= 49,638 person-spells). Pearlin’s Stress Process Model (1990) informed this study to analyze how religiosity impacts caregiver self-rated health and mortality by comparing the intensity of provided care among spousal caregivers and spousal noncaregivers. This study used two indicators to measure religiosity: 1) the importance of religion in life and 2) frequency of attending religious services. Bivariate probit model was used to model the impact of caregiving intensity and religiosity on self-rated health and all-cause mortality. After controlling for sociodemographic and health covariates, results showed that only the importance of religion in life predicted a better self-rated health among high intense spouse caregivers defined by providing >=14 hours of care per week. Findings suggest religiosity may buffer the adverse effect of caregiving stress on health for high intense spousal caregivers. Development and maintenance of religiosity may enhance positive aspects of caregiving and decrease caregiver burden.
Unmet Home- and Community-Based Service Needs Among Informal Caregivers in Rural and Urban Areas
Authors: Bouldin Erin , Chase Jo-Ana , Miyawaki Christina , Russell David , Gell Nancy , Taylor Christopher , McGuire Lisa
Published: December 2020

Home- and community-based services (HCBS) can reduce caregiver burden. We compared the prevalence of HCBS unmet needs among caregivers in rural and urban areas and identified factors associated with unmet HCBS needs. We used 2015-2018 Behavioral Risk Factor Surveillance System data, including the optional Caregiver Module, from 44 states, District of Columbia, and Puerto Rico. Caregivers were individuals providing care/assistance to a friend/family member with a long-term illness/disability during the past 30 days. Unmet needs were defined as needing, but not receiving, one or more of the following: caregiving classes, help accessing services, support groups, individual counseling, or respite care. “Rural” was defined as living outside Metropolitan Statistical Areas (available only for landline respondents). We calculated weighted estimates and used log-binomial regression to estimate adjusted prevalence ratios (PR). 19% of 25,180 caregivers lived in a rural area. Rural caregivers were less likely to report unmet HCBS needs (14.4% versus 20.6% urban, p<0.001), even after accounting for sociodemographic and caregiving characteristics (PR=0.81, 95% CI: 0.65-0.99, p=0.040). Unmet needs were more common among caregivers who provided more care, personal care, or care for someone with Alzheimer’s disease/dementia, regardless of rural residence. Although rural individuals can experience more barriers to accessing health services, rural caregivers in our study reported fewer unmet HCBS needs than urban caregivers. Additional research is needed to determine if stronger systems of informal support in rural areas may explain this difference. Further investigation of factors contributing to differences in unmet service needs among rural and urban caregivers is needed.
Insular and Hippocampal Connectivity Is Associated With Perceived Financial Exploitation in Older Adults
Authors: Weissberger Gali , Mosqueda Laura , Nguyen Annie , Axelrod Jenna , Boyle Patricia , Spreng Nathan , Han Duke
Published: December 2020

Little is known about the neural correlates of financial exploitation (FE) in older adults. Cognitively-intact older adults who self-reported a history of FE (N=19; M age=69.84, SD=13.06) and demographically-matched non-FE older adults (N=16; M age=65.13, SD=8.48) underwent resting-state fMRI. Predefined regions of interest were prescribed using the Harvard-Oxford atlas for their involvement in tasks of economic decision making: insula, hippocampus, and the medial prefrontal cortex (mPFC). Analyses adjusted for age, education, sex, and MoCA scores; groups did not differ on these factors. Clusters were FDR-corrected with a threshold of p<0.05 (voxel threshold p<0.005), two-tailed. Compared to the non-FE group, the FE group exhibited greater functional connectivity (FC) between the right insula and left temporal lobe regions (t(29)= -4.81), and between the left insula and right temporal lobe regions (t(29)= -5.78). The FE group showed less FC between the left insula and two clusters in the right lateral occipital cortex (t(29)= 5.18) and left cerebellum (t(29)= 4.68). Additionally, FE was associated with greater FC between the right hippocampus and five clusters spanning the right temporal lobe, parietal lobe, and frontal pole (ts(29)= -4.11 to -4.51), and less FC between the right hippocampus and three clusters spanning the bilateral caudate and the left intracalcarine cortex (ts(29)= 4.76-6.03). Groups did not differ in FC patterns with the mPFC. Results suggest that FE is associated with whole-brain FC differences involving the insula and hippocampus among cognitively-intact older adults.
Grip Strength Changes in Bone Marrow Transplant Patients
Authors: Chaves Paulo , Cristian Adrian , Ruiz Marco
Published: December 2020

Emerging evidence that cancers survivors may experience premature aging has prompted epidemiology research aimed at the characterization of key premature aging phenotypes. Physical functioning data relevant for premature aging phenotype classification in cancer survivors, however, remain scarce. We assessed the burden of dynapenia, a key sarcopenia indicator, and muscle strength loss in the understudied population of bone marrow transplant (BMT) patients. This study involved secondary analyses of data from patients who underwent bone marrow transplant (BMT) in a cancer Institute in South Florida (June 2018-April 2019) with traditional hematopoietic cell transplantation specific comorbidity index (HCT-CI) scores and other relevant information. T-tests for paired data assessed pre- vs. post-BMT changes in grip strength (GS) (n=9). Prevalence of dynapenia (GS<27Kg and <16Kg) in pre-BMT (n=20) and post-BMT (n=9) periods were calculated. Median age [25th-75th percentiles] age was 61 [55-68] years old. Fifty-percent were females. GS and HCT-CI scores were not correlated. Mean GS loss after BMT was 6.4 Kg (95% confidential interval: 2.5-10.4 Kg, p-value=.003) in post-BMT (median-time-after-BMT: 90 days) minus pre-BMT (median-time-before-BMT: 62 days) comparison. Proportion with dynapenia increased from 10% (1/10) to 20% (1/5) in women, and 10% (1/2) to 75% (3/4) in men. We observed substantial muscle strength loss and dynapenia burden in patients who underwent BMT. Considering that dynapenia is a major, potentially modifiable risk factor for frailty, which is not captured by HCT-TI, we speculated that dynapenia-related targeted assessments and interventions – preventive and/or rehabilitative – could offer complementary approaches for treatment enhancement in BMT patients.
Pain Management and Cognitive Function Among Older Adults in China
Authors: Pan Xi , Meng Hongdao
Published: December 2020

Chronic pain and cognitive decline are common age-related conditions affecting a large segment of older populations. Little is known about the pathway of cognitive functioning during the course of pain management in older adults. The current study aimed to examine the association between chronic body pain management and cognitive function over time among Chinese older adults. A total of 792 respondents aged 60 and above from urban and rural households in 28 provinces, 150 counties/districts, and 450 communities were selected from the China Health and Retirement Longitudinal Study (2013–2015). Cognitive function was measured in three domains: episodic memory, mental status, and global cognitive function. Difference-indifferences approach and mixed-effects linear regression models were employed to assess the association between chronic body pain management and cognitive function over time. Scores of mental status were found to decline slower by 0.49 unit (SE = 0.22, p < 0.05) in respondents who received pain management using analgesics, complementary and alternative medicine, or both from 2013 to 2015 after controlling for basic demographic and health confounders. Chronic pain management was associated with slower decline in domain-specific cognitive function, mental status over time. Findings of the study may contribute to understanding the mechanism of change in diverse cognitive abilities attributable to pain symptoms. More research is needed to elucidate the mediating effect of pain on cognitive decline, which could lead to testing of the impact of pain management on cognitive function among older population in both clinical and community settings.
A Systematic Review of Visual Impairment and Cognitive Decline Among Older Adults
Authors: Nagarajan Niranjani , Swenor Bonnielin , Assi Lama , Ehrlich Joshua , Whitson Heather
Published: December 2020

Cognitive and visual impairments frequently coexist. With the aging of populations worldwide, the prevalence of these conditions are projected to increase substantially over time. A number of studies suggest that cognitive function and vision impairment are associated, and it is hypothesized to be due to a (1) common cause etiology, where both share common risk factors, and/or (2) causal association, where visual impairment causes cognitive decline. Sensory loss can lead to increased cognitive load, structural and functional changes in the brain, and/or decreased emotional, social, and physical well-being, all of which could potentially increase the risk of cognitive impairment. We conducted a systematic review of the existing literature, examining the association between cognitive and visual impairment among older adults. A total of 80 observational studies that reported a measure of association between visual and cognitive function and met the following criteria were included: (1) cross-sectional or longitudinal study design, (2) baseline mean age of participants ≥50 years, and (3) sample size of ≥100 participants. Of these 80 studies, 56 found a positive, significant association between visual function and cognitive decline. Forty-nine of the 56 studies used objective measures to test for visual acuity, contrast sensitivity, or visual fields. The sample included participants from 14 countries, including the US, UK, China, and Australia among others. Converging evidence of an association between vision impairment and subsequent cognitive decline suggests that visual impairment is a possible modifiable risk factor for cognitive decline and dementia. This hypothesis should be tested in prospective, controlled studies.
Age as an Overlooked Element of Diversity: Approaches to Addressing Intergenerational Perspectives
Authors: Graf Allyson , Carney Amy Knepple
Published: December 2020

Outside of gerontology, age is an often underappreciated element of diversity. At a time when all generations must work together to provide inclusive, multi-faceted solutions to today’s societal problems, ageist and generational stereotypes are often barriers to meaningful intergenerational exchanges. Age derogation and negative stereotypes have been used to splinter communities, perpetuate misinformation, and trivialize intergenerational conversations. As researchers, educators, and practitioners, we understand why age matters, but our students, community leaders, and employers may not. It is our disciplinary obligation to convince those who ignore, dismiss, or misrepresent age of the importance of this aspect of diversity for navigating any multigenerational setting. In this talk, we provide three approaches to addressing age-related beliefs in the classroom. We begin by exploring the impact of generational stereotypes within minority communities. For the LGBT community, negative stereotypes coupled with rapid social change have lead to a growing generational gap. We then shift perspectives to examine the role that lifespan developmental psychology can play in preparing students to enter a diverse multigenerational workforce. Here, we discuss research on age identity and generational identity as distinct and self-enhancing life-span processes, and highlight the developmental barriers that must be navigated in order to foster intergenerational cohesion. Finally, we discuss the findings from Generation to Generation, an intergenerational discussion course for older and younger adults, designed to promote productive intergenerational contact. The results provide evidence that intergenerational discussion may facilitate improved connections between generations.
The Personal Beliefs About Aging Scale
Authors: Bowen Lauren , Silverstein Nina , Whitbourne Susan , Jansen Taylor
Published: December 2020

Most existing ageism scales (e.g., Fabroni et al., 1990; Laidlaw et al., 2007; Rupp et al., 2005) are designed to measure younger people’s age attitudes, often asking respondents to affirm or reject stereotypes of older people. The Personal Beliefs about Aging (PBA) Scale gathers information about the degree to which respondents, regardless of age, value age diversity on their campus. Preliminary findings from a 2019-2020 University of Massachusetts system-wide electronic survey that yielded 2,563 responses across 3 (of 5) campuses indicate that most faculty (83%), staff (84%), and students (72%) perceived ageism as a serious problem in society; however far fewer considered ageism as a serious problem on their own campus, with students (20%) perceiving campus ageism to an even lesser extent than faculty (39%) and staff (36%). Part of a symposium sponsored by Age-Friendly University (AFU) Interest Group.