bluuebunny/crossref_metadata_2025 huggingface dataset:
DIGITAL COMMUNICATION AS COMPENSATION FOR INFREQUENT IN-PERSON CONTACT WITH GRANDCHILDREN DURING THE PANDEMIC
Authors: Fu Xiaoyu , Hwang Woosang , Silverstein Merril
Published: December 2023

Maintaining interactive relationships with grandchildren represents an important and rewarding aspect of family life for grandparents. The goal of this study is to explore stylistic patterns of intergenerational contact with grandchildren including digital communication (texting, e-mail, video call, and social media interaction) and how they were associated with older grandparents’ psychological well-being during the COVID-19 pandemic. Using data from the 2021-22 survey of the Longitudinal Study of Generations (LSOG), the analysis applied latent class analysis to identify communication styles with grandchildren among 264 grandmothers and 174 grandfathers. We identified four communication styles for both grandmothers and grandfathers. Life satisfaction was relatively low and no different among grandparents with a detached style (little contact of any type) and those with a digitally connected style (little in-person contact but some digital contact). However, fully connected grandparents (digital contact and in-person contact) had significantly better life satisfaction than detached grandparents. Results suggest that digital communication with grandchildren did not compensate for the lack of face-to-face contact with grandchildren but complemented this more traditional form of contact. We conclude that digital contact with grandchildren provides added value above and beyond in-person contact for the psychological well-being of older grandparents.
DONALD P. KENT AND ROBERT W. KLEEMEIER AWARD LECTURES
Authors: Nelson James
Published: December 2023

The Donald P. Kent Award lecture will feature an address by the 2022 Kent Award recipient Nancy R. Hooyman, PhD, FGSA, of the University of Washington. The Kent Award is given annually to a member of The Gerontological Society of America who best exemplifies the highest standards of professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society. The Robert W. Kleemeier Award lecture will feature an address by the 2022 Kleemeier Award recipient Sheryl Zimmerman, PhD, FGSA, of the University of North Carolina at Chapel Hill. The Kleemeier Award is given annually to a member of The Gerontological Society of America in recognition for outstanding research in the field of gerontology.
CORPORATE PERSPECTIVES OF A NATIONAL NURSING HOME PRAGMATIC TRIAL AND FACTORS AFFECTING IMPLEMENTATION FIDELITY
Authors: Weems Jacy , McCreedy Ellen , Wittenberg Grace , Baier Rosa
Published: December 2023

Implementation fidelity is concerning for embedded pragmatic clinical trials (ePCTs), where effectiveness is evaluated in real-world settings instead of a structured clinical environment. Healthcare facilities paused ePCT research activities during the COVID-19 pandemic to address related staffing issues and infections. We examined a 54-nursing-home ePCT implementing Music & Memory, a nonpharmacological intervention using music to improve quality of life for residents living with dementia. Our qualitative study describes factors influencing implementation fidelity across four nursing home corporations. The interview guide assesses corporate perceptions of implementation barriers, facilitators, and participation incentives. Themes were organized within the Conceptual Framework for Implementation Fidelity’s potential modifying factors: 1) context, 2) participant responsiveness, 3) intervention complexity, 4) facilitation strategies, 5) quality of delivery, and 6) recruitment. Interviewees (n=4) lead corporate-wide dementia initiatives. 1) Context: COVID-19-related capacity issues and local “champion” turnover impacted success. 2) Participant responsiveness: Developing playlists strengthened staff-resident relationships, although time-consuming and requiring staff competency. Residents experienced decreased agitation while staff satisfaction increased. 3) Intervention complexity: Brown’s research team adapted processes to save staff time. 4) Facilitation strategies: The relationship with Brown promoted problem-solving. 5) Quality of delivery: The ePCT was an effective, non-pharmacological approach addressing dementia symptoms. 6) Recruitment: Corporate leadership makes decisions regarding individual nursing homes’ recruitment in research. Financial incentives did not drive participation, although some voiced appreciation for offsetting time and resources invested. Recommendations for future efforts included in-person champion training and site-specific quality improvement efforts. Researchers maintaining relationships with corporate and local leadership promotes sustainable engagement.
EFFECT OF AMYLOID PET RESULTS DISCLOSURE ON HEALTH-RELATED BEHAVIORS IN PERSONS WITH MILD COGNITIVE IMPAIRMENT
Authors: Wang Yan , Ren Dianxu , Roberts Scott , Lingler Jennifer
Published: December 2023

Mounting evidence supports the clinical utility of amyloid PET. However, whether patients use knowledge of their amyloid status to alter health behaviors remains unclear. We describe health-related actions taken by Mild Cognitive Impairment patients following amyloid PET disclosure (n=34) vs. a comparison group (n=37). Patients were 92% non-Hispanic white, 59% male, 73±8.61 years old with 16.25±2.49 years of education. Over 12 months of follow-up, all participants reported at least one behavior change from baseline on a 14-item health behavior questionnaire. Amyloid positive patients reported the most behavior changes (mean=4.67±1.83) while amyloid negative patients reported the fewest (mean=3.72±1.58). Across groups, no significant differences were observed in: lifestyle, vitamin/supplement use, stress reduction activities, cognitive stimulation, or advance directive completion. Amyloid negative participants were significantly less likely than controls to consider long-term care insurance (63.6% vs. 89.2%; P=.025), and to endorse changes classified as “other” (36.4% vs. 64.9%; P=0.037). After adjusting for education level, gender, and MMSE, logistic regression showed that amyloid negative patients were 74% less likely than controls to report “other” changes (OR=0.26, 95% CI [0.08, 0.85], P=0.025), and 78% less likely to consider long-term care insurance (OR=0.22, 95% CI [0.06, 0.86], P=0.03). Qualitative analysis of supplemental interviews with scan group participants revealed “other” activities to include changes in employment, driving, and residential status, and engagement in other non-medical activities (pursuing bucket lists and mending strained relationships). Health-related behavior changes following amyloid PET disclosure may differ by scan result and encompass actions to enhance not only cognition but quality of life.
AN ONLINE VIGNETTE STUDY TO EXAMINE THE OUTCOMES OF A PRECLINICAL ALZHEIMER’S DISEASE DIAGNOSIS
Authors: Picchiello Matthew , Wynn Matthew , Carpenter Brian
Published: December 2023

Preclinical Alzheimer disease (AD) is characterized by abnormal levels of amyloid beta and tau proteins in the brain of a cognitively normal person. There are potential risks and benefits of communicating biological marker (biomarker) risk information for AD using the preclinical AD label. The current study used a vignette methodology to evaluate older adults’ reaction to their hypothetical risk for developing AD. Community dwelling cognitively intact older adults (n = 300, M age = 64.1) completed an online survey, randomized to disclose biomarker results and risk information (with or without the preclinical disease label) pertaining either to heart disease or AD. Participants reported on their perceptions of risk and behavioral intentions based on the Health Belief Model. A series of ANCOVAs and moderated mediation models support the idea that, across disease conditions, a preclinical label does not influence perception of the disease or behavioral intentions. Both groups indicated a similar and proactive intention to engage in more health-promoting behaviors and plan for the future. Results also highlight differences in individual perceptions of AD versus heart disease such that participants in the AD condition perceived their risk information as implying a more severe condition, perceived fewer benefits to knowing their risk, and reported lower self-efficacy about doing anything to address that risk. Despite these perceptions, older adults who received risk information for AD maintained interest in undertaking behavioral changes that may improve their quality of life. These findings have implications for the development of empirically supported disclosure processes for preclinical AD.
PERCEIVED NEIGHBORHOOD CHARACTERISTICS AND COGNITIVE AGING: FINDINGS FROM THE SEATTLE LONGITUDINAL STUDY
Authors: Hueluer Gizem , Willis Sherry , Schaie Warner , Gerstorf Denis
Published: December 2023

Lifespan developmental perspectives widely acknowledge that cognitive development and aging is shaped by an individual’s social, historical, and geographic context. The residential neighborhood is the most immediate geographic context of an individual. In this study, we used within-person longitudinal data from the Seattle Longitudinal Study to examine how cognitive aging trajectories in five primary mental abilities are associated with perceived characteristics of one’s residential neighborhood. 3,482 participants (aged 19 thru 100 years, 54% women) contributed a total of 8,021 observations over up to 35 years. Longitudinal trajectories were examined across age and analyses additionally controlled for sex, education, and income. Our findings showed that cleanness of air and availability of trees and open spaces were indeed associated with higher levels of most primary mental abilities at age 60. In addition, cleanness of air was associated with less pronounced cognitive aging for two of the five primary mental abilities and availability of trees and open spaces was associated with less pronounced cognitive aging for four of the five primary mental abilities. In contrast, noise, closeness to transportation, and feelings of safety showed only few associations with trajectories of cognitive aging, whereas familiarity with neighbors was associated with lower levels of most primary mental abilities at age 60. Taken together, the findings of this study demonstrate that characteristics of an individual’s neighborhood are related to trajectories of performance-based measures of cognitive aging over and above indicators of socio-economic status. We will discuss potential mechanisms underlying these associations and implications for future research.
LESSONS LEARNED FROM DIGITAL EQUALITY RESEARCH WITH COMMUNITY PARTNERS
Authors: Batista-Malat Eleanor , Lomeli Sindy , Capolino Alexandria , Leedahl Skye , Wilber Kathleen
Published: December 2023

Despite strong interest among policymakers and service providers and a pipeline of Federal funding for programs that address digital inequalities in older adults, there is limited research on the challenges and outcomes of programs designed to reduce the digital divide. To better understand these issues, we compared and contrasted challenges and lessons learned administering digital inclusion projects in California and Rhode Island. In California, challenges included the complexity of state and local interface, managing public-private partnerships, and deciding on and communicating roles and responsibilities through the required formal channels. In Rhode Island, timing and communication were challenging because universities and community partners operate on different calendar systems and cater to different demands. For both programs, ensuring that training and technical support were available, accessible, and appropriate for diverse populations of older adults was a challenge. However, the training and support approaches were different as California leveraged private and non-profit partnerships while Rhode Island used university student mentors. Further, the rollout and data collection needed to evaluate the programs created barriers and slowed the process, including partners’ language capabilities not matching the participants’ and the time-consuming nature of data collection via telephone. Nevertheless, in both states, research opportunities afforded by collaborating with state and local agencies and private sector providers were invaluable. Partnerships allowed older adults to participate in research via a trusted organization with linguistic and cultural sensitivity, and researchers accessed underserved populations less likely to participate in research.
ASSOCIATION BETWEEN BALANCED DIET AND FRAILTY IN JAPANESE OLDER ADULTS: THE MODERATING ROLE OF SOCIAL PARTICIPATION
Authors: Li Yaya , Akagi Yuya , Fujiwara Natsumi , Yoshida Hiroko , Kido Michiko , Kabayama Mai
Published: December 2023

The association between diet and frailty in older adults may be related to social factors. This study aimed to investigate whether there is an interaction effect between balanced diet and social participation on frailty in older Japanese. Balanced diet was defined as the consumption of more than one meal per day that contained carbohydrates, protein, and fiber. Data were collected from 4,832 community-dwelling older adults aged 65-89 years through self-reported questionnaires (response rate 49.0%). Frailty was measured using the Kihon Checklist developed by the Ministry of Health, Labour, and Welfare. We stratified participants by age (65-74 and 75-89 years) and conducted logistic regression models adjusted for economic status, gender, marital status, living alone, disease, and physical activity. The interaction between dietary diversity and social participation in frailty was also assessed. Results showed that in both age groups, consuming balanced diet was associated with a lower risk of frailty (OR=0.56, 95%CI=0.40–0.79). Lack of social participation was found to be a risk factor for frailty (OR=1.51, 95%CI=1.03–2.21). Furthermore, the interaction between balanced diet and social participation revealed that a combination of lack of social participation and balanced diet was also associated with a lower frailty risk in the 75-89 age group (OR=0.63, 95%CI=0.40–0.99). These findings suggest that balanced diet consumed at least once a day may be beneficial for preventing frailty for older adults, however, social participation should also be taken into consideration for those aged 75-89. This study has some limitations as a cross-sectional study. Longitudinal research is needed.
BUILDING FOUNDATIONAL COMPETENCIES IN OLDER ADULT MENTAL HEALTH: VIRTUAL AND IN-PERSON TRAINING
Authors: Emery-Tiburcio Erin , Mack Laurin , Wang Siqi , Buehler Susan
Published: December 2023

Designed to develop foundational knowledge competencies for generalist clinicians, this program was created by a team of geropsychologists, geriatric social workers, geriatric psychiatrists, and neuropsychologists, who reviewed competencies of multiple mental health disciplines, and identified 14 key areas of knowledge for clinicians. Content was created by Rush faculty, externally peer-reviewed, and developed into two versions. The 14-hour online version includes knowledge checks and national expert videos to provide multiple perspectives and voices of experience. Of the first 176 learners in the online version, 96.8% rated the overall program as excellent, with strong agreement (97.4 – 98.3%) that the training was applicable to practice, expectations were met, and learners had intention to apply the knowledge. All learners are required to achieve a minimum of 75% on knowledge post-test to complete each module. The three-day in-person program provided 25 diverse clinicians representing every HHS region with didactic content, interactive exercises, discussion, and a simulated patient experience to practice skills with live expert feedback. Participants demonstrated 14% improvement in knowledge (p<.01). Didactic lectures were rated 100% extremely or very helpful; 82% rated group learning exercises extremely helpful; 100% rated the simulation lab as extremely or very helpful. Balance between activities and match with learning style were rated good to very good. All participants rated the likelihood of recommending the program to a colleague as extremely or very likely. Evaluation of skill implementation is ongoing. Implications for expanding generalist competencies in older adult mental health will be discussed.
BECOMING INCLUSIVE: A NECESSARY PURSUIT FOR SUPPORTING FAMILY CAREGIVERS IN HOSPITAL CARE
Authors: Muntefering Chloe
Published: December 2023

Given advances in medicine and technology, shorter hospital stays, and a shrinking health care workforce, an increasing number of older adults are relying on family caregivers for support during and after hospital care. Yet, our healthcare system is often unresponsive to the needs of family caregivers. Recent consensus recommendations including the National Strategy on Family Support encourages health systems to include family caregivers in care processes of older adults. This presentation will report interview and community advisory board findings from a qualitative descriptive study of N=24 stakeholders consisting of hospitalized older adults (n=4), family caregivers (n=6), healthcare providers (n=9), and health policymakers (n=5). The goals of the study were to identify and describe existing barriers and facilitators to the inclusion of family caregivers in older adult’s hospital care. Of the participants, 87% were female and from the Midwest region, and all were Caucasian. The average age was 56 years. The resulting themes from this exploration demonstrated that inclusion of family caregivers in hospital care is influenced by personal factors of both the caregiver and the provider (caregiver availability, health literacy, education, values/priorities), interpersonal skills between these two parties (communication style and methods), hospital environment/resources (accessibility, comfortability, staffing, documentation), and social climate/policy (Covid-19 Restrictions, HIPAA, Power of Attorney). Findings from this study can be used to develop or adapt healthcare system policies and practices, fulfilling Outcome 2.1 of the National Strategy on Family Support’s recommendation for recognizing family caregivers as essential members of the care team.
STAKEHOLDER PERSPECTIVES ON QUALITY DEMENTIA CARE IN LOW-RESOURCE LONG-TERM CARE SETTINGS
Authors: Rataj Alison , Holmes Sarah , Kusmaul Nancy , Davie Laura , Kim Yoon , Lepore Michael
Published: December 2023

Having dementia care staff who are knowledgeable about the needs and preferences of residents living with dementia (RLWD) in long-term care (LTC) settings holds promise for supporting quality of care. However, staff who work in low-resource LTC settings tend to have fewer opportunities to get to know the residents, who in turn experience increased risk of adverse outcomes. Low-resource LTC settings can experience barriers in providing quality dementia care due to their limited ability to capture pertinent information about residents’ needs and preferences and ensuring that information is known by dementia care staff. We sought to describe stakeholder perspectives regarding the collection and sharing of information about RLWD in four low-resource LTC settings (two nursing home; two assisted living) that serve RLWD. All four settings were in medically underserved areas with two rural settings in New Hampshire and two urban settings in Maryland. Preliminary site visits conducted revealed strategies used by LTC providers to recruit and retain dementia care staff. In-depth semi-structured interviews were conducted with a purposive sample of stakeholders (administrative leaders, direct care staff, RLWD and family members). Interviews were transcribed and thematically analyzed in NVivo12. Themes were identified in four core topic areas: 1) identifying information about RLWD to support quality care; 2) finding and accessing information by the care team; 3) sharing information with RLWD; and 4) describing quality measures most relevant for RLWD. Findings shed light on practical strategies used by low-resource LTC settings and motivate future research on measuring dementia care quality.
RELIABILITY AND VALIDITY OF THE MCDR FOR HISPANIC OLDER ADULTS
Authors: Mendoza Lisandra , Garcia Patricia , Padron Dilianna , Duarte Andres , Marsiske Michael , Fiala Jacob , Duara Ranjan , Rodriguez Miriam
Published: December 2023

Objective

Effective functional measures can be used among Hispanics to diagnose and evaluate functional dementia progression, especially in the prodromal stages when treatment can be most effective. The current study examined the reliability and validity of the modified version of the modified Clinical Dementia Rating Scale (mCDR) compared to the Alzheimer’s Disease Cooperative Study (ADCS)-MCI-ADL. These are quantitative severity measures of functional impairment in dementing conditions. The mCDR uses an itemized informant-based structured interview with multiple-choice responses and does not include cognitive testing (Duara et al., 2010).

Methods

Functional measures were administered to 101 White non-Hispanic Cognitively Normal (CN, n=20) and MCI (n=81) and 159 Hispanic CN (n=32) and MCI (n=127) participants in the patient’s primary language (English or Spanish). Inter-rater reliability and convergent validity for these instruments were examined. Multiple regression analyses were conducted to determine if the administration’s language (English vs. Spanish) moderated the raters’ scores relationships.

Results

The results revealed moderate-to-good mCDR inter-rater reliability [β =.73, F (40,40) = 6.24, p < .001], even when controlling for language (β = .72, p < .001; main effect and interaction were not significant). ADCS-MCI-ADL showed moderate-to-good inter-rater reliability [β = .71, F (40,36.6) = 6.34, p < .001] also, when controlling for language (β = .72, p < .001; main effect and interaction were not significant). The mCDR and the ADCS-MCI-ADL were correlated at -.75, suggesting a high convergent validity (56%).

Conclusions

The m-CDR is a valid and reliable quantitative functional measure among Hispanic individuals.
YES! YOU CAN DO DAILY DIARY RESEARCH WITH DEMENTIA CAREGIVERS!
Authors: Winstead Vicki , Pickering Carolyn , Winstead Vicki
Published: December 2023

Successful recruitment and retention of dementia caregivers for intensive research protocols such as daily diary research is thought to be hindered by factors that include having limited time and the stress in dementia caregiving. Knowing why caregivers participate and what keeps them motivated to comply in daily diary research is crucial in understanding the experiences of dementia caregiving for the purpose of developing and ensuring successful interventions. The purpose of this symposium is to present data from three online micro-longitudinal daily diary studies on caregiving and dementia that inform successful practices in recruitment, compliance and reducing missing data in dementia caregivers. Each of the studies required daily participation ranging from 1) four daily diaries each day over 8 consecutive days, 2) 21 consecutive days of diaries once per day, and 3) three different data collection points of 21 consecutive days over one year. The symposium includes three papers that address the following areas: 1) Identifying factors that motivate dementia caregivers to participate in research for the purpose of developing relevant and meaningful recruitment materials. 2) Describing and predicting “missingness” within diary research, and 3) Effective strategies that are intentional in promoting high levels of compliance in completing diaries. Discussion will include ways to enhance recruitment materials that are congruent with caregivers’ motivations to participate, how strategies were used in each of the three studies for compliance in completion of daily surveys and retention and provide evidence that caregivers do take the time to participate in intensive research protocols.
THE ROLE OF SOCIAL SUPPORT AND SELF-EFFICACY ON HOPEFULNESS IN LOW-INCOME OLDER ADULTS AGED 50 AND OVER
Authors: Kwon Soonhyung , Benoit Ellen , Windsor Liliane
Published: December 2023

Background

Social support and self-efficacy play a significant role in improving positive psychological well-being in marginalized older adults. However, to date, there are few studies on identifying the relationships during the COVID-19 pandemic. We examined the effect of social support and self-efficacy on hopefulness in marginalized low-income older adults during the COVID-19 pandemic.

Methods

This study used baseline data from a clinical trial designed to increase COVID-19 testing in Essex County, NJ. The dataset involved participants aged 50 and over. We conducted: 1) cross-sectional descriptive/frequency statistics to understand the sociodemographic characteristics, 2) multivariate linear regression to investigate the direct relationships between social support subscales or self-efficacy and hopefulness, and 3) mediation analyses to examine the mediating role of self-efficacy in the relationship between social support and hopefulness.

Results

After adjusting for covariate variables, social support subscales (emotional/informational social support: b = 0.20, p < 0.05; tangible social support: b = 0.13, p < 0.05; affectionate social support: b = 0.17, p < 0.05; positive social interaction social support: b = 0.15, p < 0.05) and self-efficacy (b = 0.55, p < 0.001) were significantly associated with hopefulness. The indirect effect of social support via self-efficacy was positive and statistically significant (Effect = 0.14, Bootse = 0.04, BootLLCI - BootULCI = 0.06 - 0.23)

Conclusion

Self-efficacy mediated the relationship between social support and hopefulness in marginalized older adults aged 50 and over. Further research needs to identify the various facets of positive psychological well-being using longitudinal data and larger sample size.
AGING WELL, AGING DIFFERENTLY: A COMPARISON BETWEEN LIFE PLAN COMMUNITY RESIDENTS AND THE COMMUNITY AT LARGE
Authors: Mertz Laurel , Smith Jennifer , Lehpamer Nicole , Basic Ajla , O’Brien Catherine
Published: December 2023

Residing in Life Plan Communities (or Continuing Care Retirement Communities) may have benefits to well-being due to greater access to wellness programs and services. The purpose of this research was to examine changes in health and wellness between Life Plan Community residents and older adults residing in the community at large over five years. Data included 1,729 residents (69% female, mean baseline age = 81.64) who participated in Years 1 and 5 of the Age Well Study, and 427 older adults (50% female, mean baseline age = 80.78) residing in the community at large who participated in multiple waves of the Health and Retirement Study. The community-at-large group was proportionally sampled to be similar to the residents on age, income, and race/ethnicity, and both groups completed the same measures of health and wellness at each time point. Data were analyzed using multilevel models controlling for age, gender, income, education, and marital status. Compared to the community-at-large older adults, residents tended to exhibit better physical, emotional, social, intellectual, and vocational wellness in Years 1 and 5, but lower spiritual wellness in Year 5. When comparing Year 1 and Year 5, both groups reported similar changes over time on physical and vocational wellness measures. Community-at-large older adults tended to report more favorable changes in emotional and spiritual wellness, and residents showed more favorable changes in social and intellectual wellness. Although effects of the pandemic should be explored further, these findings have implications for supporting aging well in different types of residential settings.
ASSOCIATIONS OF HOME ENVIRONMENT AND UNMET CARE NEEDS AMONG LOW- AND MODERATE-INCOME OLDER ADULTS
Authors: Okoye Safiyyah , Samuel Laura , Fabius Chanee , Pollack Craig , Gitlin Laura , Szanton Sarah L , Wolff Jennifer
Published: December 2023

The home environment is an increasingly important setting for long-term services and support. However, more information is needed about the relationship between the home environment and adverse consequences due to unmet needs (i.e., going without assistance with everyday activities such as eating or bathing) among older adults. We draw on information from N=4,898 low and moderate-income (annual income <$60,000) community-living respondents to the National Health and Aging Trends Study (NHATS). Two aspects of the home environment were directly observed by NHATS interviewers: home disorder (six items, including flooring problems, tripping hazards, pests) and home disrepair (five items, including missing siding and broken steps). NHATS asked participants who reported a disability whether they experienced one of seven adverse consequences (e.g., going without eating) due to no one being there to provide help or the activity is too difficult for them to complete on their own. About half of our sample (48.5%) reported a disability. We found home disorder and disrepair more prevalent among older adults with disabilities than those without (36.2% v. 28.1% and 18.2% v. 15.0%, respectively). Among older adults with disabilities, the presence of any home disorder and any home disrepair were associated with higher odds of experiencing an adverse consequence of an unmet care need in unadjusted analyses (home disorder: OR 1.33; 95% CI 1.11, 1.60; home disrepair: OR 1.16; 95% CI 0.90, 1.50). Findings show an association between home environment and unmet care needs and can signal the need to target housing-related risk factors in future interventions.
HEALTH AND FUNCTION FROM MID LIFE TO LATE ADULTHOOD: FINDINGS FROM THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION (SWAN)
Authors: Karvonen-Gutierrez Carrie , Woods Nancy Fugate
Published: December 2023

Midlife (age 40-64) is characterized by physiologic, psychosocial and situational change, and a time when women experience the seminal endocrinological event of menopause. From a lifecourse perspective, understanding the relationship between midlife and older adult health is critical, particularly for identifying modifiable factors in midlife that impact later life health and functioning. Previous research has demonstrated that midlife health and functioning is dynamic and thus potentially amenable to intervention, though there remain crucial gaps in our understanding of this period. The Study of Women’s Health Across the Nation (SWAN) is an observational multi-racial/ethnic (White, Black, Chinese, Japanese, Hispanic) longitudinal study of 3,302 women recruited in 1996 from 7 sites in the United States (Boston, MA; Newark, NJ; Pittsburgh, PA; Detroit-area, MI; Chicago, IL; Oakland, CA; Los Angeles, CA). Over the past 27 years, women have participated in up to 17 near-annual study visits, spanning from midlife (age 42-52 years at baseline) to later life (age 69-79 years). This symposium features new science from SWAN including: an examination of rate of change in depressive symptoms across the menopausal transition (Avis); the impact of impaired glucose levels in midlife on muscle quality and power (Leis); the importance of sleep regularity for cognitive function (Derby); and the association of urinary incontinence with disability (Dugan). The symposium provides information regarding data and biospecimen access for investigators interested in using SWAN resources (Brooks). The Discussant will consider the implications of studying midlife health and function in relation to health and well-being in late adulthood.
LATENT CLASSES OF RESILIENCE IN A NATIONWIDE SAMPLE OF AMERICAN ADULTS DURING COVID-19 PANDEMIC: THE ROLE OF AGE
Authors: Chepkorir Joyline , Hladek Melissa , Huang Jing , Pavlovic Noelle , Phan Phillip , Gross Alden
Published: December 2023

Intra-individual coping and responses to stressors vary across people, influencing health outcomes. We aimed to identify distinct subgroups, using latent class analysis, of resilience based on coping resources and responses to COVID-19 using data from a nationally representative sample of American adults (N=3,640), including 2,507 younger (age< 65 years) and 833 older adults (age≥65 years). Data were collected in June 2020, after the first three months of COVID-19 lockdown. We identified sub-groups of resilience based on 11 self-reported coping resources and responses: pain, trauma, depressive and anxiety symptoms, alcohol, drug and food usage, coping resources, social networks, perceived cognitive deficit, and loneliness. Using conventional fit criteria (AIC, BIC, LMR-LRT, BLRT), we identified four latent classes: Low mental/physical resilience (N=187, 5.6%), Low mental resilience (N=432, 13.0%), Low social resilience (N=832, 25.0%), and High resilience (N=1888, 57%). While the first resilience class showed the poorest coping in all measures, the fourth class displayed good resilience qualities across all responses. Low mental resilience was characterized by high anxiety and depression, while the Low social resilience class was characterized by relatively poor social networks. Adults in the High Resilience class were on average 54 years old while adults in the low resilience class were considerably younger (average 33 years old, p< 0.001). Understanding patterns of resilience, especially by age strata, may help identify and support those who have an increased risk for poorer outcomes and may guide the development of individual- and population-level interventions to promote adaptive coping in the event of such a global stressor.
FORETHOUGHT OR AFTERTHOUGHT? THE FUTURE OF GERONTOLOGICAL EDUCATION
Authors: Masters Julie , Staley Mark , Karasik Rona
Published: December 2023

The increasing population of older adults would suggest a comparable increase in the demand for gerontological education. The current workforce shortage and number of Gerontology programs that are struggling and/or closing, however, suggest this is not necessarily the case. Bass and Ferraro (2000) reported over 1,000 gerontology/aging or related programs in operation. Today, there are 537 programs in gerontology and/or aging including 31 Associate degrees; 185 Minors; 79 Undergraduate and 92 Graduate Certificates; 43 Majors; 57 Masters; and 16 doctoral programs (University of Nebraska Omaha, 2023). Many interrelated factors have been suggested to account for the decline. From an economic point of view, these factors are thought to include: decreasing enrollments in and revenue generation from gerontology programs; demographic shifts away from traditional age college students; and decreasing interest and value of higher education overall. From a pedagogical point of view, this might reflect a return to individual courses and programs ensconced in more traditional disciplinary approaches (e.g., family studies, psychology, and sociology). Pervasive ageism has also been thought to be an underlying societal factor. While none of these factors are easily remedied, understanding their impact is an important first step. GSA programming such as Ageism First Aid and Reframing Aging Initiative are taking the next Herculean step in tackling societal ageism. This presentation focuses on reframing the value of gerontological education to students, employers, and policymakers– moving it from an afterthought to a prioritized strategy for addressing the mounting demand for aging services and service providers.
AGE DIFFERENCES IN EMOTION UTILITY KNOWLEDGE: COMPARING DISCRETE VERSUS DIMENSIONAL MODELS
Authors: Kravljaca Nikolina , Stanley Jennifer , Allard Eric
Published: December 2023

Do young and older adults have the same metacognitive schema for emotional utility? We examined young and older adults’ knowledge of which emotion would be best for achieving a goal (e.g., anger for confrontation). We captured responses using both a discrete emotions framework (e.g., happy; Ekman 1992) and a dimensional/circumplex model approach (e.g., arousal and valence; Russell, 1980) to determine which framework is most useful for understanding age differences in utilitarian emotion knowledge. Seventy-five young and 66 older adults indicated the most useful emotion when playing video games associated with different goals (Approach, Avoid, Confront, Analyze). Participants were asked to rate discrete emotions as well as identify the best combination of preferred valence and arousal on an affect grid. Two separate mixed-design ANOVAs were conducted for discrete emotion and dimensional ratings. Young and older adults exhibited similar preferences for both the discrete and circumplex model and chose the emotion with the most expected utility for each goal (e.g., happy for approach). One interesting age difference emerged where young adults endorsed the expected utilitarian emotion of sadness for the analyze goal to a greater extent than older adults. For the affect grid ratings, age differences were driven by arousal but not valence. We discuss how a discrete emotions approach may allow some clarity and a common language for interrogating the role of aging in utilitarian emotionality but may lack the nuance provided by the circumplex model.
OLDER ADULT PERCEPTIONS OF HEALTHY AGING MEASURES
Authors: Rule Payton , Allemand Mathias , Hill Patrick
Published: December 2023

Little is known about how lay older adults view measures commonly employed to assess healthy aging. This study examined older adults’ perceptions of scales capturing psychological wellbeing, psychosocial factors, and physical health. Participants (n = 60 US adults; MAge = 65.49, 41.18% Female, 94.12% White) were asked to rate how easy each measure was to understand and interpret on a scale of 1 (Not easy at all) to 7 (Very easy). In addition, they were asked to identify any items with which they had difficulty responding. Finally, participants provided opinions of whether these scales fully addressed their perspective on healthy aging, or if additional components were needed. Results showed that, on average, participants rated the aging-related outcomes measures as easy to understand and interpret (M = 6.14). Older adults rated measures related to physical health and health behaviors as the easiest to use (the PROMIS Health Measure (M = 6.47) and the Good Health Practices Scale (M = 6.49)), while measures that capture future planning were the most difficult to comprehend and interpret (the Consideration of Future Consequences Scale (CFC; M = 5.19) and the Goals Related to Healthy Aging Scale (M = 5.73)). While participants generally reported satisfaction with the comprehensiveness of the measures, some (22%) felt that these measures did not fully capture the social aspects of aging. Future measurement development may benefit from older adults’ input to increase their utility and better capture the experiences of older adults.
GENDER DIFFERENCES IN PSYCHOLOGICAL OUTCOMES OF DEMENTIA CAREGIVERS
Authors: Roden Elena , Falzarano Francesca
Published: December 2023

Substantial research has been conducted on the high prevalence of anxiety and depression among dementia family caregivers. Stressors, such as financial hardships related to costs of care and feelings of role captivity, can exacerbate adverse mental health outcomes. However, there is limited literature focused specifically on gender differences in the caregiving stress process. Using data from a mixed-methods study of 46 dementia family caregivers between the ages of 23-96, the purpose of this study was to examine gender differences in self-reported caregiving stressors (e.g., cost of care, care intensity) and psychosocial outcomes including depression and anxiety. Results showed that compared to females, male caregivers reported greater costs of care, greater feelings of role captivity, higher frequency of assistance with medical/nursing tasks (p=.01) and activities of daily living (ps range from .01-.04). Male caregivers also reported significantly greater distress related to care tasks (p=.04), as well as higher levels of depression (p=.02) and anxiety (p=.05). These findings provide insight into how the informal caregiving experience can vary by caregiver gender and potential factors contributing to these differential outcomes. The data establishes the importance of considering demographic characteristics in providing needed resources to dementia family caregivers.
IRRATIONAL FALL RISK APPRAISAL GROUP CHARACTERISTICS IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Rossler Aleatha , Thiamwong Ladda , Stout Jeffrey , Loerzel Victoria , Ng Boon Peng
Published: December 2023

Approximately 43% of older adults are affected by fear of falling (FOF). A portion of those affected by FOF have irrational fall risk appraisal (FRA) which means they have a high FOF despite normal balance. This secondary analysis aimed to examine the 18% of the 124 study participants living with irrational FRA from the RO3AG06799-0 data source. Descriptive statistics were used to examine characteristics of older adults with Irrational FRA. Spearman Rho and linear regression were used to evaluate factors (age, sex, race, education, financial status, living situation, fall history, depression symptoms, anxiety, hand grip strength, balance, and fear of falling) associated with Irrational FRA in older adults. Of the 22 participants with irrational FRA, 20 were female, 70% were aged 70 or above (average age 74), and 72% were white (25% Asian, AA, and Hispanic). 77% had anxiety symptoms, with 50% having high anxiety scores, and 32% had depression symptoms. 40% lived alone, 45% had no prior falls, and 70% had low hand grip strength. 23% had inadequate financial means, and 72% had a college education or higher. Statistically significant correlations were found between the FES score and age (p=.044), who the participant lived with (p=.033), and balance (p=.042). Regression analysis showed predictors of FES score in this group to be anxiety (p=.042) and who they live with (p=.024). This study provides valuable insights into the demographic and clinical characteristics of older adults with irrational FRA and highlights the role of anxiety and living status in predicting FOF.
PREDICTORS OF MAXIMUM STEP LENGTH IN OLDER ADULTS: ROLES FOR STRENGTH AND ACE GENOTYPE
Authors: Goldberg Allon , Norris Hayden , Garber Johnathon , Burkhardt Summer , Little Natalie , Sucic Joseph
Published: December 2023

Deficits in step length, assessed clinically by the maximum step length (MSL) test, are associated with poor balance and falls, in older adults. Determining predictors of MSL would facilitate targeted interventions to improve balance and reduce falls in older adults. Angiotensin-converting enzyme (ACE) insertion/deletion polymorphism genotypes interact with strength to predict stepping speed, but the interplay between ACE genotype, strength and MSL is unclear. Our objective was to determine whether strength and ACE DD genotype, through main effects or interactively, are associated with MSL, in older adults. Adults (N=103, female=58.2%, mean age 72.1 years, range 65-85 years) provided demographic, health and balance confidence information, completed grip strength and MSL testing, and provided saliva for genotyping. Multiple regression determined variance in MSL explained by strength, DD genotype (present/absent), and strength x genotype interaction, while controlling for covariates (age, sex, self-rated health and balance confidence). Covariates (model 1) explained 47.7% of MSL variance, while adding grip strength (model 2) explained additional 9.7% of variance. Adding DD genotype (model 3) explained .2%, while adding a strength x genotype interaction term (model 4) explained additional 3.4%, of MSL variance. The final model explained 61% of the variance in MSL (p<.001). DD genotype did not independently predict MSL (β=-.053; p=.421), but was interactively with strength, a significant predictor (β=.216; p=.005) of MSL. Strength was a significant predictor (β=.264; p=.003) of MSL, and as a modifiable physiological factor should be a focus of rehabilitation interventions to improve MSL and reduce falls risk in older adults.
PERSON-CENTERED COMMUNICATION AND APATHY IN NURSING HOME RESIDENTS WITH DEMENTIA
Authors: Jao Ying-Ling , Liao Yo-Jen , Berish Diane , Mogle Jacqueline , Kales Helen , Boltz Marie
Published: December 2023

Apathy is prevalent in dementia and is associated with poor health outcomes. Communication is fundamental for daily caregiving activities. Person-centered communication has positively impacted some neurobehavioral symptoms, but its impact on apathy remains unclear. This video observation study examined the association between healthcare workers’ use of person-centered communication and apathy in nursing home residents with dementia. Three videos, three to ten minutes each, were recorded for each resident to capture daily caregiving interactions. Healthcare workers’ communication was transcribed and segmented into phrases. Communication was coded phrase-by-phrase via video observations using the Person-Centered Behavioral Inventory. Communication was categorized as none, person-centered, non-person-centered, or others. Apathy was coded second-by-second via video observations using the Person-Environment Apathy Rating. Concurrent correlations and ANOVA were used for analysis. A total of 17 residents with dementia and apathy and 21 healthcare workers (e.g., certified nurse assistants, activity staff, and nurses) were recruited from three nursing homes. Results showed that caregiver communication approach had widely mixed correlations with second-by-second apathy scores across all videos (averaged r=0.09, range: r=-0.18 to r=0.54). Further ANOVA analysis showed that using person-centered communication, as compared to other communication approaches, had mixed associations with apathy; 19.6% showed significantly lower apathy, 35.7% showed significantly higher apathy, and 44.6% showed no significant associations. Overall, healthcare workers’ communication approach can potentially impact apathy for residents with dementia. Future research that examines the sequential associations between communication and apathy is needed to guide intervention development to reduce apathy and improve dementia care in nursing homes.
CHANGES IN PHYSICAL ACTIVITY, SEDENTARY TIME, AND SELF-RATED HEALTH ACROSS THE RETIREMENT TRANSITION
Authors: Westerlund Hugo , Fröberg Andreas , Sacco Lawrence , Suorsa Kristin , Leskinen Tuija , Hettiarachchi Pasan , Svartengren Magnus , Stenholm Sari
Published: December 2023

The aim was to investigate concurrent changes in accelerometer-measured total physical activity (TPA), moderate-to-vigorous physical activity (MVPA) and sedentary time, and changes in self-rated health across the retirement transition. Data from two longitudinal studies was pooled: the Swedish Retirement Study (SRS) and the Finnish Retirement and Aging (FIREA) study that used similar methods. Data from three waves (each approximately 12 months apart) was included: one pre-retirement (wave 1, W-1) and two post-retirement follow-ups (W-2 and W-3). In total, 245 participants (27% men, mean age 64 years at W-1) were included. Thigh-worn accelerometers were used to collect data for TPA, MVPA and sedentary time at W-1 and W-2 and processed through ActiPASS and harmonized for time spent in different physical activity intensities. To be included in the analyses, a minimum of 4 days with at least 10 hours of accelerometer wear time during waking hours at both W-1 and W-2 was required. Questionnaires were used to collect data for self-rated health at W-1, W-2, and W-3. Ordinal regression models showed that 10 more minutes of MVPA at W-1 was significantly associated with higher odds of reporting better self-rated health at W-1 (OR: 1.12 [1.02-1.22]) in non-manual workers only. The association between MVPA and self-rated health was non-significant in the fully adjusted models. No significant associations were observed between changes in TPA, MVPA or sedentary time during retirement transition, and self-rated health at post-retirement follow-ups. In conclusion, this study showed a significant cross-sectional association between MVPA and better self-rated health before retirement.