bluuebunny/crossref_metadata_2025 huggingface dataset:
I WILL KEEP CONTRIBUTING TO MY FAMILY: FAMILY OBLIGATION AMONG OLDER ADULTS WITH MEXICAN IMMIGRANT BACKGROUNDS
Authors: Toyokawa Noriko
Published: November 2019

Providing care of older parents is a family obligation for children with Mexican cultural contexts (Knight et al., 2010). Nevertheless, little is known about how parents with Mexican cultural backgrounds believe about their family obligations. The current study conceptualized Mexican American older adults’ sense of family obligation. Data was collected from 307 Mexican Americans (Mage=54, SD=8, range 45-77 years old, females=56%) through an online survey. A 2-factor model: Expectation on children’s caregiving (3-item) and Efforts to reduce children’s burden (7-item) were identified as the best-fit model through EFA and CFA analyses (CFI=.96, SRMSA=.4). The component of efforts to reduce children’s burden predicted participants’ generativity assessed by the scale of McAdams and Aubin (1992). The findings suggest that Mexican American older adults expect their children to take care of them, as they feel obligated to reduce their children’s caregiving burden. The function of the cultural value in intergenerational relations is discussed.
HEALTH STATUS OF OLDER VIETNAMESE REFUGEES: RESULTS FROM THE VIETNAMESE AGING AND CARE SURVEY (VACS)
Authors: Miyawaki Christina E , Chen Nai-Wei , Meyer Oanh L , Tran Mindy Thy , Markides Kyriakos S
Published: November 2019

Over 1.3 million Vietnamese including refugees migrated to the U.S., after the Vietnam War. Vietnamese are the 4th largest Asian ethnic group in the U.S. Despite the number, little is known about their health conditions. To fill this gap, the Vietnamese Aging and Care Survey (VACS) was developed, and sociodemographic and health data on 132 refugees (≥65 years) were collected in Houston, Texas. They were on average 75.4 years-old, retired (77%), married (58%), female (55%) with less than high school education (86%) in poor/fair health (76%). They immigrated around age 49 years-old, and have hypertension (74%), arthritis (48%), and diabetes (41%). They manage their lives by living in a multi-generation tightly-knit enclaves, and show resilience to their low sociodemographic status (≤25K, 94%). Findings suggest healthcare professionals to introduce more social services such as adult daycare programs in culturally-sensitive ways to ease their transition to new lives in the U.S.
EDUCATIONAL INITIATIVE ABOUT MEDICATION MANAGEMENT FOR OLDER ADULTS
Authors: Boparai Manpreet , Muniz Rosario Costas , Gangai Natalie , Manna Ruth , Korc-Grodzicki Beatriz
Published: November 2019

Older adult patients often have multiple comorbidities, see multiple providers, leading to poor medication management (MM). Educational seminars were conducted to health care providers (HCPs) and community-based organizations to deliver health programs to linguistically diverse communities by a pharmacist utilizing interpreters. Participant knowledge was assessed using matched pre-post surveys (translated to participants’ respective languages). Behavioral intention was measured using a Likert scale. Results indicate participation from 136 community dwelling adults via 6 educational sessions; 44 caregivers via 5 sessions, and 22 HCPs (4 students and 22 residents) participated in one session. 91% of the community population were born outside of the US, 67% coming from South Asian countries, speaking over 7 different languages. Knowledge about medication management increased from an average of 44% correct responses pre-session to 48% correct post-session – a statistically significant change (t (135) =-2.26, p<.03). Most caregivers were females (82%) and born in a South Asian country (87%). Knowledge about medication management when caring for a loved one increased significantly from an average from pre (46%) to post (60%) (t (41) =-3.07, p< .01) Finally, most HCPs were females (53%), 63% Asian; 87% were born outside of the US, predominantly in East Asia. Providers had a significant increase on knowledge (t (21) =-3.03, p< .01) about prescribing for older adults. Detailed results of the programs will be presented. Despite challenges in diverse audience members, all three target populations indicated a statistically significant change in knowledge indicating the value in targeted and tailored health education topics.
CAN HEARING AIDS DELAY THE ONSET OF ALZHEIMER’S AND OTHER AGE-RELATED CONDITIONS AMONG ADULTS WITH HEARING LOSS?
Authors: Mahmoudi Elham , Basu Tanima , Langa Kenneth , McKee Michael , zazove Phillip , Kamdar Neil
Published: November 2019

In this study, we examined the association between hearing aids (HAs) and the onset of Alzheimer’s disease or dementia; depression or anxiety; drug or alcohol disorders; and falls among adults aged 50 and older with hearing loss (HL). We performed a retrospective study of 176,716 adults (50+) with HL diagnoses using a national, insurance claims data (2008-2016). We used Kaplan Meier curves to examine disease-free survival and Cox regression models to examine the risk-adjusted association between HAs and time to diagnosis of 4 age-related/HL-associated conditions within 3 years of HL diagnosis. Large gender and racial/ethnic differences exist in HAs use. Approximately 11.3% of women vs. 14.5% of men used HAs (95% CI Difference: -0.04, -0.03). About 14.1% of Whites (95% CI: 0.14, 0.14) vs. 9.5% of Blacks (95% CI: 0.09, 0.10) and 7.8% of Hispanics (95% CI: 0.07, 0.08) used HAs. The risk-adjusted hazard ratios of being diagnosed with Alzheimer’s disease or dementia, depression or anxiety, drug/alcohol disorders, and injurious falls within 3 years after HL diagnosis, for those who used HA vs. those who did not, were lower by 0.82 (95% CI: 0.76-0.88), 0.92 (95% CI: 0.89-0.95), 0.91 (95% CI:0.80-1.04), and 0.86 (95% CI: 0.81-0.92), respectively. Use of HAs is associated with delayed onset of Alzheimer’s, dementia, depression, anxiety, and injurious falls among adults 50 years of age and older with HL. This is important because HL are increasingly common among older adults and early HL diagnosis and use of HAs may prevent or delay physical and mental decline.
INTRODUCING ARTIFICIAL COMPANIONS TO USERS WITH DEMENTIA IN UNREGULATED MARKETS: OPPORTUNITIES VS. ETHICAL ISSUES
Authors: Portacolone Elena , halpern Jodi , Luxenberg Jay , Harrison Krista , Covinsky Kenneth
Published: November 2019

Because of the high costs of providing long-term care, artificial companions are increasingly considered an opportunity to provide support to older adults with cognitive impairment while saving costs. Artificial companion can comfort and inform, thus inducing a sense of being in a relationship. Sensors and algorithms usually allow these applications to exude a life-like feel. The explosion of these technologies has created a “cultural lag” between their rapid commercial introduction and the slower evolution of regulations. An outcome of this cultural lag is a tension between the potential of artificial companions to support users and a series of unresolved ethical issues related to the fact that users might lack the capacity to fully understand the implications of using these technologies. Specific challenges of deception, surveillance, consent and social isolation are raised by the introduction of these technologies in users with cognitive impairment. The case study of a sophisticated artificial companion commercially available in the United States lends the opportunity to examine the tension between the potential of this technologies vs. unresolved ethical issues. This companion is an avatar on an electronic tablet that is displayed as a dog or a cat. Whereas artificial intelligence guides most artificial companions, this application is a hybrid of robots and human beings because it also relies on technicians “behind” the on-screen avatar, who via surveillance, interact with users. We conclude with a call to develop regulations promoting artificial companions as “human-driven technologies,” i.e. technologies focused on truly empowering users according to their cognitive abilities.
PHYSICAL ACTIVITY MEDIATES THE EFFECTS OF DEPRESSIVE SYMPTOMS ON THE COGNITIVE FUNCTION OF OLDER ADULTS
Authors: Khoo Yit Mui , Matsuo Hisako
Published: November 2019

Evidence suggests that depressive symptoms among older adults were associated with cognitive impairment and affect cognitive decline over time, while physical activity was associated with lower risk of cognitive decline or have positive effect on cognitive function. The purpose of this study is to examine whether physical activity could mediate the effects of depressive symptoms on the cognitive function of older adults. Data from the 2014 Health and Retirement Survey (HRS) of older adults ≥ 60 years (N=9,753) were used. Hierarchical regression was conducted to examine the relationship between depressive symptoms, physical activity, and cognitive function. Mediation analysis was used to examine whether physical activity could mediate the effects of depressive symptoms on cognitive function. Regression results indicated that increased depressive symptoms was associated with poorer cognitive function, while increased moderate and mild physical activity were associated with better cognitive function. Mediation analysis indicated that the direct effect of depressive symptoms on cognitive function was significant. The indirect effect of depressive symptoms on cognitive function mediated by moderate and mild physical activity were also significant. Findings suggest that physical activity could potentially improve the cognitive function of older adults who have depressive symptoms. Moderate and mild physical activity could benefit older adults with depressive symptoms and reduce the risk of cognitive decline. Frail, disabled or chronically ill older adults are less likely to participate in vigorous physical activity, but they could benefit from moderate or mild physical activity and have better cognitive health.
EFFECTS OF COGNITIVE DECLINE ON DIABETES SELF-MANAGEMENT EDUCATION AND CARE
Authors: Lee Shinduk , Smith Matthew L , Ory Marcia G
Published: November 2019

People with diabetes experience a faster cognitive decline and have a greater risk for future dementia diagnoses. Cognitive impairment can negatively influence diabetes management activities. Diabetes self-management education (DSME) can enhance diabetes control, but limited evidence exists about the differential effects of DSME based on cognitive status. This study examines the moderation effects of cognition on the relationship between participation in DSME and diabetes management among older adults using Georgia 2017 BRFSS data (N=496). Primary outcomes were diabetes self-management (e.g., self-blood glucose monitoring, self-feet check, and physical activity) and clinical care (e.g., seeing a health professional for diabetes and A1C, feet, and eye exams). Multiple logistic regression models examined the effects of DSME and self-reported cognitive decline on diabetes care. Based on the Anderson-and-Newman Framework, all regression models were adjusted for predisposing (age, sex, race, ethnicity, and education), enabling (income, marital status, and health plan), and need (insulin treatment) factors. About 48% of participants participated in a DSME, and about 16% reported experiencing cognitive decline. DSME participation was positively associated with self-blood glucose monitoring (p=0.014), physical activity (p=0.024), seeing a health professional for diabetes (p=0.002), and feet exam (p=0.043), but cognitive decline was not significantly associated with most diabetes care (p>0.05). Further, no significant difference in DSME impact on diabetes care based on reported cognitive decline was observed (p>0.05). Findings suggest that DSME can benefit diabetes care among people with and without cognitive decline. Future research can expand upon impacts of rates and degrees of cognitive decline on program benefits.
CHALLENGES AND STRATEGIES FOR SUSTAINING A NEW DEMENTIA BEHAVIORAL CARE APPROACH IN NURSING HOMES
Authors: Karel Michele J , Benson Karen M , Piscopo Youliana , Maataoui Susan , Curyto Kimberly
Published: November 2019

The STAR-VA training program in Veterans Health Administration Community Living Centers (CLCs) has been helping interdisciplinary care teams understand and manage dementia-related behaviors in the nursing home setting, with promising clinical outcomes. However, sustaining a new care approach in a health care system poses multiple challenges. This presentation will discuss facilitators and barriers to STAR-VA sustainability based on CLC team and nurse leader feedback. Findings are informing development of a new site coaching program and a sustainability toolkit. Feedback to date suggests that critical STAR-VA implementation and sustainability strategies include: regularly scheduled team meetings to discuss behavioral assessment and care plans; ongoing staff training (e.g., new staff orientation); communicating care plans across shifts and in the health record; multiple nurse/shift champions; impromptu huddles; acknowledging staff successes; leadership engagement. The coaching program engages teams in setting and tracking site sustainability goals. Lessons learned will be discussed.
DEMENTIA-FOCUSED PERSON-DIRECTED CARE TRAINING IN THE NURSING HOME: FIDELITY AND OUTCOMES
Authors: Reinhardt Joann P , Burack Orah , Cimarolli Verena , Weiner Audrey
Published: November 2019

To address the behavioral health of nursing home (NH) residents living with dementia, training direct care staff (DCS) is essential, for the well-being of both residents and staff. We evaluated a training for DCS focused on providing care for persons with advanced dementia who are at-risk of not having care needs met, largely due to communication deficits. Staff were trained in promoting comfort and reducing distress through person-directed care (PDC), deeply knowing each resident, and anticipating needs. Subsequent fidelity interviews with staff showed a higher number of PDC practices utilized by staff in the intervention communities compared to usual care. We also compared the impact of the PDC model versus a traditional model of NH care on resident clinical outcomes, finding a significant interaction where those in the intervention group had fewer clinical symptoms over a 6-month period. Implications for training in the NH setting will be discussed.
EVALUATING THE EVIDENCE BASE OF A STAFFING GUIDELINE FOR DUTCH NURSING HOMES
Authors: Backhaus Ramona , Verbeek Hilde , Boer Bram De , Rossum Erik Van , Schols Jos , Hamers Jan
Published: November 2019

Related to the Dutch nursing home quality framework implemented in 2017, a staffing guideline was developed, aimed at assisting nursing homes to adequately staff their wards. For the Dutch Ministry of Health, we investigated the evidence base of this guideline. We critically reviewed scientific literature (n=65) and interviewed (inter)national experts (n=8) and potential guideline users (n=5). We found that departing a quality improvement dialogue directly from teams, clients and their families is positive. However, weaknesses were identified as well. Several risks exist for employees to adequately assess resident needs. Furthermore, buy-in is needed from board level to develop a vision on which competencies and amount of staff are needed to fulfill these needs. Examples of guideline improvement recommendations were assisting teams in how to assess resident needs, critically reflect on care provision and considering a role for (top)management. Overall, it was concluded that the value of the guideline was limited.
PRELIMINARY FINDINGS ON FAMILY PERPETRATORS AS DESIGNATED SURROGATE DECISION MAKERS
Authors: Bolkan Cory , Teaster Pamela , Ramsey-Klawsnik Holly , Gerow Kenneth
Published: November 2019

Vulnerable older adults needing surrogate decision makers typically rely upon others for care and are unable to advocate for themselves. The issue of EFFE perpetrated by family members designated as surrogates has become highly visible nationally, yet no reliable, empirical documentation exists on the nature or extent of exploitation by surrogate perpetrators. In collaboration with the National Adult Protective Services Association (NAPSA), we prospectively gathered APS data from six geographically diverse counties on 450 substantiated cases of abuse by POAs, representative payees, and guardians of vulnerable adults 65+ living in community settings. This presentation will highlight how family member surrogates perpetuated abuse and the outcomes on elder victims. These findings elucidate person and process-level factors (e.g., characteristics of victims, perpetrators, and their relationships) within the context of the APS system and can inform practice and policy recommendations for better prevention, detection, investigation, and intervention in these challenging cases.
ADDRESSING THE THEORETICAL GAPS IN ELDER FAMILY FINANCIAL EXPLOITATION
Authors: Gilligan Megan , Betz-Hamilton Axton , Chapman Ashton
Published: November 2019

A systematic review of elder family financial exploitation (EFFE) literature from the past five years reflects limited use or consensus of theoretical perspectives. In this paper, we propose using Bronfenbrenner’s Bioecological Theory to frame the dynamic, interrelated factors associated with EFFE. Bronfenbrenner’s Bioecological Theory, specifically the PPCT model includes Proximal processes, Person characteristics, Contextual systems, and Time. Proximal processes are increasingly complex interactions between individuals (e.g., family communication). Person characteristics include demand (e.g., gender, age), resource (e.g., education), and force (e.g., temperament) characteristics affecting interactions. Contextual levels drawn from Bronfenbrenner’s original model (e.g., micro, meso, exo, and macro) emphasize the effect of interrelated systems on development. T refers to Time, including changes occurring in time (e.g., longitudinal) and over time (e.g., historical). Collectively, the PPCT model provides a framework for understanding the iterative, complex factors linked to EFFE.
ATTITUDES TOWARD OWN AGING AND PERSONALITY IN LATER LIFE: EXAMINATION OF BIDIRECTIONALITY OVER 20 YEARS
Authors: Kornadt Anna E , Siebert Jelena S , Wahl Hans-Werner
Published: November 2019

Big Five personality traits are assumed to be linked with attitudes toward own aging (ATOA). Both constructs have central importance for the aging process, it is thus important to comprehensively address their mutual connection over time. We used data from the ILSE study, a longitudinal study with four measurement occasions, spanning 20 years and including two participant cohorts (n = 501; born 1950-52 and n = 500; born 1930-32). Dual latent change score models showed that personality was longitudinally related to change in ATOA: Lower Neuroticism, higher Conscientiousness, and higher Openness predicted more positive attitudes; the effect for Extraversion varied by time. Furthermore, the role of personality seems to be confined to certain sensitive periods in midlife and early old age. ATOA had only marginal longitudinal impact on personality. Our results shed light on the developmental co-dynamics of personality and subjective perceptions of aging across the second half of life.
COGNITIVE PERFORMANCE AND COGNITIVE COMPLAINTS WITH ATTITUDES TOWARD AGING IN MIDLIFE AND OLD AGE
Authors: Siebert Jelena , Siebert Jelena S , Braun Tina , Wahl Hans-Werner
Published: November 2019

Converging longitudinal research suggests that more negative views on aging go along with higher cognitive impairment. In some contrast, although conceptually suggested, possible reciprocal relationships remain less clear empirically. Using 20-year data from the Interdisciplinary Longitudinal Study of Adult Development (ILSE), we aim to better understand developmental co-dynamics between cognitive factors and attitude toward own aging (ATOA). Drawing on 1002 baseline participants (445 at T4) from two age cohorts (midlife: 40 years at baseline; old age: 60 years), longitudinal trajectories between ATOA, performance-based cognitive measures and subjective cognitive complaints are examined. Findings based on multi-group latent growth curve models (a) reveal substantial associations between ATOA and subjective complaints as well as objective cognition in both age groups; (b) confirm previous findings that ATOA predicts cognitive change over 20 years; and (c) find cognitive complaints but not cognitive performance able to predict change in ATOA in later life.
AGE-RELATED ATTRIBUTIONS OF CHANGE: DETERMINANTS AND CONSEQUENCES
Authors: Rothermund Klaus , Couto Clara de Paula
Published: November 2019

Diehl and colleagues recently introduced the concept of “Awareness of Age-related Change” (AARC; Diehl & Wahl, 2010), emphasizing the need to investigate the subjective experience of one’s own aging. In the Aging-as-Future project (n=1,300 participants, age range 35-85), we separately assessed the experience of changes and attributions of these changes to age. Attributions of changes were driven by a correspondence between the direction of change (gain vs. loss) and negative vs. positive age stereotypes. Importantly, our data also support the assumption that changes interact with age-related attributions in predicting life satisfaction. Specifically, age-related attributions were shown to exacerbate negative effects of losses on well-being.
MOVING TOWARD BEST PRACTICES IN STATE APPROACHES TO SUPPORTING FAMILY CAREGIVERS OF OLDER ADULTS
Authors: Burgdorf Julia , Aufill Jennifer , Wolff Jennifer L
Published: November 2019

In January 2018, Congress passed the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act to establish a national strategy to acknowledge and assist family caregivers. The success of such an effort will be contingent on knowledge and dissemination of best practices. We conducted a policy project funded by the Milbank Memorial Fund that profiles five geographically and politically diverse states that have pursued novel approaches to supporting family and unpaid caregivers of older adults. We discuss findings from national and state reports, state aging plans, and interviews with 26 key informants. We find that each state (Hawaii, Maine, Minnesota, Tennessee, Washington) sought to strengthen supports for family caregivers as an element of broader community-based long-term services and supports strategies. Supports for family caregivers included financial support for working caregivers, caregiver assessment and care planning, and expanded access to respite care: several states included these services within programs targeted to persons at high risk of institutionalization or Medicaid-entry. Key informants noted the importance of tailoring programs to suit each state’s unique demographic, geographic, and service delivery context, and reported that individual stories, advocacy, and data were critical to placing family caregiving on legislative policy agendas. State leaders highlighted the pivotal role of state aging networks in efforts to supporting caregivers, given these entities’ deep knowledge of local community needs and challenges and established relationships with local service providers. Meaningful change often required a long-term commitment and sustained incrementalism, typically by innovating on a smaller scale before expanding statewide.
NOTHING FOR ME WITHOUT ME: CAREGIVER TRAINING NEEDS
Authors: Elkins Jeananne , Rustin Phillip
Published: November 2019

Over 34 million informal caregivers provide care to an adult aged 50 or older with over 15 million caregivers caring for a person with dementia. People often become caregivers unexpectedly. For most caregivers little training is available, and most skills are learned “on the job”. The objective of this study is to determine the training needs of caregivers. An anonymous survey was conducted at two caregiver conferences. Caregivers were asked to name up to 5 training needs. For this abstract we report the percent of responses by caregivers. Seventy-nine caregivers completed the survey. Seventy-seven percent (77%) of the caregivers cared for a person over age 50. Increased knowledge of health issues (17%) and resources (17%) were the highest responses. Training in physical caregiving skills i.e. bathing (10%), transfers (8%) and diaper changes (4%) were voiced as important. Training for improving personal interactions with the care recipient was important (9%) as well as how to practice patience, kindness and compassion (7%). Two areas where training is available but perhaps not accessible – caregiver support (9%) and care recipient behaviors (8%) were all important to caregivers. Healthy eating (9%) and stopping or limiting driving by the care recipient (2%) were enunciated as areas requiring training. Many of the training needs should be addressed by healthcare professionals in their interactions with caregivers and care recipients. Programs are available online, but caregivers are not accessing this training. To improve outcomes for both caregivers and care recipients targeted training for caregivers is needed.
PHYSICAL ACTIVITY AND SEDENTARY BEHAVIORS: IMPACT ON SELF-RATED HEALTH AND PHYSICAL OUTCOMES IN CANCER SURVIVORS
Authors: Bluethmann Shirley M , Flores Eileen , Matthews Charles , Perna Frank
Published: November 2019

Physical activity (PA) and avoidance of inactivity are recommended in cancer survivorship. But survivors are not meeting these recommendations. We used national data (NHANES) collected 2011-2014 (n=9620) to estimate associations of PA and TV viewing with 3 health outcomes: self-rated health, functional limitations and multimorbidity in older cancer survivors and adults without cancer. Greater PA was associated with reporting excellent health in survivors. Survivors that obtained 22.5+ MET-hours/week were 5.5 times more likely to report excellent health than those that did no exercise (OR=5.5, p<.001). We observed a decrease in likelihood of multimorbidity and functional limitations with increasing PA (both significant at p<.001). We noted survivors that abstained from watching TV were 3x more likely to report excellent health and between 60-80% less likely to report functional limitations and multimorbidity than TV watchers (p<001). Findings with non-cancer adults were similar. Survivors need PA and reduced TV to maximize health outcomes.
SELF-REPORTED WALKING PACE AND ALL-CAUSE MORTALITY AMONG CANCER SURVIVORS IN THE NIH-AARP DIET AND HEALTH STUDY
Authors: Salerno Elizabeth , Maurice Pedro Saint , Willis Erik , DiPietro Loretta , Matthews Charles
Published: November 2019

We examined the association between self-reported walking pace and all-cause mortality among cancer survivors in the NIH-AARP Diet and Health Study. Participants included 30,110 adults (Mage=62.4+/-5.14 years) diagnosed with cancer between study enrollment and follow-up, when they self-reported walking pace. Individuals were followed until death or administrative censoring in 2011. We estimated the hazards ratios (HR) and 95% confidence intervals (CI) for walking pace and all-cause mortality adjusting for age, sex, race, BMI, health status, physical activity and cancer type. Cancer survivors reporting faster walking paces had significantly reduced mortality risk. Relative to those reporting an ‘easy’ walking pace, walking at a ‘normal,’ ‘brisk,’ or ‘very brisk’ pace was associated with significantly lower risk: [HR=0.74 (0.70,0.78)], [HR=0.66 (0.61,0.71)], and [HR=0.73 (0.60,0.89)], respectively. Being ‘unable to walk’ was associated with 30% increased mortality [HR=1.30 (1.15,1.46)]. These findings provide novel support for the association between self-reported walking pace and survival after cancer.
HARNESSING TECHNOLOGY TO SUPPORT PERSONS WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Andersen Stacy L , Boot Walter , Kaye Jeffrey
Published: November 2019

One in eight older adults in the US has Alzheimer’s disease or a related dementia, which are characterized by progressive cognitive and physical declines. The impact of dementia also goes beyond the individual since 92% of persons with dementia receive functional and emotional support from family members and other informal caregivers. The time demands, financial strain, and emotional toll of caregiving are known to cause increased stress and health problems. Therefore, there is a wealth of opportunities to develop new ways to intervene in the progressive loss of function among persons with dementia and ways to support them and their caregivers. Co-sponsored by the Alzheimer’s Disease and Related Dementias and Technology and Aging Interest Groups, this symposium addresses innovations in the implementation of new and existing technologies in the dementia care continuum. We will discuss the development and testing of a new mobile application designed to integrate both physical activity and cognitive training. Then we will discuss results from a virtual support group intervention to provide disease education, care planning, and emotional and social support among persons newly diagnosed with Alzheimer’s disease and living alone. Next we will share results from a study using customized voice-assisted technologies to enable individuals with memory impairment to maintain independence and quality of life and reduce caregiver burden. Finally, we will present findings regarding the validity and accuracy of a wearable sensor-based device that measures skin conductivity and heart rate variability to monitor stress level among caregivers of persons with dementia.
CUSTODIAL KNOWLEDGE AND LEGAL PERCEPTION AMONG GRANDPARENTS RAISING THEIR GRANDCHILDREN
Authors: Bownes Elizabeth , Crowther Martha R , Cox Jennifer
Published: November 2019

The current study examines the ways in which grandparents raising their grandchildren (GRCs) understand custody, perceive the legal system, and access resources related to their grandchild(ren)’s welfare. Due to the detrimental impact of the opioid crisis over the last decade, the number of skipped generation households is growing significantly not only in Alabama, but across the U.S.. Many GRCs lack crucial information regarding custody arrangements in a general sense or as it applies to education, healthcare, mental health, and financial aid. Critical gaps remain present in the GRC literature necessary to aid in future intervention studies and promote more effective support, resources, and policy for this population. The present study sought to examine the unique needs and experiences of GRCs, and to specifically explore legal aspects associated to their grandchild(ren)’s welfare. Using a mixed methods approach, GRCs in Tuscaloosa, Alabama completed a quiz of custodial knowledge, a survey on legal perception, and a semi-structured interview. Quantitative data revealed the most and least commonly understood aspects of custody, as well as opinions on associated legal systems related to a child’s “best interest.” Qualitative data analysis revealed the common themes related to custody to be unexpected assistance, ineffective assistance, leniency for parental deviance, fear of losing custody, and time and cost demands.
EFFECTS OF SOCIAL RELATIONS ON MORTALITY IN THE CONTEXT OF GRANDPARENTING
Authors: Jang Heejung , Tang Fengyan
Published: November 2019

Issues of health and well-being have received considerable attention as a way to help grandparent caregivers. There is growing evidence that grandparenting is beneficial for grandparent caregivers’ health, yet acting as grandparent caregiver also is detrimental to health and social relations when a grandparent provides an extensive level of care to grandchildren. The extent to which grandparent caregiving benefits or harms of the health of a grandparent is still unknown; mortality specifically has not been systematically studied. Moreover, although altruistic behaviors towards others have been shown to have beneficial effects on caregivers’ health in general, there is little information regarding social relations of grandparent caregivers and their impact on mortality. This study aims to investigate the roles of different aspects of social relations among community-dwelling older adults, examining whether aspects of social relations, including social networks, received functional support aid, and perceived support quality, mediate the association between grandparent caregiving and mortality. The data were drawn from the 2008 and 2014 Health and Retirement Study (N=1,196). Results of survival analyses indicate that custodial and co-parenting grandparents were significantly associated with all-cause mortality over a 6-year period; however, the associations were marginally significant after health statuses were added into the model. Specifically, family-focused network groups were significantly associated with mortality. Received functional support and perceived positive support mediated the association between custodial grandparents and mortality. This study suggests that community-based support may be beneficial to older grandparents and perceived positive relationship quality could matter for older adults’ well-being.
INTEREST GROUP SESSION—NUTRITION: IMPLEMENTATION OF NUTRITION, BODY COMPOSITION, AND FUNCTIONAL ASSESSMENT IN VULNERABLE OLDER ADULTS
Authors: DiMaria-Ghalili Rose Ann , Locher Julie
Published: November 2019

This symposium will highlight the implementation of nutrition, body composition and functional assessment in vulnerable older adults. Understanding the barriers and enablers of implementing traditional nutrition screening and assessment tools, nutrition focused physical examination, body composition analysis, functional assessment and biomarkers can aid researchers in the design of pragmatic nutrition studies in vulnerable older adults. DiMaria-Ghalili will provide an introduction to overall nutrition assessment in community-dwelling older adults and present lessons learned in regards to nutrition assessment protocols (Mini-Nutritional Assessment, hand-grip strength, and inflammatory biomarkers) from an ongoing clinical trial. Starr will discuss the issues surrounding nutrition screening and assessment in high-risk older adults undergoing abdominal surgery. A comparison of data on different nutrition screening and assessment tools (NRS-2002; PG-SGA, Nutrition Focused Physical Examination) in older adults undergoing abdominal surgery will be presented. Batsis will discuss the controversies and challenges in body composition assessment focusing on sarcopenic obesity. Data highlighting the different diagnostic criteria of sarcopenic obesity and diagnostic accuracy will be presented. The link between overall nutrition status and physical function on health outcomes is emerging in older adults. Bales will discuss the types of physical function assessment tools used in studies of older adults and discuss her findings on the impact of higher protein intake on functional outcomes. The symposium will conclude with a discussion led by Locher on practical implications of integrating best assessment techniques into clinical practice.
NUTRITION ASSESSMENT IN HIGH-RISK PATIENTS: NRS-2002, PG-SGA, AND NFPE IN OLDER ADULTS PREPARING FOR ELECTIVE SURGERY
Authors: Starr Kathryn N Porter , Young Kenlyn , McDonald Shelley R , Loyack Nancy , Lagoo-Deenadayalan Sandhya ​Sandhya , Heflin Mitchell T , Pieper Carl F , Bales Connie W
Published: November 2019

Post-surgical complications are most common in older adults. While a number of factors contribute, one key determinant is malnutrition. Malnutrition is seen in up to 86% of older adults at hospital admission. Malnutrition and post-surgical complications are linked through two critical observations: 1) malnutrition dramatically reduces the ability of older adults to overcome postsurgical health stressors, and 2) nutritional status is likely to deteriorate further during hospitalization and after discharge. Despite convincing evidence that perioperative nutrition intervention can improve surgical outcomes, nutrition screening and assessment in the preoperative period is not required or standardized. We will review issues surrounding screening and assessment of malnutrition in older adults preparing for elective surgery and present data on screening (NRS-2002) and assessment tools (Nutrition Focused Physical Exam and PG-SGA) used in this high-risk population. Finally, we will discuss best practices for identifying and intervening with malnourished older adults in the preoperative setting.
PHYSICAL FUNCTION AND BODY COMPOSITION AS NUTRITIONAL OUTCOMES: ASSESSMENT APPROACHES
Authors: Bales Connie W , Starr Kathryn N Porter , Miller Marshall
Published: November 2019

Nutritional status is a strong determinant of both body composition and physical function (PF), parameters that are closely interrelated but rarely evaluated in the clinical setting due to cost, access, and lack of agreement on best approaches in older adults. Recent evidence that changes in muscle mass do not closely correspond to changes in muscle function will be reviewed in the context of our studies of higher protein obesity interventions. PF assessments, including indices for older adults (Short Physical Performance Battery and Physical Performance Test), as well as specific tests like gait speed and handgrip strength, will be explained as nutrition outcomes and in relation to body composition from air displacement (BodPod) and dual energy x-ray absorptiometry (DXA). These results, along with new studies of muscle quality, will bring a better understanding of the complexity of responses to nutritional interventions designed to optimize body mass and composition in older adults.
INTEREST GROUP SESSION—MENTAL HEALTH PRACTICE AND AGING: INTEGRATION OF SOCIAL DETERMINANTS OF HEALTH IN DEFINING HEALTH BEHAVIORS AND OUTCOMES AMONG DIVERSE OLDER ADULTS
Authors: Minahan Jacquelyn , Baker Tamara A
Published: November 2019

Social determinants of health (SDoH) are conditions in which individuals live, learn, work, and play. Specifically, they are influenced by the distribution of resources, money, and power, and have significant implications on health behaviors and outcomes across the life span. Existent data show the influence these indictors may have in the onset and progression of chronic illnesses. However, much of these data focus on the effect of race and health, as social determinants, but fail to adequately address the myriad other factors (e.g., health care, social and community context) that influence the social patterning across the life course. This symposium presents findings from several studies highlighting the nuanced role of SDoH across diverse populations of older adults. Scholars will present findings on the influence that identified determinants, such as social networks, lifestyle behaviors, and gender, have in defining health outcomes across the life course. Minahan presents the relationship between chronic illnesses and depression and compares depressive symptomatology according to disease cluster in a nationally-representative sample of older adults. Atakere discusses determinants of well-being among African American males with chronic illnesses and the challenges associated with this marginalized population. Booker examines spirituality as a mechanism for pain management among older African Americans and presents this as a crucial determinant of health. This symposium will expand on the existing body of literature by emphasizing social and cultural determinants, aside from race, that influence health behaviors and outcomes across the life span.
MULTIMORBIDITY IN OLDER ADULTS: CAN DISEASE CLUSTER PREDICT DEPRESSION SEVERITY?
Authors: Minahan Jacquelyn
Published: November 2019

Multimorbidity, defined as the co-occurrence of two or more chronic conditions, is positively correlated with depression severity among older adults. However, few studies have compared depression outcomes by disease cluster. To address this gap, secondary data analyses were performed using data from the National Social Life, Health, and Aging Project (NSHAP), Wave 2. For the purpose of this study, disease clusters are composed of conditions that implicate similar body systems (e.g., musculoskeletal system, cardiovascular system). Participants reported an average of 2.69 (+/- 1.97) chronic conditions. Multimorbidity and depressive symptom severity, as measured by the Center for Epidemiological Studies – Depression, Iowa Form (CES-D) were positively associated (p<0.001). Individual disease clusters, age, self-identifying as female, and lower educational attainment were predictive of depressive symptom severity (p<0.001). Findings support the necessary inclusion of social determinants (health status, gender, education, age) in the conceptualization of health and health outcomes within an aging population.
POLICY SERIES: INTERDISCIPLINARY PUBLIC POLICY DISCUSSION SESSION
Authors: Harootyan Linda K , Lindberg Brian W
Published: November 2019

This session, organized by the GSA Public Policy Committee, will provide both GSA section leadership and attendees an opportunity to have an open dialogue on important public policy issues of significance to the aging population. Section leaders will discuss key policy issues of particular relevance to their section’s mission and purpose. They also will comment on improving physical and mental health to illustrate how their different disciplines and perspectives inform and apply to public policy on that issue. This will be an interactive session with plenty of opportunity for audience feedback and input.
PUBLIC POLICY ISSUES OF SIGNIFICANCE IN SOCIAL RESEARCH, POLICY, AND PRACTICE
Authors: Harootyan Robert
Published: November 2019

This presentation will cover public policy issues of significance to the aging population, focusing on the perspective of the social research, policy and practice community and on policies that may improve physical and mental health.
IS AGING AN ACQUIRED MITOCHONDRIAL DISEASE?
Authors: Bitto Alessandro
Published: November 2019

Mitochondrial dysfunction is a hallmark of aging, but severe mitochondrial dysfunction leads to rare childhood disorders such as Leigh Syndrome. This session explores the similarities and differences between normative aging and mitochondrial disease and the potential for interventions to positively impact both conditions.
THE ROLE OF AMBIVALENCE ON WELL-BEING OF AGING PARENTS WHO HAVE A DISABLED CHILD: MULTILEVEL MEDIATION APPROACH
Authors: Namkung Eun Ha
Published: November 2019

According to the family systems theory, strains from parenting an adult with disabilities may spillover to parents’ relationships with their other children and disrupt family dynamics and their well-being in later life. This study examined whether parental ambivalence toward their non-disabled children is greater in families of adults with disabilities [developmental disabilities (DD) or serious mental illnesses (SMI)] than families without an adult child with disabilities. The study also investigated whether ambivalence mediates the associations of having an adult child with DD or SMI on parents’ health. Data were from the 2011 Wisconsin Longitudinal Study in which aging parents (Mage = 71; n = 6,084) were asked about their relationship with each of their adult children. Multilevel regression models and multilevel structural equation models (MSEM) were estimated to analyze the data. Our findings showed that parents of an adult with SMI felt greater ambivalence toward their non-disabled adult children than comparison group parents of adults without disabilities, whereas no significant differences were found between parents of an adult with DD and comparison group parents. Parental ambivalence toward their non-disabled adult children played a significant indirect role in the negative association between having a child with SMI and parental physical and mental health, after adjusting for parent- and child-characteristics associated with parental health and/or ambivalence. The findings have implications for clinical practice with aging families of adults with disabilities and suggest the need for additional research to better understand intergenerational dynamics in these families.
DOES AUGMENTATION OF MITOCHONDRIAL THIOREDOXIN REDUCTASE 2 IMPROVE METABOLIC FITNESS?
Authors: Chocron Sandra , Pickering Andrew
Published: November 2019

Mitochondrial Thioredoxin Reductase (TrxR2) is a rate limiting enzyme in the mitochondrial thioredoxin system which serves as one of the major mitochondrial ROS scavenging pathways. Txnrd2 is also a repressor of the ASK-1 oxidative stress induced apoptotic pathway. Our group previously identified a correlation with the expression of this protein and long-lived species and its overexpression prolonged lifespan in Drosophila. We have generated a TrxR2 transgenic (T-tg) mouse which has ubiquitously heighted (two-fold) TrxR2 expression. We found that overexpression of TrxR2 leads to enhanced mitochondrial metabolism and increased resistance to mitochondrial oxidative damage in MEFs (data not shown). We also found that female T-tg mice showed a leaner trend and reduced food consumption, with improved glucose tolerance but no difference in insulin sensitivity. These mice showed a lower Oxygen consumption and CO2 production with lower energy expenditure in individual metabolic cages. We further tested their exercise capacity where T-tg mice had a similar performance to control mice. These results suggest that TrxR2 overexpression can lead to some beneficial metabolic changes that need to be further understood. (Acknowledgments to Nathan Shock Lifespan assessment Core for the help developing all these assays in mice).
THE ROLE OF FRAILTY IN DEMENTIA EXPRESSION: EVIDENCE FROM CLINICAL-PATHOLOGIC COHORT STUDIES
Authors: Wallace Lindsay M , Theou Olga , Andrew Melissa K , Bennett David , Brayne Carol , Rockwood Kenneth
Published: November 2019

A growing body of evidence suggests that pathological features of dementia are diverse and don’t wholly explain variability in dementia incidence. Objective: discuss the role of frailty in dementia expression using evidence from clinical-pathologic cohort studies. Methods: Cross-sectional relationships between neuropathology (Braak, CERAD staging), frailty (frailty index at last study visit before death), and dementia diagnosis at death were performed using data from the Rush Memory and Aging Project (MAP) and the Cambridge City Over 75s Cohort study (CC75C). Results: Participants were 89.7±6.2 and 92.2±4.5 years in MAP (n=451) and CC75C (n=177) and mostly female (69.4-70.1%). Most had dementia (52.8%-59.3%). Frailty was normally distributed (mean FI0.42±0.18 in MAP and 0.34±0.16 in CC75C). Frailty was associated with dementia in MAP (OR=1.88, p<0.001) and CC75C (OR=1.30, p=0.03) after controlling for age, sex, time to death, and neuropathology. Longitudinal analysis is in progress. Frailty appears to play a meaningful role in dementia expression.
LESSONS LEARNED FROM ACCREDITING GERONTOLOGY PROGRAMS: GETTING READY!
Authors: Sterns Harvey L , Hahn Janet S
Published: November 2019

Accreditation for Gerontology Education Council (AGEC) is an organization that collaborates with, but is independent from the Gerontological Society of America and the Academy for Gerontology in Higher Education. It is directed by a Board of Governors consisting of nine members representing higher education gerontology programs and entities associated with the field of aging. The organizational structure also includes review teams, site visitors, and staff support. Higher education degree granting programs in gerontology, specifically associate arts degree, baccalaureate degree, and master’s degree programs, are eligible to apply to AGEC for accreditation. This symposium will have presentations that focus on Overview and Experiences to Date that will describe the accreditation process and what has been learned by the accreditation of the first three degree programs. The second presentation will focus on How and Why to Apply for Accreditation and will provide background information on the steps and processes necessary to submit for the accreditation review with clarification updates. The third presentation will provide lessons learned from our first reviews with suggestions on Preparing the Self- Study and will include guidance on approaches to be taken. The fourth presentation is also lessons learned with a focus on Mapping the Competencies as part of the Self Study. Symposium presenters share important information to encourage gerontology degree programs to apply for AGEC accreditation.