bluuebunny/crossref_metadata_2025 huggingface dataset:
EVALUATING THE IMPACT OF THE ALZHEIMER’S ASSOCIATION HELPLINE
Authors: Hodgson Nancy , Talwar Sonia , Huang Liming , Finegan Kerry , Fazio Sam
Published: January 2025

Most persons living with dementia in the US live at home and are supported by family. The Alzheimer’s Association national Helpline offers free 24/7 support, including telephone care consultations. Three iterative studies evaluating the Alzheimer’s Association Helpline were conducted between January 2019 and December 2023. The first study compared the benefit of the Helpline Care Consultation to a Care Consultation Plus program on the emotional and mental health of 445 callers (75% White, 80% women). The second study compared outcomes in 1822 callers (75% White, 79% women) randomly assigned to staff who provided the traditional care consultation model, or those trained in a brief solution-focused approach. The third study (2503 callers – 80% women, 73% White) evaluated the efficacy of up to two additional care consultations. In all three studies, we observed statistically significant improvement in self-efficacy in managing emotions. In the first study, callers’ mental health and self-efficacy improved significantly. In the second study callers assigned to the solution-focused approach had higher therapeutic alliance than callers assigned to the traditional care consultation. The self-efficacy scores in the third study were significantly lower in callers that requested an additional. Self-efficacy improved significantly in those who opted for one or two calls. Support services provided via the Helpline can be very effective at improving caregiver self-efficacy, managing emotions and ability to take action. Additional research is indicated to understand the diverse needs of caregivers and what types of supportive services work best for Helpline callers.
USER CHALLENGES AND PREFERENCES FOR VOICE INTERFACE DESIGN ON SMART SPEAKERS AMONG LOW-INCOME MINORITY OLDER ADULTS
Authors: Chung Jane , Mansion Natalie , Viceconte Madeleine , Syros Reiley , Winship Jodi
Published: January 2025

Voice-assisted smart speakers offer benefits for independent living and wellness, particularly for individuals with mobility disabilities, vision impairments, or dexterity issues. Voice user interfaces (VUIs) integrated into smart speakers enable hands-free and eyes-free interaction, allowing users to perform tasks through voice commands. Despite increasing research on older adults’ adoption and interaction with voice-operated smart speakers, the specific usability challenges faced by low-income, minority older adults remain largely unexplored. We synthesized qualitative findings from two smart speaker-related projects, focusing on low-income, primarily African American older adults. Employing qualitative descriptive methods, including matrix analysis and content analysis, we explored usability issues and VUI design preferences. Overall, participants expressed positive experiences with hands-free interactions. However, some encountered difficulties due to a lack of instruction on using different buttons or specific commands to navigate to or exit certain functions. Users also experienced unintentional voice assistant activation, requiring careful command monitoring. While many participants were satisfied with the voice assistant’s gender, tone, and accent, occasional misunderstandings or actions that users do not comprehend have been noted. Participant interviews highlighted the significance of designing VUI that can be customized to accommodate users’ health conditions and speech abilities, given the prevalence of poorly managed chronic conditions and dental health issues among low-income minority older adults. This customization is essential to smart speaker adoption and use, as health outcomes such as stroke or missing teeth may affect users’ ability to pronounce certain words or articulate commands understood by the voice assistant.
CELL SENESCENCE AND MITOCHONDRIA: A MATTER OF LIFE OR DEATH
Authors: Passos Joao
Published: January 2025

Senescence is a multi-functional cell fate, characterized by an irreversible cell-cycle arrest and a pro-inflammatory phenotype, commonly known as the senescence-associated secretory phenotype (SASP). Emerging evidence indicates that accumulation of senescent cells in multiple tissues drives tissue dysfunction and several age-related conditions. This has spurred the academic community and industry to identify new therapeutic interventions targeting this process. Senescence is a complex and highly heterogenous phenotype and despite tremendous progress in recent years we are still far from fully understanding it. There is no single, stand-alone marker that allows the identification of senescent cells, posing a challenge to their identification and targeting. Mitochondrial dysfunction is an often-unappreciated hallmark of cellular senescence which plays important roles not only in the senescence growth arrest but also in the development of the SASP and resistance to cell-death. In my talk, I will first describe some of our recent efforts to accurately map senescent cells in different tissues, including the application of imaging methods involving artificial intelligence. Additionally, I will describe how mitochondria contribute to the development of senescence and resistance to cell-death. Finally, I will propose that a detailed road map of mitochondrial biology in senescence will be crucial to guide the future development of therapies targeting cellular aging.
GEROSCIENCE-DRIVEN THERAPIES TO TARGET HEALTHSPAN WITH AGING: CLINICAL IMPLICATIONS
Authors: Espinoza Sara , Gonzales Mitzi , Musi Nicolas
Published: January 2025

The geroscience hypothesis posits that by targeting aging we may simultaneously prevent or delay several age-related diseases and thereby increase healthspan, or lifespan spent free of significant disease and disability. Clinical trials of candidate agents are underway to examine several pharmacological interventions for this purpose. Beyond determining the safety of these agents, substantial work will be needed to determine the efficacy of these interventions on various domains of healthspan, i.e., physical function, cognitive function, frailty, disability, patient reported outcomes and health-related quality of life. Further, we will need consensus to identify the most meaningful and clinically relevant outcomes and biomarkers of target engagement to identify appropriate patient populations and monitor therapeutic response. It is likely that no single intervention will be broadly indicated, but agents will be tailored using an individualized, patient-centered approach. Larger pragmatic clinical trials will be needed to demonstrate efficacy beyond smaller, early phase clinical trials. Furthermore, any interventions for older adults must not inadvertently exacerbate existing medical comorbidities or geriatric syndromes, such as contribute to polypharmacy or cause side effects that outweigh any potential benefits. This will require that physicians and others providing medical care to older adults, the vast majority of which are not geriatricians, must be trained and knowledgeable in basic principles of geroscience and the use of such therapies toward the goal of improving healthspan (as opposed to the traditional single disease approach). Clinical practice guidelines specific to promoting healthspan in older adults may be needed to guide any future broad clinical use.
GAIT SPEED IMPLEMENTATION IN TWO GERIATRIC CLINICS IS CONSISTENT ACROSS PATIENTS AND VISIT TYPES
Authors: Baillargeon Emma , Jones Nancy , Rosso Andrea , Brach Jennifer
Published: January 2025

We are implementing gait speed assessment in two outpatient geriatric clinics of a large, academic hospital system in an ongoing quality improvement project. We trained rooming staff (Clinic A: n=5; Clinic B: n=4) to measure 4-meter gait speed using a stopwatch and document the measured speed, or reason for not measuring, in the electronic health record (EHR). The project has been active since 11/1/2023 in Clinic A and 1/19/2024 in Clinic B. EHR data are analyzed monthly to track progress; data through 2/29/24 are included here. We tested whether patient (age, sex) and visit (type, ICD-10) factors were associated with gait speed documentation (yes/no) and measured gait speed. Documentation was completed in 23-58% of visits-per-month for a total of 621 visits (542 patients) in Clinic A and 186 visits (173 patients) in Clinic B. Whether gait speed was documented was not associated with patient age (p=0.3), sex (p=0.2), or appointment type (p=0.2). Gait speed was negatively associated with patient age (R=-0.24, p<0.001) but did not differ by patient sex (p=0.2) or appointment type (p=0.5). Gait speed documentation was not associated with an abnormality of gait and mobility diagnosis (ICD-10 R26; p=0.8), but gait speed was slower in visits with this diagnosis (median (IQR): 0.60m/s (0.51,0.75)) than without (0.69m/s (0.56,0.86), p<0.001). Gait speed documentation is feasible and is being used similarly across patients and visit types. Ongoing data will be assessed as available to inform our goal of increasing the reach and adoption of gait speed assessment in geriatric primary care.
INTERVENTIONS TO IMPROVE GAIT SPEED
Authors: Brach Jennifer , Shuman Valerie , Perera Subashan
Published: January 2025

Numerous evidence-based interventions exist to treat patients’ mobility limitations once identified in primary care. We will present an overview, focusing on the Program to Improve Mobility in Aging (PRIMA) study as one example. Interventions to improve walking historically focused on underlying impairments, with modest improvements. We hypothesize mobility limitations are a result of the loss of motor skill in walking and timing and coordination exercises targeting the skill of walking are an essential component of a mobility intervention. Participants >64 years were randomized to the standard strength and endurance (STD, n=125) or standard-plus timing and coordination (PLUS, n=124) intervention, 50-60 minutes, twice a week for 12 weeks. Participants with slower initial gait speed (< 1.0m/s) in both groups improved gait speed after the intervention (STD: 0.111m/s, PLUS: 0.088m/s) and maintained those improvements at the 12-week follow-up (STD: 0.087m/s, PLUS: 0.086m/s). In contrast, participants who initially walked faster (≥1.0m/s) in both groups improved gait speed after the intervention (STD: 0.060m/s, PLUS: 0.074m/s) but only those in the PLUS intervention maintained those improvements at the 12-week follow-up (STD: 0.027m/s, PLUS: 0.052m/s). Individuals in the PLUS group who were most likely to improve had better baseline endurance (longer six-minute walk distance) and were more active (greater activity counts by actigraphy) than those who did not improve. Both interventions improved gait speed. Faster walkers and those with greater capacity (i.e., endurance and activity level) may need the challenge of the timing and coordination component to become motor experts in walking and sustain treatment benefits.
USING GENERATIVE AI TO ENHANCE BEHAVIORAL INTERVENTIONS FOR CARE PARTNERS OF OLDER ADULTS
Authors: Washington Karla , Demiris George , Huh-Yoo Jina , Rezapour Rezvaneh , Wang Lu , Aghakhani Elham , Song Max
Published: January 2025

Care partners play an essential role in providing long-term care to community-dwelling older adults, offering vital support to individuals who require or desire assistance with instrumental and other activities of daily living. However, care partners’ responsibilities often entail significant physical, emotional, and financial strain, resulting in compromised health and well-being. Numerous studies support the efficacy of behavioral interventions in reducing the deleterious health outcomes often associated with serving as a care partner, but the resource-intensive nature of many such interventions introduces numerous implementation barriers. This presentation will explore the promise and potential pitfalls of using generative AI to enhance the delivery of behavioral interventions for care partners of older adults. Presenters will supplement a review of relevant literature with specific examples drawn from their own research using a large language model (ChatGPT 3.5) to enhance the delivery of PISCES (Problem-solving Intervention to Support Caregivers in Everyday Situations), a cognitive-behavioral intervention developed for care partners of older adults with serious illness. Generative AI’s potential as a tool to deliver the intervention’s psychoeducational content and also to monitor intervention fidelity demonstrated by human interventionists will be described, as will researchers’ intentional efforts to ensure the tool does not perpetuate problematic (e.g., ageist) perspectives based on an analysis of 250 transcribed intervention sessions used to train it. The presentation will conclude with actionable practice recommendations that harness the potential of this rapidly emerging technology in an ethically sound manner that enhances the equitable delivery of evidence-based care partner support for all.
THE ERA OF CHATGPT: RECOMMENDATIONS FOR THE INTEGRATION OF LLMS IN GERONTOLOGY
Authors: Friedman Ari
Published: January 2025

Large language models (LLMs) and the platforms they support such as ChatGPT have experienced an exponential growth in popularity and use in the last year. ChatGPT surpassed100 million users in just two months after it was released to the public. These technological advances introduce opportunities for health care applications and it is anticipated that LLMs and various chatbot applications may significantly redesign clinical and health related processes and services. More specifically, in the space of gerontology, the use of Generative AI is anticipated to inform applications including automating clinical decision making, and even predicting cognitive decline based on end user data, providing digital companionship chatbots for isolated older adults, processing and increasing the accessibility of health education material and assisting in the documentation of care transitions. Rather than aiming to anticipate how companies will use LLMs to disrupt the field of gerontology, we have the opportunity and responsibility to define how ethical and appropriate gerontological care will shape the training of LLMs and the creation of guidelines for the use of Generative AI in gerontology. In December 2023 a group of national experts in the fields of gerontology, LLMs, AI and bioethics convened with the goal to propose guidelines to inform appropriate use of LLMs for systems that target older adults and persons with dementia and recommendations for the promotion of transparency in the design of LLMs for gerontology. This presentation will provide insights into these recommendations and guidelines for the role of LLMs in gerontology.
PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH AND WITHOUT HIV IN UGANDA: COHORT STUDY IN RURAL UGANDA
Authors: Ratnayake Aneeka , Tong Yao , Reynolds Zahra , Chamut Steffany , Paul Robert , Tanner Jeremy , Olivieri-Mui Brianne , Siedner Mark
Published: January 2025

Studies from high-income countries have established the benefits of physical activity (PA) for health among older people. Yet, PA and its links to frailty and quality of life (QOL) in older rural African populations living with HIV remain under-explored. We analyzed data from the first three annual assessments in a cohort of older people living with HIV (PLWH) and age- and sex-similar, community-based people not living with HIV. PA was measured through self-reported minutes of moderate and vigorous PA, converted into metabolic equivalent of task (METs). PA adherence to World Health Organization (WHO) guidelines was defined as a minimum of 150 minutes of moderate PA or 75 minutes of vigorous PA weekly. Linear and logistic generalized estimating equations (GEE) regression models were employed to estimate the association between HIV status and PA, adjusting for frailty, QOL, comorbidities, and age. At enrollment there were 297 PLWH and 302 people not living with HIV, 304 men and 295 women, with a median age of 58 years (IQR:54-63); 96% met PA guidance. After multivariable adjustment, PA in METs was associated with younger age (b=-187.18 per year, p<0.0001), HIV infection (b=-1039.12, p=0.041), higher health-related QOL (b=38.05 per point on a 0-100 scale, p=0.034), frailty (b=-2661.24, p=0.028), and medical comorbidity (b=-2208.07, p<0.0001). Guideline-concordant PA was inversely associated with frailty (OR:0.27, p=0.0076) and medical comorbidity (OR:0.43, p=0.0069). Correlates of lower PA were older age, living with HIV, frailty, and medical comorbidity. Those with frailty and medical comorbidity may not be benefitting from recommended levels of PA.
INCREASING DEMENTIA DETECTION IN HEALTH CARE SYSTEMS: LEARNINGS FROM THREE PRAGMATIC CLINICAL TRIALS
Authors: Dublin Sascha , Barnes Deborah , Ling Shari
Published: January 2025

In the US, an estimated 6.7 million older adults have dementia, yet only about half have received a diagnosis. Earlier detection has potential to improve health and quality of life for people living with dementia and their caregivers by improving access to education, supportive services, and emerging treatments. The National Institute on Aging has funded pragmatic clinical trials of innovative, low-cost approaches aimed at increasing recognition of dementia within healthcare systems. In this symposium, we will present methods and early results from 3 such trials. The eRADAR study is applying a machine learning-based algorithm that draws on electronic health records (EHR) data to identify high-risk individuals. The intervention involves inviting high-risk individuals in the intervention arm for a “brain health” assessment visit within primary care. The D Cubed Study is testing two approaches: an EHR-based algorithm, the Passive Digital Marker, and a brief patient-reported questionnaire, alone and in combination. Results are shared with primary care providers via the EHR together with next steps for evaluation. The Toolbox Detect study is examining whether self-administered, brief cognitive screening tests given via tablet computers as part of annual wellness visits can increase dementia detection. Investigators leading these trials will describe their interventions and study methods and present early results related to uptake, feasibility and acceptability. They will also discuss challenges encountered, potential solutions, and lessons learned. A major goal will be to engage audience members to consider how they might apply these methods to increase detection of dementia in their own settings.
DIGITAL DETECTION OF DEMENTIA (D CUBED) TRIALS
Authors: Boustani Malaz , Fowler Nicole
Published: January 2025

At Indiana University, we leveraged electronic health record (EHR) data and Machine Learning algorithms to develop a Passive Digital Marker (PDM) for dementia detection with 80% accuracy. At the University of Miami, we developed the Quick Dementia Rating Scale (QDRS) as a 2-3 minute patient-reported outcome tool with 85% accuracy for dementia diagnosis. Two pragmatic cluster-randomized controlled comparative effectiveness trials randomized primary care clinics to Usual care, PDM alone, and both the PDM and the QDRS. Trials recruited diverse rural, suburban and urban primary care practices located in central Indiana and south Florida. The positive results are communicated via the EHR only to clinicians within the PDM and PDM + QDRS clinics during an ambulatory primary care visit. The primary outcome measure is the annual rate of new documented dementia diagnosis. In the first year, the Indiana trial enrolled 5960 older patients with a mean age of 71.9 years and SD of 6.50, 61% were female and 51% were African American. In the clinics that were randomized to PDM + QDRS, there were 827 patients who completed at least one question on the QDRS. The Indiana trial used a non-interruptive Best Practice Alert (BPA) for the first year of operation. For the second year of operation, the trial coupled the BPA with an InBasket message to primary care physicians to overcome the shortcoming of the Non-interruptive nature of the BPA. We have created an IT implementation manual to deploy the PDM with minimum expertise.
INTEGRATING VIRTUAL REALITY DEMENTIA SENSITIVITY TRAINING INTO THE UNDERGRADUATE CURRICULUM
Authors: Shovali Tamar
Published: January 2025

There is a need for Age-Friendly endeavors to include dementia-inclusive educational opportunities in higher education. Given the rising aging population, undergraduate students increasingly will (a) have personal experiences with loved ones diagnosed with dementia or Alzheimer’s disease, (b) pursue careers in the field of aging and directly work with individuals with dementia or Alzheimer’s disease, or (c) indirectly work with individuals with dementia or Alzheimer’s disease and their caregivers through roles in various professions such as finance or law. Undergraduate students in a gerontology course at an Age-Friendly University engaged in a dementia inclusive virtual reality training intended to sensitize individuals to the needs of people living with dementia. Virtual reality experiences related to dementia can help build empathy towards daily challenges faced by people living with dementia. Prior to and after engagement in the session students were asked questions about their understanding and empathy for people with dementia and their caregivers. Small group discussions followed the session to prompt reflection, encourage critical thinking, and facilitate discussion on the impact and lessons learned from the training. This experiential learning was preceded by an interactive lecture about the basics of Alzheimer’s disease and dementia delivered by a Community Educator from the Alzheimer’s Association. Age-Friendly University principles provide a guideline for the many ways higher education can shape age inclusive teaching and learning environments that promote greater empathy and understanding for people living with dementia or Alzheimer’s disease and their caregivers.
IMPACT OF STATE-LEVEL FACTORS ON CONSUMER-REPORTED UNMET NEEDS IN HOME AND COMMUNITY-BASED SERVICES
Authors: Parikh Romil , Shippee Tetyana , Langworthy Benjamin , Wang Zheng , Jutkowitz Eric , Giordano Stephanie
Published: January 2025

In the value-based purchasing framework, provider-specific quality indicators are often compared with national average estimates to measure performance. Hence, it is important to elucidate the impact of state-level administrative factors on consumer-level quality indicators for their national use. Therefore, we evaluated associations of state-level factors (from publicly reported data) with consumer-reported service-specific unmet needs for six commonly used home and community-based services (HCBS) from the NCI-AD data (2015-2019, n=23,333 community-dwelling older respondents; age, ≥65 years). We fit a mixed-effects logistic regression model for unmet needs in each of six HCBS; adjusting for state ID random effect, consumer-level health and demographic fixed effects, and four state-level fixed effects including HCBS spending relative to institutional care spending, percent managed care population, HCBS spending per client, and Medicaid expansion. To evaluate whether addition of these 4 state-level fixed effects improved model fit, we evaluated improvement in the Akaike Information Criterion, for each of six HCBS. A 10% increase in the proportion of managed care population in state was significantly associated with greater odds of consumer-reported unmet needs in personal care (Odds Ratio [OR], 1.37, p<0.01), homemaker services (OR, 1.74, p<0.001), and transportation services (OR, 1.22. p<0.05). There were no significant associations between other state-level factors and service-specific unmet needs. Addition of the four state-level factors improved model fit for personal care, homemaker, meal delivery, and transportation services, and worsened model fit for adult day and caregiver-respite services. State-level factors likely have very little impact on consumer-reported unmet needs as an HCBS quality indicator.
WORKING THE SCHOLAR-ACTIVIST HYPHEN: QUEER GERONTOLOGY PERSPECTIVES FROM OLDER BLACK LESBIANS
Authors: Oswald Austin
Published: January 2025

The LGBTQ+ aging population is growing increasingly racially and ethnically diverse; however, older adults of color are underrepresented in LGBTQ+ aging research. This significant gap in the field constitutes a critical ethical issue that future scholarship must address. Advancing LGBTQ+ aging research necessitates a heightened focus and specificity on subgroups, particularly those with intersecting marginalized identities, while generating knowledge that challenges structural oppression. This presentation sheds light on insights gleaned from an ongoing, multi-year participatory action research project aimed at addressing gaps within contemporary LGBTQ+ aging research by highlighting the needs and experiences of LGBTQ+ older adults of color within an age-friendly city. Five older Black lesbian women, aged between 65 and 75, actively participated in designing, implementing, and evaluating a research project that analyzed data from public records and focus groups. Findings emphasize three fundamental principles of queer gerontology, providing tangible examples of community-engaged scholarship that researchers can utilize to advance the field of LGBTQ+ aging. This includes strategies aimed at deepening visibility and awareness of underrepresented subgroups through an intersectional lens, applying critical perspectives to challenge dominant frameworks that narrowly define old age and aging through heterosexual and gender norms, and combating oppression and injustice through activist-scholarship committed to real-world change. The insights from this presentation underscore the imperative for inclusive, community-engaged scholarship to advance our understanding of LGBTQ+ aging, promote social justice, and effect meaningful change in the lives of older LGBTQ+ adults with multiple intersecting identities.
USING CREATIVE NARRATIVES AND VISIONS OF LATER LIFE TO QUEER GERONTOLOGICAL SCHOLARSHIP
Authors: Jen Sarah
Published: January 2025

Queering gerontology calls for more diverse and inclusive visions of old age, including those that resist normative ways of being. LGBTQ people have particular contributions to make to this project given their experiences of non-normative life events, sequences, and desires. This study presents a secondary qualitative data analysis, drawing from two existing datasets (13 life reviews with older bisexual-identified women and 40 creative narratives published in Bi Women Quarterly). The analysis examines queer and non-normative visions and experiences of aging from the perspective of queer and trans individuals across the life course. The findings are examined through the lens of three principles of queer gerontology, illustrating the potential of queer and creative visions of aging to reimagine the potential of gerontological scholarship. Notably, the creation and dissemination of queer narratives of aging and later life deepen visibility and awareness of diverse and marginalized experiences while also offering new and creative ways of imagining later life for all populations. The examined narratives engage critical perspectives, often dispelling normative ways of being through camping up, resisting, or queering notions of self, kinship, life and death, and the narrative form. Narratives also illustrate the engagement of multiple epistemologies, creating potential for more creative modes of inquiry, including creative writing and imagery, in envisioning later lives. These findings indicate the potential of revisiting existing data through the lens of queer gerontology principles to illuminate the possible forms queer gerontological scholarship could take, both empirical and conceptual.
OPTIMIZING STAFF RECRUITMENT AND RETENTION IN CARE HOMES: WHAT WORKS? THE REACH REALIST REVIEW
Authors: Devi Reena , Haunch Kirsty , Spilsbury Karen , Dalkin Sonia , Bate Angela , Jones Liz , Goodman Claire , King Natalie
Published: January 2025

Solutions for sustaining the social care workforce need to a) consider the different factors which influence staff experiences, b) recognize the nuances between different care settings, and c) differentiate between staff groups (e.g. age, levels of experience). At the University of Leeds, we led research which uses a realist synthesis approach to reviewing international academic and grey literature and contributions from sector stakeholders to develop theories. The results identified strategies used in care homes to attract, recruit, and retain Registered Nurses and care workers, e.g., effective job interviews, opportunities for career development, rewards and recognition, flexible working options, and caring conversations. The strategies used to attract, recruit, and retain staff do not operate independently, they interact and work together. We brought the evidence-based programme theories together into an explanatory framework to explain how and why these strategies work, for which staff, the conditions needed for strategies to work, and the outcomes to be expected. The framework summarizes the different ways the strategies help with attracting, recruiting and retaining staff. For example, empowering staff through caring conversations and opportunities for career development; building and fulfilling a psychological contract to set accurate expectations of care work; and reciprocating positive experiences (when providing staff with positive experiences staff will reciprocate and respond positively (i.e. commitment and loyalty at work). We will summarize the full findings during the symposium. To the best of our knowledge, this is the first time a realist synthesis approach has been used to review the literature in this area.
IMPACT OF A NURSING INTERVENTION ON PHYSICAL ACTIVITY AND INDEPENDENCE IN NURSING HOME RESIDENTS
Authors: Bleijlevens Michel , den Ouden Mirre , Meijers Judith , Zwakhalen Sandra , De Vries Erica , Hamers Jan
Published: January 2025

DAILy nurse is a complex intervention that was used in changing the breakfast routine for nursing home residents. It was expected that nursing home residents would be more engaged and would perform more activities independently; furthermore, it was expected that nursing staff behavior would change towards encouraging residents and taking over fewer activities. A quasi-experimental design with a pre- and posttest in four nursing homes was utilized. Participants were 104 residents and 134 staff. Video recordings were used to observe primary outcomes: engagement and independence in breakfast activities, and nursing staff activities. Results showed that staff succeeded in changing the breakfast routine dramatically. Departing from a standardized breakfast moment (with sandwiches fully prepared, no choice for residents) in a rather sterile environment (e.g., no ambiance, empty tables, almost no interactions), the routine was changed into a breakfast moment where tables were set with breadbaskets, different types of sandwich filling and pots of coffee and tea. This enabled residents to prepare their own sandwich and to be engaged in this activity, which led to interactions between residents; and residents and staff. Video recordings, and perceptions of nursing home staff, indicated statistically significant improvement of the daily lives of residents during the breakfast moment. However, no effect was found in nursing staff behavior. In conclusion, this study showed that applying DAILy NURSE, led to more engagement and independence of residents. It should be emphasized that this was feasible without increasing the number of staff or the allocation of extra budgets.
INTRODUCING NURSES IN EXPANDED ROLES IN LONG-TERM CARE FACILITIES
Authors: Zúñiga Franziska , Kotkowski Kornelia , Guerbaai Raphaelle-Ashley , Brunkert Thekla
Published: January 2025

INTERCARE is a nurse-led care model introducing registered nurses in expanded roles (nurses with advanced education and training beyond the traditional scope of practice for registered nurses) into long-term care facilities (LTCFs) to strengthen geriatric expertise and reduce unplanned hospitalizations. INTERCARE nurses promote the core components of INTERCARE, such as interprofessional collaboration. INTERCARE was implemented in 11 LTCFs in Switzerland from 2018 to 2020 and tested in an effectiveness-implementation hybrid-type II design. Six months post-implementation, care staff (n=108) were interviewed about their perception of the INTERCARE nurse’s role. INTERCARE nurses (n=18) were interviewed at the end of the study to explore the content of their work and the factors supporting their role adoption. Staff reported high acceptability of INTERCARE nurses, feeling supported in daily practice and experiencing increased confidence in skills, such as responding to acute situations. INTERCARE nurses provided regular coaching to care teams in complex resident situations and guided interprofessional collaboration by supporting phone calls with physicians. They considered the ongoing training during the study as important to expand their clinical and leadership skills. Bi-weekly one-to-one coaching sessions, where they practiced analyzing and solving problems and additional exchanges with peers, were crucial in sustaining them in their challenging role. In conclusion, nurses in expanded roles provide a supportive environment for care staff to enhance their skills and provide quality care. Peer support and coaching are pivotal in sustaining these expanded roles in the demanding low-resource LTC environment.
SARCOPENIA: NO CONSENSUS, NO DIAGNOSTIC CRITERIA, AND NO APPROVED INDICATION HOW DID WE GET HERE?
Authors: Evans William , Cawthon Peggy
Published: January 2025

In addition to the role of skeletal muscle in movement and locomotion, muscle plays a critical role in a broad array of metabolic processes that can contribute to improved health or risk of disease. The age-associated loss of muscle has been termed sarcopenia. Muscle is the primary site of insulin-stimulated glucose disposal and the largest component of basal metabolic rate, directly and indirectly affects bone density, produces myokines with pleiotropic effect on muscle and other tissues including the brain, stores essential amino acids essential for the maintenance of protein synthesis during periods of reduced food intake and stress. As such, not surprisingly deterioration of skeletal muscle health, typically operationalized as decline of muscle mass and muscle strength is both a powerful risk factor and main consequence of chronic diseases, disability, and loss of independence, and it is one of the strongest risk factors for mortality. As a result, the development of pharmacological therapies to increase muscle mass (or prevent loss) an important goal for decades. However, while remarkable advances in the understanding of molecular and cellular regulation of muscle protein metabolism have occurred recently, there are no approved drugs for the treatment of sarcopenia, the loss of skeletal muscle affecting millions of older people The goal of this symposium is to describe the possible reasons for the lack of new and effective pharmacotherapies to treat one of the most important risk factors for age-associated disease and loss of independence.
SARCOPENIA: NO CONSENSUS, NO DIAGNOSTIC CRITERIA, AND NO APPROVED INDICATION HOW DID WE GET HERE?
Authors: Evans William
Published: January 2025

In addition to the role of skeletal muscle in movement and locomotion, muscle plays a critical role in a broad array of metabolic processes that can contribute to improved health or risk of disease. The age-associated loss of muscle has been termed sarcopenia. Muscle is the primary site of insulin-stimulated glucose disposal and the largest component of basal metabolic rate, directly and indirectly affects bone density, produces myokines with pleiotropic effect on muscle and other tissues including the brain, stores essential amino acids essential for the maintenance of protein synthesis during periods of reduced food intake and stress. As such, not surprisingly deterioration of skeletal muscle health, typically operationalized as decline of muscle mass and muscle strength is both a powerful risk factor and main consequence of chronic diseases, disability, and loss of independence, and it is one of the strongest risk factors for mortality. As a result, the development of pharmacological therapies to increase muscle mass (or prevent loss) an important goal for decades. However, while remarkable advances in the understanding of molecular and cellular regulation of muscle protein metabolism have occurred recently, there are no approved drugs for the treatment of sarcopenia, the loss of skeletal muscle affecting millions of older people The goal of this symposium is to describe the possible reasons for the lack of new and effective pharmacotherapies to treat one of the most important risk factors for age-associated disease and loss of independence.
WHO’S SARCOPENIC? AN ANALYSIS USING THE CANADIAN LONGITUDINAL STUDY ON AGING DATA
Authors: Phillips Stuart
Published: January 2025

A limitation of the sarcopenia definitions used in our analyses is the use of DXA measured ALM to approximate muscle mass. Although many consider ALM to be the reference standard for measuring muscle mass for sarcopenia, it is actually a measure of lean mass that includes organ tissue, water, and all other non-bone and non-fat soft tissues in addition to muscle mass. The results may be substantially altered if more accurate measures of muscle mass such as the D3-creatine method were used. We have reported that there is generally slight to moderate agreement (Cohen’s κ values of.00–.60) between most of the combinations of variables used to ascertain sarcopenia status recommended by the expert group definitions. For definitions using lean mass, the agreement between different adjustment techniques for lean mass ranged from slight to substantial. These findings were consistent across the range of cutoffs for each variable that are either observed in the literature or recommended by the expert group definitions for sarcopenia. The general lack of agreement between sarcopenia definitions observed in our study underscores the importance of the sarcopenia research community identifying a unified ascertainment method for sarcopenia. Having multiple definitions of sarcopenia identifying different groups of individuals as sarcopenic may hinder vital research developing clinical management strategies for sarcopenia by decreasing the comparability between studies.
A DETROIT-BASED COALITION TO PROMOTE EQUITY AT THE INTERSECTION OF HEALTH, HOUSING, AND AGING
Authors: Perry Tam , Draughn Melissa , Sanford Claudia , Archambault Dennis , Kilgore Zach , Watkins Michele
Published: January 2025

This presentation focuses on a multi-sector coalition focused on senior housing. Since its founding in 2013, Senior Housing Preservation-Detroit has worked tirelessly to address the displacement of older adults, the loss of senior housing as the city gentrifies; and ways to improve quality of life to those living in senior housing. This presentation will focus on the decade long work achieved respect among Detroit elected officials and housing staff through direct advocacy. Members have also testified at Detroit City Council meetings and participated in numerous local, state, national, and international forums on affordable housing for older adults. To date, coalition members have published four peer-reviewed articles; three invited articles; one white paper; and two book chapters as well as a documentary. The work of the coalition also involves numerous agencies serving older adults in Detroit. The Special Commission to Advance Macro Social Work awarded the coalition the Jack Rothman award for Structural Change in 2023. The presentation will focus on milestones, lessons learned, and the coalition’s COVID-19 outreach in senior buildings. It will offer perspectives on its current initiative on preparing an emergency preparedness plan for Detroit’s older population.
WEB-BASED PRESENCE FOR SOCIAL CONNECTEDNESS IN LONG-TERM CARE
Authors: Garnett Anna , Yurkiv Halyna , Booth Richard , Connelly Denise , Donelle Lorie
Published: January 2025

The COVID-19 pandemic and resultant restrictions on in-person gathering severely disrupted the social networks of older adults living in long-term-care homes (LTCH). Furthermore, the pandemic highlighted the need for embedded interventions such as web-based technology (WBT) to support social connectedness and well-being among older adults and their families. This qualitative study sought to explore how older adults living in LTCH, their family members and staff benefit from and envision WBT to support social connectedness. Semi-structured interviews were conducted with 22 family members, seven older adults and 10 staff across three LTCH. Data were analyzed using directed content analysis informed by Technology Acceptance Model. Participants predominantly used iPads, tablets, and phones to videoconference via Zoom, Teams, Facetime, or Skype. Older adults’ sense of social connectedness benefitted from their ability to visualize faces, observe non-verbal cues, perform lip reading, and follow the lives of their families outside of LTCH using WBT over conventional phone connections. In most cases, staff facilitated WBT use due to the older adults varied digital literacy, high rates of dementia and physical or visual limitations. Some family member participants found greater utility in videoconferencing technology called Portal and Alexa Echo Show which required limited navigation by the older adult. Henceforth, LTCH must adopt and implement technology that reflects the needs of people living in LTCH. In addition, adequate staffing, training, and funding is needed to enhance and sustain WBT use for the purposes of social connection among older adults in LTCH and their families.
THEORIZING FORTITUDE: MINDFULNESS
Authors: Rhoads Kristoffer
Published: January 2025

Normal and pathological aging both require a tremendous amount of resilience and fortitude. Successful aging also requires the ability to fully and accurately appreciate one’s past, rectified in the context of one’s present and future. Defined as the practice of intentionally cultivating non-judgmental awareness of the present moment, without criticism or evaluation, mindfulness practices offer a powerful tool to enhance acceptance of the “here and now” while cultivating compassion for the aging self and others. This presentation will briefly review the tenets and principles of mindfulness meditation as conceptualized implemented by Jon Kabat-Zinn, PhD and colleagues at the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Specifically, this presentation will explore applications to older adults with and without later life neurological disorders. This will include benefits of accepting one’s current abilities and strengths decoupled from comparisons to earlier life as well as disengaging from a catastrophic narrative of future losses. The presentation will also review the benefits of mindfulness practices for older adults living with memory loss and dementia, including how mindfulness meditation practices may interact with neurobiological underpinnings and risk factor modification of conditions such as Alzheimer’s disease, vascular dementia, depression and anxiety.
WHAT’S NEW IN AGING AND EMOTIONAL EXPERIENCE RESEARCH? NEW QUESTIONS, METHODS, AND SAMPLES
Authors: Stanley Jennifer , Allard Eric
Published: January 2025

Older adults tend to report greater control over their emotions and higher well-being, compared to younger adults (Carstensen et al., 2011). Evidence for this phenomenon is robust, but the mechanisms and boundary conditions of improved emotional experience with age are less well understood. This symposium presents four innovative papers that tackle these questions using new methods, asking new questions, and extending to new samples. First, Hamilton and Allard argue for the utility of estimating emotion networks for understanding age differences and similarities in the co-occurrence of emotions. Next, Kravljaca and Stanley investigated age differences in facial feedback effects when posing angry and happy facial expressions. Contrary to expectations based on the Maturational Dualism hypothesis (Mendes, 2010), both young and older adults exhibited increases in angry ratings following the posing of an anger expression. Then, Amanambu and Allard investigated whether specific facets of mindfulness relate to age-related decreases in negative affect in a lifespan sample in Nigeria. They found that the Describing facet mediated the relationship between age and negative affect. Overall, they report similar findings in the Nigerian sample to what has been shown in Western samples. Finally, Behrend and colleagues report an online study that explored whether young and older adults consider specific emotions useful for accomplishing social goals. Both age groups endorsed the most useful emotion for each type of goal, suggesting that there is age similarity in the knowledge of utilitarian emotions in the social domain. These papers present new frontiers in emotions and aging research.
SMILE, YOU’LL FEEL BETTER: TESTING THE FACIAL FEEDBACK HYPOTHESIS IN YOUNG AND OLDER ADULTS
Authors: Kravljaca Nikolina , Stanley Jennifer
Published: January 2025

We investigated age differences in the effect of facial feedback on the emotional experience on a sample of young and older adults. The Facial Feedback Hypothesis proposes that feedback from facial expressions impacts the emotional experience by enhancing or dampening the emotional experience (James, 1884; Darwin 1897). Embodied cognition, the bidirectional relationship between the mind and the body is central to maturational dualism, which suggests older adults show reductions in proprioception, interoception, and physiological reactivity (Niedenthal et al., 2005; Mendes, 2010). Based on this, we expected older adults to show reduced facial feedback effects. Participants were instructed to pose a happy, angry, and neutral facial expression and rate their happiness and anger on a 7-point scale before and during the facial manipulation. We found that in the Angry Condition, there was a main effect of Time, such that both age groups showed reductions in happiness scores, F(1,119) = 86.243, p<.001, η2=.420 and increases in anger, F(1,119) = 29.798, p<.001, η2=.200, as well as a Time x Age Group interaction, F(1,119) = 4.546, p<.035, η2=.03, showing that older adults had a larger decrease in happiness scores, but no age differences in feelings of anger. In the Happy Condition, we did not find any significant age differences in ratings of happiness or anger from pre to post while posing the happy or angry facial expression. Contrary to our hypotheses, these results suggest that older adults do experience facial feedback effects specifically for anger, but not happiness.