bluuebunny/crossref_metadata_2025 huggingface dataset:
BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA: DOES GENDER MATTER?
Authors: Galik Elizabeth , Boltz Marie , Resnick Barbara , Kolanowski Ann , Haitsma Kimberly Van
Published: November 2019

Regardless of presenting symptoms, there are concerns that BPSD is more often identified in males versus females and males are more likely to be treated with pharmacologic and non-pharmacologic interventions than females. In part this is due to the behaviors in men, specifically aggression, being more distressing for staff and more difficult to manage. The purpose of this study was to test for gender differences in identification and management of BPSD. This was a secondary data analysis using data from the EIT-4-BPSD study including 357 residents, 114 males and 243 females. Men had more aggressive behavior (p=.03) and women more refusal of care (p=.05) and repetitive verbal behavior (p=.03). Men received more mood stabilizers (p=.02) than women. Ongoing research is needed to evaluate if aggression in females may not be recognized or treated as aggressive women are less distressing for staff than these same behaviors in males.
PRESIDENTIAL SYMPOSIUM: MULTIDISCIPLINARY EMERGING PERSPECTIVES ON BUILDING AND MAINTAINING NETWORKS IN AGING.
Authors: Petrovsky Darina V , Justice Jamie N
Published: November 2019

This ESPO Presidential Symposium features a multidisciplinary perspective and recent scientific advances made by early career researchers from each of the GSA scientific sections. They will provide examples of how their work is addressing ways to build and maintain networks in aging and gerontological workforce. These talks will span research on the age-associated transcriptional networks (Biological Sciences, Kulkarni), enhancing care for persons with dementia using a professional healthcare network (Health Sciences, Kovaleva), ways to maintain care networks in nursing home residents (Behavioral and Social Sciences, Kennedy), exploring the impact of social isolation in older adults on the Autism Spectrum (Social Research, Policy, and Practice, Waldron) and reflections on a project that linked aging education and student involvement within the aging network at the state level (Academy for Gerontology in Higher Education, Stephenson). These talks will demonstrate the diversity of aims, strategies, methodologies, and tools employed across disciplines. In addition, these early career researchers will share how they use networks in their own disciplines to advance their science with the goal of building an independent program of research. We will conclude with a discussion on ways to identify synergies across different fields and promote strategies for successful cross-discipline collaboration.
AGING ON THE AUTISM SPECTRUM: AN EXPLORATION OF SOCIAL NETWORKS AND IMPLICATIONS
Authors: Waldron Danielle , Coyle Caitlin , Kramer John
Published: November 2019

Social isolation is associated with poor health and well-being in older adults. Little is known about isolation in persons aging on the Autism Spectrum (AS), a group with varied physical and mental health comorbidities. The purpose of this study was to explore social networks of adults aging on the AS. We conducted in-depth interviews (N=30) with adults on the AS (age 50+) and analyzed findings using a constant comparative method. Findings suggest that older adults on the AS struggle to build and maintain social networks over the life course, in large part, because of challenges with communication and trust. Implications of isolation include challenges with community supports and employment. We propose several social convoy models and intervention mechanisms to support this population--as their social networks narrow over time, and they face aging-related challenges without the buffer of strong social relations.
INTEREST GROUP SESSION—ENVIRONMENTAL GERONTOLOGY: PRECARIOUS AGING IN PLACE? CRITICAL PERSPECTIVES ON AGING IN CONTEXTS OF INSTABILITY
Authors: Finlay Jessica M , Yeh Jarmin C
Published: November 2019

Population aging and longevity in an era of immense environmental instability raises concerns about the precarity of aging and insecurity in later life. From home- and neighborhood-level insecurities to uncertainties generated by climate change or broad economic and sociopolitical upheaval across the globe, the factors contributing to instabilities relevant to older populations are heterogeneous in scale and cause. This symposium focuses on understanding older people’s needs and experiences in the context of unstable social, economic, political, and natural environments. The first paper investigates effects of socio-environmental disruption on the well-being, recovery, and resilience of older adults in Louisiana and Mississippi deeply affected by Hurricane Katrina. The second paper explores the confinement, exclusion, and loss of autonomy, as well as the creative negotiation and sociopolitical reclamation of space, among disabled older adults experiencing houselessness. The third paper discusses filmmaking with formerly homeless older adults as a method to engage marginalized individuals in community-based participatory research and better understand nuanced meanings of ‘home’. The fourth paper explores how transportation and technology can serve as both facilitators and barriers to accessibility and social connectivity among ethnically diverse low-income older adults. Altogether, the papers critically discuss novel scholarship and applied research in environmental gerontology from the micro to macro scale. The symposium inspires methodological innovation and critical research directions, and informs place-based policymaking to address diverse contexts of aging in place.
COMMUNITY-BASED PARTICIPATORY RESEARCH FILMMAKING WITH FORMERLY HOMELESS OLDER ADULTS
Authors: Burns Victoria F
Published: November 2019

This methodological paper discusses the process of co-creating a documentary film with seven formerly homeless older adults, highlighting some of the tensions carrying out community-based participatory research (CBPR). This paper is part of a larger study that explored ‘finding home’ through a series of individual and group audio and video-recorded interviews (including walk and drive alongs) with seven adults (aged 50+) with diverse homeless histories. In addition to the main findings, participants shared their experience of filmmaking and CBPR. Findings revealed four main tensions: 1) openness of sharing stories versus privacy and anonymity; 2) balancing participation/engagement and over-burdening; 3) negotiating interpersonal conflict and community building; and 4) ethical issues surrounding copyright and ownership of the film. Ultimately, we advocate for more CBPR film projects, as they not only provide a rich contextualized window into people’s everyday lives but serve to advance the voices of marginalized populations beyond traditional academic circles.
SOCIAL HEALTH, MOBILITY, AND TECHNOLOGY: ACCESSIBILITY WITHIN AGE-FRIENDLY COMMUNITIES
Authors: Gallo Haley B , Marshall Lia W , Levy-Storms Lené , Wilber Kathleen H , Loukaitou-Sideris Anastasia
Published: November 2019

To explore how access to transportation and technology/social media influence social connectivity among an ethnically diverse group of vulnerable low-income older adults, six focus groups were conducted (N=48) in English, Spanish, and Korean at a senior services agency. Qualitative thematic analyses revealed overarching themes that fit within the World Health Organization’s Age-Friendly Domains of Livability. The sub-theme “barriers and facilitators to accessibility” ran through each of the overarching themes, demonstrating how specific factors of the built, social, and community health environments intersect to promote or hinder social connection. Although transportation and technology uses were linked to social engagement, challenges with the built environment and limited financial resources hindered older adults’ abilities to remain engaged in their communities, both in-person and electronically. Age-Friendly initiatives must continue to consider the community-specific barriers and facilitators for older adults to remain physically and socially connected to the community.
CAN PERSONS WITH DEMENTIA MEANINGFULLY PARTICIPATE IN ADVANCE CARE PLANNING CONVERSATIONS? A MIXED-METHODS STUDY
Authors: Song Mi-Kyung , Ward Sandra , Hepburn Ken , Paul Sudeshna , Kim Hyejin , Morhardt Darby , Shah Raj C
Published: November 2019

Studies of advance care planning (ACP) in persons living with dementia (PLWDs) are rare. We conducted an intervention development study to adapt an efficacious ACP intervention, SPIRIT (Sharing Patient’s Illness Representations to Increase Trust), for PLWDs in early stages and their surrogates and assessed the feasibility/acceptability of the adapted SPIRIT. SPIRIT was adapted by the investigators and underwent expert panel review. The refined SPIRIT was then evaluated in a randomized trial with 23 dyads of PLWDs and their surrogates. Dyads were randomized to SPIRIT in-person (in a private room in a memory clinic) or SPIRIT remote (via videoconferencing from home). Participants completed preparedness outcome measures (dyad congruence on goals of care, patient decisional conflict, surrogate decision-making confidence) 2-3 days postintervention along with a semi-structured interview. PLWDs’ levels of articulation of end-of-life wishes during SPIRIT sessions were rated (3 = expressed wishes very coherently, 2 = somewhat coherently, 1 = unable to express wishes coherently). Fourteen PLWDs had moderate dementia, but all 23 were able to articulate their end-of-life wishes very or somewhat coherently during the SPIRIT session. While decision-making capacity was higher in PLWDs who articulated their wishes very coherently, global cognitive function did not differ by articulation levels. PLWDs and surrogates perceived SPIRIT as beneficial, but the preparedness outcomes did not change from baseline to postintervention in either group. SPIRIT for PLWDs and surrogates engaged them in meaningful ACP discussions. Further research is warranted to test its efficacy and long-term outcomes with a larger and diverse sample.
USING INNOVATIVE INTERGENERATIONAL STRATEGIES TO BOOST CAREERS IN AGING
Authors: Hanks Roma S
Published: November 2019

Educational pipelines are effective in medical education with minority student populations. The University of South Alabama has a successful medical pipeline in the NIH/NIMHD-funded USA Center of Excellence – but no formal pipeline to support entry into careers in aging. In Gerontology and Geriatrics, the preponderance of pipelines focuses on students in advanced degree programs. The need remains largely unmet to inform young students about careers and research pathways in Gerontology before career and academic plans are established. The USA Gerontology Club initiated a student-led outreach to deliver information about careers in aging and academic programs in Gerontology and Geriatrics to high schools in communities with high health disparities. The program seeks to develop peer relationships with high school students to introduce them to careers in aging and related academic opportunities. The presentation includes barriers identified and development of a multi-phased, multi-disciplinary model leading to a formal pipeline for Gerontology.
NARRATIVES ENHANCING TRAINEES’ ATTITUDES TOWARD AGING
Authors: Powers James S
Published: November 2019

We analyzed narratives from graduate students trained in aging themes who then interviewed older hospitalized adults about their life experiences. Three Discovery Fellows given a 90-minute training on open-ended interviewing, the medical care system, empathy, and aging themes derived from the Reframing Aging Program performed semi-structured interviews of 30-90 minutes. Subjects were hospitalized older veterans receiving care by an interdisciplinary geriatric rehabilitation team. Narratives were composed following the interviews and electronically uploaded to a secure site. Qualitative analysis was performed with each statement treated as a separate quote using a hierarchical coding system. A total of 774 codes were used to describe the themes present in 582 quotes. A conceptual framework from the narrative themes emerged with 5 groupings: 1) personal experience, 2) people important in life, 3) self-reflection, 4) medical condition, and 5) health maintenance. Concepts displayed included openness, compassion, and morality, as components of wisdom.
AGEISM AT WORK: A THEORETICAL AND EMPIRICAL CONSIDERATION
Authors: Vickerstaff Sarah A , van der Horst Mariska , Street Debra A
Published: November 2019

Ageism at work is becoming an increasingly popular research topic. It has been claimed that ageism is a serious threat to the extending working lives agenda that is prevalent in many Western countries, including the US and many countries in the EU. In this symposium, we consider this concept from a variety of perspectives in order to better understand what ageism is as well as how it affects older workers. To get a better grip on the concept, Sarah Vickerstaff and Mariska van der Horst look at the intersectionality of this concept, by assessing its relationships with gender and disability. Clary Krekula uses the concept of age coding to look at how both age normality and ageism are constructed. Jaap Oude Mulders assesses how age-related stereotypes translate into employment preferences of employers. Hannah Swift et al., testing social psychological theories, uses results from two experiments to analyse the role of ageism in recruitment practices. This symposium is inter-disciplinary combining sociologists, social psychologists and gerontologists and further combines quantitative (Jaap Oude Mulders), qualitative (Clary Krekula, Sarah Vickerstaff, and Mariska van der Horst) and experimental (Hannah Swift) methods. Together, the papers in this symposium show various dimensions of the concept ‘ageism’ and how it affects older workers in three European countries: Sweden, Netherlands, and the United Kingdom.
DOING AGE AS MARGINALIZATION AND EXCLUSION: ON AGE CODING AND THE CONSTRUCTION OF AGE NORMALITIES AND AGEISM
Authors: Krekula Clary
Published: November 2019

Early definitions of ageism as prejudice, attitudes and discrimination tend to stress the cognitive aspects of the processes where groups of people are being marginalized and/or excluded because of their age. This differ from recurrent studies which emphazise social categorization such as age and gender as a dynamic social positioning practice and as a complex form of doing age as marginalization and exclusion. Based on qualitative interviews with eleven men between the ages of 56 and 74, who work with manual labour at a steel company in Sweden, this paper discusses the processes where age normality and ageism are constructed in parallel. Departing from the concept age coding; distinctive practices associating a context or a phenomenon with demarcated ages, it shows the disciplining dimension of ageism. The paper concludes with a reflection on the central position which ageism can have in neo-liberal governance by creating social insecurity among older workers.
EMPLOYERS’ AGE-RELATED NORMS, STEREOTYPES, AND AGEIST PREFERENCES IN EMPLOYMENT
Authors: Mulders Jaap Oude
Published: November 2019

Social norms about retirement timing and stereotypes about qualities of younger and older workers are pervasive, but it is unclear how they relate to employers’ ageist preferences. Analyzing 2017 survey data from 960 Dutch employers, I study effects of employers’ retirement age norms and age-related stereotypes on their preferences for younger or older workers in three employment decisions: (1) hiring a new employee; (2) offering training; and (3) offering a permanent contract. Higher retirement age norms are related to lower preferences for younger workers in all employment decisions. More positive views about older workers’ soft qualities (such as reliability), but not about hard qualities (such as physical capacities), lead to managers being more favourable towards older workers for hiring and training, but not providing a permanent contract. The results show how ageist preferences of high-level organisational actors can influence outcomes in different employment decisions at the organisational level.
GENDERED AGEISM: OLDER WORKERS’ NARRATIVES ABOUT AGE
Authors: Vickerstaff Sarah A , van der Horst Mariska F
Published: November 2019

Existing research has highlighted that ageism in the workplace may take gendered forms with women ‘never being the right age’ (Duncan & Loretto, 2004). It is further known that individuals have internalised age stereotypes and self-stereotype when being older themselves, also referred to as stereotype embodiment. In this work place based study, through analysis of older workers talk, we examine the extent to which narratives of age differ by gender and work setting. The data base includes 185 participants in five different work settings and different kinds of jobs: blue collar, white collar, managerial, manufacturing and services sectors. Whilst many of the fears about ‘being old’ at work are common across women and men there are some distinct nuances related to the kind of work that people do and others that we argue are gender based.
TO WHAT DEGREE IS AGEISM ACTUALLY DISABLEISM? A QUALITATIVE STUDY
Authors: Horst Mariska van der , Vickerstaff Sarah
Published: November 2019

Ageism has been identified as a possible threat to the extending working lives agenda that is prevalent in many Western countries. It recently became a popular topic of research, but is not yet well understood. In this article we explore to what degree ageism is actually hidden disableism. We suggest that not all ageism is likely to be disableism, but a large part is, with the difference that it is not (necessarily) about actual impairments, but expected impairments. Using data from a large case study based project in the UK (containing 185 participants), we further assess to what degree older workers link ageism to disableism in their own accounts of future work plans. We conclude that even though we would still expect ageism to affect employment of older workers, without disableism it is unlikely that ageism would be as detrimental to the employment of older workers as it is now.
WHOM WOULD YOU HIRE? AGEISM IN ORGANIZATIONAL CONTEXTS
Authors: Swift Hannah , Dias Vanessa , Abrams Dominic
Published: November 2019

People want to work at older ages, yet ageism and discrimination remain a barrier. Using theories of prejudice, social role theory, and conceptual models of age diversity in organisational contexts, we explore age-bias in hiring practices (Study 1) and how to reduce it (Study 2). Study 1 (N=150) investigated pro-youth bias in hiring practices and how this manifests depending on job/occupation. Study 2 (N=150) investigated whether pro-youth bias is reduced by manipulating organisational culture. In both studies, participants were given a fictional organisation, a job ad, and two applicants’ profiles manipulated to represent men one each in their 30s and 50s. Study 1 supported the social role theory hypothesis: people match candidates to the age profile of the job. In the age-neutral job occupation participants chose equally between candidates. Study 2 supported the hypothesis that pro-youth bias can be mitigated when age-diverse nature of the organisational culture is made salient.
AGHE PROGRAM OF MERIT: HEALTH PROFESSIONS PROGRAMS OPPORTUNITIES
Authors: Gugliucci Marilyn R , Weinreich Donna
Published: November 2019

In 2015, the Program of Merit was expanded and adapted to implement a voluntary evaluation process for health professions programs that are choosing to integrate gerontology/geriatrics competencies in order to prepare students for working with older adults as well as their informal care partners. These programs are now eligible to apply for the Program of Merit designation. The Program of Merit for Health Professions Programs is based on the AGHE Standards and Guidelines for Gerontology/ Geriatrics in Higher Education, Sixth Edition (2015), specifically Chapters 11 and 12. This session will provide the information and support systems in place for health professions programs to be recognized with the AGHE Program of Merit designation.
GENDER DIFFERENCES IN DEPRESSIVE SYMPTOMS OF PATIENTS WITH END-STAGE LIVER DISEASE
Authors: Hiatt Shirin O , Lee John , Hansen Lissi
Published: November 2019

Background/aims: Similar to many chronic diseases, depression is common in patients with end-stage liver disease (ESLD), although gender differences are less known. Understanding the burden of depression in this population may help identify at-risk patients who would benefit from early intervention. The purpose of this work, therefore, is to describe gender differences in depressive symptoms in patients with ESLD. Methods: Patient data were collected as part of a larger study (NINR: 1R01NR016017-01). Patients (≥ 21 years) diagnosed with ESLD from the outpatient hepatology clinics of two healthcare systems in Pacific Northwest completed Patient Health Questionnaire (PHQ-9). Survey data were analyzed using descriptive statistics. Results: Sample included 154 participants, 101 males (65.6%), average age 57 years (SD=10.92), and 53 females (34.4%), average age 55 years (SD=11.28). More than 75% of the sample (78% females and 77% males) reported at least mild depression (PHQ score ≥ 5); mean PHQ-9 scores were higher for males (M=9.26±5.86) than females (M=9.10±5.07), but were not statistically different (U=2396, p=0.99). There was no significant relationship between depression severity and gender [X2 (4, N=147)=1.90, p=0.594]. Conclusion: Our study showed a high prevalence of depression in patients. A higher percentage of females reported mild to moderate depression and had higher clinically significant levels of depression (PHQ-9 score ≥ 10) than males, indicating females may be at a greater risk for depression. Females may, therefore, gain greater benefit from interventions to improve depressive symptoms. Future studies should examine the benefit of interventions on depression severity in this patient population.
UNIVERSAL FAMILY CARE: DECISION POINTS FOR STATES IN IMPROVING THE CARE INFRASTRUCTURE THROUGH SOCIAL INSURANCE
Authors: Veghte Benjamin , Bradley Alexandra L , Cohen Marc , Hartmann Heidi , Veghte Benjamin
Published: November 2019

This report presents policy options for a new social insurance program – akin to Social Security or Medicare – that would provide an integrated approach to protecting against the risk of needing to provide or receive care across the lifespan: Universal Family Care. The program would allow individuals and families to access caregiving supports at various points throughout the life course, from the arrival of a child to end-of-life care for a family member or oneself. The program covers three specific caregiving needs: long-term services and supports, paid leave, and early child care and education. This report identifies key design questions for states to consider in crafting a UFC program, outlines a range of vetted approaches, and describes the building blocks and tradeoffs involved. This analysis was developed during a year of deliberations by a Study Panel of 30 experts in care policies from a variety of perspectives.
FRAILTY
Authors: Addison Odessa
Published: November 2019

The ability to safely maintain mobility function with aging is critical as immobility and falls are among the top reasons for long-term care admissions. One potential cause for these functional deficits are muscle composition changes resulting in reductions in muscle mass, strength and power, ultimately contributing to the development of frailty. While the majority of work examining muscle composition and mobility changes with aging have focused on the quadriceps and ankle plantarflexor/dorsiflexor muscles, accumulating evidence suggests that deficits involving the proximal hip muscles may be particularly harmful to balance and mobility functions leading to falls, hip fractures, and frailty. We will discuss muscle changes that occur with aging and frailty, the implications on mobility, and the effects of potential exercise interventions on muscle structure and function as well as their ability to improve functional mobility.
AEROBIC TRAINING, THE DEFAULT MODE NETWORK, AND COGNITION IN OLDER ADULTS WITH MILD VASCULAR COGNITIVE IMPAIRMENT
Authors: Crockett Rachel A , Hsu Chun Liang , Barha Cindy , Hsiung Ging-Yuek Robin , Liu-Ambrose Teresa
Published: November 2019

Aerobic training has been shown to be effective at improving cognitive and brain outcomes in older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI). However, uncertainty remains regarding the underlying neurobiological mechanisms by which exercise elicits these improvements in cognition. Increased aberrant functional connectivity of the default mode network has been highlighted as a factor contributing to cognitive decline in older adults with cognitive impairment. Greater connectivity of the DMN at rest is associated with poorer performance on attention-demanding tasks, indicative of a lack of ability to deactivate the network on task. Our previous work on a randomized controlled trial of participants with mild SIVCI, demonstrated that 6-months of thrice weekly aerobic training led to improved global cognitive function, as measured by Alzheimer’s disease Assessment Scale-Cognitive subscale (ADAS-Cog), compared with a health education program. Thus, we conducted secondary analyses to investigate whether these changes in global cognitive function were associated with changes in resting state DMN connectivity. A subsample of 21 participants underwent a resting state functional magnetic resonance imaging (fMRI) scan before and after trial completion. Change in resting state DMN connectivity was found to significantly predict change in ADAS-Cog score (β = -.442, p=.038) after controlling for age, intervention group, and baseline functional capacity (R2=.467, F(4,16)= 3.507, p=.031). These findings suggest that functional connectivity of the DMN may underlie changes in global cognitive function. Furthermore, aerobic exercise is a promising intervention by which to elicit these changes in older adults with mild SIVCI.
IT’S ACTUALLY WORSE THAN IT LOOKS: IDENTIFYING ABUSE-RELATED INJURIES AMONG APS CLIENTS
Authors: Yonashiro-Cho Jeanine , Gassoumis Zach , Wilber Kathleen , Homeier Diana
Published: November 2019

While recent work has described elder abuse injuries seen in medical contexts, most abuse determinations are made by community-based health and social services practitioners in the field. Little is known about the types of injuries present among victims who do not seek medical care. The purpose of this study was to identify and describe injuries more likely to occur through abuse, rather than accidental injury, among older adults seen in non-medical settings. An observational, matched-comparison group design was used to compare findings among physically abused APS clients (n=61) with those from non-abused older adults (n=104) seeking usual-care in a Geriatrics clinic. Forensic nurse examiners conducted full-body examinations of subjects and collected data on injury diagnoses, locations, and characteristics. Descriptive statistics and bivariate tests of association were used to analyze differences in injury presentation between groups. Though 21.8% of APS clients had no observable injuries upon examination, as a group, they were more likely than non-abused elders to be injured (p<0.05) and had more injuries present (p<0.01). Abuse victims were also more likely to have at least one upper extremity abrasion (p<0.05) or a diagnosis of ecchymosis (p<0.01), swelling (p<0.05) or tenderness (p<0.05) in the head, neck, or maxillofacial region. Because physical abuse may not result in injury to victims, screening protocols are needed to improve abuse detection. The presence of injuries among older adults at-risk for abuse warrant further evaluation or queries from medical and social service providers, regardless of injury severity.
STAFF PERSPECTIVES ON COUNTERING STAFF-TO-RESIDENT MISTREATMENT IN LONG-TERM CARE FACILITIES
Authors: Couture Melanie , Alarie Milaine , Israel Sarita
Published: November 2019

In Canada, as well as in other countries, resident mistreatment is common in long-term care (LTC) facilities. In many situations, residents are mistreated by LTC staff. To address this problem, LTC facility managers and their employees must play an active role in the prevention as well as in the management of staff-to-resident mistreatment situations. However, it is still unclear what type of support they need to counter this type of mistreatment. Using an exploratory descriptive qualitative design, twenty-one managers and employees working in four different LTC facilities participated in semi-structured individual interviews. To allow participants to express themselves without risking self-incrimination or feeling pressured to report colleagues, vignettes depicting fictitious and common situations of staff-to-resident mistreatment were used as a conversation starter. Data analysis was performed using Miles, Huberman & Saldaña (2013) analytical method. Results show that participants think that staff-to-resident mistreatment is mainly caused by three staff characteristics: 1) not having the psychological profile to work in LTC facilities; 2) lack of training; and/or 3) being overworked. Consequently, participants believe that mistreatment prevention starts by improving employee selection practices to ensure candidates have adequate attitudes and training to work in LTC facilities. They also argue that staff should receive more training regarding mistreatment. Lastly, support interventions are suggested to prevent and address situations involving staff experiencing high levels of stress for personal or work-related reasons. This study shows that both individual and organisational measures are needed to fight against staff-to-resident mistreatment in LTC facilities.
THE USE OF ELDERCARING COORDINATION FOR RESOLVING CASES INVOLVING OLDER ADULTS AND HIGH-CONFLICT FAMILY DYNAMICS
Authors: Teaster Pamela B , Dolbin-MacNab Megan L
Published: November 2019

The Association for Conflict Resolution and The Florida Chapter of the Association of Family and Conciliation Courts developed a model of Eldercaring Coordination for use in guardianship/probate cases involving high-conflict family dynamics that interfere with the well-being and safety of an older adult, limit adherence to court orders, impede court processes, or detract from the efficacy of guardianship and other appointments by the court. Developed by 40 organizations and entities in the United States and Canada, Eldercaring Coordination focuses on improving family dynamics so that the older adult, family members, and other involved parties can better work together and with professionals to make thoughtful and informed decisions and to support each other during times of transition. The purpose of this research was to gather information about participant experiences with Eldercaring Coordination. A pre-post test design was employed in which data were collected from older adults or their surrogates, family members and other court-ordered participants, judges and court administrators, and the Eldercaring Coordinators themselves. Findings from post-tests of 23 judges and court administrators revealed that the most common advantages of Eldercaring Coordination were that the intervention prioritized the older adults’ needs and improved family relationships. Post-test surveys from 17 Eldercaring Coordinators indicated some positive outcomes for older adults and their families, but also a need for enhanced authority, greater support from attorneys, and more cooperation from participants. Preliminary findings support the assertion that Eldercaring Coordination holds promise for intervening in high-conflict court cases involving older adults.
DAILY EMOTIONS AND STRESS: AGE CHANGES AND DIFFERENCES
Authors: Blaxton Jessica , Bergeman Cindy , Wang Lijuan (Peggy)
Published: November 2019

Developmental processes differ between individuals (interindividual differences), fluctuate within them on a short-term basis (intraindividual variability), and change over time on a longer-term basis (intraindividual change; Nesselroade, 1991). We situate the relationship between stress and emotions in this process-oriented perspective by examining how the daily relationship between stress and negative affect (NA) as well as stress and positive affect (PA) change over time, while considering cross-sectional age and stress differences. Participants (N = 966) completed daily questionnaires assessing stress, NA, and PA. Three-level multi-level models depicted how cross-sectional age, within-person age changes, and global stress differences impact the daily stress-affect relationship. Findings illustrate that cross-sectional age and the aging process uniquely buffer the stress-NA relationship whereas global stress exacerbates it. Furthermore, older adults as well as adults with low global stress experience a weaker relationship between daily stress and PA as they age, but midlife adults and adults with high global stress experience a stronger relationship. These results depict differences in aging trajectories for both midlife and older adults and thus inform intervention and preventative care strategies aimed toward promoting emotional well-being, suggesting that targeting these strategies at the daily level can promote better stress regulation. Furthermore, we see that midlife adults and adults with greater global stress perceptions are most in need of these interventions, and encouraging these adults to maintain PA in the face of daily stress can be particularly beneficial.
LINKING FAMILY TRANSITIONS AND LATER-LIFE DEPRESSION: DOES LIFE-COURSE SOCIOECONOMIC STANDING MATTER?
Authors: Recksiedler Claudia , Cheval Boris , Sieber Stefan , Stawski Robert S , Cullati Stephane
Published: November 2019

Research documented the impact of marital transitions—particularly marital loss—on depression in old age, yet its severity depends multiple factors. Individuals’ capability to cope with transitions depends on available resources and previous exposure to stressors, such as early-life adversity, which buffers or aggravates the impact of marital transitions on later-life depression. Although studies documented the pivotal link between early-life adversity and negative health trajectories, our study is the first attempt to examine whether early-life adversity influences the relationship between prospectively-tracked, later-life marital transitions and depression. We drew data from SHARE, which samples individuals aged 50+ across Europe (N = 13,258; 2004-2016). Using multilevel linear models, we found that women who became widowed had higher levels of depression compared to coupled and single women, but experienced lower increases in depression over time. After adjusting for early-life and adulthood SES, losing a partner remained significantly associated with depression. Life-course SES was associated with levels of depression, yet interactions between marital transitions and SES were not, with some exceptions: single women who reported difficulties in their ability to make ends meet experience higher increases of depression over time. Overall, results were similar for men. Interactions between family transitions and SES were again not significant, with a few exceptions for single men: those born in more childhood conditions, and those with high education, had lower levels of depression. We interpret and discuss our findings through the lens of life-course and stress-resiliency perspectives and in light of changing family dynamics for this age group.
COMPONENTS OF A HEALTHFUL DIET ARE ASSOCIATED WITH WAIST CIRCUMFERENCE AMONG PRE- AND POSTMENOPAUSAL WOMEN
Authors: Troy Lisa M , Witkowski Sarah
Published: November 2019

After menopause, women are at increased risk of diabetes and cardiovascular disease. A contributing factor to increased risk may be weight gain, especially visceral adiposity. Diet plays a role in maintaining weight at all ages but less is known about the specific contributions of a healthful dietary pattern after menopause. Therefore, we evaluated associations between diet and WC as a measure of visceral adiposity. We compared 869 pre- (aged 35-45 years) and 353 post-menopausal (aged 40-65 years) women from NHANES III (1988-94). Women were pre-menopausal if they self-reported menses in the past 2 months and postmenopausal if they reported no menses in past 12 months and were aged > 40 years. Compared to premenopausal women, postmenopausal women consumed fewer Calories (-200 kcal/d) and had a higher mean waist circumference (+4.43 cm, p=0.007), after adjusting for age, race-ethnicity, height, physical activity, and smoking. Higher intakes of dark green vegetables (p=0.03) and lower intakes of potatoes (p=0.03), refined grains (p=0.001), and meats (p=0.04) were associated with lower WC for all women. Higher intakes of nuts and seeds and fish high in Omega-3 fatty acids were associated with smaller WC while higher intakes of poultry and dairy products were associated with higher WC in post- but not pre-menopausal women. Our findings generally support a diet high in nuts and seeds, dark green vegetables, and fish, and low in potatoes, refined grains, and meats. After menopause it may be important to incorporate fatty fish, nuts and seeds into the diet for lower visceral adiposity.
FRAILTY AND THE COMPARATIVE EFFECTIVENESS AND SAFETY OF SGLT2I AND SULFONYLUREA IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Pawar Ajinkya , Patorno elisabetta , Kim Dae
Published: November 2019

We conducted a 1:1 propensity score-matched retrospective cohort study of 70,826 patients with type 2 diabetes (mean age, 71.4 years [standard deviation, 5.0]) initiating a SGLT2i or a second-generation sulfonylurea in Medicare data. We estimated HRs (95% CIs) for a composite cardiovascular endpoint and severe hypoglycemia comparing the two treatments in the entire population and by the CFI-based frailty subgroups. Compared with sulfonylureas, SGLT2is were associated with lower rates of the composite cardiovascular endpoint (HR, 0.68 [95% CI, 0.62-0.75]) and severe hypoglycemia (0.43 [0.35-0.53]) over a mean follow-up of 9.5 months. The lower rate of composite cardiovascular endpoint for SGLT2i vs sulfonylureas was observed in pre-frail (0.68 [0.61-0.77]) and frail (0.64 [0.53-0.77]) subgroups, but not in non-frail subgroup (0.95 [0.59-1.54]). The rate of severe hypoglycemia was consistently lower for SGLT2i vs sulfonylureas across frailty subgroups (non-frail, 0.37 [0.12-1.16]; pre-frail, 0.45 [0.35-0.59]; frail, 0.40 [0.28-0.58]).
FRAILTY AND THE COMPARATIVE EFFECTIVENESS AND SAFETY OF SGLT2I AND GLP1-RA IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Patorno Elisabetta , Pawar Ajinkya , Kim Seoyoung , Kim Dae
Published: November 2019

We conducted a 1:1 propensity score-matched retrospective cohort study of 87,218 patients with type 2 diabetes (mean age, 71.5 years [standard deviation, 5.1]) initiating a SGLT2i or a GLP1-RA in Medicare data. We estimated HRs (95% CIs) for a composite cardiovascular endpoint and severe hypoglycemia comparing the two treatments in the entire population and by the CFI-based frailty subgroups. Compared with GLP1-RA, SGLT2i were associated with similar rates of the composite cardiovascular endpoint (HR, 0.94 [95% CI, 0.86-1.03]) and severe hypoglycemia (0.87 [0.71-1.07]) over a mean follow-up of 8.6 months. The rate of composite cardiovascular endpoint was not meaningfully different between SGLT2i and GLP1-RA across non-frail (1.33 [0.80-2.23]), pre-frail (0.96 [0.85-1.08]), and frail patients (0.87 [0.73-1.04]). Similarly, the rate of severe hypoglycemia was not meaningfully different between the two treatments among non-frail (0.97 [0.20-4.80]), pre-frail (0.83 [0.64-1.08]), and frail patients (0.95 [0.67-1.34]).
NOVEL METABOLOMICS MARKERS PREDICT 18-MONTH DECLINE IN HAND GRIP STRENGTH IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Siang Ng Ted Kheng , Kovalik Jean-Paul , Ching Jianhong , Chan Angelique , Matchar David
Published: November 2019

Sarcopenia that accompanies aging necessitates early detection tools, ideally before the presentation of clinically evident symptoms. The acylcarnitines (ACs) are a class of metabolites generated by cellular fuel metabolism and their predictive utility in declining muscle strength in community-dwelling older adults is unknown. We aim to examine whether baseline acylcarnitines levels can predict changes in hand grip strength over 18 months in 121 community-dwelling older adults. We measured ACs by targeted plasma metabolomics profiling. We then performed a biologically-relevant classification of these markers. Hand grip strength was measured using a Smedley spring-type dynamometer. Multivariate linear regressions were performed to examine if: 1) there was an association between ACs and hand grip strength at baseline and 2) baseline ACs could significantly predict changes in hand grip strength over an 18-month period. At baseline, AC levels were not significantly associated with hand grip strength. We found an inverse association between baseline short-chain carboxyl and dihydroxl acylcarnitines (AC-DC/-OH) levels and 18-month changes in hand grip strength (p=0.047, β=-0.548, 95% CI=-1.088 to -0.008). Notably, a specific AC-DC/-OH species, C4-DC/C6-OH, accounts for the majority of the variance. The mean difference between Malay and Chinese ethnicity is 2.28kg (p=0.042, β=2.275, 95% CI=0.084 to 4.466). These findings suggest an association between metabolic markers and deterioration in hand grip strength. These results suggest that perturbations in fuel metabolism are detectable way before the emergence of clinically evident sarcopenia and frailty. The use of AC-DC/-OH panel as antecedent biomarkers may enable clinicians to risk stratify patients in the future.
SOCIAL CONNECTIONS AND HEALTH AMONG OLDER ADULTS IN SENIOR HOUSING COMMUNITIES
Authors: Taylor Harry O , Morrow-Howell Nancy
Published: November 2019

Our study describes social connections among residents in two low-income senior housing communities and then examines if these connections influence their well-being. Operationalization of social connections included social network size, informal social support, social engagement, and loneliness. The Convoy Model of Social Relations guides our study in identifying objective and subjective social connections and examining how they affect well-being. Most residents maintained active connections: 53% saw five or more family members in the previous month, 52% felt they could rely on their family members and over 60% participated in group and/or Church activities; however, 70% of residents were moderately or severely lonely. Greater loneliness and less informal social support were associated with worse self-rated physical health, worse mental health, and lower life satisfaction. This residential setting offers promise for developing interventions to decrease loneliness and strengthen social connections to improve residents’ health and well-being.
THE ROLE OF CULTURE AND LANGUAGE IN DEPRESSION CARE EXPERIENCES AMONG OLDER LATINAS/OS AND HEALTH CARE PROVIDERS
Authors: Aranda Maria P , Christensen Janelle , Aguilar Iris
Published: November 2019

Older Latinas/os face significant difficulties in accessing quality depression treatment due to cultural and language barriers. In our study, Programa Esperanza (a randomized behavioral trial), we conducted after-treatment, in-depth interviews with two groups: 21 low-income Latinas/os (55+) receiving psychosocial depression care (Problem Solving Treatment, and Psychoeducation) in a health care setting, and 22 staff (interventionists, supervisors) participating in study implementation. Speaking the same language was highlighted by both groups as an overarching factor in effective depression care, although matching providers and patients by country of origin was considered less a priority than a shared language. The mechanisms by which language serves as a facilitator of effective care were highlighted: fomenting rapport; facilitating the expression of feelings; shortening initial relationship-building; understanding nuanced words and linguistic expressions; etc. Similarly, we found that shared culture included themes around intervention uptake, decreased stigma, increased advocacy, enhanced identification of coping strategies, etc. Unlike patients, providers were more likely to speak in diverse narratives of “them,” and “us.” Given that depression is still a stigmatizing disorder in our society, asking for help and receiving quality care remain significant challenges for older persons in general, and older underrepresented minorities, in particular. Our work signals the importance of differentiating language from culture in intervention development for older, primarily Spanish-speaking Latinas/os with high medical comorbidity.
DUAL DECLINE IN MEMORY AND GAIT UNIQUELY IDENTIFIES OLDER PERSONS AT HIGH RISK OF DEMENTIA
Authors: Tian Qu , Resnick Susan , Mielke Michelle , Yaffe Kristine , Rosano Caterina , Simonsick Eleanor M , Studenski Stephanie , Ferrucci Luigi
Published: November 2019

Recent study has shown that incident dementia risk is higher among older persons who decline in both cognition and gait. This study assesses whether this relationship exists in multiple other aging populations. Data are from the Baltimore Longitudinal Study of Aging (n=662, 51%women,22%blacks), Health, Aging and Body Composition Study (n=746, 51%women,44%blacks), and Mayo Clinic Study of Aging (n=2771, 48%women,0.3%blacks). Participants were at least 60, initially free of cognitive impairment, dementia, and dismobility (gait speed≤0.6m/s), with repeated measures of verbal memory and gait speed before dementia diagnosis (average follow-up 5.8-12.1 years). Within each cohort, participants were divided into four groups: memory decliners alone, gait decliners alone, dual decliners, or neither (healthy agers). Gait speed decline was defined as a loss of ≥0.05m/sec/year; memory decline was defined as cohort specific bottom slope tertile. Incident dementia risk was examined by Cox regression with healthy agers as reference, adjusted for sex, race, baseline age, gait speed and memory. Across studies, incident dementia ranged from 3% to 17%. Compared to healthy agers, memory decliners alone had 3.4 to 4.3 times higher risk for developing dementia (p<0.01). Gait decliners alone had 2.1-5.6 times higher risk for dementia (p<0.05). Dual decliners had 7.6-10.8 times the risk (p<0.001). Dual decline signifies a more rapid progression to dementia. These consistent findings suggest that dual decliners might be a potentially valuable target group for both preventive interventions and mechanistic studies. Whether dual decline identifies a particular subtype or multiple subtypes of dementia remains to be investigated.
MECHANISMS OF COGNITIVE AND NEUROLOGICAL AGING
Authors: Kaczorowski Catherine
Published: November 2019

This session will focus on recent advances in understanding how biological aging impacts neurological function and risk of developing age-related neurodegenerative diseases.