bluuebunny/crossref_metadata_2025 huggingface dataset:
DEVELOPING A SENSOR-BASED MOBILE APPLICATION FOR IN-HOME FRAILTY ASSESSMENT: A QUALITATIVE STUDY
Authors: Blinka Marcela D , Buta Brian , Bader Kevin , Hanley Casey L , Schoenborn Nancy , McNabney Matthew , Xue Qian-Li
Published: November 2019

Frailty is an important concept in the care of older adults, and there is great interest in incorporating user-friendly frailty assessments into research and clinical settings. In-home, sensor-based technologies may provide a more dynamic, sensitive, and accurate assessment of frailty measures. To investigate user perspectives for use of sensor-based technologies and mobile applications, we held five focus groups with community-dwelling older adults (n= 10), their informal caregivers (n=9), and medical professionals (n=8). We used qualitative inductive analysis to organize thematic content. Caregivers and care-recipients viewed the early identification of frailty as beneficial, but highlighted the need for secure data infrastructure and clear demonstration of how frailty assessment would improve care. They also expressed concerns that technology-based communication could reduce in-person interactions. Medical providers noted the utility of objective data for difficult conversations with caregivers of frail patients, but worried about resources for analyses and interpretation of sensor-based health information.
AGEISM IN HEALTH CARE: 72 IS NOT A DIAGNOSIS
Authors: Greenberg Phyllis A , Johnson Tarynn
Published: November 2019

This poster examines what value, if any, there is in using age as a predictor or impetus for testing, examining and diagnosing older adults. In a cross sectional survey (Davis et al. (2011) used the Expectations Regarding Aging Scale to assess primary care clinicians perceptions of aging in the domains of physical/mental health and cognitive functioning. Sixty-four percent of respondents agreed with the statement “Having more aches and pains is an accepted part of aging while 61% agreed that the “Human body is like a car when it gets old it gets worn out. And 51% agreed that one should expect to become more forgetful with age while 17% agreed that mental slowness is impossible to escape. How might these attitudes and biases effect how older adults are diagnosed, heard, spoken to, and treated (medical treatment as well as patient/professional interaction)? Are older patients/clients underserved or over served? Is forgetting where you put your keys always or even usually a sign of dementia? How helpful then is the use of age and are there other factors that should and can take precedence? What do we know and what don’t we know if we know someone’s age? Successful and innovative tools are explored that acknowledge age biases and strategies are presented to change age biases in education, training and practice.
THERAPEUTIC DELIVERY OF ANG(1-7) VIA GENETICALLY MODIFIED PROBIOTIC: A DOSING STUDY
Authors: Carter Christy S
Published: November 2019

Aging is associated with loss of diversity in gut microbiota leading to dysbiosis; a condition linked with cognitive/physical frailty. Age-related health benefits have been ascribed to the renin-angiotensin system (RAS), mediated via the angiotensin-converting-enzyme-2 (ACE2)/angiotensin (1-7) or Ang(1-7) axis. A genetically modified probiotic secreting Ang(1-7) or GMP-A, targeting the gut, has been described for diabetes and hypertension; however, we are the first to provide proof of concept for its use in aging. We report that GMP-A increases circulating levels of Ang(1-7) when orally-administered over 4 weeks in aged F344/BN rats. Ongoing experiments examine GMP-A impact on distal tissues (muscle/brain). GMP-A provides translational advantages including ease of administration, production cost, and burden for regulatory approval.
NONHUMAN PRIMATE GUT MICROBIOME: IMPACT OF AGE AND CALORIE RESTRICTION
Authors: Colman Ricki , Rey Federico
Published: November 2019

The human microbiome is composed of bacteria, archaea, viruses and eukaryotic microbes that reside in and on our bodies, the largest community of which is in the gut. Although the functions of the gut microbiota are not fully understood, they are known to play an essential role in immune, endocrine, and metabolic functions. To begin to understand the relationship between the gut microbiome, aging, and adult-onset, moderate calorie restriction in rhesus macaques (Macaca mulatta), we collected fecal samples at one timepoint from a total of 52 macaques for 16S rRNA gene analyses. Samples were taken from 20 males and 20 females across the natural macaque age range and from 6 males and 6 females enrolled in the long-term study of aging and calorie restriction at the Wisconsin National Primate Research Center. Preliminary data show that, like humans, NHPs exhibit a large interindividual variation in microbiota composition despite well-controlled environmental conditions.
PATHOLOGICAL TAU ABORTS CELL CYCLE ACTIVATION BY MIMICKING EPITHELIAL-MESENCHYMAL-TRANSITION IN NEURONS
Authors: Phan Roseann V , Beckmann Adrian , Frost Bess E
Published: November 2019

Alzheimer’s disease (AD) is an irreversible neurodegenerative disorder which is characterized by neurofibrillary tau tangles and amyloid-ß plaques. Our laboratory uses tau transgenic Drosophila to rapidly test hypotheses along with human brain samples in order to ensure that our work is relevant to clinical endeavors. Using this approach, we identified a neurodegenerative pathway whereby pathological tau over-stabilizes filamentous actin (f-actin), leading to disrupting aberrant nuclear pleomorphisms and decondensation of heterochromatic DNA. Due to the neuronal phenotypes observed in tau-transgenic Drosophila and reentry of post-mitotic neurons into the cell cycle, we hypothesized that tau perturbs the cellular program that maintains terminal neuronal differentiation. Based on RNA-sequencing, we identified prospero as the most differentially expressed and downregulated transcript in tau transgenic flies. Prospero regulates genes that promote and maintain terminal neuronal differentiation. At the protein level, prospero is significantly reduced in tau transgenic flies at 10 days old. We find that over stabilization of f-actin or over-expression of moesin, a cytoskeletal protein known to participate in tumor progression and metastasis, depletes prospero. Using genetically manipulated prospero target genes we find a connection to neurodegeneration. These targets include a PKC, tep4, and knot-suggesting that broad cellular processes are affected by this reduction. Overall, our findings suggest that pathological tau causes cell cycle re-entry by disrupting transcription factors governing terminal neuronal differentiation as well as over-stabilization of f-actin being the driving loss of terminal neuronal differentiation and casually associated with neuronal death.
MICRORNA REGULATORS OF THE SENESCENCE TRANSCRIPTOME
Authors: Rodney O’Wayne , Gorospe Myriam , Abdelmohsen Kotb
Published: November 2019

Cellular senescence is a state of indefinite growth arrest triggered in response to sublethal stresses such as telomere shortening, DNA damage, oxidative injury, oncogene activation, and hypoxia. Compared with proliferating cells, senescent cells are enlarged, display heterochromatic DNA foci, and express distinct subsets of proteins, including the enzyme β-galactosidase (β-gal). Previously, we identified transcriptome signature of senescent cells. We asked if these transcripts might be regulated by microRNAs (miRNAs). To address this question, we identified six miRNAs (miR-129-5p, -19a-3p, -128-3p, -124-3p, -340-5p, and -27b-3p) as potential regulators of subsets of transcripts differentially expressed during senescence. RT-qPCR analysis indicated that miR-129-5p, -19a-3p, -128-3p, -124-3p, and -340-5p were downregulated in senescent cells. We modulated these miRNAs in proliferating WI-38 fibroblasts and found that miRNA antagomirs did not show significant changes in β-gal activity. Interestingly, however, overexpression of miR-124-3p or miR-340-5p increased β-gal activity. We conclude that despite the decrease of miR-124-3p and miR-340-5p in senescent cells, their overexpression enhanced senescence as indicated by β-gal activity. Future analyses will focus on the mechanisms through which these miRNAs induce senescence and their physiologic and pathologic impacts in vivo.
PRIVACY AND SECURITY FOR TELEHEALTH DEVICES
Authors: Thompson London , Farkas Csilla
Published: November 2019

In this research, we study the privacy and security capabilities provided by telehealth devices. Our aim is to evaluate how vulnerable these popular devices are in the presence of malicious cyber attackers. As older adults increasingly rely on telehealth devices, it is crucial that cybersecurity aspects of these devices are clearly communicated to them. Moreover, older adults frequently lack the technical expertise to evaluate the security and privacy capabilities of the devices. The lack of control over telehealth devices is a major concern for older adults. Older adults view certain limitations within these devices as decreasing their privacy and security. These limitations include the lack of control over accepting calls, taking screenshots, and assigning access privileges. For large scale adaptation of telehealth devices by older adults, it is crucial that these devices not only satisfy their intended purpose but also exhibit user friendly features and strong security and privacy capabilities. Modeling cyber threats against telehealth devices is not studied sufficiently . Malicious actors may compromise telehealth devices and create further threats to security and privacy of the users. In this research, we studied the cyber threats against telehealth devices. We built a threat model that ranks cyber threats based on their impact. We investigated how the operating system of popular devices supports access control. We found that none of the current technologies support location-based access control. We claim that this represents a major limitation and that supporting location-based access control is necessary to ensure users’ privacy in their own home.
PERCEPTIONS OF INDIVIDUALS WHO CONFRONT AGEISM
Authors: Horhota Michelle , Chasteen Alison L , Crumley-Branyon Jessica
Published: November 2019

What are the consequences for older adults who confront ageism? We compared young (n=316), middle-aged (n=464), and older adults’ (n=273) perceptions of an older target who confronts the perpetrator of an ageist action. Participants read a vignette about a pedestrian offering unwanted help to an older woman crossing the street. We manipulated the type of ageism (benevolent or hostile), the reaction of the older target (acceptance, moderate confrontation or strong confrontation) and assessed how impressions of warmth, competence and overall impression of the target changed over time. Type of Ageism x Reaction x Time interactions emerged for all three variables. In the hostile condition, a strong confrontation resulted in the target being rated as less warm, more competent, and the overall impression decreased over time. In contrast, a moderate confrontation increased perceptions of warmth, competence and overall ratings of the target. In the benevolent condition, a strong confrontation decreased perceptions of the target’s warmth, competence and overall impression. Moderate confrontation increased perceptions of target competence but did not change perceptions of warmth or overall impression. Targets that accepted the ageist act were rated lower on warmth for both hostile and benevolent conditions. Competence ratings were not affected. However, targets that accepted benevolent ageism experienced a cost to their overall impression. Taken together, these results suggest that when confronting ageism, older adults should take a moderate approach. When participants perceived the target’s reaction to be incommensurate with the offer of help, the target was viewed more negatively overall.
AGING AND FEELING CURIOUS: A TIME-SAMPLING STUDY
Authors: Chu Li , Fung Helene H
Published: November 2019

Curiosity is commonly defined as “the desire for new information and experience.” While curiosity has been associated with numerous positive outcomes (e.g., improved well-being, better cognitive performance and longer life expectancy, some studies suggested that curiosity declined with age. However, very few studies actually attempt to examine why curiosity may be lower among older adults. Moreover, scholars disagreed on “why” people feel curious. According to the dual process theory (Spielberger & Starr, 1994), curiosity is induced by optimal level of uncertainty and anxiety with the desire to reduce these aversive feelings. However, the personal growth facilitation model (Kashdan, Rose, & Fincham, 2002) posits that people are curious intrinsically for one’s own growth, which is associated with positive affects. Therefore, the present study aims to examine age differences in the affective profile of feeling curious by comparing the momentary affective experience of curiosity between younger and older adults. In this study, we conducted a 2-week time-sampling study with 78 younger adults (age 19-29) and 79 older adults (age 60-85) from Hong Kong. Multilevel modeling analyses demonstrated a positive relationship between curiosity and positive emotions for both younger (β=.29, p<.01) and older adults (β=.70, p<.01). Interestingly, anxiousness was positively associated with younger adults’ curiosity (β=.09, p=.01) but not for older adults (β=.06, p=.29). Our study supported both theories, but suggested that one may be more dominant among older adults. These findings have important implications for future interventions to reduce anxiousness to encourage older adults to keep an open-minded attitude towards novelties.
RACE AND ETHNICITY DISPARITIES IN SUBJECTIVE COGNITIVE DECLINE
Authors: Reed Nia , Taylor Christopher A , Olivari Benjamin , Wooten Karen , McGuire Lisa C
Published: November 2019

Alzheimer’s disease (AD) is the most common form of dementia. Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss and it is one of the earliest noticeable symptoms of AD. Data from respondents aged 45 years and older to the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System Cognitive Decline module were examined to identify race and ethnicity disparities in SCD. This module was administered by 49 participating states, District of Columbia, and Puerto Rico from 2015-2018. Data were analyzed using SAS statistical software and methods that accounted for survey design and weighted data. Prevalence of SCD by race/ethnicity with 95% confidence intervals (CI) was calculated. Among adults aged 45 years and older, one in nine (10.8%; CI=10.5-11.2) non-Hispanic white adults experienced SCD. In comparison, among adults aged 45 years and older, one in nine (11.2%; CI=9.8-12.7) Hispanic, one in eight (13.2%; CI=12.0-14.3) African American/black, and one in five (19.6%; CI=16.0-23.2) American Indian/Alaska Native (AI/AN) adults experienced SCD. These numbers are expected to increase significantly over time, especially for some minority groups. More specifically, Hispanics and African Americans are expected to constitute a large proportion of older adults in the coming decades. There are implications in how communities are reached with respect to awareness of cognitive decline (this includes AI/AN adults, as well). Race and ethnicity disparities in SCD may be influenced by differences in chronic diseases and other risk factors that are also disparate between communities.
ETHNIC DIFFERENCES IN THE RELATIONSHIP BETWEEN SOCIAL CAPITAL AND PSYCHOLOGICAL DISTRESS IN OLDER CALIFORNIANS
Authors: Caceres Nenette A , Alemi Qais , Ortiz Larry , Stempel Carl
Published: November 2019

Seniors aged 65 and older are at great risk of psychological distress given their functional decline, which is known to limit participation and engagement in community life. The purpose of this study is to examine whether higher indices of social capital have a positive impact on the mental health of older, ethnic Californians. We conducted a secondary analysis of data for 7,485 Californians 65 and older from the 2016 California Health Interview Survey (CHIS). A principal components analysis generated two social capital measures; one measuring safety and social cohesion, the other civic engagement. Hierarchical linear regression analyses were conducted to assess the independent effects of social capital subscales on the severity of psychological distress as measured by the Kessler-6 (K6).Respondents were on average moderately distressed, with small yet significantly higher K6 scores observed among African Americans, Asians, and Native Americans. The addition of our social capital variables in subsequent steps resulted in little yet significant change in explaining psychological distress (ΔR2 = .02, p < .001) with only neighborhood safety and social cohesion being inversely associated with K6 (β = -.15, p < .001). The interaction between ethnicity and neighborhood safety and social cohesion resulted in non-significant associations with K6 scores for all ethnic minority subgroups; however, for African Americans the relationship with psychological distress actually increased significantly (β = .24, p < .001). Our findings suggest that specific types of social capital may be helpful in remediating psychological distress for certain ethnic minority groups.
DEPENDENT INDEPENDENCE: REFRAMING AGING AND CAREGIVING AFTER CHINA’S ONE-CHILD POLICY
Authors: Chi Chen
Published: November 2019

Global aging has led to substantive demands for caregiving. In China, the country’s birth control policy and recent economic downturn have exacerbated the situation. Given the decreasing care they have received, older Chinese online users 65-74 years of age from single-child families, however, have demonstrated more positive attitudes than negative ones—expressing satisfaction and speaking highly of their adult children’s filial care. Why older Chinese come to appreciate their adult children’s filial performance? Building upon the concept of “regeneration” (Cole and Durham, 2007), I propose the term “dependent independence” to highlight the mutually constitutive parent-adult children relations in China’s single-child families. Employing a relational approach to aging and care in China, I analyze online posts from China’s most populous information-sharing platform, Zhihu. As the major cause of the care crisis in China, the One-Child Policy, I argue, creates the solution at the same time by modernizing Chinese families such that new care values and preference, specifically affective bonds and independence, have become dominant. I first demonstrate that this sample of older Chinese adults have shifted care preferences from physical support to affective bonds. I then analyze their reformulation of care values from servility to older adults to adult children’s independence and individual success. Revealing the changing values and preference of caregiving and family relations in China, this paper reminds us of what kind of future we aspire to, and what kind of values we cling to no matter as an adult child or an older adult.
THE IMPACT OF MORTALITY SALIENCE ON COLLEGE STUDENTS’ INTENT TO HELP OLDER ADULTS
Authors: Fenstermacher Erika A , Birg Jessica , Barbieri Vincent , Herr Nathaniel
Published: November 2019

Terror Management Theory (TMT) states that the awareness of one’s own death causes humans to experience intense anxiety, which must be continuously managed. Much of the research on TMT has focused on negative outcomes, rather than prosocial behavior, begging the question: “Can priming individuals with the thought of their own death trigger them to behave in ways that benefit others?”. Jonas et al. (2002), found that when mortality salience was primed prosocial behavior increased. In line with TMT, they hypothesized that people may behave in a more prosocial manner as it fits in with their personal values. The present study recruited 108 students who were randomly assigned to a mortality salience (MS) or control condition. Participants also completed baseline self-reports, which included measures of ageism, social desirability, personality, and empathy. After the study seemed to end, participants were given a disguised measure of helping behavior, which they believed to be an interest survey for a student volunteer group. Preliminary analyses indicate that those in the MS condition were more willing to be contacted to volunteer with kids than being contacted to volunteer with older adults. We also found that those in the MS condition were more likely to be contacted to volunteer with kids than those in the control condition. Our findings are consistent with previous work showing that individuals favor their ingroup when primed with their death. This reflects the importance of focused efforts on encouraging young people to identify with older adults and on promoting prosocial behavior.
PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA
Authors: zhang liangwen , Fang Ya
Published: November 2019

Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.
EMBEDDING DEMENTIA-FRIENDLY TRAINING IN A HEALTH CARE SYSTEM
Authors: Schneider Ellen C , Dale Maureen , Wells Krista , Gotelli John , Roberts Ellen , Henage Cristine B , Busby-Whitehead Jan
Published: November 2019

Alzheimer’s disease, the most common form of dementia, is now the 6th leading cause of death in the United States, affecting one in ten people over the age of 65. With our country’s rapidly aging population, and age being the primary known risk factor for dementia, the number of people with dementia is expected to increase from 5.8 million in 2019 to 14 million in 2050. People with dementia are hospitalized more often and have prolonged stays, poorer outcomes, higher costs, and increased readmission rates. Hospital employees have expressed the desire to have specialized training to learn how to more effectively communicate with and provide better care to patients with dementia to minimize adverse outcomes and increase patient satisfaction. To better address these identified patient and hospital employee needs, the University of North Carolina’s Center for Aging and Health (UNC CAH) is disseminating hospital-specific dementia-friendly training to four hospitals within the UNC Health Care System. The training is being delivered via online modules and follow-up didactic sessions to over 4,000 clinical and non-clinical staff who interact with patients. To monitor outcomes, pre and post training data is being collected on dementia patients’ length of stay, readmission rates, and falls. The pilot project was conducted in 2019, and results of the pilot will be presented in the poster. The dementia-friendly hospital training initiative will prepare hospitals to provide better care for people with dementia, which should lead to improved health outcomes and more positive experiences for patients, caregivers, and hospital employees.
THE IMPACT OF ALIVIADO DEMENTIA CARE HOSPICE EDITION TRAINING PROGRAM ON HOSPICE STAFF’S DEMENTIA SYMPTOM KNOWLEDGE
Authors: Schneider Catherine E , Bristol Alycia A , Ford Ariel , Lin Shih-Yin , Brody Abraham A
Published: November 2019

A lack of high quality dementia training for healthcare workers is a key barrier to effective care for persons with dementia (PWD), a vulnerable and increasing population across the care continuum. Hospice agencies in particular are underprepared to care for this population, although annually about 17% of hospice patients have a primary diagnosis of dementia and an additional 28% as a comorbidity. Aliviado Dementia Care-Hospice Edition is an interdisciplinary, evidence-based quality improvement program developed to assist hospice interdisciplinary teams in caring for PWD and their caregivers. Interdisciplinary hospice team members in two agencies were enrolled in online training modules, which addressed multiple areas including pain, behavioral and psychological symptoms of dementia (BPSD), and working with caregivers. They were also provided a toolkit to integrate training in daily practice. Changes in knowledge, confidence and attitudes were tested before and after training and paired t-tests were utilized to evaluate the program’s effect. Thirty-five individuals completed the program and pre/post tests. Paired t-tests showed clinically and statistically significant increases in knowledge, attitudes and confidence in five of 10 domains including depression knowledge and confidence and BPSD knowledge, confidence and interventions. The greatest increase was in using BPSD interventions (18.5% increase, p-value: 0.0002), depression confidence (15.9% increase, p-value: 0.006) and BPSD confidence (12.6% increase, p-value: 0.02). Aliviado is an evidence-based, systems-level intervention shown to improve clinical knowledge, attitudes and confidence in treating pain and BPSD in PWD. This training could be used to produce systems-level practice change for hospice interdisciplinary team members serving PWD.
FROM PERSONAL TO GLOBAL: CULTIVATING YOUR GERONTOLOGICAL VOICE
Authors: Janssen Leah M
Published: November 2019

From intro-level undergraduates to advanced graduate students in gerontology, understanding and developing a “gerontological voice” is often an elusive concept and challenging process to articulate. How we view, understand, and give voice to aging-related issues is influenced by a number of different factors: Micro-level factors (e.g., personality, personal experiences with older adults, and personal interests and values); meso-level factors (e.g., coursework in aging and academic major/discipline); and, macro-level factors (e.g., societal and cultural values, media, activism, and advocacy). As an adaptable teaching exercise for all levels of students, this poster presents a novel framework to support students’ exploration and cultivation of their unique gerontological voice. Through this three-level scaffolded discovery, students across disciplines strengthen their awareness and understanding of their distinct voice and build confidence to activate around aging-related issues pertinent to their specific interests and passions. From personal to global, this guided introspective exercise provides an opportunity for students to focus and embed their voice into the larger tapestry of gerontology, an inclusive community rich with perspective and diversity. Encouraging the development of students is an essential part of building social capital which is instrumental to the creation of strong networks to serve older adults through a multitude of disciplines.
EVALUATING ITEM NONRESPONSE IN A LIFE HISTORY CALENDAR: AN ANALYSIS OF MEMORY EFFECTS
Authors: Hu Mengyao , Melipillán Roberto , Zhang Xinyu , Smith Jacqui
Published: November 2019

Memory decline contributes to response inaccuracy and can produce item missing data, especially in retrospective surveys with older adults. Event history calendars, or the life grid approaches, are commonly used to obtain retrospective life history data. As indicated in previous literature, this approach can assist respondents’ memory retrieval. Despite its wide use, the important issue of item nonresponse due to memory effects in life grid questions has received little attention. Autobiographical memory (AM) research has shown that there are two interconnected long-term memory systems: episodic memories of event details from specific remote times in an individual’s life; and semantic memories of the important facts and themes that define an individual’s life history. Episodic and semantic AM may introduce different levels of difficulty in retrieving memory and thus contribute to different levels of missing data. This study examines the effects of both item-level predictors (e.g., types of memories) and respondent-level predictors (e.g., cognitive status, age, and health status) on the likelihood of item missing data in life grid questions. We analyzed missing data in the 2017 Health and Retirement Study (HRS) Life History Mail Survey (n = 3,844), using multilevel logistic regression. The results revealed higher rates of item missing for episodic memories, and that overall respondents’ cognitive status was significantly associated with their likelihood of providing item missing data. Recent residential information was better recalled than childhood information. These results have implications for life course analysis of exposures linked to residential histories.
THE MEDIATING EFFECTS OF LIFESTYLES AND HEALTH CAPABILITIES ON THE RELATIONSHIP BETWEEN AGING AND LIFE SATISFACTION
Authors: Cho Dongwook
Published: November 2019

The importance of life satisfaction has been getting significant attention as the older population has increased rapidly. There are many studies to examine the relationship between older adults’ past and current lifestyles and life satisfaction levels that resulted to be either positively or negatively associated with. It is also well documented in the literature that aging is negatively associated with life satisfaction level due to the decrease in health capabilities. However, little study has been researched the direct and indirect relationships among advancing age, lifestyles, health capabilities, and life satisfaction levels. The purpose of the study was to examine the mediating effects of lifestyles and health capabilities on the relationship between aging and older adults’ life satisfaction levels. A total of 290 older adults completed the self-administered questionnaire of lifestyles and life satisfaction levels and their health capability assessments were evaluated at three clinical research centers in the U.S. Multiple regression test was utilized to analyze the data. The results showed the direct effects of advancing age [B =1.196, t=2.608, p=.010] and engagement in exercise or physical activity [B=-2.684, t=-3.071, p=.002] on life satisfaction levels among older adults. However, there were no mediating effects of lifestyles and health assessments on the relationship between age difference and life satisfaction levels among older adults. The results suggest the advancing age itself would be the strongest factor in older adults’ life satisfaction. Additionally, the findings also suggest that exercise and physical activity can enhance older adults’ life satisfaction levels as a supplemental factor.
DEVELOPMENT OF A TAILORED EDUCATIONAL PROGRAM TO ASSESS FALL RISK AND PREVENT FALLS FOR DIVERSE OLDER ADULTS.
Authors: Thiamwong Ladda , Conner Norma E
Published: November 2019

Background: There is limited data on personal use fall prevention programs, and the relationship of race and ethnicity on fall risk awareness, personal beliefs, behavior change, and response to intervention. Objective: The aim of this study was to develop an educational program to prevent falls for ethnically diverse older adults. This program will be a culturally attuned program that values diversity and seeks to eliminate words and behaviors that might be discriminatory based on racial/ethnic or cultural identity. Methods: Three steps were used to develop the program: 1) constructing content domains; 2) generating the program draft; and 3) judging the program domain and content. The content domains were constructed based on data from a conventional content analysis of four focus groups from older participants (n=28) and their family caregivers (n=4), and individual in-depth interviews from health care providers (n=8). We generated the program outline with three response choices. Eight older participants and two health care providers rated it. Results: The program consisted of risk assessment, outreaching and raising awareness and knowledge. Risk assessment: all participants suggested that risk assessment should consists of objective and subjective measures. Outreaching: participants agreed that group-teaching and individual learning by peer coaching based on their culture, new blasts, brochures, and family-based approaches were the best outreaching methods that they preferred. They identified that raising awareness and knowledge should include the following topics: performing physical activity with fall risk awareness, medication management, visual care, behavioral adaptation with appropriate accessories /equipment, and environmental safety.
DEVELOPMENT OF A SCALE TO MEASURE CONTACT WITH OLDER ADULTS
Authors: Intrieri Robert C , Kurth Maria
Published: November 2019

Allport (1954) hypothesized that intergroup contact would reduce prejudice that an in-group member would experience toward an out-group member. Allport held that positive effects of intergroup contact would occur when four conditions were met: (a) equal group status within the situation, (b) common goals, (c) intergroup cooperation, and (d) the support of authorities, law, or custom. Although contact with older adults is an important influence on attitudes toward older people, no psychometrically adequate measures of contact exist. Specifically, this study examined the factor structure of an instrument to measure contact with older adults. The convenience sample consisted of 188 women and 282 men (n = 470). Mean ages for men and women were 21.06 (SD = 2.28) and 20.88 (SD = 3.09), respectively (Mtotal = 20.99, SDtotal = 2.63). Participants were predominantly Caucasian (n=295, 62.6%), African American (n=67, 14.2%), Hispanic/Latino/a (n=63, 13.4%), and other minorities comprising the remaining 9.8%. Results of a confirmatory factor analysis showed the three factor model exhibited a reasonable fit to the data X2 (41, N = 471) = 281.81; p<.0001, CFI =.954; TLI =.938; RMSEA =. 000 (90% CI, 0.100-0.124) SRMS = .054. Results and further adjustments to the model will be discussed.
THE ETHNIC-SPECIFIC EFFECTS OF BEHAVIORS ON INCIDENT GOUT WITHIN A LARGE MULTIETHNIC COHORT OF OLDER ADULTS
Authors: Thompson Mika D , Pirkle Catherine M , Wu Yanyan , Youkhana Fadi , Cooney Robert V , Wilkens Lynne R
Published: November 2019

Gout, a common rheumatic disease in older adults, disproportionately affects Pacific Islander and Black populations, relative to Whites; however, the ethnic-specific incidence and determinants remain severely understudied within these groups. We examined gout incidence and the effects of behavioral factors, including diet, physical activity, and smoking, on incident gout within a large multiethnic population of older adults from the Multiethnic Cohort Study linked to approximately 20 years of Medicare gout claims. Using samples of Black (N=15,660), Native Hawaiian (N=7,600), Japanese (N=32,923), Latino (N=21,793), and White (N=29,129) participants, we conducted multiple Cox regressions, producing hazard ratios (HR) and 95% confidence intervals (CI). Native Hawaiians had the highest incidence of gout (9.97 per 1,000 person-years), followed successively by Black, Japanese, White, and Latino participants. 3+ alcoholic drinks/day was associated with an increased risk, especially among Blacks (HR:1.55, 95%CI:1.23,1.94). Current smoking was associated with increased risk among Blacks (HR:1.28, 95%CI:1.10,1.49) and Japanese (HR:1.17, 95%CI:1.03,1.32). Better dietary quality tertiles were associated with a decreased gout risk for most ethnic groups, with the largest effect observed among Whites (HR[Q1vsQ3]:0.70, 95%CI:0.63,0.78), while vitamin C was weakly associated with a decreased risk of gout only among Native Hawaiians (HR:0.85, 95%CI:0.75,0.98) and Japanese (HR:0.91, 95%CI:0.85,0.98). Overall, notable ethnic differences were observed in both gout incidence and effects of modifiable behaviors. As the first study to examine the incidence and longitudinal determinants of gout utilizing several large samples of underrepresented ethnic groups, our findings offer crucial insights that may improve precision in preventing and treating gout.
ORGANIZATIONAL AND OLDER ADULT VOLUNTEER PERSPECTIVES ON ROLE CONFLICT MANAGEMENT STRATEGIES
Authors: Crittenden Jennifer A , Butler Sandra S
Published: November 2019

Older adults are increasingly occupying multiple life roles, including working, caregiving, and volunteering, creating the opportunity for role conflict. Such conflict occurs when stress and strain created by the demands of multiple life roles outstrips an individual’s resources to successfully manage such demands. A two-phase research study was recently completed with 1,697 RSVP volunteers drawn from 55 RSVP program sites across the country (Phase I) with a follow-up survey of RSVP programs conducted with 17 sites (Phase II). Grounded in role theory, the Phase I volunteer survey explored role conflict in addition to self-reported strategies used to mitigate the experience of role conflict. The Phase II program survey gathered responses from volunteer managers and staff about the strategies used by their older adult volunteers to avoid and address role conflict. Based on findings from both surveys, caregivers engaged the following strategies in order to minimize role conflict: obtaining respite care, and volunteering alongside their care recipient. Worker-specific strategies focused largely on time management and included volunteering during off-work hours and completing time-limited volunteer assignments. While a high level of convergence was noted between volunteer manager and volunteer perspectives, two themes emerged from the volunteer survey that were not identified in program survey responses: seeking volunteer opportunities that leverage similar skills and experiences across roles and seeking volunteer opportunities that provide a different experience from that of other roles. Implications for future research and volunteer management strategies will be discussed.
CAREGIVER PREFERRED STRUCTURE FOR A TELEHEALTH-BASED INTERVENTION ONE-TO-ONE VERSUS GROUP
Authors: Shofner Sabrina J , McKenzie Glenise , LaFazia David , McNeill Loriann , Spoden Natasha , Mattek Nora , Teri Linda , Lindauer Allison
Published: November 2019

Caring for a person with Alzheimer’s disease and related dementias (ADRD) can be stressful. Support programs are available for caregivers, but distance and cost present barriers to participation. Our mixed-methods study explored consumer acceptability and preliminary efficacy of a telehealth-based caregiver intervention, Tele-STAR. Caregivers in Tele-STAR met one-to-one with a consultant over eight weeks, via video conferencing, to address behavioral symptoms of dementia. We measured the effect of the intervention on caregiver reactivity to behavioral symptoms. Focus groups were used to assess acceptability. The literature suggests that stressed caregivers drop out of support programs. Thus, in the focus groups we asked about preference for intervention mode (one-to-one versus group). We hypothesized that more stressed caregivers would prefer the one-to-one mode. Data were analyzed using paired t-tests for the quantitative data, and a phenomenological lens for the qualitative data. Of the thirteen enrolled caregivers, twelve completed the study. Significant improvement was found in caregiver reactivity (p=0.001). Twelve caregivers participated in focus groups, in which they reported that the intervention helpful and they valued the therapeutic relationships with the consultants. Few had difficulty with the technological interface. Most liked the one-to-one mode of the intervention, but were open to a hypothetical group-based option. However, more stressed caregivers preferred a one-to-one intervention over a group intervention (p=0.06). While one-to-one interventions tend to be preferred by caregivers, they are expensive. Our findings suggest that one-to-one telehealth-based interventions should be reserved for more stressed caregivers who need intensive support with managing behavioral symptoms of dementia.
INEQUALITY IN COMMUNITY HEALTH SERVICES USE IN ISRAEL: A COMPARISON BETWEEN ELDER JEWS AND ARABS
Authors: Lowenstein Ariela , Naim Sigal Pearl
Published: November 2019

Population aging is an important social and public health issue globally. However, increase in longevity causes physical frailty and disability for many elders, which might lead to independence loss and impact quality of life. This increases health services usage and leads to higher costs of medical treatments. Data show that higher socio-economic status and accessibility to health services might reduce inequality in service use and impact mortality rates and quality of life. Also, that improved socio-economic status and population accessibility to Health services may stem from inner health system factors, as well as those related to the patients. Among minorities lower usage of formal professional services, including health services, are often related to cultural differences and many times to lower technological level, which are not considered by service providing organizations. Thus, lack of attention to service using minorities’ needs may cause a gap between potential consumers to services use. Israel is a multi-cultural society with mixed population of Jews and Arabs. Currently, Arabs comprise 20.9% and Jews 74.3%. However, the rate of disabled Jews is 16% compared to 31% among older Arabs.
SERUM 25(OH)D SIGNIFICANTLY IMPACTS ALZHEIMER’S DISEASE IN OLDER ADULTS LIVING IN LONG-TERM CARE COMMUNITIES.
Authors: Churchill Robert A , Robbins Ronna , Ranjit Nalini , Sweitzer Sara , Briley Margaret
Published: November 2019

6.08 million Americans suffer from Alzheimer’s Disease (AD), with some estimating diagnoses will reach 15.0 million by 2060. Age is the strongest risk factor for AD, and the prevalence of AD among older adults necessitates investigation into preventable risk factors. 25-hydroxyvitamin D [25(OH)D] deficiency is more prevalent in older adults than other age demographics. Research shows a strong correlation between deficient 25(OH)D serum levels (≤20ng/ml) and AD diagnosis. The association with insufficient (≤30 ng/ml) levels remains unclear. Older adults (age > 65 yo) of five LTC communities in Texas participated in the cross-sectional study. One-year medical history and demographics were abstracted from medical records using double-blinded data abstraction and entry. Blood draws measured 25(OH)D serum levels. Adjusted logistic regression models examined if insufficient 25(OH)D serum levels (≤30 ng/ml) are associated with AD diagnosis. Confounders were total daily vitamin D supplementation, BMI, race, gender, age, years in community, and diagnosis of liver and renal disease. Participants (n=174, mean age: 83 yo) consisted of 63% female and 89% Caucasian. Fifty five percent had insufficient serum 25(OH)D levels (mean level: 32.6 ng/ml; mean supplementation rate: 1,138 IU per/d), and 20% had diagnosis of AD. 25% had both insufficient serum levels and AD, while 12.6% had adequate serum levels and AD. Those with insufficient 25(OH)D serum levels had elevated odds (OR=2.8; CL: 1.14, 7.02; p=0.024) of having AD after adjusting for confounders. Insufficient serum 25(OH)D levels (≤30 ng/ml) are associated with increased diagnoses of AD, indicating the importance of adequate levels among LTC residents.
COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL: POST-ACUTE CARE AND PREFERRED PROVIDER NETWORKS
Authors: Gruman Cynthia A , Cowell Amy , Palmisano Kathryn , Rogers Shannon , Dummit Laura
Published: November 2019

The Comprehensive Care for Joint Replacement (CJR) model, implemented by the Centers for Medicare & Medicaid Services in 2016, is a randomized, controlled trial that tests the effect of holding a hospital accountable for payments and quality of all services provided to lower extremity joint replacement (LEJR) patients during an episode of care. The newly released results include 147,923 LEJR episodes that were initiated by 733 hospitals in 67 randomly selected metropolitan statistical areas. The objective of this presentation is to explore changes to the care pathway using results from a mixed-methods analytic approach including triangulation of findings from analysis of Medicare claims, hospital survey and hospital and associated provider interview data. Hospitals reported implementing notable changes over the past two years including hiring navigators, changes to therapy protocols, and direct discharge home. Hospital interviewees described efforts to strengthen relationships with PAC providers including the investment of resources into the development of preferred PAC provider networks. As a result of these changes, the average number of SNF days decreased by 2.3 days more for CJR episodes than for control group episodes from the baseline to the intervention period (p<0.01). Changes in two of nine complexity measures indicated a statistically significant relative decrease in CJR patients’ functional status at SNF admission. The relative increases in CJR patients’ average early-loss activities of daily living (ADLs) scores (p<0.05) and motion scores (p<0.10) suggest an increase in patients with greater needs were discharged to a SNF relative to the control group.
ASSOCIATION BETWEEN WALKING ENERGETICS AND FRAGMENTED PHYSICAL ACTIVITY IN MID-TO-LATE LIFE
Authors: Liu Fangyu , Wanigatunga Amal A , Kuo Pei-Lun , Zipunnikov Vadim , Simonsick Eleanor M , Schrack Jennifer A
Published: November 2019

Physical activity becomes increasingly fragmented with age, and may be an early marker of functional decline. Energy regulation has been linked with functional decline, yet whether the energy needed for walking, a common type of physical activity, is related to fragmentation of physical activity remains unknown. The study population included 493 participants aged 50-93 years from the Baltimore Longitudinal Study of Aging. Energetic measures included the energetic cost of usual-paced overground walking (ml/kg/m), the average energy expended (ml/kg/min) during a rapid-paced 400-m walk, and a cost-to-capacity ratio between the energy expended during 5-min treadmill walk (0.67 m/s, 0% grade) and the energy expended during the 400-m walk. Activity fragmentation was extracted from accelerometer data collected over ≥3 valid days and quantified via an active-to-sedentary transition probability (ASTP). Associations between the energetic measures and ASTP were assessed using multivariate linear regression models. Interactions between energetics and total daily physical activity, quantified as total log-transformed activity counts (TLAC), were also assessed. After adjusting for TLAC, demographics, body composition and comorbidity, higher cost-to-capacity ratio was associated with 3.51% greater fragmented physical activity (p=0.005). Energetics by TLAC interactions revealed that lower rapid-paced walking energy expenditure and higher cost-to-capacity ratio were only significantly associated with greater fragmentation in the most sedentary participants (p<0.01 for both). Our results suggest that deterioration of walking efficiency may manifest as a more fragmented physical activity profile, especially among sedentary adults. Future longitudinal studies to understand whether declining walking efficiency predicts the onset and progression of activity fragmentation are warranted.