bluuebunny/crossref_metadata_2025 huggingface dataset:
Purposes of Smartphone Use in Later Life: User Perspectives on Digital Daily Life in Germany
Authors: Wolf Friedrich , Oswald Frank
Published: December 2020

Smartphones affect everyday life of people across the lifespan with increasing relevance in later life. Although half of older adults in Germany (65+) use smartphones and the numbers of users are growing, only few studies address the integration of older adult’s smartphone use in everyday life as well as its potential effects on social context and wellbeing, which is been done in this study. Data are drawn from surveying the devices of 35 older adults (age 61-77 years; 60% women), allowing to objectively monitor real time smartphone use over the course of a regular week. In addition a semi-standardized ambulatory assessment procedure is administered four times a day to capture the everyday situation of smartphone use as well as aspects of user experience, affect and social context. Preliminary findings show inter- and intra-individual differences in everyday smartphone use in relation to individual differences in social context and wellbeing.
Impact of Hearing Impairment on Missingness of Cognitive Test Scores in the ARIC Study
Authors: Deal Jennifer , Gross Alden , Abraham Alison , Sharrett A Richey , Reed Nicholas , Mosley Thomas , Lin Frank , Swenor Bonnielin
Published: December 2020

Despite its high prevalence, the impact of hearing impairment on completion of cognitive tests, many of which rely on auditory input to access test material, has not been described. We investigated if hearing impairment is associated with missing scores in 3602 adults (72-94 years, 23% black, 60% female). Cognition was measured using 10 neurocognitive tests. Pure tone better-ear hearing thresholds (0.5-4 kHz) were averaged and categorized. ≥Moderate hearing impairment (versus none) was associated with greater missingness on two auditory tests: Logical Memory (prevalence ratio [PR]:1.40, 95% confidence interval [CI]:1.01,1.70) and Digits Backwards (PR:1.35, 95% CI:1.00,1.82); and the non-auditory Trail Making Test Part B (PR:1.48, 95% CI:1.24,1.77). Compared to models using complete cognitive data, models that imputed missing scores showed stronger associations of hearing impairment with poor cognitive performance. Older adults with HI are less likely to complete cognitive testing, resulting in biased estimates of the hearing impairment-cognitive performance relationship.
What Am I Measuring? Disentangling Cognitive Status From Sensory Impairment
Authors: Nichols Emma , Swenor Bonnielin , Deal Jennifer , Abraham Alison , Carlson Michelle , Ramulu Pradeep , Resnick Susan , Gross Alden
Published: December 2020

Some studies have shown sensory impairment is associated with impaired cognitive test performance, however tests rely to varying degrees on hearing and vision. We hypothesized scores for cognitive tests whose administration depends on vision or hearing are biased among those with vision or hearing impairment, respectively, after controlling for underlying cognitive performance. We used item response theory methods to test for differential item functioning (DIF) by hearing and vision impairment in the Baltimore Longitudinal Study of Aging (BLSA) and the Atherosclerosis Risk in Communities study (ARIC). We identified DIF by hearing impairment for tests that do not rely on hearing and DIF by vision impairment for tests that do not rely on vision. We found no clinically meaningful differences between unadjusted and DIF-adjusted measures of cognition. Our finding that DIF by sensory domain was independent of administration modality suggests cognitive load may play a larger role than previously acknowledged.
DIVISION OF EXTRAMURAL ACTIVITIES
Authors: Santora Kenneth
Published: December 2020

Dr. Santora will discuss research priorities for the Division of Extramural Activities. He and his team will in addition be available for small group discussions
Physicians’ Moral Dilemmas in the Age of Viagra
Authors: Ayalon Liat
Published: December 2020

Oral phosphodiesterase5 inhibitors (PDE5i; e.g., Viagra®) have become the first line of treatment of erectile dysfunction in men. Relying on interviews with 38 physicians, this study explored moral dilemmas associated with the prescription of PDE5i to older men. Moral dilemmas at the micro level concerned the interest of the patients to receive medical treatment, even when this was counter-indicated. At the meso level, physicians expressed their concerns about the impact of PDE5i on their patients’ partners. At the macro level, physicians discussed the substantial contribution of the pharmaceutical industry to the education of patients and physicians about pharmacological treatments for sexual problems. Physicians reported no moral concerns about industry involvement and reported only the benefits associated with it. The study raises moral issues associated with the treatment of erectile dysfunction. As such, it stresses the importance of facilitating a bio-psycho-social approach to treat sexual dysfunctions.
The Importance of Studying Health Behavior in Older Adults
Authors: Hughes Jaime , Hughes Susan , Raj Mina , Bettger Janet
Published: December 2020

Behavior change is an inherent aspect of routine geriatric care. However, most research and clinical programs emphasis how to initiate behavior change with less emphasis placed on skills and strategies to maintain behaviors over time, including after an intervention has concluded. This presentation will provide an introduction to the symposium, including a review of prior work and our rationale for studying the critical yet overlooked construct of maintenance in older adults. Several key considerations in our work include the impact of multiple chronic conditions, declines in cognitive and functional capacity over time, changes in environmental context and/or social support, and sustainability of community and population-level programs and services.
Latent Class Trajectory and Growth Mixture Models in the Study of Physical Resilience
Authors: Pieper Carl , Pendergast Jane , Neely Megan
Published: December 2020

After a stressor, individuals may experience different trajectories of function and recovery. One potential explanation for this variation is differing trajectories may be indicators of differing classes or levels of resilience to the stressor. Latent Class Trajectory (LCTA) and Growth Mixture models (GMM) are two similar approaches used to discover the number and types of trajectories in a study population. Class membership may determine the shape and level of recovery, which may be predicted by individual characteristics. In this talk, we present some insights to using these models to successfully identify the number of classes of trajectories, membership of trajectory classes, and the functional form of the trajectory. We will identify methods for deciding class enumeration, indices for assessing fit quality, and, importantly, the importance of proper model specification. Real life and simulated examples will be shown to compare and contrast differences between GMM and LCTA results. Part of a symposium sponsored by Epidemiology of Aging Interest Group.
Physical Resilience as a Determinant of Healthspan and Lifespan in Mice
Authors: LeBrasseur Nathan
Published: December 2020

Dynamic measures of physical resilience—the ability to resist and recover from a challenge—may be informative of biological age far prior to overt manifestations such as age-related diseases and geriatric syndromes (i.e., frailty). If true, physical resilience at younger or middle ages may be predictive of future healthspan and lifespan, and provide a unique paradigm in which interventions targeting the fundamental biology of aging can be tested. This seminar will discuss research on the development of clinically-relevant measures of physical resilience in mice, including anesthesia, surgery, and cytotoxic drugs. It will further highlight how these measures compare between young, middle-aged, and older mice, and how mid-life resilience relates to later-life healthspan. Finally, it will provide insight into whether interventions targeting the biology of aging can modify physical resilience in mice. Part of a symposium sponsored by Epidemiology of Aging Interest Group.
Importance of Will in Resilience and Recovery: Findings From the BLSA
Authors: Simonsick Eleanor , Griswold Michael , Windham B Gwen
Published: December 2020

Using data from 743 initially well-functioning men and women (49.5%) aged ≥60 in the Baltimore Longitudinal Study of Aging we interrogated the association between physical reserve operationalized as fast 400m walk performance scaled from 0 to 4 and psychological reserve (“will”) operationalized as personal mastery (high versus not) and likelihood of recovery from a decline of ≥2 points in reported walking ability. Of the 35% who declined 1-2 years post study baseline, 54% recovered 1-2 years later and 45% did not. Controlling for age, sex, race and initial walking ability, for each increment in reserve, likelihood of recovery was 43% greater (95% confidence interval (1.10, 1.85); p=.007). This association was most pronounced in women (odds ratio=1.84; 95% CI (1.19, 2.86; p=.006). Personal mastery showed no association with likelihood of recovery. Continuing work will further explore alternative operationalizations of “will”. Part of a symposium sponsored by Epidemiology of Aging Interest Group.
Mapping the Possible Futures of Technology and Caregiving
Authors: Coughlin Joseph , Fulmer Terry
Published: December 2020

As people age, more individuals are expected to need health and caregiver services; it is therefore anticipated that families will face greater demands and carry an increasing burden. Frontier technologies – such as artificial intelligence, sensors and naturalistic user interfaces – are increasingly entering people’s lives, and may be leveraged to support family caregivers. These innovations may make it possible to provide comprehensive care to loved ones while reducing caregiver burden. Similarly, professional caregivers, from social workers to clinicians, may benefit from new devices and services that enable them to provide care more effectively and even proactively prevent a health event. However, challenges around technology maturity, potential risks and skepticism may interfere with a successful implementation. This session reports on research that explores how evolving technologies may shape the future of caregiving. A panel of 41 experts from related disciplines – engineering, data science, medicine, nursing, public policy, business, aging services and more – participated in a modified Delphi study. Across two rounds of data collection, the expert panel provided their opinions and insights about how various technologies and related systems may impact family and professional caregivers by the year 2030. This symposium will present findings from the expert panel, including: how different caregiving tasks and activities may be impacted by new technologies, and what the benefits and barriers may be; possible impacts of new technologies on related topics including elder abuse and fraud, service delivery, and labor and education; and possible future scenarios and expert predictions for 2030.
Societal Impacts and Broader Implications of Using Technologies for Caregiving
Authors: D’Ambrosio Lisa , Rudnik John , Coughlin Joseph
Published: December 2020

Advances and greater adoption of new technologies may have impacts beyond day-to-day caregiving. This presentation will explore additional implications related to the future of caregiving and technology, including their potential effects on elder abuse, financial fraud, career and labor, social isolation and more. Opinions from the expert panel – which pointed to various possibilities, benefits and challenges – will be shared during this presentation.
Presidential Symposium: Interdisciplinary Perspectives From Early-Career Scholars on Why Age Matters
Authors: Petrovsky Darina , Waldron Danielle , Sakel Katie
Published: December 2020

The 2020 ESPO Presidential Symposium features interdisciplinary perspectives and recent scientific advances made by early career researchers from each of the GSA scientific sections. They provide examples of how their work is addressing ways age matters. The first paper by Justice (Biological Sciences) will present the latest geroscience research. The second presentation will explore how age influences end-of-life care (Health Sciences, Starr). The third presentation will focus on age as a predictor of kidney function decline (Behavioral and Social Sciences, Surachman). The fourth presentation will explore how age shapes older adults’ resilience (Academy for Gerontology in Higher Education, Bouchard). The fifth presentation will examine opioid use in older adults (Social Research, Policy, and Practice, Jansen). Additionally, early career scholars will share information about their research trajectories and future directions within their disciplines. Given the diverse nature of these presentations, attendees will be exposed to varying strategies, methodologies, and tools that are employed across disciplines. The symposium concludes with a discussion on ways to identify synergies across different fields and promote strategies for successful cross-disciplinary collaboration.
Life Course Pathways From Childhood SES to Age-Related Declines in Kidney Function Across Adulthood
Authors: Surachman Agus , Santos Alexis , Daw Jonathan , Alexander Lacy , Coe Christopher , Almeida David
Published: December 2020

Age is a strong predictor of declines in kidney function across adulthood. Using data from 2,045 adults (ages 25-84) in the Midlife in the United States (MIDUS) study, we examined the life course pathways through which low parental education, through adult SES and body mass index (BMI), was associated with faster age-related declines in kidney function. Kidney function declines by 0.8 mL/min/1.73 m2 per year across adulthood. Lower parental education, through adult SES and BMI, was associated with higher kidney function among younger adults (Est = -1.61, SE = 0.62, 95%CI = -2.62, -0.60), but lower kidney function among older adults (Est = 0.93, SE = 0.51, 95%CI = 0.11, 1.79). The impact of early socioeconomic adversity on kidney function is initiated by kidney hyperfiltration in early adulthood and followed by faster declines and development into disease state in later adulthood.
Resilient Identity: How Aging Matters in Exploring Resilience
Authors: Bouchard Lauren , Manning Lydia
Published: December 2020

Defining resilience is complex given its multidimensional and contextualized nature within the gerontological literature. The construct has been described as a trait, state, and process, and less often, as a cultivated identity. Older adults are key in the understanding of resilience from their own point view as experts of their experiences with adversity. This presentation focuses upon the findings of qualitative research utilizing grounded theory methodology, which explores the way aging may shape “resilient identity.” Given the varying challenges across the life course, resilient identity may be highly dependent on individual and environmental context. This talk also focuses on who determines the definition of resilience as well as the nature of such an identity. Educational implications regarding key factors, management strategies, and protective practices are also discussed.
Health Behaviors and Oral Health Among Centenarians in Nanjing, China: A Cross-Sectional Study
Authors: Xu Xin , Zhao Yuan , Gu Danan , Pei Yaolin , Wu Bei
Published: December 2020

The aim of this study was to examine the association between health behaviors and oral health among Chinese centenarians. Data from the Nanjing Centenarians Study (NCS) in China was used (N=185, Mean age = 102). Oral health status was measured by self-reported oral health and edentulous status. Results from ordinal regression and logistic regression models indicated that centenarians who were male, smoking, normal weight (18.5-24.9kg/m2), participated in more activities, and brushed teeth more frequently were more likely to report better oral health. Those who ate fruits daily and brushed teeth more frequently were more likely to be dentate. The association between frequent toothbrushing and oral health was stronger for those who had some formal education and were living with family members. Our study demonstrated the significance of health behaviors on oral health in very old age, and the importance of lifestyle on healthy aging.
Addressing Racial Compatibility Between Trainees and Minority Older Adults in Applied Care Settings
Authors: McDuffie Danielle
Published: December 2020

This talk explores the importance of a racially diverse graduate student interacting in an applied care setting with minority older adults in the Southeast relative to assessment of cognitive status and in the context of cultural mistrust and misdiagnosis. ~250 older adults (16% AA) in an applied care setting were administered a cognitive screener as part of a larger research battery. An independent samples t-test was conducted to assess differences in mean cognitive status. Non-Hispanic Whites (NHW) (M=76.8 years) were found to be more intact than AAs (M=73.27) on measures of cognitive status (21.32 vs. 14.72, t=4.976, p=.0001). Implications highlight that cognitive screeners have often been found to lack sensitivity in groups of marginalized older adults. Having an AA graduate student in these settings could be a way of mitigating the effects of culturally incompatible screening tools and bridging the gap between research and practice for AA older adults.
Patterns of preference importance ratings among African-American and White nursing home residents
Authors: Hicks Nytasia , Abbott Katherine , Heid Allison , Leser Kendall , Van Haitsma Kimberly
Published: December 2020

Background: The Preferences for Everyday Living Inventory (PELI) was developed to assess the psychosocial preferences of older adults receiving home care (PELI-HC) and then revised for nursing home residents (PELI-NH). While the PELI-HC has been tested to identify patterns in preference ratings by race, the PELI-NH has not. We sought to explore whether the PELI-NH tool captures differences in preference ratings of African-American and White NH residents. Methods: Preference assessment interviews were conducted with NH residents (n = 317). Analysis via a Mann-Whitney U test, results show that 46 of 72 (63.88%) a preference importance items were not statistically different between African-American and White NH residents. Additionally, African-Americans reported greater importance than White older adult NH residents in 26 of 72 (36%) preference importance items. Conclusion/Implications: It appears that the PELI-NH can test group differences in preference importance among African-American and White NH residents; implications for practice will be discussed. Part of a symposium sponsored by the Research in Quality of Care Interest Group.
Insights Gained From Developing Academic-Community Partnerships for Minority Aging, Community-Engaged Research
Authors: Rooks Ronica , Lichtenberg Peter
Published: December 2020

Increasingly community-engaged research, characterized by collaborations between researchers and community partners, is recognized as an important part of translating research into improved health outcomes and reduced health disparities for community participants. Training community participants to engage in some or all aspects of this research, particularly focusing on racial and ethnic minority older adults, highlights the need to understand its opportunities and challenges. With this symposium we will discuss and reflect on community-engaged and community-based participatory research approaches to community-academic partnerships with minority older adults. The first presentation addresses recruitment, retention, and training of a community advisory board of older African Americans in Michigan. The second presentation addresses a health education outreach and engagement program to improve health outcomes among older African Americans in California. The third presentation combines community engagement with survey design methods for research with older Native Hawaiian and Pacific Islander adults to improve data collection and health outcomes in this U.S. population. The final presentation examines partnerships between a hospital memory clinic, meal delivery service, research university, and low-income health clinic to improve caregiver and dementia patient outcomes for minority older adults. The symposium discussant will address opportunities, challenges, and implications of community-academic partnerships promoting minority aging.
The Geometric Framework for Nutrition: New Insights Into How What We Eat Affects How We Age
Authors: Cohen Alan , Raubenheimer David
Published: December 2020

The geometric framework for nutrition (GFN) is an approach to understanding the effect of nutrition considering multiple nutrients simultaneously. Originally developed in experimental studies of insects to model how nutritional needs evolve depending on ecological context, and since extended to many taxa including non-human primates in the wild, the technique is increasingly applied to understand human health and aging. Here, we invite four varied talks showcasing the flexibility and potential of this approach from the basic biology of aging to observational human studies and clinical trials. D. Raubenheimer will give an overview of the method, its history, and its applications in aging and human health. D. Wahl will present results showing how GFN can help develop diets that recapitulate caloric restriction and its effects on brain aging. S. Das will show how GFN can be used to improve the feasibility of caloric restriction in humans without compromising its effects. Finally, A. Cohen will present results showing how GFN can be deployed in an epidemiological context and used to characterize complex interactions among large numbers of nutrients in determining health. Together, these results show that a simplistic conception of nutrition as calories is far from sufficient to understand its effects on health and aging. Evolution has shaped the nutritional needs of each species for its environment, with appropriate levels of flexibility. GFN provides an approach to capture the relevant nuance, with the results presented at this symposium but scratching the surface. Nutrition Interest Group Sponsored Symposium.
Evidence-Based Exercise Recommendations for Older Adults With Cognitive Impairments
Authors: Heyn Patricia , Tagawa Alex , Negm Ahmed , Sood Pallavi
Published: December 2020

Since the publishing of our meta-analysis evaluating the effects of randomized exercise trials on cognitive function of Older Adults with Cognitive Impairments (OAwCIs) (Heyn et al 2004), several meta-analysis reviews were published addressing similar question. We currently appraised this evidence and preliminary synthesis of twelve, well-designed meta-analysis reports resulted in 193 RCTs and 15,614 participants over the age of 65 years old diagnosed with MCI or Alzheimer’s disease (AD). Exercise prescription paradigms averaged 156 minutes per week for 20-week. The combined cognitive function outcome mean effect size was medium; 0.67 (0.06-1.34 95% CI). Grounded in this unique umbrella study results, sustained and prolonged exercise training might provide an effective intervention for the maintenance or enhancement of cognitive function for MCI and AD. This comprehensive meta-analysis umbrella offers valuable and strong exercise recommendations for OAwCIs. This study results will be of great significance to professionals involved in the care of OAwCIs.
The Long Life Family Study: Sequencing Exceptional Pedigrees for Rare Protective Variants
Authors: Province Michael , Christensen Kaare , Consentino Stephanie , Lee Joseph , Newman Anne , Perls Thomas , Thyagarajan Bharat , Zmuda Joseph
Published: December 2020

The Long Life Family Study (LLFS) has longitudinally measured key aging phenotypes on 4,953 participants (539 pedigrees) in the USA and Denmark selected for exceptional familial longevity. On average, both generations of the LLFS sample are healthier than average for their age/sex, for many phenotypes. However, the pedigrees are heterogeneous, with different families showing familial clustering of protection for different phenotypes. Linkage analyses identified extremely strong genetic linkage peaks for many cross-sectional as well as longitudinal trajectory rates of change phenotypes. These peaks are NOT explained by GWAS SNPs (either measured or imputed). Pedigree specific HLODs and preliminary deep sequencing suggests that these peaks are driven by rare, protective variants running in selected pedigrees. Whole Genome Sequencing, a third longitudinal visit, and extensive OMICs (transcriptomics, epigenomics, metabolomics and proteomics) will help us resolve the mechanisms behind these protective genetically linked variants, and could illuminate new biology and enable new therapeutics.
Omics of Long-Lived Mammals and Links to Human Centenarians
Authors: Tombline Gregory , Gigas Jonathan , Simon Matthew , Suh Yousin , Seluanov Andrei , Gorbunova Vera
Published: December 2020

Mammalian species differ up to 100-fold in their aging rates and maximum lifespans. Long-lived mammals appear to possess traits that extend lifespan and healthspan. Pro-longevity mechanisms are complex traits afforded by connections between metabolism and protein functions that are unlikely to be predicted by genomic approaches alone. Thus, metabolomics and proteomics studies are required to understand the mechanisms of longevity. Sirtuin 6 will be presented as an example of a protein that evolved enhanced enzymatic function in long-lived species and also demonstrates enhanced activity and unique alleles in human centenarians. Proteome analysis reveal several longevity related proteins such as Cip1/p21, FOXO3, TOP2A, AKT1, RICTOR, INSR and SIRT6 harboring PTM sites that preferentially appear in either short- or long-lived species. The prospects of enhancing life expectancy and healthspan of humans by altering metabolism and proteoforms with drugs that mimic changes observed in long-lived species will be discussed.
Biological Heterogeneity
Authors: Rogina Blanka
Published: December 2020

Studies of aging in invertebrates, mammalian animal models and humans have demonstrated increasing heterogeneity with aging in terms of varied facets of biological aging. In addition to growing heterogeneity, aging is also associated with qualitative and quantitative changes involving DNA methylation captured in epigenetic clocks of aging which seek to predict chronological and biological aging. Increased heterogeneity with aging is also evident in terms of posttranslational histone modification, gene expression, somatic clonal expansion, and increased degree of tissue mosaicism. Senescent cells accumulating with aging demonstrate significant heterogeneity. For example, while most studies targeting senescent cells have focused on cells expressing p16 (CDKN2A), not all p16-positive cells are senescent and not all senescent cells express p16. Further studies are needed to better define heterogeneity involving other hallmarks of aging and to also explore associations between heterogeneity involving these biological measures with clinical manifestations or outcomes.
Clinical Considerations
Authors: Kuchel George
Published: December 2020

Varied physiological functions demonstrate increased heterogeneity with aging. Variability in force exertion and motor performance is higher in old age, with increased step-to-step gait variability indicating greater risk of falls and cognitive decline. Even in healthy older adults, renal function may show no change, slight decline, or marked decline. In contrast, heart rate variability declines with age, with decreased complexity and a higher risk of cardiac events. The risk of death, disease and disability varies among individuals with increasing heterogeneity with aging. As a result, frailty has been conceptualized as both as a phenotype and an accumulation deficit index, offering strong predictive validity when seeking to understand the heterogeneity of aging from the perspective of risk of mortality and physiologic dysregulation across different systems. Physical resilience defined as ability to maintain or restore function following exposure to stressors also demonstrates increased heterogeneity with aging.
Adding Heart Disease Outcomes to REGARDS: The REGARDS Myocardial Infarction Ancillary Study
Authors: Durant Raegan , Levitan Emily , Muntner Paul , Brown Todd , Safford Monika M
Published: December 2020

The REGARDS-MI ancillary study provided new outcomes of heart disease events and adjudicated cause of death. A primary focus has been disparities in and risk factors for coronary artery disease. We demonstrated that compared to White men, Black men have a higher risk of fatal coronary heart disease (CHD) but a lower risk of non-fatal CHD. Ongoing work is investigating potential reasons for this. We have investigated the role of CHD in aging including the relationship between heart failure and cognitive function and the association of MI with functional status. The REGARDS-MI study has served as a platform for mentoring trainees and early stage investigators, many from underrepresented groups, and provided data to a large number of investigators to purse research in CHD. To date, REGARDS-MI has contributed to nearly 200 publications and spawned additional ancillary studies. This presentation will highlight some of these publications and other research in progress.
Transparency, Documentation, and Open Science
Authors: Isaacowitz Derek
Published: December 2020

Some GSA journals are especially interested in promoting transparency and open science practices, reflecting how some subdisciplines in aging are moving toward open science practices faster than others. In this talk, I will consider the transparency and open science practices that seem most relevant to aging researchers, such as preregistration, open data, open materials and code, sample size justification and analytic tools for considering null effects. I will also discuss potential challenges to implementing these practices as well as reasons why it is important to do so despite these challenges. The focus will be on pragmatic suggestions for researchers planning and conducting studies now that they hope to publish later.
Daily Alcohol and Cigarette Use Among Sexual Minority Adults: Moderating Role of Daily Stress and Daily Well-Being
Authors: Surachman Agus , Wardecker Britney , Exten Cara , Matsick Jes , Almeida David
Published: December 2020

The goal of this study was two-fold: 1) to investigate whether gay, lesbian, and bisexual (GLB) adults, compared to heterosexual adults, used alcohol and cigarettes daily to a greater extent, and 2) to test the moderating role of daily stress and well-being on the association between GLB status and alcohol and cigarette use. We analyzed data from 3,421 adults (GLB = 98; age range = 20-83 years) who completed an 8-day daily diary protocol as part of the Midlife in the U.S. Study (MIDUS). Compared to heterosexual adults, GLB participants reported greater daily alcohol and cigarette use. However, among GLB individuals, more negative affect was associated with less daily alcohol use and people who reported more stressor days and physical symptoms across the week consumed less alcohol. We will discuss how daily affect, stress, and substance use may function differently among GLB people in middle and older adulthood.
Designing Technology for Aging and Disability
Authors: Cotten Shelia
Published: December 2020

Technology has massive potential to improve the lives of older adults in terms of their health, wellbeing, quality of life, and independence. However, benefits will not be realized unless these technologies are designed considering the needs, abilities, and attitudes of the diverse population of older adults. This is especially true when we consider older adults experiencing physical, sensory, or cognitive impairments that influence their ability to adopt and use technology-based solutions. This symposium highlights a variety of approaches to using technology to support older adults living with disability, and important design considerations. The first talk will highlight the important role technology can play in helping persons with cognitive and /or physical impairment in the workplace. The next talk outlines a framework and methodology designed to provide older adults with hearing or visual impairments the capability to use and adapt digital health tools. This is followed by a discussion of a research agenda to use technology to help older adults experiencing disability as a result of cognitive impairment participate in their community. Then, there will be a discussion of how digital health technologies, when considering their unique needs and abilities, can support older adults with cognitive impairment and dementia. The final talk focuses on the intersection of technology, cognitive impairment, and leisure, and explores engagement with digital games by older adults with and without dementia. Common themes that emerge and future directions will be highlighted.
Building Digital Health Tools for Older Adults With Disabilities
Authors: Abujarad Fuad , Swierenga Sarah , Edwards Chelsea
Published: December 2020

Adults with disabilities are more likely to be excluded from digital health research compared to those without. In this symposium, we will describe how user experience (UX) research can be used to successfully develop digital health tools that are both usable and acceptable by older adults with physical disabilities. Our framework and methodology are designed to provide older adults, age 60+ with hearing or visual impairments, the capability to use and adapt digital health tools (including tools that run on mobile devices like smart phones and tablets). Our approach includes one-on-one sessions to evaluate the ease of use and usefulness of digital health for older adults, including 6 blind, 6 deaf, 6 low vision, 6 hard of hearing. This approach allows us to increase the scope of the research participants and, eventually, end users to include adults with disabilities that we may not normally include in research study design.
Mentoring Across Academia and Communities: A Holistic Approach Involving Needs of the Mentee
Authors: Kopera-Frye Karen
Published: December 2020

What is mentoring? Mentoring is defined as a professional relationship in which an experienced person assists another in developing specific skills and knowledge enhancing the mentee’s professional and personal growth. Mentoring benefits include: Knowledge transfer, creating a mentoring culture, and challenging the mentee to move beyond their comfort zone. Carmel and Paul (2015) describe self-selected mentoring as a process in which a mentee identifies a potential mentor based on similarities in interests and need. Findings indicated mentees experienced opportunities in career advancement, expanded thinking, scholarly confidence, facilitation of a collaborative culture, and understanding the importance of goal setting. Mentoring as a health promotion or intervention strategy has become widespread in communities. Two mentoring approaches will be discussed: a traditional format with students and faculty in academia, another utilizing an intergenerational approach with Latinx and Native American families. Recommendations will be discussed in terms of underlying core similarities across the venues.
Kent and Kleemeier Award Lecture and Presentations
Authors: Dobbs Debra
Published: December 2020

The Donald P. Kent Award lecture will feature an address by the 2019 Kent Award recipient, Terry Fulmer, PhD, of The John A. Hartford Foundation. The Kent Award is given annually to a member of The Gerontological Society of America who best exemplifies the highest standards of professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society. The Robert W. Kleemeier Award lecture will feature an address by the 2019 Kleemeier Award recipient, Steven Zarit of Pennsylvania State University. The Kleemeier Award is given annually to a member of The Gerontological Society of America in recognition for outstanding research in the field of gerontology
Creating Age-Friendly Health Systems: Age Matters
Authors: Fulmer Terry
Published: December 2020

Since 2015, The John A. Hartford Foundation has been funding strategies to create Age-Friendly Health Systems (AFHS). Led by the Institute of Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association, the AFHS movement is rapidly growing, with participation in all 50 states from over 450 sites, including the full continuum of care settings. Partnerships with private and public entities are accelerating the work. As one example, the Health Resources and Services Administration has embedded AFHS principles into the Geriatrics Workforce Enhancement Program. This Kent Lecture will focus on the genesis and trajectory of the AFHS social movement and discuss how the effort will lead to an age-friendly ecosystem that transcends boundaries and cultures and leads to a common framework for the way we approach care, caregiving and communities for optimizing the lives and wellbeing of all older adults.
Estimating the Risk of Poverty Transitions at Old Age in the United States: A Survival Analysis Focused on the Hispanic Population
Authors: Iriarte Antonia Diaz-Valdes , Ramos Fidel Bennett
Published: December 2020

Many Americans work well past the Social Security full retirement age. Moreover, the high labor participation rate of aged workers does not translate into better living conditions and decreased poverty at old age. According to the OECD’s relative poverty threshold, the poverty rate at old age is 23.1% (14 points higher than the absolute measure), showing important increases as age progresses. In the context of financial pressure faced by SS, understanding the factors that could help people ensure themselves against poverty is crucial at old age, especially for groups such as Hispanics. Hispanics tend to rely mostly on SS, and tend to retire earlier than non-Hispanics due to limited working opportunities. Using data drawn from the Health and Retirement Study (2008-2016), cox survival models, were conducted to estimate the risk of transitioning into poverty during retirement on determinants of long-term accumulation of disadvantages over the life course (i.e.: wealth accumulation, medical care access, unemployment history). Results suggest that being foreign born and Hispanic are strongly associated with an increase on the probability of experiencing poverty at old age, conditional on health, education and employment status. Furthermore, delaying claims of SS by one year reduces the probability of falling into poverty by 3%, supporting that socioeconomic conditions faced by older adults, especially, the interactions between such factors and ethnicity are key in explaining poverty at old age. This would help policy makers to implement policies could be targeting those factors earlier on, beneficiating the individuals and society as a whole
New Perspectives on Predicting and Modifying Cognition in Older Adulthood
Authors: Bielak Allison
Published: December 2020

The underlying theme of my research is to advance our understanding of cognitive aging through early detection of cognitive decline and the promotion of positive lifestyle factors. I will present my past and recent work that uses new perspectives to predict and modify cognition with older age, specifically focusing on intraindividual variability in cognitive speed, and lifestyle activity engagement. This includes examining the utility of variability in cognitive speed, usually a predictor of decline, instead as a predictor of cognitive plasticity following activity interventions. Further, the association between activity engagement and later cognitive ability and dementia risk is more complex than first appears. I will present research that looks at critical issues about the activity-cognition relation from a different perspective, including unique frameworks investigating the ideal way to measure activity, and the duration of how long past activity can potentially impact cognition. Finally, I will discuss my future research directions.
Rehabilitation of Aging Persons: The Past, The Present & The Promise
Authors: Ottenbacher Kenneth
Published: December 2020

The 2020 Excellence in Rehabilitation of Aging Persons Award presentation will address my efforts over the past 35 years related to research methods, functional status, mobility, and self-care. Studies conducted in the past 25 years on disability and recovery in older adults with an emphasis on minority health will be presented. Research examining rehabilitation outcomes related to health care reform including the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, and using Medicare files, will be described. The role of Data Science and Discovery, as defined by the NIH and related to rehabilitation in older adults, will also be presented.
Clinical Correlation of Cerebrospinal Fluid Total tau Levels and MMSE Score in a memory clinic
Authors: Tangal Neil , Tangal Neeraj , Nair Anil , Nair Malini
Published: December 2020

Tau protein levels in cerebrospinal fluid are a biomarker of Alzheimer’s disease. We correlated MMSE severity to CSF tau levels in a large memory clinic sample. We retrospectively analyzed data from patients attending a memory clinic in the south shore of Boston from 2010 to 2020, and had a lumbar puncture to obtain CSF Tau levels. We compiled cognitive screen data from MMSE scores. Univariate analyses used Spearman correlation as data were non-normal. A multivariate model was created including covariates of age, sex, and race. 965 patients attended the memory clinic from 2010 to 2020. 711 had available MMSE scores. 129 subjects had lumbar punctures and available CSF tau levels. Univariate analyses showed that cognition as measured by MMSE total was not correlated to total tau levels in the CSF (rho=-0.07, p>0.05), but caucasian race was inversely associated with CSF tau levels (rho= -0.217, p<0.05). In a multivariate model, tau levels in the CSF were not associated with MMSE, race, gender, or age. In a large memory clinic sample, CSF tau levels did not correlate to MMSE scores, age, race or gender.
Assessing sleep quality in older adults: A comparison of three measurement approaches
Authors: Berkley Amy , Carter Patricia
Published: December 2020

Discrepancies between subjective and objective sleep measures have been reported for some time; however, it is critical to consider the implications of inaccurate or incomplete sleep assessment for frail older adults who are struggling to maintain independence. To compare sleep assessment methods, we collected objective sleep measurements (via wrist actigraphy), subjective measures via self-report sleep surveys (Pittsburgh Sleep Quality Index; Insomnia Severity Index, Sleep Hygiene Index), and qualitative data through semi-structured audio-recorded interviews, from 8 older adults who self-reported sleep problems while living in a retirement community in southwestern US. Participants’ objective sleep (Total Sleep Time, Sleep Onset Latency, Wake After Sleep Onset, and Sleep Efficiency) and qualitative narratives were congruent, but self-report measures failed to capture several unique sleep problems identified in the sample. Disordered sleep in older adults has been linked to increased incidence of falls, depression and anxiety, cognitive impairment, institutionalization, and mortality, but traditional sleep assessment instruments, designed for the general adult population, fail to capture many of the experiences and causes that are unique to older adults. functioning. A sleep assessment tool designed to measure older people’s sleep experiences could provide more accurate and sensitive data.
Self-Perceptions of Aging, Cognitive Function, and Physical Activity
Authors: Connelly Caitlin
Published: December 2020

Stereotype embodiment theory suggests that internalized aging stereotypes will influence subsequent physical and cognitive health for older adults. This is proposed to occur through behavioral, physiological, and psychological pathways. Guided by stereotype embodiment theory, this study examined the how self-perceptions of aging are associated with cognitive function and the mediating role of physical activity as a behavioral pathway. The sample consists of 7,990 community-dwelling older adults age 65 from the Health and Retirement Study. Cross-sectional data analyses were conducted using bivariate and multivariate linear regression. Positive self-perceptions of aging were significantly associated with better cognitive function. Physical activity partially mediated the association between self-perceptions of aging and cognitive function. Findings suggest that self-perceptions of aging are important for cognitive function and physical activity may help to explain this relationship. Self-perceptions of aging may serve a possible intervention point to increase physical activity engagement and improve cognitive function.
Seeing the past through rose-colored glasses? Age differences in recounting a difficult memory
Authors: Jones Arya , Wilson Stephanie , Shrout M Rosie , Kiecolt-Glaser Janice
Published: December 2020

According to socioemotional aging theories, people better regulate their emotions in older age by reframing stressors and focusing on the positive aspects of difficult experiences. However, empirical results have been mixed. To address this gap, we examined age differences in the language use and cardiovascular reactivity of 188 adults (mean age=56, range=40-86) who relived an upsetting memory from their past. Consistent with theory, results revealed that older adults used significantly fewer negative emotion words and, among the negative emotions, marginally fewer words of anger, to describe their upsetting memory. Notably, however, there were no age differences in the expression of positive emotion or sadness. Controlling for education and cognitive function, greater expression of anger was associated with heightened systolic blood pressure (SBP) reactivity among older adults, not middle-aged individuals. Despite their expression of less negative emotion, older adults’ heart rate variability (HRV) dipped lower during disclosure than did middle-aged adults’. However, among those who used more positive emotion, sadness, and/or cognitive processing words, older adults no longer showed lower HRV than middle-aged participants. Overall, these results provide some evidence of positivity bias among older adults even when asked to recount a distressing personal memory, although this trend was not consistent for the expression of sadness or positive emotion. Further, cardiovascular responses appear more clearly tied to older adults’ level of engagement and emotional focus compared to their middle-aged counterparts’.