bluuebunny/crossref_metadata_2025 huggingface dataset:
PROSOCIALITY AND SUBSEQUENT COGNITIVE HEALTH: A PROSPECTIVE COHORT STUDY
Authors: Farmer Justin , Macchia Lucía , Gong Jessica , Steptoe Andrew , Bu Feifei , Kubzansky Laura
Published: January 2025

Specific prosocial behaviors, including volunteering and caregiving, have been linked to better maintenance of cognitive health in older adults. However, limited epidemiologic work has examined the relationship between one’s cognitive-emotional orientation toward prosociality generally and these same health outcomes. This study uses data on 7844 participants from the English Longitudinal Study of Ageing (ELSA) to test the hypothesis that higher versus lower prosociality is associated with higher maintenance of cognitive health in adults 50 years or older. We derived a 9-item prosociality scale using items from well-validated measures of self-reported altruism and collectivism assessed in ELSA. Linear mixed-effects models were used to examine the relationship between this measure and changes in executive function and verbal memory over an 11-year period. Cox proportional hazards models were then used to compare time to dementia based on level of prosociality. Results from both longitudinal and survival analyses suggest that higher prosociality is associated with maintaining better cognitive health even after controlling for sociodemographics (e.g., age, education, wealth) and baseline health characteristics such as depression and cardiovascular disease. Comparing across tertiles, participants with high versus low prosociality had 24% slower decline in verbal memory and 55% slower decline in executive function. This aligned with a 35% reduced hazard of dementia during this same period for those with high vs. low prosociality. These results suggests that prosociality, beyond formal volunteering, is an important modifiable risk factor for improving later life cognitive function on an individual and population level and should therefore be further examined.
PALLIATIVE CARE FOR PEOPLE WITH MODERATE-SEVERE DEMENTIA IN THE COMMUNITY: RESULTS OF THE IN-PEACE TRIAL
Authors: Sachs Greg , Johnson Nina , Gao Sujuan , Pan Minmin , Torke Alexia , Hickman Susan , Kroenke Kurt
Published: January 2025

Dementia care management programs in the community demonstrate some benefits. Study limitations include limited numbers of people living with dementia (PLWD) with advanced disease or from minoritized populations; lack of palliative care components; and limited success reducing health care utilization. IN-PEACE tested dementia care management integrated with palliative care for PLWD with moderate-severe disease in the community and their caregivers. 201 PLWD-caregiver dyads were randomized to either a dementia care coordinator (99) or usual care (102) and followed for 24 months. Outcomes were neuropsychiatric symptoms (NPI-Q severity) and symptom management (SM-EOLD) in PLWD; distress (NPI-Q distress) and depression symptoms (PHQ-8) in caregivers; and the combined measure of ED visits/hospitalizations. Outcomes were assessed quarterly. Separate mixed effects models were run for each symptom/distress measure and a zero-inflated Poisson model compared the mean number of ED/hospitalization events. Subgroup analyses were conducted based on baseline NPI-Q severity, sex, race, income, and health system. There were no statistically significant differences between groups in any symptoms or distress measures in PLWD or caregivers. PLWD receiving the intervention, however, had substantially fewer ED/hospitalization events (means 1.06 events versus 2.37, p < 0.007). The intervention reduced the proportion of PLWD who had one or more ED/hospitalization events (78.4% of controls vs. 50.5% of intervention, p < 0.001). The relative risk reduction was 35.6% for an event, absolute risk reduction 27.9%, and number needed to treat (NNT) of 3.6. PLWD with higher NPI-Q at baseline and Black PLWD experienced greater reductions in ED visit hospitalization events.
EQUITABLE AND SOCIALLY JUST AGE-FRIENDLY COMMUNITIES FOR OLDER LGBTQ+ ADULTS OF COLOR
Authors: Oswald Austin , Cooper Lujira
Published: January 2025

The age-friendly movement has been critiqued for inadequately addressing the needs of historically disadvantaged populations, like older LGBTQ+ adults of color. This presentation describes a multi-year participatory action research project with five older Black lesbian women aged between 65 and 75. We hosted five focus groups where participants shared their daily experiences living in an age-friendly city and proposed ideas to more inclusively meet the needs of older LGBTQ+ adults of color within age-friendly activities. Focus group data were analyzed thematically, and four themes were identified which expand existing age-friendly frameworks, promoting greater equity and justice: 1) attending to the interaction between identities and structures throughout the life course, 2) understanding the impact of historical and contemporary experiences of violence and discrimination on health and aging, 3) addressing the evolving sociopolitical landscape regarding the human rights and freedoms of diverse older adults, and 4) developing interventions that create safe and affirming spaces for older LGBTQ+ adults of color. While mainstream age-friendly frameworks are widely acknowledged for enhancing the health, independence, and social connectivity of older adults, addressing the unique challenges associated with aging while navigating multiple intersecting marginalized identities requires a critical perspective. The findings of this research underscore the necessity of culturally tailored age-friendly frameworks and interventions to address the distinct needs and experiences of older LGBTQ+ adults of color. We argue that gerontology must seriously consider the impact of privilege and oppression on the health and aging experiences of vulnerable and underserved populations within age-friendly communities.
VOLUNTEERING AMONG OLDER ADULTS AND EFFECTS OF ETHNIC MINORITY IDENTITY BEFORE AND DURING COVID-19
Authors: O’Dea Eireann , Wister Andrew , Li Lun , Canham Sarah , Mitchell Barbara
Published: January 2025

The ongoing COVID-19 pandemic has presented numerous challenges to older adults in Canada, including the ability to engage in volunteer work. This situation has created a new volunteer landscape in which common predictors of volunteering may have shifted. The purpose of this study is to improve understanding of the current social context surrounding volunteering in Canada, by a) determining changes in the associations between human, social, and cultural capital variables and volunteering among older adults and b) examining the potential relationship between ethnic minority background and volunteering among older adults, using data from the Canadian Longitudinal Study on Aging (CLSA), collected prior to and during the pandemic. This study utilized data from 24,306 participants (aged 55+) who participated in the CLSA Baseline, Follow-up 1 and the COVID-19 Study Baseline surveys. Results confirm a decrease in volunteering among CLSA participants during the early stages of the pandemic. When compared to pre-pandemic associations, volunteers during the early stages of the pandemic were more likely to be young-old (55-64), male, employed, and not involved in religious activities. Findings provide evidence of pandemic effects on volunteering among older adults in Canada.
WHO ENJOYS THE GOLDEN YEARS? RACIAL AND SOCIOECONOMIC DISPARITIES IN YEARS OF HEALTHY RETIREMENT
Authors: Abrams Leah , Zhang Yuan
Published: January 2025

For several decades, until around 2010, Americans enjoyed increases in life expectancy, and for some, extended disability-free life expectancy. However, mortality progress has since stagnated, Americans with low education have not benefited from delayed disability, and there remain substantial racial disparities in morbidity and mortality. We aim to determine who in American society retains health and functioning to enjoy retirement years by simultaneously examining healthy life expectancy and time spent in retirement. We use data on physical functioning and work status from the Health and Retirement study in two periods (1998 and 2016) to run Markov models that calculate the number of years and percent of remaining life in healthy work, unhealthy work, healthy retirement, and unhealthy retirement by race and socioeconomic status. Results to date reveal that, in 2016 compared to 1998, adults over age 51 spent a smaller portion of their life in healthy retirement, with a shift toward healthy work. In 2016, Black and white men and women all spent between 17-20% of remaining life years after 51 in healthy retirement, but they arrived there differently. Men spent about 42% of life years healthy and working, compared to about 30% for women. Women spent more time not working with functional limitations. Looking to race, white men spent a greater portion of time working with functional limitations, whereas Black men were not working with functional limitations. Black women spent more time working with functional limitations and less time not working, with and without functioning.
ASSESSING AND STRENGTHENING THE INFRASTRUCTURE FOR CAREGIVING SUPPORTS: A STATE PERSPECTIVE
Authors: Rabalais Jennifer , Rataj Alison
Published: January 2025

Objective. While progress has been made in policies that recognize and support caregivers, there is a need for a unified framework for caregiver supports. The New Hampshire Alliance for Healthy Aging (NHAHA), a statewide coalition focused on building meaningful partnerships to support and promote healthy aging in communities, has a focal area of ensuring that informal family caregivers have adequate supports. Through NHAHA, we examined current state data, policies, and practices that could be leveraged to develop a recommended plan of actions for caregiving supports that aligns with national caregiving strategies. Methods. Using a mixed-methods design, this study used qualitative data from a focus group (n = 14) to assess barriers to accessing caregiving services. A statewide survey (2024) is underway to understand existing services and supports in NH and will be used in further analysis. Data from NH’s State Plan on Aging (2023), which conducted a survey (n = 955) asking several questions about caregiving supports and hosted 10 public listening sessions (n = 185) was also used. Data was catalogued and inventoried across themes in this applied research approach. Results. Three major themes emerged. Caregivers often do not self-identify. Caregiving has negative effects on caregivers financial standing and career. Caregiving supports are siloed, difficult to navigate, and often dissolve without warning. Future Directions. Increased education for caregivers that provides information and resources. Create a system of care for caregivers including respite and financial relief. Advance caregiver friendly work environments.
SPOUSAL EDUCATION AND COGNITIVE FUNCTION: EVIDENCE FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING
Authors: Liu Hui , Wang Juwen , Zhang Wencheng , Zaborenko Callie
Published: January 2025

Education is one of the strongest social factors influencing cognitive outcomes. Previous studies have predominantly focused on the impact of one’s own education, with less attention given to the education of one’s spouse. Guided by the “linked lives” perspective, this study examines the association between spousal education and cognitive function among older couples in England. We analyzed data from the English Longitudinal Study of Ageing (ELSA) Waves 7-9, 2014-2019. The sample comprised 7,131 married and cohabiting couples. Cognitive function was assessed using the modified version of the Telephone Interview for Cognitive Status (TICS). Results from the Actor-Partner Interdependence Model (APIM) showed a significant correlation in cognitive trajectories between spouses within dyads. Cross-sectional APIM analysis revealed that higher educational attainment of both spouses was associated with better cognitive function in both themselves and their partners. Longitudinal APIM growth curve analysis suggested that the association between spousal education and cognitive function was mainly driven by correlations at the initial levels, with no significant association observed with the slope of cognitive trajectories over time. We discuss these findings in the context of England and compare them to recent studies conducted in the U.S. and Mexico. Potential explanations for both similarities and differences in findings across studies are explored, shedding light on the nuanced interplay between spousal education and cognitive function.
GENDER DISPARITIES IN VISUAL DIFFICULTY AMONG OLDER ADULTS: A CROSS-NATIONAL ANALYSIS
Authors: Burns Shane , Saenz Joseph , Ehrlich Joshua
Published: January 2025

Background

Rapid global aging will lead to an increase of older adults with visual difficulty, especially women. However, little is known what contextual factors drive this gendered distinction across the world.

Methods

Using data from the Health & Retirement Study (HRS) international family of studies, we investigate gender disparities in visual difficulty among respondents ages 55-89 in the United States (n=14,452), England (n=5,708), Mexico (n=10,972), and Korea (n=6,649) while adjusting for demographic, socioeconomic, and health characteristics.

Results

Reports of visual difficulty across age groups were generally highest in Mexico, followed by Korea, the United States, and England. In the United States, women had a visual difficulty disadvantage that was fully explained by education and socioeconomic indicators. In England, women had a visual difficulty disadvantage that was partially explained by education and socioeconomic indicators. In Mexico, men had a visual difficulty disadvantage that was explained by comorbidities. In Korea, women had a visual difficulty disadvantage that was explained by comorbidities and health behaviors. Conclusions: Our results highlight the heterogeneity of gender disparities in visual difficulty among older adults across the world.
WHO PAYS FOR VETERANS’ POSTACUTE SKILLED HOME HEALTH CARE? A COMPARISON AMONG VA, MEDICARE, AND MEDICARE ADVANTAGE
Authors: Daus Marguerite , Devone Frank , Corneau Emily , Magid Kate , Kennedy Katherine , Gozalo Pedro , Thomas Kali , Jones Christine
Published: January 2025

Although costs to the Veteran Health Administration associated with post-acute home health care (HHC) have grown, limited evidence is available about the use and financing of HHC among older Veterans. The objective of this study is to identify Veteran, VA Medical Center (VAMC), and market characteristics that are associated with VHA versus Medicare-funded post-acute skilled HHC for Veterans who are discharged from a VAMC hospital with skilled HHC. We assembled and merged data from several sources for FY 2017-2019 including the VHA’s Residential History File, VHA Corporate Data Warehouse, and Centers for Medicare and Medicaid Services. Our cohort (n=64,347 Veterans, VAMCs=114) included all VHA and Medicare enrolled Veterans, aged 66 years or older, admitted to a VAMC for an acute care hospitalization and who received post-acute home health care within 14 days of discharge. We found that being MA-enrolled increased the probability of the VHA paying for HHC by 28.05% (95% Confidence Interval (CI): 27.12%, 28.96). Other important predictors that increased the probability of VHA-paid HHC include previous VHA-paid HHC episodes, previous VHA inpatient admission in the past 12 months, and an admitting diagnosis of sepsis. The most notable finding was that Veterans who are enrolled in MA have a significantly higher probability of having their post-acute HHC paid for by VHA. We will discuss how differences in HHC cost-sharing between MA and TM for members, prior authorization requirements, and denials of care used by MA plans could explain the lower rates of MA-paid HHC.
HOME HEALTH USE BY OLDER ADULTS WITH DEMENTIA: COMPARING MEDICARE ADVANTAGE AND TRADITIONAL MEDICARE
Authors: Smith Jamie , Xu Jianhui (Frank) , Brown Teneil , Burgdorf Julia , Polsky Daniel , Ornstein Katherine
Published: January 2025

Skilled home health care (HHC) is a critical service for community-dwelling older adults with dementia, but the majority of evidence about its use and quality is based on Traditional Medicare (TM) beneficiaries. Medicare Advantage (MA) plans - which now enroll over half of Medicare beneficiaries - have flexibility in financing and managing HHC, potentially affecting access and utilization. Given the growth in MA, increasing dementia prevalence, and delivery shifts to community settings, understanding how HHC use differs between MA and TM among persons with dementia is needed. This study compared HHC utilization in a nationally representative sample of persons with dementia in MA and TM. We used Medicare enrollment files linked to FY 2018-2019 MA encounter and TM claims data to identify persons 65+ years with dementia and at least one HHC visit in 2019. Our study sample included 316,407 persons with dementia (66% TM vs 34% MA). MA enrollees were more likely to identify as non-Hispanic, Black (13% vs. 10%), or Hispanic (12% vs. 6%) than TM. Greater proportion of TM beneficiaries were dual eligible (37% vs. 32%). The groups were similar in age, and 34% were male. Overall, MA enrollees were less likely to use HHC services than TM beneficiaries (26.2% vs 29.8%). This presentation will discuss variation in home health visit type/intensity and findings stratified by MA plan type, carriers, and geographic distribution. We will share novel approaches and best practices for measuring HHC utilization among people with dementia using newly available MA encounter data.
BARRIERS AND FACILITATORS OF THE INNOVATION PROCESS IN LONG-TERM CARE HOMES DURING COVID-19
Authors: Santos Suzanne , Duan Yanjun , Rabello Gilciney Andrade , Bhatti Sumaya , Chu Charlene , Lepore Michael , Zuniga Franziska , Melo Ruth
Published: January 2025

The innovation process is complex and multidimensional regardless of the context in which it is applied. However, innovation sustainability can be even more challenging when applied in the Long-Term Care (LTC) sector. So, understanding the barriers and facilitators associated with innovation adoption can be essential to innovation sustainability in LTC homes. In the qualitative studies incorporated within the scoping review (n =18), an in-depth analysis was conducted to discern barriers and facilitators related to innovation in LTC homes during COVID-19. Barriers to innovation identified were related to residents (e.g., safety, privacy, and appropriateness), staff (e.g., workload and tight routine), LTC homes (e.g., infrastructure and material/human resources), and innovation itself (e.g., cost, technical and connectivity problems). Concerns about the inclusiveness of the residents, especially those with some health-related issues (e.g., dementia and macular degeneration) were also pointed out. Conversely, innovations are likelier to be adopted if they prove to be useful and convenient, align with the needs of both LTC homes and residents, and exhibit user-friendly features. From an organizational standpoint, facilitating innovation during COVID-19 involves preparing the LTC home, providing necessary equipment, and offering training and support to staff. Familiar members/caregivers also point as a positive factor the ability of innovation in relief of care burden. Codesign approaches, involving different stakeholders, might be essential to identifying barriers and facilitators and, therefore, contribute to the sustainability of the innovations inside LTC homes.
INNOVATIVE GERIATRICS EDUCATION FOR STUDENTS AND PROFESSIONALS
Authors: Emery-Tiburcio Erin
Published: January 2025

Training in working with older adults is lacking across health care disciplines, and in interprofessional education, both at the student and licensed professional levels. This symposium will describe five unique and highly diverse programs to educate students and professionals about elements of providing optimal health care to older adults. The Extension for Community Healthcare Outcomes (ECHO) Geriatrics program at the University of Washington engaged interprofessional health professions students to participate in monthly learning sessions about age-friendly care and post-session debriefs. The University of Louisville engaged social work students in their highly successful FlourishCare curriculum (FCC), which includes online modules, workshops, interprofessional case management experiences, case conceptualization meetings, Project ECHO, and more. The 4Ms STOP and WATCH Program at St. Louis University provides education and experiential learning for Certified Nursing Assistants (CNAs) in nursing homes. Virginia Commonwealth University trained Emergency Medical Services (EMS) providers on foundational knowledge and skills in care of older adults living with dementia, including advance care planning needs. Finally, the 4Ms framework of an Age-Friendly Health System (What Matters, Medication, Mentation, Mobility) was adapted by Rush University for use by behavioral health providers, who provided training to interprofessional Community Mental Health Center clinicians. Each of these programs has demonstrated significant positive impact and serve as models for training in geriatrics.
LONGITUDINAL ASSOCIATIONS BETWEEN MULTIMORBIDITIES AND PATIENT-REPORTED QUALITY OF LIFE
Authors: Graham Eileen , Atherton Olivia , Mroczek Daniel , Thames Marquita Lewis , Wolf Michael
Published: January 2025

The global prevalence of multimorbidity is increasing as the population ages. Older adults are very likely to develop multiple chronic conditions, and nearly two-thirds of the older adult population in the U.S. are estimated to be experiencing two or more chronic conditions. The current study examined whether multimorbidity was associated with longitudinal patterns in health-related quality of life (i.e., anxiety, depression, physical function) and whether these associations were moderated by sociodemographic factors (i.e., sex, race, marital status, income, insurance, education). The present pre-registered study used data from the Health Literacy and Cognitive Function Among Older Adults Longitudinal Study (LitCog), a prospective cohort study of English-speaking older adults (N=900). At each measurement occasion, participants reported anxiety, depression, and physical function using the Patient Reported Outcomes Information System (PROMIS), current chronic conditions, and socio-demographic characteristics. We employed multilevel growth models to estimate changes in health-related quality of life, with multimorbidities as a predictor and socio-demographics as covariates. Results indicated that individuals with multiple chronic conditions reported persistently high levels of anxiety and depression, and worse physical function. We found evidence for racial health disparities, such that individuals who identified as non-white experienced worsening health-related quality of life as multimorbidities increased, relative to white participants. These results contribute to the current conversation about the long term impacts of structural and systemic barriers experienced by minoritized groups. We further discuss the public health implications of multimorbidity in older adulthood.
“MY LIFE WAS EASY; HIS LIFE TAKES ALL OF MY TIME”: THE INTERPLAY OF SUPPORT STRUCTURES AND DEMENTIA CARE NEEDS IN THE HOME
Authors: Allison Theresa , Smith Alexander , Gubner Jennie , Covinsky Kenneth
Published: January 2025

We have limited literature about the lived realities of in-home dementia care. Using data from two ethnographic studies of music and everyday life in the homes of people living with dementia, we investigated the relationship between care support resources and multimorbidity care needs. Data included demographics, measures, fieldnotes and semi-structured interview transcripts. We inductively coded transcripts using ATLAS.ti and triangulated findings across data sources. N=83 (38 people living with dementia, 34 family care partners, 11 professionals). Participation varied from a single phone interview to 8 in-home visits over two years. Participants identified complex mismatches between resources and care needs, particularly in ambulatory stages of dementia or with care partner multimorbidity. In contrast, participants identified spirituality as a powerful motivator for providing care. Participants identified adequate social support and financial resources as critical. The findings underscore the need for nuanced approaches to interventions, acknowledging both positive and negative aspects of caregiving.
HARMONIZATION OF MEDICARE BENEFICIARIES’ COGNITIVE FUNCTION DATA
Authors: Zafar Anum , Kobylarz Fred , Zaritsky Rebecca , Kim Hyosin , Lopez Maria , Xia Weiyi , Lin Haiqun , Jarrín Olga
Published: January 2025

This study explains the methodology to harmonize data from healthcare claims and clinical assessments across various post-acute and long-term care settings for Medicare beneficiaries who died in 2019, age 50 or older at death, with at least five years of continuous Medicare enrollment. The cognitive function trajectory file was constructed from 2014-2019 Medicare and Medicaid claims and encounter files (ICD-9 and ICD-10 codes), and cognitive assessments from post-acute and long-term care settings (BIMS scores and other relevant items from MDS, MDS-SB, OASIS, and IRF-PAI assessments). Cognitive function data were harmonized to create a four-category variable: no impairment, memory loss, mild cognitive impairment (MCI), and dementia/severe cognitive impairment. Data were summarized for each quarter (3-month period) of the last five years of life (20 timepoints). Of the nearly two million beneficiaries in our study population, 19.4% had no evidence of cognitive impairment at any point. Five years before death, 3.2% of the sample population had mild cognitive impairment (MCI) and 7.7% had dementia or severe cognitive impairment. At the time of death, 14.8% of the sample had MCI and 50.6% had severe cognitive impairment/dementia. Among beneficiaries with any cognitive impairment, claims or assessment data contributing new information to the trajectory file were available for an average of 7 (out of 20), s.d. 5.7 quarters, median=5, inter-quartile range: 2-11. The harmonized longitudinal dataset allows for tracking change in cognitive function and identifying risk factors for cognitive decline.
MAXIMIZING COGNITIVE TRAINING OUTCOMES WITH SIMULTANEOUS BRAIN STIMULATION
Authors: Jaeggi Susanne
Published: January 2025

Cognitive health is a fundamental issue facing everyone across their lifespan, however, while there is accumulating evidence for the efficacy of targeted interventions to improve cognition, the outcomes have been inconsistent. This contrasts the vast basic science literature suggesting that brain circuits are highly malleable, even in older age. Non-invasive transcranial direct current stimulation (tDCS) has shown to facilitate brain plasticity, especially when administered during a learning event. Here, I will summarize the results of several randomized controlled trials as well as a meta-analysis conducted by my group focusing on cognitive training that is paired with tDCS. Across 4 separate studies involving 257 younger and older adults, we found evidence for improved learning trajectories as a function of tDCS, and in addition, we observed improvements in measures of long-term memory, some of which remained significant several months after training completion. The effects on working memory outcomes appear to be more mixed and dependent on baseline ability, i.e., those with initial lower performance typically benefit more from brain stimulation. Our primary findings are supported meta-analytically in that we found a small positive net effect of tDCS on transfer measures after working memory training, both, in the short- and long-term. However, the effects were most pronounced for measures that were similar to the trained tasks. Collectively, our studies illustrate the potential of tDCS to support cognitive training outcomes, but at the same time, there are boundary conditions and important individual differences that moderate training efficacy.
EFFECTS OF ATTENTIONAL CONTROL DEMANDS IN PROCESSING SPEED TRAINING ACROSS THE ADULT LIFESPAN: FIRST FINDINGS
Authors: von Bastian Claudia , Reinhartz Alice , Hyde Eleanor , Jiang Shuangke , Loranger Elisabeth , Ferreri Jeff , Belleville Sylvie , Strobach Tilo
Published: January 2025

Evidence for cognitive training-induced far transfer of improvements to untrained cognitive abilities is mixed. One notable exception appears to be training interventions that target speed of processing. However, the mechanisms underpinning these training effects are yet unclear. In this pre-registered, multi-site training study, we tested the hypotheses that (a) training tasks with stronger attentional control demands will induce larger transfer effects, and that (b) gains in the rate of information accumulation (i.e., drift rate) will be positively associated with these effects. For this purpose, we recruited 476 healthy participants spanning the adult lifespan (18-85 years) from three sites in the United Kingdom, Germany, and Canada, who were randomly allocated to one of four groups practising tasks with increasing attentional control demands. Transfer to working memory, executive functions, reasoning, and everyday cognitive functioning was assessed before, immediately after, and 3 months after 10 training sessions. N = 388 participants (age in years M = 48.61, SD = 18.28, range 18 – 85; 218 women, 168 men, 2 participants with undisclosed gender; education in years M = 16.68, SD = 3.68) completed the study. The first results from this study will be presented in this talk.
NOVEL FINDINGS AND LESSONS LEARNED FROM CROSS-NATIONAL LONGITUDINAL RESEARCH ON MIDLIFE DEVELOPMENT AND AGING
Authors: Infurna Frank , Gerstorf Denis , Nielsen Lisbeth
Published: January 2025

The goal of this symposium is to bring together a collection of papers that shed light on opportunities gained and challenges encountered in cross-national comparisons of development in midlife and aging and lessons learned. Infurna and colleagues used longitudinal panel data from 16 nations to examine historical changes in midlife pain and report historical increases in pain in the U.S., and Continental and Nordic Europe, whereas Mediterranean Europe, South Korea, and Mexico experienced historical declines. Wettstein and colleagues studied historical changes in midlife memory and explanatory factors in longitudinal panel data from 16 nations; the U.S. was the only nation/region to exhibit historical declines in memory, whereas historical improvements were observed in the European nations. Women, higher educational attainment, better grip strength, and fewer chronic diseases were associated with better memory across cohorts. Steptoe and Brocklebank used data from England and China to examine how physical activity and sleep patterns relate to cognitive decline and highlight challenges related to data collection and instrumentation and approaches to carry out robust cross-national comparisons. Wong provides an overview of research on cross-national comparisons using the Mexico Health and Aging Study by illustrating various examples and discussing gaps in knowledge pertaining to how low and middle-income nations could be supported by cross-national data. The discussion by Nielsen will integrate the four papers by highlighting novel findings that can arise from conducting cross-national research (e.g., historical change, comparisons of explanatory factors) and insights gained through the increasing availability of comparable data that can be harmonized.
EMPOWERMENT IN MOTION: ANALYZING THE EXPERIENCE OF WOMEN HIP-HOP DANCE CREW
Authors: Lee Kyung Eun , Min Hae Youn , Heo Jinmoo
Published: January 2025

Hip-hop dance is known as one of the dance genres, primarily associated with the younger generation. However, it has gained popularity among not only the youth but also the older generations worldwide. Participants in this study have formed hip-hop dance crews targeting middle and old-aged women, engaging in regular practices and performances to create and enjoy their leisure activities. According to the innovation theory (Nimrod & Kleiber 2007), individuals can achieve successful aging by actively engaging in leisure activities. This theory emphasizes the importance of continuously seeking new experiences and challenges, even in later stages of life. Therefore, this study aimed to explore the experiences of participation in the women’s dance crew based on the innovation theory. In-depth interviews were conducted with 16 middle and old-aged women regarding their motivations, identity as members, and outcomes. The interview results confirmed that participants initially began their activities for various reasons (e.g., family recommendations, maintaining health), but continued their activities due to intrinsic motivation. Interestingly, it was found that both self-preservation innovation (leisure activities related to previous life experiences) and self-reinvention innovation (completely new leisure activities) were simultaneously discovered among the participants. Furthermore, participants were able to enhance psychological, physical, and social well-being through dance activities. These findings align with the key factors proposed in the innovation theory. Consequently, it was observed that middle and old-aged women preserve their past identities and explore new aspects of themselves by enjoying hip-hop dance, highlighting the significance of leisure activities in later life.
MULTISECTOR PLANS FOR AGING: OPPORTUNITIES FOR AGING RESEARCH TO INFORM STATE POLICY
Authors: Flores Valerie , Graham Carrie
Published: January 2025

State Multisector Plans for Aging (MPA) are state-led, cross-department, stakeholder- and evidence-informed plans through which states set goals and priorities to transform their state and improve care, services and support for their diverse aging populations. Often these plans are led by the Governors’ offices, Departments of Aging or Medicaid agencies, but also engage across departments of public health, social services, emergency preparedness, housing, transportation, labor, and more. They are also informed by meaningful stakeholder engagement, including advocates, consumers, aging services providers and employers in the state. By far one of the most important MPA stakeholders are universities and researchers who can provide cutting edge data to inform MPAs. Currently, almost half of all U.S. states are engaged in either the development process or implementing an MPA. Evidence and data are important at every stage, from building the case for the necessity of an MPA, to the identification of unmet needs in the state, to development of strategies, and ultimately defining benchmarks and measuring progress. Many states have partnered with gerontological researchers to inform their plans. This offers the mutual benefit of informing the state, as well as providing an opportunity for researchers to learn how to better formulate their research questions to help the state build actionable and timely policy. This session will include an overview of how researchers have contributed to MPAs in many states and how the relationships forged through that process has opened more opportunities for continued collaboration and the translation of research into policy.
PRODUCING “QUALITY”: ASSISTED LIVING ADMINISTRATORS’ EXPERIENCE OF THE LICENSING AND SURVEY PROCESS IN OREGON
Authors: Tunalilar Ozcan , Kohon Jacklyn , Carder Paula
Published: January 2025

Assisted living (AL) communities in the United States are home to a steadily growing population of over 900,000 individuals and provide assistance with daily activities, medical treatments, and social and recreational activities in a congregate residence. States license AL and oversee regulatory compliance. Studies have examined states’ regulations in terms of stringency and specificity, though they did not address survey processes, especially administrators’ perspective. We conducted semi-structured interviews with 37 AL administrators in Oregon to examine AL administrators’ experiences of the licensing and survey process. Using thematic analysis, we identified three major themes: emotional reactions, practical considerations, and relational assessments. First, administrators expressed feelings of high-level stress related to the survey process. Second, administrators discussed drawing on multiple practical approaches to become “survey ready,” including reviewing prior survey results, having support during a new administrator’s first survey process, and setting up other types of partner or mentor support systems for administrators. Third, administrators defined the survey process through their relationship with surveyors, in terms of tone (adversarial vs. collaborative), hierarchical/power structure (“negotiating the evidence”), and the extent of collaboration (“surveyor as mentor”). We interpret these findings using elements from the Resource Dependency Theory by situating “substantial compliance” as a vital resource for the successful operation of AL and regulatory authorities as key resource providers for AL administrators. These results also emphasize a potential mismatch between how AL administrators view their setting and how regulators do.
FILLING GAPS FOR OLDER OHIOANS WITH LOCALLY RAISED FUNDS
Authors: Brekke Bailee , Janssen Leah , Dikhtyar Oksana , Nelson Matt , Applebaum Robert
Published: January 2025

Most older Americans aging in place at home do not financially qualify for support through the Medicaid program, and funding provided through the Older Americans Act is insufficient. As a result, 15 states have turned to local revenue sources to fill service gaps for individuals living in the community, who require social care to support independence. Ohio has a long history of utilizing such funds, generating over $200 million, more than the other 14 states combined. Despite the demonstrated success of these programs, local levy programs in Ohio do experience an array of implementation challenges. This study conducted 15 qualitative descriptive interviews with 20 program officials from various locally funded levy programs across Ohio. Thematic analysis revealed barriers, including increasing state and federal eligibility requirements, staffing issues, rural access to resources, and challenges in setting reimbursement rates. These barriers are coupled with added pressure from county officials to move individuals onto state funded programs (e.g., Medicaid HCBS Waiver programs), rather than keeping them on locally funded programs. The aim of this paper is to examine challenges that local programs are facing and provide program and policy recommendations. Findings reveal the important role local levy programs play in addressing gaps in service and the importance of local advocacy and education to continue passing these levies. Increasing communication between levy staff across the state, integration of cross-funding streams allocated by the state and increasing reimbursement rates are needed to ensure the success of the local levy programs for the future.
DIGITAL APPROACHES TO ROUTINE COGNITIVE SCREENING FOR OLDER ADULTS IN PRIMARY CARE SETTINGS
Authors: Thompson Louisa , Lawrence Molly , Eaton Charles
Published: January 2025

Cognitive screening remains under-utilized for older adults in primary care due to time constraints and limitations of existing measures. Well-validated digital assessments could potentially increase screening efficiency and accuracy. We compared two new digital cognitive tools with the Montreal Cognitive Assessment (MoCA) in a sample of 32 dementia-free older adults (ages 55-85) completing annual follow-up visits with a primary care provider (PCP). Participants self-administered the Boston Online Cognitive Assessment (BOCA), an online measure with alternate forms, twice prior to (1-4 weeks before and day of) an upcoming PCP follow-up visit. At their visit, they completed the Digital Clock and Recall (Linus Health DCRTM), a 5-minute, provider-administered tablet-based measure. Finally, they completed the MoCA with a research coordinator or behavioral health staff at the clinic. Five PCPs aided in protocol development and participated in data collection. The sample is currently 54% female and 81% White. Test-retest reliability for the BOCA was excellent (r =.81). BOCA score (time 1) was correlated with scores for the DCR and MoCA at the p <.05 level. The association between the DCR and MoCA approached significance. On an exit survey, 79% of participants said that they would prefer to do cognitive screening at home before their appointment, compared to in the clinic (21%). These preliminary data replicate excellent test re-test reliability for the BOCA and demonstrate good convergent validity between the BOCA and two provider-administered screening measures. Next, we will compare test accuracies to detect impairment and their associations with demographics variables.
FRIENDSHIP QUALITY IN COLLEGE PREDICTS WELL-BEING IN QUALITATIVE LIFE REFLECTIONS 50 YEARS LATER
Authors: Chopik William
Published: January 2025

Theories of successful aging and psychosocial development posit that well-being later life indicates successful adaptation and portends a longer life. In identifying antecedents to late life well-being, close relationships have emerged as a prominent antecedent for health and well-being across life. However, prospective studies examining the impact of social relationships on health and well-being are relatively rare, particularly mixed methods studies. I paired the Harvard Student Study Class of 1964 (N = 252) with qualitative reflection data in their alumni class reports every five years after graduation for over fifty years. Machine learning techniques will be featured depicting how psychological traits can be inferred through autobiographical reflections. Having more friends and closer friends during their freshman year of college (at age 22) was associated with more positive life reflections (r =.22), more positive relationships (r =.23), and less mental illness (r = -.25) fifty years later (at age 72). I will then leverage these archival sources to examine the impact of social relationships on health and well-being across nearly 100 years to test secular changes in a newly constructed cohort sequential design. Emerging methods for linking family reports across generations and cohorts will be discussed and preliminary results presented. The discussion of the talk will focus on the antecedents of successful aging and how to leverage existing data—in its many forms—to study psychosocial development within a person’s life and across historical time.
AGE DIFFERENCES IN THE FREQUENCY AND NATURE OF ADULTS’ DAILY INTERACTIONS WITH OTHERS
Authors: Fiori Katherine , Rauer Amy , Birditt Kira , Turkelson Angela , Huxhold Oliver
Published: January 2025

Decades of research show that although adults’ social networks tend to shrink with age, the proportion of closest ties stays relatively constant and older adults rate their relationships as more positive. However, little research has examined with whom adults actually interact on a daily basis and the nature of those interactions. We used hierarchical network mapping data and ecological momentary assessment to examine whether there were age differences in social interaction types (inner circle, middle/outer circles, outside network) and in their valence (positive, negative, ambivalent), and if age moderated the link between interaction type and valence. Participants from the Stress and Well-being in Everyday Life (SWEL) study (N = 168; M age = 52.96, range = 33-91; 66.1% female; 47.6% Black) completed surveys every three hours for 4-5 days, reporting a total of 5,771 social interactions. Results showed that 36.6% of all interactions occurred with people outside of the network. Furthermore, against common theoretical expectations, only interactions within the inner circle declined with age. Moreover, although older participants reported more positive and more ambivalent interactions overall than younger adults, age did not moderate the association between interaction type and valence. This indicates that the increased positivity in older adults’ interactions was not specific to inner circle ties, but rather cut across interactions with all types of ties. Examining interactions on a daily level provides new insights into the specificity of potential age effects in social relationships.
DEVELOPMENT, CONTENT VALIDATION, AND USER TESTING OF AN ICU FAMILY WORKBOOK FOR TRANSITIONS FROM HOSPITAL TO HOME
Authors: Scheunemann Leslie , Arivudainambi Aishwarrya , Isenberg Avital , Makeen Mutasim , Christensen Janelle , Donovan Heidi
Published: January 2025

Background

No evidence-based interventions provide education and training for families experiencing critical illness to adapt to the caregiving role and attend to self-care while caregiving across transitions from hospital to home.

Methods

We integrated literature with input from community engagement studios to develop a family-facing ICU Family Workbook addressing common unmet needs. A convenience sample of post-ICU family caregivers, clinicians, and researchers qualitatively and quantitatively assessed content validity related to 11 evidence-based elements. Given a strong content validity index, it is undergoing user testing with a convenience sample of 10 families experiencing critical illness to refine its structure and format.

Results

The ICU Family Workbook includes roughly 70 pages of content covering 11 elements: (1) identifying a transitional “system navigator”; (2) education on symptom management; (3) education on functional support; (4) caregiver needs assessment; (5) development of written plans; (6) financial, legal, employment and insurance resources; (7) interdisciplinary decision support; (8) online resources; (9) self-care/psychological support and referral; (10) education on communicating with clinicians; (11) respite resources. Overall content validity index was 0.93. Qualitative feedback informed revisions refining educational content, enhancing screening tools, and making clearer education and self-care recommendations. Early user testing suggests usability and acceptability to families and is informing additional refinement of its content and formatting. Conclusions: This publicly available ICU Family Workbook (www.picturethis.pitt.edu) has content validity for addressing 11 common gaps in caregiver support. After additional refinement based on user testing, it should undergo efficacy testing for improving caregiving and self-care for families after critical illness.