bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ROAD MAP STRATEGIST INITIATIVE: A NATIONWIDE EFFORT TO BUILD LOCAL PUBLIC HEALTH CAPACITY ON DEMENTIA
Authors: Fadel Meghan , Holtgrave Peter , Roberts Shelby , Jackson Eva , Shean John , Garbarino Lisa , McGuire Lisa
Published: December 2022

The Road Map Strategist Initiative is a nationwide effort to build local health department (LHD) capacity to address cognitive health and dementia. Through a collaboration between the Alzheimer’s Association and the National Association of County and City Health Officials (NACCHO), the initiative aims to make policy, systems, and environmental change, with a focus on health equity. Participating health departments receive funding, training, and technical assistance to establish a part-time Healthy Brain Initiative (HBI) Road Map Strategist, a public health professional serving as a system change agent. With support and education from the program sponsors, Road Map Strategists conduct a community health needs assessment, train LHD staff and leadership, and collaborate with community partners to implement and accelerate public health actions on dementia. Actions taken by the Road Map Strategists are informed by the Healthy Brain Initiative’s State and Local Public Health Partnerships to Address Dementia, The 2018-2023 Road Map. Presenters will share lessons learned from the first cohort of eight (8) LHDs during each stage of the initiative, with a focus on approaches used for Road Map implementation efforts in their communities. This session will share evaluation findings on successes and barriers for changing health department capacity to support local dementia efforts. Data from key indicators related to knowledge gain and capacity change will be shared, including the way LHD characteristics influenced success. The session will also cover effective approaches toward advancing health equity in dementia in local communities and plans for future iterations of the initiative.
ASSOCIATIONS BETWEEN COVID-19 VACCINE HESITANCY AND SOCIOSPATIAL FACTORS IN NYC TRANSIT WORKERS 50 YEARS AND OLDER
Authors: Meltzer Gabriella , Harris Jordan , Heffner Michelle , Lanternier Paula , Gershon Robyn , Merdjanoff Alexis
Published: December 2022

This analysis aimed to investigate how age, race/ethnicity, and geographical location contributed to vaccine hesitancy in a sample of New York City (NYC) Metropolitan Transit Authority (MTA) workers. Transport Workers Union, Local 100 members completed online surveys in August 2020 about their COVID-19 history, workplace protections and policies, fear of COVID-19 exposure, vaccination attitudes, and sociodemographic and health characteristics. We conducted univariate and bivariate analyses, followed by multivariate logistic regression, to determine the association between respondent age (younger than 50 vs. 50+) and vaccine hesitancy (willing vs. unwilling/unsure). We also produced spatial visualizations to examine these factors by participants’ zip codes. Of 645 respondents, 59% were 50 years or older, 53% were non-White, and 71% expressed vaccine hesitancy. MTA workers ages 50+ were 46% less likely to be vaccine hesitant than their younger counterparts (OR 0.64; 95% CI 0.42, 0.97). Compared to Whites, non-Whites (OR 3.95; 95% 2.44, 6.39) and those who did not report their race (OR 3.10; 95% CI 1.87, 5.12) were significantly more likely to be vaccine hesitant. Those who were not concerned about contracting COVID-19 in the community had 1.83 greater odds (95% CI 1.12, 2.98) of being vaccine hesitant than those who were concerned. Spatial visualizations revealed that the oldest respondents tended to reside in Queens. Zip codes with high vaccine hesitancy were clustered in Brooklyn, where non-White respondents tended to reside. The trends observed in COVID-19 vaccine hesitancy based on race and age persist in a population of high risk, non-healthcare essential workers.
RESEARCH, (UN)INTERRUPTED? EFFECTS OF THE PANDEMIC ON A 1 YEAR FOLLOW-UP TO AN ONLINE RCT
Authors: Jeanblanc Alexandra , Musil Carol , Burant Christopher , Zausniewski Jaclene
Published: December 2022

The pandemic profoundly disrupted research, largely due to the interruption of data collection. Our online-only behavioral RCT, evaluating two methods of stress-reduction for grandmothers with co-resident grandchildren, completed the originally planned 4 data collection points prior to the pandemic. When it began, we were in the process of collecting a 5th questionnaire (Q5) from a sample of 152. Our pre-existing work from home policies allowed us to continue data collection uninterrupted.Of 152 potential grandmothers, 51 (58 eligible) grandmothers completed Q5 prior to the pandemic and 62 (94 eligible) completed it after it began, (total N=113, 74.43% response rate. We compared Q5 responses pre/post pandemic, finding no significant differences on resilience, mindfulness/decentering, subjective support, instrumental support, or the friendship scale. Post-pandemic participants had significantly lower scores on the social resourcefulness subscale (t=-1.723, p=.044), but not personal or overall resourcefulness. They reported more depressive symptoms for the CES-D positive affect and depressed affect subscales (t=1.997, p=.048; t=1.673, p=.049). The post-pandemic sample reported worse self-rated health over the last year (t=2.753, p=.003) and worse overall health (t=1.781, t=.039).The higher levels of depressive symptoms, worse self-reported health, and lower social resourcefulness aligns with pandemic-related changes observed by other studies. We did not need to adapt our research procedures for the pandemic and, due to the lower post-pandemic response rate, our subsamples were of relatively equal size. Consequently, it is likely that the differences we observe here are real and reflect the negative effect of the pandemic on individual health and psycho-social well-being.
PROMOTING HEALTHY AGING OF WORLD TRADE CENTER RESPONDERS
Authors: Ornstein Katherine , Ko Fred
Published: December 2022

By 2030 the majority of World Trade Center (WTC) rescue and recovery workers (general responders) will be aged 65 and over and at risk for age-related conditions and consequences. Despite the US government’s commitment to support WTC responders who have exposure-related health conditions (e.g., cancers, PTSD), little research to date has focused on age-related issues in this population. Because WTC responders were exposed to high levels of toxicants and intense psychological trauma in the emergency response and cleanup following the 2001 WTC disaster—hazards that can accelerate the aging process – they are likely at increased risk for premature aging and associated age-related syndromes (e.g., functional decline, falls). An improved understanding of how aging affects the health of WTC responders is critically important to improving their clinical care, health outcomes, and overall quality of life. In this symposium we will present 3 studies that have shed light on the aging of WTC responders. First, we assess frailty among responder using a frailty phenotype. In the next study we examine the extent of polypharmacy among WTC responders and associated factors. Finally, we examine trajectories of frailty in this population over 2 decades of follow up using a validated clinical frailty index. This work represents the first examination of frailty and aging among WTC responders and will be an area of growing research as the population ages.
SENIOR CENTER RESPONSE TO COVID-19: INVOLVEMENT WITH VACCINE DISTRIBUTION
Authors: Somerville Ceara , Coyle Caitlin , Mutchler Jan
Published: December 2022

In early 2021, access to a COVID-19 vaccine was prioritized for older adults and people with multiple co-morbidities. Between high demand, emerging supply, and new systems for booking a vaccine appointment, many people had challenges getting an appointment. Senior centers became a crucial resource for access to the vaccine and additional information about its efficacy and safety. This poster presents survey data collected from 282 senior centers in Massachusetts regarding their involvement with the COVID-19 vaccine distribution in 2021. Nearly all senior centers reported making vaccine appointments on behalf of residents and were responsible for over 166,000 appointments made. Nearly 100,000 hours were spent by senior center staff or volunteers to make appointments. About a third of senior centers participated in hosting nearly 2,000 vaccine clinics, which vaccinated over 175,000 adults. Respondents reported challenges faced during the booking process, including the length of time and the developing technologies to book an appointment. Almost two-thirds of senior centers reported assisting community members under age 60, operating beyond the traditional scope of their services. Other assistance provided by senior centers included providing information about eligibility and guidelines (84%), information about vaccine efficacy and safety (62%), offering transportation to appointments (70%), and providing physical assistance for appointments (31%). Evidence from this poster emphasizes the important role that senior centers play in the community, not just for older adults but also for the community at large.
MEANING IN CHALLENGING TIMES: SENSE OF MEANING SUPPORTS COPING WITH PANDEMIC STRESSES
Authors: Kero Katherine , Podlesek Anja , Kavcic Voyko
Published: December 2022

The COVID-19 pandemic created disruptions in daily life and trauma for many individuals. Traumatic experiences often trigger reflection on meaning in life (MIL), which may result in either resilience or despair. The purpose of this study was to evaluate the role of MIL in mediating the relationship between COVID-related stressors and well-being outcomes. Further, age-related differences in MIL were examined. Web-based surveys were completed by 831 Slovenian participants in April of 2020. Demographic data; perceptions of stressors related to lacking necessities, movement restrictions, and concerns at home; MIL; perceived overall health status; anxiety; emotional state; and perceived stress were measured. Overall, a moderately strong sense of MIL (M = 5.0, SD = 0.74, range 1-7) was reported by participants. Older age was a significant predictor of greater MIL, (B = 0.098, SE = .036, p < .01). Older adults also experienced less perceived stress, negative emotions, and home-related stressors compared to younger adults, but greater stress from lacking necessities (p < .05). MIL partially mediated the relationship between stressors and well-being outcomes, especially stressors related to lacking necessities and concerns at home (13-27% mediation) and outcomes of anxiety, perceived stress, and negative emotions. A strong sense of MIL was associated with improved well-being and a buffering of the effects of pandemic-related stressors. Older adults were less vulnerable to stress and had a greater sense of MIL than younger individuals. Public health initiatives and media may help improve resilience to pandemic trauma by emphasizing the collective meaning in challenging situations.
WHAT IS THIS COVID? COMMUNITY PERCEPTIONS OF COVID-19
Authors: Kopera-Frye Karen , Delgado JoJo
Published: December 2022

The COVID pandemic was complicated by the varied amounts and sources of information available on what exactly COVID was, e.g., CDC website, social media; some fact-based and some not. The purpose of the project was to learn how people defined COVID. The surveyed sample consisted of 155 community dwellers (M age = 45.7 years), with above average education, primarily female (66%), and slightly over one-half identifying as Caucasian and approximately 40% Latinx. The sample were all residents of the Southern Border region, having very high rates of COVID infection in this area, and a statewide mask mandate both inside and outside. The open-ended question inquiring “What is COVID?” was answered by the respondents and thematic analysis focused on two dimensions: 1) was the response factual or not (incorrect in some manner); and 2) the definition of COVID in terms of a virus, flu, etc. Interestingly, despite the median education being around 15 years, 44.5% of the sample gave an incorrect definition of COVID. The three most predominant themes emerging from the definitions were (in descending order): 1) a virus with specific facts noted; 2) a disease/infection; and 3) an affective reaction such as annoying. The results highlight the diverse conceptualizations in a very high-risk area, especially focused on oftentimes an incorrect understanding of COVID.
OLDER ADULT'S SEPSIS CARE: CROSSING THE CONTINUUM: LESSONS LEARNED, OPPORTUNITIES PRESENTED
Authors: Cranston Teresa , Kontra Joseph , Roldan Lanyce
Published: December 2022

Sepsis is the body’s overwhelming response to infection that can lead to tissue damage, organ failure, and death. Delays in identification and treatment are associated with increased morbidity and mortality especially for older adults. It is key that clinicians practice collaboration and communication when diagnosing & treating patients that may have a different presentation. The Continuous Monitoring Unit (CMU) consists of RNs, who monitor the Sepsis Dashboards 24 hours/7 days a week. These nurses evaluate all BPA data points. They dismiss the irrelevant and align the significant while looking for possible notes of infection. They act upon the BPA when the patient meets criteria. They collaborates with the provider to initiate recommended sepsis care. Once the sepsis diagnosis is confirmed, the CMU RN communicate with inpatient nursing via EMR shift reporting and Care planning tools. Nursing utilizes these tools for daily rounds with the health care team communicating patient discharge needs. Identifying the Sepsis survivor on admission allows for early sepsis survivor education, discharge preparation and outpatient follow up referrals. Case Management utilizes an electronic application for outpatient referrals and includes a Sepsis Survivorship alert. Community resources, alert to a sepsis diagnosis will follow up within 24-48 hours of discharge to insure that the patient is having a smooth transition. Referred providers can escalate care to the PCP for early intervention therefore reducing worsening state or readmission. Specifically, our home care agency monitors the patient closely upon discharge due to the sepsis survivor’s tenuous state and reinforces sepsis education.
POLYPHARMACY AND FRAILTY AMONG WORLD TRADE CENTER GENERAL RESPONDERS
Authors: Hung William , Bello Ghalib , Ko Fred , Sabra Ahmad , Thanik Erin , Lucchini Roberto , Ornstein Katherine
Published: December 2022

Polypharmacy in older adults is associated with increased risk of adverse events such as falls, adverse drug reactions and functional decline. WTC responders suffer from conditions related to WTC exposure and are at higher risk of polypharmacy. We examined patterns of medication use among WTC general responders aged 50 and over who had at least one visit from 2017 to 2019 (n=7,679); 56.1% took 5+ medications and 22.5% took 10+ medications. Factors associated with polypharmacy (taking 5+ medications) include age (OR 1.08, p<0.001), female sex (OR 1.33, p<0.001), obesity (1.90, p<0.001), fair/poor self-rated health (OR 1.32, p<0.001) and limitations on performing moderate activity (OR 1.52, p<0.001). Frailty, as measured by the deficit count in the Clinical Frailty Index, is associated with polypharmacy after adjusting for other covariates (OR 1.23, p<0.001). Addressing polypharmacy by improving medication use may yield health benefits for this rapidly aging population at risk for adverse outcomes.
COSTS OF DEMENTIA CARE AND EARLY-STAGE PREVENTIVE NURSING: A COMPARATIVE BIG DATA STUDY IN OSAKA
Authors: Hu Xujing , Kanaya Reiko , Yamamoto Ryohei , Toki Hiroshi , Takeya Yasushi , Yamakawa Miyae
Published: December 2022

Data show a substantial increase in the costs of dementia care nationally and globally. We assessed the factors increasing financial pressure, and found an association between the costs and the severity of dementia. We suggest that early diagnosis and preventive nursing care can reduce the deterioration associated with dementia, and therefore the overall costs of dementia care. The purpose of this study was to determine the relationship between the costs of dementia care and early-stage preventive nursing care in a sample of people with dementia aged 65 to 85 years, using the Medical Care Insurance and Osaka Prefecture Long-Term Care Insurance Database (N = 17973). We found that early care might have a significant effect on formal care costs in the early period of dementia but did not influence the medical care costs of dementia. During the first 5 years, the long-term care costs of people with dementia with an initial care level of Support 1/2 (one type of care level of Japanese long-term care insurance system, and the participants receive preventive services) were $4,389, while people with an initial care level of Care 1/2 (the other type of care level, and the participants receive nursing services) were $12,333. About 20% of people who received preventive care recovered, suggesting that preventive nursing care can restore the ability of people with early-stage dementia. This might be the reason for the reduction in long-term care costs. This research provides a basis for supporting preventive nursing care and extending healthy lifespans.
DEMENTIA AND THE ROLE OF EVIDENCE-BASED GUIDELINES IN PRIMARY CARE: RESULTS OF A CLUSTER RANDOMIZED CONTROLLED TRIAL
Authors: Lech Sonia , O'Sullivan Julie L , Spang Robert P , Voigt-Antons Jan-Niklas , Gellert Paul , Nordheim Johanna
Published: December 2022

General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the potentials of evidence-based dementia guidelines in primary care remain unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices and to evaluate the effectiveness of a tablet-based intervention aiming at improving guideline-based care. A two arm, cluster-randomized controlled trial (cRCT) with an intervention group (tablet-based intervention) and a control group (treatment as usual) was conducted from April 15, 2018, to July 31, 2021, in Berlin and the surrounding area. Primary outcome was defined as adherence to dementia guideline recommendations after 9 months. Secondary outcomes included various health outcomes assessed in PwD (e.g., quality of life). Linear Mixed Models were used to analyse cross sectional baseline data. Primary and secondary outcomes were analysed by intention-to-treat analysis and using Mixed Models. Data of N = 28 GPs and N = 91 PwD was analysed. PwD were on average 80.5 years old (SD = 6.3), 59% were female. Self-reported overall guideline adherence of GPs was on average 71% (SD = 19.4, range: 25–100). Further, lower guideline adherence was found to be significantly associated with higher numbers of patients (γ10 = − 5.58, CI = − 10.97, − 0.19, p = .04). The effectiveness of the cRCT is still under evaluation. Final results will be presented and discussed at the GSA Annual Scientific Meeting. Further, implications and conclusions of the trial will be provided.
FORMAL AND INFORMAL VOLUNTEERING AMONG OLDER ADULTS: ASSOCIATIONS WITH HEALTH OUTCOMES ACROSS SEXUAL ORIENTATIONS
Authors: Frey Joseph , Shen Huei-Wern , Wang Yi
Published: December 2022

Volunteering is associated with positive physical and mental health outcomes among older adults. However, little is known about the impact of volunteering on health among older lesbian, gay, and bisexual (LGB) Americans. Using nationally representative 2016 Health and Retirement Study data, the present study explored associations between volunteering and health outcomes (i.e., self-rated health, current memory rating) across sexual orientations among older Americans. Two types of volunteering were considered in the study—formal volunteering (doing unpaid work for religious, educational, health-related, or other charitable organizations) and informal volunteering (providing unpaid help to friends, neighbors, or relatives who do not co-reside). We included 235 (5.7%) respondents who self-identified as LGB or something else, and 3,894 (94.3%) heterosexual-identified respondents. Controlling for health-related variables (e.g., ADLs/IADLs), SES (e.g., income), contextual features (e.g., urban/rural), and sociodemographics (e.g., age, gender, race), results from eight stratified OLS regression models showed that for heterosexual-identified older adults, both formal and informal volunteering promoted self-rated health (p<.001, respectively) and memory rating (p<.001, respectively). However, for LGB-identified older adults, only informal volunteering was detected to increase memory rating (p<.038). Findings suggest that the well-documented health benefits of formal volunteering may not be supported in the LGB population. The current theoretical model and discourse about productive aging should be modified to be more inclusive with respect to sexual orientation. Further research identifying the pathways (e.g., identity-related stigmatization and discrimination) between various types of volunteering and health outcomes among older LGB adults is urged and possible directions will be discussed.
AGEISM, CONTACT, AND OLDER ADULT ADLS RELATE TO MENTAL HEALTH TRAINEES’ INTEREST IN GEROPSYCHOLOGY
Authors: Caskie Grace I L , Voelkner Abigail , Sutton MaryAnn , Canell Anastasia , Root Eve
Published: December 2022

Despite growing demand, few mental healthcare professionals specialize in clinical work with older adults. A better understanding of factors related to geropsychology interest may increase the pipeline of future geropsychologists. Graduate-level trainees (N=460; 67.4% doctoral; age=21-64) completed the Fraboni Scale of Ageism, Contact with Older Adults Scale, six indicators of interest in work with older adults, and an imagined “typical” older adult’s ability to complete activities of daily living (ADLs). 60% imagined full ADL independence. Between 14.1%-25.7% expressed strong interest in education/training related to treating older adults and having some older adult clients; only 6.7% planned to specialize in clinical work with older adults. In regression analyses (R-squared=16%-32%), more ageist attitudes, less contact, and being a master’s trainee were related to less interest. ADL status was significant only for interest in specialization; imagining more ADL-dependence related to higher interest in specializing in older adults. ADL status significantly moderated the relation of contact to interest in learning about issues related to older adults; ADL-based differences in interest were non-significant at low and average contact, but at high contact, interest in learning about older adults was significantly higher when the older adult was imagined as ADL-dependent rather than ADL-independent. Findings may indicate benevolent ageism partially motivates trainees’ interest in learning about/working with older adults whom they imagine need more help with basic tasks of daily living. Increasing contact, reducing ageist attitudes, and providing more clinical opportunities with older adults may facilitate trainees’ readiness and interest in future clinical work with older adults.
EXPLORING HEALTHCARE WORKERS' GERIATRIC EDUCATION AND SUBSEQUENT COMMUNICATION WITH OLDER ADULTS
Authors: McQuaid Tina
Published: December 2022

Research shows that older adults are living longer than ever, are the fastest growing population, and can have increasingly complex health-related issues. However, the health knowledge and literacy of older adults can be limited, and these adults may have difficulty understanding the terminology that healthcare workers use to communicate with them about their health. For impoverished older adults especially, this can contribute to poor health decisions and decreased care. Given this, educating healthcare practitioners to communicate effectively with older adults becomes essential to older patients’ quality of care. Using predominantly North American studies of healthcare workers’ practices, education, and their interactions with older adults (aged 65-85, primarily), this review paper finds that: i) older adults are responsible for their communication with healthcare workers, but practitioners, because of their implied authority, control the narrative, and therefore it is necessary for them to become more educated in communicating with older adults; ii) some current communication practices by healthcare workers (with older adults) are not reflective of sufficient care; and iii) new gerontology education can foster increased empathy and shared communication practices among healthcare workers, and this can aid patients to better control and have confidence in their healthcare decisions. Social and cultural factors that may explain the health literacy divide in older adults are discussed, as are recommendations and best practices for healthcare workers working with older adults.
EVALUATION OF FALL RISK PREVENTION EDUCATION THROUGH AGE-FRIENDLY PARTNERSHIPS
Authors: Rivera-Torres Solymar , Severance Jennifer
Published: December 2022

Falls in the home and community environments are the leading cause of injuries and long-term disabilities for the aging population. This study examines the outcomes of a partnership among an academic institution, government agency, community nonprofit, and emergency services organization to expand access to a fall prevention training program by targeting delivery in postal codes identified as underserved with high rates of falls emergencies (hot spots) and non-high rates (non-hot spots). A total of 354 adults aged 50 and older participated in a fall prevention education program, with 188 (53%) participants completing at least five sessions (completers), of which 35% resided in hot spot areas. Descriptive statistics for frequency, percentage, mean, and standard deviations values were calculated for demographic variables. A paired t-test analysis was conducted to compare initial and final scores for self-assessed general health and fall efficacy programs. The paired sample t-test statistics revealed significant improvements in fall efficacy for completers in hot spots (t= -6.23; p < 0.001) and non-hot spots areas (t= - 11.17; p < 0.001). No statistical differences (p > 0.05) were observed between the initial and final scores of the self-assessed general health for completers in hot spots and non-hot spot areas. Cross-sector collaboration to deliver targeted falls prevention training at various community locations can effectively reach underserved, at-risk older adults, although additional retention strategies must be considered. In conclusion, identifying at-risk older adults to mobilize partnerships, limited resources can be allocated towards improving retention and program outcomes of community-based fall prevention education.
DOES AGEISM ACCELERATE BIOLOGICAL AGING
Authors: Liu Mingxin , Cohen Alan , Fulop Tamas , Legault Véronique , Betrisey Carine , Levasseur Melanie
Published: December 2022

Defined as, “stereotype, prejudice, and discrimination directly towards people because of their age”, ageism may contribute to adverse health outcomes, accelerate aging process, and increase the burden on health and social services. Little is known about the ageism impact on biological aging. Secondary analysis of the American Health and Retirement Study (2012 and 2016 waves) was carried out. Participants were asked: the self-perception of aging (SPA), the causes of receiving discrimination, including ageism as one of the causes, and the frequency of receiving such discrimination. The aging rate was measured using two distinct measurements: homeostatic dysregulation (using Mahalanobis distance on 44 biomarkers, n= 9934, 2016 wave) and epigenetic aging clocks (n=4018, 2016 wave). The influence of perceived ageism (current or previous waves) on the aging rate was modelled with linear models using biological aging (aka. homeostatic dysregulation and epigenetic age) as the dependent variable (outcome), ageism as the exposure, with considering confounders: sex, depressive symptom. The results show that more negative SPA, either from the previous (2012) or the same wave (2016), is associated with elevated homeostatic dysregulation (e.g. the slope increases from 1.20 to 1.34, p< 0.001, previous wave) and increasing epigenetic age (e.g. DNAm PhenoAge, the slope increases from 53.81 to 61.14, p< 0.001, current wave). The association between the ageism receiving frequency and biological aging is similar but less significant. The results demonstrate that ageism is associated with accelerated biological aging. More interventions are called to combat ageism and foster the health and wellbeing of the older adults.
CROSS-CULTURAL DIFFERENCES IN AGE ESTIMATION AND AGE BIAS
Authors: Benz Hannah , Scherer Hailey , Rodriguez Gustavo , Steele Jenessa
Published: December 2022

Our society is aging rapidly with older adults composing a continuously growing proportion of the population. This expected shift in population age is likely going to carry societal consequences, such as an increase in age discrimination. Previous research has shown that ageism (the systematic stereotyping and categorizing of people based on their age) is the most experienced kind of prejudice across Europe, with individualistic, industrialized countries like the USA and Germany showing greater levels of age bias towards the elderly. The current study aimed to investigate cross-cultural differences in age estimation and attitudes towards older adults. Pilot measures included 102 participants (65 American, 37 German) who estimated the age of 12 male celebrities representing three different age groups (young, middle, and older adult) and completed the Fraboni Scale of Ageism (FSA), a survey measurement investigating ageism. Although the Fraboni scale has been validated in other countries, it has not yet been translated to German, nor tested on a primarily German-speaking population. Preliminary analyses showed that both the original FSA scale and the German translation were reliable (αOriginal = 0.909, αGerman = 0.703), however, t-test revealed significant differences between the FSA mean scores of the original scale (M = 1.78, SD = .34) and the translated version (M = 3.15, SD = .28), t(100) = -20.90, p < .001. The researchers are currently recruiting 400 additional participants to explore the effects of culture, race, and participant age on age estimation and further validate the German translation of the scale.
INCLUSION OF ETHNICALLY DIVERSE POPULATIONS IN CLINICAL TRIALS OF HEALTHSPAN: IMPLICATIONS FROM THE SALSA STUDY
Authors: Espinoza Sara , Cortes Tiffany , Hazuda Helen
Published: December 2022

Background

Geroscience-guided clinical trials focused on healthspan may seek to enroll older adults initially free of chronic diseases and disability. Here we examine healthspan in the San Antonio Longitudinal Study of Aging (SALSA), a cohort of 749 community-dwelling older (65+ years) Mexican Americans (MA) and European Americans (EA), and describe prevalence and characteristics associated with poor healthspan.

Methods

Poor healthspan was defined at the SALSA baseline exam as presence of any one of: 1) chronic disease (diabetes, myocardial infarction, congestive heart failure, stroke, chronic obstructive pulmonary disease, or cancer); 2) dependence in basic or instrumental activities of daily living; or 3) mini mental state exam score < 18. Frailty was defined by Fried phenotype criteria. The association of poor healthspan with age, sex, ethnic group, socioeconomic status (SES), and frailty was assessed using chi-square or t-tests.

Results

544 (72.6%) participants met criteria for poor healthspan, which was associated with older age (69.6 ±3.4 vs. 69.3 ±3.4, p< 0.05), male sex (77.3% vs. 69.2%, p< 0.05), MA ethnicity (77.4% vs. 67.3%, p< 0.05), lower income (11.3 ±3.1 vs. 12.2 ±2.9, p< 0.001 and education (10.4 ±4.6 vs. 12.7 ±3.2, < 0.0001), and frailty (95.5% vs. 4.6%, p< 0.001).

Conclusion

Poor healthspan was highly prevalent (>70%) in SALSA and associated with MA ethnicity, low SES, and frailty. Geroscience-guided clinical trials of potential interventions to improve healthspan by preventing chronic diseases and disability may under-represent individuals of ethnic minority background and lower SES and, thereby, jeopardize generalizability of the findings to the broader population.
SYSTEMATIC EXCLUSION AT STUDY COMMENCEMENT MASKS EARLIER MENOPAUSE FOR BLACK WOMEN IN THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION (SWAN)
Authors: Reeves Alexis , Elliott Michael , Karvonen-Gutierriez Carrie , Harlow Sioban
Published: December 2022

Assumptions regarding “normative” aging, including average age at onset of disease, are often based on White populations. However, evidence suggests that Black and Hispanic populations may experience “weathering” or accelerated health declines compared to Whites due to the cumulative impact of social and economic marginalization. If “weathering” leads to a differential probability of inclusion into a cohort study, it will likely misinform understanding of aging in minoritized populations. Using SWAN, a longitudinal multi-ethnic cohort of midlife women, and its cross-sectional screening study, we quantified the extent of potential selection bias at study commencement and re-estimated racial/ethnic differences in age at menopause, the main outcome of SWAN, with adjustment for various forms of potential selection bias. Left truncation was corrected for using inverse probability weighting and right censoring using multiple imputation. Two selection mechanisms were identified, eligibility and participation. Black and Hispanic women had the lowest probability of eligibility stemming from a high prevalence of surgical menopause. Their eligibility rates decreased with increasing age faster than in White women. Correcting for selection biases showed that uncorrected analyses overestimated of the median age of menopause in Black and Hispanic women, thereby underestimating racial/ethnic disparities. After adjustment, Black women had earlier natural and surgical menopause (average 1.2 years) versus White women. Overall, this study found that failure to account for different forms of selection can lead to mis-estimation of racial/ethnic disparities in health and aging. Selection bias is particularly acute at study commencement, and particularly affects minoritized populations.
RURAL LIVING AND DISABILITY IN OLDER ADULTS: THE ROLE OF ALTERNATIVE SUPPORT RESOURCES AS MEDIATORS
Authors: Steinman Bernard , Barbakoff Daniel
Published: December 2022

Rural communities are often characterized by sparse service environments offering limited care, services, and conveniences that help with daily activities. In lieu of community services that target older adults to assist with aging-in-place, alternative supportive features, including environmental modification and informal social networks may be especially important in rural settings to preserve functional independence. The purpose of this study was to assess the role of alternative support resources as potential mediators between service environments and Activities of Daily Living (ADL) functioning of older adults living in rural settings. Data from the National Health and Aging Trends Study (NHATS) were analyzed. Guided by the International Classification of Functioning, Disability and Health, regression models included covariates for sociodemographics, chronic conditions, mobility functioning, and participation. Service environments were quantified using a measure of the number of services (e.g., help with bathing) available in communities. Two potentially important support features were tested as mediators. Environmental modification was operationalized using indicators of whether homes had been modified (e.g., with features such as grab bars). Size and quality of individuals’ social networks were calculated using indicators of whom participants spoke to about important things in their life. Measures of ADLs served as key dependent variables. Results suggest a negative statistical relationship between service environments and disability that is explained in part by the availability of alternative support resources. Implications are that older adults who live in rural communities may often benefit by employing home modifications and relying on informal care options to meet their needs.
DEPRESSION IS ASSOCIATED WITH POORER CLINICAL FUNCTIONING AMONG HISPANIC OLDER ADULTS
Authors: Duarte Andres , Padron Dilianna , Gonzalez Joanna , Garcia Patricia , Mendoza Lisandra , Duara Ranjan , Rodriguez Miriam
Published: December 2022

Objective

The aim of the current study was to examine associations between depression and clinical functioning among a multi-ethnic sample.

Methods

35 cognitively normal and Mild Cognitive Impairment (MCI) participants were included and self-identified as Hispanic or white non-Hispanic (WNH). The Hispanic group (n=18), had a mean age of 70.83 (SD=7.66) and 15.59 mean years of education (SD= 3.43). The WNH group (n=17) had a mean age of 71.76 (SD=6.9) and 16.81 mean years of education (SD=2.59). Subjects were given the Alzheimer’s disease Cooperative Study (ADCS) ADL inventory, the modified Clinical Dementia Rating scale (mCDR), and the Geriatric Depression Scale (GDS). Linear regressions were conducted to analyze the predictive associations between GDS scores and ADL functioning while controlling for the effect of diagnosis and age.

Results

Among Hispanics, the overall regression was significant (R2 = .622, F(2,17)= 12.32, p<.001). Higher GDS scores was found to significantly predict worse mCDR scores (β = .676, p<.001) when controlling for the effects other factors. When examining ADCS-ADL scores, the overall model was also found to be significant (R2= .413, F(2,17)=5.28, p<.05). Higher GDS scores significantly predicted worse ADCS-ADL scores (β = =.652, p<.01) when controlling for the effects of other factors. Diagnosis and age did not significant predict ADL scores. Among the WNH group, the regression model was not significant and depression was not a significant predictor of ADL functioning.

Conclusions

The results suggest Hispanics are more vulnerable to the effects of depression on ADL function which has important implications for AD diagnosis.
ADDRESSING ALZHEIMER’S DISPARITIES AMONG BLACK POPULATIONS WITH BRAINGUIDE BY USAGAINSTALZHEIMER’S
Authors: Kenny Brooks
Published: December 2022

Older, Black Americans are disproportionately impacted by Alzheimer’s disease (AD), accounting for 15% (~1 million) of all individuals aged 65+ living with AD (5.8 million). Stigma, fear, and gaps in education contribute to 60% of undetected AD cases. In Georgia, AD remains the 6th leading cause of death. By 2029, cases are projected to spike by 46%, from 130,000 to 190,000. Given these alarming statistics and in response to AD health disparities in this population, UsAgainstAlzheimer’s, in partnership with community leaders and organizations, launched a pilot outreach program to promote AD prevention and brain health awareness in Atlanta. Program goals included: increasing knowledge about brain health, emphasizing the importance of early detection and diagnosis, raise awareness of BrainGuide™ by UsAgainstAlzheimer’s and other brain health resources, and develop a network of organizations for ongoing collaboration, awareness, and education. Program strategies included accessing highly saturated, faith-based spaces like mega churches, circulating key messaging through paid and earned media, and hosting widely received community webinars. UsAgainstAlzheimer’s collected participant feedback and examined BrainGuide website traffic to evaluate the effectiveness of community engagement on increasing brain health awareness and addressing AD stigma in Atlanta. Preliminary findings indicate a 96% increase in BrainGuide traffic from Atlanta and 70% increased engagement with BrainGuide resources, compared to the national average. UsAgainstAlzheimer’s’ pilot program suggests that brain health promotion, grounded in community engagement from trusted influencers, has potential to raise brain health awareness and empower people to take action. Further research and learnings are required to determine program scalability.
HEALTH SURVEILLANCE OF PERSONS LIVING WITH DEMENTIA AND CAREGIVER DYADS
Authors: Robitaille Annie , Drummond Neil , Garcia Linda , Marasinghe Himasara , Barber David
Published: December 2022

The relationship between individuals living with dementia and their caregivers is important and can impact their dementia journey. However, limited national longitudinal data exists about the caregiver-person living with dementia dyad. Availability of such data would provide important information about joint trajectories and help to better identify the needs of caregivers and persons living with dementia across the dementia journey. The objective of this study was to develop a linked national longitudinal database of persons living with dementia and their caregivers. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) extracts and de-identifies clinical data from electronic medical records (EMR) from approximately 2 million patients across Canada. CPCSSN data is used to identify persons living with dementia and caregivers willing to participate in the study. CPCSSN data from participating dyads are linked (e.g., chronic and mental health conditions, diagnoses, laboratory test results) and additional information about the experiences of persons living with dementia and their caregivers (e.g., ethnicity, amount and type of care provided, burden, availability of support) are collected yearly using surveys. The growing database contains linked, de-identified, comprehensive information about persons living with dementia and their caregivers that will become a rich source of data for researchers, clinicians, and policymakers. Specifics around how the database was developed, and lessons learned will be discussed as these findings can be used as a template to develop similar linked health surveillance databases.
INVOLVING PERSONS LIVING WITH DEMENTIA AS KEY STAKEHOLDERS: RESEARCH “WITH” RATHER THAN RESEARCH “ON”
Authors: Cordell Ashlee , Wilk Christa , Orsulic-Jeras Silvia , Powers Sara , Ejaz Farida , Sanders Beth
Published: December 2022

Involving persons living with dementia (PLWD) as members of the research team is an important step in establishing an environment of conducting research “with” as opposed to research “on”. Emerging research is also capturing PLWDs' lived experiences to inform product development. This presentation highlights the importance of conducting product development research with PLWD as key stakeholders and the valuable insight they provide to researchers and developers. Five community-dwelling PLWD with varying diagnoses (60% mild cognitive impairment; 20% Alzheimer’s Disease; 20% mixed dementia) and tMMSE scores ranging from 22-26 (Mean=25) participated in two rounds (9 months apart) of 60-minute-long virtual focus groups via Zoom to test multiple versions of LifeBio MemoryTM: an app-based product designed for PLWD which utilizes advanced technology to improve an existing life story intervention. In Time 1, PLWD provided feedback on prototypes of the app and associated training that was used to inform the final product. In Time 2, participants reviewed the final product. A thematic analysis was conducted at each time point to inform further development of the app. Findings determined the following themes: 1) life stories can help with providing better person-centered care, 2) potentially sensitive topics require more training, 3) simple and clear instructions are vital for success. Topics further discussed in this presentation will include PLWDs': 1) thoughts on the concept of LifeBio and its adaptation, 2) comfort with answering life story interview questions, 3) opinions on dementia-friendly materials, and 4) reactions to the use of app-based technology.
DOES KNOWLEDGE MATTER? AN INVESTIGATION INTO KNOWLEDGE OF ALZHEIMER’S DISEASE AND CAREGIVER BURDEN
Authors: Grelle Kaitlin , Hardin-Sigler Kristen , Deason Rebecca
Published: December 2022

A caregiver for someone with Alzheimer’s disease often experiences burden, which can negatively impact their own physical and mental health, social participation and network, and financial stability (Chaio et al.; 2015, George & Gwyther, 1986). There is much interest in determining how to mitigate burden and studies suggest knowledge of the disease and recognizing positive aspects of caregiving may help reduce burden (Abdollahpour et al., 2018; Graham et al., 1997). The purpose of this study was to better understand how certain caregiver characteristics may impact burden. Participants (N=112) completed questionnaires regarding burden, disease knowledge, specific characteristics, and their caregiver experience. Pearson’s correlations were conducted to examine the relationship between knowledge, burden, and caregiver characteristics. There was no significant correlation between burden and knowledge (p =.457), but burden was significantly correlated with positive aspects of caregiving (p <.001) and life satisfaction (p <.001). To better understand how well these two variables predicted burden, a multiple regression was conducted, R² = .352, F(2, 90) = 24.48, p < .001. Our findings provide further evidence that a focus on the positive aspects of caregiving and higher levels of life satisfaction are predictors of reduced caregiver burden. Some prior studies suggested knowledge of Alzheimer’s disease led to decreased burden, whereas other studies found more knowledge increased anxiety, thus increased burden (Zawadzki et al., 2011). Our failure to find a correlation between knowledge and burden levels suggests this relationship may not be straightforward and future research needs to explore more specific aspects of this question.
OLDER ADULTS’ ONLINE INFORMATION SEEKING FOR ALZHEIMER'S DISEASE
Authors: Picchiello Matthew , Rule Payton , Carpenter Brian
Published: December 2022

Many older adults use the internet to gather health information. Yet past research shows that older adults display less understanding of internet concepts and score lower on information-retrieving tasks than younger adults, making them more vulnerable to internet misinformation. To address this, a variety of guidelines (e.g., HONCode) have been developed to help consumers identify credible sources. This is especially relevant for Alzheimer disease (AD), as research has shown that online AD information is mixed in its quality. The purpose of this study was to examine how older adults gather online AD information and evaluate their ability to find credible sources to improve knowledge. We recruited 83 older adults (Mage = 70.0, 60.2% female; 85.5% White) who completed the Alzheimer Disease Knowledge Scale (ADKS; Carpenter et al., 2009) before and after engaging in six AD-related search tasks (e.g., identify age of onset, risk factors, treatment, etc.). Older adults utilized a variety of search strategies, visiting both reputable (i.e., not-for-profit or university-based) and less scrutinized (i.e., commercially sponsored) websites, and a vast majority (95.0%) were unaware of HONCode guidelines for evaluating website quality. While most participants could locate some AD-related information (97.6% identified risk factors), other information was more elusive (29.3% could not identify age of onset). Despite this, participants showed improved ADKS scores, t(74) = 5.55, p < 0.001. Our research shows that many older adults can gather some accurate online information about AD but may benefit from additional resources on using effective search strategies and identifying credible sources.