bluuebunny/crossref_metadata_2025 huggingface dataset:
NOVEL TRANSPORTATION SOLUTIONS FOR STRUCTURAL INEQUITIES AFFECTING HOME HEALTH AIDES CARING FOR OLDER ADULTS
Authors: Okereke Olivia , Eme Vivian Anable , Liu Cerelia , Talukder Farhabi , Totten Keliane , Locascio Joseph , Weiner Anthony
Published: January 2025

Home health aides (HHAs) provide support for homebound older adults with cognitive impairments, while lessening strain on familial caregivers. However, HHAs face structural challenges in work-related transportation. To address this gap, we began a pilot study of on-demand access to free Uber rides for HHAs who were recruited, trained and provided job placement in partnership with Community stakeholder-partner CCHERS (Center for Community Health Education Research Services). Through community engagement with CCHERS, and as informed by other community partners (e.g., Mothers for Justice & Equality, Mass HomeCare Alliance), we identified lack of affordable, accessible, reliable transportation as the most-cited structural barrier affecting HHAs and their delivery of homecare. Thus, this study provided access to free Uber rides for HHAs’ job training, home care assignments and other work-related travel, for the duration of study funding; all HHAs were offered access to free rides for as long as funding was available, and key metrics were measured among HHAs during periods with and without ride funding. Preliminary data show high prevalence of other social determinants of health among HHAs using rides (e.g., 50% reporting food and housing insecurity). Outcomes among HHAs (work satisfaction, work hours, visit completion) and patients (patients reached, patient diversity) will be presented regarding whether free, on-demand transportation support for HHAs via Uber will: 1) Improve metrics among HHAs (total visits, hours/week and days/week worked, missed visit/no-shows, work satisfaction); 2) Increase racial, ethnic, socioeconomic and geographic diversity of older adults with cognitive impairment/dementia receiving homecare.
BUILDING FORTITUDE: STRATEGIES FOR TEACHING TENDER TOPICS IN GERONTOLOGY CURRICULA
Authors: Decker Autumn , Weaver Raven , Donorfio Laura
Published: January 2025

Gerontology educators are tasked with navigating a myriad of sensitive topics (e.g., discrimination/inequality, abuse/neglect, end-of-life) that lay the foundation for understanding aging and its complexities over the life course. These topics challenge educators but hold profound significance for gerontological practice. Inequities shape opportunities over time as advantages/disadvantages accumulate, such that “the reality is later life is not the end of inequality, it is inequality’s end game” (Abramson, 2016, p. 4). Inequities related to racism, ageism, and homo/transphobia affect individuals’ exposure to death, trauma, loss, and grief, and require facilitation of difficult classroom conversations. Social justice necessitates learning how to provide all groups with adequate supports/resources for growing old and educators are responsible for imbuing the next generation of gerontological practitioners with knowledge, skills, and compassion. Presenters in this symposium delve into the nuances of navigating “tender topics” in gerontology curricula. Two presentations share research on end-of-life teaching strategies from a faculty perspective (Decker and colleagues) and from an interdisciplinary team approach (Newsham and colleagues). Weaver and colleagues present insights on suicide education based on faculty/student perspectives. Finally, Bolkan and colleagues provide survey data on student perceptions of sensitive issues and an overview of effective pedagogies for teaching difficult topics. Each presenter offers unique insights, findings, and tools to foster inclusive learning environments and lead challenging discussions with integrity and fortitude. Following the presentations, Laura Donorfio, AGHE Vice-Chair Elect and creator of the AGHE Teaching Institute will serve as discussant to identify key themes and facilitate a discussion with attendees.
TEACHING (WITH) FORTITUDE: ADDRESSING END-OF-LIFE AND ADVANCE CARE PLANNING THROUGH AN INTERDISCIPLINARY LENS
Authors: Newsham Tina , Dark-Freudeman Alissa , Chulak Jamy , Fugate-Whitlock Elizabeth , Kringle-Baer Kirsten
Published: January 2025

Topics related to end-of-life (EOL) and advance care planning (ACP) can be fraught, both for instructors and students. Further, teaching about these topics can be challenging as they can (and, we argue, should) be addressed through multiple disciplinary lenses, and ideally in an interdisciplinary fashion. In this paper, we share an interdisciplinary effort to teach about EOL and ACP at the University of North Carolina Wilmington. Faculty in Psychology, Gerontology, Philosophy, and Respiratory Therapy collaborated to create an interdisciplinary, seven-week module that was integrated into classes from each participating discipline. Students were grouped across disciplines and worked together to gather data regarding needs and desires related to EOL and ACP and then to create discussion guides around relevant topics to foster meaningful conversation and planning related to sensitive topics. Students completed guided reflections regarding what they learned about and from partners with different disciplinary perspectives and how the interdisciplinary collaboration resulted in outcomes that would otherwise have been absent in a singular discipline effort. This project serves as a model for interdisciplinary teaching, particularly around sensitive topics.
THE IMPACT OF COVID-19 ON AVOIDANT COPING STRATEGIES AND PERCEIVED STRESS: INSIGHTS FROM THE HANDLS SLEEP STUDY
Authors: Tian Junyan , Allan Alexa , Simon Lena , Ross Lesley , Beydoun May , Zonderman Alan , Evans Michele , Gamaldo Alyssa
Published: January 2025

Coping strategies are usually defined as both effective and ineffective methods to reduce the impact of stressful life events. Avoidant coping, characterized by passive strategies, is more frequently used as people age. However, it is correlated with a higher level of perceived stress and more depressive symptoms. This study used a subsample of the Healthy Aging in Neighborhood of Diversity Across the Life Span Sleep Study (HANDLSleep) to examine the impact of the COVID-19 pandemic on the relationship between avoidant-focused coping and perceived stress. Our participants included 86 middle-aged and older adults (52.33% Black adults, age range: 46-82). The Avoidant Brief COPE scale measured how frequently they utilized avoidant coping strategies, such as substance use and denial, to disengage from stressful events. Results of the independent sample t-test indicated that individuals who tested positive for COVID-19 had lower levels of avoidant coping than those without infection, t(84) = -2.79, p <.05. Furthermore, regression analyses revealed a significant interaction effect between COVID-19 infection and perceived stress on avoidance coping, even after controlling for age, education, race and income. Specifically, only individuals who did not test positive for COVID-19 showed a correlation between higher levels of perceived stress and increased utilization of avoidant coping, b = -.02, t(76) = 2.54, p <.05. The simple slope for those with COVID-19 infection was not significant. These results highlight the significant social impact of COVID-19 infection on older adults’ coping strategy utilization when dealing with stress.
HURRICANE KATRINA AND COVID-19: LASTING IMPACTS ON NEW ORLEANS’ AFRICAN AMERICAN WOMEN
Authors: Cherry Katie , Balaam Kori , Hardy-Smith Oliver , Bordes Piper , Simon Kennedy
Published: January 2025

In 2005, two Category 5 hurricanes slammed into south Louisiana. Katrina brought catastrophic damage and substantial loss of life across the US Gulf Coast. Four weeks later, Rita crippled southwest Louisiana with tremendous destruction. In this study, we tested younger and older women who self-identified as African American / Black. All lived in the greater New Orleans metropolitan region at the time of the 2005 hurricanes. They completed a structured storm questionnaire and open-ended questions that tapped their Katrina experience and the more recent Covid-19 pandemic. Qualitative analyses on their narrative responses yielded three core themes: (1) Katrina Stressors: Family and Community Disruption, which captured catastrophic losses of homes and neighborhoods. Salient and frequent stressors included the disruption of social networks and pivotal life events (wedding plans, graduations). (2) Religiosity and Post-Traumatic Growth: Seeing Silver Linings, where coping through religious beliefs and practices (meditation, prayer, bible reading) helped participants navigate a new life journey. However, some questioned God following Katrina and one reflected that she did not join a new faith community after being separated from her home church in New Orleans, LA. (3) Katrina and COVID-19: Environmental Trauma on a Global Scale. The COVID-19 pandemic meant adjusting to a new normal with limited access to resources and businesses, reminiscent of post-Katrina life. A pressing responsibility to protect the safety and well-being of their family was also mentioned. Overall, these data permit new insight into individual and community-level vulnerabilities and strength-based resilience resources in the years after devastating environmental events.
THE ROLE OF PARENTAL EDUCATION AND ADVERSE CHILDHOOD EXPERIENCES IN COGNITIVE FUNCTION AMONG DIVERSE OLDER ADULTS
Authors: Wright Regina
Published: January 2025

An expansive body of research suggests older adults’ cognitive abilities are linked to a number of factors across the lifespan, including socioeconomic status and physical health. Early life experiences have emerged as an important predictor of cognitive function, as researchers identify long-term trajectories linking factors such as early life trauma and poverty to poor outcomes; however, much of these findings have been limited to largely homogenous study samples. Therefore, we examined the cross-sectional relationships between parental education, adverse childhood experiences (ACEs), and cognitive function in a diverse sample of community-dwelling older adults. Data were analyzed from 165 older adults (mean age = 68.48y, 33% male, 41% African American), free of major disease, who completed a battery of psychosocial and neuropsychological tests and a sociodemographic assessment, and underwent a physical screening in two study visits. We found no significant associations between ACEs and cognitive performance. However, linear regression analyses, adjusting for age, sex, race, education, and ACEs, showed a statistically significant association between maternal education and short-term verbal (p=.007) and visuospatial memory (p=.003) performance, and paternal education and long-term verbal memory performance(p=.029). Results further showed that maternal education was a stronger influence on cognitive performance than paternal education. Findings suggest having parents with greater educational attainment, and in particular a mother with greater educational attainment, is related to better cognitive performance in late life, independently of participant education or ACEs. This presentation will explore plausible pathways for intergenerational transmission of cognitive resilience.
PEER (DYADIC) SUPPORT: EXPERIENCES AND PERSPECTIVES FROM OLDER AFRICAN AMERICAN WOMEN WITH HYPERTENSION
Authors: Groves Angela , Allen Julie Ober
Published: January 2025

African American women have a higher prevalence of hypertension than women of other ethnicities. Interventions have not adequately addressed the higher prevalence of hypertension in this population. Social support networks can be an effective strategy for improving hypertension self-management behaviors. The objective of this study was to evaluate the feasibility of an 8-week peer (dyadic) support intervention to improve Dietary Approaches to Stopping Hypertension (DASH) adherence and reduce systolic blood pressure among older African American women with hypertension and describe the relationship that occurred during the intervention. This mixed methods study used a convergent parallel design. A total of 40 African American women diagnosed with hypertension, aged 60 and older were paired to form 20 dyads. At the end of the 8-week intervention, participants discussed their experiences in a 60-minute focus group session. Content analysis was used to analyze focus group interviews. Qualitative preliminary data analysis will be presented. Emerging themes included, accountability, epiphany, partnership-dyad, communication, and receiving support. Preliminary findings suggest that peer (dyadic) support is feasible and can be an effective intervention strategy to improve DASH diet and blood pressure management. Future studies should examine the extent in which dyadic relationships are maintained over time to improve diet and blood pressure outcomes. Also, future randomized controlled trials should be conducted to evaluate the effectiveness of the peer dyadic support modality on DASH diet adherence to reduce systolic blood pressure.
ASSOCIATIONS BETWEEN DISCRIMINATION AND COGNITION AMONG INDIGENOUS, BLACK, HISPANIC, AND WHITE OLDER ADULTS
Authors: Whetung Cliff , Gonzales Ernest
Published: January 2025

The number of Indigenous older adults will more than double in the next thirty years, and they are at high risk of cognitive pathologies in later life. This study centers on Indigenous older adults among Black, Hispanic, and White peers. It examines whether structural inequities (educational attainment, low incomes) and discriminatory experiences (everyday discrimination, major lifetime discrimination) are associated with racial inequities in cognitive health. Using 14 years (2006-2020) of restricted Health and Retirement Study (N = 27,327) data, we estimated cognitive trajectories among Indigenous, Black, Hispanic, and White older adults using mixed effect growth curve models. Models were adjusted for discrimination experiences and relevant covariates. We found that everyday discrimination experiences were negatively associated with cognition at baseline and over time. Major lifetime discrimination experiences were associated with lower baseline cognition scores and positively with cognitive change over time. Indigenous older adults who experienced high levels of everyday discrimination had significantly lower cognition scores at baseline than any other race or ethnicity. We also found that Indigenous older adults primarily attribute perceived discrimination experiences to their age, ancestry, and race. Indigenous older adults have a unique profile that places them at elevated risk for cognitive pathology in later life, and structural inequities are powerfully associated with many of these risk factors. Addressing these inequities will require the development of policies, programs, and research agendas that target the fundamental causes of these discriminatory stresses: structural inequities in education and socioeconomic opportunities.
COMPASSIONATE CAREGIVING: CREATING A CNA LEADERSHIP ACADEMY
Authors: Long Monica , Gleason Lauren , Graupner Jeffrey , Mittal Kanika , Thompson Katherine
Published: January 2025

Certified Nursing Assistants (CNAs) provide direct patient care such as bathing, dressing, feeding, as well as reporting changes in patients’ conditions under the supervision of licensed nurses. Despite the crucial role CNAs play, this role is characterized by high turnover rates and relatively low wages compared to other healthcare roles. SHARE Network at UChicago Medicine created a CNA Leadership Academy with an aim to retain and empower CNAs to cultivate their potential as leaders in their respective healthcare facilities. This initiative comprised of a comprehensive curriculum design to enhance CNAs understanding of leadership principles, communication techniques, quality improvement (QI), resilience and self-care techniques using Project ECHO, an educational model that provides tele-mentoring to healthcare workers. Kern’s 6-step approach for curriculum development, mixed-methods pre/post survey, qualitative analysis for curriculum evaluation and a 7-point Likert Scale was used for evaluation. Participants in 2 cohorts were mostly African Americans and resulted Likert scores of, 5=Competent, 6=Very competent, 7=Expert post training. Participants created QI projects utilizing Stop & Watch communication tools, fostering a culture of communication among healthcare professionals, resilience, self-care, and a team approach to patient care. Within the CNA Leadership Academy, CNAs are better equipped to advocate for patients, address emerging challenges, and drive positive change within their healthcare organizations. The CNA Leadership Academy educational initiative represents a proactive approach to nurturing leadership talent within the CNA workforce. Equipping CNAs with knowledge and support, the program initiative contributes to resilience and effective healthcare, ultimately improving outcomes for patients and healthcare providers alike.
EMPOWERING FRONTLINE CNAS TO ENGAGE IN EFFECTIVE COMMUNICATION THROUGH AN INTERACTIVE LEARNING EXPERIENCE
Authors: Campbell Sarah , Saville Neika , Bueno Michael , Rousseau Julie , Varshney Ishan , Lee Jung-Ah , Gibbs Lisa
Published: January 2025

While considerable efforts have been directed towards continuing education for bedside nurses and providers, certified nursing assistants (CNAs) are often marginalized, despite their substantial involvement in patient care within skilled nursing and rehabilitation facilities. Collaborating with 36 sites throughout Orange County and Los Angeles County, California, our GWEP team identified crucial curricular topics to address geriatric-specific knowledge deficits among CNAs. These topics focused on the 4-Ms and included fall risk management, care for patients exhibiting challenging behaviors, addressing mental health conditions, effective communication with healthcare team members, and self-care strategies to mitigate burnout. Recognizing the importance of engaging and interactive education and trauma-informed pedagogy, we designed participatory activities such as gaming, storytelling, meditation, yoga, journaling, and sharing into the curriculum. Over a span of three years, education was delivered to over 615 diverse CNAs, nurses, and other healthcare professionals in our 4-part education series titled, “Building Resiliency While Advancing Your Caregiver Skills.” The curriculum was structured and disseminated through synchronous online sessions via Zoom, in-person workshops, and asynchronous self-paced modules. Throughout the sessions, empowerment and evidence-based burnout prevention were taught utilizing a customized “CNAs CAN” learning kit. Evaluations were conducted after each session, and we found that providing multi-modal learning opportunities promoted engagement. Knowledge was gained in reporting changes in condition, preventing falls, and recognizing the signs and symptoms of dementia, delirium, and depression. In the qualitative data collected, learners overwhelmingly reported gaining skills to prevent burnout, stress reduction, and acquiring new self-care skills.
BUILDING CAPACITY: GRECCS’ CONTRIBUTION TO SPECIALIZED GERIATRIC WORKFORCE TRAINING
Authors: Shaughnessy Marianne
Published: January 2025

In 1975 Congress established Geriatric Research, Education, and Clinical Centers (GRECCs) within the Veterans Health Administration as Geriatric Centers of Excellence. Twenty GRECCs currently exist across the United States that bring together diverse interdisciplinary teams of researchers, educators and clinicians. All GRECCS are also associated with major academic research universities. Due to their unique nature, GRECCs are well positioned to advance the training and development of the scientific and clinical geriatric workforce across health care disciplines and settings. Their environments foster learning for trainees engaged in health professions careers from initial training through advanced fellowships. As Geriatric Centers of Excellence, GRECCs also provide educational programs and resources to train VA healthcare providers in geriatric principles and best practices. This presentation will include an overview of the GRECC programs, their areas of specialty, and clinical and didactic training opportunities offered. A discussion of GRECC collaborations with academic institutions and community partners to disseminate geriatric education and promote geriatrics will also be discussed. Education, Research, and Clinical training delivered through the GRECCs help to ensure that clinicians and researchers have the knowledge and skills necessary to develop and deliver high-quality, patient-centered care to older adults.
NURTURING INTERDISCIPLINARY EXCELLENCE: INSIGHTS FROM ADVANCED FELLOWSHIP IN GERIATRICS FELLOWS
Authors: Serra Monica , Wherry Sarah , Erickson Alexander , Song Yeonsu , Yang Betsy , Syed Quratulain
Published: January 2025

This facilitated panel discussion offers a comprehensive exploration of the transformative impact of the Veterans Health Administration’s (VHA) Advanced Fellowship in Geriatrics across various disciplines within the post-graduate clinical and clinical research spectrum. Drawing from the perspectives of current and former fellows spanning diverse backgrounds including medicine, nursing, psychology, public health, and research, this session delves into their fellowship experiences, the array of activities they engaged in, and the profound influence of the fellowship on their professional trajectories. The Advanced Fellowship in Geriatrics provides a robust platform for fellows to engage in clinical rotations, honing their skills in geriatric assessment, management, and interdisciplinary collaboration. Additionally, through structured mentorship and access to research resources, fellows are empowered to conduct impactful clinical research, fostering their professional growth and contributing to the advancement of high-quality, patient-centered care within the VHA. Through a multi-disciplinary lens, panelists will describe their encounters experiences within the post-graduate training VHA fellowship, encompassing clinical rotations, research endeavors, educational initiatives, and quality improvement projects tailored to the unique needs of older adults and older veterans. By highlighting their collaborative endeavors and interdisciplinary interactions, the discussion will underscore the significance of a holistic approach in addressing the complex healthcare challenges faced by aging populations. Additionally, the panel will illuminate the instrumental role of the fellowship in enhancing healthcare delivery within the VHA, fostering innovation, and optimizing geriatric care practices to meet the evolving demands of veterans.
PREPARING LEADERS IN GERIATRICS HEALTH CARE THROUGH THE VA’S ADVANCED FELLOWSHIP IN GERIATRICS
Authors: Hawley Chelsea , Martinchek Michelle , Hursh Colleen , Moye Jennifer , Pruskowski Jennifer , Congedo Benjamin , Dunlap Shawn , Jump Robin
Published: January 2025

The VA Advanced Fellowship in Geriatrics (AFiG) prepares leaders in geriatric research, education, and clinical innovation, to meet the complex needs of the rapidly growing older Veteran population. This interprofessional, two-year fellowship welcomes physicians, nurses, psychologists, and other associated health fellows, including but not limited to pharmacists, social workers, physical and occupational therapists, and non-clinician scientists. AFiG is funded by VA’s OAA, and fellows are hosted by the 20 GRECCs, which are VA Centers of Excellence focused on aging. Fellows devote 75-80 percent of time to scholarly pursuits and 20-25 percent to clinical work (or activities supporting clinical care for non-clinician scientists), working closely with mentors to develop an individualized training experience. AFiG began in 2001 with seven sites and has grown to 20 sites as of 2024. In 2022, a new national Coordinating Center (CC) for AFiG was established to support and empower all fellowship sites to align their training with the fellowship mission and strengths of their individual sites. This presentation will describe efforts to foster a community of practice and increased collaboration, including national curriculum development, facilitation of networking and professional events, and curation of educational opportunities. The CC is also prioritizing a new national recruitment initiative to increase the number and diversity of applicants and to facilitate hiring fellowship graduates into VA positions, which will be discussed. With these such efforts, the CC is further strengthening AFiG as a nationally recognized leader in training future leaders in geriatric healthcare.
INNOVATION IN AGING
Authors: Albert Steven
Published: January 2025

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JOURNAL OF GERONTOLOGY: BIOLOGICAL SCIENCES
Authors: Duque Gustavo
Published: January 2025

The “Journal of Gerontology: Biological Sciences” is a peer-reviewed academic journal that focuses on research related to the biology of aging. It covers a broad range of topics within this field, including genetics, cellular aging, molecular mechanisms of aging, age-related diseases, and interventions to promote healthy aging. More recently, we have participated in the creation of a Translational Geroscience Section, which integrates the growing subject of geroscience into both the medical and biological sections of the journal with an emphasis on the translation of discoveries into clinical practice. Our journal serves as a valuable resource for researchers, clinicians, and policymakers interested in addressing the challenges and opportunities associated with an aging population. In this session, the editorial criteria for selecting the highest-quality manuscripts will be discussed. In addition, practical tips for preparing manuscripts reporting biomedical research will be provided.
PUBLIC POLICY AND AGING
Authors: Lepore Michael
Published: January 2025

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CRITICAL ENGAGEMENT WITH AI: MAPPING ETHICAL PRINCIPLES TO APPLICATIONS IN AGING
Authors: Berridge Clara
Published: January 2025

Navigating the algorithmic age is difficult because of many unresolved ethical issues and policy gaps. A significant barrier to addressing ethical problems in AI and aging is that their scope is often restricted, leaving questions of power and social impact ill-defined. A contributing phenomenon is that people tend to take algorithmic output as objective, authoritative, and fair. In this way, ideas about objective data-based truth can convert questions that are ethical in nature into technical questions. Examples of questions with ethical aspects that are often not treated as such include which problems are prioritized for datification and how they are defined, which data are mobilized and sidelined, how data are collected and monetized, how representative data are, how older adults are involved in data collection, and how algorithmically mediated decision-making plays out with what differential impacts. Further, as technologies incorporate socially persuasive techniques, it is important to examine the ethical issues, such as implications for autonomy of misplaced trust with low awareness of these techniques. Recently, the broader discourse about ethics in AI that includes questions of power and societal impact has sharpened. The White House’s Blueprint for An AI Bill of Rights operationalized core principles that design, policy, and practice should uphold to protect people from potential harms. These principles are safe and effective systems, algorithmic discrimination protections, data privacy, notice and explanation of use of AI, and meaningful human alternatives. This presentation will discuss principles to promote ethical use of AI in tools and services for older adults.
ASSISTING DEMENTIA FAMILY CAREGIVERS WITH INTERACTIVE AI TECHNOLOGY
Authors: Jiang Lin , Sun Fei , Chen Xiayu , Feng Yali
Published: January 2025

The escalating prevalence of Alzheimer’s and related dementias (ADRD) presents a global health crisis, straining family caregivers. This study, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT), examines the role of artificial intelligence (AI) in assisting ADRD family caregivers through a mixed-methods approach. It involves qualitative analysis of marginalized dementia caregivers’ experiences in the technology era and a systematic review of interactive AI evidence in dementia care. Qualitative insights from six focus groups and 24 individual interviews highlight the need for adaptable AI solutions, particularly for emotional and social support. Systematic review results underscore various AI applications, their acceptance, benefits, and challenges, including technological literacy, trust issues, limited access, and cultural considerations. The discussion emphasizes interdisciplinary collaboration and caregiver involvement in AI development. The study concludes by emphasizing AI’s transformative potential in dementia care, advocating for collaborative research efforts and innovative services to support diverse caregiver groups and their ADRD care recipients.
OVERCOMING APATHY AMONG OLDER COMMUNITY DWELLERS IN RURAL NORTHERN BC: THE BENEFITS OF ENGAGING IN AN EBOOK CLUB
Authors: Agboji Aderonke , Freeman Shannon
Published: January 2025

The study aimed to investigate the impact of an eBook Club on the apathy and overall well-being of older adults dwelling in rural community settings. Employing a mixed-method approach, the research gathered data through surveys and interviews both before and after the program implementation. We recruited twenty-eight older adults, aged between 60 and 86 years, predominantly female (23 out of 28) from three communities in Northern British Columbia, Canada. Each participant was provided with a Kobo eReader loaded with books tailored to their interests, alongside a tutorial for using the device. Each eReader was linked to the public library, facilitating easy access to a broader range of books. The eBook Club convened weekly for sessions lasting 45 minutes to an hour, with groups capped at four members, over a span of 4 to 6 weeks. Initially, about half of the participants (10 out of 28) reported apathy. Remarkably, by the program’s conclusion, these individuals unanimously reported a decrease in apathetic feelings. Additional benefits noted by participants included enhanced mood, improved social connections, and sustained engagement with reading activities beyond the club meetings. We concluded that a relatively straightforward intervention like the eBook Club can significantly ameliorate symptoms of apathy and bolster the overall well-being of older individuals in rural community settings. While initial challenges with the Kobo eReader were reported, the collective support and encouragement within the group played a crucial role in overcoming these obstacles, underscoring the value of peer support in facilitating the adoption of new technologies.
INTERNATIONAL INVESTIGATIONS OF MENTAL HEALTH AND PSYCHOSOCIAL WELL-BEING IN LATER LIFE
Authors: Gessa Giorgio Di , Beach Brian , Prina Matthew
Published: January 2025

Good mental health and psychosocial wellbeing are important factors for older individuals’ fortitude as they move through later life. Attention to mental health and wellbeing has continued to grow in recent years, with the COVID-19 pandemic playing a key role in raising the profile of psychosocial experiences across societies. However, many countries face ongoing challenges to provide support services that meet existing and projected needs. While these issues are not limited to older adults, people in later life may face vulnerabilities that make them more susceptible to negative outcomes in mental health and wellbeing or that introduce additional barriers to accessing adequate supports. This symposium highlights international investigations into mental health and wellbeing that enrich our understanding of these issues and some of the dynamics for identifying potential solutions to enhance support. The first presentation highlights the experience of older people’s psychosocial wellbeing across the pandemic using the English Longitudinal Study of Ageing (ELSA), with measures before, during, and in the years after the pandemic. The second presentation explores the concept of resilience in later life drawing on qualitative interviews among older people with long COVID from other longitudinal UK studies. The third presentation examines the role that mental health diagnoses play in shaping labor market exit among adults aged 65+ in paid work, drawing on Swedish register data. The final presentation investigates joint trajectories in depression scores and various blood-based biomarkers using ELSA data, exploring the potential for such measures to be useful in identifying risk for depression. International Comparisons of Healthy Aging Interest Group Sponsored Symposium
BODY AND MIND: EXPLORING ASSOCIATIONS AMONG PARALLEL TRAJECTORIES OF BIOMARKERS AND DEPRESSION SCORES
Authors: Beach Brian , Zaninotto Paola , Shim Eun-Jung
Published: January 2025

Multiple studies have found associations between levels of various blood-based biomarkers and depression, including how some biomarkers are associated with future development of depression or the worsening of depressive symptoms. The nature of such associations, however, cannot demonstrate a causal relationship between levels of biomarkers and depression. With recent advances in data collection, this study examines whether associations exist between the trajectories of biomarkers and depression scores. It draws on data from the English Longitudinal Study of Ageing, using four measurement points for depression and nine distinct biomarkers among respondents aged 50+ collected during nurse visits between 2004 and 2019. Associations in joint trajectories are assessed using a series of parallel process latent growth models, testing goodness of fit for both linear and quadratic models. Results suggest associations between blood hemoglobin and depression, with no significant associations among the other biomarkers. More specifically, intercepts and slopes demonstrate joint negative associations, while the intercept of depression is positively associated with the rate of change for hemoglobin (β=0.029; 95%CI: 0.004,0.054). When stratified by sex, the associations with blood hemoglobin remains only for women, while men display a negative association between the intercept of depression and the rate of change for HDL cholesterol (β=-0.016; 95%CI: -0.029,-0.004). Overall, results find no relationships between change in depression scores and levels of biomarkers, suggesting little diagnostic utility of these biomarkers to identify risk for worsening depression.
INTERVENTIONS FOR CAREGIVERS AND PERSONS LIVING WITH DEMENTIA ACROSS THE LONG-TERM CARE CONTINUUM
Authors: Dobbs Debra , Meng Hongdao
Published: January 2025

According to estimates from the Alzheimer’s Association 2023 Alzheimer’s disease Facts and Figures, there are an estimated 6.7 million people living with dementia (PLWD) in the United States. With increasing older age as the number one risk factor, this number will only continue to grow. Family and direct care workers (e.g., nurses, certified nursing assistants, social workers) provide the bulk of care to PLWD across the health care continuum. Interventions are needed to assist and improve dementia care for families, direct care workers and PLWD. This symposium includes four papers that have conducted dementia care interventions in different care settings. The first paper is a Palliative Care Education in Assisted Living intervention for nurses and administrators in 10 ALs to increase advance care planning documentation for AL residents (N=118) and to increase staff self-efficacy (N=23). Self-reported self-efficacy will be compared to treatment fidelity data on ACP discussions with family to examine how well the ACP discussion intervention protocol was adhered to. The second paper is an intervention study that employs mixed methods in a sample of 155 Veterans Health Administration clinicians to test the effectiveness of the Virtual Dementia Tour (VDT) and the impact the VDT has on their clinical practices. The third paper tested the feasibility of a group digital gaming intervention in a sample of 40 PLWD and their caregivers in adult day centers. The fourth paper tests the feasibility of an e-Pain support intervention for ADRD hospice patient caregivers. The scalability of each intervention will be discussed.
IMPACT OF GROUP-BASED DIGITAL GAMING INTERVENTION AMONG INDIVIDUALS LIVING WITH EARLY TO MODERATE DEMENTIA
Authors: Inoue Megumi , Hand Michelle , Koizumi Naoru , Chen Limei , Booker Emma
Published: January 2025

Slowing the progression of dementia and maintaining good behavioral and psychological symptoms are important aspects of life for individuals living with dementia and their caregivers. This study involved a group-based digital gaming system called Obie Technology as an interactive intervention for individuals living with dementia at a local adult day health center for 20 weeks, from mid-November 2023 to mid-April 2024. This gaming system promotes movement, stimulates cognitive activity, and encourages socialization. For example, colorful balloons float around the board or floor as clients try to hit as many as they can. A mixed methods approach with a pre-post design was employed to examine the effects of the intervention on cognitive function, mood, and behaviors in 24 individuals with early or moderate-level dementia. The average scores of the Montreal Cognitive Assessment (MoCA) at the baseline and midpoint (after 10 weeks) were 15.65 and 15.60, respectively, indicating no significant progression of dementia between these time periods. Participants’ depression level and neuropsychiatric symptoms presentation assessed by standardized instruments also showed no significant changes. The results from qualitative observations demonstrate that the group of people living with early-stage dementia in this study were more engaged and enjoyed the intervention compared to a group with moderate-stage dementia. They often comment that the intervention was fun, interesting, and enjoyable while actively engaging in the game with enhanced movement. In this presentation, we will present the findings based on the completed data, including the post-assessments.
ADAPTATION OF THE E-PAINSUPPORT INTERVENTION FOR ADRD CAREGIVERS
Authors: Mayahara Masako
Published: January 2025

The lack of adherence by family caregivers to prescribed analgesic regimens has been recognized as a significant barrier to effective pain management in hospice. Advancements in healthcare technology provide an opportunity to enhance timely access to pain education and promote better adherence to analgesic regimens for family caregivers of patients with Alzheimer’s Disease and Related Dementias (ADRD). The aims of this presentation are to report the findings from a recently completed randomized controlled trial of hospice patient-caregiver dyads and discuss adaption of the intervention for ADRD caregivers. The initial efficacy trial used a 2-group, 2-week longitudinal, randomized controlled trial design. The study participants were recruited from four hospice agencies located in in the Midwest. Forty-four patient-caregiver dyads participated. There was a small positive effect size (d=0.27) associated with the e-PainSupport intervention, suggesting efficacy in reducing pain intensity. The regression analysis revealed that increased knowledge had a significant independent effect on decreasing pain (p<0.01). Female caregivers and children of patients were more likely to respond to the intervention compared male or spouse caregivers. The study highlighted the importance of caregiver knowledge in reducing patient pain. Adaptation of the intervention for ADRD caregivers requires a tailored approach to increase usability for male and spouse caregivers.
IMPROVING OUTCOMES IN OLDER VETERANS WITH HEART FAILURE AND CKD: FROM PROPENSITY SCORE USE TO AI
Authors: Ahmed Ali
Published: January 2025

Older adults are often excluded from randomized controlled trials (RCT). Consequently, gold-standard RCT-evidence to improve outcomes in older adults is often unavailable. Properly-designed outcome-blinded propensity score matched studies can provide high-quality non-RCT evidence when RCTs are impractical, unethical, or lack sponsors. Renin-angiotensin system inhibitors (RASIs) improve outcomes in patients with heart failure (HF) and chronic kidney disease (CKD). National HF guidelines recommend that these drugs be prescribed in higher doses, but be used with caution in those with CKD as it may worsen kidney function. Dr. Ahmed has shown that RASIs improve survival in older patients with HF and CKD. However, concerns remain about their effect on kidneys. Recent findings from VA-Merit Review grant suggests that high-dose RASIs lower risk of kidney failure and death in octogenarians with HF and CKD. Additionally, artificial intelligence methods can be utilized to personalize care for this heterogeneous and diverse population of older patients.
DO DAILY STRESSOR TRAJECTORIES VARY BETWEEN CIVILIANS, NONCOMBAT, AND COMBAT VETERANS?
Authors: Kurth Maria , Witzel Dakota , Almeida David
Published: January 2025

Proximal (i.e., daily) experiences may be a crucial indicator of how larger-scale events, such as trauma, impact health and well-being (Epel et al., 2018). It has also been suggested that military service – especially combat exposure – is a “hidden” variable of aging (Spiro et al., 2016), with positive and negative long-term consequences for well-being. However, few studies have directly compared differences in civilian and Veterans’ daily experiences, especially exposure to stress. We used data from three waves of the National Study of Daily Experiences (NSDE; Almeida, 2005) to examine how daily stressor exposures change across ~20 years (N = 2220). At each wave, participants completed eight end-of-day phone interviews, including the Daily Inventory of Stressful Events (DISE; Almeida et al., 2002). For this project, we were interested in the following stressor domains: argument; avoided argument/disagreement; home; work/school. Similar to previous research (e.g., Piazza et al., 2022), civilian (83%) non-combat Veteran (12%), and combat Veteran status (5%) was gleaned from responses to two Life Event Survey items (LES; Sarason et al., 1978). We estimated two-level generalized multilevel models for each stressor domain and controlled for age, sex, education, and race. Preliminary results suggest only avoided argument exposure varied by civilian/Veteran status. Although there was no difference at baseline, civilians increased in likelihood (~20%), while combat Veterans were ~15% less likely to experience avoided arguments every 10 years. Results underscore a potential long-term advantage for aging combat Veterans’ well-being, as avoiding arguments has negative consequences for physical and psychological health.
ADVANCE CARE PLANNING AND THE MILITARY EXPERIENCE: FROM ACTIVE DUTY TO VETERAN
Authors: Berry-Stoelzle Maresi
Published: January 2025

Active duty military are one of the few groups who are required to face the possibility of mortality and morbidity while young. Pre-deployment paperwork for preparing a servicemembers and their family include the designation of a healthcare power of attorney. Despite this previous experience, rates of advance directive completion (ACP) and documented serious illness conversations (SICC) in VA served Veterans are comparable with the civilian population. Discussing goals and attitudes towards managing current and future healthcare is often sidelined for more immediately urgent medical needs. However, from our recent cohort of Veterans with an inpatient admission, 18% of Veterans admitted inpatient died within a year after their hospitalization, comparable to recent US wide data. Our previous work explores how personalization can help engage Veterans in serious illness conversations. Extending this, we explore how particularly pre-deployment planning organizational structures and discussion formats differ in structure and uptake. We coordinated with local palliative care, social work and inpatient service experts and collected suggestions from Veteran stakeholders exploring the relationship between the military service and deployment history and subsequent views of ACP of Veterans and their families. Several contributing themes emerge which are sorted in the CFIR framework including: the level of associated support services, formal inclusion of families, group identity, difference in the perceived outcome, time since military service, branch of service. This preparatory overview informs an ongoing QI project for increasing Veteran engagement in formal and informal ACP and SICC including formal and informal documentation.
POLICY SERIES: AGING AND HEALTH POLICY UPDATE: A VIEW FROM WASHINGTON
Authors: Lindberg Brian , D’Antonio Patricia
Published: January 2025

Leading policy advocates will present their findings and viewpoints regarding aging and health care policy during a divided Congress. Issues will include behavioral health, social isolation, health care workforce, telehealth, hospice policy, elder justice and nursing home care, home and community-based services, and Medicare and Medicaid.
“WE NEED TO BE AT THE TABLE” COLLABORATION WITH OLDER ADULTS WITH EXPERIENCES OF HOMELESSNESS
Authors: Canham Sarah , Weldrick Rachel , Cartledge Anne , Chapple Hilary , Danielsen Chris , Kestle Dorothy , Teichman Samantha
Published: January 2025

Increasingly recognized as an asset to research endeavors, persons with lived experience (LE) offer key insights into the impact of research processes and outcomes with those most affected by social or medical conditions. Additionally, LE advisors and co-researchers are uniquely positioned to inform knowledge mobilization and community engagement efforts that complement research activities and disseminate findings to diverse knowledge users. This presentation will share an example of a LE advisory group that collaborated in conceptualizing and implementing a knowledge mobilization project on aging and homelessness within three Canadian cities (Vancouver, Calgary, and Montreal). Following the establishment of the advisory group, priorities and objectives were determined, resulting in community engagement initiatives to disrupt discrimination toward older adults with experiences of homelessness. We will present lessons learned from this project, including the necessity of 1) digital supports to enable inclusion of advisors, 2) honoraria for advisors’ time and contributions, 3) scheduling regular meeting days and times, and 4) dedicating meeting time for personal updates. Insights from this collaborative project are widely applicable across disciplines. This model offers a blueprint for other research teams aiming to enhance the impact of research and knowledge mobilization efforts and build capacity among LE communities.