bluuebunny/crossref_metadata_2025 huggingface dataset:
SHAPING LIVING IN SOLIDARITY AMONG OLDER VULNERABLE PEOPLE IN BRUSSELS
Authors: Smetcoren An-Sofie , De Donder Liesbeth
Published: November 2019

This research explores how older people construct their view on ‘living in solidarity’. The data was collected during a cohousing project (from construction till occupation). Co-creation sessions with residents and project coordinators were analyzed. 7 conditions and success factors were unraveled that deemed important to realize ‘solidary housing’: 1) The challenge to unite individual and collective needs; 2) Continuous task to engage (candidate-) residents, from early beginning; 3) A targeted selection of residents; 4) Maximizing the competences of older people, 5) Developing a group identity consciousness, 6) Involving experts providing support for group- and individual trajectories, 7) Creating a climate of confidence. Solidary housing appeared to be a nuanced and layered concept which should not be overidealized. Participants demonstrate what is realistic, and how it can be shaped in daily practice. By discussing and deciding on group issues, the project coordinators created a shared platform for implicit and explicit agreements.
EXPERIENCES OF OLDER PEOPLE AND INFORMAL CAREGIVERS WITH LIVE-IN MIGRANT CARE WORKERS IN BELGIUM
Authors: Hoens Sylvia , Smetcoren An-Sofie , Donder Liesbeth De
Published: November 2019

The increasing number of older people has a significant impact on the organization of care in European countries. Despite the availability of formal care services, adequate solutions are still missing and older people themselves search for alternative strategies to meet their care needs. For example, a recent tendency is to call upon help of migrant care workers. In Belgium, research concerning this often invisible care solution remains absent. Therefore, the study at hand explores the experiences of the older care users and their informal caregivers and examines how this care can increase their well-being. Eight in-depth interviews with older people who rely on live-in migrant care workers, five interviews with professionals and one focus group with experts have been conducted. This study found that live-in caregivers relieve the informal carers, guarantee the presence of permanent care 24/7 and enable older people to live longer at home.
ANALYTICAL CONSIDERATIONS OF DEVELOPING A PHENOTYPIC AGING MEASURE: THE CONCEPTUAL FRAMEWORK MUST COME FIRST!
Authors: Shardell Michelle , Shardell Michelle , Kuo Pei-Lun , Schrack Jennifer , Simonsick Eleanor M , Resnick Susan M , Levine Morgan E , Ferrucci luigi
Published: November 2019

We propose a latent structural model framework where phenotypic aging is a latent variable influenced by chronological age, genes and environment. Within this framework, phenotypic age influences aging-related outcomes and is reflected by latent domains of aging (body composition, energetics, homeostasis, and neural functioning) reflected by biomarkers. First, we validate the framework by selecting age-associated domain-specific biomarkers and assessing internal consistency and convergent construct validity (Cronbach’s alpha). Using data from the Baltimore Longitudinal Study of Aging, within-domain Cronbach’s alphas ranged from 0.80 to 0.92, supporting convergent construct validity. Second, we evaluate two broad methods for combining biomarkers into one phenotypic age measure customized to different objectives: 1) confirmatory factor analysis of chronological age-adjusted biomarkers to create a measure to identify pleiotropic genetic and environmental mechanisms, and 2) machine-learning methods to create a measure optimizing predictive and concurrent criterion validity. This framework will enable evaluation of candidate biological mechanisms of aging.
PRECARITY AND LATER LIFE: UNDERSTANDING NEW INEQUALITIES AND RISKS IN LATER LIFE
Authors: Dannefer Dale , Phillipson Christopher , Dannefer Dale
Published: November 2019

This symposium addresses debates around the theme of precarity and its implications for understanding social and economic changes affecting the lives of older people. To date, the concept of precarity has been applied to several subpopulations by various academic disciplines but has yet to be systematically applied to later life. The symposium will give particular attention to the extent to which the lens provided by precarity can illuminate different types of inequalities experienced through the life course and reflected in public policies directed at older people. Chris Phillipson reviews theoretical perspectives relating to precarity, examining their potential contribution for the development of critical gerontology. His paper also considers the extent to which the concept of ‘precarious ageing’ offers a competing or complementary view to theories of ‘active’ and ‘successful ageing’. Larry Polivka examines the growing precarity of life for older Americans emanating from austerity budgets and privatization of public services. The paper suggests that policies such as health care and long term care are in jeopardy, creating a glide path toward the extension of precarious employment into a precarious retirement for millions of older people. Wenxuan Huang examines how the focus on agency and other individual-level foci obscure understanding of social dynamics. Finally, Amanda Grenier draws on a scoping review of precarity to outline conceptual distinctions between frailty, vulnerability, and precarity. She presents reflections on what these concepts offer in terms of understandings of late life the study of disadvantage across the life course.
PRECARITY AND AGING: THE SOCIAL CONSTRUCTION OF RISK IN LATER LIFE
Authors: Phillipson Christopher
Published: November 2019

This paper examines the growth of precarious lives in the context of policies which have marginalised the welfare state and priorities of social inclusion/security. Blackburn observes that ageing societies ‘requires new welfare principles not their repudiation’. However, the reality has been the erosion of the social solidarity which gave the welfare state legitimacy. In Europe, one set of welfare and related institutions is being abandoned, replaced by precarious arrangements -- extended working lives, privatization of pensions, and greater demand for women especially) for unpaid work. This paper 1) draws upon perspectives from political economy and sociology to examine precarity, 2) considers ‘precarious ageing’ as a competing or complementary view to theories of ‘active’ and ‘successful ageing’ third, examines specific dimensions of precarity (work, resources, the environment, frailty), assessing prospects for an index of precarity and aging; finally, considers the public policy implications of the growth of old-age precarity .
PRECARITY IN OLD AGE IN AMERICA
Authors: Polivka Larry
Published: November 2019

This presentation will analyze the growing precarity of life for older Americans emanating from austerity budgets and privatization of public services. As governments at every level continue to look for ways to reduce social and health spending and cut taxes they are also pursuing privatization through contracts with for-profit firms to provide regulated social and health services. The presentation will discuss how these trends toward greater precarity in old age relate to Streecks’ concept of the Consolidation State in Western neoliberal political economies. The Consolidation State serve the interest of capital, especially finance capital by implementing austerity budgets, preserving low taxes on wealth, prioritizing the financing of deficits/debt and privatizing public services and assets. Such policies put health care, long term care and other programs supporting older persons in jeopardy, creating a glide path toward the extension of precarious employment into a precarious retirement for millions of older people.
ATTITUDES TOWARD AGING, RESILIENCE, AND SELF-RATED HEALTH OF CHINESE OLDER ADULTS: FINDINGS FROM HONOLULU AND WUHAN
Authors: Zhang Keqing , Zhang Wei , Liu Sizhe , Wu Bei
Published: November 2019

A growing body of literature found that attitudes towards aging is related to individual’s health among older adults. This paper aims to examine the relationship between negative attitudes towards aging and self-rated health among Chinese older adults living in Honolulu (N=400) and Wuhan (N=552) and explore the moderating roles of resilience and gender. Results showed that the positive relationship between attitudes towards aging and self-rated health was moderated by resilience such that higher levels of resilience weakened this association significantly and substantially, implying its stress-buffering role. Both the positive focal relationship and the moderating effect appeared to be stronger among older adults in Honolulu than their peers in Wuhan. For gender differences, the moderating effect of resilience was only significant for males in Honolulu and females in Wuhan, indicating that males in Honolulu and females in Wuhan may rely heavily on psychological resources such as resilience in coping with stressors.
INTERGENERATIONAL TRANSFERS, RESILIENCE, AND SELF-RATED HEALTH: FINDINGS FROM HONOLULU AND WUHAN
Authors: Liu Sizhe , Zhang Wei , Zhang Keqing , Wu Bei
Published: November 2019

This study investigated the association between intergenerational transfer and self-rated health (SRH) using data collected from 323 older Chinese immigrants in Honolulu and 752 Chinese older adults in Wuhan. We also explored the mediating role of resilience and the moderating role of gender in linking the associations. Findings show, for both study sites, receiving greater emotional support was associated with increased levels of SRH and this association was partially explained by resilience for females but not for males. For country differences, receiving economic support was negatively associated with SRH whereas providing economic support was positively associated with SRH for males but not for females in Honolulu. In Wuhan, receiving housework support was negatively associated with SRH for females but not for males. These findings indicate that future studies need to consider country differences as well as the impact of acculturation when examining intergenerational transfers and health among Chinese older adults.
EDUCATIONAL ATTAINMENT AND YOUNG ADULT HEALTH IN THE UNITED STATES: DIFFERENCES BY RACE AND GENDER
Authors: Noppert Grace A
Published: November 2019

There is compelling evidence to suggest that educational disparities in health differ by both race and gender. This study examines the relationship between respondents’ education and six health outcomes related to cardiometabolic and inflammatory outcomes using data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (ages 24-32 years; N = 13,458). We used logistic regression models to examine the relationship between education and the odds of each health outcome. Models were stratified by race and gender. We found that the association between education and each health outcome differed by race/ethnicity and gender. While among whites we observed an association between education and each health outcome, for blacks we observed no such associations. It may be that the benefits of education are particularly salient for those in more structurally advantaged positions, pointing to the continued need to address structural inequalities by both gender and race.
EXAMINING THE ASSOCIATION BETWEEN NEIGHBORHOOD CHARACTERISTICS AND TELOMERE LENGTH BY RACE AND URBANICITY
Authors: Thierry Amy
Published: November 2019

A dearth of research investigates socio-environmental mechanisms of health disparities. Therefore, this paper tests the association between neighborhood characteristics and telomere length (TL), a biomarker of cellular age, and examines if this relationship differs by race and urban residence. Data from US-born, non-Hispanic Black and White midlife and older adults (n=4,155) in the 2008 Health and Retirement Study was analyzed to test the relationship between TL and perceived neighborhood safety, cleanliness, and social cohesion. Linear regression models stratified by race included interaction terms between neighborhood characteristics and urban residence. Negative perceptions of neighborhood characteristics were associated with shorter TL in Blacks, with urban-dwelling Blacks having shorter TL than Blacks in less urban areas. Findings suggest that negatively perceived neighborhoods may be more detrimental to TL for urban compared to rural Blacks. Future research should elucidate the biobehavioral consequences of socially disadvantaged urban neighborhoods on healthy aging among Black adults.
THE VIRTUE OF A LIFE OF COMPLEXITY: THE KEY TO HEALTHY AGING
Authors: Lipsitz Lewis
Published: November 2019

People often wish to simplify their lives as they age, hoping to lead a less complex, stress-free, and happy existence. However, the loss of complexity may actually endanger one’s health. Aging is often associated with the pruning of work, family, and social networks in our external environment, and on a smaller scale, with the degradation of various anatomic structures and physiologic processes internally. This loss of complexity can impair our ability to perform activities of daily life or adapt to surgery or other stressors. We can quantify complexity using measures derived from the concept of fractals that describe patterns of behavior across different scales in space or time. Using these metrics we have shown that complexity loss is potentially reversible. This presentation will describe the measures, mechanisms, and consequences of complexity loss in different human systems, and interventions that can restore complexity and thereby improve functional health in older age.
OLDER ADULTS AND THE WORLD CAFé APPROACH: CROSS-GENERATIONAL INITIATIVES IN RESEARCH AND EDUCATION
Authors: Novik Nuelle , Jeffery Bonnie , McIntosh Tom
Published: November 2019

In Canada, numbers of older adults are considered to be increasing, and by 2036, it is expected that seniors will reach 25% of the total population. Since 2009, the Saskatchewan Population Health and Evaluation Research Unit (SPHERU) has developed an interdisciplinary approach to a community-based research program focused on rural older adults. The world café approach is recognized as collaborative and ideal for encouraging dialogue, sharing knowledge, and developing action plans. Set up like a café, four to six participants at each table engage in a series of three conversational rounds lasting approximately 20 minutes each. At the end of each round, participants move to different tables while the facilitator(s) remain at their original tables. We incorporated a world café approach in three distinct research projects, facilitating a total of five world café events. For each of these events, we also engaged with graduate and undergraduate students who were trained to serve as table facilitators. Participating students represented a variety of disciplines including social work, nursing, and gerontology. Older adults participating in the world café events reported positive experiences and appreciation for the opportunity to discuss new information. Student facilitators identified their participation as a “real life” learning and networking opportunity that enhanced their classroom experiences. Challenges identified included issues related to individual mobility, and issues related to noise and sound quality for those with hearing deficiencies. A community-based approach to research is effective when engaging with this population, and a word café event brings seniors directly into the discussion.
AGING SUPPORT, HEALTH, AND WELL-BEING OF THE ELDERLY IN CHINA AND JAPAN
Authors: Zang Emma , Zhang Yuan
Published: November 2019

Countries in East Asia have the largest aging population in the world. The consequences of aging largely depend on whether it is accompanied by a healthy, active, and high-quality life. This symposium aims to gain a better understanding of aging support and determinants of health in the contexts of two major East Asian countries - China and Japan. We will present new research using data from the Fukui Longitudinal Caregiver Study (FLCS) in Japan, and two most important aging surveys in China – the China Health and Retirement Longitudinal Study (CHARLS) and the Chinese Longitudinal Healthy Longevity Survey (CLHLS), addressing critical topics including retirement, family care, social mobility, and mortality. Song and Smith investigate the impact of hukou change on mental health in later life. Zang examines the effect of a man’s retirement on his wife’s mental and physical health in China. Zhang et al. explore the determinants of mortality in China by conducting a comprehensive analysis of life-course conditions, community characteristics, biological and physical functioning, and disease burden. Zeng et al. compare demographic, socioeconomic, behavioral characteristics and health phenotypes of centenarians in China and Italy. Wakui et al. focus on the emergence of compound caregiving and the relationship of caregiving status to burden, depression, and social support in Japan. The cross-national comparisons will be informative regarding aging in various contexts. We will discuss the potential for further investigations using population-based aging data from different countries.
FAMILY-MEMBER LOSS AS A CUMULATIVE BURDEN FOR HEALTH AMONG BLACK AND WHITE OLDER ADULTS
Authors: Donnelly Rachel
Published: November 2019

The health consequences of multiple family member deaths across the life course has received less attention in the bereavement literature. Moreover, recent research shows that black Americans are more likely than white Americans to lose multiple family members. I analyze longitudinal data from the Health and Retirement Study (1992-2014) to assess how multiple family member losses across the life course are associated with declines in health among older adults. Findings suggest that multiple family losses prior to midlife are associated with a number of indicators of poor health (e.g., functional limitations, cardiometabolic health) and steeper declines in health as individuals age. Losses after midlife additionally undermine health declines for older adults. Thus, family member loss functions as a cumulative burden of stress across the life course that erodes health in mid- and later-life. Family loss disproportionately burdens black Americans and serves as a unique source of disadvantage for black families.
RECRUITMENT TO THE GERONTOLOGY CERTIFICATE: STRATEGIES FROM UTAH STATE UNIVERSITY
Authors: Fauth Elizabeth B , Liu Yin
Published: November 2019

There is a workforce shortage in age-related fields, in both medical and non-medical, and professional and nonprofessional employment levels. Jobs in aging-related fields are cited as growth careers, or in lists of “top ten growing jobs”, yet academic training programs in gerontology are still facing low enrollment and other long-standing barriers. Utah State University offers an interdisciplinary gerontology certificate housed within the department of Human Development and Family Studies (HDFS). Recruitment to the certificate is most effective from two “feeder” classes: Adult Development and Aging (in HDFS), and via a guest lecture in Community Health (in Kinesiology and Health Sciences). Face-to-face meetings with academic advisors in other departments (e.g. Nutrition) has resulted in referrals to the certificate program. Office hours and drop-ins from interested students falls on the certificate coordinator, but is essential in recruitment. In sum, face-to-face recruitment is time intensive, but significantly more effective than online/print material.
GROWING AN ONLINE GERONTOLOGY MINOR AT THE UNIVERSITY OF UTAH
Authors: Eaton Jacqueline
Published: November 2019

The Gerontology Interdisciplinary Program at the University of Utah has a long history of offering certificates (48 years) and a Master of Science degree (25 years). Relatively new to our program is the minor in gerontology, first available in 2013. This paper will describe efforts to grow this program, barriers to enrollment, and plans for expansion. In 2018, the program developed a targeted strategy to increase student awareness of and enrollment in the minor. First, we focused on newly enrolled pre-nursing students through new student orientation presentations and registration support. The introductory course within the minor jumped in enrollment from 6 students in Fall of 2017 to 40 in Fall 2018. Students taking courses in the minor received follow-up support and instructions mid-semester to ease matriculation. Enrollment in the minor increased by 140%. Next, we plan to apply these strategies to a broader number of colleges and departments throughout campus.
INTEGRATION OF OBJECTIVE AND SUBJECTIVE EXPERIENCES OF HEALTH IN OLD AGE
Authors: Mejia Shannon T , Drewelies Johanna , Berg Cynthia
Published: November 2019

Life-span perspectives on adult development and aging highlight the processes of understanding and acting to support one’s own health and well-being. Within this framework, subjective measures offer insight into the experience of objective measures of health. This symposium brings together four papers that highlight the overlap and discrepancy between subjective and objective measures of health and how these are shaped by individual development in different contexts and phases of adult development over various timescales. Mejía and colleagues consider the intraindividual dynamics of older adults’ perceived and actual fall risk. Using 30 days of subjective and objective balance assessment, they illustrate individual differences in how awareness of fall-risk relates to physical activity on that day. Koffer and Kamarck use data from the Pittsburgh Healthy Heart Project to examine how reactivity of cardiovascular response and affective experience to daily experiences of stress changes with age. Drewelies and colleagues consider how objective aging feels. Using data from the Berlin Aging Study II, they examine how chronological and subjective age are linked to biological age in older adults. Gonzalez and colleagues use self-reported and behavioral data from an in-context biosocial research lab to comment on the theoretical and methodological implications of integrating objective and subjective measures of experience. The discussion by Berg integrates the four papers, highlights their theoretical and methodological contributions, and considers challenges and opportunities for subjective and objective inquiries of older adults’ experiences of health.
FEELING YOUNGER, BEING YOUNGER: ASSOCIATIONS BETWEEN BIOLOGICAL AGE AND SUBJECTIVE AGE IN OLDER ADULTS
Authors: Drewelies Johanna , Demuth Ilja , Duezel Sandra , Hueluer Gizem , Bertram Lars , Steinhagen-Thiessen Elisabeth , Gerstorf Denis
Published: November 2019

Subjective age has been shown to be a strong predictor of both subjective and objective health outcomes. However, little is known about the extent to which individuals’ subjective age is related to one’s biological age or not. In our study, we examine how subjective age relates to biological age—a comprehensive multi-indicator biomarker algorithm aggregating information of metabolic, cardiovascular, inflammatory, lung, and kidney functioning. We used data from 996 older adults from the Berlin Aging Study II (mean age = 68.40 years, range 60 to 85, 52% women) who provided information about chronological age, biological age, and subjective age. Multiple regression analyses revealed that subjective age was associated with biological age among older women with and without controls for age, education, and physician-observed comorbidity, but not older men. Our findings suggest that subjective age might provide unique insights into how biological age differs across adulthood and contributes to overall health.
DISTINGUISHING SUBJECTIVE EXPERIENCE FROM OBJECTIVE FACTORS IN DECISION MAKING AND PERCEIVED EFFORT
Authors: Gonzalez Richard , Abbott Patricia , Ashton-Miller James , Smith Jacqui
Published: November 2019

We use self-reported and behavioral data from the HomeLab to comment on the theoretical and methodological implications of integrating objective and subjective measures of experience. To illustrate, we will focus on two domains that vary in the nature of objective and subjective measurements examined. One domain will be decision making where subjective measures include subjective probability and utility and the respective objective measures include probability and actual outcomes. The second domain will be activities of daily living where the subjective measure is perceived effort and the objective measures include various data from sensor such as EDA (arousal) and EMG (muscle contraction). The presentation will discuss the benefits of conducting such research in a realistic standardized context such as the HomeLab, which is a fully connected, fully functioning apartment set up as a standardized lab in order to study activities of daily living.
INCREASED LIFESPAN THROUGH ALTERED GCN4 / ATF-5 IN S. CEREVISIAE AND C. ELEGANS
Authors: McCormick Mark , Robbins Christine , Heath Olivia , Westenskow Marissa
Published: November 2019

In a whole-genome screen for deletions that increase lifespan in S. cerevisiae, we identified increased Gcn4 signaling as a mediator of increased lifespan. Gcn4 is a nutrient-responsive transcription factor whose entire pathway is functionally conserved from yeast through humans. Accumulation of uncharged tRNAs has been shown to upregulate Gcn4, and its mammalian ortholog, ATF4. Here we demonstrate that chemical inhibitors of tRNA synthetases significantly extend lifespan in both yeast and the nematode C. elegans, in a dose- and Gcn4-dependent manner.
LEVERAGING DRUG-DRUG INTERACTIONS FOR PHARMACOLOGICAL EXTENSION OF HEALTHY LIFESPAN
Authors: Gruber Jan
Published: November 2019

Traditional approaches aimed at delaying or preventing age-dependent diseases view each disease as a distinct entity, resulting from separate pathophysiological chains of events. However, it is becoming increasing clear that even in adult animals there remains significant plasticity in terms of ageing trajectories and lifespan, suggesting that targeting ageing processes directly may be a promising alternative strategy. However, to date effects of even the most efficacious pharmacological interventions are smaller than those of ageing mutations, even when targeting the same ageing pathways. Interestingly, it has been shown that simultaneously targeting multiple ageing pathways can result in lifespan benefits that are synergistic (more than additive). We have recently shown that dramatic lifespan and healthspan extension can also be archived by leveraging interactions between drugs targeting distinct subsets of the gene-regulatory network controlling ageing of C. elegans. These interventions were highly efficacious, even when animals were treated only as adults.
UNDERSTANDING AGING IN TERMS OF PHYSIOLOGICAL STATES
Authors: Mendenhall Alexander , Burnaevskiy Nikolay , Yun Soo , Sands Bryan
Published: November 2019

The “network” of homeostatic systems fails in distinct ways in individual isogenic animals during the aging process. We believe that understanding these distinct physiological states, the transitions between them, and how they relate to homeostatic system functions will allow us to better affect change in the aging process. Work in yeast showed that fixing an initial system failure, loss of vacuole acidification capacity, could increase cellular lifespan. Here we showed how the long-lived physiological state conferred by high expression of the hsp-16.2 promoter based lifespan/penetrance biomarker correlates with differences in the expression of other genes, and the structure and function of lysosomes. We found that vacuole acidification failure is not a major initial proximal cause of aging in C. elegans – at least not in their intestine cells.
QUALITATIVE FINDINGS AND THEMES IN REIMAGINING LTC: RESULTS ROUND 1 AND 2 OF THE NATIONAL DELPHI STUDY
Authors: Kane Rosalie A , Workman Audrey
Published: November 2019

From Round 1 we developed programmatic building blocks, which we classified as: housing suggestions; services suggestions; housing and/or technology heavy suggestions; policy or regulation suggestions;new philosophical approaches; and long-range social engineering. Besides the quantitatively ratings of the importance of each building block, respondents explained what they liked and disliked about each.. They frequently commented that environments rich in design features, amenities and activities would not be practical for low-income people. Respondents felt that some ideas would not be suitable for people with dementia because they would be insufficiently protected. Principles that seemed to be incompatible could be highly endorses; e.g., the principle that we prioritize people staying in their own homes and a principle that frail elderly persons living along should relocate to group residential settings to avoid social isolation. This paper concludes with a list of areas for further discussion by work groups.
QUANTITATIVE RE-IMAGINING OF LTC : RESULTS FROM ROUNDS 1 AND 2 OF A NATIONAL DELPHI STUDY
Authors: McCreedy Ellen , Hoover Caleb
Published: November 2019

At Round , 110 participants answered an open text question about how they would redesign LTC if starting fresh without regulatory or financial constraints.. They also rated a list of values as to whether they were reflected in the respondents’ suggestions. From analysis of Round 1 open text, principles for LTC were extracted and 20 programmatic building blockscreated. At Round 2, respondents rated the importance of the original value list (after Round 1 results were shared) and rated the principles and building blocks. This paper presents those findings and highlights inconsistencies in results: for example, both a universal LTC and a means-test benefit were endorsed. Participants preferred the term Long-Term Services and Support for the subject matter but no strong term was the favorite for service users. Alternate ways of displaying endorsement of individual items (mean value, different score cutoffs) resulted in the same most popular and least popular items.
REFLECTIONS FROM THE PERSPECTIVE OF AN ADVOCATE AND CASE MANAGER
Authors: Keibler Tracy
Published: November 2019

From her perspective as director of ApparentPlan, a nonprofit care agency to assist low income consumer of LTC, and as co-founder and director of the MN Long-Term Care Think Tank, an advocacy organization. Ms. Keibler will reflect on these findings and next steps.
GRANDPARENTS’ ROLES IN THE CONTEXT OF ADVERSE CHILDHOOD EXPERIENCES: THE VOICES OF EMERGING ADULTS
Authors: Chan Athena Chung Yin , Leung Doris , Chan Bessie , Ho Grace Wing Ka
Published: November 2019

The influence of grandparents, in the context of adverse childhood experiences (ACEs), is largely understudied. With strong kinship in Asian families, grandparents may provide a crucial resource to their grandchildren; not limited to those living together, but having close emotional proximity. This qualitative study used secondary analysis to explore the roles of grandparents, upon reflection of participants’ childhood adversities. Semi-structured interviews were conducted with 19 emerging adults, between 18 and 24 years old in Hong Kong, China. Participants were eligible if they: (1) reported at least one ACE, namely, abuse (physical, emotional, sexual), neglect (physical, emotional), witnessing domestic violence, or a dysfunctional household (due to parental divorce/death, household member substance use, incarceration, mental illness); and (2) described their interactions with grandparents during the interviews. Participants were asked to think of a challenging time during their childhood, and strategies they used to overcome them. All interviews were audio-recorded and transcribed verbatim. Data regarding the interactions with grandparents were coded and analyzed by four researchers following interpretive description. Preliminary findings described four primary roles grandparents played in the context of ACEs, which were sometimes positive and/or negative. Grandparents were portrayed as being unique persons in participants’ lives that influenced how they faced their childhood adversities. We will discuss how grandparents’ stewardship may significantly shape cultural patterns of how families cope with ACEs. In particular, our findings, examined against literature, will discuss how grandparents may enhance resilience of young people with ACEs.
MORE OR LESS? A DECADE’S TREND OF SOCIAL PARTICIPATION AMONG CHINESE OLDER ADULTS: BASED ON A LONGITUDINAL SURVEY
Authors: Tan Chenxin , Zhou Yun
Published: November 2019

Social participation is of great significance in healthy aging. While studies on social participation among Chinese elderly are growing, there is a lack of understanding the changes over time of the participation. Using datasets from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this paper presents a comprehensive analysis on a decade’s trend of social participation among Chinese older adults. First, we use the method of Latent Class Analysis (LCA) to identify types of social participation; in this study, we concluded three types, no participation, the family-centered, and the society-oriented. Second, we examine the characteristics of the elderly by types of participation in terms of demographic, socioeconomic and health condition and analyze the changes in the characteristics over time. And third, we interpret the trend of social participation with broader social environment, or the fluctuant structural and institutional differences under the context of China’s unique social system. Our general conclusion is that while the overall level of participation holds relatively steady, there is a dynamic micro progress and complex mechanisms in this long period. In addition, although both the family-centered participants and the society-oriented possess broader scopes of social participation, the related attributes are different across time. This paper contributes to our knowledge of life of the elderly under the circumstances of fast aging process in China.
MATTERING AND MOBILITY: POSITIVE RELATIONS WITH OTHERS PROTECTS AGAINST FUNCTIONAL DECLINE IN AGING ADULTS
Authors: Baker Hannah , Mitoraj Meghan , Friedman Elliot M
Published: November 2019

Social relationships are robust predictors of better health and greater longevity in aging adults. The current study examined a relatively understudied aspect of relationship quality - positive relations with others, a domain of eudaimonic well-being - and its independent associations with change in and incidence of mobility limitations in a sample of mid-life and older adults from the Midlife in the United States (MIDUS) study. Using data from all 3 waves of MIDUS, we examined the extent to which positive relations with others predicted smaller increases in limitations and reduced risk of onset of new limitations over a 18-20 follow-up period. Linear and logistic regression models, adjusted for demographic and health confounds, showed that higher positive relations scores predicted slower increase in limitations over time (p=.003) and reduced risk of incidence of new limitations (p=.01). These effects were also observed over and above the associations with more traditional structural and functional measures of social relationships, neither of which was significantly linked to changes in functional abilities. These results suggest that positive relations with others may act as a unique protective factor for functional decline, both in individuals with no initial functional limitations and in those with existing limitations. They also extend prior research on the potential health benefits of social relationships to include a social dimension of eudaimonic well-being. Finally, they suggest that vulnerability to functional limitations and the potential benefits of social connectedness extend to mid-life as well as older adults.
PSYCHOCOGNITIVE REACTIVITY TO INSUFFICIENT SLEEP AND ITS ASSOCIATION WITH BODY MASS INDEX IN MIDDLE-AGED WORKERS
Authors: Drury Taylor , Lee Soomi , Buxton Orfeu M , Almeida David M
Published: November 2019

Individuals tend to report more stressors on days after nights with fewer hours of sleep. There may be individual differences such that this negative sleep duration—stressor perception relationship is stronger for some than others, which may have implications for health outcomes. However, we know little about whether differences in stressor perception in response to insufficient sleep (“psychocognitive reactivity to insufficient sleep”) are associated with health outcomes such as body weight. This study examined whether psychocognitive reactivity to insufficient sleep were associated with body mass index (BMI) in midlife workers. We used a sample of 127 office workers (Mage=45.2±6.2) who participated in a daily diary study for 8 consecutive days as part of the Work, Family, and Health Study. Multilevel models tested whether daily number of stressors was predicted by previous nights’ sleep. We outputted within-person slopes of stressors regressed on sleep duration to predict BMI (kg/m2). Analyses adjusted for sociodemographic characteristics and mean stressors across days. On average, workers reported more stressors following nights with shorter sleep duration than usual (negative slope means higher reactivity). Compared to those with average reactivity (within ±½SD; reference), workers with higher reactivity (≤-½SD) had higher BMI (p<.05). The BMI of these workers fell in the obese range. This study is one of the first to report that middle-aged workers with higher psychocognitive reactivity to insufficient sleep may be at greater risk for obesity. Future interventions should focus on improving middle-aged workers’ sleep health to reduce next-day stressors and thereby improve their body weight.
A NATIONAL ASSESSMENT OF THE RELATIONSHIP BETWEEN NURSING HOME CULTURE CHANGE AND RESIDENT OUTCOMES
Authors: Schwartz Margot L , Lima Julie C , Gozalo Pedro L , Clark Melissa A , Miller Susan C
Published: November 2019

Literature is mixed regarding the relationship between Nursing Home (NH) culture change and resident outcomes, and the majority of studies are limited to small samples. We evaluated this relationship separately for five unique domains of NH culture change (physical environment, resident care, staff empowerment, leadership, and family and community involvement practices) using a 2016/2017 survey administered to a stratified-random national sample of NHs; 74% of NH administrators responded (n=1,583). We assessed the relationship between each culture change domain and 8 outcomes (calculated with MDS 3.0 and Medicare claims data) using resident-level multivariable logistic regression models, that accounted for resident and NH characteristics, and were weighted by facility-level inverse probability weights (to address NH Selection). We found the relationship between NH culture change and resident outcomes varied by culture change domain. High scores on leadership practices (i.e., two-way communication, staff involvement, education/training, respect for workers, and coaching) were most strongly associated with outcomes. Compared to the lowest quartile, performance in the highest quartile (most implementation of practices) on the leadership domain was associated with 13% lower odds (OR: 0.87, 95%CI: 0.78, 0.96) of urinary tract infections, 15% lower odds (OR: 0.85, 95%CI: 0.80, 0.91) of worsened locomotion, and 41% lower odds (OR: 0.59, 95%CI: 0.42, 0.83) of physical restraint use. For the other domains the estimates (and statistical significance) of the relationship with outcomes varied more than observed for leadership. Our findings emphasize the importance of high-quality NH leadership. Investments in improved leadership practices may result in higher-quality resident outcomes.
A RISING TIDE LIFTS ALL BOATS: OLDER WORKER EMPLOYMENT RATES
Authors: Harootyan Robert
Published: November 2019

U.S. population aging has been accompanied by aging of its workforce. One-fourth of workers are now 55+, a result of increasing labor force participation rates (LFPRs) of boomers. Older female LFPRs increased notably since 2000, now 34% (1.5 times greater than the 1947-2000 average). Older male LFPRs steadily declined for 50 years, but increased since 2000 (currently 45%). Despite higher LFPRs, many older workers are underemployed, unemployed or having trouble finding desired jobs. We conducted a pilot to test the hypothesis that areas with strong economic and overall-employment growth are more likely to have higher age 55+ LFPRs - i.e., strong overall demand should increase the likelihood that older persons are employed. Major metropolitan areas were selected because of their large labor pools and ACS age-specific labor force data. Of 318 large metros, we selected 14 whose 2017-2018 employment growth ranged from 0.7% to 3.3% (excluded were those with small negative change and those with concentrated special industries). Results: After calculating age-specific LFPRs from ACS five-year data and overall employment growth for each metro, we found a generally strong relationship between high growth and higher than average LFPRs for persons ages 55+. For example, two opposites: Dallas, with 3.2% employment growth, had age 55+ (five year intervals to 75+) LFPRs substantially higher than the national average (by 4-7 percentage points; significant at 0.05). But Pittsburgh, with 0.8% overall employment growth, had age 55+ LFPRs slightly lower than national average. Conclusion: A rising (economic/employment) tide lifts all boats, including older workers.
NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY
Authors: Lepore Michael J , Lima Julie C , Clark Melissa A , Gozalo Pedro L , Miller Susan C
Published: November 2019

Transforming nursing home (NH) cultures—from impersonal institutions to enriching communities where residents and employees thrive—requires multifaceted change. NHs deploy an array of culture change (CC) practices, in three core domains: resident-centered care, staff empowerment, and physical environment. This study uses novel data on CC practice from a nationally representative panel of NHs (N=1,585) surveyed in 2009/2010 and 2016/2017. To understand how changes in practice adoption may relate to quality changes we linked longitudinal data on the CC practice domain scores for resident-centered care, staff empowerment, and physical environment and on NH deficiencies relating to health and quality of life (QoL) and combined these with Certification and Survey Provider Enhanced Reporting baseline data. Multinomial logistic regressions incorporating survey weights and inverse probability of weight (to address CC selection) estimated the relative risk ratios (RRR) of increased CC practice corresponding with NHs having fewer or no change in deficiencies, versus increased deficiencies. NHs with much increase in staff empowerment scores had a higher likelihood of no change (compared to an increase) in health deficiencies (RRR 2.0; 95% CI 1.15, 3.61) and severe health deficiencies (RRR 2.03; 95% CI 1.05, 3.93). With a RRR of 1.63, NHs with any improvement in resident-centered care scores appeared to have a higher likelihood of no change (compared to an increase) in QoL deficiencies but statistical significance was not reached (p=0.11). This study provides some support for the benefits of CC practices, and in particular, supports the importance of staff empowerment practices in NHs.
CONTEMPORARY EARLY RETIREMENT FACTORS AND STRATEGIES TO ENCOURAGE AND ENABLE LONGER WORKING LIVES
Authors: WILSON Donna M
Published: November 2019

Accelerating population aging is raising concern in many countries now about the availability of workers for essential work roles and responsibilities. A scoping research literature review was done to identify factors currently associated with early retirement and contemporary strategies to encourage and support longer working lives. Among 53 relevant articles, seven early retirement factors were revealed: Ill health, good health, workplace issues, the work itself, ageism, social norms, and having achieved personal financial or pension requirement criteria. Six solutions, none of which had been proven effective, were identified: Occupational health programs, workplace enhancements, work adjustments, addressing ageism, changing social norms, and pension changes. The evidence base on early retirement prevention is not strong, with qualitative research studies needed to gain a more in-depth understanding of early retirement influences and also mixed-methods studies needed to test early retirement prevention solutions for their effects, and particularly in the healthcare sector as healthcare needs typically rise with advanced ageing. Until more evidence is available, every healthcare and other organization should perform an early retirement risk assessment and identify current versus needed policies and programs to encourage and to enable more middle-aged and older people to work longer in life.
SKILLED NURSING FACILITY VALUE-BASED PURCHASING PROGRAM: DISPARATE IMPACTS
Authors: Gaudet Hefele Jennifer L , Wang Joyce , Lim Emily
Published: November 2019

In 2018, the federal government delivered the first round of incentive payments under the Skilled Nursing Facility (SNF) Value Based Purchasing (VBP) program. Incentive payments are based on post-acute readmissions performance. Facilities received payments that were either higher, on-par, or less-than typical. Our study sought to determine whether minority- and Medicaid-serving SNFs had the same likelihood of being among the top performers/incentive payment earners compared with SNFs serving more advantaged populations. We used publicly available data on SNF-VBP performance rankings available from CMS, linked to SNF characteristics publicly available from LTCFocus.org. Using logistic regression, our three analytic models examined the likelihood of being in the top 20% of SNF-VBP performance rankings among: SNFs in which the majority (>50%) of residents are African American(AA)/Black; SNFs in which the majority of residents are Hispanic/Latino; and SNFs in which 85% or more residents are Medicaid-pay. Results show that AA/Black-serving SNFs have two-thirds the odds of being in the top 20% of rankings compared to SNFs where the majority of residents are White (OR: 0.667 p<0.001). Hispanic/Latino-serving SNFs have less than half the odds (OR: 0.447 p<.01). High-Medicaid SNFs have less than one-third the odds of being in the top compared to SNFs with no Medicaid-pay residents (OR: 0.271 p<0.0001). Results are robust to alternate specifications of racial/ethnic and payer compositions. Lower payments to SNFs serving vulnerable populations is concerning, in that fewer resources may be available to these SNFs for patient care and quality improvement, which may result in creating or exacerbating disparities.