bluuebunny/crossref_metadata_2025 huggingface dataset:
SOCIAL ISOLATION AMONG MARGINALIZED OLDER ADULTS: APPLYING A UNIFIED MODEL OF RESILIENCE
Authors: Wister Andrew
Published: January 2025

Social isolation is associated with reduced psychological well-being; increased anxiety and depression; compromised physical health; and higher mortality among older adults. Moreover, those who experience various forms of vulnerability and marginalization in society are particularly at risk. We apply the Unified Model of Resilience and Aging (UMRA), an interdisciplinary model that integrates psychological, physiological, and social dimensions of resilience, the latter of which embodies social participation, social isolation, and community belonging. Resilience models, like the UMRA, seek to understand why some individuals, families, and communities recover from adversity better than others, in this case, social isolation and loneliness. The UMRA integrates individual and system-level processes that occur over the life course. According to the UMRA, resilience depends on the activation of internal resources (positive attitude), and activation of external resources (e.g., support from family, friends or organization) which also vary with age and other factors. The UMRA thus includes four domains of environmental resilience situated across the socio-ecological spectrum from individual to global. It also includes four system-level (organizational) functions used by the National Academy of Sciences Resilience Model: 1) Planning for adverse events requires reductions in risk in response to an identified threat. 2) Absorption of stressors and outcomes associated with an adversity is necessary to initiate resilience through recovery and adaptation. 3) Recovery occurs through various forms of short and long-term strength-based resilience. 4) Adaptation relates to changes in the system to promote future resilience. We apply the UMRA to frame causes and consequences of social isolation.
SOCIAL ISOLATION AND SOCIAL ENGAGEMENT IN OLDER ADULTS: DETERMINANTS AND INTERVENTIONS
Authors: Liu Jinyu
Published: January 2025

This symposium brings together five studies to examine determinants of social isolation and social engagement and to explore ways to enhance social engagement and well-being among older Americans. Focusing on marital status, the first study finds that the risk of social isolation, from low to high, is coupled, widowed, divorced, and never married. Further, divorced and never-married men are at particularly high risk of social isolation. The second study is concerned with the co-evolution of loneliness and companionship among residents in assisted living communities. It finds that increased loneliness is associated with decreased companionship ties subsequently, but not vice versa. Using a community-based participatory research approach, the third study identifies issues related to transportation, health, and family support, that influence social re-engagement among older black Americans after the COVID-19 pandemic. The fourth and fifth studies are randomized controlled trials. The fourth study reports that older adults with cognitive impairment perceive decreased feelings of loneliness after participating in an intergenerational engagement program with trained young adults. The fifth study finds that an intervention that trains former dementia caregivers to provide volunteering support to current caregivers is feasible in the Chinese American community. Further, the intervention is effective in reducing the stress of current caregivers and increasing the sense of purpose of former caregivers. Together, the five studies show that the individual, familial, and community contexts shape social isolation and social engagement in later life and suggest that group- and context-specific interventions have promise to improve social well-being of older adults.
THE CO-EVOLUTION OF LONELINESS AND COMPANIONSHIPS IN AN ASSISTED LIVING COMMUNITY: A SOCIAL NETWORK ANALYSIS
Authors: Mauldin Rebecca , Kirsh Jaclyn , Fujimoto Kayo
Published: January 2025

Loneliness and social isolation are distinct constructs that tend to be moderately correlated. The Evolutionary Theory of Loneliness posits that loneliness can motivate people to increase or improve their social ties. However, interrelated factors including loneliness, desired relationship quality/quantity, actual relationships, and appraisals of existing social networks may affect whether loneliness leads to increased social ties. In assisted living communities (ALCs) most opportunities for socializing with non-family members occur within the community, restricting residents’ pool of potential friends and companions. This study investigates the co-evolution of loneliness and companionship ties among older residents in an ALC using three waves of secondary data from the Social Experiences in Assisted Living (SEAL) study. We estimated a stochastic actor-oriented network-behavioral co-evolution model for companionship and loneliness dynamics in a network of 38 ALC residents to understand the reciprocal effects of loneliness and companionships. We found that increased levels of loneliness were significantly associated with a decreased likelihood of subsequently maintaining or adding companionship ties among other residents (ϴ = -.131, p <.01). Changes in companionship ties were not significantly associated with changes in levels of loneliness. Greater frequency of contact with family members was significantly negatively associated with the likelihood of companionship ties with other residents (ϴ = -.113, p <.05), but was not significantly associated with levels of loneliness. These findings do not support the hypothesis that increased levels of loneliness lead to maintaining or adding companions in the ALC and have implication for both theory and practice.
STUDYING LGBT OLDER ADULTS
Authors: Waite Linda , Liu Hui
Published: January 2025

The size of the lesbian, gay, bisexual and transgender (LGBT) population in the U.S. is estimated to be at 9 to 11 million people (about 3.5–4.5%) and is expected to grow in the future. LGBT populations persistently experience health disparities across multiple physical and mental, which widen over the life course. The study of the older LGBT population would benefit from a nationally-representative, longitudinal study with information on health outcomes but also on the social mechanisms at work that may exacerbate or ameliorate these disparities. The National Academy of Medicine (NAM) has recently called for more targeted research aimed at understanding the sources and consequences of these health disparities, particularly among older LGBT adults. The papers in this session focus on strategies to carry out such as study. O’Muircheartaigh and Schumm describe a novel strategy for recruiting such a sample; Lauderdale and Meyer present recent data mental and physical health in a small pilot study using this strategy; Johns et al. study differences in social characteristics and health for LGBT versus other older adults in two nationally-representative samples; and Azar et al. present international comparisons of these differences in the UK and the US. Together these papers add to our understanding of health and health disparities in older sexual minorities and how we might learn more about them.
DIFFERENCES IN SOCIAL CHARACTERISTICS AND HEALTH STATUS BY SEXUAL IDENTITY AMONG OLDER ADULTS: COMPARISON OF TWO COHORTS
Authors: Iveniuk James , Johns Michelle , Zhong Selena , Schilt Kristen
Published: January 2025

Sexual minority women experience poorer social, mental, and physical health than their heterosexual counterparts; yet limited work has been done to describe the scope of these health differences. Challenges to such analyses include a dearth of large-scale national surveys that collect sexual orientation data and small numbers of cases among those studies that do ask. To advance our understanding of the health and wellbeing of sexual minority women, we compare key indicators of health and wellbeing (e.g., diabetes, high blood pressure, asthma, depression, loneliness) by sexual identity in the National Social Life, Health, and Aging Project, a nationally representative study of older adults, and in SAMLAP, a nationally representative sample of older LGBT adults. We employ OLS and logistic regressions to assess how health outcomes differ between sexual minority women and heterosexual women in NSHAP as well as health differences among sexual minority women in SAMLAP. We controlled for age, marital status, race, education, and network size in our models. In NSHAP, we found that sexual minority women had higher depressive symptoms than heterosexual women but there were no other health differences between these two groups. In SAMLAP, bisexual women had higher odds of developing diabetes and more depressive symptoms compared to lesbian women. We will discuss our results within the context of the minority stress model which details the impact of social stigma on the health of sexual minority populations.
UNDERSTANDING OLDER ADULTS’ DIGITAL EXPERIENCES DURING AND AFTER THE PANDEMIC: A MIXED-METHODS STUDY
Authors: Yu Zhan , Chen Xiayu , Xu Qingwen , Huang Chenxi
Published: January 2025

During the COVID-19 pandemic, China adopted the zero-case policy and made full use of digital technology, such as mandatory QR code using; consequently, older adults were forced into the experiences of digital technology. This study aims to explore the psychological and behavioral effects of policy actions on older Chinese, particularly to address the long-term effects on their technology use. We employed a sequential mixed-methods approach. Using data from the CHRLS, generalized estimating equations was performed and the study found a significant increase in internet use among older adults in 2020 compared to 2015 (OR = 12.04, p <.001). Then three focus group interviews were conducted with older adults in Shanghai. Content analysis reveals three themes: the feeling of being “compelled” to use digital technologies during the pandemic to meet daily basic needs and maintain social connections; a perception of “digital invasion” in the post-pandemic era; and an increased consciousness of the importance of self-efficacy for continued technology use. Further codes network analysis and cross-group comparisons show that both positive and negative experiences of digital use during the pandemic related to the increased use after the pandemic; prior community technology education programs and support received resulted in varied experiences and perceptions of digital use. This study offers insights into older adults’ adaptations to technology, which would help inform policies and practices for addressing the challenges of aging and technology use. It also highlights the need for tailored strategies that recognize the diverse needs of older adults in the digital age.
DIFFERENCES IN BEHAVIOR CAPTURE USING ELECTRONIC MEDICAL RECORD OF NURSING HOMES ACROSS RESIDENT RACE AND ETHNICITY
Authors: Yun Hyunkyung , McCreedy Ellen
Published: January 2025

Agitated behaviors are under-reported in the Minimum Data Set (MDS), a standardized assessment of nursing home (NH) residents, which poses challenges for pragmatic trialists hoping to use routinely collected data to assess study eligibility and outcomes. Our recent study found that using Interventions to Reduce Acute Care Transfers (eINTERACT) and physician orders from EMR increases behavior identification over the MDS alone by 25.7% relative increase (14.8% (SD 35.6) by MDS only vs. 18.6% (SD 38.9) by supplemented by EMR) among NH long-stay residents with dementia. We extended that work to consider variations in behavioral capture by race and ethnicity. We used MDS and EMR from one large, non-profit corporation serving 19,705 residents from 312 NHs between January 2020 and August 2022. We found Black residents were more likely (11.2% vs. 10.5% in total sample) to be in NHs regularly using EMR, defined as the top quartile NHs based on the percent of residents in the NH with eINTERACT form; Latinx residents were less likely to be in NHs regularly using EMR (3.5% vs. 6.0% in total sample). Among NHs regularly using EMR (n=5,192 residents, 81 NHs), Black residents were less likely to have behaviors documented in both MDS (Blacks 9.7% vs. Whites 16.5%) and EMR (eINTERACT: Blacks 1.9% vs. Whites 3.7%; Orders: Blacks 2.6% vs. Whites 3.9%) despite higher share of moderate/severe cognitive impairment (63.1% vs. Whites 60.0%) and less antipsychotic use (16.4% vs. Whites 26.2%). This has implications for inclusion in pragmatic trials and receipt of possibly advantageous treatments.
THE MEN IN DEMENTIA CAREGIVING: UNDERSTANDING MEN’S EXPERIENCES
Authors: Lindauer Allison , Hepburn Kenneth
Published: January 2025

About 30% of caregivers for family members with dementia are men, and their numbers are rising with the increasing prevalence of dementia. However, there is limited information in the extant literature about the number of men providing care to family members with dementia, their experiences, and their engagement in caregiving research. What is known is concerning. Men, like women, experience burden in the caregiving role and are at higher risk for health problems than non-caregivers. In addition, men may experience role confusion and feel unprepared to assume the caregiving role. Finally, little is known about what motivates men to participate in dementia caregiving research. Here we describe men’s experiences from three groups: Black American men, men caring for family members with primary progressive aphasia, and men caring for family members with advanced dementia. Along with quantitative and qualitative data, we will present findings from focus groups which center on men’s motivations for joining research studies, perceived benefits of research participation, and men’s concerns about research, including biospecimen collection. Unique insights and needs from each group will be addressed, along with strategies to promote recruitment and retention of men in caregiving research.
CARING FOR PERSONS LIVING WITH PRIMARY PROGRESSIVE APHASIA: AN INVESTIGATION OF THE MALE EXPERIENCE
Authors: Dowden Lauren , Morhardt Darby , Lucca Kaitlyn
Published: January 2025

Primary progressive aphasia (PPA) is a clinical syndrome that begins with language difficulties at symptom onset and for the initial phases of the disease. Multiple domains are affected over time, including behavior and personality changes. There are heterogeneous neuropathologic causes; namely, frontotemporal lobar degeneration or Alzheimer’s disease. While there is evidence that women comprise the majority of caregivers for persons living with dementia, little is known regarding sex and gender differences in the experience of caregiving. Studies on caregivers in persons with PPA are rare and none have explored gender differences in the PPA caregiving role. This study explores the male experience of caring for persons living with PPA analyzing in depth interviews from a sample of 17 male caregiving spouses who attend a monthly PPA care partner support group. Open-ended questions explore coping strategies, approaches to the caregiving role, help-seeking behaviors, use of services, and overall caregiver experience. This analysis describes the male experience of caregiving for persons with PPA, highlights their unique needs over the illness course and provides a nuanced understanding of the gendered caregiver role within the context of a specific clinical profile versus broader dementia categories.
THE PROMISE OF FITNESS, HEALTH, AND DIGNITY FOR OLDER ADULTS: A SHOWCASE OF EARLY CAREER RESEARCH IN THE OAIC NETWORK
Authors: Bandeen-Roche Karen
Published: January 2025

The NIH-funded Older Americans Independence Centers (OAICs) aim to produce scientific knowledge allowing older adults to maintain or restore their independence. This national network has a key mission to develop the next generation of investigators and leaders in aging research. Individual OAICs achieve this mission through pilot funding and career development grants, activities and mentorship. The OAIC Coordinating Center additionally provides funding, programming, and an Early Career Faculty Working Group dedicated to fostering emerging scholars. This proposed first-annual GSA showcase features three OAIC-affiliated early career faculty nominated by the Early Career Faculty Working Group based on their receipt of national multi-center pilot awards or invited presentation of their work at monthly OAIC Directors virtual meetings or at the OAIC National Meeting. The talks selected for this symposium illustrate the highly interdisciplinary nature of the OAICs. Juan Pablo Palavicini (UTHSA) will present cross-species pilot work with Andrew Murton (UTMB) to evaluate whether myriocin may inhibit ceramide synthesis, and ultimately preserve muscle and insulin sensitivity in obese older adults. Emma Barber (Northwestern) will present work demonstrating association of heart and respiratory parameters with frailty—and of preoperative physical activity with post-operative complications—in older gynecologic oncology patients, laying groundwork for interventions. Cameron Gettel (Yale) will present findings documenting substantial emergency department use and expenditures by older adults in the last 180 days of life, using Medicare Current Beneficiary Survey data. The symposium concludes with a panel and open discussion addressing aging research career and science topics.
REVERSING INSULIN RESISTANCE AND SARCOPENIA BY LOWERING TOXIC CERAMIDES IN OBESE NONHUMAN PRIMATES
Authors: Palavicini Juan , Murton Andrew
Published: January 2025

Obese and old individuals are at heightened risk of developing insulin resistance, sarcopenia, and frailty. Specifically, we found that older obese men experience a diminished capacity to synthesize new muscle proteins in response to exogenous amino acids, a process pivotal for the maintenance of muscle mass and quality. Our ability to recreate this “anabolic resistance” to nutrition in lean young individuals through the acute infusion of lipid to induce obese-like ectopic lipid accumulation, suggests that the accumulation of lipid represents a pivotal mechanism by which the responsiveness of muscle to dietary amino acids diminishes with obesity. Ceramides are a class of lipids that have been associated with multiple negative metabolic effects and hallmarks of aging including insulin resistance, apoptosis, mitochondria disfunction, senescence, and inflammation. Using a variety of lipidomics approaches in combination with mouse models of obesity and diabetes, we have consistently found that ceramides accumulate in insulin sensitive organs, including muscle. Given prior evidence that protein synthesis is inhibited in human muscle cells subjected to ceramide treatment, which occurs in concert with the inhibition of mTOR signaling, a key driver of protein translation, we hypothesized that ceramides are major drivers of both insulin resistance and frailty. Here we will report how myriocin, an inhibitor of ceramide synthesis, restores insulin resistance in obese and diabetic mice. Findings from our ongoing pilot study in non-human primates to examine if myriocin improves insulin resistance and the anabolic response of muscle to diet in obese marmosets also will be reported.
THROUGH THE LENS OF THEORY: APPROACHES TO BEHAVIORAL INTERVENTION OPTIMIZATION AND EVALUATION IN AGING ADULTS
Authors: Curtis Ashley , McCrae Christina
Published: January 2025

A shortage of geriatric mental health providers, limited efficacy of pharmacological agents for cognition, sleep and associated functioning, as well as polypharmacy-related side effects, has prompted research on behavioral interventions. Several behavioral interventions show promise for improving cognition and associated functioning, but optimization of treatments according to target end-user needs and characteristics is needed. This symposium describes psychosocial theory-based approaches for optimization and evaluation of behavioral interventions for aging adults. Dr. Ashley Curtis (Chair) will introduce the session. Paper 1 applies a biopsychosocial model to evaluation of cognitive training benefits and describes how intervention expectations and game engagement impact training benefits in middle-aged/older adults. Paper 2 discusses an iterative optimization process for a multi-modal positive psychiatry intervention for older adults that targets psychological wellness, health, and resilience. Paper 3 describes a user-centered mixed-methods evaluation of needs/preferences of grandparents raising grandchildren for behavioral sleep treatment and proposes recommendations for optimization of cognitive behavioral therapy for insomnia (CBT-I). Paper 4 describes mixed-methods optimization of web-based CBT-I for rural dementia caregivers and presents preliminary efficacy for sleep, arousal, cognition, and associated outcomes. Dr. Christina McCrae (Discussant) will integrate findings and discuss areas for future investigation. In sum, this symposium applies a theoretical lens to the optimization and evaluation of behavioral interventions for improving cognition, sleep and associated functioning in mid-to-late life. Thus, this session will provide recommendations for precision medicine-based tailoring of digital/multi-modal interventions that can be easily disseminated (online/in the community), to maximize improvement of psychological and behavioral wellbeing of aging adults.
MIXED METHODS OPTIMIZATION OF BEHAVIORAL SLEEP TREATMENT FOR GRANDPARENTS RAISING GRANDCHILDREN
Authors: Stearns Melanie , Curtis Ashley , McCrae Christina
Published: January 2025

Grandparents raising grandchildren (GRG) report greater sleep problems compared to non-caregiving grandparents. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an evidence-based treatment for insomnia; however, the needs of older individuals caring for young children differ from the typical adult who receives CBT-I. Thus, we examined behavioral sleep treatment preferences and collected qualitative and quantitative sleep data from GRG to inform the adaptation of CBT-I for them. The sample consisted of 99 grandparents (Mage=53.62, 70% female) who reported being the primary caregiver of their grandchild (>17 years old). Participants reported on treatment preferences and provided open-ended responses to what negatively impacts their sleep and what they think might improve their sleep. Participants also completed the Pittsburg Sleep Quality Index (PSQI). Based on SOL (Mean=43min) reported on the PSQI, 55% (N=56) of GRG met insomnia criteria. Most GRG (54%) preferred online treatment (27%-in person, 18%-telehealth) and 60% reported they would rather have a behavioral treatment instead of sleep medication to improve their sleep. GRG reported that their stress, anxiety, family issues, and poor grandchild sleep negatively impact their sleep and that stress reduction, greater social support, bedtime routines, and better sleep habits for their grandchildren would likely improve their sleep. These results suggest that GRG prefer online behavioral sleep treatment compared to other modalities (in-person, telehealth) and sleep medication. They may also benefit from a CBT-I which also targets grandchild sleep, reduces stress/anxiety, and helps promote more positive family relationships. Thus, there is a need to adapt CBT-I for their needs.
MENTAL HEALTH IMPACT OF BULLYING BY ETHNIC PEERS IN SENIOR HOUSING: A STUDY WITH OLDER KOREAN AMERICAN RESIDENTS
Authors: Jang Yuri , Park Juyoung , Rhee Min-Kyoung , Lee Hi-Woo , Park Nan Sook , Chung Soondool
Published: January 2025

Bullying, a persistent negative interpersonal behavior directed at a specific individual or a group of individuals, is often associated with youth in school settings and young adults in the workplace. However, peer bullying is also common among older populations. Particularly in senior housing, where individuals with diverse backgrounds and characteristics reside in close proximity and where relocation is often not feasible, peer-to-peer aggressive behaviors are of concern. The purpose of the present study is to examine the experience of peer bullying and its mental health effects among ethnic minority older residents in subsidized senior housing. Surveys were administered to Korean Americans aged 65 and older (N = 343) in six senior housing facilities in the greater Los Angeles area. Multivariate regression models were used to examine the effect of being either a target or a witness of bullying on mental health outcomes, after controlling for covariates. About 18% of the sample had been a target of bullying, and over 31% had witnessed someone being bullied. Being a target of bullying was a significant predictor for both depressive symptoms and anxiety, whereas witnessing other residents being bullied was a significant predictor for anxiety only. These findings shed light on the common experience of bullying among ethnic minority older residents in senior housing as well as the adverse mental health impacts of peer bullying. Findings highlight the need for effective programs (e.g., awareness program, bystander education, and assertive communication training) to promote healthy interpersonal relationships in senor housing.
ELDER ABUSE PROSECUTION WITHOUT VICTIM COOPERATION: A DECISION-MAKING MODEL FOR PROSECUTORS
Authors: Koss Catheryn
Published: January 2025

Victims of elder abuse frequently refuse to cooperate with the prosecution of their abusers, especially if the accused is a spouse or other family member. What little guidance there is on how prosecutors should proceed in these situations tends to focus on evidentiary challenges and strategies to overcome them. While victims and prosecutors share the common overarching goal of addressing the problem of abuse, they may differ on how best to achieve that goal or at what cost. Victims may prioritize maintaining their relationships with their abusers and protecting their loved ones from the consequences of their actions. They may also fear loss of independence or placement in a long-term care facility. Prosecutors tend to prioritize preventing future abuse by keeping the abuser away from the victim and/or by reforming the abuser’s behavior. Prosecution sends a message that abuse is a serious crime that will not be tolerated, potentially having a deterrent effect by putting other potential abusers on notice that they too will likely be punished. This presentation will examine the common barriers to participation elder abuse victims face and the concerns elder abuse victims may have about prosecuting their abusers. Then, drawing on existing elder abuse scholarship as well as debates about this issue from the intimate partner violence literature, the presenter will share a novel decision-making framework - grounded in trauma-informed practices - that prosecutors and others may use to weigh the victim’s interests against the state’s interests in prosecuting the accused.
LESSONS LEARNED FROM A FIVE-YEAR STUDY ON PREVENTING SELF-NEGLECT AMONG AT-RISK HEALTH CARE PATIENTS IN TEXAS
Authors: Ejaz Farida , Reynolds Courtney
Published: January 2025

This presentation focuses on lessons learned from a study on preventing self-neglect among healthcare patients that is currently featured as a Success on the Administration for Community Living’s Elder Justice webpage. Collaborators included researchers, a large healthcare system, and Adult Protective Services. We focused on preventing self-neglect by identifying older and disabled patients from 19 primary care clinics with risk factors for self-neglect such as depression and dementia. Clinics were randomized to intervention (patients received 4-months of case management) and control (usual care) conditions, and 477 randomly selected patients participated. The sample was predominantly Hispanic (68%) and low income (< $1,361). The lessons learned have important implications for practice, policy, and future research. For example, language mattered when recruiting study participants and the term ‘self-neglect’ needed to be softened. Despite paying $25-$35 for an interview, the response rate was approximately 30%, leading to timeline delays. Intervention group patients (285) who were interviewed at home had higher response rates than control patients (192) interviewed at the clinic/other settings. Thus, conducting home assessments for self-neglect and offering case management to at-risk patients was feasible. In general, at-risk patients were not self-neglecting but had a variety of needs (823 total needs) such as food insecurity and home modifications and needed service referrals (total 1,226 referrals). Needs were met 65% of the time. Barriers to service utilization included refusals. Discussion will focus on how the lessons learned can help research-practice collaborations prevent self-neglect among low-income, minority populations and prepare for challenges in the field.
PREIMPLEMENTATION OF A QUALITY IMPROVEMENT PROGRAM FOR VETERANS LIVING IN COMMUNITY NURSING HOMES
Authors: Carpenter Joan , Kutney-Lee Ann , Murray Andrew , Ersek Mary
Published: January 2025

We designed Preferences Elicited and Respected for Seriously Ill Veterans through Enhanced Decision-Making (PERSIVED), a five-year VA-funded quality improvement program, to support VA clinicians with data and tools to ensure consistent documentation of life sustaining treatment (LST) preferences for Veterans who receive care in community nursing homes (CNHs). Guided by the VA Quality Enhancement Research Initiative (QUERI) Roadmap for Implementation and Quality Improvement, we designed the pre-implementation phase. Over 5 months, we conducted virtual meetings with partners at six VA CNH programs to: 1) engage site leadership and recruit champions; 2) assess barriers and facilitators to documenting LST preferences; 3) develop process maps of existing workflows; and 4) evaluate baseline knowledge, skills and resources related to these clinical practices. Through individual interviews (n=41) and 14 meetings with clinical and administrative partners, we recruited 19 champions. Common barriers included lack of knowledge/training and confusion about roles/responsibilities among VA CNH program clinicians. Facilitators included access to VA and CNH electronic medical records and positive relationships among VA and CNH staff. Across the programs in this sample, process maps revealed variability in formal systems for ensuring LST documentation in CNHs and VA. Using these findings, we tailored educational resources, developed site-specific audit tools for tracking VA and CNH LST documentation, and created processes that integrated LST documentation into existing VA CNH program workflows. Pre-implementation proved to be a critical step to ensure success and guided us in developing individualized implementation plans and addressing potential challenges to evidence-based practice adoption.
SUBJECTIVE COGNITIVE DECLINE IN OLDER ADULTS BY SEXUAL ORIENTATION AND GENDER IDENTITY
Authors: Akre Ellesse-Roselee , Miller Katherine , Barbee Harry , McKay Tara
Published: January 2025

LGBTQ+ adults experience a high risk of subjective cognitive decline (SCD) due to increased exposure to stressors that threaten cognitive health. Yet, researchers know little about how the risk of SCD varies by sexual orientation and gender identity (SOGI). We examine how SCD differs by SOGI using Wave 1 of the Vanderbilt University Social Networks, Aging, and Policy Study survey of LGBTQ+ adults aged 50-76 residing in the South (n=1256). We assess subjective cognitive health using an index of self-reported cognitive difficulties, many of which have been used in validated instruments. Using linear probability models, we examine the association of SCD with SOGI. To identify significant differences, we use standardized differences >10% in the average predicted probability of reporting ≥1 cognitive difficulty across SOGI, after adjusting for sociodemographic characteristics. Forty percent of respondents reported ≥1 cognitive difficulty. Bisexual individuals have the highest likelihood of SCD (54%), while lesbian/gay respondents had the lowest (39%). Across gender identities, gender non-conforming persons have the highest predicted probability of SCD (57%), followed by transgender men (54%), transgender women (48%), females/assigned female at birth (40%), and males/assigned male at birth (39%). Standardized differences are >10% across all comparisons. We find evidence that the prevalence of ≥1 cognitive difficulty in the sample of LGBTQ+ adults varies significantly by SOGI. Comprehensive SOGI health data from all US states is essential to accurately gauge SCD prevalence among LGBTQ+ older adults and to ensure inclusive clinical and public health interventions for populations at higher risk of cognitive impairment.
ELDER MISTREATMENT AND COGNITIVE FUNCTIONING: FINDINGS AMONG CHINESE OLDER ADULTS IN THE US
Authors: Jin Guoping , Tang Fengyan
Published: January 2025

Elder mistreatment disproportionately affects racial and ethnic minority older adults, particularly Chinese older adults in the U.S., who face increased risks due to cultural disparities, intergenerational conflicts, and socioeconomic disparities. While elder mistreatment is known to compromise cognitive health as a stressful life event, research in racial/ethnic minority populations is limited. This study aimed to address this gap by investigating the longitudinal effects of elder mistreatment on cognitive decline over time among older Chinese Americans. Latent growth curve modeling (LGCM) was applied in a sample of Chinese older adults residing in the Greater Chicago area, drawn from the population Study of Chinese Elderly in Chicago (2011-2019), comprising 2,811 participants across four waves of assessment. Elder mistreatment was assessed using a comprehensive instrument at baseline and follow-ups to evaluate its prevalence and incidence, respectively. Cognitive performance tests were administered across four waves to track change trajectory. Compared with respondents without mistreatment reports at baseline, those reporting mistreatment exhibited better cognitive functioning (B = 0.07, p<.05). Those who reported being mistreated at follow-ups showed a faster cognitive decline (B = -0.04, p<.05). Neither mistreatment prevalence nor incidence was associated with an accelerated rate of cognitive decline. The results indicate that recent and potentially cumulative experiences of elder mistreatment have a negative effect on cognitive decline, underscoring the critical need for prevention, detection, and mitigation of elder mistreatment. Furthermore, culturally tailored practices and policies are needed to address elder mistreatment issues within the Chinese minority community.
HANDS AND HEALTH AT HOME: THE IMPACT OF INTERGENERATIONAL SERVICE-LEARNING ON STUDENTS’ PREHEALTH COMPETENCIES
Authors: Schwartz Anna , Cook Rachel Logue , Vanderlaan Courtney , Brown Susan
Published: January 2025

There is a critical need for developing the geriatric healthcare workforce, yet pre-health students are rarely given the opportunity to engage with older adults during their coursework. In addition, many health-related professional programs require students to demonstrate proficiency with a number of professional and analytical competencies. The purpose of this study was to determine the impact of Hands and Health at Home, an intergenerational hand-training program, as a gerontology-focused educational experience. In this program, upper level and graduate pre-health students were trained to deliver hand-based exercises to homebound older adults twice a week for 8 weeks. Students completed the Geriatric Attitudes Scale (GAS), Coping Self-Efficacy Scale (CSES), and a program evaluation survey. Forty students completed Hands and Hand at Home across three semesters. After the program, scores on the GAS (p< 0.05) and CSES (p< 0.05) significantly improved. Feedback about the program was overwhelmingly positive, where students indicated high satisfaction, said they would recommend the program to a friend, and felt prepared for their home training sessions. When asked to express any skills learned during the program, students often reported communication, teamwork, compassion, confidence, and creativity. The results from Hands and Health at Home demonstrate that this intergenerational service-learning program was a mutually beneficial way to deliver hand training to homebound older adults while also providing valuable hands-on experience for pre-health students. The program also resulted in reductions in ageist attitudes, improved self-efficacy, and the development of several important pre-health competencies, underscoring the need to offer more intergenerational and gerontology-based educational opportunities.
TRAUMA-INFORMED PERSPECTIVES AND PRACTICES FOR TEACHING AND LEARNING IN GERONTOLOGY
Authors: Sasser Jennifer
Published: January 2025

With the increasing incidence of individual and shared traumatic events, as well as the complexity and poignancy of many of the issues considered in social gerontology and aging-related courses, there is a concomitant need for expanded awareness of the ways in which trauma shows up, both for our students as well as for ourselves as educators. What’s more, for students preparing for careers in the field of aging, especially those who intend to work directly with older people and their families, developing a trauma-informed disposition and skill-set is particularly important. In this interactive session, an ongoing initiative in the context of a community college applied social gerontology program to infuse the curriculum with trauma-informed perspectives will be shared. In addition, a framework for trauma-informed andragogical practices for teaching and learning about aging issues will be introduced. Enacting a trauma-informed approach, the presenter will facilitate an opportunity for participants to think together about ways to apply this powerful approach in the context of their own professional practices.
DESIGNING AND DISSEMINATING AN EDUCATIONAL PROGRAM IN OVER-THE-COUNTER HEARING TECHNOLOGY
Authors: Shen Yi , Urbanski Dana , Anderson Susan , Lee Adrian
Published: January 2025

Over-the-Counter (OTC) hearing aids have been available to the US market since October 2022. These “do-it-yourself” hearing devices were introduced to promote accessibility and affordability of hearing healthcare to primarily older adults with perceived mild-to-moderate hearing loss. To date, many new delivery models of hearing healthcare have emerged in response to the availability of OTC hearing aids. However, without the assistance of a licensed hearing care professional, it is unclear whether older adults who purchase OTC hearing aids will receive sufficient support and assistance to achieve successful OTC hearing aid use. In this presentation, we review recent research to identify areas of unmet need in currently available delivery models for OTC hearing aids. The available evidence suggests the need for and potential benefits of an educational program on OTC hearing technology independent from any device manufacturer that could be delivered to professionals who are not hearing healthcare professionals but who may interact with older adult OTC hearing aid candidates (e.g., community health workers, long-term care staff, pharmacists, and other allied health professionals). To address this need, we conducted an instructional design process with a team of healthcare educators, researchers, audiologists, and instructional designers to create the blueprint of an educational program on OTC hearing technology. Here, we describe our design process for transforming the identified unmet needs into (1) the target audience; (2) the appropriate learning modes for the intended audience; and (3) a list of learning objectives. Additionally, we highlight our plans for implementation and dissemination of the program.
DEVELOPING THE INTERGENERATIONAL TECHNOLOGY ENGAGEMENT CHECKLIST FOR HIGHER EDUCATION (IG TECH)
Authors: Juris Jill , Leedahl Skye , Sexton Athena , Santilli Josie , Colvin Meaghan
Published: January 2025

Intergenerational programs, as part of service learning initiatives in higher education, have shown to greatly benefit students in gaining professional experience that connects with classroom learning. In recent years, intergenerational technology programs in the United States and Canada have worked to enhance digital inclusion for older adults and provide service learning opportunities for students. Funded by the RRF Foundation for Aging, our multi-university research team set out to examine the implementation of programs that utilized the Cyber-Seniors reverse mentoring model within higher education. This presentation will describe the creation of a checklist to aid in the development of intergenerational technology programs within higher education, with the goal of building sustainable programs. The checklist was developed following a systematic review of the literature and interviews with 12 stakeholders. The systematic review included the analysis of 17 sources that addressed key elements of intergenerational programs such as planning, technology, accessibility, inclusivity, recruitment, marketing, safety, implementation, staffing, and training. Interviews were conducted with a purposive sample of ten higher education representatives and two Cyber-Seniors staff members, all with extensive knowledge of barriers and facilitators to program implementation. This resulted in the development of the InterGenerational Technology Engagement Checklist for Higher education (IG TECH). The IG TECH includes a series of questions to help faculty and/or staff make decisions about key elements of the program, including program planning, student recruitment, older adult recruitment and onboarding, and implementation/monitoring. Future research will evaluate the checklist through a Delphi Panel.
A COMPREHENSIVE EVALUATION OF END-OF-LIFE CARE EDUCATION NEEDS FOR HEALTH CARE PROFESSIONAL STUDENTS
Authors: Phung Quynh , King Angelique , Decker Autumn , Roman Anna , Patterson Logan , Weaver Raven , Bolkan Cory
Published: January 2025

People are living longer than ever before, ushering in a need for more healthcare professionals to engage older patients about aging and end-of-life (EOL) values. Despite 99% of healthcare providers acknowledging the importance of advance care planning discussions, over two-thirds of physicians lack adequate training (Fulmer et al., 2018). To address this gap, rigorous evaluations of existing EOL education in professional health programs are needed. This study was conducted at a large public university’s Health Science campus; 84 healthcare students (i.e., medical, nursing, and “other” programs) completed a survey, exploring their educational and socio-emotional needs regarding current death education curricula. Findings revealed deficiencies in EOL education in professional training, with only 32% reporting any curricular exposure. Individuals with prior exposure to death exhibited less negative feelings about death and greater familiarity with EOL care topics (p< 0.05). Compared to other programs’ students, nursing students demonstrated a significantly higher overall familiarity of EOL topics (p< 0.05). However, there was still consistently lower familiarity in dementia directives and community resources across all programs. Over 83% expressed a strong desire for more death education. Though students favor comprehensive elective courses, time constraints make workshops and seminars more feasible. Important components in training include real exposure, reflection, and debriefs around EOL conversations or deaths. These findings underscore the urgent need for earlier and more comprehensive training in navigating complex EOL discussions and caring for older adults. Addressing these barriers has the potential to enhance professionals’ skills and wellbeing, improving quality of care provided for older adults.
ANALYZING LONGEVITY TRENDS: AGE-SPECIFIC CONTRIBUTIONS TO LIFE EXPECTANCY GAINS ACROSS EUROPE
Authors: Lee Yeonjung , Tsui Iona , Yon Yongjie
Published: January 2025

The increase in life expectancy at birth has been apparent as mortality has decreased over the past decades. However, as people live longer, it is important to know which age groups have seen the greatest gains in life expectancy. The objective of this study is to examine how different age groups contribute to longer life expectancy. We applied Arriaga’s (1984) life expectancy decomposition method to life tables for the total population of 50 out of the 53 Member States of the WHO European Region comparing two different time periods. Average life expectancy gains between 1999 and 2019 are 5.08 years, compared to 3.50 years between 1980 and 2000. Decomposing the differences in life expectancy showed that the gains in total life expectancy was increasingly driven by reduced mortality at older ages in many countries, especially those with the highest current life-expectancy, though there are variation among the countries. There are also differences between men and women. The differences in life expectancy gains between men and women range from 3.05 to 10.43 years and there are the largest differences in Eastern European countries. There is still room for improvement in health beyond age 70, as older age groups are contributing more to increasing longevity. The contribution of increased longevity after age 70 to total improvement in life expectancy at birth is above 30% for more than half of the countries, and this measure is expected to rise as population ageing continues to accelerate.
MEDICARE ENROLLEES WITH COMPLEX HEALTH NEEDS FROM PUERTO RICO
Authors: Rivera-Hernandez Maricruz , Campos Matthew
Published: January 2025

Older adults in Puerto Rico have higher rates of chronic conditions and poverty rates compared to adults in the US mainland (Matos-Moreno et al., 2022; U.S. Census Bureau, 2019). In addition, the island of Puerto Rico has faced unique challenges related to infrastructure damages as a result of Hurricane Maria in 2017 (Florido, 2020), and further continues to face disparities in quality of care for older adult populations (Rivera-Hernandez et al., 2021). While the proportion of older adults with health insurance in Puerto Rico is comparable to older adults in the U.S. mainland, disparities in quality and access to care exist for older adults in Puerto Rico (Matos-Moreno et al., 2022). Thus, the purpose of this study was to characterize older adults with complex care needs enrolled in Medicare Advantage (MA) from Puerto Rico. We used data from the Medicare Health Outcomes Survey and the Master Beneficiary Summary File from 2010 to 2019. We classified enrollees into high-need and non-high-need adults (DuGoff et al., 2019). We identified about 46,699 beneficiaries from Puerto Rico. Approximately, 57.09% were identified as high-need adults. A higher proportion of high-need older adults were female (56.59% vs. 50.99%), married (50.95% vs. 58.68%), had high school education (28.09% vs. 22.88) and household income of less than $10,000 (35.48% vs. 28.83%) compared to non-high-need beneficiaries. With physicians and health care providers leaving Puerto Rico, older adults with high-needs may be experiencing health care challenges. These issues may be contributing to the exodus of older adults from Puerto Rico.
HEALTH AND AGING POLICY FELLOWSHIP: AN INCREDIBLE JOURNEY
Authors: Baker Natalie
Published: January 2025

Dr. Natalie Baker is a geriatric nurse practitioner and nursing professor. Her passion for improving the quality of care delivered in the long-term care setting led her to apply for the Health and Aging Policy Fellowship (HAPF). She will describe her previous national experience in health policy and desire to gain an in-depth immersion experience in policymaking at the federal level. As a nonresidential HAPF with the U.S. Senate Special Committee on Aging, Dr. Baker has had the opportunity to interact with national aging policymakers, research topics of concern, assist in drafting legislative bills, and plan committee hearings. Through the HAPF program, she experienced an unforgettable opportunity to have conversations with affected individuals, health care workers, and professional organizations. She observed skillful negotiations for bipartisan support in a deeply divided Congress while working alongside Senator Bob Casey’s staff. From this incredible journey, Dr. Baker has gained a new perspective on aging challenges and pathways for meeting the needs of this vulnerable population.