bluuebunny/crossref_metadata_2025 huggingface dataset:
ANXIETY IN PATIENTS UNDERGOING OPEN-HEART SURGERY: THE ROLE OF CHARACTER, STRENGTH, AND HOPE IN A STRUCTURE EQUATION MODEL
Authors: Nash Veronika , Ai Amy
Published: December 2023

In an era of patient-centered care, more research is needed to examine the protective function of patients’ internal strengths against the damage of poor mental health. Mental health plays a significant role in cardiac health. Anxiety is a mortality risk for cardiac patients, the evidence has indicated high prevalence (13-59.5%) post cardiac events. However, anxiety hasn’t been extensively investigated as depression in cardiac patients, especially after open-heart surgery (OHS). Even less is known about protective function of Character Strength Hope in cardiac anxiety during stressful OHS, also a life-altering intervention for advanced heart conditions. This interdisciplinary study evaluated a structural equation model (SEM) on the relationship of Hope with pre- and post-OHS anxiety. Two weeks prior to the scheduled operation, research assistants conducted a face-to-face psychosocial interview with 481 patients (male, 58%; mean age=62 years, range=35-89) at the hospital, followed by a second telephone interview to assess an indicator of Hope two-days prior to surgery. Postoperative measures were assessed 36 days after OHS. Female and older patients reported higher levels of anxiety preoperatively. The SEM demonstrated adequate fit of the final solution in which pre- and post-OHS anxiety levels were related. Higher levels of pre-OHS anxiety were related to lower levels of optimism and hope right before OHS. Higher levels of optimism, indicating Hope predicted lower levels of post-OHS anxiety. Because patients with high anxiety would be disadvantaged in postoperative recovery, our finding suggests enhancing preoperative strength, Hope, might have some psychological benefits for optimal outcomes in patients undergoing OHS.
DEVELOPING A GERIATRIC ONCOLOGY FELLOWSHIP SUBSPECIALTY TRACK FOR ADVANCED PRACTICE PROVIDERS
Authors: McMillan Sincere , Korc-Grodzicki Beatriz , Cataldo Amelia , Zakak Nicole , Haviland Kelly
Published: December 2023

Although a relatively young subspeciality, geriatric oncology is a fast-growing discipline. As the population ages, clinicians skilled in geriatric oncology principles and management are needed to care for an increasingly complex older adult population. Educating Advanced Practice Providers (APP) in geriatric oncology may offer innovative ways of increasing access to care, supporting patient health, and improving quality of life. The need for trained clinicians represented a unique opportunity for the development of a geriatric oncology focused APP fellowship subspecialty track at our institution. In 2019, with support from the Samuels Foundation, an electronic geriatric oncology needs assessment was completed among the APPs at our institution. Data from this needs assessment and from a thorough literature review were used to develop the geriatric oncology fellowship track curriculum. With support from APP leadership at our institution, the fellowship track launched in September, 2021. It is a 12-month postgraduate academic program that focuses on geriatric assessment, risk stratification prior to cancer directed therapies, management of geriatric syndromes, and geriatric co-management. Additionally in 2023, the fellowship track will include an elective in a long-term care facility. We believe this unique elective rotation will be a strong addition to the clinical experience of the fellow. Our current program has one position per fellowship year with the goal of increasing the number of positions in the future. This is a major step forward in the education of APPs in the care of older adults with cancer that we hope will be replicated across the country.
INITIAL EFFICACY OF THE SAVVY CAREGIVER PROGRAM IN KOREAN AMERICAN DEMENTIA CAREGIVERS
Authors: Jang Yuri , Hepburn Kenneth , Park Juyoung , Haley William , Kim Miyong
Published: December 2023

Dementia caregivers in ethnic minority communities have often been excluded from access to caregiver interventions and their benefits because of linguistic and cultural barriers. In pursuit of equal treatments for all, it is imperative to make evidence-based interventions available and accessible to ethnic minority dementia caregivers, and linguistic and cultural adaptation is indispensable for reaching out to them. In the present study, we adapted the Savvy Caregiver Program for Korean American dementia caregivers and tested its initial efficacy for reducing depressive symptoms. This pilot intervention was delivered to 13 Korean American dementia caregivers by two Savvy-certified Korean-speaking trainers. Over the 6-week period of program implementation, there was no attrition (session completion rate = 98%). All participants’ depressive symptoms were reduced at completion of the program, and the level of reduction was statistically significant, with a large effect size (t = 8.64, p < .001, Cohen’s d = .89). Although patterns of change did vary among participants, the score difference between post-intervention and 6-month follow-up was not statistically significant (t = .74, p = .47). The program played a significant role in reducing depressive symptoms in this pilot sample of Korean American dementia caregivers, and this benefit was sustained at the 6-month follow-up. Along with the program’s notably high retention rate, its efficacy suggests strong unmet needs for psychoeducational programs among Korean American dementia caregivers. The study offers promise for sharing the therapeutic benefit of the Savvy program with linguistic minorities when delivered in a linguistically, culturally appropriate manner.
INVESTIGATING THE NEURAL CORRELATES OF SOCIAL AND INDIVIDUAL SINGING IN PERSONS WITH DEMENTIA
Authors: Tamburri Nicholas , Sheets Debra , Smith Andre , MacDonald Stuart
Published: December 2023

Music interventions for persons with Alzheimer’s Disease and related dementias (PwADRD) have documented psychological benefits; however, the neurological correlates underlying these advantages remain less certain. Using functional near infrared spectroscopy (fNIRS), the present study i) investigated within-person patterns of cortical oxygenation during choral vs. individual singing; ii) explored how singing context (choral vs. individual) modulated patterns of functional connectivity (FC) within and across frontal and parietal cortices; and iii) leveraged these functional activations as predictors of cognitive status (degree of impairment) in a series of discriminant function analyses (DFA). Participants were 13 PwADRD who volunteered from a larger, ongoing social-cognitive choir intervention. fNIRS data were collected using a TechEn Cw6 system during both choral and individual singing conditions. Paired sample t-tests evaluated differences in activation patterns between singing conditions, with DFA used to determine whether these activations and neuropsychological function were predictive of between-person differences in cognitive impairment. Significant differences in cerebral oxygenation were identified in the right anterior PFC, with individual singing associated with significantly greater cortical oxygenation relative to group singing. Although not significant, individual singing was also associated with bilateral increases in cortical oxygenation across the majority of fNIRS channels, as well as increased FC, relative to group singing. The DFA analyses were not significant. This novel study is the first to examine differences in music-cognition correlates across environmental contexts for PwADRD. Patterns of functional activation suggest that choral singing in particular may represent an optimal lifestyle activity, placing comparatively fewer demands on cognitive function.
PREDICTORS OF RESILIENCE AMONGST INFORMAL DEMENTIA CAREGIVERS
Authors: Grelle Kaitlin , Vacek Sarah , Rayha Kara , Hale Willie , Deason Rebecca
Published: December 2023

Informal caregivers of People with Alzheimer’s Disease (PwAD) report greater levels of burden compared to non-caregivers, which is associated with an increase of impaired physical and mental health (Pinquart & Sorensen, 2003; Cheng, 2017; Zhou et al., 2021). Recent studies focusing on resilience (a person’s adaption to the physical and psychological demands of providing care) showed higher levels of resilience in caregivers was inversely related to depression, burden, and anxiety (Lopes Da Rosa et al., 2018; Zhou et al., 2021). With resilience being a protective factor against burden in caregivers, it is imperative to understand what psychological characteristics act as predictors of resilience. Participants (N = 59) completed questionnaires about resilience, mental health, and knowledge of Alzheimer’s disease. A classification and regression tree (CART) analysis was conducted to evaluate caregiver psychological characteristics as possible predictors of resilience. The analysis produced a tree with four terminal nodes, with one characterized by having scores greater than 152 for self-efficacy, followed by scores greater than 15 for knowledge of Alzheimer’s Disease. The overall model is 79.7% correct in predicted resilience, with a specificity of 95.7% and a sensitivity of 69.4%. These findings provide evidence that caregivers with greater confidence in their abilities are more likely to be resilient, especially for those with increased knowledge about Alzheimer’s disease (Choi et al., 2018; Kim & Bolkan, 2022). Interventions that focus on bolstering knowledge of Alzheimer’s disease and increasing self-efficacy may be critical in enhancing resilience in caregivers, in turn reducing depression and burden.
SOURCES OF BURDEN IN CAREGIVERS OF PERSONS WITH EARLY- AND LATE-ONSET ALZHEIMER’S DISEASE
Authors: Crouch Adele , Massimo Lauren
Published: December 2023

Functional impairment and neuropsychiatric symptoms (NPS) are common in Alzheimer’s disease (AD) and contribute to caregiver burden. Persons with early-onset AD (EOAD) on average experience greater functional impairment and NPS compared to late-onset AD (LOAD), yet their contribution to caregiver burden have not been explored. Objectives were to: 1) compare functional impairment, NPS, and caregiving burden in EOAD and LOAD; 2) identify sources of caregiver burden including functional impairment and NPS in EOAD and LOAD. Caregivers of 85 persons with EOAD (n=63) and LOAD (n=22) completed questionnaires [Functional Activities Questionnaire, Neuropsychiatric Inventory, Zarit Burden Inventory]. T-tests compared group differences in function, NPS, and caregiver burden. Persons with EOAD had greater NPS frequency than LOAD (t= 2.275, p=0.026). There were no significant differences between groups in function or caregiver burden. Multivariate regression analyses were performed in AD groups, with function and NPS frequency as predictors of caregiver burden covarying for age, caregiver sex, and global cognitive function (MMSE). In the total AD sample, the model explained 12.6% of the variance in caregiver burden [F(5,52)=2.64, adjusted R2=0.126; p=0.033] and poor function was a significant predictor (standardized B=0.42, p=0.003) of caregiver burden. In EOAD, the model explained 17% of the variance in caregiver burden [F(5,35)=2.64, adjusted R2=0.17; p=0.04], and poor function was a significant (standardized B=0.42, p=0.015) predictor of caregiver burden; however this was not the case in LOAD. Results suggest poor function predicts caregiver burden in EOAD. Although NPS in EOAD are more frequent, this was not a predictor of caregiver burden.
HETERONORMATIVE SILENCES AND QUEER LONGINGS IN LGBTQ PEOPLE’S EXPERIENCES OF ELDER CARE AND HOME
Authors: Siverskog Anna
Published: December 2023

The meaning of home for queer people have been widely empirically explored as well as theorized. Not least has the home been important for the older generations of queer people, who lived in times where their sexualities and gender identities have been criminalized, pathologized and where there have been few public meeting places historically. However, having care needs may blur the lines between private and public and complicate notions of integrity in one’s home. This paper is based on qualitative interviews and aims to explore experiences of LGBTQ people in a Swedish context who have eldercare services; either people who have home-care-services or who are living in care homes. A queer theoretical framework and thematic analysis was used. The results illustrate how there is a silence around gender and sexuality in the everyday life within eldercare. This in turn is caused by material conditions where downsizing and effectivization of the eldercare has created pressed working conditions that leaves little room for small talk between staff and recipients of care. Norms on age, gender, and sexuality with notions on older people as asexual (as well as cisgender and straight) may play into this silence as well. The boundaries between the private (home) and the public (eldercare) become blurred. This in turn conditions which intimacy practices that become im/possible. Simultaneously, there is a presence of queer resistance as well as of longings for other (queer) futures.
THE EFFECT OF CHRONIC CONDITIONS ON DEPRESSIVE SYMPTOMS IS MODERATED BY SEXUAL MINORITY STATUS
Authors: Trubits Em , Newsom Jason , Saucedo Jennifer , Botoseneanu Anda , Allore Heather , Nagel Corey , Dorr David , Quiñones Ana
Published: December 2023

It is important to examine disparities in the effects of physical health on depression among sexual minority (SM) older adults. We examined whether the effects of chronic conditions (CCs) and self-rated health (SRH) on depressive symptoms were moderated by sexual orientation among 3,741 adults aged 50+ (SM = 216) who participated in the 2016 wave of the Health and Retirement Study (HRS) and responded to the recently added sexual orientation item. Structural equation modeling was used to model the effects of SRH and CCs on depressive symptoms, while controlling for participant sex, age, years of education, net-worth, and race/ethnicity. Greater numbers of CCs were associated with greater depressive symptoms (b= .24, SE = .04, p <.001), whereas better SRH was associated with fewer depressive symptoms (b = -.60, SE = .05, p <.001). The direct effect of SM on depressive symptoms was significant, b = 1.14, SE = .48, p =.02, indicating greater depressive symptoms among SM adults. The interaction between SM and SRH on depressive symptoms was significant (b = -.39, SE = .17, p = .02). The same effect was seen for CCs (b = -.32, SE = .15, p = .04). Simple slopes revealed that for heterosexual older adults, greater CCs were associated with greater depressive symptoms (b = .27, SE = .04, p <.001), however this association was not significant for SM older adults (b = -.05, SE = .16, p = .75). Future research should examine health disparities among SMs in relation to mental health.
ASSOCIATION BETWEEN EXERCISE AND UNCONTROLLED BLOOD PRESSURE IN HYPERTENSIVE PATIENTS
Authors: Hwang Sinwoo , Cho Eunhee
Published: December 2023

Hypertension is closely associated with cerebrovascular and cardiovascular diseases, the most frequent causes of death in Korean adults. Despite its continuously improving treatment rate, it is necessary to consider patients whose blood pressure remains uncontrolled. Walking exercises are strongly recommended to lower blood pressure. This study aimed to examine the level of walking in hypertensive patients and factors that deterred walking. This cross-sectional study was conducted through secondary data analysis using data collected from the Korea National Health and Nutrition Evaluation Survey from 2016 to 2020. Participants included 1,800 hypertensive patients over the age of 19 years, whose blood pressure was not under control despite medication. Walking was defined as exercise lasting for at least 30 minutes more than five times a week. Multiple logistic regression analysis was conducted to evaluate factors that deterred walking as an exercise in hypertensive patients. Of the total sample, 63.8% patients (n=1,149) were not exercising (walking). Job and obesity were two significant factors associated with walking less. Patients who were employed or obese were more likely to not walk, compared to those unemployed (OR, 1.31; 95% CI, 1.04–1.65) or those with normal weight (OR, 1.43; 95% CI, 1.03–1.98). Patients with uncontrolled blood pressure despite medication need lifestyle modifications as well. High medication adherence should not be the reason to overlook the management of hypertensive patients. In fact, detailed management is required to identify vulnerable groups, particularly those who do not engage in even walking exercises regularly, which is a simple treatment of hypertension.
DIFFERENCES IN HOSPICE AND NONHOSPICE NURSES’ PERSONAL AND PROFESSIONAL CHARACTERISTICS
Authors: Taylor Janie , Zucchero Renee’
Published: December 2023

The overextension of nurses due to an aging population, increase in chronic conditions, and the COVID-19 pandemic, places them at risk of negative outcomes. However, less is known about how hospice nurses compare to nurses in other subfields in terms of professional quality of life or factors that may potentially protect against adverse consequences of caregiving. Therefore, this study investigated differences between hospice and non-hospice nurses across several factors, including the work environment, self-awareness (SA), psychological flexibility (PF), palliative care self-efficacy (SE), and three components of professional quality of life – compassion satisfaction (CS), burnout, and secondary traumatic stress (STS). Using a cross-sectional, exploratory, and quantitative design, participants were sampled through snowball and convenience techniques. Participants (N= 72) completed an online survey, 31 (43%) identifying as working in hospice and 41 (57%) as working in non-hospice settings. Independent samples t-tests were conducted. Hospice nurses reported significantly healthier work environments, higher levels of SA, SE, and CS, and lower levels of burnout than non-hospice nurses. However, there was no significant difference in PF or STS. These findings offer a novel comparison between hospice and non-hospice nurses that could inform workplace change to better support nurses as they face increased demands and increased risk for negative outcome.
OLDER ADULT PERCEPTIONS OF USING IOT TO SUPPORT MEDICATION ADHERENCE AND COMBAT PHYSICAL INACTIVITY
Authors: Choi Yong Kyung , Lin Shih-Yin , Thompson Hilaire , Demiris George
Published: December 2023

The literature has explored the potential of using the Internet of Things (IoT) to support aging in place, but less is known about its ability to motivate older adults for health behavior change. This study aimed to understand older adults’ perception of using IoT to promote medication adherence and combat physical inactivity. We conducted a qualitative secondary analysis of exit interviews of 22 older adults (78% female; mean age: 77.8) who participated in an IoT feasibility evaluation study. In the feasibility study, older adults were asked to choose any combination of the following IoT devices, a door/window sensor, a multi-sensor (motion, light, humidity, temperature), an IP web camera, and a smart speaker, to be installed in their home for 2 months. Thematic analysis revealed that older adults identified creative uses of smart speakers to 1) update, log, and share medication lists/usage and physical activities; 2) set up medication and exercise reminders; 3) support diabetes self-management – taking the guesswork out of the equation (e.g., continuous blood glucose monitoring combined with a smart speaker to recommend the appropriate insulin dosage); 4) read out loud small-print medication labels (when also linked to a smart camera); 5) verbally direct older adults to reach their medications; 6) provide warnings to get up and move when prolonged inactivity is detected by the motion sensor; and 7) bring up music/video for exercise, or serve as a virtual exercise coach. In summary, older adults are receptive to using IoTs to promote medication adherence and reduce physical inactivity.
PLANNING AHEAD FOR POSTHOSPITALIZATION DISCHARGE NEEDS AMONG OLDER ADULTS
Authors: Relerford Raven , Miller-Winder Amber , Schierer Allie , Olvera Charles , Murawski Alaine , Ramirez-Zohfeld Vanessa , Lindquist Lee A
Published: December 2023

Frequently hospitalized older adults require assistance at discharge – either with transfer to a skilled nursing facility (SNF) or additional support at home. Our research has demonstrated that older adults can effectively plan ahead for their discharge needs (e.g., selecting SNFs) prior to hospitalization but some chose not to. Very little is known about what motivates older adults to plan. We sought to identify what variables impact older adults’ post-hospitalization planning. We surveyed a cohort of non-hospitalized adults age 65+ who received PlanYourLifespan.org (PYL), a tool to help older adults plan for their post-hospitalization needs, and then completed follow-up surveys at one month and every 6 months thereafter. Surveys inquire about their post-discharge plans if they were to be hospitalized, specifically rehabilitation/caregiver preferences. Multivariate logistic regression models adjusted for baseline hospitalization decision-making, sex, race, self-efficacy, living status, cognitive impairment, and PYL use. 293 subjects were enrolled (mean 73.5 yrs,40.4% non-White;12 mo. retention rate 94.5%). Subjects were more likely to have plans if they had increased chronic conditions (OR 1.23;p>0.05,1.02-1.47), increased medications (OR 1.15;p< 0.01,1.07-1.25), power of attorney (OR 1.84;p< 0.05,1.01-3.38), and used PYL (OR 2.61;p< 0.01,1.45-4.72). Subjects were more likely to have plans if they had higher medical complexity (OR 1.13 [p< 0.05, 1.03-1.24]), limited health literacy (OR 3.13 [p< 0.05, 1.25-7.81]), and used the PYL website (OR 1.72 [P< 0.05,1.00-2.93]) when asked about planning for future post-hospitalization requiring help in the home. Higher medical complexity, limited health literacy, and use of the planning website were associated with increased hospitalization discharge planning.
HOPE—A UNIQUE MODEL TO PROVIDE ORAL HEALTH SERVICES FOR NURSING HOME RESIDENTS
Authors: Dhar Sohini , Marwaha Rochisha Singh , Challa Suman
Published: December 2023

Optimal oral health care is an essential component of primary health care for all individuals but especially among the older adults due to chronic health issues and polypharmacy. Moreover, there are several barriers to oral health care for the older adults that include but are not limited to cost of dental care, lack of perceived need for care, dearth of transportation, and fear for dental care. To address these barriers to access, UT Health San Antonio School of Dentistry launched Holistic Oral Health Program for Elders (HOPE) program that aims to address oral health needs of nursing home residents living within a 65-mile radius of San Antonio, TX. The HOPE team is formed of trained dental and public health professionals who work together as a group to ensure that preventive, palliative, and clinical oral health services are provided to all eligible residents of the nursing home. For successful implementation of the HOPE program, the team efficaciously completed several critical steps while planning and developing the program, such as- establishing a relationship and procuring contracts with several nursing homes, collaborating with social workers and nurses, and following an interprofessional approach to provide oral health care to the nursing home residents. Since its inception, the HOPE program has successfully signed contract agreements with several nursing homes and has addressed the oral health needs of more than 300 nursing home residents. The HOPE program aims to continue serving this vulnerable and underserved population to address their oral health needs.
THE IMPACT OF COVID-19: IDENTIFYING WELLNESS STRATEGIES FOR ACADEMIC GERONTOLOGY AND NURSING FACULTY AND STAFF
Authors: Friberg-Felsted Katarina , Armstrong Cheryl , Macali Jennifer , Simonsen Sara , Clifton Jennifer
Published: December 2023

The continually evolving nature of the COVID-19 pandemic has presented challenges for individuals working in all sectors of the population, and academia is no exception. The nursing workforce is aging: the average age of a nurse is 52; 55% of the RN workforce is age 50 or older, and the average age of an employed nursing faculty is 46 years old. To date, little is known about the impact of the pandemic on individuals working in gerontology or nursing academia. The purpose of this study was to determine the impact of the COVID-19 pandemic on faculty and staff in a College of Nursing (CON) with a Gerontology program and identify practical strategies to promote health and wellness. A mixed-method survey was administered to faculty (n=140) and staff (n=139) in a College of Nursing in the Intermountain West. Quantitative and qualitative data were collected through a convenience sample. The researchers asked respondents to rate their experiences working from home, including the effects on work-related factors and social-lifestyle factors. Descriptive statistics were used to analyze the data. A total of 139 respondents completed the survey (faculty, n=86; staff, n=53). Respondents identified areas that were better and worse with regard to both work-related and social-lifestyle factors. Further, practical strategies to promote health and wellness were also identified. Finally, themes regarding support from leadership were recognized. This presentation will discuss these three results. These findings highlight the pandemic impact on aging nursing faculty and staff and introduce valuable strategies for promoting health and wellness.
DESIGN AND DEVELOPMENT OF VIRTUAL REALITY APPLICATION: AGE-FRIENDLY HEALTH SYSTEM SCENARIO
Authors: Mitha Samrah , Dezine Marie , Tewary Sweta , Guida Vincent , Masri Hadi , Pandya Naushira , Oviawe Elizabeth
Published: December 2023

With an increase in the aging population, evidence-based practice education can help strengthen knowledge, skills, and clinical practice for healthcare students caring for older adults. Age Friendly Health Systems (AFHS) is one of the frameworks founded on providing evidence-based and low-risk care centered on what matters most to older adults, their families, and caregivers. While didactic education is still the primary force in teaching medical students, innovative methods are being included in the medical curriculum to practice competency. Virtual Reality (VR) platforms are popular due to their ability to provide an immersive hands-on learning experience resembling an actual medical practice. The immersion abilities engage the students’ sensory organs promoting an innovative way of learning concepts that are difficult to teach in real life. The project’s objective was to develop and publish a case highlighting AFHS that can help educate medical students on the 4Ms (Mobility, Mentation, Medication Management, and What Matters). The case was completed in multiple phases 1) using a design document modified through multiple edits and reviews by our interprofessional team; 2) technical development including environment, objects, and interfaces of the application; and 3) publication. The VR case displays four scenarios where an elderly patient is admitted for a hip fracture. Students learned how to triage and treat patients from admission to discharge while demonstrating their knowledge of AFHS. The case is integrated in the geriatric curriculum for medical students, and the education is ongoing. Future studies will evaluate the learning outcomes of medical students.
NEIGHBORHOOD DISORDER MODERATES THE EFFECT OF SLEEP DIFFICULTIES ON COGNITIVE DECLINE AMONG OLDER AMERICANS
Authors: Esiaka Darlingtina , Luth Elizabeth
Published: December 2023

Research suggests that the neighborhood where people live can be a risk or protective factor for various health outcomes, including cognitive decline. Similar to the impact of neighborhood on health outcomes, sleep quality has been linked to cognitive functions in older adults. However, limited studies have examined how neighborhood disorders moderate the effect of sleep on cognitive decline. Data were obtained from 2,494 respondents (1,065 men and 1,429 women) from wave 11 of National Health and Aging Trends (NHATS) data. Approximately 55% of the respondents were age 80+, and 74% identified as non-Hispanic White Americans. Sleep quality was operationalized as the absence of difficulties in falling and staying asleep. Neighborhood disorder (e.g., vandalism, graffiti) was based on observations by interviewers. Cognitive decline was operationalized as subjective reports of increasing or worse memory loss in the past 12 months. Moderated regression analysis using PROCESS macro (model 1) was performed to determine the associations between sleep, neighborhood, and cognitive decline. Results showed a significant main effect between neighborhood and cognitive decline (higher levels of neighborhood disorder result in an increase in cognitive decline, B= 0.369, p =.014), but no significant main effect between sleep and cognitive decline. There was a significant interaction between sleep and neighborhood on cognitive decline. Participants who reported higher-than-average sleep difficulties experienced a greater effect of neighborhood disorder on cognitive decline. Our findings could add to inform future health interventions and policy recommendations that can address modifiable sources of cognitive decline.
SINGING WITH DEMENTIA: CREATING AND PILOT TESTING A VIDEO TO CHANGE ATTITUDES OF MEDICAL RESIDENTS
Authors: Sharninghausen Jody , Davison Carrie Ann , Marottoli Richard
Published: December 2023

As part of the “Creativity in Aging” project at Yale Geriatrics, we are making a series of short videos highlighting individuals and programs that transcend dementia through music. The target audience includes health trainees and professionals who care for older adults. The first video, made by a PhD candidate and an internal medicine resident physician, features The Recollections: a chorus of community dwelling people with dementia, their caregivers, and college students. Video learning objectives are to 1) change dementia attitudes; 2) demonstrate preserved skills and abilities of persons with dementia; and 3) raise awareness about local initiatives for music in dementia and how to refer patients. We interviewed the chorus founder, a geriatric psychiatrist, who described the creative process, including logistics and vision, and provided advice to caregivers and medical residents. Live clips from chorus rehearsals were shown, including singing and dancing, with voiceovers describing participant stories. Slides reinforced key points. The video was pilot tested on a group of residents from the Internal Medicine and Psychiatry programs. All respondents (N=6) used positive words such as “optimistic” and “inspired” to describe how the video made them feel. Most indicated it was moderately relevant to their care of patients with dementia and several provided suggestions on how to increase relevance. Constructive feedback included parts to compress or expand, overall length, visual aspects, and desire for more ‘how to’ guidance. Future plans include sharing a revised version with the broader residency program with pre-and-post dementia attitudes surveys.
THE RELATIONSHIP BETWEEN MOOD OF CAREGIVERS AND CARE RECIPIENTS WITH DEMENTIA
Authors: Hwang Yeji
Published: December 2023

Anxiety and depression are common behavioral and psychological symptoms of dementia. Although there are many individual level factors related to their anxiety and depression, it is unknown whether caregivers’ mood influence anxiety and depression of their care recipients with dementia. Therefore, this study was conducted to examine the relationship between anxiety and depression of caregivers and that of care recipients with dementia. This study was a secondary data analysis using the National Health and Aging Trends Study (NHATS) Round 7 data and National Study of Caregiving (NSOC) III. This study used 553 dyads of older adults aged 65 years and older who had probable dementia at the time of the interview and their family caregivers. Anxiety and depression of both the caregivers and care recipients of dementia were measured with the Generalized Anxiety Disorder-2 (GAD-2) and Patient Health Questionnaire-2 (PHQ-2) respectively. Descriptive statistical analyses, chi-square tests, and logistic regression analyses were used. There were significant relationships between the caregivers’ anxiety and the care recipients’ anxiety presentation (Chi2=10.06, p< 0.01). Similar relationships were also found for depression (Chi2=5.22, p=0.02). Logistic regression analyses showed that when caregivers had anxiety or depression, it was more likely that their care recipients show anxiety (OR=2.25, p=0.002, 95% CI=1.35-3.74) or depression (OR=1.78, p=0.023, 95% CI=1.08-2.94). Because dementia caregivers’ negative mood can influence their care recipients’ mood, health care professionals should conduct early interventions for caregivers with negative moods.
SENSE OF PURPOSE AMONG OLDER ADULT VOLUNTEERS DURING THE COVID-19 PANDEMIC
Authors: Wilkinson Lindsay , George Mollie , Masters Julie , Boron Julie Blaskewicz
Published: December 2023

The psychological benefits of volunteering among older adults are well established, but little is known about the influence of the pandemic on this relationship. Indeed, the COVID-19 pandemic led to social distancing, closures, and other restrictions that hampered the volunteer efforts of many older adults. Utilizing data from a survey of older adult volunteers participating in Foster Grandparent and Senior Companion Programs in a metropolitan area of Nebraska, this study investigates sense of purpose during the COVID-19 pandemic. The analytic sample was comprised of 65 adults ages 57 to 89 years. Linear regression models adjusting for demographic characteristics were used to examine the association between the perceived impact of the pandemic and disruptions to volunteering, and whether disruptions to volunteering were subsequently linked to a reduced sense of purpose. The results reveal that 1 in 4 respondents somewhat or strongly agreed that their sense of purpose had declined during the pandemic. Compared to older adults who perceived that the pandemic had little effect on them, those who perceived that the pandemic had been either difficult or a hardship more strongly agreed that it had been challenging to visit with their clients (both ps < 0.05). Older adults who agreed that there were new challenges in their volunteer role, in turn, more strongly agreed that their sense of purpose had declined (p < 0.01). These findings highlight the importance of volunteering for sense of purpose during the pandemic and suggest a possible pathway through which the pandemic may influence future health.
GENDER DIFFERENCE IN USING DIGITAL HEALTH TECHNOLOGIES AMONG OLDER ADULTS WITH CANCER: A PILOT QUALITATIVE STUDY
Authors: Hwang Misun , Cho Youmin , Gahn Katie , Manojlovich Milisa , Jiang Yun
Published: December 2023

Digital technologies hold promises to improve health and care delivery for various populations, including older adults with cancer. However, older adults’ adoption of digital health technology is less optimal. While age and gender can interfere with people’s technology behavioral intention, it is unknown how gender differences may influence older adults with cancer’s technology use experiences. This pilot qualitative study investigated gender differences in older adults’ experiences using digital technologies to manage their cancer and care. Semi-structured interviews were conducted with 16 older adults with breast, colorectal, lung, or prostate cancer (men=7 and women=9) aged 65 to 78 years. Thematic data analysis revealed that older men favored the adjustability and efficiency of using technology to save time and cost compared to in-person visits. Also, they perceived that technology facilitated their adherence to treatment plans. Older women, however, preferred technology-supported individualized care and perceived being able to review their medical notes as beneficial. Women were comfortable using technology to timely communicate with their trusted care providers. However, they preferred to see their providers in person if they experienced severe condition changes or unanticipated symptoms. Despite all these different preferences, both genders were comfortable using video calls with their providers, using the portal to keep track of their medical records and share decision-making with clinicians. These pilot results demonstrated gender differences in experiences and perceptions of using digital technology among older adults with cancer and suggested integrating gender preferences into technology design and development to facilitate personalized user experience and improve patient engagement.
DOES SELF-REPORTED DISCRIMINATION INCREASE AS COGNITION DECLINES?
Authors: Hanes Douglas , Clouston Sean
Published: December 2023

Progressing cognitive decline causes limitations on daily life and emotional changes, including increased aggression, agitation, and restlessness that might occasion greater scrutiny, limitations, discrimination, and disrespect due to a combination of care-provision and ageism. While there are a number of studies of discrimination as a cause of cognitive decline, there are no studies of how real and perceived discrimination during cognitive decline might affect the aging person and their caregivers. This study analyzes whether people currently experiencing cognitive decline report greater frequency of discrimination. Using the Health and Retirement Study (HRS; 2006–18; N = 37,059), we used multilevel ordered logistic regression to test the role of changes in cognitive performance in predicting self-reported frequency of six forms of discrimination, adjusting for age, socioeconomic, and demographic covariates. We found that lower cognitive scores were associated with increased discrimination frequency in three forms of treatment: less respect (β=-0.010; p=0.022), being treated as “not smart” (β=-0.026; p< 0.001), and worse medical treatment (β=-0.014; p=0.027) though no differences were evident in service quality (β=-0.002, p=0.736), evidence of being threatened (β=-0.11, p=0.069), or having people report being afraid of you (β=-0.004, p=0.455). Results suggest that perceptions of discrimination could emerge as a result of declining cognitive performance and highlight the need for greater sensitivity to discrimination among older adults in both everyday and medical settings. Further investigation will enable us to distinguish between experienced discrimination due to changes in treatment versus ageism.
CULTURALLY TAILORED INTERVENTION EFFICACY TO PROMOTE BREAST CANCER SCREENING AMONG AMERICAN INDIAN WOMEN
Authors: Roh Soonhee , Lee Yeon-Shim , Kenyon DenYelle , Elliott Amy , Petereit Daniel , Gaba Anu
Published: December 2023

Purpose

The purpose of this project was to develop and evaluate the feasibility and effectiveness of the Mobile Web App Breast Cancer Screening (wMammogram) intervention among American Indian (AI) women. Method: Using a randomized controlled trial design, 122 AI women (40-70 years old) were recruited and randomly assigned to the wMammogram group (n=62) to receive culturally and personally tailored multimedia messages through a mobile web app along with health navigator services or the control group (n=60) to receive a printed educational brochure. Outcome measures included mammogram receipt, intention to receive breast cancer screening after the intervention, and satisfaction with and perceived effectiveness of the intervention. Result: A significantly higher proportion of women who received the intervention (42%, 26/62; p<.01) completed mammograms by the 6-month follow-up compared with the control group (20%, 12/60). The wMammogram group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22, p<.001), increase in knowledge (t120=-4.75, p<.001), and satisfaction with the intervention (t120=-3.61, p<.001). The wMammogram group also expressed greater intention to receive a mammogram in the future when it is due (100%, 62/62 vs. 85%, 51/60) and were more willing to recommend the intervention they received to their friends (98.4%, 61/62 vs. 90%, 54/60) compared with the brochure group. These differences were statistically significant.

Conclusion

Based on our results, a mobile web app-based intervention combined with health navigator service was a feasible, acceptable, and effective intervention mechanism aimed at promoting breast cancer screening in AI women.
EXPLORING THE PHENOMENON OF BOREDOM IN THE CONTEXT OF LEISURE AMONG OLDER ADULTS
Authors: An Jaesung , Payne Laura , Janke Megan
Published: December 2023

Boredom is a concept that seems at odds with leisure, yet research on this topic indicates these constructs are often connected. Leisure boredom has been studied primarily among adolescents (Donati et al., 2019; Weybright et al., 2015). However, boredom is prevalent among older adults. Social isolation and loneliness often intertwine with boredom, and research suggests that prolonged boredom can negatively affect health and well-being (An et al, 2022; Goldberg et al., 2011). Yet, there is a dearth of research on this topic and existing literature typically examines adults’ functional status and disengagement or selective investment in leisure activities (Kleiber et al., 2008) rather than examining boredom more broadly. Thus, the purpose of this study was to examine the concept of boredom holistically in the context of leisure among community-dwelling older adults. The study used a multi-method approach utilizing focus groups and projective techniques of sentence completions and drawings. Forty-two older adults were recruited from senior centers and senior communities located in four western US cities. Thematic analysis with a six-step process outlined by Braun and Clarke (2006) was employed to analyze the data. Boredom was described as a personal state (e.g., negative self-perception, low energy and sensation/arousal, lacking motivation) and as activity-related emotions derived from unsatisfied/disengaged leisure participation. Participants also highlighted how life events and circumstances shaped their identity and contributed to boredom. Findings offered meaningful insights into how participants defined boredom, articulated causes of boredom, and strategies they use to alleviate boredom.
QUALITY OF LIFE OF OLDER ADULTS DURING THE COVID-19 PANDEMIC: RACIAL DISPARITIES AND SOCIAL CONNECTEDNESS
Authors: Ogunjesa Babatope , Ashrafi Sadia Anjum , Guimaraes Rafael , Schwingel Andiara
Published: December 2023

Social connectedness is crucial for well-being, especially among older adults. The Covid-19 pandemic has worsened mental distress in society due to prolonged social isolation practices aimed at curbing the virus’s spread. This study examined disparities in older adults’ self-reported quality of life during the pandemic and the influence of family and friends interaction. This study utilizes secondary data from the coronavirus worries and social isolation among older adults study by AP-NORC Center for Public Affairs Research on individuals aged 50 years and above (N=1,051). We aim to observe the effect of social interactions on the self-reported quality of life (QoL) of adults. Logistic regression analysis and marginal effect post-estimation analysis were utilized in this study, with adjustments made for race, education, gender, and income. The result showed that individuals who meet with family and friends more often (AOR=17.19, 95% CI=3.75-78.88, p< 0.05), or about as often (AOR=2.24, 95% CI=1.15-4.36, p< 0.05), are more likely to report a high quality of life than those who meet with them less frequently. A marginal effect analysis revealed that White adults had an 89.5% probability of reporting a high quality of life, non-Hispanic Black adults had an 83.4% probability of high quality of life, Hispanic adults had an 88.3% probability of high quality of life, and individuals from other ethnic groups had an 83.3% probability of high quality of life. These findings underscore the need for targeted interventions that address social isolation, especially among older adults, particularly those from racial and ethnic minority groups.
ASPECTS OF AMYLOID SCAN DISCLOSURE WHICH INFLUENCE PATIENT AND CARE PARTNER SATISFACTION DURING DEMENTIA DIAGNOSIS
Authors: Couch Elyse , Zhang Wenhan , Belanger Emmanuelle , DePasquale Nicole , Gabois Emily , Shepherd-Banigan Megan , Van Houtven Courtney , Wetle Terrie
Published: December 2023

Amyloid PET scans can be used to make a differential diagnosis of dementia or indicate a person’s risk of developing dementia in the future. The use of biomarkers for diagnosing dementia is not yet standard in clinical practice. Research is needed to better understand how to disclose the results from amyloid PET scans to patients and care partners. We interviewed 38 patients with MCI or dementia and 68 care partners from the CARE-IDEAS study to explore their experiences of receiving the results from amyloid PET scans as part of the diagnostic process for dementia. We were specifically interested in identifying aspects of amyloid disclosure which affected patient and care partner satisfaction. Patients had an average age of 73.5, were mostly male (65.8%), and Non-Hispanic White (67.6%). Care partners were mostly female (75.8%), caring for their spouse (87.1), with a mean age of 69.5. We identified 5 factors affecting patient and care partner satisfaction: 1) clarity of the explanation of the scan result and its implications, 2) discussion of potential options for treatment, research opportunities or follow-up support, 3) disclosure of scan results in person, 4) involvement of a care partner during disclosure, and 5) provision of a written summary of the scan result after disclosure. As diagnostic procedures for dementia evolve, it is important to consider their effect on patients and care partners. These findings can be used to inform the development of disclosure procedures for amyloid PET scans.
EVALUATING THE IMPLEMENTATION OF A SELF-CARE INTERVENTION FOR CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Fisher Lauren , Massimo Lauren , Hirschman Karen
Published: December 2023

In this study, we evaluated the implementation of the Virtual Caregiver Coach for You (ViCCY) intervention delivered as part of the “iCare4Me for FTD” (Frontotemporal Degeneration) Study (NCT04686266). This randomized controlled trial was designed to evaluate the efficacy of the evidence-based ViCCY intervention designed to increase self-care in caregivers of persons living with FTD. All caregivers received health information (HI) which included targeted caregiver and FTD websites on an iPad. The intervention group received ViCCY, 10 health coaching sessions focused on self-care and delivered via an iPad over 6 months. Guided by the Consolidated Framework for Intervention Fidelity (CFIF), the goal of this sub-study was to evaluate intervention implementation by measuring key CFIF components: coverage, exposure, and content delivered. Thirty-one caregivers were randomly assigned to ViCCY+HI (n=15) or HI only (n=16). One caregiver withdrew from the HI group. For exposure, at Month 1, a higher number of HI participants (87%) reported reviewing the websites 30 minutes a week compared to ViCCY group (67%). By Months 3 and 6 the groups were identical (3M: 100%, 6M: 93%). Thirteen out of 15 ViCCY caregivers completed all 10 health coaching sessions. On average, these sessions lasted 52 minutes (range: 24.8-113.5). For content adherence, 28% (40/142) of the completed sessions were examined for adherence to the protocol across the 10 sessions. Overall, content adherence across all sessions was 96% (range: 92-100%). This evaluation demonstrated that a virtual intervention targeting self-care is feasible and acceptable in this population. Implications for future research will be discussed.