bluuebunny/crossref_metadata_2025 huggingface dataset:
LINKING PLASMA PROTEOMICS TO BRAIN ACCELERATED/RESILIENT AGING IN THE ATHEROSCLEROSIS RISK IN COMMUNITY STUDY
Authors: Casanova Ramon , Justice Jamie , Walker Keenan , Anderson Andrea , Barnard Ryan , Hughes Tim , Kritchevsky Stephen , Wagenknecht Lynne
Published: December 2023

Machine learning models are increasingly being used to estimate ‘brain age’ from neuroimaging data. The gap between chronological age and the estimated brain age (BAG) is potentially a measure of accelerated/resilient brain aging, and we estimated BAG based on an elastic net regression approach. Here, we report associations between this brain age measure and plasma protein levels (measured using an aptamer-based proteomic platform) in the Atherosclerosis Risk in Communities (ARIC) Study to determine whether BAG was associated with proteins linked to biologic aging. We used brain MRI scans from 1507 ARIC visit 5 participants: 938 were Cognitively Normal (CN), 495 had mild cognitive impairment (MCI) and 74 had dementia. The proteomic dataset contains 4877 plasma proteins in these same individuals. We fitted univariate linear regression models adjusting for age, race, smoking, education, sex, diabetes, hypertension and intra-cranial volume. A Bonferroni correction was applied to account for multiple testing to maintain an analysis-wise α=0.05. In total 31 proteins were significantly associated with BAG. Among these SEVP1, GDF-15, pleiotrophin, MMP7, Natriuretic-peptides and Hsp70 were found to be associated with accelerated BAG, whereas EGF-receptor, mast/stem-cell-growth-factor-receptor (KIT), Coagulation-factor-VII and cGMP-dependent-protein-kinase-1 were associated to resilient BAG. The analysis based only on CN participants produced 3 significant proteins: retinoblastoma-2 and SEVP1, which were associated with accelerated BAG and Coagulation-factor-VII, which was associated to resilient BAG. These results suggest circulating proteins implicated in biological aging, cellular senescence, angiogenesis and coagulation are associated with a neuroimaging measure of accelerated brain aging.
PARTNER ENGAGEMENT STRATEGIES FOR AN EMBEDDED PRAGMATIC CLINICAL TRIAL: A CASE STUDY
Authors: Reddy Ann , McCreedy Ellen , Mitchell Susan , Baier Rosa
Published: December 2023

Embedded pragmatic clinical trials (ePCTs) rely on providers, rather than research staff, to implement study protocols. Partnerships need to be carefully managed to ensure a sustainable relationship. This case study describes strategies used by our research team while partnering with a large physician practice on an ePCT to improve advance care planning for people with dementia living in 160 assisted living centers. We focus on engagement between the research and provider teams co-designing and leading the implementation. Communication and project management tools held the teams accountable to decisions and set expectations for time and resources. At project initiation, we discussed the commitment of resources through different phases of the research (planning, executing, and monitoring) and determined the frequency and expected attendance for meetings during each phase. We focused on ensuring the intervention and protocols were feasible and integrated into existing clinical workflows. Regular meetings and continuous communication enabled us to make iterative modifications driven by provider needs and feedback. We used a project management register to track deliverables and document key decisions and next steps. A single point of contact on the research team fielded all inquiries and ensured timely responses to provider partners. ePCTs require a unique and active partnership between researchers and providers. In this case study, communication and project management tools enabled researchers and provider partners to identify and make changes to the ePCT’s intervention design and implementation protocol in real time. This case study provides best practices for management of stakeholder relationships in the ePCT context.
SELF-ASSESSED ORAL HEALTH IN DETROIT SENIOR CENTERS
Authors: Byrappagari Divesh , Jones Judith
Published: December 2023

The objective of the Detroit Mercy Senior Oral Health Equity Project (SOHEP) survey was to gather information from seniors about their opinion regarding their oral health status and satisfaction with their past dental care experience. The questionnaire was developed based on previously tested questions from other national senior oral health surveys. Data were collected using Qualtrics© and analyzed using SPSS©. The majority of the seniors screened were African American (88.9%), female (79.1%) and between the ages of 65 and 85 yrs. Over half (58.2%) reported their oral as Fair or Poor. Over one third (37.3%) reported avoiding eating certain foods due to poor oral health, and 43.3% have not been to a dentist in over 2 years. Although most participants indicated that they have insurance and have good experiences with their past dental care, a significant number of seniors have not used dental care. A community-based program that is accessible to seniors, especially in places where they congregate frequently might be helpful and improve access to preventive dental care for this population.
POPULATION REFERENCE VALUES FOR PEAK EXPIRATORY FLOW IN OLDER US ADULTS
Authors: Donahue Patrick , Balasubramanian Aparna , Davoudi Anis , Schrack Jennifer , Wanigatunga Amal , Carlson Michelle
Published: December 2023

Respiratory function predicts physical and cognitive health outcomes in older adults. Peak expiratory flow (PEF) is simple, inexpensive, and has been validated against traditional respiratory function measures (FEV1, FVC). PEF has additional utility because it measures maximal respiratory effort without relying on spirometry equipment. However, there is a lack of epidemiological data to support PEF reference values for aging populations, especially those ≥80 years. The National Health and Aging Trends Study (NHATS) is a large, nationally representative sample of US adults ages ≥65 that offers a unique opportunity to develop PEF population reference values. Using a healthy subsample from NHATS Round 1 (N=2,082), excluding those with history of smoking, respiratory, or cardiovascular diseases, we applied NHATS sampling weights to estimate age- and sex-specific PEF percentiles. The sample was stratified by sex (68.9% female) and categorized into six, 5-year age groups: 65-69, 70-74, … ≥90 (36.6% age ≥80 years). In a secondary analysis, we estimated age- and sex-specific PEF/height3 percentiles, per current recommendations. We calculated 5th, 95th, and 10th, 20th, … 90th percentiles, by age and sex, for both absolute and height-adjusted PEF. PEF population estimates were higher in healthy males vs. females (456.8±130.1 vs. 293.9±89.9 liters/minute [mean±SD]). After adjusting for height, estimates remained higher for males (83.1±22.4 vs. 70.9±21.5 liters/m3/minute) and higher for younger (65-79 years) vs. older (≥80 years) participants (78.9±19.7 vs. 62.9±26.6 liters/m3/minute). These results may serve as PEF population reference values for healthy older adults in the US.
THE ASSOCIATION OF FRAILTY AND MORTALITY IN OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF COHORT STUDY
Authors: Gao Xianqi , Song Rhayun , Park Moonkyoung , Li Yuelin , Lyu Linyu , Oh Eunna , Fan Xing
Published: December 2023

Frailty is associated with poor health outcomes in later life, improving lifespan and death through different mechanisms. This study aimed to systematically review the epidemiological evidence from cohort studies investigating the association between frailty and all-cause mortality, and to determine if frailty affects mortality in older adults. We searched for studies published and indexed in 4 electronic databases (EMBASE, PubMed, Cochrane Library, and Web of Science) and manual search and identified 28 cohort studies before Dec 31, 2022. We include studies if their design was longitudinal; the exposure of interest was measured frailty; the endpoint of interest was mortality; they provided a risk estimate (i.e., hazard ratio [HR]) and the corresponding 95% CI for the association between frailty and mortality. They used different indexes as their frailty as exposed definitions. Two investigators independently screened the full-text articles for inclusion. We used a random-effects model to obtain pooled HRs. Thirty-one studies were included for qualitative review, of which twenty-eight were eligible for meta-analysis, and included 67,114 individuals from 16 countries. Compared with healthy adults, frail adults had a significantly higher mortality risk. The pooled HR for mortality per increment of 0.1 frailty of community-dwelling adults was 2.33 (95% CI 2.05-2.65; I2 76.9%). The present study demonstrated that frailty was not only significantly related to an increased mortality risk but was also a strong predictor of mortality in community-dwelling adults.
EVALUATION OF A TECHNOLOGY-BASED EXERCISE PROGRAM FOR OLDER ADULTS IN THOSE WITH CHRONIC MEDICAL CONDITIONS
Authors: Lieber Sarah , Moxley Jerad , Sharit Joseph , Pirolli Peter , Reid M Cary , Czaja Sara
Published: December 2023

Although physical exercise is known to be beneficial, most older adults do not engage in recommended levels of physical activity, particularly those with chronic medical conditions. In an exploratory analysis, we evaluated the efficacy of a technology-based exercise program (Fittle) for sedentary community-dwelling adults ≥60 years of age with social support features in a subset of participants with ≥2 self-report chronic medical conditions. Participants in the Fittle condition received group training and were placed into teams to complete exercises at home via a computer tablet. They also were able to “chat” with other team members. Participants in the control condition were directed to exercise websites designed for older adults. A total of 181 participants with a mean age 70.1 years were randomized to the intervention or control condition. Participants were predominantly women (80.1%) and came from diverse backgrounds, with 13.4% self-identifying as Black or African American and 12.7% as Hispanic or Latino. Among 93 participants with ≥2 self-report chronic conditions, individuals in the intervention (versus control) arm described greater social support (t(162)=1.97, p=0.03) and less loneliness (t(163)=-1.97, p=0.03) at 6 months; there was a non-significant trend for higher self-report physical activity in the Fittle arm (t(166)=1.17, p=0.12). Fittle improved perceptions of social support and loneliness in older adults with chronic medical conditions. Further study is needed in a larger dedicated cohort of older adults with chronic medical conditions to determine Fittle’s efficacy in this population.
FEASIBILITY OF AN AUTOMATED SELF-ADMINISTERED 24 HOUR (ASA-24) DIETARY ASSESSMENT TOOL IN OLDER ADULTS
Authors: Spangler Hillary , Driesse Tiffany , Fowler Michael , Lynch David , Gross Danae , Liang Xiaohui , Batsis John
Published: December 2023

Background

Certain dietary patterns impact trajectories of healthy aging. However, dietary assessment tools can be challenging to use. With the increased technology use in older adults, we aimed to explore the feasibility of completing an online, Automated Self-Administered 24-hour (ASA-24) dietary assessment tool.

Methods

We conducted a randomized, crossover study of n=20 community-dwelling older adults’ (>65 years) preference for self-administered (SA) versus research assistant-administered (RAA) ASA-24. Participants were recruited via ResearchMatch.com and randomly allocated 1:1 to each group and completed either an SA or RAA ASA-24. One week later, the alternative sequence was completed. After each session, participants completed an online 11-item feasibility survey (Likert-scale;1-5, strongly disagree to strongly agree). Mean and standard deviations were reported for each question.

Results

Mean age was 69±3.5 years (90% females), and no differences were observed for sex, age, race, ethnicity, education, or income. Neither group felt a need for RA assistance (p=0.34). However, both groups felt the system was easier to follow with a research assistant (RAA 4.4±1.3 vs. SA 4.6±0.5, p=0.65), particularly when self-administered first (p=0.04). When conducting an SA ASA-24 first, there was less confidence the system could be learned quickly (SA 4.5±0.5 vs RAA 3.4 ±1.0, p=0.001).

Conclusion

Older adults can complete dietary recall using a self-administered online assessment; however, use of a research assistant led to better accessibility. Order of administration method may impact perceived ease of use. Next steps include increasing sample diversity and using an RAA ASA-24 platform to identify dietary patterns that impact aging.
INTERACTIVE VOICE ASSISTANT ROUTINES: A USABILITY STUDY
Authors: Shade Marcia , Yan Changmin , Boron Julie Blaskewicz , Jones Valerie
Published: December 2023

Musculoskeletal pain is prevalent among older adults and is associated with disability and social isolation. This study explored the feasibility of using conversational voice assistant (CVA) routines for proactive interaction and pain reduction with older adults. A 12-week randomized controlled pilot trial was conducted with adults aged 60 years and older who self-reported living alone and chronic musculoskeletal pain. Participants (N=37) were randomly assigned to a standard routine or an enhanced routine group. Data were collected on participants’ CVA engagement, self-reported pain, and system usability. Overall, older adults-initiated morning routines more frequently than the evening routines. The enhanced group initiated more morning routines (M=50.01; SD=33.07) than the standard group (M=16.11, Z= -1.70, p<.05, r= -.28). Participants reported significant post-study pain reduction, t(35)=1.84, p<.05, r= .30 (baseline mean=3.60, SD=1.93; post-study mean=3.19, SD=1.97); there were no significant group differences in amount of pain reduction. The enhanced group participants rated the system usability as good (Mean=74.81, SD=9.28); those in the standard condition reported a lower-tier rating of “OK” (Mean=65.88, SD=12.76), t(31)= -2.29, p<.05, r=.37. System usability predicted pain reduction (B= -0.55, t(13)= -2.46, p<.05) in the enhanced condition (R2=.30, F(1,14)=6.07, p<.05), but the association was non-significant in the standard condition (R2=.14, F(1,15)=0.29, p=.60). These results show that the CVA routines were feasible to use with older adults, and resulted in perceived pain reduction. Future creation of tailored routines based on the older adults’ pain characteristics, personality, and interaction preferences when alone, may further increase engagement.
CONDUCTING A COUNTYWIDE ALZHEIMER’S DISEASE AND RELATED DEMENTIAS CAREGIVER LANDSCAPE ANALYSIS
Authors: Robinson D’Artagnan , Barragan Noel , Parrish Monique , Benton Donna , Reyes Mariana , Mage Susanna , Kuo Tony
Published: December 2023

In Los Angeles County (LAC), approximately 1 in 5 caregivers provide care to older adults with dementia and cognitive impairment. By 2040, a projected 1.5 million Californians will be living with Alzheimer’s disease and related dementias, foreshadowing an unprecedented need for family caregivers across the state. In 2021, the LAC Department of Public Health launched the Centers for Disease Control and Prevention-funded LA BOLD initiative with the intent of developing a strategic plan to address dementia awareness and care in LAC, including improving local infrastructure for supporting unpaid family caregivers. To support this effort, LA BOLD commissioned the University of Southern California Family Caregiver Support Center to conduct a landscape analysis of the caregiver population in LAC. The analysis used a multi-method approach that included: primary analysis of community-based organization surveys, stakeholder interviews, focus groups with family caregivers, and secondary analyses of California Health Interview Survey and California Caregiver Resource Center System CareNav™ data and an environmental scan of best-practice caregiving models in use in other states. Results informed the development of three functional recommendations specific to LAC caregivers: 1) Leverage existing infrastructure to strengthen and build family caregiver services and supports; 2) Promote health care payer, provider, and system recognition of and support for family caregivers; and 3) Increase respite services for caregivers. This presentation highlights the methods and the findings from the landscape analysis, providing insights into the barriers and opportunities that a growing caregiver population of persons with dementia may pose to LAC.
CONTACT: AN ONLINE COACHING TOOL TO EMPOWER CARE PARTNERS TO FACILITATE CONVERSATIONS IN NURSING HOMES
Authors: Towsley Gail , Terrill Alexandra , Bayles Gregory
Published: December 2023

In the post COVID-19 context, nursing homes struggle with staffing. The role of care partners (CPs; relative, friend) has never been more crucial, including the need to advocate for persons living with dementia (PLWD) and being an integral part of the care team. The online CONversaTion cAre Coaching Tool (CONTACT) empowers CPs of PLWD prepare for conversations that may include communicating what matters to the PLWD, need for a different type of care, or treatment decisions. We engaged CPs to complete and provide feedback on CONTACT, which includes four sections: 1) education about nursing homes to clarify key terms/processes 2) guidance on goal setting to identify what is important; 3) creation of action plan to achieve the goal; and 4) reflection on the impact of achieving the goal. CPs (n=8) completed a survey about using the tool (acceptability (4 items), appropriateness (4 items), feasibility (4 items); scale of 1=strongly disagree to 5=strongly agree), and participated in a focus group to discuss the tool’s content and function. CPs favorably rated the tool. Mean ratings for acceptability ranged from 4.13 – 4.25, appropriateness 3.88 – 4.43, and feasibility 4.13 – 4.57. CPs reported that the tool was clear, simple, logically organized, informative, and it provided direction for starting a conversation. They liked the definitions of terms, large response buttons and that instructions were provided via video and in writing. Recommendations included additional videos depicting conversation prompts and scenarios, and utilizing community-based programs such as the Ombudsman office to disseminate CONTACT.
FAMILY INVOLVEMENT IN BRITISH COLUMBIA LTC FACILITIES DURING A PANDEMIC: THE IMPACT OF COVID-19 RESTRICTIONS
Authors: Christianson Tracy , Appiah-Kusi Evans , Bremner Jordan , Filewich Andrew , Qazi Amna , Reid Colin
Published: December 2023

Family involvement in long-term care is linked directly to LTC resident quality of life and family satisfaction with care. The public health restrictions implemented to protect the vulnerable LTC population, the majority of whom have some type and level of dementia, represented a serious breach of families’ ability to visit and care for their institutionalized loved ones. While much of the early research on the impact of the restrictions focused on the LTC resident and the paid care staff, the purpose of this study was to explore what impacts COVID-19 restrictions had on family involvement and family well-being in LTC facilities across the province of British Columbia. A mixed-methods design using a survey, interviews, and arts-based focus groups was the approach implemented. Families (direct, friends, legal guardians) of residents living in long-term care settings were invited to participate. Using a nested approach, online and paper-based surveys (N=55) were distributed, one-to-one interviews conducted (N=19), ending with two arts-based focus groups (n=4 each focus group). Qualitative interview data revealed six different but interconnected themes through the thematic analysis of the data. The themes were: 1) Quality of life, 2) Quality of care, 3) Mental Health concerns, 4) Communication, 5) Communication Strategies, and 6) The Rules. Quantitative results indicated positive relationships between satisfaction with care and a series of variables that aligned with the qualitative themes (example: satisfaction and treatment of family by LTC staff). Strategies offered by family participants to improve public health policies for future outbreaks are reviewed.
ONLINE MEDICAL RECORD (OMR) USE IN CAREGIVERS OF PEOPLE WITH DEMENTIA IN THE UNITED STATES
Authors: Inoue Megumi , Oh Kyeung Mi , Beran Krista , Booker Emma , Koizumi Naoru
Published: December 2023

Objective

Studies have found that there are higher levels of stress among informal caregivers of individuals with dementia. As a result, it is important to seek ways to reduce their burden. Online Medical Records (OMRs), often referred to as patient portals, provide effective communication tools to caregivers and the use of OMRs have been found to have the potential to ease their stress levels. This study examined OMR usage in informal caregivers of people with dementia and identified factors that were associated with their usage.

Methods

Data came from the HINTS, a National Cancer Institute (NCI)-sponsored survey of American adults. We merged data from HINTS 5 cycles 2, 3, and 4 administered between 2018 and 2020 into 1 data set. Our analytical sample included a total of 304 informal caregivers of people with Alzheimer’s disease. The outcome variable was OMR use in the last 12 months, and independent variables included age, sex, race and ethnicity, education, household income, marital status, employment status, relationship to care recipient, and the number of chronic conditions. Data was analyzed using multivariate logistic regression.

Results

53% of caregivers have used OMRs at least once in the past 12 months. Caregivers with a higher level of education and greater number of chronic conditions are more likely to have used OMRs.

Conclusion

Being able to access OMRs could reduce caregiver stress. There are certain caregiver characteristics that increase the likelihood of them utilizing this resource. Targeted approaches may be necessary to increase the range of use.
SOCAL SAVVY CAREGIVER: FOCUS GROUP INSIGHTS
Authors: Aguilar Iris , Aranda Maria
Published: December 2023

Dementia due to Alzheimer’s disease (AD) is a public health crisis in our nation. More than 1.6 million Californians provide unpaid care for a person with AD. Qualitative data from focus group discussions were obtained from unpaid/informal/family caregivers in a clinical trial testing the efficacy-effectiveness of Savvy Caregiver Express compared to the Savvy Caregiver Program.

Objectives: 1) explore class participation motivations, 2) perceived class benefits, and 3) class improvement recommendations.

Methods: We randomly selected and invited participants who had completed the class intervention cycle. Focus group subsample (n=25) was 84% female, mean age 54.48 years (28 to 80 years); 36% non-Latino white, 20% Latino, 8% African American, 4% Asian and American/Pacific Islander. 60% cared for a parent (44% mother and 16% father), 16% cared for a spouse/partner, 20% other relatives, and 4% friends. Focus group were transcribed, coded, and themes were created using inductive analysis.

Findings: Themes identified for discussion topic #1: seeking to gain knowledge about AD and stages, peer support, and caregiver competence; #2 knowing AD stages, management of meaning, caregiving mastery, and self-care; and #3 audiovisuals improvements, class structure changes, printed materials, and ongoing virtual sessions.

Implications: Participation in caregiving classes are critical to the improvement of quality of life for the person with dementia and caregiver. These findings offer actionable changes to improve the transformation of classes and adjust future materials or provide additional resources to help participants fully understand the course and better understand the motivations for increasing engagement with caregivers.
“THERE’S A LOT OF FACTORS”: UTILIZING I-POETRY TO UNDERSTAND VACCINE-HESITANT DECISION MAKING
Authors: Van Vleet Bryce , Fuller Heather , Huseth-Zosel Andrea , Carson Paul
Published: December 2023

Despite higher vaccinations rates as compared to other age groups, many US older adults remain under-vaccinated against common, preventable diseases leaving them at increased risk of serious illness, hospitalization, or death posed from diseases including shingles, pneumonia, influenza, and novel coronavirus. This study investigates the underlying reasons older adults have for not getting vaccinated. Eight older adults (Mean Age = 73.86) selected from a larger interview study conducted in North Dakota were identified as being vaccine hesitant as indicated by receiving two or fewer vaccines from a list of five common vaccines including influenza, shingles, pneumococcal, and initial and booster doses of the COVID-19 vaccine. Participants were asked, “How do you decide about whether or not to get a specific vaccine?” Their open-ended responses were analyzed using the I-poetry qualitative methodology which combined participants’ “I” statements into a poem for all eight participants that reflected their underlying motivations of vaccine hesitancy. This poem was structured in stanzas to highlight and convey overarching themes including: practical barriers, vaccine-alternatives, and skepticism. Practical barriers included allergies and concerns about side effects. Vaccine-alternatives highlighted a belief in natural immunity, vitamins, and exercise. Skepticism was directed at government agencies and the efficacy of a vaccine. These findings highlight potential benefits to providing medical professionals with first-person narratives from vaccine hesitant older adults which could help clarify sources of unease. Implications can be drawn for better understanding this at-risk population and developing tailored and effective interventions to bolster older adults’ vaccine uptake.
COMPARISON OF SEDENTARY BEHAVIOR GUIDELINES FOR OLDER ADULTS: A REVIEW OF LITERATURE AND QUALITY APPRAISAL
Authors: Huang Amy , Wang Ellen , Sanger Stephanie , Papaioannou Alexandra , Rodrigues Isabel
Published: December 2023

Most older adults (≥65 years) accumulate >8.5 hours/day of continuous sedentary time, which is associated with increased risk of metabolic syndromes and falls. The impact of increased sedentary time in older adults globally has prompted the development of national and international sedentary behaviour guidelines. The purpose of our review was to identify and compare national and international sedentary behaviour guidelines for older adults and appraise the quality of the guidelines to promote best practice in guideline development. We conducted our search in Medline, Embase, Global Health and relevant grey literature. We included the most updated guidelines for older adults written in English. AGREE II was used to assess the quality of the recommendations. We identified eight national and international sedentary behaviour guidelines for older adults. The guidelines were developed from reviews, cohort studies, knowledge user opinions, or other guidelines; all guidelines were based on low quality and certainty of evidence. The terms “sedentary behaviour” and “sedentary time” were used interchangeably, and the definitions of both terms were not consistent between guidelines. Six guidelines recommended a reduction in total time with one suggesting limiting sedentary time to < 8 hours/day. Three guidelines suggested reallocating sedentary time to light activity, with one recommending to stand-and-stretch every hour for 5-minutes. Most sedentary behaviour guidelines for older adults are based on low quality and low certainty evidence. Terminology, definitions, and recommendations were not consistent between guidelines. Further work is needed to develop evidenced-based recommendations specific to older adults.
LONG-TERM CARE CONCERNS AMONG CHILDLESS OR SINGLE CAREGIVERS TO PEOPLE LIVING WITH DEMENTIA
Authors: Couch Elyse
Published: December 2023

It is estimated that 77% of people living with dementia receive help with self-care and household activities from informal caregivers (typically family members), meaning there is a significant proportion of the population not receiving informal support. In this qualitative study, we aimed to explore similarities and differences in family caregivers’ concerns about organizing their own care should they develop dementia in the future between those who were childless and/or single and those who had a current partner and children. We interviewed 12 British current and former dementia family caregivers, 5 of whom were childless and/or single, 9 were women and 3 were men, with a mean age of 61. All 5 childless and/or single participants were women. Participants perceived a caregiver as vital for ensuring the person with dementia received the care they needed from services. Caregivers who were childless and/or single expressed concern that by not having someone to be their caregiver should they develop dementia in the future, they would be vulnerable to receiving poor care. In these cases, childless and/or single caregivers described the possibility of exploring options for suicide or euthanasia should they be diagnosed with dementia in the future. Similar sentiments were not expressed by caregivers with current partners and children. While this study uses a small sample size, these findings highlight persons without children and/or a partner have serious concerns about their future care, should they develop dementia. More research is needed to understand how to better support people with dementia without caregivers.
ASSESSING THE NEEDS OF OLDER ADULTS IN RURAL WEST TEXAS
Authors: Macaluso Suzie , Free Julia
Published: December 2023

With 1 in 5 adults over the age of 65 living in rural areas, understanding their unique concerns and needs becomes increasingly important. This study was carried out in partnership with the West Central Texas Area Agency on Aging (WCT AAA) to identify the top concerns of older adults in rural West Texas. The survey was conducted in person at four locations across the region served by the WCT AAA. A total of 183 respondents completed the survey and their responses to the question “what are the biggest issues facing older adults today” along with demographic information were collected. Participants were between the ages of 56 and 95 years old with a mean age of 76 years old. 60% of the participants were female and 40% were male. Respondents were predominantly White, 80%, with 16% Hispanic or Latino, and 3% Black or African American. The most common concern among respondents was physical health and well being with the increasing cost of living being the second most frequent response. Additionally, residents from more rural counties reported social interaction as more important than either health or cost of living. These findings highlight the need for targeted interventions to address the concerns of older adults in rural areas, particularly related to healthcare access and social isolation. Strategies such as telemedicine and community-based programs to address transportation and social isolation may be particularly effective in addressing these concerns.
EFFECTS OF CIVIC BEHAVIOR AND DEPRESSION KNOWLEDGE ON DEPRESSION STIGMA AMONG OLDER CHINESE: A PATH ANALYSIS MODEL
Authors: Yau Jessie Ho-Yin , Liu Tianyin , Leung Dara Kiu Yi , Tang Jennifer Yee-man , Wong Gloria Hoi-Yan , Lum Terry
Published: December 2023

Older adults are at risk of experiencing depression personal stigma because of negative attitudes towards older persons and the creation of popular stereotypes, therefore reducing stigma becomes necessary. By receiving training and acquiring depression knowledge from engaging in civic behavior, such as providing voluntary services to peers in the community, these knowledge helps counter false assumptions and reduce personal stigma. However, previous stigma-related studies mainly conducted in Western countries and in relation to schizophrenia, research on depression stigma among older Chinese remain scarce. The goal of this study was to examine depression knowledge as a moderator to test its influence on the relationship between civic behavior and personal stigma. A cross sectional survey was conducted with 145 older adults in Hong Kong, they completed Older Adult Mental Health First Aid training and engaged in voluntary services related to mental health promotion after the training. Civic behavior, depression knowledge (symptoms, facts, myths), personal stigma (stereotype, prejudice, discrimination), and demographics were collected. Path analysis was performed to determine the structural relationship between the variables. Civic behavior positively affected symptoms (β=.089,p=.008) and facts (β=.088,p=.001). Symptoms negatively affected prejudice (β=-.627,p=.014). Facts negatively affected all dimensions of personal stigma while myths positively affected all dimensions of personal stigma. Results of the measurement showed an excellent fit (χ2 = 148, χ2 /df = 7.048, RMSEA = .029, SRMR = .023, CFI = 0.997, TLI = 0.98, p<.001). Mediating effects were computed by bootstrap method; facts as a significant mediation was confirmed. Findings and implications were discussed.
INNOVATIVE APPROACHES TO MENTAL HEALTH SERVICES FOR DIVERSE COMMUNITY OLDER ADULTS
Authors: Abramson Tobi , Sirey Jo Anne , Berman Jacquelin
Published: December 2023

Addressing the triple stigma (age, mental health, race) faced by older adults in need of mental health services has necessitated innovations that move the service provision needle. Co-located services within community settings, mental health interventions addressing those with nutritional needs, and victims of elder abuse and elder crime benefit from innovative services. The following session will highlight research outcomes from innovative treatment models: (a) In a sample of 138 diverse individuals participating in PROTECT (a brief behavioral intervention for late-life depression among elder abuse/crime victims) showed 5.15 point reductions in PhQ-9 scores across the sample and found video-delivery was non-inferior to traditional in-person therapy. Those receiving video therapy completed treatment faster, with more rapid rate of symptom reduction. (b) Do More Feel Better (a 9-week peer-led manualized intervention for those with depression and nutritional needs) found 78% experienced clinically significant reduction in depressive symptoms and over two-thirds (66%) reported satisfaction with the program. (c) DGMH (mental health services co-located in older adult centers) data indicate that of the 4,118 clients assessed, 3,373 endorsed at least one mental health need (81.9%), significantly higher than the mental health literature indicates. Over 2,133 clients have been treated in 67,597 sessions since program inception in 2018. Within 3-months of treatment, 60.8% and 52% showed clinically significant improvements in depression and anxiety, respectively. A third reported decreased loneliness and 39.4% indicated feeling less socially isolated. Further data will be presented (demographic, racial, ethnic differences). Data supported efficacy lend support to innovative mental health treatment approaches.
THE STRONGERMEMORY PROGRAM: EXPLORING COGNITIVE BENEFITS AND FOSTERING COMMUNITY
Authors: Tompkins Catherine , Ihara Emily , Keesee Francesca , Lauber Mckenzie , Magee Catherine , Fredericksen Jessica , Liebreich Robert
Published: December 2023

Background

StrongerMemory is a brain health program centered on spending 30 minutes per day on handwritten journaling, reading aloud, and arithmetic exercises as a method to enhance cognition in older adults. The StrongerMemory research protocol is a 12-week program that includes a weekly meeting. After 104 participants completed the StrongerMemory research protocol, they were invited to participate in a focus group to share their experiences. Six focus groups were conducted by members of the StrongerMemory research team yielding 30 participants.

Methods

Focus groups were conducted virtually, with a set of pre-determined, open-ended questions centering around participant experiences and attitudes towards the StrongerMemory program. Participants were also asked to reflect on differences in their memory, cognition and well-being before and after StrongerMemory participation. Two researchers independently coded the focus group transcripts, and utilized the grounded theory analysis techniques of memoing and constant comparative analysis to explore the data. Common themes were then discussed.

Results

Five overarching themes emerged: Motivating, appreciating, challenging, committing, and enhancing. Conceptualizations of these themes focused on participants’ experiences and suggestions for strengthening the program. “Fostering community” was an outcome of the program often discussed.

Conclusion

The participant experience in StrongerMemory revealed unique perspectives on their motivation for participation and provided the researchers with new insights into the program such as fostering community within older adult groups. Further research includes exploring cognitive and social benefits of group participation in the StrongerMemory program.
APPLYING A BILL OF RIGHTS FOR PEOPLE UNDER GUARDIANSHIP IN RURAL AREAS
Authors: Teaster Pamela , Shealy E Carlisle
Published: December 2023

In the U.S., 35.2% of people aged 65 and older live with a disability, of which 8.9% have a cognitive disability. For some, cognitive disabilities necessitate the help of a surrogate decision-maker (e.g., a guardian), including adults with serious mental illness, intellectual disability, and traumatic brain injury. Guardians are bound by statutory requirements, case law, and ethical principles to act in the best interests of an adult adjudicated by a court to lack the capacity to make certain decisions. Guardians are charged to act according to the highest standards of care, accountability, trust, honesty, confidentiality, and avoidance of conflict of interest. Powers given to guardians are often immense (e.g., authority to sell a person’s home and personal property, consent to medical treatments). Little is known about the characteristics of people with a guardian. Our study in rural Virginia examined all new guardianships of adults in one jurisdiction across three years (89% Caucasian, 54% male). Their most common disabilities were dementia and intellectual disabilities. No guardian’s report indicated any improvements in the adults’ mental or physical health. The National Guardianship Network, a collaboration of 13 national organizations, drafted a Bill of Rights for Adults with a Guardian, categorizing rights always retained after a guardian is appointed, personal rights that a court may restrict but not delegate to a guardian, and rights a guardian may exercise on behalf of an adult. Characteristics of a population of persons with a guardian living in a rural area are presented alongside considerations of their rights.
SUPPORTING CARE PARTNERS OF PEOPLE LIVING WITH DEMENTIA: EXPLORING CHANGES IN POLICY AND PRACTICE
Authors: Dawson Walter , Reed Jenn Hollandsworth , Colon Anaeliz , Prince Devlin , Chapela Sofia , Gelmon Sherril
Published: December 2023

Most care and support for people living with Alzheimer’s Disease and related dementias (ADRD) is provided unpaid at home or in community settings. To better understand the caregiving-related priorities of people with lived experience as care partners (CP) of people living with ADRD, focus groups were convened with CPs who identify with historically and currently underserved communities that may have difficulty accessing culturally specific services for people living with ADRD in and near Portland, Oregon. In-depth interviews (n=20) were conducted with local, state, and national-level organizational leaders who represent or provide ADRD support services to various underserved communities including Black, Indigenous, Asian, and Latinx Americans to gather additional perspectives on ADRD care and support needs. Care partners across all populations reported a need for additional supports that could help them in carrying out their caregiving responsibilities. While the specific needs and types of supports identified varied across populations, the findings point to multiple unmet needs across all populations in terms of ADRD CP-specific supports. Changes to policy and practice are needed to improve the experience of CPs of people living with ADRD. New policies focused on promoting access to services, education and training, and financing of supports such as respite must be developed and implemented in partnership with community-based organizations and ADRD CPs from underserved communities and communities that may have difficulty accessing culturally-specific services and unique supports. The findings also point to universal needs related to caregiving across all populations that could be addressed through new policy initiatives.
EMERGENCY PREPAREDNESS AMONG CLIENTS OF OLDER AMERICANS ACT PROGRAMS
Authors: Campione Joanne , Robinson Kristen
Published: December 2023

Older adults who are clients of Older Americans Act (OAA) programs, such as home-delivered meals and transportation services, often have unique needs during an emergency or crisis. Many OAA clients have mobility challenges and/or chronic health conditions, making it difficult to access and respond to emergency directions. For these reasons, in 2022, the Administration for Community Living added to the annual National Survey of Older Americans Act Participants (NSOAAP) a one-time module of questions regarding emergency preparedness. Among 5,136 respondents of the 2022 NSOAAP, 67% said they have ready 3 days’ worth of food and water, 69% have a way to charge their phone without electricity, and 51% have a battery-powered radio. Thirty-seven percent of the clients said their household has a medical device that requires electricity. While 74% said they have a list of list of family, friends, and community organizations, only 37% said their household has a specific plan for a disaster or emergency. Seven percent said they would not evacuate if public authorities announced a mandatory evacuation with the top three reasons for not evacuating being: 1) concern about leaving pets, 2) lack of transportation, and 3) could not be moved due to health problems. In summary, support services that an older adult relies on to live at home, such as help from family caregivers and in-home health care, may be unavailable due to a disaster thus increasing a person’s vulnerability and possibly leading to nursing home care that may have been otherwise avoidable.
EVALUATION OF THE IMPACT OF COMMUNITY CARE IN KOREA: NAMYANGJU CITY’S FOUR-YEAR EXPERIENCE
Authors: Choi Mi Sun , Cho Sangmi , Park Yoonsei , Woo Misuk , Park Sumin , Cho Youngmin
Published: December 2023

In 2019, the Korean government launched a community care project in response to the rising need for care brought on by the nation’s aging population and state-funded medical expenses. Namyangju, Korea, has implemented community care for the care of older people. However, little is known about how to ensure the sustainability of community care by investigating the impact of community care services. To enhance our knowledge in this domain, we conducted focus group interviews (FGI) with 24 participants, including 18 service providers and six older adult service users, from August to November 2022. In the FGI, service providers and users identified vehicle and meal support services as core needs. They described the beneficial outcomes of these services, such as increased psychological well-being and the desire for independence and decreased depression. On the other hand, users expressed difficulty in accessing information about various services and mentioned restrictions on service usage (period, number of times), while the providers emphasized the difficulty of providing comprehensive services when health and welfare services were separated amid budget constraints. Both groups proposed solutions to these problems through community care services. Individual citizens’ perceptions of universal welfare should be changed, while institutions must actively promote this program and recruit professionals. A partnership between private and public institutions must be established at the regional level, and services must be differentiated to reflect the region’s distinctive features. Finally, national legislation must be enacted to promote care coordinators and ensure that appropriate budgets are allocated for successfully operating the program.
“A FRAIL LITTLE THING, BUT SHE’S WILEY”: POLICE BRUTALITY MEETS DEMENTIA: A NARRATIVE INQUIRY
Authors: Marnfeldt Kelly
Published: December 2023

From 2000 to 2020 overall arrests in the U.S. declined, but arrests of people 65 and older increased by nearly 30 percent. In addition, between 2010 and 2020 approximately 12,000 adults 65 and older were admitted to the emergency room due to injuries sustained during encounters with police or private security. To illuminate the scope of negative consequences that may occur during such encounters, the present study examined the 2020 arrest of a 73-year-old community-dwelling woman living with dementia who walked out of a big-box store with $13.88 worth of merchandise she did not pay for. During her arrest, she sustained multiple injuries at the hands of two officers, including a dislocated shoulder and a broken arm. Despite her injuries, she did not receive medical care for six hours while in custody. The methodological approach to this case draws on elements of interpretative phenomenological analysis, and narrative analysis to explore publicly available archival data sources, including surveillance and police body-worn camera footage. Supporting data sources include police filings at the time of her arrest and legal filings by a civil rights attorney representing the woman’s family. The analysis demonstrated that deeply entrenched ageism, failure to recognize the signs of dementia, and the systemic normalization and defense of police use of force against non-normative behavior when interacting with neuro diverse older adults. This has critical implications for family caregivers and trusted others who struggle to balance the dialectic between safety and independence for people aging in place with dementia
PEER (DYADIC) SUPPORT: A FEASIBILITY STUDY FOR OLDER AFRICAN AMERICAN WOMEN WITH HYPERTENSION
Authors: Groves Angela , Roche-Dean Maria , Bosak Emily
Published: December 2023

African American women have a higher prevalence of hypertension than women of other ethnicities. Interventions have not adequately addressed the higher prevalence of hypertension in this population. Social support networks can be an effective strategy for improving hypertension self-management behaviors. The objective of this study was to evaluate the feasibility of an 8-week peer (dyadic) support intervention to improve diet adherence and reduce systolic blood pressure among older African American women with hypertension and describe the relationship that occurred during the intervention. This mixed methods study used a convergent parallel design. A total of 26 African American women diagnosed with hypertension, aged 60 and older were paired to form 13 dyads. All participants completed a 3-hour training session consisting of home blood pressure monitoring, DASH diet, and communication. Participants completed pre and post DASH diet surveys, and the Social Support Survey (MOS) post intervention. At the end of the 8-week intervention, participants discussed their experiences in a 60-minute focus group session. Content analysis was used to analyze focus group interviews. Preliminary data analysis will be presented. Emerging themes included, accountability, epiphany, challenges with hypertension management, communication with each other, and receiving support. Preliminary findings suggest that peer (dyadic) support is feasible and can be an effective intervention strategy to improve diet and blood pressure management. Future studies should address specific challenges to hypertension management identified by participants. Lastly, this study used random within site pairing for participants without an identified partner. Future studies should develop criteria for pairing partners.