bluuebunny/crossref_metadata_2025 huggingface dataset:
INNOVATIONS IN AGE-FRIENDLY UNIVERSITY (AFU) CAMPUS PRACTICES: ENGAGING COMMUNITY
Authors: Gautam Ramraj
Published: December 2022

The Age-Friendly University (AFU) global network adopted 10 AFU principles, and AGHE endorsed the AFU principles in 2016. Institutions of higher education are initiating several innovative age-inclusive approaches to teaching, research, and community engagement. This symposium features AFU partner institutions that will discuss their approaches, guided by the AFU principles, for engaging the older adult community to foster age-inclusivity at universities. Guided by the AFU Principle 8 (access for older adults to the University’s range of programs) Elfenbein (University of North Georgia) will discuss the design and implementation of the University of North Georgia (UNG) Personal Enrichment, Action and Knowledge Series (PEAKS) program, a novel university and community coalition activity for older adults from the region. The program aims to develop a future life-long learning program. Gautam, et al. (University of Massachusetts Lowell) will discuss their initiative to engage the university’s own retired community (AFU principle 9) in promoting intergenerational activities benefiting both students and the University. Melillo, et al. (University of Massachusetts Lowell) will share the qualitative study findings exploring the perceptions of emeritus professors regarding AFU principles 4 and 9. Clark, DiMaria-Ghalili and Gitlin (Drexel University) will discuss the design, implementation, and challenges of launching a pilot grant program at the University that focused on faculty, staff, and students, and integrated the 10 AFU principles. Townsend, et al. (University of Massachusetts Lowell) will highlight the Age Friendly Communities (AFC) and AFU initiatives involving graduate students working with 25 Action Group community-residing adults 50+ (AFU Principle 7 and 10).
AFU INNOVATIONS: PEAKS (PERSONAL ENRICHMENT, ACTION, KNOWLEDGE SERIES)
Authors: Elfenbein Pamela
Published: December 2022

With careful consideration, including SWOT analysis, demographic projections data, and community input, we envisioned and designed PEAKS – Personal Enrichment, Action, and Knowledge Series. In creating PEAKS our mission was to provide engaging programming designed for the older adults. Our vision was to establish the University of North Georgia, an AFU, as the region’s premiere educational and activity resource for older adults in our region. In January of 2021 PEAKS began as monthly series of virtual programs that attracted our intended constituents. During the summer programming paused. During this pause, community members approached the university and asked for PEAKS to expand to include in-person experiences during the summer months. This presentation follows our journey as we research, create, and facilitate the PEAKS programs, both virtual and in-person. We also share our research focusing on the development of PEAKS and goals and the degree to which we achieve them.
METHODOLOGICAL APPROACHES TO GERONTOLOGICAL CANCER RESEARCH
Authors: Halpin Sean
Published: December 2022

The wide range of gerontological cancer research necessitates a variety of methodological approaches. In our symposium, we bring together researchers who represent varied approaches to studying multiple cancer types—with a focus on demonstrating how to apply different methods. First, Ye, will discuss the use of a unique cross-sequential design to facilitate comparison between health change in long-term older cancer survivors and demographically-matched older adults with no history of cancer. Zanwar, will present disparities in cancer screening using secondary nationally representative complex survey data, provide examples of survey data that can be utilized in aging and cancer prevention and control research, and present challenges and opportunities for using survey data. Von Ah, will discuss research methods pertaining to a series of non-pharmacological clinical trials and offer insight to reducing barriers and improving acceptability to technology-based intervention programs in older breast cancer survivors. Next, Castaneda will present quantitative (i.e., group trajectory modeling, conditional Poisson regression) and qualitative approaches to understand the role of monoclonal gammopathy of undetermined significance in healthcare utilization and progression to multiple myeloma. Last, Halpin will discuss the use of naturally occurring data such as participant observation and audio recordings to evaluate education for patients with multiple myeloma preparing for autologous stem cell transplant. Understanding how a variety of methodological approaches are applied to gerontological cancer research will help facilitate a broader understanding of the tools available for these studies.
MORTALITY RISK AMONG OLDER VETERANS AND NONVETERANS: THE IMPORTANCE OF COMBAT STATUS
Authors: Landes Scott , Piazza Jennifer
Published: December 2022

Over 17.4 million Americans have served in the U.S. armed forces. Although long-term mortality risk is reported to be higher among older veterans than nonveterans, research does differentiate whether there is variation by combat status. This study examined later-life mortality rates among nonveterans, noncombat veterans, and combat veterans. Data were from Wave 2 of the Midlife Development in the United States Survey (N = 4,633). Participants included 3832 nonveterans, 584 noncombat veterans, and 217 combat veterans. Mortality rates did not differ when comparing nonveterans and noncombat veterans. Combat veterans, however, had a higher risk of mortality than did than nonveterans. Combat experience is a determinant of long-term mortality risk among veterans. Future studies should account for combat status when comparing health and mortality between veterans and nonveterans. Because of their heightened mortality risk, combat veterans should be provided with additional services during and after their time in the armed forces.
MARITAL QUALITY AND LONELINESS AMONG AGING COMBAT VETERANS: THE MODERATING ROLE OF PTSD SYMPTOMS
Authors: Marini Christina , Yorgason Jeremy , Kaiser Anica Pless
Published: December 2022

Loneliness is a robust predictor of aging veterans’ health. Even married older adults may experience loneliness if their relationships are of poor quality. We therefore examined facets of marital quality as predictors of loneliness within a sample of aging veterans: (1) companionship (relationship promotes connection to spouse) and (2) sociability (relationship promotes connection to others). We further evaluated whether veterans’ PTSD symptoms moderated these associations. We utilized two waves of data from 269 Vietnam-era combat veterans (M age = 60.5, SD = .73) collected in 2010 and 2016. Upon controlling for baseline loneliness, demographics, and chronic conditions, higher companionship and sociability each predicted lower subsequent loneliness. We detected interactions between companionship and PTSD subclusters. For example, companionship protected against loneliness only for veterans with low and moderate (but not high) avoidance. Findings highlight nuances in how marital quality predicts aging veterans’ loneliness, some of which are dependent on PTSD symptoms.
TEMPORAL ASSOCIATIONS OF SENSORY FUNCTION AND BLOOD-BASED NEURODEGENERATIVE AND ALZHEIMER'S DISEASE BIOMARKERS
Authors: Merten Natascha , Paulsen Adam , Chappell Richard , Chen Yanjun , Cruickshanks Karen , Engelman Corinne , Hancock Laura , Schubert Carla
Published: December 2022

Sensory changes are risk factors of neurodegeneration and Alzheimer’s Disease (AD) but their relations with emerging blood-based biomarkers of neurodegeneration and AD are rather unknown. We assessed long-term temporal relationships of sensory functions and blood-based neurodegenerative and AD biomarkers.This study is based on 10-year follow-up data of n=1529 (primarily middle-aged) Beaver Dam Offspring Study participants. We conducted pure-tone audiometry, visual acuity testing, and quantified serum neurofilament light chain (NfL), total tau, and amyloid beta. Linear mixed-effects and linear regression models were used to determine longitudinal associations and the effect sizes of temporal effects.Preliminary analyses revealed that NfL increased slightly more slowly per year with every 1SD better hearing (-0.3%/year[-0.5%,-0.1%]) and vision (-0.2%/year[-0.4%,0.01%]). Effect sizes of baseline sensory function effects on NfL levels 10-years later were 3-4 times larger than effects of the opposite direction. Longer follow-up is needed to confirm whether hearing changes occur before blood-based NfL changes.
ASSESSING PREFERENCES FOR COMMUNICATING WITH TECHNOLOGY: A PERSON-CENTERED APPROACH TO CARE MANAGEMENT
Authors: Sillner Andrea , Boltz Marie , Sweeder Logan , Van Haitsma Kimberly
Published: December 2022

Technological advances, such as telehealth, have been used to manage the multiple chronic conditions that impact over 25% of the US adult population. Technology-assisted communication (TAC) can help to bridge the gap in effective management of health conditions in the community by patients, informal caregivers, and healthcare providers, while emphasizing person-centered care. The purpose of this project was to develop a new theoretically-derived and evidence based subscale for the Preferences for Everyday Living Inventory (PELI) that addresses preferred TAC approaches for community-dwelling adults over the age of 50 years in the context of multiple chronic conditions (N=297). Results indicated that over 60% of older adults are satisfied with technology-based healthcare communications. In general, older adults in the sample are satisfied with all domains of technology-assisted communication that are asked within P-TAC, including timing, sending and receiving of information, and content of communications. Almost 80% (N=234) indicate that they are satisfied with the content of TAC. This research has lead to the development of assessment items that will allow providers to better assess and then integrate patient preferences for technology communication strategies into plans of care. Potential benefits of understanding preferences for TAC include alignment of chronic care management with preferred strategies which may lead to improvement care congruence and improved healthcare outcomes for the older adult.
TALKING ABOUT LONELINESS: QUALITATIVE INSIGHTS FROM OLDER ADULTS: IMPLICATIONS FOR RESEARCH, POLICY, AND SERVICES
Authors: O'Sullivan Roger , Leavey Gerry
Published: December 2022

The very personal and complex nature of loneliness is too rarely articulated in research papers. Each presenter in this interdisciplinary and international symposium presents insights into loneliness and /or social isolation that can help bridge this gap. Victor (Social Gerontology) using open ended responses from the 2018 BBC Loneliness Experiment, presents how 1480 older people describe loneliness and highlights the need to give more attention to existential loneliness. O’Sullivan (Public Health) presents the results of 18 life story interviews with older adults attending a mental health service. The analysis identified three different typologies of loneliness with specific recommendations for training and services. Phone-based support programs are increasingly being used as a solution for those experiencing loneliness. However, less is known about what aspects are most helpful. Perissinotto (Geriatrics and Palliative care) presents results from 38 qualitative interviews with a focus on barriers and facilitators to implementing a phone-based support intervention, particularly for older adults experiencing loneliness. Cudjoe (Medicine) presents qualitative data from older adults (English, Spanish and Mandarin speaking), living in non-profit affordable housing in 22 different states. Drawing on experiences of their social connections during the COVID-19 pandemic, the paper gives voice to the implications of the loss of common facilities, and opportunities to socialize with other residents, and the increased role technology plays in staying connected. Our discussant, Prof Leavey, a leader in the field of mental health, will reflect on the major themes emerging from these multidisciplinary perspectives, especially what they mean for public health and services.
LONELINESS ACROSS THE LIFE COURSE; LIFE STORY INTERVIEWS WITH MENTAL HEALTH SERVICES USERS
Authors: O'Sullivan Roger , Burns Annette , Leavey Gerry , Golden Jeannette , Reilly Dermot , Lawlor Brian
Published: December 2022

Introduction

The complexity of loneliness and its negative impact on our health and wellbeing is well established. However, the qualitative experience of loneliness over the life course is poorly understood. Method: This presentation, based on 18 life story interviews, with a sample of older adults, who were attending a mental health service and objectively defined as lonely, provides an insight into the personal experiences of loneliness as well as the situations and factors associated with loneliness across the life course.

Results

The analysis identified three distinct typologies of loneliness; those who experienced (1) chronic loneliness across their life (2) those whose loneliness became chronic after a transition e.g. bereavement (3) those whose loneliness remained situational/transitional.

Conclusions

The insights are important to inform both general loneliness services and policy as well as specialist mental health services and training. The presentation demonstrates the importance of a life course approach to addressing and understanding loneliness.
HOW DO LONELY OLDER PEOPLE TALK ABOUT LONELINESS? PRELIMINARY ANALYSIS OF THE BBC LONELINESS EXPERIMENT
Authors: Victor Christina , Barreto Manuela , Qualter Pamela
Published: December 2022

Three types of loneliness, social, emotional and existential, are identified in research, policy and practice. Do these categories reflect the language used by older adults to describe their experiences of loneliness? We use data from the 2018 BBC Loneliness Experiment and focus upon lonely adults aged 60 and older, living in the UK and with a maximum score of 9 on the UCLA loneliness scale. 1619 participants meet these criteria, 1480 provided a response to the question ‘’What does loneliness mean to you?" Participants ages ranged from 60-94; 90% aged 60-74 and 38% male. Free text answers ranged from 1-189 words, included both subjective (feeling alone) or objective (being alone) words and described social (no one to talk to), emotional (lack of closeness) and existential (lack of purpose) loneliness. Lonely older adults ‘talk’ about the three different types of loneliness singly or in combinations when explaining what loneliness means to them. We conclude that:- (a) existential loneliness merits more attention as it is less prominent in research compared with other types of loneliness and (b) lonely older adults describe different types of loneliness in the same answer.
EVALUATING A PHONE-BASED SUPPORT PROGRAM TO ADDRESS LONELINESS: LESSONS LEARNED FROM PARTICIPANTS AND STAFF
Authors: Perissinotto Carla , Kotwal Ashwin , Tha Soe Han , Hough Katrina , Matusovsky Bri
Published: December 2022

Introduction

Phone-based support programs are increasingly being used as a solution for those experiencing loneliness. However, less is known about what aspects of these support programs are most helpful to participants and even less known about the staff and volunteer who work in these programs.

Methods

Mixed methods structured surveys of participants (N=247 baseline, N=147 follow-up), and in-depth qualitative interviews of both participants (N=15, and staff=23).

Results

We present the results from the qualitative interviews with a focus on what barriers and facilitators are to implementing a phone-based support intervention, particularly for older adults experiencing loneliness. Preliminarily, 77% of staff and volunteers felt more connected themselves through their role in the phone-support program. 100% of staff also believe the callers feel less lonely as a result of using the line, and 80% feel they create a meaningful relationship with callers. Themes included and overall sense of need for expansion of these services, while better understanding the optimal length and frequency of calls. Consistent with staff responses, amongst callers, 90% fell more socially connected because they use the telephone support line. Similarly, to staff and volunteers, participants felt their needs were met during calls, but wished the length of calls could be flexible. This demonstrates that the line is beneficial to both participants and staff. There is high satisfaction on the quality of the calls and the connections made, but emerging themes suggest a need to scale services to meet demand at all hours and allow for flexibility in length of calls.
OVERVIEW OF COVID-19 STUDY WITH OLDER ADULTS IN PUERTO RICO
Authors: Buckley Thomas , Burnette Denise
Published: December 2022

This presentation will provide an overview of our study with older adults in Puerto Rico during COVID-19. From January through December, 2021, we conducted telephone and face-to-face interviews with a nonprobability sample of 213 adults aged 60+ in 21 of the island’s 78 municipalities. Average age of participants was 71.9 (SD=8.8), 55.9% were female and 55.4% had annual household incomes under $12,500. About two in five older adults reported feeling lonely (39.4%) and poor/fair health (39.9%). Fully 65.3% were overweight or obese, 59% reported at least one chronic disease (59.4%) and 25.8% had delayed medical care during COVID-19. KAP index scores were reasonably high and 97.2% of participants were either vaccinated or planned to be. We will also discuss the development, translation and adaptation of the data collection instrument and the important social, economic and political backdrops of successful public health measures during the pandemic in Puerto Rico.
CARING FOR CAREGIVERS: HEALTH AND HEALTHCARE EXPERIENCES OF DIRECT CARE WORKERS
Authors: McCall Stephen
Published: December 2022

Direct care workers play a significant role in supporting the health of older adults and people with disabilities across long-term care settings—but as a primarily low-income, women of color workforce, they likely face significant health risks themselves. To build understanding on the health of this essential workforce, this paper examines direct care workers’ health status, health insurance coverage, and experiences utilizing, accessing, and paying for healthcare services using pooled 2014 to 2018 data from the National Health Interview Survey. We find direct care workers have worse health, lower rates of insurance coverage, poorer access and utilization, and greater cost barriers compared to other healthcare workers. We also observe disparities within the direct care workforce according to industry, gender, and race/ethnicity. This study helps inform efforts to support the health of direct care workers and stabilize the critical services they provide.
IMPACT OF COVID-19 ON OCCUPATIONAL INJURY AMONG LONG-TERM CARE WORKERS IN CALIFORNIA
Authors: Lee Soo-Jeong
Published: December 2022

Long-term care is the industry with the highest occupational injury and illness rate in the United States. During the Coronavirus Disease 2019 (COVID-19) Pandemic, healthcare workers have been affected physically and psychologically by increased workload and stress. Such increased physical and psychological demands may increase the risk of injury among long-term care workers. The aim of this study is to assess the impact of COVID-19 on occupational injury or illness incidence among long-term care workers. Analyzing California Workers’ Compensation (WC) data reported in 2019 and 2020, the study will report the number and rate of WC claims among California long-term care workers by month and examine changes over time during 2019-2020. The study will also characterize WC claims during 2019-2020 by demographic (age, gender), occupational (occupation, job tenure), and injury or illness characteristics (cause of injury, nature of injury, affected body part) and identify characteristics with greater changes during COVID-19.
BARRIERS AND FACILITATORS OF DISASTER PREPAREDNESS FOR CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Peterson Lindsay , Dobbs Debra , Hackett Sara , Haley William
Published: December 2022

Emergency preparedness for disasters such as hurricanes is critical. A common feature of disasters is their disruption of daily life, which is magnified for persons living with Alzheimer’s disease and related dementias (ADRD). It is critically important to understand more about disaster preparedness for those with ADRD and the informal caregivers responsible for their safety. We conducted individual interviews between April and September, 2021. The sample included 50 family caregivers of persons with dementia (11 Hispanic, 12 Black, 27 White), who were asked about their disaster experiences, concerns about future disasters and level of preparedness. Interviews were transcribed and coded using a team coding approach. Initial analysis identified three main themes, 1) caregivers attitudes about the importance of disaster preparedness, 2) what makes it difficult to prepare, and 3) facilitators of preparedness. Results have the potential to guide program development to improve preparedness among diverse caregivers of persons with ADRD.
CONDUCTING DIVERSITY, EQUITY, AND INCLUSION-INFORMED RESEARCH WITH OLDER ADULTS
Authors: Taeckens-Seabaugh Ashley
Published: December 2022

Researchers are encouraged to think broadly and holistically about how they conceptualize diversity, equity, and inclusion (DEI) efforts in their work. Each element of a research project must be rigorously devised to identify or address existing gaps in the literature, which will continue to be increasingly important as the US population of older adults continues to expand and diversify. Intentionality throughout every stage of a project is bound to result in a better understanding of the focus populations’ needs, and how to best address those needs through their perspective. Moreover, consider weighing the pros and cons of working to implement culturally competent versus multiculturally competent research and whether either approach is as culturally appropriate and responsive as possible. This work summarizes guidance to increase DEI efforts by meticulous research question development and thoughtful determinations regarding literature review terminology, recruitment efforts, data collection, and reporting and dissemination techniques.
LGBTQ+ OLDER ADULTS AND COMMUNITY NEEDS IN METRO DETROIT: ADAPTING METHODS TO EVOLVING CONDITIONS
Authors: Perone Angela
Published: December 2022

Gerontological researchers have long called for more research on diverse older adults, including diverse communities of lesbian/gay/bisexual/trans*/queer+ (LGBTQ+) older adults (e.g., race/ethnicity, economic status, religion). This paper identifies lessons learned from a community-based participatory action research (CBPR) project with LGBTQ+ older adults across four counties. Initiated by LGBTQ+ older adults of color and transgender older adults concerned about access to affordable and culturally responsive housing as they age, researchers worked with a coalition of 8 LGBTQ+ focused organizations to design, implement, and analyze a mostly online survey (n=270). Topics include: Capturing diverse perspectives in survey design (8 focus groups, N=35); addressing external threats to data integrity; implementing multiple types of outreach in phases to expand participant diversity; and working with the coalition and other partners through different stages of survey design, recruitment, data analysis, and identification/enactment of goals for change informed by data, while also navigating a pandemic.
CBPR: AN EFFECTIVE APPROACH TO RECRUIT AND RETAIN MINORITY OLDER REFUGEE ADULTS IN COMMUNITY-BASED RESEARCH
Authors: Shreeniwas Sudha
Published: December 2022

Community based participatory research (CBPR) builds mutually beneficial partnerships between diverse communities and researchers, yielding improved communication among stakeholders, more interest in research participation among community older adults, and improved insights on health disparities. CBPR approaches have great utility for culturally appropriate research design, data collection and analyses, and dissemination with minority underserved communities. We describe outreach, research methods, and community capacity-building from three projects with refugee communities in Greensboro, NC: the Montagnard Hypertension Research Project; The Refugee Older Adults Needs Assessment Project; and the Elder Abuse and Neglect exploratory study. These projects were initiated by community leaders, with technical partnership provided by university researchers and students. We used community-centric methods, and collected a range of data including interviews, photographs, oral histories, surveys, and biological specimens. These efforts have advanced social justice and health equity agendas for both academic and community partners, working to advance health of older adults.
INTERDISCIPLINARY PUBLIC POLICY DISCUSSION SESSION
Authors: Taffet George , Lindberg Brian
Published: December 2022

This interactive session is an interdisciplinary look at policy issues in aging with the speakers representing the four sections of GSA, ESPO, and AGHE. This session, organized by the GSA Public Policy Advisory Panel, will provide both GSA section leadership and attendees an opportunity to have an open dialogue on important public policy issues of significance in the field of aging.
HOW OLD DO YOU FEEL? CONSIDERING THE CONTEXTS, DYNAMICS, AND ASSESSMENT OF SUBJECTIVE AGE
Authors: Kornadt Anna , Bellingtier Jennifer
Published: December 2022

How old people feel is a highly effective predictor of later life health and well-being. Despite a wealth of research, the developmental dynamics of the construct as well as its antecedents and consequences are not well understood. Our symposium brings together research that models dynamic trajectories in subjective age over long- and short periods of time and links it to psychological constructs and objective indicators of health and functioning. First, Weiss and colleagues present longitudinal findings of subjective age trajectories in a lifespan sample that highlight the reciprocal dynamics between subjective age and social contexts. Bellingtier and colleagues link the age people feel on a daily basis to the age people want to feel and find that when people felt closer to the age they desired, their affect was more positive. Rupprecht and colleagues measured subjective age as well as affect, stress and physical activity on 21 consecutive days. Data attest to the relevance of daily experiences for subjective age. In a similar approach, Tingvold and colleagues show the relationship of momentary subjective age with subjective and physiological stress in late-midlife adults’ daily lifes. Finally, Touron and Hughes found that momentary fluctuations in subjective age are associated with current task engagement and enjoyment. Together, the findings show that innovative perspectives and research designs are needed to understand how people respond to the question “How old do you feel” and why it predicts how well they actually age.
I WISH I MAY, I WISH I MIGHT FEEL THE AGE I WISH TONIGHT
Authors: Bellingtier Jennifer , Rupprecht Fiona , Neupert Shevaun , Lang Frieder
Published: December 2022

Subjective age has traditionally been considered by comparing felt age to chronological age, with those who feel younger reporting more adaptive developmental outcomes. Here we consider a new approach: subjective age discordance, which compares felt ages to the ideal ages of participants. Across eight study days, 116 older and 107 younger adults reported their daily felt and ideal ages. On the majority of days, both older and younger adults idealized ages younger than they felt. The opposite pattern, idealized ages older than felt ages, was rare and primarily seen in younger adults. Days when felt ages were less discordant from ideal ages were characterized by higher levels of positive affect than days with greater subjective age discordance. These findings suggest that positive developmental outcomes can occur not only from feeling younger, but through a greater alignment of ideal and felt ages.
THE DYNAMIC NATURE OF SUBJECTIVE AGE ACROSS THE LIFE SPAN
Authors: Weiss David
Published: December 2022

A large body of research has confirmed that from childhood to old age most individuals feel significantly younger or older than their chronological age. Up to now, however, there is no clear theoretical understanding as to why younger adults tend to feel on average older and older adults tend to feel on average younger. We adopt a motivated social-cognition perspective on subjective age and examine age-differential antecedents and correlates of subjective age across the adult life span. Results from a cross-sectional study (N = 1652, 18-84 years) and a 9-month longitudinal study (N = 814; 18-84 years) highlight the dynamic link between subjective age bias and individual (motivation and emotion) as well as social factors (social comparison, meta stereotypes). We discuss the role of reciprocal dynamics between individuals and social contexts in explaining why individuals adopt a younger or older subjective age.
OPIOID USE DISORDER AMONG OLDER ADULTS: ADDRESSING MULTIMORBIDITY AND GERIATRIC CONDITIONS
Authors: Han Benjamin
Published: December 2022

Dr. Han will present multidisciplinary research focused on understanding the healthcare needs of older adults with opioid use disorder. Nationally, there is a sharp increase in older adults with opioid use disorder (OUD) and the number of older adults dying of opioid-related overdoses. This lecture will first describe the prevalence of geriatric conditions and comorbidities among older adults who receive care in opioid treatment programs. Then, Dr. Han will present patterns of acute healthcare utilization among older adults with opioid use disorder. Qualitative data from patient experiences of aging with opioid use disorder and the challenges of managing chronic diseases will then be presented. The lecture will conclude with a discussion about opportunities for developing multidisciplinary models of care to best deliver geriatric-based interventions for this population.
PERCEIVED AND OBJECTIVE EXECUTIVE DYSFUNCTION JOINTLY PREDICT BRAKING REACTION TIME IN OLDER DRIVERS
Authors: Pope Caitlin , Bell Tyler , McManus Benjamin , Stavrinos Despina
Published: December 2022

Motor vehicle crashes are a leading cause of injury and death for older adults in the United States. Braking reaction time (BRT), how quickly a driver responds to the situational demands of driving, is a known predictor of driver fitness and hypothesized as sensitive to difficulties with executive functioning. Unclear is how BRT may vary across different levels of executive functioning, including objective test performance and perceived executive dysfunction, and if awareness of executive dysfunction in the presence of objective difficulties jointly predicts BRT. Using data from a simulated driving study, 50 adults aged 65-94 years old (49.1% female) completed computerized EF tests (inhibition [Stroop], working memory [Automated Operation Span]), the Behavior Rating Inventory of Executive Function, the Big Five Inventory, and a simulated drive. Multilevel modeling analyses controlling for covariates of empirical and design relevance (simulated road segment, age, gender, and neuroticism) were performed. Our results show a significant interaction between perceived executive dysfunction and objective test performance on BRT. Specifically, associations with BRT were stronger for individuals who perceived more executive dysfunction in the presence of worse inhibition (b = 0.79, 95%CI = 0.27, 1.30) and worse working memory (b = 0.94, 95%CI = 0.26, 1.62). Findings provide further justification for the role of executive functioning in monitoring driver fitness in older age. Future directions and implications are discussed.
QUALITY OF LIFE IN ADULTS LIVING WITH COGNITIVE IMPAIRMENT: DEVELOPMENT OF A UNIVERSAL MEASURE
Authors: Anderson Keith , Peters-Beumer Lisa , Westmore Megan , Logsdon Rebecca
Published: December 2022

Quality of life is one of the most important and holistic measures of perceived overall well-being across the lifespan. For older adults living with cognitive impairment, quality of life has been conceptualized as consisting of an array of intertwined domains, such as relationship quality, physical health and ability, and opportunities for roles and activities. A subset of measures have been developed to gauge quality of life in older adults living with cognitive impairment, yet no “gold standard” in measurement has emerged. Quality of Life – Alzheimer’s Disease (QOL-AD) is one of the most commonly used and long-standing measures, yet it was developed in 2002 and has yet to be updated to reflect the evolution of our understanding of quality of life in adults living with cognitive impairment. Drawing from the literature on adults living with intellectual and developmental disabilities (IDD), the researchers identified several domains and items to update and expand the applicability of the QOL-AD measure. The proposed revised measure, Quality of Life – Alzheimer’s Disease/Intellectual and Developmental Disabilities (QOL-AD/IDD), is intended for adults living with cognitive impairment regardless of age or cause of impairment (e.g., dementia, IDD). The QOL-AD/IDD retains the format of the original measure, most notably the useful prompts that accompany each item and the supplemental proxy measure for caregivers. In this presentation, the researchers will discuss the development of the QOL-AD/IDD and ongoing (e.g., Delphi review) and planned steps to evaluate the reliability and validity of this promising measure.
X CHROMOSOME-DERIVED MECHANISMS OF SEX DIFFERENCES IN LIFESPAN AND BRAIN AGING
Authors: Dubal Dena
Published: December 2022

Women live longer than men worldwide – and also show cognitive resilience in many aging populations. One major source of biologic difference between the sexes is that females have two X chromosomes and males have one. This difference in sex chromosome complement causes unique X-derived mechanisms that are sex-specific. In mammalian development, one X randomly inactivates in XX cells. One X-derived sex difference is that females are mosaics with the active X chromosome in each cell being either maternally-derived (Xm) or paternally-derived (Xp), whereas males harbor only a maternally-derived X (Xm) in all cells. Interestingly, some females show considerable or complete skew toward Xm or Xp. We utilized several genetic models of sex biology to understand mechanisms of sex difference in aging. We found that the X chromosome contributes to longevity and better cognition in male and female mice. In aging, a genetic manipulation in females to express only the maternally-derived X (Xm), like males, accelerated cognitive decline and epigenetic brain aging. This suggests that Xm is harmful and that female mosaicism (Xm+Xp) provides a buffer to deleterious processes in aging. To assess if Xm alters transcription, we used mice with nuclear localized genetic reporters and sorted Xm from Xp neurons from young and aging XX hippocampi. We found that Xm imprinted several genes within aging hippocampal neurons, suggesting silenced cognitive loci. Our data suggests that Xm – the maternal X – accelerates brain aging and causes cognitive deficits. Understanding how Xm impairs brain function could increase understanding of female heterogeneity and of sex differences in cognitive heath – and unlock new X-derived pathways against cognitive deficits and brain aging of males, females, or both.
SEXUAL-DIMORPHISM IN HUMAN IMMUNE SYSTEM AGING
Authors: Ucar Duygu , Kuchel George , Banchereau Jacques , Ravichandran Sathyabaarathi , Karakaslar Onur , Diaz Fernando Erra , Marquez Eladio , Marches Radu
Published: December 2022

Differences in immune function and responses contribute to health- and life-span disparities between sexes. However, the role of sex in immune system aging is not well understood. Here, we characterize peripheral blood mononuclear cells from 172 healthy adults 22–93 years of age using ATAC-seq, RNA-seq and flow cytometry. These data reveal a shared epigenomic signature of aging including declining naïve T cells and increasing monocyte and cytotoxic cell functions. These changes are greater in magnitude in men and accompanied by a male-specific decline in B-cell-specific loci. Interestingly, genomic differences between sexes increase after age 65, with men having higher innate and pro-inflammatory activity and lower adaptive activity. In a separate cohort (n=39) we studied how older adults respond to two available pneumococcal vaccines: T-dependent Prevnar and T-independent Pneumovax. How older adults respond to these vaccines at the molecular and cellular level, and whether there are pre-vaccination predictors for vaccine responsiveness, is poorly understood. To address this, we characterized serum antibody responses and peripheral blood leukocyte composition using flow cytometry and transcriptional profiles using RNA-seq, in healthy older adults before and after vaccination. The vaccines induced comparable serological responses and increases in the number of ICOS+ T follicular helper cells. A shared plasmablast transcriptional signature (IGHG2, IGHA1, IGHA2) was induced by both vaccines ten days after vaccination, which is distinct from influenza vaccine responses. Importantly, the pre-vaccination (baseline) ratio of Th1/Th17 cells predicted responsiveness to Prevnar but not to Pneumovax. Interestingly, women had higher levels of Th1/Th17; and responded stronger to Prevnar compared to men. This study uncovered how older adults respond to different pneumococcal vaccines and demonstrated the significance of considering biological sex and the immune cell composition for precision vaccinology.
TOOLS TO SUPPORT NEEDS ASSESSMENTS ON DEMENTIA, COGNITIVE HEALTH, AND CAREGIVING
Authors: Shean John , Sands Talyah , Shah Priya , Donnellan Kelsey
Published: December 2022

Dementia, cognitive health, and caregiving are not always included in community health needs assessments, leading to their absence in public health improvement and strategic plans, and subsequent lack of action and funding to address these needs. In response, the Alzheimer’s Association and the Association of State and Territorial Health Officials published the Needs Assessment Toolkit for Dementia, Cognitive Health, and Caregiving. Designed for state, local, and territorial public health and aging officials, this toolkit helps communities identify unmet needs of older adults, scale up existing community strengths, and promote healthy aging. The toolkit embeds health equity as a cornerstone to assessing community health. It offers approaches to operationalize equity in the assessment process by including wide representation of people from different racial and ethnic backgrounds, geographic locations, and levels of socioeconomic status and educational attainment. The toolkit’s five steps are modular in design and allow jurisdictions to enter the process at any stage. It considers alignment with jurisdiction-wide plans including Alzheimer’s plans, health improvement plans, aging plans, and the Healthy Brain Initiative Road Map, helping public health agencies advance attention to Alzheimer’s through their networks. Developed through an iterative process, expert input from public health and aging practitioners guided the development and organization. Over 1,600 comments were reconciled to ensure usability among stakeholders, elevate equity to an essential component throughout the assessment process, and add value to allied strategic plans. This presentation complements Learn, Plan, Do: Public Health Planning to Address Dementia and Caregiving, abstract ID 1229181.
PEDAGOGY OF AGING: A JOURNEY TOWARD AUTHENTICITY AND WHOLENESS
Authors: Donorfio Laura
Published: December 2022

Innovation in gerontological education has been a driving catalyst since the beginning of my career over 30 years ago. While sometimes seen as a curse, this catalyst has shaped my teaching pedagogy in unimaginable ways. Examples include field trips with 40+ students, developing an aging toolbox for students to make the material more concrete, creating a new interactive television teaching platform over multiple university campuses, developing experiential curriculum and an undergraduate minor in aging, and proudly, developing AGHE’s first teaching institute now in its 11th year. Unexpectedly, at this stage of my career, I have become very aware that my teaching about aging has intersected with my personal aging, shaping my personal pedagogy in profound ways--increased empathy, sensitivity, and social awareness. I am living the subject matter I thought I intimately knew. I am the other. Has my teaching been inauthentic? Hypocritical? Ageist? Please join me for a healthy discussion on how this insight can be leveraged to teach the next generation of aging scholars.
CUMULATIVE (DIS)ADVANTAGE IN COGNITIVE HEALTH: RURAL/URBAN RESIDENCY, HUKOU, AND COGNITIVE AGING IN OLDER CHINESE
Authors: Zhang Yuan , Song Qian , Chen Jen-Hao
Published: December 2022

Urban residency benefits cognition in later life. In China, the household registration system (hukou) creates another place-based advantage/disadvantage for cognitive aging. We exam the interplay of rural/urban residence and hukou across the life-course in creating cumulative advantage/disadvantage in cognitive aging trajectories using longitudinal data from the 2011-2018 China Health and Retirement Longitudinal Study and its Life History Survey. Results from linear mixed effect models show that always urban dwellers with urban hukou exhibited the highest level of cognitive function and the slowest decline, and the always rural dwellers with rural hukou had the worst cognitive function and experienced a faster decline. Rural-to-urban shifts had better cognitive health than always rural dwellers, but the advantages depend on urban hukou attainment and specific mechanisms. This research suggests cumulative advantage/disadvantage in cognitive aging by residence and hukou throughout life and demonstrates that institutional discrimination and exclusionary policy may create inequality in aging processes.
OVERVIEW AND EVIDENCE-BASE FOR PREVENTING LOSS OF INDEPENDENCE THROUGH EXERCISE (PLIÉ)
Authors: Barnes Deborah , Chesney Margaret , Chao Linda , Mehling Wolf
Published: December 2022

PLIÉ was initially developed and tested in the adult day setting. Caregivers reported qualitative improvements in PLWD in psychological, physical, cognitive, and social domains that were supported by class video-recordings. Paired PLIÉ was adapted for the community setting and expanded to include dyads of PLWD and care partners (CPs) who participated in group classes together. PLWD reported significant improvements in self-rated quality of life, and CPs reported psychological, physical, cognitive, and social benefits for PLWD as well as themselves. We then adapted PLIÉ for people with mild cognitive impairment (MCI) and found that it significantly increased default mode network connectivity on resting-state functional MRI scans, while improving quantitative measures of cognitive function, social isolation, physical performance and self-regulation. We also implemented PLIÉ in a VA skilled nursing facility, where a post-implementation evaluation determined that residents, staff and family members all reported psychological, physical, cognitive and social benefits.
MOVING TOGETHER ONLINE FOR PEOPLE LIVING WITH MILD COGNITIVE IMPAIRMENT/DEMENTIA AND CARE PARTNERS
Authors: Nicosia Francesca , Lee Amanda , Chesney Margaret , Lee Jennifer , Benjamin Cynthia , Mehling Wolf , Sudore Rebecca , Barnes Deborah
Published: December 2022

This study used Human Centered Design methods to develop a digital platform tailored for PLWD and test an online version of PLIÉ, called Moving Together. We assessed feasibility and satisfaction of a 12-week online program using completion rates, attendance, and evaluation surveys. 39 people (18 PLWD, 7 MCI, 14 CP) attended 75% classes; 96% rated classes as excellent or good; and 88% were highly likely to recommend Moving Together. Participants reported benefits in social connection (“camaraderie,” “like a family”), emotional well-being (“happier,” “less stressed”), physical function (“stronger,” “more range-of-motion”), cognitive function (“more focus,” “learning new things”), and present-centered body awareness (“more conscious of breathing patterns”). PLWD/MCI experienced improved self-concept (“less immediate shame and more confidence”); and Care Partners reported improved caregiving efficacy (“greater purpose,” “more comfortable”). Online delivery of Moving Together is feasible for people with dementia or mild cognitive impairment and care partners.
DESIGN AND DEVELOPMENT OF MHEALTH FOR DEMENTIA: CURRENT AND FUTURE DIRECTIONS
Authors: Sadarangani Tina , Holden Richard
Published: December 2022

Alzheimer’s disease and related dementias (ADRD) represent an increasingly prevalent group of neurodegenerative chronic diseases for which there is no cure. Progressive functional and cognitive decline in individuals with ADRD places considerable demands on those involved in their care, including clinicians and care partners. Mobile health technology has the potential to support people living with dementia and their care team members, as well as potentially prevent the onset of dementia symptoms. In this symposium we first examine best practices in mhealth application development for dementia care based on applications developed for other chronic illnesses. We then examine mhealth applications being developed in three different NIH-funded studies that address the needs of clinicians, care partners, adult day centers involved in the care of people with dementia, as well as an application for people with mild cognitive impairment. The Aliviado Dementia Care app is a resource that enables clinicians to access best practices for managing behavioral and psychological symptoms of dementia at the point of service. CareMOBI streamlines communication between care partners, adult day centers, and primary care providers, allowing care team members to track and exchange information relevant to dementia care and identify emerging clinical problems. Finally, Spanish-language information and culturally relevant motivational messages to promote physical activity and delay progression to ADRD among those with mild cognitive impairment within the Tiempos Juntos intervention are presented. Our discussion summarizes the current and future direction of mhealth application development in ADRD, and key learnings from presenters’ work.
CAREMOBI: AN APP CONNECTING CAREGIVERS, ADULT DAY CENTERS, AND HEALTHCARE PROVIDERS CARING FOR PEOPLE WITH DEMENTIA
Authors: Sadarangani Tina , Boafo Jonelle , Zhong Jie
Published: December 2022

Fragmented communication between care partners, health care providers, and adult day centers around the needs of persons living with dementia (PLWD) contributes to avoidable health care utilization. CareMOBI, is a user-centered mobile application that streamlines information exchange around datapoints relevant to the care of PLWD. CareMOBI facilitates team-based communication around emerging clinical problems by uniquely integrating the knowledge and day-to-day observations of adult day center staff and care partners. We present a stakeholder engaged approach to iteratively designing and validating an initial prototype. Through interviews and focus groups with adult day center staff (n=31), primary care providers (n=22), and family caregivers (n=13) we identified barriers to communication across settings. We then visually mapped the domains of a future app which we subsequently validated and refined with end-users (n=25). We present our current prototype which synthesizes these findings and addresses key barriers to information exchange across community settings serving PLWD.