bluuebunny/crossref_metadata_2025 huggingface dataset:
LONELINESS, MARITAL STATUS, AND COGNITIVE IMPAIRMENT AMONG OLDER AMERICANS
Authors: Lam Jack , Bardo Anthony R , Yamashita Takashi
Published: November 2019

Loneliness has been linked to increased risk of mortality and morbidity, and emergent research has identified a negative association between loneliness and cognitive functioning. While the determinants of loneliness are wide in scope, loneliness is closely tied to marital status in later life. At the same time, research has shown that those who are married have lower risk of cognitive impairment. The aim of this study was to determine the association between loneliness and cognitive impairment, and examine whether it is moderated by marital status. Data come from 9 waves of the RAND version of the HRS (1998 - 2014). Consistent with previous research, results from random effects logit models showed that loneliness is associated with greater risk of cognitive impairment [Odds-ratio (OR) = 1.41, p < 0.01]. Additionally, those who are widowed (OR = 1.29, p < 0.01), separated/divorced (OR = 1.33, p < 0.01), or never married (OR = 1.70, p < 0.01) are also more likely to have a cognitive impairment, compared to those who are married. However, the association between loneliness and cognitive function was found to only differ among those who are widowed. Contrary to expectations, widows who report feeling lonely are 29% (p < 0.01) less likely to have a cognitive impairment. In sum, while loneliness and marital status are closely linked with one another, they are both independent determinants of cognitive impairment. The distinct theoretical mechanisms linking loneliness and marital status to cognitive function in later life are discussed.
DEVELOPING DEMENTIA-SPECIFIC PROVIDER TRAINING IN MENTAL HEALTH: WHAT IS THE TARGET?
Authors: Wyman Mary F , Voils Corrine I , Trivedi Ranak B , Gleason Carey E
Published: November 2019

Most persons with dementia (PwD) live in the community and receive mental health care in the outpatient setting, making these providers an important target for education to improve dementia care. To inform the development of training curricula, we surveyed 65 mental health providers in a Veterans Affairs outpatient clinic on perceived barriers and training needs related to service delivery to PwD and caregivers. We used an adapted version of the Sense of Competence in Dementia Care Staff scale to assess domain-specific competencies. Respondents rated this work as highly important and wanted dementia-related training. They reported low competency in person-centered care approaches and challenging clinical situations, e.g., managing risk of harm. System-level barriers affecting services for PwD were noted. Findings suggest that outpatient mental health professionals are an underutilized resource in dementia care. This work can inform the development of provider training and identification of system-level barriers in this setting.
THE RELATIONSHIP BETWEEN STAFFING AND QUALITY FOR CARE HOME RESIDENTS: A REALIST REVIEW
Authors: Spilsbury Karen , Haunch Kirsty
Published: November 2019

In recent years, quality of care in the sector has come under increasing scrutiny, and practice and policy concerns have been raised about staffing levels, recruitment and retention. Beyond broad recognition that ‘staff influence quality’, little is known about the care home workforce and its relationship to quality. We are undertaking the first study in the UK to address this important question, considering quality from a range of perspectives. One work package comprises a realist review to develop theoretical explanations of how, why and in what circumstances staffing promotes quality for residents and relatives. We will present three mechanisms that promote quality - individual commitment to resident focused care, reciprocity in the team, and a mandate to be creative and flexible to meet residents’ needs. We will consider the contexts required to trigger these mechanisms – staffing numbers, stability of the team, size of the team, and clear leadership.
A NEW INSTRUMENT TO DETERMINE ADEQUATE STAFFING RATIOS IN GERMAN NURSING HOMES
Authors: Wolf-Ostermann Karin , Rothgang Heinz , Darmann-Fink Ingrid , Kalwitzki Thomas , Fünfstück Mathias
Published: November 2019

Ever since mandatory long-term care insurance was introduced in Germany there has been concern about staffing of nursing homes. As attempts to introduce the Canadian PLAISIR system failed today staffing ratios between federal states differ by more than 20 % and perceived understaffing is a major reason for the lack of nurses. Against this background the reform act from December 2015 commissioned the development of a new instrument to identify necessary staffing ratios. The University of Bremen was mandated to develop this instrument, and will present the final product in August 2019 to the Commissioner. The contribution will describe the methods applied in developing the instrument and the resulting instrument itself which translates the number and characteristics of any given nursing home into staffing requirements according to certain degrees of qualification, thus replacing general quotas of registered nurses to auxiliary staff by individual ratios for each nursing home.
CAREGIVING AND PREPARATION FOR RETIREMENT
Authors: Porterfield Shirley L , Kwon Eunsun
Published: November 2019

Saving for retirement should begin with the first job, but preparation with respect to determining a specific retirement age and plans for post-retirement life, generally occurs closer to the retirement date. However, among those who provide care for family or close friends who are elderly and/or have disabilities, retirement preparation may take a back seat to more pressing current concerns. While we know quite a lot about patterns of saving for retirement and the factors that influence those patterns, we know little about retirement expectations and patterns of thinking about and planning for the broader retirement experience, particularly among caregivers. This paper uses data from the 2008-2016 rounds of the nationally-representative 1979 National Longitudinal Survey of Youth to examine retirement expectations and five areas of retirement preparation (reading, using a computer app, consulting a financial planner, calculating income, or attending meetings) among employed adults (ages 51-59 in 2016) who are or are not providing care for someone in or out of their household. Longitudinal analysis finds significantly lower retirement preparation among adults caring for someone inside versus outside the household, as well as significantly lower preparation activities among female versus male caregivers. Caregiving influences employment and, in turn, the types of retirement accounts held by men and women. Although caregiving is associated with decreased retirement savings among both men and women who have pension accounts, retirement preparation activities in 2008 and 2012 are associated with higher retirement savings in 2016.
LONG-TERM POVERTY, SPATIAL DISADVANTAGE, AND MULTIPLE EXCLUSIONS IN LATER LIFE: A CASE IN SHANGHAI
Authors: Tong Hongmei , Lai Daniel, W L , Li Lun
Published: November 2019

Objectives: This study aimed to examine the associations among three types of cumulative disadvantages: long term poverty, spatial disadvantage, and multiple exclusions using a Cumulative dis/advantage (CDA) and life course perspective. Method: A sample of 419 Chinese adults aged 60 and older from three communities in Shanghai completed a structured questionnaire. Multiple exclusions were measured by variables related to material resources, housing conditions, social relations, civic activities, basic services, and neighbourhood factors. Hierarchical regression was implemented by SPSS 25 and moderation analysis was performed with the SPSS macro PROCESS from Hayes (2013). Results: 39% of respondents reported that they experienced multiple exclusions and one in five respondents report often or most time living in poverty. Regression analysis indicated that experience long-term poverty and length of living in the same neighbourhood is positively associated with multiple exclusions in later life and these associations are not attenuated by demographics, and health factors. But, moderation analysis showed the length of living in the same neighbourhood has significant moderating effect on the relationship between long term poverty and multiple exclusions, particularly for older adults living in the same neighbourhood for more than 30 years. Discussion: The study findings illustrate the need to consider not only life course risks such as long-term poverty but also spatial disadvantages in addressing multiple social exclusions among older Chinese adults.
THE ROLE OF SECURED AND UNSECURED DEBT IN RETIREMENT PLANNING AMONG PRE-RETIREES
Authors: Chen Zibei , Zurlo Karen
Published: November 2019

The retirement landscape is transformed by the shifting of risk and responsibility to individuals, who are increasingly responsible for their retirement security. Many factors lead to indebted and overleveraged American households. Specifically, nearly 40% of Americans approaching retirement are heavily indebted. Understanding the role of secured and unsecured debt in retirement planning becomes an urgent concern because debt is highly related to well-being in retirement among a growing number of older Americans. We focus on pre-retirees because these individuals have time to earn an income and plan ahead before they commit to a fully retired lifestyle. Utilizing data from the 2015 National Financial Capability Study, we identified the secured and unsecured debt that influences retirement planning among a national sample of pre-retirees, aged 51 to 61 years. Regression and mediation analyses were used to examine the relationship between debt and retirement planning and to identify the mediating effect of having a retirement account on the relationship between unsecured and secured debt and retirement planning. Our results indicated that mortgage debt and credit card debt were negatively associated with retirement planning. Having a retirement account is positively associated with retirement planning and it also mediates the relationship between credit card debt, specifically, and retirement planning. In conclusion, we urge individuals and financial planning executives to take time during the pre-retirement years to assess various forms of debt and determine how it is affecting their retirement planning objectives. And policy-makers should address the challenges faced by indebted pre-retirees.
THE SOCIAL CONSTRUCTION OF RETIREMENT AND GENDER DIFFERENCES IN RETIREMENT TIMING
Authors: Silver Michelle
Published: November 2019

Retirement is an ever-evolving, dynamic, and complex social construct we associate with the end of one’s career. For some the term is a bad word and a term that needs to be retired, while others can’t wait to retire and enjoy the good life. This paper examines a brief history of retirement and theoretical work from feminist gerontology, while focusing on gender differences in the social construction of retirement and policy implications of 10 different government pension plans. In doing so, it looks at policy implications associated with the standard retirement age tied to public pension plans in the United States, Canada, and the European Union. Findings indicate that women live longer than men in each country, yet women retire earlier and receive lower pensions than men. As the landscape surrounding women’s work experiences changes and concerns about gender equity in salaries and workplace compensation continue to be raised, this paper extends the concerns to raise important questions about inequities in retirement.
ELDER FINANCIAL ABUSE IN FAMILIES: EXPANDING THEORY AND RESEARCH
Authors: Bolkan Cory , Stum Marlene , Teaster Pamela B
Published: November 2019

Elder family financial exploitation (EFFE) is widespread and increasing. The effect is devastating, causing significant financial losses, reducing health and well-being of elders, and disrupting family systems. Research reveals that most (90%) perpetrators are family members or trusted others and researchers typically focus on identification of the problem, rather than understanding how and why exploitation occurs within the family unit. Furthermore, limited consensus exists regarding a theoretical understanding of the complexities of EFFE. Theory-driven, empirical explanations of how and why EFFE transpires are urgently needed to enhance and deepen intervention and prevention efforts. In this symposium, we extend both theory and research by using a common theoretical lens to present research findings from three distinct EFFE studies. The first paper reviews the current literature on EFFE and theory and introduces Bronfennbrenner’s bioecological Process-Person-Context-Time (PPCT) model as an under-utilized, but useful framework for understanding EFFE. The second paper reports on findings from in-depth interviews with non-perpetrator family members who experienced EFFE and will highlight complex intergenerational family systems processes in PPCT. The third paper highlights findings from a national study of substantiated and investigated cases of EFFE in which family member perpetrators were designated as surrogate decision makers. The fourth paper shares results from a qualitative study of family member POAs and how components of the PPCT model can be interpreted for use by helping professionals assisting families. We will also focus on the opportunities and challenges of developing theoretically sound EFFE research and the implications for improving practice and policy.
EXAMINING THE NATURE AND ROLE OF FAMILY SYSTEM INTERACTIONS AND ELDER FAMILY FINANCIAL EXPLOITATION
Authors: Stum Marlene
Published: November 2019

Guided by Bronfenbrenner’s Bioecological Theory, this paper contributes insight into family processes associated with elder family financial exploitation (EFFE). Processes involve “everyday” reciprocal interactions in the family microsystem between and among elder victims, perpetrator family members (i.e. adult children), and involved non-perpetrator family members (i.e. adult children, in-laws). Qualitative data from a purposeful sample of 28 non-perpetrator/non-victim family members who had experienced EFFE were thematically coded and analyzed. The findings suggest eight intergenerational family processes are relevant for understanding EFFE: a) parent/child resource exchange patterns, b) negotiating a “fair” use of resources, c) quality of parent/child and sibling relationships, d) family of origin functioning and dynamics (e.g. trust, respect, closeness), e) communication patterns, f) alliances and taking sides, g) role negotiation, and h) physical interactions. Consistent definitions and quality measures relevant for parent/adult child relationships over the life course and in later life developmental stages are needed next steps.
PERSON-CENTERED CARE RELATED TO RESOURCE USE, RESIDENT QUALITY OF LIFE, AND STAFF JOB STRAIN IN SWEDISH NURSING HOMES
Authors: Backman Annica , Sköldunger Anders
Published: November 2019

A critical challenge facing aged care systems throughout the world is to meet the complex care needs of a growing population of older persons. Although person-centred care has been advocated as the “gold standard” and a key component of high quality of care, the significance of care utilization in person-centred units as well as the impact of person-centred care on resident quality of life and staff job strain in nursing home care is yet to be explored. Thus, the aim was to explore person-centred care and its association to resource use, resident quality of life and staff job strain. The study is based on a cross-sectional national survey and data on 4831 residents and 3605 staff were collected by staff in 2014, deriving from nursing homes in 35 Swedish municipalities. In this study, descriptive statistics and regression modelling were used to explore this association. The preliminary results showed that person-centred care was positively associated to resource use (i.e care hours) and resident quality of life in Swedish nursing homes, when controlling for resident age, gender and cognitive status. Person-centred care was negatively associated to staff perception of job strain. This indicates that person-centred care provision seem to increase resource use (i.e. slightly more care hours utilized) but also beneficially impact resident quality of life as well as alleviate care burden in terms job strain among staff.
ELDER FAMILY FINANCIAL EXPLOITATION BY POWER-OF-ATTORNEY AGENTS THROUGH THE LENS OF BRONFENBRENNER’S PPCT MODEL
Authors: Vincenti Virginia B , Chapman Ashton
Published: November 2019

This paper presents a subset of qualitative data from a phenomenological study of 3 men and 17 women (N=20) from families with designated power of attorney (POA) agents who allegedly perpetrated elder family financial exploitation (EFFE). Participants were aged 22 to 63 (M = 43.5) with varying educational and income levels. The study explored EFFE by POA within Bronfenbrenner’s PPCT model. Data were analyzed using a thematic, inductive approach. Person characteristics (e.g. perpetrators’ personality and victims’ cognitive functioning), proximal processes (e.g. family patterns of communication and resource sharing), context (e.g. geographic location), and time (e.g. prevailing legal, economic, and cohort factors) emerged as relevant for EFFE experiences. Given that EFFE helping professionals (e.g., attorneys, practitioners) often lack training in family- or systems-focused dynamics and interventions, implications and applications of the PPCT model will be discussed with the goal of raising awareness of factors related to EFFE identification and prevention.
EXAMINING THE DETERMINANTS AND OUTCOMES OF SUBJECTIVE AGING
Authors: Brothers Allyson F , Sabatini Serena , Neupert Shevaun D
Published: November 2019

Given a growing body of evidence for the developmental relevance of the perceived experience of aging and for the presence of interindividual variability in the way people experience aging, this symposium examines the determinants and outcomes of various subjective aging constructs. This session will explore the role of various psychological variables in explaining variability in subjective aging experiences. Consequences of various subjective aging concepts on cognitive functioning, emotional and physical well-being will also be discussed. The first two presentations examine Attitudes Toward Own Aging (ATOA). Kornadt, Siebert and Wahl will address the developmental co-dynamics of personality and ATOA across the second half of life. Siebert and Wahl will examine the associations of ATOA with subjective and objective cognitive functioning. The last two presentations focus on awareness of age-related change (AARC). Sabatini, Silarova, Collins, Martyr, Ballard, Anstey, Kim & Clare will present findings from a systematic-review and meta-analysis synthesizing and quantifying associations of awareness of age-related change (AARC) with emotional and physical well-being and cognitive functioning. Finally, Rothermund and de Paula Couto will show how both the experience of positive and/or negative changes (gains and losses) and the presence of positive and/or negative age stereotypes predict individual’s attributions of change to age. This last presentation will also examine how together the presence of change and attribution of change to age predict developmental outcomes. The symposium will conclude with summarizing remarks from the discussant who suggests possible directions for future research on determinants and outcomes of perceived experience of aging.
META-ANALYSIS OF AARC AND EMOTIONAL AND PHYSICAL WELL-BEING
Authors: Sabatini Serena , Silarova Barbora , Martyr Anthony , Collins Rachel , Ballard Clive , Anstey Kaarin J , Kim Sarang , Clare Linda
Published: November 2019

Associations of awareness of age-related change (AARC) with emotional and physical well-being and cognitive functioning were synthesised in a systematic review with a correlational random-effects meta-analysis. Twelve studies were included in the review, nine exploring the association between AARC and emotional well-being and eleven exploring the association between AARC and physical well-being. No study explored the association between AARC and cognition. There is evidence of weak associations between higher level of AARC gains and better emotional well-being and between higher level of AARC losses and both poorer emotional well-being and poorer physical well-being. There was no association between AARC gains and physical well-being. There is some indication that AARC gains and losses can play a role in emotional well-being and that AARC losses are associated with physical well-being but these associations are weak. Due to the limited number of studies and their high heterogeneity, interpretation of these results remains unclear.
PUBLIC HEALTH AND SOCIAL SERVICES SYSTEM: THE DISENCHANTMENT OF ISOLATED SENIOR CAREGIVERS
Authors: Couture Melanie , Orzeck Pam , Petropoulos Apostolia
Published: November 2019

Social isolation is one of the negative consequences associated with caregiving and is experienced by approximately 20% of Canadian family caregivers. Being in a public health and social services system, Canadian caregivers should normally turn to their local community service centres (CLSC) to access formal services and feel less isolated. However, studies have shown that satisfaction is low regarding accessibility and continuity of formal support services. In an effort to develop interventions that meet the needs of isolated senior caregivers, the purpose of this exploratory descriptive qualitative study was to identify challenges encountered in accessing and utilizing formal supports within the public health and social services system in Canada. Nineteen isolated senior caregivers participated in seven focus groups. Data analysis was performed using the Miles, Huberman, and Saldana (2014) approach. Results showed that isolated caregivers do not know where to get information about existing services within the formal system. Once services are found, waiting lists are linked to unbearable delays. Some caregivers are actually redirected to private services, if they can afford it. Isolated caregivers also criticize the unpredictability of the system as they face relentless changes of care providers, inadequate services and sometimes unwarranted cancellations or terminations. In addition, they find formal services lacking human sensitivity. Many of them come to the conclusion that formal services are not worthwhile and exclude themselves from the formal system. This research demonstrated that the health and social services system can actually contribute to the social isolation of senior caregivers longing for support.
DETERMINANTS OF LEISURE-TIME PHYSICAL ACTIVITY IN OLDER, RURAL CANCER SURVIVORS IN CENTRAL PENNSYLVANIA
Authors: Mama Scherezade K , Bhuiyan Nishat , Lengerich Eugene , Schmitz Kathryn
Published: November 2019

This study explored social and environmental determinants of leisure-time physical activity (LTPA) in cancer survivors (CS) residing in Central Pennsylvania, a largely rural region. Rural CS completed questionnaires assessing LTPA, social support (SS) for LTPA, home and neighborhood environments for LTPA. Logistic regression models were used to assess associations with being active/inactive. Participants (n=219) were categorized as mature survivors (<75 years, 80.7%) or elderly survivors (>=75 years, 19.3%). Only 28.2% of elderly survivors reported meeting LTPA guidelines compared to 45.6% of mature survivors. Survivors reporting SS for LTPA were 10% more likely to active than those who did not have SS (OR=1.1, CI 1-1.1). Mature survivors that reported environmental support (home: OR=1.2: CI 1-1.3; neighborhood: OR=1.8, CI: 1-3.2) were more likely to be active than those without strong environmental support. Creating more supportive environments to foster LTPA in elderly survivors in rural areas is a key priority for future research.
VETERAN MORTALITY DISADVANTAGE AMONG RURAL, SUBURBAN, AND URBAN RESIDENTS
Authors: Wilmoth Janet M , Landes Scott D , London Andrew S
Published: November 2019

Although veterans tend to have higher mortality rates than non-veterans, recent research suggests there is substantial heterogeneity in veteran mortality on the basis of various characteristics such as race, period of service, type of health insurance coverage, and service-connected disability status. This analysis extends the extant literature by using the 1978-2014 General Social Survey linked to the National Death Index (GSS-NDI) to examine veteran status differences in mortality by geographic location. We estimate a series of Cox regression models predicting death for male veterans and nonveterans, controlling for age, race/ethnicity, education, income, and work status. Separate models are presented for rural, suburban, and urban residents. All models are weighted and include robust standard errors. The results indicate that rural veterans have higher mortality risk than rural non-veterans, particularly among older adults. There are no significant differences in mortality risk between veteran and non-veterans living in suburban and urban areas.
THE GRAYING OF PRIMARY CARE: THE ROLE OF PSYCHOLOGY IN GERIATRIC PRIMARY CARE
Authors: Kube Erin , Harris Grant , Hicken Bret
Published: November 2019

As of 2012, more than half of Veterans receiving care within a VA medical facility were age 65 or older. They have complex co-occurring medical and mental health needs, cognitive impairments, functional deficits, and psychosocial complexity. In 2015, GeriPACT emerged as a specialized geriatric primary care clinic model to serve this vulnerable population. The presence of psychologists in geriatrics has significant implications for treatment of cognitive, behavioral, and psychosocial needs. This mixed methods project aimed to describe the current scope and functions of GeriPACT psychologists and differentiate their services from other PACT clinics. Twenty total GeriPACT psychologists participated. The results suggest that mental health services within GeriPACT are multifaceted and need-driven. Significant themes highlight role specific characteristics of psychologists, clinician backgrounds, team education, and referral processes to improve access to care. Recommendations for implementation, clinician training, and future policy planning will also be presented.
DEVELOPMENT AND TESTING OF A MOBILE APPLICATION INTEGRATING PHYSICAL ACTIVITY AND COGNITIVE TRAINING
Authors: Smith Lenora
Published: November 2019

Dementia is progressive, which causes a debility in activities of daily living, leading to bedridden and uncommunicative individuals. Evidence has shown that physical activity may protect the brain from memory impairment. Based on a previous study we conducted using consumer-based applications with people with mild cognitive impairment, we developed a mobile application called the mPACT app (mobile physical activity and cognitive training). The System Usability Scale and Usability Test Observation Coding Form were used to capture usability and verbal/nonverbal behaviors respectfully of 5 participants. Results noted an above average score for usability, with a mean score of 72.5. Observations noted that almost all participants were smiling and enjoying most of the games within the app; some had difficulty with a couple of the games. Overall, there was a positive response to the mPACT app, revisions have been made, and next steps include another beta test with people with MCI.
A VIRTUAL SUPPORT GROUP FOR PERSONS LIVING ALONE WITH ALZHEIMER’S DISEASE
Authors: Gibson Allison
Published: November 2019

To date, early stage programming for the persons with the disease has been limited. The purpose of this study was to explore the challenges and opportunities of a virtual support group intervention for persons living alone with Alzheimer’s disease (AD). Following recruitment, participants who were newly diagnosed (within 2 years of diagnosis) and residing alone in their own residence were included in a pilot study of a virtual support group intervention for a 3-month period. Data were collected before and after the intervention through the use of surveys and one-on-one interviews with all 12 participants (n=12). Data were analyzed using a mixed methods approach including thematic analysis. Results indicated that the virtual support group intervention increased group members’ education of the disease, knowledge regarding care planning, feelings of empowerment towards the diagnosis of the disease, and increased feelings of social support. Implications for such interventions will also be discussed.
VOICE FIRST TECHNOLOGY: SIMPLIFYING LIFE FOR COMMUNITY-DWELLING OLDER ADULTS LIVING WITH DEMENTIA
Authors: Sheets Debra J , Malone Marilyn , MacDonald Stuart W , Asche Carl , Smith Andre
Published: November 2019

Voice first technology offers older adults with dementia support that may maintain independence, reduce social isolation and improve quality of life (QoL). This study investigates the impact of a voice-controlled technology customized to the needs of participants living with dementia and their caregivers. A mixed methods design focused on psychosocial factors and usability characteristics. The purposive sample consisted of older adults with dementia (n=12) and their care partners (n=12)) living independently in the community. Validated measures for cognition, depression, caregiver burden, quality of life and usability were included. Qualitative in-home interviews were conducted to assess impact on social connections and independence. Results indicate that voice first technology can reduce caregiver burden and can support the independence and QoL of older adults with dementia. The discussion considers the value of low cost voice first technology as a way to support older adults with dementia and their caregivers.
DETECTING STRESS INCIDENCE WITH WRISTBAND SENSOR-BASED DEVICE: A WAY TO SUPPORT CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Leung Angela YM
Published: November 2019

This experimental study aimed to investigate the sensitivity of detecting stress level with a wearable device. A total of 10 caregivers underwent a psychological stress test with a wearable sensor-based device that measured skin conductivity (Electrodermal Activity, EDA) and heart rate variability (Interbeat Interval, IBI). Two sample t-tests were used to compare the mean scores of EDA and IBI at baseline and during stress. The accuracy for classifying stress test epochs was 70%. There was a significant increase in EDA at the time when the participants were under stress [mean score (SD) at baseline vs at stress: 0.089 (SD 0.150) vs 0.427 (SD 0.430), p <0.001]. However, insignificant changes in IBI were observed. In conclusion, this wearable sensor-based device was able to recognize stress incidence and accurately capture physiological changes. It has a potential to be part of the sensor-based stress monitoring and alleviating system (SbSMA).
INTEREST GROUP SESSION—DISASTERS AND OLDER ADULTS: HARNESSING THE POWER OF SOCIAL NETWORKS DURING DISASTERS TO FACILITATE PREPARATION AND RECOVERY
Authors: Phillips Judith Robertson R , Cherry Katie E
Published: November 2019

With the increasing occurrences of disasters throughout the world, researchers, communities, and organizations have become interested in how the use of social networks during and after a disaster can ease the psychological recovery of older adults who are affected by traumatic disaster events such as hurricanes and wildfires. This symposium will focus on the power of social networks and highlight the importance of preparedness, informal and formal groups, and interventions to assist recovery of older adults. First, Dr. Judith Phillips will present data on how informal and formal social network groups affected the psychological well-being of older adults who experienced exposure to multiple wildfires. Second, Dr. Denise Eldemire-Shearer will address how both formal and informal social network groups in Jamaica are informed and mobilized to provide support to older adults on the island during hurricanes and other water-related disasters. Third, Dr. Lisa Brown will introduce the Skills for Psychological Recovery intervention and provide an overview and modifications needed when using with older adults; she will also demonstrate an exercise. Fourth, Dr. Debra Dobbs will present themes examining the role of community engagement in hurricane preparedness which were gathered from focus groups and interviews with assisted living administrators in Florida. Lastly, Dr. Mary Helen McSweeney-Feld will address how voluntary organizations active during disasters aid older adults with disaster relief efforts. Together these presenters will provide evidence of the power of various social networks that will lessen the vulnerability of older adults after disasters.
IMPACT OF INFORMAL AND FORMAL SOCIAL NETWORKS DURING A WILDFIRE ON PSYCHOLOGICAL RECOVERY
Authors: Phillips Judith Robertson R
Published: November 2019

Having the support of a social network can play an important role towards psychological well-being for those impacted by a disaster. The purpose of this study was to investigate how type (emotional, tangible, informational) and source (family, friends, others) of social support during three Southern California wildfires impacted the psychological well-being of three victim-groups (based on severity of exposure) of community-residing adults (N= 203; meanage = 63.4 years; range 50-94 years) who responded to surveys about their experiences during the 2007, 2014, and 2017 northern San Diego County, CA wildfires. Analyses revealed that emotional social support from friends and neighbors was the most frequently received type and source of support, especially for the primary victim-group, those with residential loss. All victim-groups exhibited healthy psychological well-being. Discussion will focus on how informal groups differed and were similar to formal groups in providing social support during a disaster to encourage psychological recovery.
PERSPECTIVE FROM A CARIBBEAN ISLAND, JAMAICA
Authors: Eldemire-Shearer Denise , Donaldson-Davis Kayon M , Davis Julian McKoy , Willie-Tyndale Douladel M
Published: November 2019

Jamaica is prone to hurricanes and associated flooding. The older adult population is vulnerable given the increasing ageing population (12% over age 60), high rate of disability (20% - 30%) low literacy levels, increased feminization, and high numbers of old-old. This paper describes strategies employed in disaster management with a special focus on older persons as a vulnerable group. The significant contribution of social networks to disaster mitigation will also be discussed. Age-friendly strategies include older person representation on local disaster committees; mainstreaming the needs of older persons in community disaster plans; training of disaster workers on ageing and the special needs of older persons; maintaining community lists of frail, single and house-bound older persons. Social networks especially faith-based organisations are integral in disaster preparedness and recovery activities.
SKILLS FOR PSYCHOLOGICAL RECOVERY DURING AND AFTER DISASTERS TO STRENGTHEN SOCIAL SUPPORT
Authors: Brown Lisa M
Published: November 2019

The combination of an aging population and a limited number of disaster responders reveals a need for trained laypeople who can implement interventions that facilitate recovery after traumatic events. Skills for Psychological Recovery (SPR) is an intervention that is designed to be implemented after use of Psychological First Aid with people who were exposed to a traumatic stressor. SPR uses a skills-building approach to promote self-efficacy, support resilience, strengthen social networks, and ameliorate the negative impact of traumatic life events. Strengthening social support is beneficial as research clearly demonstrates that destruction of communities and loss of informal social support networks produces long-term psychological distress for older adults. This presentation will demonstrate a SPR social support exercise with attendees, provide an overview of the other modules, and describe modifications for using SPR with older adults. During times of crisis, social support systems are critical to the psychological well-being of older adults.
VOADS AND OLDER ADULTS IN DISASTERS
Authors: mcsweeney-feld Mary H
Published: November 2019

Voluntary Organizations Active in Disasters (VOADs) are a key mechanism for sharing knowledge and resources throughout a disaster cycle. VOADs work as a coalition of not-for-profit organizations that can respond to disasters on a local level in a coordinated response. Given the changes in FEMA’s Strategic Plan for 2018-2022, the role of VOADs will become more important over time. It is unclear whether the needs of older adults in disasters will be addressed by VOAD coalitions. Organizations such as public health departments and emergency management services are typically involved in the activities of VOAD organizations, but it is unclear whether organizations serving older adults know about VOAD coalitions or have considered becoming members of these organizations. A case study of the state of Maryland’s VOAD coalition will be used as an example of how one state VOAD is able to provide services and supports for older adults in disasters.
NUTRITION ASSESSMENT PROTOCOLS IN COMMUNITY-DWELLING OLDER ADULTS WITH CHRONIC WOUNDS
Authors: DiMaria-Ghalili Rose Ann , Charbonneau Sarah , Bynum Keyanna , Neidrauer Michael , Weingarten Michael S , Lewin Peter A
Published: November 2019

Older adults are at risk for altered nutritional status and functional impairment due to physiological (e.g., age-related changes, acute and chronic co-morbid conditions) and psychosocial factors (e.g., depression, loneliness, cognitive impairment). Those with alterations in nutritional and/or functional status are at risk for poor health outcomes-including delayed healing of chronic wounds. We will discuss our lessons learned when devising nutrition assessment protocols from our ongoing double-blind randomized control clinical trial testing the effectiveness of ultrasound treatment on healing chronic leg wounds. The discussion will focus on the following measures: the Mini-Nutritional Assessment, hand-grip strength assessment, and inflammatory biomarkers.
IMPLEMENTING THE MEDICARE ANNUAL WELLNESS VISIT: A GWEP COLLABORATION
Authors: Flaherty Ellen , Tumosa Nina
Published: November 2019

The Geriatric Interprofessional Team Transformation in Primary Care (GITT-PC) model improves delivery of healthcare to older adults in primary care by training healthcare professionals in team functioning, rapid cycle QI, and evidence based geriatric practice. The program capitalizes on the role of nursing and other healthcare disciplines. To maximize sustainability, it focuses on Medicare-reimbursable visits. This program will focus on the implementation of the Annual Wellness Visit (AWV) through a collaboration between Dartmouth and 3 GWEPs: University of Florida, University of Louisville and the University of Wyoming. The model’s standardized approach to implementation begins with practice assessments and two trainings. The first training focuses on team functioning & rapid cycle QI and the second is a deep dive training focused on the implementation of the AWV. After the training, practices participate in a data-driven, virtual learning collaborative with monthly data collection and learning sessions. Since 2015, the AWV, through the GITT-PC model has been implemented in 14 sites in northern New England, 10 sites in upstate New York, and nationally through five other GWEP awardees across the country.
A GWEP COLLABORATION: IMPLEMENTING THE AWV IN A RURAL PRIMARY CARE CLINIC
Authors: McKibbin Christine
Published: November 2019

This presentation will focus on the collaboration with the Dartmouth GWEP to implement the AWV in a rural primary care clinic. The challenges of practice transformation in busy primary care clinics will be discussed along with lessons learned on a successful GWEP partnership to achieve improved patient outcomes in primary care.
A TEAM APPROACH TO THE IMPLEMENTATION OF THE ANNUAL WELLNESS VISIT
Authors: Guerra Lucy
Published: November 2019

The success of any practice change initiative is dependent upon a highly effective team. This presentation will focus on the “secret sauce” of our implementation of the AWV in collaboration with the Dartmouth GWEP. Participating in both asynchronous and live virtual training enabled our team to come together to successfully implement the AWV using a team based model. Using the principles of highly effective teaming and a rapid cycle QI approach we have been able to improve patient outcomes in primary care.
A UNIQUE APPROACH TO INTERPROFESSIONAL TRAINING USING THE ANNUAL WELLNESS VISIT HEALTH RISK ASSESSMENT
Authors: Faul Anna
Published: November 2019

The Kentucky (KY) Rural & Underserved Geriatric Interprofessional Education Program (KRUGIEP) participated in a unique innovative approach to the implementation of the Medicare Annual Wellness visit in collaboration with the Dartmouth GWEP. The model focused on the integration of students into the process of conducting the Health Risk Assessment through community based home visits. This talk will focus on this unique program and the participation in a multi-GWEP learning collaborative.
OLDER ADULT WOMEN’S MULTIDIMENSIONAL RESPONSIBILITIES IN SKIPPED GENERATION HOUSEHOLDS IN NIGERIA
Authors: Afolabi Mojirayo
Published: November 2019

This contribution studies the roles of grandparents in caring for grandchildren in skipped generation households, from gender perspective. Historical studies often focus on health and economic status of older adults generally, without distinguishing older adult women whose responsibilities are often undervalued. Such assessments assume that both grandparents engage in caring for grandchildren, being the joy of old age. Highlighting women’s roles will ensure proper design and implementation of policies to enhance improvement in overall well-being of skipped generation households in Nigeria. The economic value of this is high. Using detailed data from three major states in Nigeria, - Imo, Lagos and Kano (representing each of the major ethnic groups) this study provides a detailed picture of the areas of women’s responsibilities in skipped generation households, using both quantitative and qualitative methodologies. The quantitative study employed structured questionnaire to collect primary data while the qualitative technique employed the use of in-depth interviews and focus group discussions. The older adult participants are grouped into three; less than sixty five years, between sixty five and eighty and those above eighty years of age. The study reveals that social norms and expectations impact the lives of older adults, ensuring that responsibilities sharing in skipped generation households are strongly impacted by gender roles. The paper concludes that in order to ameliorate the difficulties and challenges faced in performing these roles, governments and other organizations need to put the realities in the skipped generation households into consideration during planning processes.
SPIRITUALITY IN CHRONIC PAIN SELF-MANAGEMENT: LOWER USE BUT EQUAL IMPORTANCE IN OLDER AFRICAN AMERICANS
Authors: Booker Staja
Published: November 2019

Spirituality is a key social determinant of health for African Americans (AAs) and strongly impacts management of chronic pain. Older AAs (average age 68± 12.37) from urban and rural communities completed questionnaires (N= 110) and audio-recorded, semi-structured individual interviews (N= 18) describing osteoarthritis pain self-management. Prayer was used by 42% of AAs, with substantially fewer attending church (23.6%), watching religious television or reading the Bible/Christian literature (20.9%), listening to gospel music (18.2%), and laying of hands (8.2%). Interestingly, prayer and church attendance were the only pain strategies rated by more participants as very helpful. Regardless of religiosity, most AAs believed that spirituality was “an important aspect, whether we realize it always or not”. Specifically, prayer was considered “number one… ‘cause I know it’s gonna be all right once I do pray…prayer help heal the pain”. Spiritual strategies remain integral for chronic pain self-management despite lower than expected use among AAs.
SIGNIFICANT PUBLIC POLICY ISSUES IN THE HEALTH SCIENCES
Authors: Kritchevsky Stephen
Published: November 2019

This presentation will cover public policy issues of significance to the aging population, focusing on the perspective of the health sciences and on policies that may improve physical and mental health.
MITOCHONDRIA AS REVERSIBLE REGULATORS OF AGING ASSOCIATED SKIN WRINKLES AND HAIR LOSS IN MICE
Authors: Singh Keshav K
Published: November 2019

To evaluate the consequences of the decline in mtDNA content associated with aging we have created an inducible mouse model expressing, in the polymerase domain of POLG1, a dominant-negative mutation that induces depletion of mtDNA. We utilized this inducible mouse model to modulate mitochondrial function by depleting and repleting the mtDNA content. We demonstrate that, in mice, ubiquitous expression of dominant-negative mutant POLG1 leads to 1) reduction of mtDNA content in skin, 2) skin wrinkles, and 3) hair loss. By turning off the mutant POLG1 transgene expression in the whole animal, the skin and hair phenotypes revert to normal after repletion of mtDNA. Thus, we have developed whole-animal mtDNA depleter-repleter mice. These mice present evidence that mtDNA homeostasis is involved in skin aging phenotype and loss of hair and provide an unprecedented opportunity to create tissue-specific mitochondrial modulation to determine the role of the mitochondria in a particular tissue.
LATEST ADVANCES IN UNDERSTANDING THE RELATIONSHIPS BETWEEN FRAILTY AND COGNITIVE IMPAIRMENT
Authors: Xue Qianli , Carlson Michelle C
Published: November 2019

As two of the most common geriatric conditions, frailty and cognitive impairment often coexist, and are known to predict poor health outcomes separately and jointly. The link between frailty and cognitive impairment may result from the fact that many of the aging processes underlying frailty may also be responsible for brain aging and cognitive decline. What is unknown is: (1) whether frailty as a measure of physiological resilience is predictive of dementia above and beyond neuropathology and cognitive decline; (2) whether there are individual characteristics that uniquely identify separate vs. joint presence of physical frailty and cognitive impairment. To begin to address these questions, Talk 1 reviews concept of frailty in relationship to reserve and resilience and discusses theoretical underpinnings of three integrated phenotypes of physical and cognitive impairment; Talk 2 uses data from two epidemiological cohorts to study the relationship between frailty and dementia after accounting for neuropathology. Talk 3 uses data from the Gait & Brain Study to compare the strength of associations of cognitive impairment alone vs. cognitive impairment plus physical frailty (or gait performance) with incident dementia. Talk 4 uses data from the National Health and Aging Trends Study to develop a U.S. national profile on the intersection between physical frailty and cognitive impairment in community-dwelling older adults. Together, findings from this study help elucidate the interconnection between physical frailty and cognitive impairment, as well as clinical utility of joint consideration of cognitive decline and physical frailty for predicting risk of dementia.