bluuebunny/crossref_metadata_2025 huggingface dataset:
WHO CAN BENEFIT FROM HOME-BASED MEDICAL CARE?
Authors: Ornstein Katherine , Leff Bruce , Reckrey Jennifer , Bollens-Lund Evan , Salinger Margaret , Wang Yihan , Ritchie Christine
Published: December 2022

Leaving the home to access medical care may result in undue burden for patients with dementia and other serious illnesses and their caregivers. While home-based medical care (HBMC) may be beneficial for many older adults, it is not clear how to best identify individuals who could benefit from such services. Using the 2015 NHATS linked to Medicare claims we estimated prevalence across multiple overlapping subtypes: Individuals who have moderate/severe dementia; are homebound; have serious illness; are frail; rely on assistive devices; have high caregiving needs; those with minimal primary care and high ED use; and those who met previously established criteria for Independence at home. Using these criteria, more than half of community-dwelling older adults could benefit from HBMC and more than 25% meet multiple criteria. Medicare and other payers can benefit from targeted identification of patients who could benefit from HBMC.
SPECTRUM OF DEMENTIA IN OLDER HOSPICE RECIPIENTS
Authors: Hunt Lauren , Cenzer Irena , Smith Alexander , Kelley Amy , Aldridge Melissa , Covinsky Kenneth , Harrison Krista
Published: December 2022

We know little about differences between hospice enrollees with dementia co-existing with another terminal illness (like cancer), those dying from dementia (as principal hospice diagnosis), and those dying with no dementia. We used the National Health Aging and Trends Study linked to Medicare claims to compare characteristics, hospice use patterns, and care quality ratings. Among 1,105 decedent hospice-enrollees age 70+, we found 39% were dying with coexisting dementia, 17% from dementia, and 44% without dementia. In adjusted analyses, those dying with dementia had similarly high rates of functional impairment, higher rates of clinical needs, and worse measures of care quality compared to elders dying from dementia. Hospice use patterns were different for elders dying with dementia compared to elders without dementia. In summary, 56% of older hospice enrollees have dementia, mostly in addition to another terminal illness. Their differing hospice experience implies changes are needed to hospice care and policy.
UTILIZING PHYSICAL THERAPY RESIDENTS' AS HEALTH PROMOTION EXPERTS TO IMPROVE QOL FOR OLDER VETERANS
Authors: Patel Susan
Published: December 2022

Gerofit, an evidence-based supervised exercise and health promotion program for older Veterans, has demonstrated success with its best practice model through the improved health, physical function, and well-being of participants. In 2017, Cincinnati VA Medical Center (CVAMC) launched an innovative approach to address the staffing needs of this wellness program by utilizing a Physical Therapy (PT) resident model for Gerofit group supervision/functional testing. As licensed PTs, residents engage in year-long advanced training in geriatrics across a variety of settings. They encounter adults who have unhealthy behaviors (lack of physical activity, smoking, poor nutrition, inadequate sleep, and stress), and demonstrate the knowledge/skills to reduce risk factors, prevent/treat chronic disease, prescribe physical activity/exercise, perform interventions consistent with the biopsychosocial paradigm, design/deliver individualized exercise prescriptions, and lead telehealth group exercises classes for Veterans. This presentation will explore how PT residents are in an ideal position to promote health/wellness in the Gerofit Program.
FUNCTIONAL IMPROVEMENTS AMONG OLDER VETERANS WITH PAD FOLLOWING 12 MONTHS OF EXERCISE TRAINING
Authors: Gutierrez J Antonio , Pearson Megan , Gu Lin , Hall Katherine , Rao Sunil , Morey Miriam
Published: December 2022

The prevalence of peripheral artery disease (PAD) increases exponentially with age and is associated with heightened risk of functional impairment. We assessed baseline function and compared changes in mobility among older Veterans with PAD participating in Gerofit, a clinical exercise program. A total of 545 Veterans (mean age: 79 years) completed baseline, 3-, 6-, and 12-month mobility assessments and were divided into the following cohorts: PAD (n=99) and no PAD (n=446). Assessments included 10-m walk speed, 6-min walk distance, 30-s chair stands, and 8-ft up-and-go time. Veterans with PAD performed worse on all measures than non-PAD Veterans at baseline. Veterans with PAD demonstrated significant improvements (p < 0.05) in all measures from baseline at 3, 6 and 12 months. There were no significant differences in change scores between PAD and non PAD across all time points, controlling for age, except for 8-ft up-and go. PAD Veterans benefit from function-based exercise.
SOCIAL DIFFERENCES IN ALLOSTATIC LOAD TRAJECTORIES ACROSS ADULTHOOD
Authors: Walsh Christine , Yang Yang , Belsky Daniel , Mills Sarah , Hall Marissa , Golden Shelley
Published: December 2022

Chronic psychosocial stress has been indicated as a potentially important driver of U.S. health disparities. Allostatic load (AL) is an indicator of cumulative biological risk or “wear and tear” on the body resulting from repeated adaptations to life stressors. A population-level examination of AL may be particularly useful in understanding the intermediate physiological dysregulation that underlies social inequalities in health. No study has yet documented changes in allostatic load over a wide range of ages and intersecting sociodemographic groups. To address this gap, we pooled biomarker data from three U.S. longitudinal cohort studies (National Longitudinal Study of Adolescent to Adult Health, Midlife Development in the U.S., and the Health and Retirement Survey) to create an integrated dataset covering individuals ages 24 to over 95 from several birth cohorts. We conducted growth curve models to examine associations of AL trajectories with cohort and multiple dimensions of social identity. We found more recently born cohorts were associated with higher mean levels in AL as compared to earlier-born cohorts. Net of cohort, education, and other covariates, Black men and women and Hispanic men had significantly higher AL than their White counterparts. These differences were present in early adulthood and persisted at all ages. Hispanic women experienced the largest increases in AL with age, surpassing nearly all other groups at older ages. These findings contribute new knowledge about the temporal dynamics and social patterning of AL as individuals age, particularly intersecting stress exposures as an underlying and enduring source of health inequity.
EXPERIENCES OF LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND/OR QUEER (LGBTQ) OLDER ADULTS WITH SERVICE PROVIDERS
Authors: Moone Rajean , Gordon Barbara , Moone Rajean
Published: December 2022

Many lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) older adults have experienced a lifetime of oppression and discrimination that often results in significant health, economic, and social disparities in comparison to their peers. Historically labeled as illegal, immoral, and/or sick, LGBTQ older adults often fear, hide, and distrust health care and other social services providers. This symposium will highlight contemporary research on the experiences and perceptions of LGBTQ older adults in relation to service providers. The first presentation will contextual factors that influence the healthcare utilization of LGBTQ middle-aged and older adults. The second presentation will explore older adult couples’ experiences of minority stress with service providers and effects on their relationships. The third presentation will explore explore the beliefs, experiences, and needs related to housing and housing discrimination in LGBTQ older adults living in coastal North Carolina. The fourth presentation will explore panel data of older LGBTQ adults residing in the U.S South and examine the effects of access to an LGBTQ affirming provider on health service utilization and aging outcomes.. The final presentation will explore the association between increased awareness, understanding, and belief in the Undetectable equals Unstransmittable campaign and having an LGBTQ affirming care provider. The symposium will conclude with a discussion on policy and practice impacts for aging services and health care providers.
THE ROLE OF FAMILY CAREGIVING CONFIGURATIONS AND SUPPORTS IN OLDER ADULT OUTCOMES
Authors: Chong Natalie
Published: December 2022

This study uses data from the 2017-2018 National Health and Aging Trends Study and the 2017 National Study of Caregiving to examine whether caregiving network configuration factors (e.g., if and how multiple caregivers of the same care recipient distribute tasks, responsibility and disagreement among caregivers, involvement of paid caregivers) and caregiver supports (e.g., emotional support, skills training, respite services) are associated with consequences of unmet needs among older adults. Findings from this study will provide greater understanding of how caregiving contexts shape the quality of care and health of older adults who rely on help from family caregivers.
THE ROLE OF FAMILIES IN FACILITATING USE OF HOME-BASED SERVICES
Authors: Reckrey Jennifer , Zhao Duzhi , Ritche Christine , Ornstein Katherine
Published: December 2022

Homebound older adults rely on home-based clinical services (e.g., home based medical care) and long-term services and supports (e.g., caregiving support, environmental modifications) to remain living at home, however patterns of service use are unknown. Using data from the 2015 National Health and Aging Trends Study linked to Medicare Claims Data, we identified a population of homebound older adults enrolled in fee-for-service Medicare (n=1066). Latent class analysis identified 3 distinct patterns of home-based service use: low (36%), medium (51%), and high (13%) service use. High family caregiving support was particularly prevalent in the medium service group (35% with over 40 hours of family care per week), but receipt of home-based medical care was minimal in this group. Additional support to connect family caregivers with other home-based services may improve care and outcomes for older adults living at home.
EMANCIPATORY VISIONS: USING VISUAL METHODS TO CO-CONSTRUCT KNOWLEDGE WITH OLDER ADULTS
Authors: Yeh Jarmin , Reyes Laurent , Versey H Shellae
Published: December 2022

Research is a political activity. Researchers are responsible for theories and methods used to explore, explain, or ignore injustices. A need exists for developing new tools and pathways of knowledge based on experiences, language, and intellect of older adults from Black, Indigenous, and People of Color communities. This presentation argues for the utility of visual methods in critical qualitative research as a medium that allows researchers and participants to co-construct knowledge. Lessons learned about implementing projects using visual methods from the intersectional standpoint of the authors – three younger women of color – will be discussed. Promises and complexities of navigating interpersonal dynamics, decolonizing knowledge-production, and scaling visual methods on multiple levels will be elucidated. Collectively, we argue that visual methods are rigorous for subverting power dynamics rooted in extractive research practices, and provide a vehicle for community-engaged participatory action research that has potential to advance social justice in gerontology.
EXPLORING HOUSING AND HOUSING DISCRIMINATION FOR LGBT OLDER ADULTS IN COASTAL NORTH CAROLINA
Authors: Rowan Noell , Norris Haley
Published: December 2022

This study explored the beliefs, experiences, and needs related to housing and housing discrimination in LGBT older adults living in coastal North Carolina. Surveys were administered to staff (N = 138) of various types of older adult living communities (including long term care, public housing, and specific units of care including memory care and skilled nursing) to understand the status of discrimination, any integrative activities and human diversity/cultural sensitivity training offerings for staff. Findings indicate that nearly 80% of the participants received no training in the specific needs of LGBT communities and less than 10% provided inclusionary marketing/advertisement. No prior studies to date have been conducted on housing needs or discrimination of LGBT older adults within this coastal region. Implications include extensive need for cultural sensitivity education to plan for and improve housing experiences for LGBT older adults.
DUAL ELIGIBILITY AND INJURY-RELATED EMERGENCY DEPARTMENT VISITS AMONG ASSISTED LIVING RESIDENTS
Authors: Hua Cassandra , Cornell Portia , White Elizabeth , Kennedy Katherine , Nelson Ian , Thomas Kali
Published: December 2022

Using 2018 Medicare data, we examined the relationship between dual eligibility and injury-related emergency department use among a cohort of assisted living residents (n=116,754). We fit multilevel models with random intercepts at the assisted living community and license type levels. The baseline rate of injury-related emergency department emergency department use was 0.17. After controlling for resident characteristics (i.e., age, sex, race, and chronic conditions), license type characteristics (i.e., dementia care licensure, staffing regulations), and assisted living community characteristics (i.e., size and percentage of residents with dementia), being dually eligible for Medicare and Medicaid was associated with a 12% increase in the probability of having an injury-related emergency department visit (b=.02; p<.001). Assisted living communities that serve duals may have fewer resources and staff to provide personal care, potentially leading to increased rates of injuries.
URBAN AGING RESIDENTS COALITION (UARC): A HYBRID MODEL TO BRIDGE THE TECHNOLOGY GAP
Authors: Wright Kathy , Moss Karen , Tate Judith , Rose Karen , Shields Pamela
Published: December 2022

The COVID-19 pandemic spotlighted technology barriers for urban Black/African American older adults that lead to chronic stress, social isolation, and inability to fully engage with the world. In partnership with an African American older adult community leader, the Urban Aging Residents Coalition was founded in May 2020 to address engaging older adults with technology. A primary goal of UARC is to prevent social isolation and promote mental wellness through education. Using a hybrid model of videoconferencing and socially-distanced meetings, volunteer health professionals and community members (e.g., Information Technology Technician, Psychologist, and Nurse) delivered education to older adults. Participants also met for computer training to build confidence by sharing technology accomplishments with others (e.g., online bill paying). UARC has 75 active members and conducted over 12 videoconferences and in-person programming. The UARC project serves as a model for community/academic partnerships to support mental wellness and technology use in urban older adults.
INTERPLAY BETWEEN LOSS OF PROTEOSTASIS AND CELLULAR SENESCENCE: A SPOTLIGHT ON MISFOLDED PROTEIN QUALITY CONTROL
Authors: Samant Rahul
Published: December 2022

Loss of protein homeostasis (‘proteostasis’) and onset of cellular senescence are two conserved hallmarks of ageing. Healthy proteostasis relies on tightly-regulated intracellular quality control circuits that co-ordinate clearance of potentially toxic misfolded proteins arising from various internal or external stresses throughout an organism’s lifespan. Proteostasis imbalances are mechanistically linked to a broad range of ageing-associated diseases, and are also characteristic of cellular senescence—a permanent cell cycle arrest that prevents uncontrolled proliferation during development, injury repair, and tumorigenesis, but drives ageing-associated frailty, degeneration, and therapy resistance. Across a range of replicative and stress-induced senescence models in primary human cells, we have discovered differences in how misfolded proteins are triaged when compared with proliferating, quiescent, or immortalised cells—especially at the level of ubiquitin-mediated protein clearance systems. Given recent findings that proteostasis modulators act as senolytics with geroprotective properties, our work highlights the need for an improved fundamental understanding of how different ageing hallmarks are inter-connected in order to drive advances in human healthspan.
LGBTQ+ OLDER ADULT COUPLES' EXPERIENCES OF MINORITY STRESS BY SERVICE PROVIDERS
Authors: Bybee Sara , Cloyes Kristin , Mooney Kathi , Supiano Katherine , Baucom Brian , Ellington Lee
Published: December 2022

This study explored LGBTQ+ older adult couples’ experiences of minority stress with service providers and effects on their relationships. Twelve LGBTQ+ cancer patient-partner couples (N = 24) completed surveys assessing demographics, stress, and health, and participated in dyadic semi-structured interviews. Descriptive statistics summarized demographic characteristics. Interview data were content analyzed to identify sources of minority stress. Participants were aged 50.9 years on average (SD = 9.9, R =32-70), mostly white (21, 87.5%), and had been together for 19.1 years (SD = 9.9, R = 9-44). Common minority stress sources included derogatory language, belittling comments, heteronormativity, and cisnormativity in routine healthcare, cancer care, and legal services. Couples attributed relationship strength and durability as mitigating negative effects of stress; they described feeling closer, stronger, and more confident in their relationships. Some couples denied experiences of minority stress by service providers and these couples ascribed their equitable care to their geographic location.
BARRIERS TO REDUCING AND PREVENTING INVOLUNTARY TREATMENT: THE PERSPECTIVE OF PROFESSIONAL CAREGIVERS
Authors: Bleijlevens Michel , Willems Jules , Passos Valeria Lima , Hamers Jan
Published: December 2022

Measures to which a person resits and/or does not provide consent for are defined as involuntary treatment. The use of involuntary treatment violates the autonomy of (older) persons and causes more harm than benefit. Moreover, it contradicts the values of person-centred care. Nevertheless, its use among Persons Living with Dementia (PLWD) is still common practice and remains difficult to prevent and/or reduce. The aim of this study was to gain insights into the barriers towards the prevention and/or reduction of involuntary treatment in long-term geriatric care. We conducted a cross-sectional, mixed-methods study, including an online survey for professional caregivers, and a semi-structured focus group interview with professional caregivers. A total of 218 participants completed the questionnaire. The percentage of participants that experienced barriers in one of the twenty-two survey items ranged from 15% to 42%. Lack of time; the experienced need to use involuntary treatment; uncertainty about responsibilities of stakeholders; and a lack of knowledge on methods to prevent and/or reduce its use were most seen as barriers. Nursing staff experienced a lack of time more often than other professional caregivers. Working in home care and having no former experience with involuntary treatment usage increased perceived barriers. Participants of the focus group interview confirmed these findings. One out of four professional caregivers experience barriers hindering prevention and/or reduction of involuntary treatment. More research is needed to gain better understanding on how professional caregivers can be supported aiming to, remove barriers and consequently prevent and/or reduce the use of involuntary treatment.
LIFETIME CLOSE TO THE END: EFFECTS ON PERCEIVED TIME AND AGING IN OLDER ADULTS WITH ADVANCED CANCER
Authors: Wahl Hans-Werner , Laryionava Katsiaryna , Schönstein Anton , Heussner Pia , Hiddemann Wolfgang , Winkler Eva
Published: December 2022

This study addressed two questions: (1) Does advanced cancer in later life affect a person’s awareness of time and their subjective age? (2) Are awareness of time and subjective age associated with distress, perceived quality of life, and depression? We assessed patients with terminal cancer (OAC, n = 91) and older adults with no life-threatening disease (OA, n = 89). All participants were age 50 or older. OAC perceived time as being a more finite resource and felt significantly older than OA controls. Feeling younger was significantly related with better quality of life and lower levels of distress. In the OA group, feeling younger was also associated with reduced depression. Perceiving time as a finite resource was related to higher quality of life in the OA group. Indicators of an older person’s awareness of time and subjective aging differ between those with advanced cancer versus controls without a terminal disease.
GAIN- BUT NOT LOSS-RELATED VIEWS ON AGING PREDICT MORTALITY OVER A PERIOD OF 23 YEARS
Authors: Wurm Susanne , Schaefer Sarah
Published: December 2022

Some 2 decades ago, Levy et al. (2002) published their seminal study on the impact of SPA on mortality over a period of 23 years. Our study aimed at replicating and extending these findings. Based on a large German population-based sample of individuals aged 40+ (N = 2,400), for whom mortality was also documented over 23 years (1996–2019), we investigated the impact of gain- and loss-related SPA and SA on mortality. Data were analyzed with hierarchical Cox proportional hazard regressions. For individuals who perceived aging as ongoing development risk of death was half that of individuals with less gain-related SPA. Viewing aging as associated with physical or social losses could not predict mortality after controlling for covariates (age, gender, education, health-related variables, and psychological variables). Neither could SA predict mortality. The results suggest that mainly gain-related SPA explain differences in mortality and should thus be addressed in intervention studies.
INSIDE-OUTSIDE COMMUNITY ADVISORY BOARDS: ONE MODEL FOR ENGAGING OLDER BIPOC AND WOMEN IN CLINICAL RESEARCH
Authors: James Jennifer
Published: December 2022

Historical legacies of unethical research performed on people in prison, coupled with stringent policies intended to protect those who are incarcerated from exploitation, has meant that much clinical research about the health of people who are incarcerated is conducted at a distance, without directly engaging those who are incarcerated in the formulation of studies. As a result, research conducted about correctional healthcare and the healthcare needs of incarcerated persons may not reflect specific stakeholder values or priorities. In this session, we will describe barriers in engaging incarnated older women and BIPOC patients, their healthcare providers, and their loved ones in the research process and new models for the development of research questions that center stakeholder perspectives. We will describe identified priority areas for future research, insight on the ethics of research consent and participation with this population, and methodological considerations for clinical, social, and behavioral research with this vulnerable population.
EVALUATING THE FEASIBILITY AND ACCEPTABILITY OF THE WITS WELLNESS COGNITIVE HEALTH PROGRAM
Authors: Bobitt Julie , Payne Laura , Gothe Neha , Byers Chelsey , Hofer Molly
Published: December 2022

About 11% of U.S. older adults are at risk for or have subjective cognitive decline. Although some factors that affect brain health cannot be changed, research indicates lifestyle changes (i.e., physical activity, social engagement, heart-healthy diet) can delay or reduce cognitive decline. Drawing from existing research, UI Extension developed Wits Wellness, a 12-week program designed to enhance brain health among people ages 50 and older. Wits Wellness addresses multiple factors that affect cognitive health (e.g., physical activity, stress, sleep, social isolation, diet). Using a two-arm randomized control trial, 285 participants (mean age = 66.6 years, 24 males) were randomly assigned to the Wits Wellness intervention (in person or virtual) or a waitlist control group. Summative program evaluation surveys indicated adherence to the intervention was high, with 68% of participants attending 9 or more of the 12 sessions. Program acceptability was high, with 82.7% evaluating the program as great to excellent, and 90.8% reporting great to excellent interaction with program leaders. Approximately 63.6% of participant write-in comments included positive statements about the program challenging their brains, and 59.1% indicated the program positively affected participants’ socialization. For program feasibility, 90.4% rated the 60-minute weekly sessions ‘just right’ for program length, while 66.3% rated the 12-week program duration ‘just right’ and 27.7% rated it ‘too long’. Thus, preliminary results suggest that Wits Wellness delivered both in-person and virtually was well attended and highly acceptable in the community setting. Future studies will examine the program’s efficacy in improving physical and mental health related outcomes.
CONCEPTUAL ADVANCEMENT FOR SOCIAL HEALTH IN DEMENTIA RESEARCH
Authors: Vernooij-Dassen Myrra , Verspoor Eline , Perry Marieke , Wolf-Ostermann Karin
Published: December 2022

The lack of conceptual clarity on social health in dementia research hinders its articulation. We aim to apply concept advancement for social health to provide conceptual clarity by building from a conceptual meaning to domains. The procedure is underpinned by theoretical models and epidemiological evidence on the relation between social heath and cognitive functioning.This led to considering social health as a reciprocal relational concept that refers to the influence that an individual has on others (social environment), and vice versa. We distinguished three domains defining the individual level, representing the social competences of the individual, and three domains defining the social environmental level (structure , function and appraisal of the relationship. We hypothesize that social health acts as a driver for stimulating the use of cognitive reserve. This conceptual advancement promotes developments that integrate neurobiological and social sciences and new interventions to support older people with and without dementia.
CONNECTING GENERATIONS AND PRESERVING LIVED EXPERIENCES: AN ILLINOIS AGE-FRIENDLY INITIATIVE
Authors: Stanfield Alyssa , Splitstone Matthew , Mois George , Byers Chelsey , Rogers Wendy
Published: December 2022

The University of Illinois Urbana-Champaign was recently designated an age-friendly university (AFU).Our AFU program coordinated by CHART (Collaborations in Health, Aging, Research, and Technology) collaborates with our campus University of Illinois Extension office. We are partnering with a student organization called Sage to engage undergraduate students in AFU principles (i.e., promote intergenerational learning and increase the understanding of students of longevity divide). Sage is a social venture run by the Illinois chapter of the global nonprofit organization called Enactus, a social entrepreneurship organization. Sage was established in the spring of 2019 by students who noticed discomfort and lack of understanding among their fellow students of the older generations. By fostering communication, Sage aims to combat ageist social processes, reduce social isolation, and increase mutual understanding and access to the often undervalued wisdom of older adults. Sage helps facilitate life review and develops intergenerational relationships by pairing older adults with college students who listen to and capture their stories through writing to boost the morale and self-confidence of participants. The stories and wisdom they share are then preserved through the production of a cherished legacy booklet or digital media. CHART and campus Extension services support the Sage efforts by assisting with materials development and recruiting older adults from the community to participate. We will share our lessons learned to encourage the development of similar programs at other universities.
DISCUSSION OF AGE-FRIENDLY UNIVERSITY PRINCIPLES WITH OLDER LEARNERS
Authors: Takagi Emiko , Marroquin-Serrano Madeleine
Published: December 2022

The purpose of this project was to study how older learners think a university campus currently meets the 10 Age-Friendly University principles and what they see as potential steps to create an age-friendly campus community. Online focus group interviews were conducted with 17 members of Osher Lifelong Learning Institute at San Francisco State University in 2020. The participants were 60 years or older, and the majority were female and non-Hispanic white. The study participants received information about the 10 Age-Friendly University principles presented by the Age-Friendly University Global Network and were asked to discuss their thoughts about how the university satisfies these principles. The interview recordings were transcribed for the thematic analysis of qualitative data. The analysis yielded three themes. The first theme described the diversity of older adults’ learning needs and desires that the university must recognize and accommodate. The second theme represented older adults’ sense of optimism and anxiety about intergenerational learning. The third theme highlighted the challenges older adults tend to experience in accessing information, educational programs, and/or university facilities. The interviews with older learners were found valuable and indispensable in the work of Age-Friendly University assessments. The presentation is focused on the discussion regarding how older adults’ voices can be incorporated in the assessments and ways in which higher education institutions should combat ageism on and off campus as part of work to address the issues identified in this study.
AFTER THE STORM: SOCIAL WORK STUDENTS ASSISTING WITH FEMA DISASTER RELIEF FOR OLDER ADULTS
Authors: Ernst Joy
Published: December 2022

This poster describes a partnership during Fall 2021 between the Wayne State School of Social Work and the Federal Emergency Management Agency (FEMA) to assist older adults whose homes sustained damage during flooding in June 2021. This short-term project helped people access resources to repair and restore damaged homes, repair, or replace mechanical and electrical systems, deal with mold and other health hazards, and replace their personal belongings. Social work students trained by FEMA made over 700 outreach calls to homeowners whose applications for relief were rejected. The students worked with the homeowners to facilitate access to help that either resulted in the approval of their FEMA application (due to assistance with technical issues such as missing documentation or errors in the application) or connected them with alternative sources of help and support. A focus group with students provided insights on their motivations, training experiences, issues affecting the applicants, and skills developed. While FEMA-required training offered little relevant assistance, SSW staff and faculty overseeing the program provided ongoing support that students considered vital as they worked to assist applicants. Some homes were extensively damaged and resources available from FEMA were insufficient. Some homeowners suspected the students were scammers; students also learned of exploitation by contractors. Students honed empathy, reflection, and supportive listening skills as they heard stressors associated with maintaining their homes amidst losses due to covid and their knowledge of community resources expanded. Lessons learned to aid in future efforts to assist in disaster relief are described.
CAREGIVER-SPECIFIC QUALITY MEASURES FOR HCBS: STAKEHOLDER PRIORITIES AND ENVIRONMENTAL SCAN
Authors: Penney Lauren , Finley Erin , Johnson Julie Parish , Pugh Jacqueline , Leykum Luci , Noel Polly
Published: December 2022

Although informal family caregivers are increasingly recognized for their essential role in helping older and/or medically-complex adults live in the community for as long as possible, their priorities and perspectives have not been well-integrated into assessments of home- and community-based services (HCBS). Our aim was to identify measurement gaps to guide quality monitoring and improve HCBS. Caregiver concerns and quality measurement priorities were identified during a multi-level stakeholder engagement process (34 Veterans, 24 caregivers, and 39 facility leaders, clinicians, and staff) across four VA healthcare systems. We conducted an environmental scan and scoping review of national quality measure sets for HCBS, comparing caregiver-specific items against stakeholder-identified concerns and priorities. Only five of eleven non-VA measure sets and three of four VA measure sets included caregiver-specific items; these did not encompass the full range stakeholder-identified concerns and priorities. Measures that emphasize caregivers can help healthcare systems monitor and improve HCBS quality.
EVALUATING THE EFFECTIVENESS OF AN ONLINE TRAINING COURSE FOR MEETING NEEDS ASSOCIATED WITH CAREGIVING BURDEN
Authors: Hosseini Shera , Carter Lorraine , Thomson Donna , Howard Michelle
Published: December 2022

Informal caregivers make up a critical part of long-term support in the communities due to their important role in caring for older adults living at home. Modern-day caregivers are facing greater responsibility and burden for managing their care recipients. The present study aimed to explore the effect of a caregiving training program in alleviating caregiver burden. This program included four standalone online modules each with specific foci. Completion of activities across the modules allowed for the creation of a Caregiver Action Plan which offered a personal and practical resource to the informal caregivers. This evaluation study was qualitative and a used thematic analysis method of data analysis. Data stemmed from semi-structured interviews with the caregivers and their reflections on the program’s discussion board. Most caregivers provided care for persons with dementia. Interviews with the family caregivers were conducted, transcribed, and thematically analyzed. Themes were identified through constant comparison and in an iterative process. The family caregivers demonstrated consensus on the efficacy of the program in raising competence and confidence and contributing to ameliorating burden levels. Important themes were identified in association with areas for which the caregivers needed support: Early dementia education, planning for future care, learning about navigating healthcare systems, peer support, enhancing self-care, and coping with emotional burden and self-blame. The findings will be informative in shaping the program based on the caregiver’s identified needs through addressing those areas that they would need support. These findings may offer recommendations to other programs designed to support the family caregivers.
THE EFFECT OF COMMUNICATION SKILLS TRAINING FOR NURSING STUDENTS BY AUGMENTED REALITY SIMULATION SYSTEM
Authors: Kobayashi Masaki , Iwamoto Miyuki , Une Saki , Kurazume Ryo , Nakazawa Atsushi , Honda Miwako
Published: December 2022

Background

Educational methods for improving communication with dementia patients are lacking. Our study aimed to evaluate the efficacy of simulated communication skills training for nursing students using augmented reality (AR).

Methods

A randomized controlled study. 25 nursing students enrolled and learned standardized multimodal communication skills using textbooks. Participants were randomly assigned to AR training or conventional mannequin training group and each had one-hour training of basic nursing care. The mannequin of AR group was superimposed a computer graphic of an elderly woman's face, which reacts to participants' communication. Further, participants’ gaze and voice were evaluated by artificial intelligence (AI) and the participants received real-time feedback to their head-mounted display. The conventional group had the self-training with nursing mannequins. Participants performed basic nursing care to simulated patients before and after training, which were video-recorded by eye-tracking cameras and fixed cameras, then the videos were analyzed by AI. The primary outcome was the proportion of eye contact, verbal, and multimodal communication time during the care to simulated patients. Additionally, participants' empathy was evaluated by the Jefferson Scale.

Results

The interactive communication in AR group significantly increased than conventional group (eye contact 13.6% versus 4.4%, verbal communication 27.7% versus 20.1%, multimodal communication 9.6% versus 3.8%, P< 0.05, respectively). The empathy score significantly increased in AR group, whereas it decreased in conventional group [Mean (SD): 9.1 (6.6) versus -1.3 (3.8), P< 0.01].

Conclusions

The simulated communication skills training for nursing students using AR was associated with increased interactive communication skills and empathy to patients.
VITAMIN D DEFICIENCY AND FASTER EPIGENETIC AGING: RESULTS FROM THE BERLIN AGING STUDY II (BASE-II)
Authors: Vetter Valentin , Sommerer Yasmine , Kalies Christian , Spira Dominik , Bertram Lars , Demuth Ilja
Published: December 2022

Particularly older people are at risk for deficient vitamin D levels, as their capability for cutaneous synthetization is lower and they are often less exposed to sunlight. However, the resulting impact on one individual’s health is not fully understood. To examine potential consequences of low vitamin D levels for health of older people, we examined its relationship with a DNA related biomarker of aging, DNA methylation age acceleration (DNAmAA). Several epigenetic clocks, that are used to estimate this parameter from methylation fractions of specific cytosine-phosphate-guanine sites, are available and differ in aspects of aging they represent best. Five clocks, 7-CpG clock, Horvath’s clock, Hannum’s clock, PhenoAge, and GrimAge, were available in the longitudinal BASE-II cohort (n=1,100) at follow-up examination. DNAmAA estimated from 7-CpG clock and GrimAge was associated with vitamin D levels in covariate adjusted regression analysis. Additionally, a quasi-interventional study design was employed and showed 2.6 year lower 7-CpG DNAmAA (p=0.011) and 1.3-year lower Horvath DNAmAA (p=0.042) in vitamin D deficient participants that chose to start vitamin D supplementation during the follow-up period of 7.4 ± 1.5 years compared to a matched control-group of participants with untreated vitamin D deficiency. No statistically significant difference was found between sufficiently treated participants with vitamin D deficiency and a matched group of participants that reached sufficient vitamin D level without supplementation. Although validation of our results in a randomized controlled trial is needed, our findings suggest, that vitamin D deficiency associated higher rates of epigenetic aging can potentially be reversed through supplementation.
SHORT TELOMERES ASSOCIATE WITH HYPERPHOSPHORYLATED TAU BURDEN IN PRIMARY AGE-RELATED TAUOPATHY
Authors: McMillan Corey , Adhikari Bandita , Farrell Kurt , Wolk David ,   PART Working Group, Lee Edward , Crary John , Johnson F Bradley
Published: December 2022

Aging is a major risk factor for hyperphosphorylated tau burden (p-tau). Telomeres lengths (TL) shorten with age and various sources of DNA damage, thus provide a measure of biological age. Additionally, DNA methylation (DNAm) changes over time and may contribute to changes in TL. We hypothesize that shorter TL will be associated with increased risk of p-tau burden and that this process may be mediated by DNAm. We extracted DNA from frontal cortex of 113 individuals (Age=87.3 + 9.3; 37% Female) that met neuropathological criteria for primary age-related tauopathy (PART), characterized by p-tau in the absence of amyloid pathology. We measured mean TL using qPCR to determine the copy number of telomere repeat DNA in comparison to a single copy gene. We also measured DNA methylation using the Illumina MethylationEPIC Kit for ~850K CpGs. P-tau was measured in medial temporal cortex using an Aperio Digital Pathology Slide Scanner. Linear regression revealed that shorter TL was associated with increased p-tau burden (B=-0.28; p=-.003), including adjustment for age (B=0.003; p=0.003). eWAS identified six CpGs associated with TL (all q< 0.05). Causal mediation analyses identified that two of these CpGs mediate the TL and p-tau association: proportion mediated by cg08701686 (UNC5D) and cg24533059 (near IFNGR1 and OLIG3) was 32.5% and 48.6%, respectively. Shorter TL is associated with increased p-tau pathological burden in PART and may be mediated in part by DNAm at particular loci. These findings support the concept that biological aging, as measured with TL and DNAm, may contribute to tauopathy beyond chronological aging.
MEGA-ANALYSIS OF A CONSORTIUM OF FOUR CENTENARIAN STUDIES IDENTIFIES NOVEL EXTREME LONGEVITY VARIANTS
Authors: Bae Harold , Gurinovich Anastasia , Song Zeyuan , Leshchyk Anastasia , Li Mengze , Barzilai Nir , Perls Thomas , Sebastiani Paola
Published: December 2022

The meta-analysis of extreme longevity (EL) conducted in 2017 using a consortium of four longevity studies—the New England Centenarian Study (NECS), the Long Life Family Study (LLFS), the Southern Italian Centenarian Study (SICS), and the Longevity Gene Project (LGP)—confirmed previous associations with APOE alleles and identified additional candidate genes. The current study builds upon this work. Using an aggregated set of the four studies (mega-analysis), we sought to identify additional longevity variants. The current study includes 234 additional cases with a total of 2304 cases (median age=103, age range=[96, 119]), defined as living past the age at which less than 1% individuals from the 1900 - 1920 birth year cohorts survived and approximately 6,000 controls. Approximately 10 million genotyped and imputed SNPs that passed imputation quality score threshold of 0.7 and that had a minor allele count of 3 or greater were analyzed. We ran a mixed effects logistic model for EL adjusting for sex, top principal components, indicator for living in Denmark, indicator for living in Italy, and the genetic relationship matrix. The analysis identified 21 novel loci that are genome-wide significant, both common and rare, and these loci were not previously published. The genome-wide significant loci include genes such as ADGRL2 (p=6.46-15), HLA-DPA1 (p=1.06-8), GRK5 (p=2.01-8), TECTB (p=3.38-8), KCNQ1 (p=7.53-10), TEAD2 (p=9.53-10), and several intergenic regions. We are currently in the process of seeking replication of the top results in independent cohorts.
SOCIODEMOGRAPHIC DIFFERENCES IN IMMUNOSENESCENCE IN OLDER AGE: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: Noppert Grace , Stebbins Rebecca , Dowd Jennifer , Aiello Allison
Published: December 2022

Population patterns of immunosenescence are not well described. We characterized markers of immunosenescence and assessed sociodemographic differences in a population of individuals ages 56 years and older using newly released venous blood data from the nationally representative U.S. Health and Retirement Study (HRS) (n=8,400). Median values of the CD8+:CD4+, effector memory (em)RA:naïve CD4+ and emRA:naïve CD8+ T cell ratios were higher among older participants (more aged immune profile) and were lower among those with additional educational attainment (less aged immune profile). Racialized minority populations had immune markers suggestive of a more aged immune profile: Hispanics had a CD8+:CD4+ median value of 0.37 (95% CI: 0.35, 0.39) compared to Whites (0.30, 95% CI: 0.29, 0.31). Blacks had the highest median value of the emRA:naive CD4+ ratio (0.08; 95% CI: 0.07, 0.09) compared to Whites (0.03; 95% CI: 0.028, 0.033). Our regression analyses showed that race/ethnicity and education were associated with large differences in T-cell markers of aging, which were orders of magnitude greater than age. By standardizing regression coefficients to estimate years of immunological aging, we found that each additional level of education was associated with roughly an additional decade of immunological age, and racialized minorities had on average an immunological age two to four decades higher than Whites. As one of the first large-scale population-based investigations of immunosenescence, our study advances understanding of the immune mechanisms underlying age-related disease, with implications for risks such as vulnerability to novel pathogens (e.g., SARS-CoV-2).
ADAPTIVE HORSEBACK RIDING: AN INNOVATIVE PROGRAM FOR IMPROVING THE QUALITY OF LIFE OF PERSONS LIVING WITH DEMENTIA
Authors: Fields Beth
Published: December 2022

More than 5 million Americans living with Alzheimer’s disease and related dementia (ADRD) have likely experienced forced social isolation due to the COVID-19 pandemic and subsequent stay-at-home mandates and public closures. Forced social isolation negatively impacts the quality of life of persons living with ADRD by worsening behavioral and psychological symptoms. Given continued pandemic restrictions and poor outcomes, now is the time to develop and support programs designed to improve quality of life through meaningful interactions that occur in natural environments. This symposium will introduce ‘Riding in the Moment’, an adaptive riding program that improves the quality of life of persons living with ADRD. Program participants are provided a safe, social, and supportive natural environment where they can ride, groom, and care for horses. The experiences constructed from Riding in the Moment seek to impact the current public health crisis by reducing social isolation for a growing and vulnerable population.
UTILIZING BOOT CAMP TRANSLATION TO ENCOURAGE HISPANIC/LATINX PARTICIPATION IN ALZHEIMER’S RESEARCH
Authors: Moeller Stacey , John Samantha , Medina Luis
Published: December 2022

Hispanic/Latinx (H/L) individuals are 50% more likely to develop Alzheimer’s disease (AD), relative to non-Hispanic whites. Despite higher prevalence rates and earlier age of onset, H/L individuals are underrepresented in aging and AD research. The Engaging Communities of Hispanics for Aging Research (ECHAR) Network is an interdisciplinary, multi-site project that aims to address these disparities. ECHAR uses Boot Camp Translation (BCT), a community-based participatory research (CBPR) approach that partners research faculty and medical experts with community stakeholders to translate medical jargon into action-based, locally-relevant messages. Researchers at University of Nevada, Las Vegas recruited 14 community members to participate in an AD-specific BCT. The process was completed between June 2021 through January 2022 to identify: 1) key messages, 2) target audience(s), and 3) dissemination strategies. BCT members identified three messages to reflect community concerns and highlight values: 1) “Amar es saber” (“To love is to know”), which acknowledges the importance of family and addresses cultural norms that may discourage disease conversations; 2) “The community cares. Let’s talk.”; and 3) "Podemos afrontar el Alzheimer juntos." (”We can face Alzheimer’s disease together.”). Target audiences include younger and middle-age adults who may be or become caregivers and local non-profit and community organizations. Members identified social media, community education events, community influencers, and educational products as dissemination strategies. BCT is an effective tool for engaging local communities and exploring Hispanic/Latinx beliefs and attitudes toward AD. It leverages community member expertise to create meaningful, tailored, and culturally-relevant messages that address health disparities and encourage action.