bluuebunny/crossref_metadata_2025 huggingface dataset:
Distinguishing ecological outcomes of pathways in the Grain for Green Program in the subtropical areas of China
Authors: Qiu Sijing , Peng Jian
Published: December 2021

Effective forestation policies are urgently required across the globe under the initiative of the UN Decade on Ecosystem Restoration. Rather than simply planting trees, such initiatives involve complex components of societal and biophysical systems. However, the underlying pathways by which forestation influences ecological outcomes are not well understood, especially given the lack of a unified quantification framework. In this study, such a framework was developed to reveal the pathways by which reforestation programs influenced ecological outcomes by identifying the linkages among reforestation efforts, societal changes, land system changes and ecological outcomes. The framework was applied to the reforestation program of the Grain for Green Program (GFGP), to explore how the GFGP influenced vegetation dynamics and ecosystem functioning in Guizhou Province, China, through direct and indirect pathways. Two remote sensing based indicators, namely the enhanced vegetation index, derived from the Moderate Resolution Imaging Spectroradiometer, and gross primary production (GPP), obtained from the Orbiting Carbon Observatory-2 solar-induced chlorophyll fluorescence (SIF) fine-resolution dataset GOSIF, were combined with inventory data and land-use maps to detect changes in social and ecological outcomes. Using the structural equation model to apply the framework, the results showed that the GFGP positively contributed to the increasing greenness and GPP of the study area through the direct conservation pathway. Although implementation of the GFGP encouraged the rural outmigration and led to a decrease in the area of farmland, the GFGP showed negative indirect effects on greenness and GPP because of the difficulty of reforestation during land-use conversion from farmland to forest land. This study revealed divergent impacts of the reforestation program through multiple pathways, which could provide valuable information for other parts of the globe for more precise design of ecological restoration policies.
Electrochemical behaviors and discharge performance of Mg-Sn binary alloys as anodes for Mg-air batteries
Authors: Han Lu , Zhang Yuwenxi , Guo Yangyang , Wan Yangjie , Fan Lingling , Zhou Mingyang , Quan Gaofeng
Published: December 2021

In this work, the self-corrosion and discharge performance of the as-cast Mg-xSn (x = 1, 5, 9 wt%) anodes for primary Mg-air batteries were studied through microstructure characterization, electrochemical testing and discharge experiments. With the increase of Sn content, the volume fraction of the Mg2Sn phase increases, promoting dendrite refining. According to the electrochemical test, the Mg-1Sn anode shows a higher open circuit potential, resulting in a stronger electrochemical activity. The polarization curve and electrochemical impedance spectra show the corrosion resistance order as Mg-1Sn > Mg-5Sn > Mg-9Sn. In the discharge measurement, the Mg-1Sn anode achieves the best average discharge voltage, anode efficiency, specific capacity, and energy density under all current densities tested. At 10 mA cm−2, the energy density of Mg-1Sn is 1239.621 mWh g−1, which is higher than the Mg-5Sn anode and Mg-9Sn anode, 37% and 25%, respectively. The optimal discharge performance of the Mg-1Sn anode is mainly attributed to the high electrochemical activity and the micron-sized Mg2Sn phase dispersed in the matrix, which facilitates more uniform dissolution.
An investigation into the environmental and therapeutic applications of holmium-doped titanium dioxide (Ho-TiO2) nanocatalysts: a kinetic and thermodynamic study of the photocatalytic degradation of Safranin O dye
Authors: Jan F Akbar , Wajidullah  , Ullah Rahat , Salman  , Ullah Naimat , Salam Abdul
Published: December 2021

Titanium dioxide (TiO2) and holmium-doped titanium dioxide (Ho-TiO2) nanoparticles(NPs) were synthesized through a sol gel route. The synthesized NPs were characterized by ultraviolet-visible (UV–Vis) spectroscopy, x-ray diffraction (XRD), energy dispersive x-ray analysis, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy, and photoluminescence (PL) spectroscopy. DNA binding, antibacterial, hemolysis, and antioxidant assays of the synthesized NPs were also carried out in order to find their therapeutic applications. Successful doping of TiO2 with Ho reduced the bandgap from 3.10 to 2.88 eV. SEM and XRD analysis showed that both TiO2 and Ho-TiO2 NPs exhibit a tetragonal structure and the morphology of the particles improved and agglomeration reduced as a result of doping. The PL emission intensity of TiO2 also reduced with doping. The degradation of Safranin O dye over both the catalysts followed first-order kinetics. The calculated activation energy for the photodegradation of the given dye was found to be 51.7 and 35.2 KJ mol−1 for bare TiO2 and Ho-TiO2 NPs, respectively. After 180 min, 84% and 87% dye degradation was observed using pure TiO2 and Ho-TiO2, respectively. A high percent of degradation of the dye was found at a low concentration (20 ppm) and at optimal dosage (0.035 g) of both the catalysts. The rate of Safranin O dye degradation was found to increase with an increase in temperature and pH of the medium. A DNA binding study revealed that Ho-TiO2 NPs are more capable of binding to human DNA. An antibacterial activity study showed that Ho-TiO2 NPs were more efficient against both gram-negative and gram-positive bacterial strains compared to pure TiO2. Hemolysis assay showed that TiO2 and Ho-TiO2 NPs are non-biocompatible. Ho-TiO2 NPs showed higher anti-oxidant activity compared to bare TiO2.
Impact of Capsulectomy Type on Post-Explantation Systemic Symptom Improvement: Findings From the ASERF Systemic Symptoms in Women-Biospecimen Analysis Study: Part 1
Authors: Glicksman Caroline , McGuire Patricia , Kadin Marshall , Lawrence Marisa , Haws Melinda , Newby Jill , Ferenz Sarah , Sung James , Wixtrom Roger
Published: December 2021

Background

Breast Implant Illness (BII) is a term used to describe a variety of symptoms by patients with breast implants for which there are no abnormal physical or laboratory findings to explain their symptoms. There currently exists a difference of opinion among clinicians and patients concerning the diagnosis and treatment of patients self-reporting BII.

Objectives

The first aim of this study was to determine if there is a valid indication for “en bloc” capsulectomy in patients self-reporting BII and if the type of capsulectomy performed alters long-term symptom improvement. The second goal was to identify any clinical laboratory differences between the cohorts. This study was funded by the Aesthetic Surgery Education and Research Foundation (ASERF).

Methods

A prospective blinded study enrolled 150 consecutive subjects divided equally into 3 cohorts: (A) women with systemic symptoms they attribute to their implants who requested implant removal; (B) women with breast implants requesting removal or exchange who do not have symptoms they attribute to their implants; and (C) women undergoing cosmetic mastopexy who have never had any implanted medical device. The subject’s baseline demographic data and a systemic symptoms survey, including PROMIS validated questionnaires, was obtained before surgery and at 3-6 weeks, 6 months, and 1 year. Blood was collected from all 3 cohorts and implant capsules were collected from Cohorts A and B.

Results

150 patients were enrolled between 2019-2021. Follow-up at 3-6 weeks for all 3 cohorts was between 98%-100%, 78%-98% at 6-months, and 1 year data is currently at 80%. The type of capsulectomy; intact total, total, or partial all showed similar symptom improvement with no statistical difference in the reduction of symptoms based on the type of capsulectomy.

Conclusions

This study addresses one of the most discussed questions by plastic surgeons, patients, their advocates, and social media. The findings show that patients who self-report BII demonstrate a statistically significant improvement in their symptoms after explantation and that this improvement persists for at least 6 months. This improvement in self-reported systemic symptoms was seen regardless of the type of capsulectomy performed.

Level of Evidence: 2
A flexible Bayesian framework for individualized inference via adaptive borrowing
Authors: Ji Ziyu , Wolfson Julian
Published: December 2021

The explosion in high-resolution data capture technologies in health has increased interest in making inferences about individual-level parameters. While technology may provide substantial data on a single individual, how best to use multisource population data to improve individualized inference remains an open research question. One possible approach, the multisource exchangeability model (MEM), is a Bayesian method for integrating data from supplementary sources into the analysis of a primary source. MEM was originally developed to improve inference for a single study by asymmetrically borrowing information from a set of similar previous studies and was further developed to apply a more computationally intensive symmetric borrowing in the context of basket trial; however, even for asymmetric borrowing, its computational burden grows exponentially with the number of supplementary sources, making it unsuitable for applications where hundreds or thousands of supplementary sources (i.e., individuals) could contribute to inference on a given individual. In this article, we propose the data-driven MEM (dMEM), a two-stage approach that includes both source selection and clustering to enable the inclusion of an arbitrary number of sources to contribute to individualized inference in a computationally tractable and data-efficient way. We illustrate the application of dMEM to individual-level human behavior and mental well-being data collected via smartphones, where our approach increases individual-level estimation precision by 84% compared with a standard no-borrowing method and outperforms recently proposed competing methods in 80% of individuals.
Toxoplasma-proximal and distal control by GBPs in human macrophages
Authors: Fisch Daniel , Clough Barbara , Khan Rabia , Healy Lyn , Frickel Eva-Maria
Published: December 2021

Human guanylate binding proteins (GBPs) are key players of interferon–gamma (IFNγ)-induced cell intrinsic defense mechanisms targeting intracellular pathogens. In this study, we combine the well-established Toxoplasmagondii infection model with three in vitro macrophage culture systems to delineate the contribution of individual GBP family members to control this apicomplexan parasite. Use of high-throughput imaging assays and genome engineering allowed us to define a role for GBP1, 2 and 5 in parasite infection control. While GBP1 performs a pathogen-proximal, parasiticidal and growth-restricting function through accumulation at the parasitophorous vacuole of intracellular Toxoplasma, GBP2 and GBP5 perform a pathogen-distal, growth-restricting role. We further find that mutants of the GTPase or isoprenylation site of GBP1/2/5 affect their normal function in Toxoplasma control by leading to mis-localization of the proteins.
Geriatric Interprofessional Education: In-Person Simulation
Authors: Brown Diane
Published: December 2021

Our in-person geriatric interprofessional training model is layered with scaffolds of active learning, tabletop team meeting simulation, assessment of older adult community members at risk for falls, and reflective feedback. The first step addresses knowledge acquisition via online didactic content. The second step reinforces the knowledge gained in the online didactics through in-person posters and interactive skills practice, followed by a profession-specific huddle to communicate patient assessment findings. The third step is an interprofessional team meeting simulation based on a case study of a complex geriatric patient. The fourth step is performing a supervised assessment on an older adult. The assessment incorporates the assessment tools practiced during the poster/skills session and team skills learned in the didactics and simulation. This is followed by the design of an interprofessional team-developed patient-centered plan of care. The event ends with a reflective debrief focused on interprofessional collaborative competencies.
A 10-Year Behavioral and Social Sciences Research Agenda for ADRD: Reflection on a New National Academies Report
Authors: Powell Tia , Reuben David , Mor Vincent , Blacker Deborah , Checksfield Molly
Published: December 2021

The National Academies of Sciences, Engineering, and Medicine (NASEM) was charged with developing a ten-year agenda for research in the behavioral and social sciences that would substantially contribute to reducing the impact of Alzheimer’s disease and related dementias (AD/ADRD). The report, expected to be publicly released in June 2021, has been developed by a committee of individuals with expertise across a range of disciplines and fields, including dementia research. The committee was charged with assessing the role of the social and behavioral sciences in reducing the impact of dementia. The committee held several evidence-gathering sessions, reviewed published literature, commissioned several papers, and engaged individuals living with dementia and caregivers as a part of an Advisory Panel to the committee. This presentation will engage attendees in a discussion about the ten-year behavioral and social science research agenda related to dementia produced by this NASEM committee.
Creating a Person- and Family-Centered Program of Research: Lessons Learned From Over 30 Years of Applied Research
Authors: Whitlatch Carol , Orsulic-Jeras Silvia
Published: December 2021

Approximately 6 million Americans are living with Alzheimer’s Disease or related dementia. Due to these alarming statistics, there is an increased need for families to seek out services and supports to not only cope with these devastating diagnoses, but to plan effectively for their future care needs. A plethora of research has shown that both the family care partner and person living with dementia are at-risk for negative outcomes such as depression, anxiety, social isolation, and worsening physical and mental health. Moreover, further and encouraging research supports the development and implementation of empowerment-based, person- and family-centered interventions. When utilized effectively these interventions improve quality of care and well-being in persons living with dementia and their care partners. The purpose of this paper is to provide guidance for researchers interested in making their work more person- and family-centered. Strategies discussed are based on over 30 years of applied research and include: 1) placing individuals at the center of their own care, 2) including persons with dementia as co-investigators, 3) convening diverse professionals and individuals in advisory councils from the start, and 4) conducting focus groups to obtain participant and stakeholder feedback. Demonstrations of select person-and-family-centered, evidence-programs will be included and supplemented with case examples to illustrate person-centered principles in practice.
The Roles of General and Domain-Specific Perceived Stress in Healthy Aging
Authors: Luo Jing , Zhang Bo , Willroth Emily , Mroczek Daniel , Roberts Brent
Published: December 2021

Theoretical and empirical evidence suggests the existence of a general perceived stress factor overarching different life domains. The present study investigated the general perceived stress relative to domain-specific perceived stress as predictors of 26 diverse health outcomes, including mental and physical health, health behaviors, cognitive functioning, and physiological health indicators. A bifactor exploratory structural equational modelling approach was conducted in two samples from the Health and Retirement Study. Across the two samples, perceived stress was well-represented by a bifactor structure where there was a robust general perceived stress factor representing a general propensity towards stress perception. Meanwhile, after controlling for the general factor, specific factors representing perceived stress in different life domains were still clearly present. The general perceived stress factor was the most robust predictor of the majority of health outcomes. Age, sex, personality traits, and stressor exposure were found as possible diathesis underlying the general perceived stress factor.
No Increase in Short-Term Mortality Following COVID-19 Vaccination Among Nursing Home Residents
Authors: Bardenheier Barbara , Gravenstein Stefan , Gutman Roee , Sarkar Neil , Feifer Richard , White Elizabeth , Mor Vincent
Published: December 2021

Reports of fatal adverse events following mRNA-based vaccination for COVID-19 in Norwegian nursing home (NH) residents have raised concern regarding vaccine safety in very old and frail persons. A limitation of these reports, however, is the absence of contemporaneous control groups, particularly given the high baseline mortality in this population. Using electronic health records’ data on resident deaths, hospital transfer, vaccination, and daily census from Genesis Healthcare, a large NH provider spanning 24 U.S. states, we compared 7-day mortality and hospitalization rates for vaccinated versus unvaccinated NH residents. Between December 18, 2020 and December 31, 2020, 7006 residents across 118 NHs were vaccinated with the first dose. Mortality and hospital transfer rates within 7 days of vaccination were compared to rates for: (1) unvaccinated residents in the same facility within 7 days of the vaccine clinic (n=4414), and (2) residents in 166 yet-to-be-vaccinated facilities between December 25, 2020 and January 1, 2021 (n=17,076). We excluded residents with a positive SARS-CoV-2 diagnostic test within 20 days prior to their 7-day observation window. Mortality rates per 100,000 residents were lower among vaccinated (587, 95%CI: 431, 798) versus unvaccinated residents within the same facilities (984, 95%CI: 705, 1382), and compared to residents in not-yet-vaccinated facilities (912, 95%CI: 770-1080), with overlapping 95% CIs. Hospital transfers were lower among vaccinated residents than in either comparison group, but with overlapping CIs. Our findings suggest that short term mortality rates appear unrelated to vaccination for COVID-19 in NH residents, and should dispel concerns raised by previous reports.
Rural and Urban Difference in Longitudinal Trends in Prevalence of Dementia in Medicare Claims and Survey Data
Authors: Ferdows Nasim B
Published: December 2021

Shortage of physicians in rural areas can lead to lower diagnosis and underestimation of dementia prevalence in these communities. We used data from the nationally representative Health and Retirement Study and a 20-percent sample of Medicare claims to study rural-urban differences in dementia prevalence. The survey dementia diagnosis is free from medical assessment while the claims diagnosis needs a physician diagnosis. We estimated the trends in dementia prevalence from (2002-2016) based on cognitive tests (using survey data) and diagnosis codes (using claims data) utilizing ordinary least squares regression. Dementia prevalence based on diagnosis codes declined in both urban and rural areas over the course of the study, with a sharper decline in urban areas. Dementia prevalence using diagnosis codes showed significantly higher rates in urban areas during all years (0.024 vs 0.018 in 2002 and 0.017 vs 0.013 in 2014 in rural vs urban areas, respectively). Dementia in the cognitive test sample was higher in rural areas (0.11 vs 0.08 in 2000 and 0.08 vs 0.7 in 2014 in rural vs urban areas), a difference that was significant only in 2004. Our results indicate lower dementia prevalence rates in rural areas in claims based sample compared to survey sample which its dementia prevalence is free medical assessment. Claims data are valuable sources for tracking dementia in the US population, however they are based on medical diagnosis.In rural areas, where there is shortage of physicians and a lack of access to health care services, claims based studies may underestimate dementia rates.
Diversity of Activities, Emotions, and Pleasant Events and Their Associations With Mental and Cognitive Health
Authors: Lee Soomi , Urban-Wojcik Emily , Almeida David
Published: December 2021

The COVID-19 pandemic dramatically changed the structure of our daily lives. One of the most significant changes is a limited opportunity to engage in face-to-face social interactions and enjoy diverse daily activities. This raises a public health concern, because diverse experiences are critical sources of health by increasing social integration, cognitive reserve, and psychological resources. Recently, two lines of research have consistently shown that activity diversity or emodiversity is associated with multiple health outcomes. However, still more integrated efforts are needed to better understand diversity of daily experiences in various aspects and their contributions to health. This symposium brings together different endeavors towards understanding how diversity of daily experiences – activity diversity, emodiversity, and variety in positive experiences – are associated with health and well-being across adulthood. The topic of this symposium is timely to discuss potential prevention approaches to protect population well-being as the pandemic evolves. Paper 1 examines activity diversity (breadth and evenness of daily activity participation) and how it is related to positive and negative emodiversity (rich and balanced emotional experiences) differently by age groups. Paper 2 investigates the longitudinal relationship between activity variety across cognitive, physical, and social domains and cognitive functioning. Paper 3 examines variety in pleasant events and its associations with mental health outcomes. Paper 4 examines whether and how negative emodiversity is associated with mental illness during COVID-19. The discussant, Dr. David Almeida will integrate key findings from these studies, discuss their theoretical and methodological contributions, and consider opportunities for future research.
Everyday Life Experiences of Swedes Age 70+ During the COVID-19 Pandemic
Authors: Bildtgard Torbjorn , Öberg Peter
Published: December 2021

As many other countries Sweden has been hit hard by the Corona pandemic, with high numbers of dead in the older population. Since march 16, 2020, the authorities have encouraged people 70+ to voluntarily quarantine and avoid contacts outside the household. How has this affected older people’s everyday lives? This study reports on results from a web-survey on the everyday life experiences of Swedes 70+ carried out between May 28 and July 13, 2020 (n=1 926). The presentation focuses answers to an open-ended question: “Describe with your own words how your life has been affected by the Corona pandemic”. A qualitative content analysis was used to investigate changes in the everyday lives of the respondents and their appreciations of these changes. Results show that older Swedes have mostly adhered to public recommendations of self-isolation and withdrawn from social and family contacts, as well as paid and volunteer work. The vast majority (76%) of the respondents describe what they see as negative life changes, such as loss of structure in their everyday life, loss of contact with children/grandchildren and friends, loss of meaningful activities, loss of abilities due to forced unemployment and experiences of ageism. Experiences of loneliness, depression and drop in quality of life are common. Some positive changes were reported. We argue that the experience of the 70+ population during Corona needs to be understood in relation to the promise of the third age, where everyday restrictions are experienced as a forced disengagement into a fourth age life style.
Machine Learning Prediction Models for Mobility Limitation Over Time in Older Adults: The Health ABC Study
Authors: Speiser Jaime , Callahan Kathryn , Ip Edward , Miller Michael , Tooze Janet , Krtichevsky Stephen , Houston Denise
Published: December 2021

Mobility limitation in older adults is common and associated with poor health outcomes and loss of independence. Identification of at-risk individuals remains challenging because of time-consuming clinical assessments and limitations of statistical models for dynamic outcomes over time. Therefore, we aimed to develop machine learning models for predicting mobility limitation in older adults using repeated measures and variable selection. We used nine years of follow-up data from the Health, Aging, and Body Composition study to model mobility limitation, defined as self-report of any difficulty walking ¼ mile or up a flight of stairs, assessed annually. We considered 46 predictors for modeling, including demographic, lifestyle, chronic condition and physical function variables. We developed three models with Binary Mixed Model Forest, using: 1) all 46 predictors, 2) an automated variable selection algorithm, and 3) the top five most important predictors. Area under the receiver operating curve ranged from 0.78 to 0.84 for the models for two validation datasets (with and without previous annual visit data for participants). Across the three models, the most important predictors of mobility limitation were ease of getting up from chair, gait speed, self-reported health status, body mass index and depression. Longitudinal, machine learning models predicting mobility limitation had good performance for identifying at-risk older adults based on current and previous annual visit data. Future studies should evaluate the utility and efficiency of the prediction models as a tool in a clinical setting for identifying at-risk older adults who may benefit from interventions aimed to prevent mobility limitation.
Cognitive Interviewing to Evaluate the Content Validity of a Photo-Supported Preference Assessment
Authors: Neal Vanessa , Knollman-Porter Kelly , Topper Rachel , McConnell Eleanor , Abbott Katherine , Van Haitsma Kimberly
Published: December 2021

Photo-supported verbal assessments have shown to improve comprehension and expression of choices by older adults living with cognitive-communication challenges. The purpose of this study was to assess content validity (CV) of photographs used to supplement the Preferences for Everyday Living Inventory-Nursing Home (PELI-NH) from the perspective of older adults, using cognitive interviewing methods. Participants (N=21) were average age 75 (SD=5.67), mostly male (62%) and white (90%), living in residential communities (86%), with no known cognitive or communication deficits. Interview data was used to iteratively assess and revise photographs. A total of 46 photographs demonstrated CV; 26 demonstrated CV after revisions; 3 did not demonstrate CV after revisions. Content analysis revealed thematic codes describing participants’ photograph preferences including image quality, context, subject diversity, and relevance to long-term care. Discussion will include implications for clinicians and researchers on how to evaluate and improve CV of photo-supported verbal assessments.
Life Course Adversity and Early Retirement Due to Poor Health
Authors: Sonnega Amanda , Helppie-McFall Brooke , Lee Haena
Published: December 2021

The relationship between life adversity and physical and mental health is well documented. The present research investigates life course adversity and early retirement due to poor health. Data are from the Health and Retirement Study, including the Life History Mail Survey (LHMS), HRS core surveys, and HRS Psychosocial Leave-Behind surveys. We create measures of childhood financial and social adversity and young-mid adulthood financial and social adversity. Early retirement is defined as self-report of “full” retirement between age 50 and 62. We use a Cox proportional hazards model competing risk framework comparing early retirement when poor health is a major reason for retirement with early retirement for any other reason. Models include covariates for age, gender, marital status, cohort, log household income, and log household wealth. Childhood financial adversity and homelessness in young-mid adulthood increases the instantaneous hazard of early retirement due to poor health.
Bridging Age-Friendly Health Systems Into the Community
Authors: Emery-Tiburcio Erin , Snyder Rani
Published: December 2021

As the Age-Friendly Health Systems initiative is implemented across the country, building bridges into the community assures that older adults live safely, enjoy good health and stay involved in their communities. In this symposium, we present innovative approaches that bridge the Age-Friendly Health Systems initiative into the community. Each presentation explores how the 4Ms concepts are integrated into their programs and enhance community with older adults. CATCH-ON Connect provides free cellular-enabled tablets and individual training to older adults to help them do What Matters to them by using their tablets. Rush@Home is a home-based primary care program that addresses the 4Ms in the comfort of an older adult’s home. Social Connections was co-designed with older adults to decrease loneliness by connecting older adults to each other. The Caregiver Initiative identifies and supports caregivers of older adults by meeting the 4Ms health needs of both caregiver and care recipient. Dementia Friendly Communities engage community stakeholders in a process to become educated, creating safe and respectful environments for individuals with dementia. By exploring these approaches, we can bridge the Age-Friendly Health Systems initiative into the community to support older adults outside the four walls of the health system.
Implementing and Sustaining Family Care Programs in Real-World Settings: Barriers and Facilitators
Authors: Hodgson Nancy
Published: December 2021

This presentation will summarize the extant published studies on the translation of proven family care programs for dementia in different care settings. This review is the first to our knowledge to examine the specific implementation efforts deployed in care settings for different family caregiver programs. In this review, we sought to answer three basic questions: (1) What theory base(s) or conceptual framework(s) guided the implementation of evidence-based family care programs?; (2) What implementation strategies were used to support translation into practice?; and (3) What were the identified drivers of and barriers to organizational change required for adoption of an evidence-based program? Understanding the frameworks and strategies deployed in translational studies published to date can help guide future translation efforts, inform the design of new family caregiver support programs that optimize their implementation potential, and ultimately help to minimize the “family care gap.”
Do Life Course Physical Activity Profiles Reduce the Effects of Childhood Exposures on Cognition?
Authors: Williams-Farrelly Monica , Smith Jacqui
Published: December 2021

Although physical activity throughout life is one of the most reliable predictors of healthy aging, can less consistent or favorable trajectories also improve cognition trajectories among older adults? Drawing from accumulation theories, we use longitudinal data from the Health and Retirement Study and Life History Mail Survey (N=9,309) to examine the early antecedents of cognitive decline and the extent to which different life course physical activity profiles can slow such a decline. Results from latent class analysis reveal seven distinct profiles: consistently low, consistently high, consistently average (reference), improvers, decliners, midlife motivators, and previously athletic “couch potatoes.” Growth curve modeling analyses show that membership in the consistently high class and midlife motivators were associated with better cognition initially and over time, with no difference between the two classes. Additionally, though poor health and learning problems in childhood were associated with worse initial cognition, physical activity does not mediate the relationship.
COVID-19 Perspectives of Assisted Living and Health Care Providers in Seven States
Authors: Zimmerman Sheryl , Sloane Philip , Hickey Johanna , Thomas Kali , Thorp Julia , Poole Meredith , Chaudhry Aisha , Carder Paula
Published: December 2021

Thirty percent of COVID-19 deaths in long-term care were in assisted living (AL), indicating challenges providing care. This project recruited AL administrators and medical and mental health care providers in a seven-state stratified random sample of 250 communities; it asked what was most challenging responding to COVID-19, what was successful, how to have better dealt with COVID-19, and how others could have helped. The most common challenge was addressing residents’ psychosocial needs, explained as “No contact - no hugging. The seniors require touch. It's something we've always done, and we can't do; we're required not to do it.” Successes included infection prevention, and in hindsight, administrators discussed staffing. Related to external entities, one commented, “Come in the building and see what we're doing. Don't sit behind a freaking screen and act like you know what we're doing.” Providers stressed patient access to care and social isolation. Implications will be discussed.
Disruption to Transformation: Aging in the New Normal: A Chat With NIA Senior Leadership
Authors: Kelley Melinda , Kelley Melinda
Published: December 2021

The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, is the federally designated lead agency on aging research and supports significant research on aging as a lifelong process. In the last six years, NIA has experienced a tripling of its budget. Although much of this funding is targeted to Alzheimer’s disease (AD) and AD-related dementias research, there has been an increase in funds allocated to non-AD research in keeping with the overall growth of NIH. This symposium will provide a forum for exploration of the implications of the budget increases for the general research community. NIA’s senior staff will discuss research priorities and programs supported by the Institute. A question-and-answer session will follow these remarks on current funding and future priorities and research directions of NIA.
NIA Division of Geriatrics and Clinical Gerontology
Authors: Hadley Evan
Published: December 2021

Dr. Hadley will discuss research priorities for the Division of Geriatrics and Clinical Gerontology. Dr. Hadley will also be available for small group discussion.
Perspectives From the 85+ Lifestyle Leaders on Social Isolation and Multigenerational Relationships
Authors: Patskanick Taylor
Published: December 2021

The oldest of older adults are especially impacted by many of the measures recommended to slow the spread of COVID-19. This presentation explores changes in Lifestyle Leaders’ experiences with loneliness and their beliefs about the impact of COVID-19 on multigenerational relationships and intergenerational programming. For example, 55.6% strongly agreed or agreed with the statement, “The pandemic will have been more socially impactful on younger generations than older generations.” Lifestyle Leaders remain interested (68%) in virtual or socially distanced intergenerational programming. Particular activities of interest included technology tutoring, pen pals, and outdoor or virtual socializing. Additionally, this presentation will highlight how the Lifestyle Leaders have been impacted by a loss in weak ties and the extent to which the pandemic has prompted them to take on new roles in their families, including “accepting” paid and unpaid caregiving and experiences living with children and grandchildren during the pandemic.
Does Personal Goal Pursuit Alleviate Family Caregiver Stress?
Authors: Turner Shelbie , Hooker Karen
Published: December 2021

Family caregivers may experience reduced stress by maintaining their sense of self throughout their time in a caregiving role. Working towards personal goals is helpful for maintaining a sense of self, but pursuing one’s own goals amidst caregiving responsibilities may be challenging. In this study, we analyze the processes by which caregivers pursue their own personal goals – and how those processes impact daily stress – in an effort to develop a deeper understanding of goal-pursuit as a potential caregiver stress-reducing strategy. We utilized daily data from spousal (N=256 days) and adult-child (N=400 days) caregivers who participated in the PULSE (Personal Understandings of Life and Social Experiences) Project, a 100-day microlongitudinal study on goal pursuit amongst people 50 and older (Hooker et al., 2013). In daily surveys, caregivers reported progress made towards a personally-identified health and social goal, along with a 4-item measure of daily stress. We ran multi-level models to assess how daily goal progress was associated with same-day stress. Spousal caregivers’ daily stress was lower on days when their health goal (Estimate = -1.07, SE = 0.20, p<.0001) and social goal (Estimate = -0.97, SE = 0.15, p<.0001) progress was higher. Similarly, adult-child caregivers’ daily stress was lower on days when their health goal (Estimate = -0.67, SE = 0.19, p<.001) and social goal (Estimate = -0.52, SE 0.24, p=0.03) progress was higher. Results support the hypothesis that maintaining personally-meaningful goals can alleviate caregiver stress, and is a promising tool for caregiver health promotion.
Lessons Learned in the Delivery of Live Remote Group Weight Loss and Physical Activity Interventions for Older Adults
Authors: Fanning Jason , Nicklas Barbara
Published: December 2021

Social connection lies at the root of lasting health behavior change, and as such most effective interventions are built around social tools. Group leaders and peers provide education, and act as models of successful change and collaborators in addressing common barriers to behavioral adoption and maintenance. Unfortunately, many older adults do not have access to high quality group programs due to factors such as limited transport options, lack of local availability, or worries over personal safety. Importantly, developing effective, synchronous remote group programming is not as simple as delivering an in-person session via teleconference software. Instead, careful consideration must be paid to technology selection, fostering effective group communication, and developing confidence for use of remote intervention tools. This symposium provides key lessons learned from three group-based activity and weight loss interventions for older adults that focused on live, remote interaction. Jason Fanning will share lessons from the MORPH study, which paired remote group-mediated behavioral counseling with dietary weight loss and the accumulation of aerobic activity across the day. Christina Hugenschmidt will share her experiences adapting a group program involving improvisational dance or social gaming for remote delivery. Kushang Patel will present results from a mixed-methods study on the feasibility and acceptability of a remotely-delivered exercise program for older adults with knee osteoarthritis. Finally, Barbara Nicklas will place these experiences in the context of the development of exercise interventions for older adults over time, and highlighting vital next steps for ensuring more older adults have access to this important behavioral medicine.
New Developments in Views on Aging Research: Variability, Innovative Concepts, and Contextual Perspectives
Authors: Kornadt Anna , Wahl Hans-Werner , Wurm Susanne
Published: December 2021

Views on aging (VoA) such as attitudes toward own aging, awareness of aging or subjective age, have a large impact on outcomes related to positive development in later life. Recent research in this domain has focused on complex research designs and inter-systemic linkages at different levels. Indicators of short-term variability of VoA have increasingly been investigated, linking the respective findings with performance indicators, biomarkers, and trait-like data. In addition, bidirectional relationships of VoA and outcomes over time as well as data contextualizing VoA across historical time may offer new insights on the plasticity of VoA seen in bio-cultural co-construction. The symposium will showcase these recent trends with studies from the U.S. and Germany. First, Zhu and Neupert extend previous studies by linking established VoA indicators with future time perspective, all assessed by means of a daily diary study with 60-90 year-old adults. Kornadt et al. examined the variability of subjective age within a day and the relationship with trait subjective age and cortisol levels. Mejia et al. extend VoA to the area of subjective awareness of fall risks in daily life and links them with physical performance. Wettstein et al. investigate the bidirectional relationship of VoA indicators and perceived stress over time. Finally, we move from the micro to a macro-micro design in Wahl et al.’s presentation addressing historical change in VoA across 20 years in the Berlin Aging Study and in MIDUS. Susanne Wurm will discuss how different levels of VoA analysis will find better interlinkage in the future.
Caregiver-Assisted Pain Coping Skills Training for Patients With Dementia: A Pilot Study
Authors: Porter Laura , Keefe Francis , Barnes Deborah , Gwyther Lisa , Schmader Kenneth , Ritchie Christine
Published: December 2021

Pain is common and undertreated in patients with dementia, and contributes to disability, psychological distress, neuropsychiatric symptoms and caregiver stress. The goal of this study was to develop a caregiver-assisted pain coping skills training protocol tailored for community-dwelling adults with mild-moderate dementia and their family caregivers. We conducted interviews with patients and caregivers to develop the protocol. We then conducted a single arm pilot test of the intervention’s feasibility and acceptability. Patients were recruited from an outpatient memory care clinic and screened for pain using the validated Pain, Enjoyment, General Activity (PEG) scale. The intervention included five sessions of training in pain assessment, relaxation, pleasant activity scheduling, and integrative movement. Initially sessions were conducted in person or by videoconference according to the dyad’s preference; during COVID-19 (latter half of study) all sessions were conducted remotely. Eleven dyads consented and provided baseline data [patients: mean age=77.7 years (SD=4.8), 70% non-Hispanic white; caregivers: mean age=69.6 years (SD=13.3); 91% non-Hispanic white; 73% spouses]. Nine dyads (82%) completed all five sessions. Caregivers reported high levels of satisfaction with the intervention (mean=3.4 on 1-4 scale) and frequent use of pain coping skills (mean=3-4 days/week). On average, patients reported pre-post decreases in pain severity (mean=-1.2, SD=1.8) and pain interference (mean=-0.64, SD=0.67) on the Brief Pain Inventory. Overall these findings suggest that a behavioral pain coping intervention for patients with mild-moderate dementia and their caregivers is feasible, acceptable, and potentially helpful for managing pain.
Social Isolation and Accelerated Tooth Loss Among Chinese Older Adults
Authors: Qi Xiang , Pei Yaolin , Wang Katherine , Han Shuyu , Wu Bei
Published: December 2021

Social isolation and loneliness in older adults are major global public health concerns. Tooth loss is also a common problem in this population. This study examined the effects of social isolation and loneliness on the number of remaining teeth and the rate of tooth loss among Chinese older adults. We included 4,268 older adults age 65+ from three waves of the Chinese Longitudinal Healthy Longevity Survey (2011/2012, 2014, 2018). Linear mixed-effect models showed higher levels of social isolation were associated with fewer remaining teeth (β = -1.59, P < 0.05) and accelerated tooth loss (β=-0.10, P<0.05) controlled for socio-demographic, lifestyle, oral hygiene behavior, and health status. Loneliness was neither associated with the number of remaining teeth (β=0.64, P>0.05) nor with the rate of tooth loss (β=-0.09, P>0.05) before and after controlling for covariates. These findings expand our knowledge regarding the correlation between social connection and tooth loss in non-Western populations.
Aging in the Right Place? Photovoice With Older Adults Residing in Shelters During COVID-19
Authors: Kaushik Vibha , Hoselton Jill , Walsh Christine
Published: December 2021

Aging in the right place (AIRP) involves supporting older adults to live as long as possible in their homes and communities, recognizing that where an older person lives impacts their ability to age optimally and must match their unique lifestyles and vulnerabilities. Photovoice, a participatory action research strategy, allows people to document their experiences through photography, promoting critical dialogue about issues such as AIRP and rights-based housing. This presentation highlights the concept of AIRP from the perspectives of a diverse group of older adults living in promising practices shelters in Vancouver, Montreal, and Calgary, Canada using photovoice. Findings indicate that the process promoted a sense of empowerment among participants. Insights about older adults’ perceptions of AIRP residing in shelters to best meet their intersectional identities, housing, and support needs will be shared. Findings inform policy initiatives that promote AIRP and the right to adequate housing for older adults experiencing homelessness.
Disparities in Dental Services Use Among Urban and Rural Adults in China’s Megacities
Authors: Qu Xiaomin , Qi Xiang , Wu Bei
Published: December 2021

Using data from the ‘2019 New Era and Living Conditions in Megacities Survey’ that included 4,049 residents aged 18-65, we examined the urban-rural disparities in dental visits among adults living in China’s 10 megacities. All of China’s megacities are metropolitan regions that include urban, peri-urban and rural land, and all have rural populations within the city boundaries. The results show that 43.3% (n=595) rural and 23.8% urban (n=637) residents had never visited dentists. Urban residents were more likely to visit dentists than rural residents after controlling for covariates (OR=1.57, 95%CI=1.30 to 1.91). The rates of visits were similar across age groups. Higher socioeconomic status, having urban insurances, having positive attitudes towards healthy diets and visited physicians regularly, and having poorer oral health was associated with higher odds of visiting dentists (P<0.05). These findings can help develop policies to increase dental care access to underserved populations in Chinese megacities.