bluuebunny/crossref_metadata_2025 huggingface dataset:
VULNERABILITY AND RESILIENCE IN SWISS CENTENARIANS: FINDINGS FROM THE SWISS100 PHONE STUDY
Authors: Jopp Daniela , Cavalli Stefano , Herrmann Francois , von Gunten Armin , Martin Mike , Uittenhove Kim , Falciola Justine
Published: December 2023

Altfhough every second child born after the year 2000 is expected to become a centenarian, little is known about what characterizes life at age 100. This is also the case for Switzerland, one of the countries with the highest life expectancy world-wide. In this presentation, we will report findings from SWISS100, the first nation-wide centenarian study in Switzerland. During the COVID-19 pandemic, we conducted a telephone study with centenarians and a family member as proxy informant, to investigate specific characteristics and challenges of centenarians. Centenarians were identified through the national address registry. A total of 171 centenarian cases were included in the SWISS100 Phone Study, including reports from 96 centenarians and 102 proxy respondents (mostly children). Centenarians were on average 102 years old, with a range of 100 to 110 years; 75% were women and 25% were men. One third of the centenarians had received basic education only, one third had completed an apprenticeship and about one third had higher education. Most of them lived in institutions (63%). Of those living in private, about half lived alone, one fourth lived with a child, and 12% still lived with a spouse. The majority was widowed. About 85% had children. Over half of the centenarians reported good to excellent subjective health; at the same time, over 70% of the centenarians indicated to often experience health restrictions. Those still able to communicate had high well-being and notable psychological strengths. In sum, findings demonstrate vulnerability but also psychological resilience in Swiss centenarians.
DEPRESSIVE SYMPTOMS IN CENTENARIANS DURING THE COVID-19 PANDEMIC: FINDINGS FROM THE SWISS100 STUDY
Authors: da Rocha Carla Gomes , von Gunten Armin , Falciola Justine , Uittenhove Kim , Cavalli Stefano , Herrmann Francois , Martin Mike , Jopp Daniela
Published: December 2023

Depressive symptoms (DS) are prevalent among older adults (WHO, 2021). However, data on DS appear to be scarce in centenarians. In addition, DS may have been aggravated by the COVID-19 pandemic, especially in centenarians who may have been more susceptible to the negative consequences of pandemic restrictions. Thus, as part of the SWISS100 study (Jopp et al., 2023), we measured DS in centenarians living in Switzerland during the COVID-19 pandemic. Randomly selected centenarians from across the country and their proxies were invited to participate in a telephone interview between December 2020 and June 2022. The study sample was composed of 171 centenarians, with a mean age of 101.8 (SD=1.7) years; 128 (74.9%) participants were female and 63 (36.8%) lived at home. DS were assessed via five selected items of the Geriatric Depression Scale (Sheikh and Yesavage, 1986). The mean DS score was 1.6 (SD=1.6). Considering a cut-off ≥2 (Brañez-Condorena et al., 2021), 75 (43.9%) centenarians were screened positive for possible depression. Further analysis indicated that women had a higher level of DS, and that nursing home residents were more depressed than community-dwelling centenarians. Thus, our study suggests that almost half of the centenarians may have presented with relevant DS during the pandemic in Switzerland, which is notably higher than in other studies. DS in centenarians should be screened systematically, not less so in the context of a health crisis. Depressive symptomatology in the very old is highly relevant for successful professional care and needs further investigation to develop best practice.
SELF-PERCEPTIONS OF AGING AMONG VERY OLD PARENTS AND THEIR OLD CHILDREN IN KOREA
Authors: Kim Kyungmin , Kim Joohyun , Min Joohong , Kim Yijung , Boerner Kathrin , Jopp Daniela , Han Gyounghae
Published: December 2023

Research has documented the health consequences of how individuals view their own age-related changes and aging (i.e., self-perceptions of aging) in later life. However, less is known about how individuals’ self-perceptions of aging are shaped by their intergenerational experiences. This study aims to examine very old parents’ and their old children’s self-perceptions of aging within the dyads—where parents and children age together. Utilizing data from 105 dyads of parents (aged 81+) and their children (aged 65+) in South Korea, we examined how parents’ and children’s health status and care experiences are associated with their self-perceptions on aging. On average, parents reported less positive self-perceptions of aging than their children; parents’ self-perceptions of aging were positively correlated with their child’s self-perceptions of aging. A path model found that care experiences within the parent-child dyads were significantly associated with self-perceptions of aging for both parents and children—such that more caregiving burden was associated with less positive self-perceptions of aging for children and higher levels of satisfaction with received care from the child were associated with more positive self-perceptions of aging for parents. However, health status was significant only for parents; that is, parents with fewer functional limitations in activities of daily living tended to show more positive self-perceptions of aging. The findings highlight the interdependence of self-perceptions of aging within the parent-child dyads in very late life, suggesting that care experiences within the prolonged relationship constellation should be considered to enhance older adults’ views on age-related gains and loss.
POLICY CONSIDERATIONS FOR GERONTOLOGY AND GERIATRICS CONTENT IN HEALTH PROFESSIONAL EDUCATION
Authors: Kusmaul Nancy
Published: December 2023

Health professions educators in fields such as nursing, medicine, and social work struggle to prepare practitioners for the needs of growing numbers of older adults. In 2008, the National Academies of Science Engineering and Medicine identified that fewer than 5% of physicians choose to specialize in geriatrics, and even fewer in geriatric psychiatry, leading to significant shortages in mental health care for older adults. While other health professions such as clinical social workers or psychiatric nurse practitioners could potentially fill this gap, the story is the same in social work (4%) and nursing (1%). These numbers have improved marginally over the last fifteen years, but growing numbers of older adults have exacerbated shortages. In these professions, and in others, the model has been to have geriatrics/gerontology as a specialty, rather than integrated into the curriculum. Yet the interest in this specialization is not there and practitioners will have more exposure to this population than they might think. Members of the Social Research Practice & Policy section of GSA consider how we can shape policy to enhance geriatrics and gerontology education, and where AGHE can support health professions education (nursing, medicine, social work, etc.) and interdisciplinary health professional education in gerontology.
PUBLISHING ON A GLOBAL SCALE IN GERONTOLOGY: A VIEW FROM THE EDITORS’ DESKS
Authors: Miller Edward , Simpson Elizabeth , Castle Nicholas
Published: December 2023

Global aging has proceeded at an unprecedented and accelerating rate. The aging of the population creates both opportunities and challenges for older adults, their families, and society. Importantly, there is substantial variation in the effects of and response to global aging both within and across nations depending, in part, on prevailing cultural expectations and values, political and economic imperatives, and social and demographic characteristics. Thus, while some regions and countries have responded with innovative policies and programs to better enable the growing cohort of older adults to remain active and engaged in the community, other regions and countries have struggled with their response or barely begun to plan for the rising population of older adults. This symposium assembles editors at five leading gerontological journals to demonstrate the role that peer-reviewed scholarship can play in disseminating knowledge that informs gerontological research, policy, and practice internationally. The editors include: Edward Alan Miller, PhD, Journal of Aging & Social Policy; Kyungmin Kim, PhD, Research on Aging; Julie Robison, PhD and Debra Dobbs, PhD, Journal of Applied Gerontology; Julie Patrick, PhD, International Journal of Aging and Human Development; and Sandra Torres, PhD, Ageing & Society. Each presenter will review the scope, content, and focus of their journals and the role and opportunities for international scholarship. Nicholas Castle, PhD, International Editor at The Gerontologist, will serve as discussant.
MOVING FORWARD TOWARD DEPLOYING HEALTH INFORMATION TECHNOLOGY IN ALL US NURSING FACILITIES
Authors: Alexander Gregory , Caraballo Christina , Moen Maria , Morton Cynthia , O’Malley Terry
Published: December 2023

The Moving Forward Coalition established a health information technology (HIT) committee to develop action plans to advance the adoption of HIT in all nursing facilities. Currently, more than 70% of nursing facilities in the US have some HIT, although the levels of utilization vary greatly. Few facilities, however, have successfully implemented the capabilities required to survive in a Value Based Payment (VBP) model which Medicare will mandate by 2030. Fewer still have HIT that collects the resident’s goals, preferences, and priorities (GPPs) efficiently and in detail despite current CMS requirements for person-centered care. To the best of our knowledge, no nursing facilities possess an HIT-enabled capability to determine whether the care provided aligns with the individual’s GPPs. In this presentation, members of the HIT Committee of the Moving Forward Coalition will discuss the rationale for adopting the following three HIT priorities to realize the target goals of the Coalition and will review progress made to date: 1) develop a benchmarking tool that enables nursing facilities to understand and plan for the HIT capabilities needed to meet upcoming regulatory requirements and for successful participation in a VBP model, 2) create a taxonomy of GPPs and an HIT-based process to collect them, and 3) develop and test an HIT-enabled process to measure the concordance of care provided with an individual’s GPPs. Although the Moving Forward Coalition and the NASEM report focus on nursing facilities, the HIT tools being developed here will benefit all sites of care.
UNDERSTANDING PERSON-CENTERED CARE FOR OLDER PEOPLE IN SIX DEVELOPING COUNTRIES
Authors: Wang Jing , Bowers Barbara
Published: December 2023

Person-centered care (PCC) is a widely acknowledged and encouraged approach to quality care for older adults residing in residential care facilities. However, current understandings of PCC are mainly based on research and practice in western, first world nations. The lack of research on PCC in developing countries leads to uncertainty over whether and how current understandings of PCC apply to cultures and contexts in non-western, developing countries. To enhance care and outcomes for diverse populations, it is crucial to comprehend and culturally adapt PCC understandings and approaches. Therefore, we conducted interviews with researchers and practitioners from six countries in various stages of development to identify elements that form the core of high-quality care for older people and how they relate to Western notions of PCC. We gained valuable insights into how cultural differences, population health priorities, political conflict, and limited resources impact their understanding and implementation of PCC. In addition to variations in the language of PCC, some first world assumptions about PCC do not resonate well in developing countries. One example is the emphasis on individualism, a basic element of PCC. The role of the older person in decision making and focus on family and community priorities reflects both cultural and economic differences between first world, western nations and non-western, developing countries. The findings can serve as a valuable starting point for the development of a globally applicable measurement for the quality of care.
RECENT ADVANCES IN ASSESSING AGE DIFFERENCES IN AFFECT DYNAMICS
Authors: Wirth Maria , Mikkelsen Mai , Charles Susan
Published: December 2023

Affective experiences are inherently dynamic and short-term changes in affect offer important insights into well-being. Changes in the processes underlying affect dynamics, namely, affect reactivity and regulation, are often invoked as explanations for age-related stability or enhancement of well-being. However, previous evidence for age differences in affect dynamics is inconsistent. In this symposium, we leverage theory-based approaches and cutting-edge statistical tools to gain a deeper understanding of how individuals manage daily affect. Wirth and colleagues investigated age differences in affect reactivity and regulation, using a formalized theoretical approach to affect dynamics. Their results indicated complex, multi-directional age differences in reactivity and regulation. Neupert and Graham focused on the idea that perception of time remaining in life plays a key role in age differences in affect dynamics. Feeling closer to death was related to lower positive and higher negative affect. These relations were particularly pronounced in older adults. Wolfe and colleagues investigated age-differential associations between cognitive capacities and affect regulation preferences. Their results indicated that cognitive capacities affected regulation preferences mostly in middle-aged rather than older adults. Mikkelsen and colleagues related affect regulation patterns to well-being in an age-diverse sample. Their findings indicated that older adults exhibit less variation in regulation strategy use and that regulation effectiveness was less important for well-being in older adults. The discussion will center on the value of considering age-related similarities and differences in affect dynamics, age-relevant factors for successful emotion regulation, and the contexts that might influence affect dynamic processes.
DAILY SUBJECTIVE NEARNESS TO DEATH AND AFFECTIVE DYNAMICS
Authors: Neupert Shevaun , Graham Lyndsey
Published: December 2023

A core tenet of Socioemotional Selectivity Theory is that perception of time remaining in life plays a key role in the selection and pursuit of emotion regulation goals. The current study examined this idea within a daily diary framework, where subjective perceptions of nearness to death were reported on consecutive days. Age differences in the within-person coupling between daily subjective reports of nearness to death and daily affective dynamics were tested. A 14-day daily diary study of 440 adults (M age = 65, range 50-85) in the U.S. was conducted where participants reported on their subjective nearness to death, positive affect, and negative affect each day. Multilevel models were conducted separately for positive and negative affect. Being older and feeling farther away from death on average were each associated with higher levels of positive affect. Daily negative affect was predicted by both within-person and between-person constructs. On days when people reported feeling subjectively closer to death than their own average, they also experienced an increase in negative affect. A significant interaction revealed that this effect was particularly strong among older adults (aged 65+). These results suggest that daily manifestations of perceptions of limited time remaining in life are salient for daily affective dynamics, and that this salience is particularly pronounced among older adults relative to those in midlife.
ASSOCIATIONS BETWEEN COGNITIVE RESOURCES AND EMOTION REGULATION TACTICS IN AN ADULT LIFESPAN SAMPLE
Authors: Wolfe Hannah , DiGirolamo Marissa , Isaacowitz Derek
Published: December 2023

The current study investigated how trait-level cognitive capacity relates to emotion regulation tactic preferences in everyday life in adulthood and old age. 51 younger adults (ages 18-39), 53 middle-aged adults (ages 40-59), and 55 older adults (ages 60+) completed measures of working memory and verbal fluency, as well as 21 days of experience sampling. On each survey, participants indicated if they had regulated since the last survey and if so, what emotion regulation strategies they used and how they implemented that strategy through specific emotion regulation tactics. Each strategy laid out by the process model (situation selection, situation modification, attentional deployment, reappraisal, response modulation) could be implemented in three specific ways (called “tactics”): positivity-upregulating, negativity-downregulating, or negativity-upregulating. For example, a person may indicate they used situation selection and then would be asked whether they chose to (a) seek out a positive situation, (b) leave a negative situation, and/or (c) enter a negative situation. Acceptance was also included as a fourth tactic type but was not categorized under any strategy. Proportions of tactics used in each instance was calculated. Acceptance use was significantly negatively correlated with working memory performance; however, this association appeared to be driven primarily by middle-aged adults. Negativity-downregulation was positively correlated with numerous cognitive capacity measures in middle-aged adults. In sum, individual differences in cognitive resources appear to play the strongest role in tactic preferences in midlife rather than old age.
DEVELOPMENT AND TESTING OF THE PC-MET (PERSON-CENTERED MEASURE EVALUATION TOOL)
Authors: Zimmerman Sheryl , Mast Benjamin , Port Cynthia , VanHaitsma Kimberly , Fazio Sam
Published: December 2023

Despite the importance of person-centered measurement -- and that numerous research instruments are now available to measure person-centeredness -- there are no tools to evaluate the extent to which existing research instruments themselves are developed consistent with principles of person-centeredness. The PC-MET (Person-Centered Measure Evaluation Tool) was developed to fill that gap. Based on literature and theory, the PC-MET assesses the process of instrument development and the content of the instrument itself based on six overarching criteria of person-centeredness: co-creation, accommodation, incorporation, biopsychosocial-cultural components, pragmatism, and systemic focus. The inter-rater reliability of the PC-MET was evaluated based on instruments recommended for use in relation to the Alzheimer’s Association 2018 Dementia Care Practice Recommendations (DCPR). Independent raters evaluated two measures within each DCPR area using the PC-MET. Agreement was excellent (kappas>0.81) across all PC-MET criteria with the exception of the criteria assessing biopsychosocial-cultural components (where agreement was moderate; kappa=0.42) and pragmatism (where agreement was substantial; kappa=0.68). Raters provided feedback on the PC-MET and agreed or strongly agreed that the tool is easy to understand and score; the six PC-MET criteria are relevant and complete; and the PC-MET could improve the person-centeredness of dementia measurement instruments. The PC-MET has broad potential use, including to critique the extent to which existing instruments are person-centered, to promote efforts to make existing measures more person-centered, and to inform the development of new person-centered measures. This work was supported by the NIA through a grant to the Alzheimer’s Association and by the LINC-AD Research Steering Committee.
A POINT OF NO RETURN: A QUALITATIVE ANALYSIS ON RETURN MIGRATION AND AGING OF JAPANESE INDIVIDUALS LIVING IN NEW YORK
Authors: Toyama Itsuko , Nakashima Taeko
Published: December 2023

Our previous quantitative research studies have revealed that many older Japanese individuals living in overseas communities maintain hope of receiving culture-oriented care or harbor aspirations of returning to Japan to live out their final days. In this study, we analyzed the qualitative data of a free-answer question on anxieties about aging from a quantitative research study on older Japanese individuals living in Greater New York in 2018. We aimed to clarify the qualitative characteristics of anxieties among three groups: those who had decided to stay in the United States (“abiding”), those who had decided to return to Japan (“returning”), and those who had not yet decided (“undecided”). In the quantitative study, 2,057 questionnaires were distributed, with an overall return rate of 29.7%. The respondents were divided into three groups based on their answers regarding their intentions for the location of their final residence: the United States, Japan, or undecided. We performed the KJ method (affinity diagram) to visualize the differences and commonalities of their anxieties. The following is a summary of the findings: (1) Although most of the respondents are economically advantaged and healthy, “ambiguous“ anxieties about aging in New York arise in all three groups; (2) All three groups express uneasiness about supporting themselves after paying medical and nursing care costs; (3) Those in the “abiding” group express loneliness due to the societal relationship vulnerability in New York; (4) Those in the “returning” group worry about the additional burden of undergoing legal procedures and re-adjusting to the current Japanese society.
RACE/ETHNICITY DISPARITY FOR PEOPLE WITH LTSS NEEDS IN CALIFORNIA: DISABILITY, FINANCE, AND HEALTH AND WELL-BEING
Authors: Chen Lei
Published: December 2023

Older adults and people with disabilities have high needs for Long-Term Services and Supports (LTSS). Disability status, financial difficulties, and health and well-being are likely not uniformly experienced by all people with LTSS needs. Subgroups of older adults and people with disabilities, such as racial/ethnic minorities, may be at significant risk of experiencing financial difficulties and stress about making ends meet. This study used the first cycle of data (2019-2020) from the California Long-Term Services and Supports (CA-LTSS) survey, merged with select data from the California Health Interview Survey (CHIS) (N = 2,030). Multivariate Regressions and Conditional Process Analysis (CPA) were applied to test the hypothesized relationships. Findings show that black/African American and Asian participants with LTSS needs were more likely to have cognitive impairments. Black/African American participants with LTSS needs were more likely to report difficulties in activities of daily living. Racial/ethnic minorities with LTSS needs experienced diverse and more financial difficulties on average than their white counterparts. Asian participants with LTSS needs reported worse psychological distress than other racial/ethnic groups. American Indians and Alaska Natives with cognitive impairments were more likely to have more financial difficulties, and those with difficulty in instrumental activities of daily living were more likely to report worse self-rated health. This study moves beyond the typical white/black disparities analyses and focuses on diverse racial/ethnic groups. We need to address the financial needs of various racial/ethnic groups of people with LTSS needs and target policies and service programs to meet their mental health needs.
RACIAL AND ETHNIC DISPARITIES IN NEIGHBORHOOD SOCIOECONOMIC CHARACTERISTICS ASSOCIATIONS WITH VISCERAL FAT
Authors: Follis Shawna , Shropshire Jeremey
Published: December 2023

Visceral adipose tissue (VAT) has a more significant role in the pathophysiology of cardiometabolic diseases than subcutaneous adipose tissue (SAT). Our previous findings suggest VAT represents an important pathway through which racial disparities in the social environment are biologically embodied. To understand the role of structural racism in this pathway, this paper investigated racial disparities in neighborhood socioeconomic status (NSES) and VAT. We hypothesized that NSES is inversely associated with VAT and VAT/SAT ratio over 6 years and associations differ by race and ethnicity. Abdominal VAT and SAT area (cm2) were measured at years 0, 3, and 6 using dual-energy X-ray absorptiometry in a subsample (n=11,020) of the Women’s Health Initiative (age 50-79). The NSES Z-scores were obtained from the US Census and American Community Survey based on participant’s census tract residence. We evaluate racial and ethnic disparities in the exposure and outcome using ANOVA, and associations between NSES with VAT using mixed effects models. We found that NSES and VAT area differed by race and ethnicity. American Indian and Alaska Native (AIAN), Black, and Latina groups were significantly (P< 0.01) more likely to live in neighborhoods with NSES Z-scores below the population mean (Z-score=0) compared with White and Asian races. AIAN, Latina, and Black women had the highest VAT (220 cm2, 185 cm2, 177 cm2, respectively). Findings support the hypothesis that associations between NSES and VAT differ by race and ethnicity. Results from mixed effects models are expected to provide longitudinal evidence that structural determinants are associated with VAT.
ASSOCIATIONS BETWEEN REVERSED CHILDHOOD EXPERIENCE AND LATE-LIFE COGNITIVE IMPAIRMENT: THE CASE IN CHINA
Authors: Zhang Yalu
Published: December 2023

Exposure to violence, parental incarceration, household substance abuse and some other reversed childhood experience is associated with some negative impacts in one’s late life in some countries, such as difficulties in maintaining interpersonal relationships, being more likely to experience depressive symptoms, and performing certain physical functions. However, the impacts of reversed childhood experiences, such as starvation, unmet needs of healthcare services, and loss of parents, are still unknown. Using nationally representative data, China. Longitudinal Aging Social Survey, and the hierarchical cluster-based partial least squares regression, this study found a notably high prevalence of reversed childhood experience regarding childhood hunger and unmet healthcare needs. In China, 65% of the older adults aged 60 and above had experienced falling asleep with hunger, 83.1% think that their healthcare needs were not met in childhood, and 10.26% lost one or both parents before 10 years old. The regression analysis results show that compared to those who did not have experience falling asleep with hunger, those who had such experience were more likely to have a declined cognitive function by 33.8% (p< 0.001). Additionally, the loss of parents also significantly caused poorer cognitive function by 44.2% (p< 0.001). However, such a causality relationship was not detected among those who experienced unmet healthcare needs. These findings suggest that early prevention and interventions are needed among older adults with adverse childhood experience.
CREATING STRUCTURES FOR SUSTAINABILITY OF EVIDENCE-BASED DEMENTIA CAREGIVER PROGRAMS
Authors: Sherman Carey Wexler , Gaugler Joseph
Published: December 2023

Ensuring sustainable impact for broad-based evidence-based programs (EBPs) serving caregivers for persons living with dementia in the U.S. requires systemic maintenance of programmatic fidelity. This symposium aims to assist decision makers, aging and public health networks, and intervention developers to anticipate and deploy effective strategies and resources required to implement EBP interventions and sustain them. A series of four papers describes precursor studies and activities leading to the development of a structure aimed at ensuring that one such EBP, the Savvy Caregiver® (Savvy), can be faithfully sustained by sponsoring organizations. The first paper presents results from in-depth qualitative interviews of key staff (n=25) in nine organizations delivering Savvy. Findings highlight organizational, structural, and regional collaborations that contributed to sustained EBP implementation with fidelity. The second paper describes an online program to train Savvy interventionists. Informed by the first paper’s findings a fully asynchronous multi-media professional continuing educational interventionist training program was developed in collaboration with the educational design team at Emory’s School of Nursing. The third paper presents results of the online trainer program evaluation conducted among 76 interventionists from 32 organizations in eight states. High scores on content comprehension (95-99%) and participant feedback document benefits of self-paced learning, interactive materials and quizzes, and self-reflective exercises. The final paper describes a platform (Savvy Systems, LLC) created to ensure Savvy’s long-term dissemination, programmatic integrity and sustained use. The single platform provides for authorized content dissemination, leader training, enhanced referrals, and copyright compliance through licensing. Discussant will offer policy and practice implications. This is a collaborative symposium between the Alzheimer’s Disease and Related Dementias and Family Caregiving Interest Groups.
BUILDING AN ONLINE TRAINING PROGRAM FOR SAVVY FACILITATORS
Authors: Hepburn Kenneth , Sherman Carey Wexler , Hobday John , Char Adarsh , Reed Lai
Published: December 2023

Scaling evidence-based interventions to implementing organizations not linked to the development source poses difficulties in maintaining program fidelity. Program facilitator training must ensure consistency of training approach and content material across organizations. A training program must be able to certify that trainees can demonstrate a detailed understanding of the basic curriculum intent, learning objectives, core principles, mechanism of action, and operational details of the intervention. This presentation will describe the development of an online program to train interventionists to facilitate the Savvy Caregiver Program (SCP), a multi-session, group-based psychoeducational intervention grounded in Social Cognitive Theory that helps family caregivers develop the knowledge, skills, and sense of competency and confidence (mastery) important for effective caregiving. In collaboration with the educational design team at the Emory School of Nursing, we developed a prototype, fully asynchronous professional continuing educational interventionist training program. In seven components, the program employed embedded video, text, interactive interfaces, and short self-correcting quizzes to teach core principles, essential facilitator skills, and the dynamics of each of the six SCP sessions. At the end of each segment, learners were required to provide reflections on segment content; they were required to attain a score of at least 80% in order to advance to the next segment (retries were allowed). Based on feedback from the 35 interventionists who participated in the prototype training program, we added additional video assets to further illustrate methods for facilitating the program, further developed the internal quizzes and improved course navigation mechanisms.
STRATEGIES FOR MAINTAINING FIDELITY AND SUSTAINABILITY IN EVIDENCE-BASED PROGRAM DELIVERY
Authors: Gordon Kate , Sherman Carey Wexler , Hepburn Kenneth
Published: December 2023

Federal agencies and advisory councils emphasize the need to expand delivery of evidence-based programs (EBPs) to meet the needs of the increasing millions of family members and friends providing long-term, complex care to persons living with dementias in the U.S. (Alzheimer’s Association, 2022). Achieving lasting value and impact of such implementations requires systematic and replicable programmatic fidelity and sustainability to ensure caregivers’ broad access and positive outcomes, and the significant investments of providers, stakeholders, and funders are maintained. Unfortunately, a paucity of reported evidence on such strategies continues to limit the full benefit of most intervention efforts. (Hailemariam, M., Bustos, T., Montgomery, B. et al. 2019). To inform the larger RO1 effort described in the previous two papers, we recruited nine organizations from diverse regions that deliver Savvy Caregiver® to discern the key strategies employed to ensure program fidelity and sustainability. Semi-structured interviews were conducted with organization directors (n=9) and Savvy coordinators and group leaders (n=23). Thematic content analyses of transcribed transcripts yielded salient findings on fidelity best practices, including: Assuring EBP coherence with an organization’s mission; proactively integrating fidelity into interventionists’ training; and integration of fidelity monitoring strategies. Regarding structural practices supporting sustainability, findings included: Engaging leadership buy-in of Savvy as an anchor program; establishing succession plans for seamless program delivery; creation of local collaborative partnerships for long-term recruitment or in-kind contributions; establishment of infrastructure to secure ongoing state and federal financial support. Findings highlight effective, accessible, and achievable strategies for ensuring long-term benefits for all EBP implementation efforts.
NEW DIRECTIONS IN RESEARCH ON THE DYNAMICS OF PURPOSE IN LIFE AND COGNITIVE AGING
Authors: Sutin Angelina
Published: December 2023

Purpose in life is the feeling that one’s life is goal oriented and has direction. There is converging, replicated evidence that having a greater sense of purpose in life is associated with better cognitive aging outcomes, including less cognitive decline across middle and older adulthood and lower risk of incident dementia. Emerging evidence also suggests that cognitive function may likewise support purpose in life. This symposium highlights recent advances on the dynamics between purpose in life and cognition across varying time scales and populations. Kim will describe the association between purpose in life and the maintenance of better cognitive function across six years in older adulthood and moderators of this association. Nelson and Bergeman will describe how cognitive function supported purpose in life through the uncertainty of the Covid-19 pandemic and moderators of this association. Pfund and colleagues will report on the bidirectional associations between purpose and cognition in older adulthood across four longitudinal samples using a coordinated data analytic approach. Finally, Sutin and colleagues will report on an ecological momentary assessment study that found that in moments when participants felt more purposeful, they had faster processing speed. Collectively, these talks emphasize the dynamic and often bidirectional relation between purpose in life and cognitive function. This work will help stimulate research to better understand purpose and cognitive health and how to leverage purpose in life for healthier cognitive aging outcomes.
RECIPROCAL RELATIONSHIP BETWEEN SENSE OF PURPOSE AND COGNITIVE CHANGE IN OLDER ADULTHOOD: A COORDINATED ANALYSIS
Authors: Pfund Gabrielle , James Bryan , Hill Patrick , Hassenstab Jason , Rule Payton , Willroth Emily
Published: December 2023

Sense of purpose (i.e., the extent to which one has personally meaningful goals and directions guiding them through life) is a consistent promoter of healthy aging for older adults. Unfortunately, while individuals benefit from having a high sense of purpose as they age, many people’s sense of purpose declines during older adulthood. Some evidence suggests that these declines may in part be explained by health declines experienced later in life. With sense of purpose being a powerful predictor of cognitive functioning in older adulthood, the current project evaluates whether this relationship may be more reciprocal in nature. Using a coordinated data analytic approach, this work investigates how sense of purpose and cognitive functioning promote each other and change together as older adults age. Longitudinal data comes from the Health and Retirement Study (N=15,497; 4 waves over 12 years), Memory and Aging Project (N=1,700; up to 15 waves over 15 years), Minority Aging Research Study (N=950; up to 12 waves over 12 years), and Wisconsin Longitudinal Study (N=22,334; 3 waves over 18 years). Based on a series of random intercept cross-lagged panel models, initial results indicate that sense of purpose change precedes cognitive functioning change and vice versa, when accounting for between-person and concurrent within-person associations. Moreover, bivariate latent growth models show that longer-term change in sense of purpose co-occurs alongside changes in cognitive functioning. In this talk, we will discuss how promoting sense of purpose can support successful cognitive aging, and the repercussions of cognitive decline for sense of purpose.
OVERVIEW OF THE NEBRASKA GERIATRIC BEHAVIORAL HEALTH WORKFORCE SURVEY
Authors: Poon Cecilia
Published: December 2023

According to the US Census, more than 16% of Nebraska’s population is 65 and older. Many older Nebraskans reside in rural communities. Although clinicians in existing state-wide workforce surveys endorse working with older adults, it is unclear how frequently they are involved in geriatric mental health. To identify the needs of those who are providing mental health services to older Nebraskans, the Behavioral Health Education Center of Nebraska (BHECN) conducted an online survey of eligible licensed practitioners from August to December 2022. This presentation highlights the background characteristics of 193 respondents, nearly 40% of whom came from rural areas. Two-thirds identified either as licensed mental health therapists (38%), licensed clinical social workers (26%), or licensed psychologists (14%). More than a quarter did not provide direct clinical services to older adults. On average, respondents estimated devoting 18% of their time working with older adults. Respondents listed insurance restrictions, lower reimbursement rates, and limited specialized geriatric mental health training opportunities as major reasons that had kept them from serving older clients more frequently. These findings support BHECN’s ongoing efforts to further develop training and support, and advocate for potential policy changes to enhance the state’s geriatric behavioral and mental health workforce.
EXAMINING THE GERIATRIC SCHOLARS PROGRAM: IMPACT ON CLINICAL PRACTICE AMONG VA PSYCHOLOGISTS
Authors: Rodriguez Rachel , Mehta Priyanka , Gregg Jeffrey , Kramer Josea , Alfaro Ana , Gould Christine
Published: December 2023

Since 2014, the Geriatric Scholars Program – Psychology Track (GSP-P) has offered VA post-licensure psychologists with little-to-no prior geropsychology training an opportunity to enhance their knowledge and skills to better serve rural-dwelling older Veterans. This is achieved through an intensive course on geropsychology competencies, completion of a geriatric mental health focused quality improvement project and optional advanced learning components. A survey of GSP-P alumni was conducted to assess the long-term impact of participation on clinical practice with older Veterans and overall job satisfaction. Out of 148 alumni, 40 (27%) responded to the survey. Most alumni reported working within the home based primary care setting (45%), with the others working in a range of inpatient and outpatient settings. Utilizing a retrospective post-pre design, practice change was evaluated using a measure comprised of 12 items related to clinical practices/behaviors with older Veterans (e.g., “Incorporated a caregiver/family member in the assessment of an older Veteran.”) both before and after participating in the GSP-P. A paired samples t-test, t(29) = -2.91, p = .007, demonstrated a significant difference in clinical practice pre to post engagement with GSP-P, with participants reporting more frequent age-adapted clinical practices/behaviors post GSP-P participation. Sensitivity analyses showed a moderate effect size d = -.53 (95% CI: -.91, -.144). Qualitative responses reflected alumni growth in confidence and satisfaction in working with older Veterans, as well as more utilization of age-adapted evidenced based assessment and intervention. Overall, this evaluation shows that targeted training can improve psychologists’ clinical practice with older Veterans.
AGETECH AND THE ETHICAL IMPERATIVE
Authors: Chu Charlene , Boger Jennifer , Sixsmith Andrew
Published: December 2023

“AgeTech” refers to technological trends in e-health, robotics, artificial intelligence (AI), and mobile technologies” as a way to improve the health, well-being, independence, and social participation of older people. This symposium provides an overview of the imperative to integrate ethics into the design and development of technology, from start to finish. The first talk presents reflections from older adult members of two AgeTech groups: AGE-WELL’s Older Adults and Caregivers Advisory Committee, and the Research Group of Seniors 411, which will outline the ethical issues and ageism experienced by older adults. To further examine these issues, the second presentation explores a framework for how ageist attitudes can be encoded and perpetuated as digital ageism, both in AI and other technologies, and highlights a need for broader community inclusion. The third paper explores the challenges of virtual community inclusion, highlighting the challenges and benefits of digital participation in a post-COVID world. A health equity focus will be applied when highlighting the unique needs of seldom-heard and under-served older people in virtual spaces to enhance social inclusion. The last paper will highlight the “ethical by design” approach that will encourage and support culture change within AgeTech research and industry. This symposium will contribute to a more ethical, and inclusive design of technologies to support healthy aging.
INCLUSIVE AGING AND DIGITAL PLACE-MAKING IN AGETECH: THE INCLUDEAGE PROJECT
Authors: Sixsmith Judith , Fang Mei
Published: December 2023

This presentation will address the challenges of virtual community inclusion for older people, with a focus on seldom-heard and under-served groups, such as those with intellectual and developmental disabilities (IDD) and those who identify as lesbian, gay, bi, trans + (LGBT+). Given that the COVID-19 pandemic has amplified the digital divide, further excluding marginalized social groups, the aim of this ESRC funded IncludeAge Project is to explore how virtual spaces can be made more inclusive to enhance social inclusion and support health equity. The presentation will consist of two key elements. Firstly, current discourses and definitions of ’community’ and ’inclusion’ in digital spheres will be discussed through findings from a scoping review. Secondly, the presentation will introduce new and innovative ways of digital participatory mapping working alongside older people with IDD and those who identify as part of the LGBT+ community using ArcGIS digital storymapping. This approach offers a unique and powerful way of including under-served groups in the design and development of inclusive AgeTech. The presentation will further highlight the challenges and benefits of digital participation in a post-COVID world, particularly for those who experience exclusion. It will demonstrate the importance of involving under-served groups in the design and development of digital spaces to enhance social inclusion and support health equity. To conclude, we will discuss how these new ideas might be used to shape government policy and organizational practices when it comes to the future of inclusive AgeTech research, design, and development with and for older people.
FACILITATORS AND BARRIERS TO IMPLEMENTING A VIRTUAL REALITY PROGRAM IN LONG-TERM CARE
Authors: Hung Lillian , Wong Joey , Upreti Mona , Kan Winnie , Tumar Alisha , Hardern Sonia , Mann Jim , Wallsworth Christine
Published: December 2023

To successfully implement virtual reality (VR) programs for long-term care (LTC) residents, it is essential to consider contextual factors. However, current research does not explore the LTC staff’s perspectives on implementing VR in their workplaces. This qualitative study aimed to fill this gap by exploring the facilitators and barriers to adopting VR in LTC, guided by the Consolidated Framework for Implementation Research (CFIR). We applied a Collaborative Action Research (CAR) approach, which involved three phases: (1) Reflect and Plan, (2) Act and Adapt, and (3) Evaluate. Ten focus groups were conducted with 20 staff in two Canadian long-term care homes. Thematic analysis was performed collectively with the team, including researchers, trainees, and patient and family partners. Our findings suggest that implementing a VR program in LTC requires readiness and capacity for implementation within the care home. Key factors that enabled implementation were staff champions, perceived benefits, and ease of use of the equipment. However, there were also barriers, such as limited resources, including Internet infrastructure, limited adaptability to meet local needs, and relative priority and staff workload. To overcome these barriers, our results indicate a need for organizational support for infrastructure and human resources. In addition, future research can evaluate the potential impact of facilitating residents’ VR sessions on staff’s job satisfaction and the involvement of residents’ families/caregivers as well as volunteers during the sessions to reduce staff hesitancy and workload.
THE BENEFITS OF POSITIVE SOLITUDE IN LATE LIFE
Authors: Palgi Yuval , Bodner Ehud , Segel-Karpas Dikla
Published: December 2023

Positive solitude is the capacity to choose spending time by yourself in a positive manner. This session provides a wide glance on the advantage of this capacity at the second half of life. The session will try to present new theoretical perspectives regarding this capacity. The lectures will give an opportunity to follow the directions in which research in this new field is being developed. The first lecture by Palgi will describe the theoretical background for the study of positive solitude, and will provide new findings from the positive solitude scale that was lately develop by the authors. The second presentation by Bodner will describe how emotional regulation through music moderates the relationship between mindfulness and positive solitude. The third lecture by Zambrano Garza is contributing to the understanding of solitude in the interpersonal domain. Based on dyadic diary study, demonstrates that more voluntary solitude was associated with more positive affect of the partner and more negative solitude was related to more negative affect of partner. The forth lecture by Segel-Karpas will focus on the contribution of positive solitude and loneliness on negative aspects of mental health. Finally, the fifth presentation, by Jennifer Lay, will show use natural language processing to identify solitude experiences from older adults’ reports. We will conclude the session by discussing future research directives for the implementation of positive solitude in the field of gerontology, such as the development of interventions that may enhance the tendency for positive solitude in old age.
TIME BY YOURSELF: THEORETICAL BACKGROUND AND FINDINGS FROM THE NEW POSITIVE SOLITUDE QUESTIONNAIRE
Authors: Palgi Yuval , Segel-Karpas Dikla , Mor Sharon Ost , Hoffman Yaakov , Bodner Ehud
Published: December 2023

The present study describes the development of a new questionnaire for measuring positive solitude. First we will discuss the conceptualization of positive solitude, and refer to the contradictions that exist in the literature regarding this concept. We will then present the theoretical background on which we based our questionnaire, and some empirical findings regarding its utility. We will describe the 9-item tool and its relationships to positive and negative measures of well-being and mental health. Furthermore, we will discuss findings from a Holocaust survivors study showing the role of positive solitude on posttraumatic symptoms. We will conclude this presentation by discussing several future directives, some of which that will be discussed in other presentations of this symposium.