bluuebunny/crossref_metadata_2025 huggingface dataset:
THE REVIEW PROCESS AND TAKING STEPS TOWARD A SUCCESSFUL APPLICATION
Authors: Femia Elia , Plude Dana
Published: November 2019

Applications reviewed by the Center for Scientific Review go through a process that starts with assignment to a review panel and ends with the assignment of a priority score and the production of a written evaluation (summary statement). This process is overseen by a Scientific Review Officer, who enlists expert reviewers to evaluate the scientific and technical merit, and the potential contribution and impact of the application to the research field. The goal is to ensure that applications are expertly and fairly evaluated in accordance to the NIH policies of rigor, reproducibility, transparency, and research integrity. In this presentation, learn about the criteria for review of an application, how reviewers shape their evaluation, and what applicants should be addressing in their grant applications. From the field, hear tips from successful applicants and experienced reviewers about what they do and what they look for in a well-written application.
TYPES OF APPLICATIONS AND PUTTING YOUR BEST FOOT FORWARD
Authors: Plude Dana , Plude Dana , Femia Elia
Published: November 2019

The majority of peer review is conducted through the NIH Center for Scientific Review (CSR), which works closely with the institutes and centers who ultimately fund projects of high scientific merit and high potential impact. CSR conducts the review of 90% of R01s, 85% of Fellowships, and 95% of SBIR applications as well as many other research and training opportunity activities. The playing field for successful funding from NIH is highly competitive. Understanding about different application types, who to talk to about your application, finding the right review panel, and learning about the policies pertaining to review are important steps in preparing an application. In this presentation, learn about the important aspects of the grant submission process and how CSR conducts the review of application in close coordination with NIH’s 24 institutes and centers.
OLDER PEOPLE AND TECHNOLOGY: THE GOOD, THE BAD, AND THE UGLY
Authors: Antonucci Toni C
Published: November 2019

The use of multiple technologies in the service of social relations in widely evident. It is not at all clear, however, that we recognize the fundamental changes in social relations that are occurring as a result. Some changes are quite positive, e.g., low cost maintenance of geographically distant but emotionally close relationships. Others can be quite negative, e.g., the lost ability to gauge emotional reactions through face-to-face contact, often resulting in unnecessarily hurtful behaviors. Preliminary data indicate that people selectively use different forms of communication under positive circumstances, e.g. to transmit good news; or negative circumstances, e.g. resolve a dispute/express anger and dependent on the nature or closeness of the relationship e.g., parent, spouse, child. We need to be mindful of the good, the bad, and the ugly of technology; and, its specific effect on the relationships of and with older people.
TECHNOLOGY DESIGN TO SUPPORT SOCIAL ENGAGEMENT FOR OLDER ADULTS
Authors: Rogers Wendy
Published: November 2019

Evidence that loneliness and isolation are precursors to myriad negative health issues is accumulating. For older adults, social engagement may be particularly important due to life-changing events that can accompany older adulthood, including retirement, disease, or mobility limitations. Individuals vary in their levels of social engagement, and these differences may have consequential effects on quality of life. Technology has the potential to create and enhance social engagement opportunities for older adults at risk for social isolation. For such technology innovations to be effective and widely adopted, designers must consider the unique needs, capabilities, limitations, and preferences of older adults. I will describe technologies that currently exist (e.g., apps, mobile devices, social networking) or are being developed (e.g., robotics, telepresence, virtual reality) to support social engagement, connectedness, and community participation. I will discuss the potential of these technologies as well as the design and training challenges unique to older adults.
SOCIAL ISOLATION AND OLDER ADULTS: WHAT ROLE CAN TECHNOLOGY PLAY?
Authors: Czaja Sara J
Published: November 2019

Social isolation and loneliness are prevalent among older adults especially those who live in rural locations, have mobility restrictions, are in the older cohorts, live alone or live in residential institutions such as assisted living facilities or nursing homes. The detrimental consequences of isolation and loneliness on physical, cognitive, and emotional health are well documented. Technology applications such as the email, social media sites and online support groups hold promise in terms of enhancing engagement and providing support to older people and mitigating the negative impact of isolation and enhancing quality of life. Recent data indicate that use of these types of applications is increasing among older adults but there is still an age-related digital decline. This presentation will present findings from CREATE and other trials regarding the access to and use of these applications among older adults and the resultant impact on the social connectivity, loneliness and social support.
IMMUNIZATION AS A HEALTHY AGING STRATEGY
Authors: De Gomensoro Eduardo
Published: November 2019

The burden of infectious disease is heavier at the extremes of life: the youngest and the oldest typically have the highest incidence of infectious diseases along with morbidity and mortality. Demographic studies show by the next decade, adults over 65 will outnumber children under 5 years of age. Unfortunately, vaccination coverage in older adults even where permissive recommendations exist is universally lower than in infants or children. Key reasons are a lack of knowledge and understanding of the benefits of vaccination, and inconsistent recommendations by providers. Recently, the concept of ‘healthy aging’ – regular vaccination and lifestyle modification including exercise and diet – has been proposed to go beyond disease prevention and address quality of life issues such as the ability to remain in work, and to live independently. Public and healthcare provider education to ascertain the value of older adult’s immunization are critical for the fulfilment of this agenda.
WOMEN'S EXPERIENCES OF AGING AND SOCIAL CONNECTEDNESS
Authors: Newton Nicky J , Bookwala Jamila
Published: November 2019

Models of aging, such as the successful aging framework outlined by Rowe & Kahn (1987; 2015) should be holistic, necessitating the inclusion of health, psychosocial factors, and social connectedness. Even at the oldest ages, life expectancy and rates of survival are increasing, yet these longer lives are accompanied with disease and disability, especially among women (Crimmins & Beltrán-Sánchez, 2010); thus, maximizing health and well-being during these post-retirement years, which can often span decades, is a high priority. However, models of age-related change, such as those relating to age-related transitions, are predominantly based on men’s experiences; less is known about how women navigate later life (Calasanti, 2010; Kim & Moen, 2002). The presentations in this symposium provide quantitative and qualitative data from women of a broad age range concerning their experiences of aging, with the shared theme of social relationships. Sherman examines the relationship between personality and social support for well-being outcomes in Native American, African American, and European American women (Mage = 57). Conceptualizing aging as the quintessential life transition, Newton outlines the diverse themes of physical, psychological, and social aging from interviews with older women (Mage = 72). Fuller and Toyama find that for older women (Mage = 80), friendships mattered more than family, and counting on neighbors could even be detrimental in terms of life satisfaction and stress. Taken together, these presentations provide a varied picture of what it means for women to ‘age well’, suggesting nuanced ways in which we might conceptualize theories of aging for women.
SOCIAL ACTIVITIES AND DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS IN MEXICO: IMPLICATIONS OF GENDER AND PHYSICAL HEALTH
Authors: Monserud Maria
Published: November 2019

Studies in developed countries indicate that social activities can make a difference in mental health in later life. Yet, research on potential benefits of social activities for older adults in developing countries, including Mexico, has been scarce. This study uses the two most recent waves (2012, 2015) of the Mexican Health and Aging Study to investigate the impact of social activities on depressive symptoms among older men (n = 4, 749) and women (n = 6,527), aged 50+, in Mexico. The results of Ordinary Least Squares regressions indicate that it is important to differentiate among specific social activities in later life. Particularly, not only group-based but also solitary social activities were predictive of better mental health. Moreover, the findings demonstrate several gender differences and similarities. Participation in clubs, communication with relatives and friends, physical exercise, and watching television were beneficial for mental health among men, whereas volunteering, playing games, and making crafts were associated with fewer depressive symptoms among women. At the same time, reading as well as doing household chores were related to better mental health among older Mexicans, regardless of gender. Furthermore, this study shows that self-reported health, functional limitations, chronic conditions, and frequent pain might shape the implications of social activities for depressive symptoms among older adults in Mexico. The insights from this study can be helpful for intervention programs that are being developed to promote benefits of group-based and solitary social activities for mental health among older men and women with different levels of physical health.
CHALLENGES AND OPPORTUNITIES FOR TRAINING AND SUPPORTING AIDES AS MEMBERS OF HOME-BASED CARE TEAMS
Authors: Stone Robyn , Bryant Natasha
Published: November 2019

Despite home heath/home care aides being the informal “eyes and ears” of the health system, team-based home care initiatives have not incorporated this workforce into their programs. This presentation summarizes barriers to their inclusion: a basic lack of understanding on the part of clinical team members of the complex tasks these caregivers perform, inadequate investments in competency-based aide training and education, and variation in state nurse delegation laws that limit aides’ scope of practice and their ability to work effectively in teams. This is followed by a review of several programs that have successfully included aides as key members of home care teams. The presentation concludes with recommendations on how federal and state policymakers, educators and health systems and providers can support inclusion of aides in team-based care through standardization of competency-based training programs, expansion of nurse delegation nationwide, and support for piloting, evaluation, dissemination and replication of promising models.
A PROFILE OF CAREGIVING AMONG SEPSIS SURVIVORS RECEIVING POST-ACUTE HOME HEALTH CARE
Authors: Chase Jo-Ana D , Whitehouse Christina R , Jordan Lizeyka , Bowles Kathryn H
Published: November 2019

Sepsis survivors transitioning from hospital-to-home are clinically complex. Family caregivers can face challenges managing patients’ care needs; however, skilled home health care (HHC) can serve as an important resource during this care transition. This study’s purpose was to describe caregiving needs among older sepsis survivors receiving post-acute HHC, and identify sources of unmet caregiving needs. We conducted a retrospective analysis of a national dataset of Medicare beneficiaries starting a new HHC episode who were after hospital discharge for sepsis between 2013 and 2014 (n=165,228). All patients received at least one HHC visit the first week after hospital discharge. Caregiving activities included seven items from the start of care Outcome and Assessment Information Set. Descriptive statistics were used to examine types of caregiving activities and needs, demographics, and clinical information. Proportions of patients with unmet caregiving needs ranged from 9%-29%, with the largest proportion of unmet needs in activities of daily living (ADL) assistance (29%), medication administration (28%), and medical procedures/treatments (25%). Unmet caregiving needs across activities were largely due to a caregiver needing training/supportive services (75%-88%), suggesting that many sepsis survivors receiving HHC have caregivers who are available to help, but who lack the knowledge and skills to manage patients’ complex care needs. Thus, HHC providers should address caregiving training and support needs, especially related to assistance with ADLs, medication administration, and medical procedures/treatments. Future research is needed to determine specific educational strategies for caregiver training and support, especially related to skills and knowledge assessment, and training delivery and monitoring.
FAMILY CAREGIVER FACTORS AND SUBSEQUENT EMERGENCY DEPARTMENT UTILIZATION AMONG OLDER ADULTS WITH DISABILITY
Authors: Burgdorf Julia , Mulcahy John , Amjad Halima , Kasper Judith D , Covinsky Kenneth , Wolff Jennifer L
Published: November 2019

Community-living older adults with disability are frequent Emergency Department (ED) users and most rely on family caregiver support. However, no prior research has examined associations between caregiver characteristics and subsequent ED utilization among older adults. We draw on a sample of 2,521 community-living older adults with mobility/self-care disability and their primary family caregivers to identify caregiver characteristics associated with all-cause or potentially preventable ED use. We use Cox proportional hazards regression to separately model the likelihood of all-cause and potentially preventable ED use as a function of caregiver characteristics. Models account for competing risk of mortality and adjust for measures of older adults’ socio-demographic characteristics, health status, and survey wave. About half (52.5%) of older adults incurred 1+ ED visit and 26.8% incurred 1+ potentially preventable ED visit within 12 months of interview. Adjusting for survey wave and older adult sociodemographic characteristics and health status, older adults were at greater risk of all-cause ED use if their primary caregiver provided greater than 40 hours of care per week (HR: 1.22, 95% CI: 1.04-1.43; p=0.02), helped with health care tasks (HR: 1.26; 95% CI: 1.08-1.46; p<0.01), or experienced physical strain (HR: 1.18; 95% CI: 1.03-1.36; p=0.02). Older adults were at greater risk of potentially preventable ED use if their primary caregiver helped with health care tasks (HR: 1.25; 95% CI: 1.02-1.54; p=0.03). Findings highlight the relevance of caregiver factors to older adults’ ED use and suggest the need for assessment and support of family caregivers in the care delivery setting.
THE INFLUENCE OF PERSONALITY ON MEMORY SELF-REPORT AMONG BLACK AND WHITE OLDER ADULTS
Authors: Hill Nikki , Mogle Jacqueline , Bhargava Sakshi , Bell Tyler , Wion Rachel
Published: November 2019

Personality traits, particularly neuroticism, have been associated with self-reported memory problems, but little is known regarding differences across racial groups. Community-dwelling older adults (n=425; M(SD) = 76.7(4.7) years; 62.6% female; 72.0% White) without cognitive impairment completed up to 11 annual comprehensive medical and neuropsychological examinations as part of the Einstein Aging Study. Multilevel modeling tested: 1) the association of neuroticism, conscientiousness, extraversion, openness, and agreeableness with three types of self-reported memory problems (frequency, one-year decline, and ten-year decline), and 2) whether these associations differed by race, specifically Black and White. Neuroticism predicted self-reported frequency of memory problems and perceived one-year decline when considered alone; however, this did not remain significant after including all personality traits. Conscientiousness influenced perceived ten-year memory decline in Black older adults but not White. Our findings suggest that the influence of personality on self-reported memory problems may not be consistent across racial groups.
LONGITUDINAL ASSOCIATIONS BETWEEN PERCEIVED STRESS AND MEMORY COMPLAINTS
Authors: Bell Tyler , Bell Tyler , Mogle Jacqueline , Hill Nikki
Published: November 2019

Memory complaints increase cognitive decline but show weak concurrent associations with objective memory. Instead, affect might underlie some memory complaints and their impact on future cognition. Perceived stress influences cognitive performance, but temporal associations with memory complaints is unknown. We therefore explored longitudinal relationships between perceived stress and memory complaints among cognitively normal older adults. From the Einstein Aging Study (n=507, Mage=77.88, 63.30% female; 73.21% White), multilevel models examined bi-directional concurrent and one-year-lagged associations between within-person changes in perceived stress and memory complaints (frequency of forgetting, perceived one-year memory decline, perceived ten-year memory decline). Perceived stress positively covaried with memory complaints. Looking at lagged effects, only frequency of forgetting predicted next-year perceived stress. Higher frequency of forgetting thus increases perceived stress while perceived decline associates with current perceived stress. Reframing perceptions of forgetfulness might reduce stress in cognitively intact older adults, which in turn may benefit cognition long term.
THE FACTOR STRUCTURE OF MEMORY COMPLAINTS OVER TIME
Authors: Mogle Jacqueline , Hill Nikki , Bhargava Sakshi , Bell Tyler , Whitaker Emily
Published: November 2019

Although memory complaints are assessed with a variety of items to track change in individuals as they age, it remains unclear which items best capture change. Adults aged 70 to 104 (n=1,344, 38% Male) completed six memory complaints items annually for up to 11 years: frequency of problems, one year decline, ten year decline, seriousness of problems, forgetting important things, and current functioning compared to functioning at age 30. Using multilevel exploratory factor analysis, the best fitting model indicated one factor fit the between person structure with all items loading significantly. Across time, items required two factors. Items about decline loaded together while the item about functioning compared to functioning at age 30 dominated a second factor. Remaining items did not load on either factor across time. This suggests these items assessing memory complaints are better at discriminating across persons rather than tracking changes within a person across time.
APOE2 AND AGING-RELATED OUTCOMES IN 261,000 UK BIOBANK OLDER ADULTS
Authors: Kuo Chia-Ling , Pilling Luke C , Kuchel George A , Melzer David
Published: November 2019

ApoeE2 (e2) has both protective and adverse effects on health outcomes, which needs to be considered when targeting e2. We aimed to understand the role of e2 in aging via associations between e2 and a selection of aging traits using UK older adults of European descent. e2e3 (n=32,262) and e2e2 (n=1,629) were compared to e3e3 (n=153,567), adjusted for sex, age, genotyping arrays, assessment centers, and the first five genetic principal components. We found that e2 was associated with both parents top 10% survival (OR=1.14, 95% CI: 1.06-1.24), reduced risks of hypertension (OR=0.93, 95% CI: 0.91-0.96) and coronary heart disease (OR=0.86, 95% CI: 0.82-0.89), but red cell width distribution above the reference range (OR=1.17, 95% CI: 1.09-1.26). Additionally, e2 was minimally associated with frailty, cognitive function, and physical measures, suggesting that its association with parental extreme longevity may be controlled by mechanisms underlying diseases.
HOW TO CHOOSE THE RIGHT JOURNAL FOR YOUR MANUSCRIPT
Authors: Sands Laura P
Published: November 2019

Article submissions to The Gerontological Society of America’s high impact scientific journals continue to increase each year which has led to editors becoming more selective about which articles are accepted for publication. The purpose of this session is to describe how to efficiently and successfully navigate the process of determining which journal is the best fit for your manuscript. The specific objectives are to: (1) increase understanding the differences in scope and features of each journal; (2) inform how to determine which journal is most appropriate for the topic and methods of your manuscript; and (3) describe how to convey the scientific contribution of your article to the journal.
GETTING OVER THE FIRST HURDLE: PREPARING YOUR MANUSCRIPT FOR A POSITIVE REVIEW
Authors: Meeks Suzanne
Published: November 2019

In this section of the symposium, I will talk about manuscript preparation for maximizing the likelihood that your work will be sent for review. I will talk about common author errors that usually guarantee an immediate reject decision such as not reading and following the Instructions to Authors. I will emphasize the importance of plain, good writing. Editors of high impact journals receive 10 or more new manuscripts per week, and due to limited page space, have to reject 80-90% of them. Regardless of scholarly quality, if the point and contribution are not clear in a quick scan of the paper, it likely will not be reviewed favorably. I will provide tips for strong scientific writing that are commonly violated in manuscript submissions, and provide references for additional writing support.
HOW TO MAXIMIZE THE REACH OF YOUR PUBLISHED WORK
Authors: McNamara Sara
Published: November 2019

Part 2 of this symposium will discuss how to maximize the reach and impact of your published work. Researchers are under increasing pressure to demonstrate the impact of their work. First, it is important to clearly articulate the translational impact of your work in the Discussion of your manuscript and briefly in the Abstract. In addition, it is important to know how to increase visibility of your manuscript because university administrators and funding agencies rely heavily on numerical metrics for decision-making. This presentation will look at the needs that metrics serve and provide an overview of how the dominant metric, the Impact Factor, is determined (along with a discussion of the metric’s flaws). The value of newer methodologies and alternative metrics (Altmetrics) will also be discussed. The presentation will also cover practical steps for how researchers can increase the reach and potential impact of their work.
OVERCOMING THE CHALLENGES OF TECHNOLOGY IN GERONTOLOGICAL RESEARCH
Authors: Lindsey Jacob , Goodrich Elena , Nguyen Khoa , Guerrero Cierra Leon , Scavone Colton , Pandya Supriya , Dorsey Tanner , Dodge Hiroko
Published: November 2019

Many older adults express a lack of confidence in using technology and this can become a barrier to participating in technology heavy research. This presentation will introduce the face-to-face digital communication, electronic medication adherence tracking, and online recruitment technology used in the I-CONECT study (ClinicalTrials.gov: NCT02871921). In particular, we will demonstrate how the project has simplified enterprise video conferencing for in-home use, removed obstacles related to remote hardware troubleshooting, and further discuss how it has been received by older adults who have participated thus far. Finally we will cover particular hurdles related to I-CONECT (e.g., targeting social isolated older adults, aiming to recruit 50% of participants being African American older subjects living in the Detroit Metropolitan area). Our experience indicates that such high tech gerontological research is feasible given a creative and solution-focused research approaches and multi-disciplinary team.
PERSONALITY MODERATES INTERVENTION EFFECTS ON COGNITIVE FUNCTION: A 6-WEEK CONVERSATION-BASED INTERVENTION
Authors: Cerino Eric S , Hooker Karen , Goodrich Elena , Dodge Hiroko H
Published: November 2019

Conversation-based interventions have positive effects on cognitive health, though determining who benefits most is still unclear, and individuals’ personality may play a role. We utilized data from a 6-week randomized controlled trial to determine if conversation-based intervention effects were moderated by personality traits in 83 older adults (Mean age = 80.51 years, 49 cognitively intact, 34 with mild cognitive impairment). The intervention group participated in daily 30-minute face-to-face semi-structured conversations with trained interviewers for six weeks. Baseline psychosocial questionnaires and a neuropsychological battery were completed. Intervention group participants with high agreeableness, conscientiousness, and extraversion exhibited significantly more improvement in language-based executive function tasks compared to a control group (ps<.05). An opposite pattern for delayed recall memory and working memory tasks emerged among highly extraverted participants (ps<.05). Findings suggest the adaptive role of personality traits in conversation-based cognitive interventions and offer evidence for personalized approaches to cognitive health in late life.
HOW DOES SOCIAL DEPRIVATION INFLUENCE END-OF-LIFE FRAILTY TRAJECTORIES? EVIDENCE FROM ELECTRONIC HEALTH RECORDS
Authors: Stow Daniel , Hanratty Barbara , Matthews Fiona E
Published: November 2019

Recent research has highlighted inequalities in frailty status, driven by social deprivation over the life course. However, little is known about the interaction between deprivation and frailty over clinically relevant timescales. We used an electronic frailty index, generated automatically in health records at monthly intervals for one year in 13,000 people age >75 who died (cases), matched to 13,000 people with no record of death (controls). We used Index of Multiple Deprivation deciles and latent growth curve models to investigate the impact of deprivation on frailty trajectories. Greater deprivation was associated with higher baseline frailty, but did not influence the rate of change in frailty. We observed greater deprivation driven differences in frailty at baseline in controls than in cases, suggesting that a degree of convergence occurs as people near end-of-life. We discuss these results in light of end-of-life care policy and planning.
MARGRET M. AND PAUL B. BALTES FOUNDATION IN BEHAVIORAL AND SOCIAL GERONTOLOGY AWARD LECTURE
Authors: Pedersen Nancy
Published: November 2019

The Margret M. and Paul B. Baltes Foundation Award in Behavioral and Social Gerontology recognizes outstanding early-career contributions in behavioral and social gerontology. The lecture will be given by the 2018 Baltes Award recipient, Frank Infurna, PhD, of Arizona State University. This session will also include the presentation of the 2019 Baltes Award. The 2019 Baltes Award recipient is Allison Bielak, PhD, of Colorado State University. Supported by the Margret M. and Paul B. Baltes Foundation.
UNMET NEEDS IN SELF-DIRECTED HCBS PROGRAMS
Authors: Mahoney Kevin J , Mahoney Ellen k , Morano Carmen , DeVellis Andrew
Published: November 2019

Unmet Need for long-term services and supports has been linked to a variety of harmful health outcomes. One suggested strategy for ameliorating unmet need is to give participants control of the budget and let them construct individualized plans. The evaluation of the Cash and Counseling controlled experiment documented a marked reduction in unmet need when compared to traditional agency-based solutions, but it also showed significant unmet needs remained. This paper, drawing from 76 ethnographic case studies of Cash and Counseling participants, gives us an understanding of what those unmet needs are, who sees them, and what participants and their family caregivers see as possible remedies. Certain areas of unmet need identified in this study stand out. These included health-related problems, environmental issues, and the caregivers’ need for relied. The paper concludes with implications for care integration and the training of support brokers as warnings about reducing budgets.
OMICS IN AGING RESEARCH: FROM BIOMARKERS TO SYSTEMS BIOLOGY
Authors: Promislow Daniel
Published: November 2019

Advances in whole genome sequencing have dramatically increased our potential to understand what shapes variation in rates of aging and age-related disease in natural populations, but we are still far from realizing this potential. Researchers have identified thousands of genetic markers associated with complex human traits. However, these markers typically explain a very small fraction of the observed variance, leaving an enormous explanatory gap between genotype and phenotype. I will present data from diverse species to illustrate the power of so-called endophenotypes—the epigenome, transcriptome, proteome, and metabolome—to bridge the genotype-phenotype gap. Using multivariate and network models that integrate genetic information with other endophenotype variation, we are closer than ever to understanding the mechanisms that account for natural variation in aging and age-related disease, and the evolutionary forces that have shaped that variation.
HETEROGENEITY OF AGING IN HUMAN POPULATIONS
Authors: Jackie Han Jing-Dong
Published: November 2019

Recently by analyzing the 3D facial images, we generated the first comprehensive mapping of the aging human facial phenome. We constructed a robust age predictor and found that on average people of the same chronological age differ by +/-6 years in facial age, with the deviations increasing after age 40. Using this predictor we identified slow- and fast-agers that are significantly supported by health indicators. We further profiled blood cell mRNA and lncRNA expression by RNA-seq of this cohort and computationally predict their regulatory networks and their contributions to the variation in aging rate among different individuals, and those that are modifiable by their lifestyles. By extending the study to a large Northern Chinese cohort of 10,000 people we can now use deep learning AI approaches to precisely estimate aging status based on 3D facial images and their associations with individuals’ health and medical history.
HELPING OTHERS IS A MIXED BLESSING: IMPLICATIONS FOR DAILY WELL-BEING
Authors: Huo Meng , Ng Yee , Fingerman Karen
Published: November 2019

The literature documents mixed findings regarding how helping others influences individuals’ mental and physical health. We assessed various types of support that older adults offered (e.g., emotional, practical, advice) and examined how helping others was associated with older adults’ daily mood and physical activity. This study utilized data from the Daily Experiences and Well-being Study, where 293 participants aged 65+ reported on their helping behaviors and mood at the end of each day across 5 days. Participants also wore Actical accelerometers to track physical activity. Multilevel models revealed that older adults reported greater negative mood and less physical activity on days when they provided emotional support. Yet, giving advice was associated with increased positive mood that day. Moreover, older adults spent less time being sedentary on days when they offered practical help. This study offers insights into psychological and health consequences of helping others by examining older adults’ everyday lives.
THE ASSISTED LIVING SETTING: CLINICAL CARE AND OUTCOMES
Authors: Resnick Barbara
Published: November 2019

Although the description of assisted living (AL) varies by state this term generally refers to residences that provide housing and supportive services, 24-hour supervision, and at least two meals a day to meet the individual needs of residents. Approximately 37% of residents in AL need help with three or more activities of daily living (ADLs), 42% have some cognitive impairment and 39% need skilled nursing services. Approximately 15 to 50% of older adults living in AL communities experience a fall over a 6 to 24 month period. The cause of these falls involves multiple factors at the resident and facility level. In addition to a high rate of falls there is a high rate of polypharmacy, using the polypharmacy definition of taking five or more medications daily. Polypharmacy results in negative outcomes such as falls and hospitalizations among AL residents. Along with high rates of falls and polypharmacy there is also a high incidence of pain among AL residents and concerns that some pain goes unreported and untreated. Pain, polypharmacy and falls can all influence life satisfaction along with other factors such as the environment itself. The purpose of this symposium is to describe the incidence and factors that influence falls, polypharmacy, pain and pain management and the impact of these care concerns, among others, on life satisfaction drawn from 508 residents from 54 nursing homes participating in the first two cohorts of the study testing the implementation of Function Focused Care for Assisted Living (FFC-AL-EIT).
FACTORS THAT CONTRIBUTE TO FALLS AMONG AL RESIDENTS
Authors: Boltz Marie
Published: November 2019

Many nurses, patients, and families continue to believe that physical activity increases the risk of falling. The purpose of this study was to test the hypothesis that residents who are exposed to Function Focused Care for Assisted Living (FFC-AL-EIT) and engage in moderate levels of physical activity would not be more likely to fall. This was a secondary data analysis using data from the first two cohorts of the FFC-AL-EIT study. The study included 508 residents the majority of whom were female (70%), white (97%), with a mean age of 87.72 (SD=7.47). Those who engaged in more moderate intensity physical activity were 1% less likely to fall (b = -.01, Wald =6.13, p =.01). There was no association between exposure to function focused care and falling (Beta =.41, Wald =2.35, p=.13). Further, engaging in moderate level physical activity was noted to be slightly protective of falling.
KINLESSNESS AT THE TIME OF DEATH: IMPLICATIONS FOR END-OF-LIFE DECISION-MAKING
Authors: Ornstein Katherine , Mair Christine , Kristensen Marie Skov , Aldridge Melissa , Thygesen Lau Caspar
Published: November 2019

As our society continues to age and family size decreases, there is increasing concern about lack of caregiver availability. This may be especially important in the context of end-of-life decision-making. The goal of this study was to characterize the size and composition of the family network of adults at the time of death using a population-based register study. All adults in Denmark who died of natural causes 2009-2016 (n= 401,000) were linked to living adult family members (parents, children, spouses, sibling, great/grandchildren). While the majority of decedents were linked to multiple family members (median =5), 21.6% had no identified living family at the time of their death. Kinlessness was especially common among older women and those with dementia. In addition to supporting caregiving families at the end-of-life, we must also recognize that there are many kinless individuals who may benefit from early formal care planning services to facilitate end-of-life decision-making.
FACTORS ASSOCIATED WITH LENGTH OF HOSPICE STAY
Authors: Inoue Megumi , Kestenbaum Matthew G , Muir Cameron
Published: November 2019

The benefits of early referral to hospice services have been well documented. However, late admissions and short hospice stays are ongoing issues that are often barriers to improving terminally-ill persons’ and the caregivers’ quality of life and the quality of care. Using ordered logistic regression, this study analyzed the length of stay of 7,307 patients who died in 2015 while receiving care in the largest hospice agency in the DC metro region. Cancer diagnoses and residence in a higher median income neighborhood were associated with shorter lengths of stay. Female sex, older age, and residence in a lower median income neighborhood were associated with longer lengths of stay. The findings indicate that differences in demographic and diagnostic characteristics likely affect hospice length of stay.
THE INTERSECTION OF ETHICS AND VULNERABLE ELDERS
Authors: Teaster Pamela B , Anetzberger Georgia
Published: November 2019

Researchers, practitioners and policymakers are daily confronted with multiple and competing situations regarding vulnerable older adults and the complex issues that they face in all aspects of their lives. Challenges can arise in the provision of social services, dispensing justice, conducting research, or addressing legal issues. The purpose of this symposium is to discuss dilemmas that vulnerable older adults and concerned others face by elucidating current and future challenges facing this population, particularly in the realms of compromised health (cognitive impairment); effective status (gender); care arrangements (home and community-based services); and abuse, neglect, and exploitation. Teaster and Anetzberger discuss relevant ethical theories and principles as well as a definition of vulnerability. Santos and Nichols-Hadeed report on ethical issues embedded in vulnerable elders’ cognitive status. Bowland and Halaas highlight the intersection of ethics, gender and vulnerable elders. Niles-Yokum and Beaumaster discuss the nexus of ethics and the provision of home and community based services for vulnerable older adults. Heisler considers vulnerabilities of older adults and ethical challenges when addressing elder abuse. Throughout the papers, we weave the ethical principles of autonomy, beneficence, nonmaleficence, and justice.
ETHICAL DILEMMAS PRESENTED BY COGNITIVE IMPAIRMENT AND VULNERABLE ELDERS
Authors: Santos Elizabeth J , Nichols-Hadeed Corey A
Published: November 2019

Identification and assessment for cognitive impairment is a difficult task further complicated by the need to determine capacity. Issues related to cognitive impairment and capacity create ethical dilemmas potentially spanning all four ethical principles: autonomy, beneficence, non-malfeasance, and justice. This paper uses a case scenario to describe different types of cognitive impairment and demonstrate ethical issues that commonly arise when treating patients with cognitive impairment in the clinical setting. The authors also recognize the complexity of capacity as an issue that spans both the medical and legal fields and provides explanations and distinctions. The overall goal of this paper is to raise awareness of the impact of cognitive impairment on the vulnerability of older adults, describe the complex ethical issues that cognitive impairment and capacity raise and the importance of defining capacity in the context of the legal and medical fields.
GERONTECHNOLOGY PERCEPTIONS AND POTENTIAL ROLE OF VR/AR IN OPTIMAL AGING
Authors: Margrett Jennifer , Boot Wally , Charness Neil , Hertzog Christopher , Shelley Mack , Narasimhan Balaji
Published: November 2019

Technology presents opportunities to optimize whole person wellness and functioning. To understand tech readiness and the potential role of virtual (VR) and augmented reality (AR) to support optimal aging, we surveyed 604 participants from the nationally representative RAND American Life Panel. Participant age ranged from 50-90+, 51.5% were female, and 50% reported bachelor’s education or higher. Overall, 8% of the sample identified as Hispanic, with 15% of individuals also identifying as Black, Asian, or Asian Indian or Alaskan Native. Males reported greater optimism and technology innovation and adults aged 50-64 were the most optimistic. Overall, 80% of the sample reported VR familiarity compared to 33% AR. Regarding future needs, 75% of the participants expressed specific concerns about future ADL ability. Almost half of the respondents indicated willingness to use VR and AR to maintain or improve functioning with age and increased personalization of optimal aging emerged as a significant predictor.
EXPLORING OLDER ADULTS’ PERCEPTIONS OF PRESENCE AND IMMERSION IN DIVERSE VIRTUAL ENVIRONMENTS
Authors: Boot Walter R , Dilanchian Andrew , Andringa Ronald
Published: November 2019

Virtual Reality (VR) holds great promise for enhancing the health, well-being, and skills of older adults. However, VR solutions must consider the age-related “digital divide;”many older adults have less experience and proficiency with a number of newer technologies, which may serve as a barrier. Older adults especially have less experience with virtual environments, an experience many younger adults have acquired through video gaming. This study compared younger and older adults’ perceptions of immersion and presence in a series of diverse virtual environments using the HTC Vive. Participants experienced a VR meditation task, “indoor" and “outdoor” navigation tasks, and a fast-paced action game. Importantly, younger and older adults reported similarly high experiences of immersion and presence within virtual environments, and contrary to expectations, older adults reported fewer symptoms of cybersickness. Results suggest VR as a promising tool to promote the health and well-being of older adults.
HEALTH AND WELL-BEING OF OLDER ADULTS IN LONG-TERM CARE FACILITIES: LESSONS FROM LONGITUDINAL STUDIES.
Authors: Barker Robert O , Kingston Andrew , Matthews Fiona , Hanratty Barbara
Published: November 2019

Older adults in long-term care facilities (LTCF) have complex needs for health care and support. There is a perception that residents’ needs are increasing over time, but little research evidence to back this up. In this study we brought together data on 1640 residents in LTCFs from three longitudinal studies, and conducted repeated cross-sectional analyses across a 25 year period. We found that the prevalence of severe disability amongst residents has increased from 56% to 80% over a 20 year period, driven by increases in difficulties in bathing and dressing. The prevalence of multimorbidity also increased from 29% to 56% between 2006 and 2014. A growth in the number of people with dementia, cardiovascular and cerebrovascular diseases contributed to this. We conclude that residents in LTCFs have become a selected subset of the population, characterised by increasing needs for support. This poses an important challenge for future care provision.
NEW MODELS OF CARE FOR LONG-TERM CARE FACILITIES: WHAT DOES THE EVIDENCE TELL US?
Authors: Brittain Katie , Craig Dawn , Spilsbury Karen , Wilson Paul , Brittain Katie , Vines John
Published: November 2019

Models of care are evolving to meet the demands of an ageing population in long-term care facilities. Syntheses of current evidence are an essential to inform future change. In this project we conducted a rapid synthesis of evidence relating to enhancing health in long term care facilities across technology and evaluation. Mapping reviews were conducted on the uses, benefits and challenges of technology in care homes and approaches to evaluation of new models of care. Systematic evidence syntheses addressed the questions of which technologies have a positive impact on resident health and well-being and which measurement tools have been validated for use in UK care homes. Key findings will be presented in animated format, including that the most promising interventions appear to be games that promote physical activity and enhance mental health. This presentation will highlight the benefits and importance of evidence synthesis to the development of models of care.
EAST MEETS WEST: IMPROVING HEALTH AND LONG-TERM CARE FOR OLDER ADULTS IN THE U.S. AND CHINA
Authors: Wu Bei , Lu Jie Hua
Published: November 2019

As the number of older adults in the U.S. and China continues to increase, promoting healthy aging is essential for individuals, family, and society. Both countries face many similar issues due to their aging populations, including prolonging healthy life expectancy and providing quality of care. However, the change in demographics brings with it unique challenges for both the U.S and China. This forum invites scholars and researchers from these two countries to share their knowledge and insights on promoting healthy aging and improving care for older adults. This forum includes five presentations and one-panel discussion. Two presentations will focus on long-term care (LTC) in China, one is to forecast the needs of LTC in the next five decades, and the other is to evaluate the current LTC needs and discuss LTC policy. Using the data from the Health and Retirement Study, the third presentation aims to re-conceptualize spousal caregiving as a dyad-level phenomenon and provides a dynamic view of the spousal caregiving experiences. The last two presentations will focus on promoting healthy aging through clinical interventions. The fourth one is to evaluate the effectiveness of adaptive computer-based cognitive training among community-dwelling older adults in China. The last presentation provides some examples of using pragmatic clinical trials to improve the care of older adults in skilled nursing facilities in the U.S. After the five presentations, the three panelists will provide feedback to the presentations and share their views on healthy aging with the audience.
LONG-TERM CARE NEEDS BY CHINESE ELDERLY AND POLICY PRIORITIES IN CHINA
Authors: Sun Juan Juan , Wu Haichao
Published: November 2019

With the life expectancy in China continuing to increase, age-dependent chronic diseases are also likely to increase, as is the number of people with long-term care needs. This study evaluated the Long Term Care (LTC) needs of the Chinese older population and introduced related policy priorities. Using the 2014 and 2016 “China Longitudinal Aging Social Survey”, this study assessed the physical functions of older adults by measuring their ability to perform Activities of Daily Living independently, compared changes within the two years, and explored other related indicators including, Instrumental Activities of Daily Living, major chronic disease, and mental health conditions. The study also discussed the development of long-term care policies in China and highlighted the priorities of these policies.
RE-CONCEPTUALIZING SPOUSAL CAREGIVING FROM A DYADIC PERSPECTIVE IN THE U.S.
Authors: Li Yuekang , Liu Huiying , Wang Yi , Morrow-Howell Nancy
Published: November 2019

Existing literature on later-life spousal caregiving tends to focus on one member of the marital dyads, assuming a priori distinction between the caregiver and care-receiver. Theoretically and empirically, this individualistic role-related (caregiver-receiver) approach is inaccurate, as the concept of spousal care intrinsically involves two people within a marital dyad. Therefore, this paper used a social exchange perspective to re-conceptualize spousal caregiving as a dyad-level phenomenon. Using the 2014 wave of the Health and Retirement Study, 6,500 individuals (3,250 couples) aged 65 and above and their spouse were selected. Based on each partner’s need for care, receipt of spousal care, and provision of spousal care, the study identified five distinctive caregiving typologies. Household-level factors such as the availability of other types of informal care were associated with these typologies. This paper offers a broader and more dynamic perspective of the spousal caregiving experiences.