bluuebunny/crossref_metadata_2025 huggingface dataset:
DIGITAL DIVIDE AND DIFFICULTIES IN ACQUIRING HEALTH RESOURCES IN DISABLED OLDER ADULTS DURING THE PANDEMIC
Authors: Yang Eunjin , Kim Min Jung , Lee Kyung Hee
Published: December 2022

The digital divide refers to the gap between those who are connected and those who are not connected to the internet and technologies. Although COVID-19 worsens the digital divide and health inequality, few studies have focused on the relationship between digital divide and difficulties in acquiring of health resources during the pandemic. This study aimed to identify the relationship between internet use and difficulties in acquiring health resources among older adults with disabilities during the COVID-19 pandemic. This secondary analysis study included 4,871 older adults aged 55 and older among 7,025 total responders of the 2020 survey of people with disabilities in South Korea. As the results, only 23.7% of older adults with disabilities used the internet. Non-internet users are more likely to have difficulties in acquiring COVID-19-related information (aOR 1.59) and buying and using personal protective equipment (aOR 1.36). However, difficulties in using medical services (aOR 1.21) was not statistically significant. Considering that older adults with disabilities have triple burdens from old age, disabilities, and the digital divide amid COVID-19, healthcare providers need to pay more attention to mitigate gaps between internet users and non-non users among this population. By narrowing the digital divide, decreasing health gaps and increasing well-being among older adults with disabilities will be guaranteed.
FEASIBILITY AND ACCEPTABILITY OF A HYBRID AEROBIC EXERCISE PROGRAM FOR OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Erlenbach Emily , Malani Revati , McAuley Edward , Gothe Neha
Published: December 2022

The COVID-19 pandemic and ensuing lockdowns, physical distancing and mask mandates exacerbated the challenges older adults (OAs) face towards exercise engagement. We present data on the feasibility, safety, and acceptability of a hybrid (in-person and virtual) aerobic exercise program for OAs. Nf39 (30 females, Mage=64.10) low-active OAs completed an aerobics-based exercise program as part of a larger ongoing RCT. Participants exercised 3x/week by attending one in-person and two Zoom-based exercise classes. Attendance, attrition, format preferences, and adverse events were documented. Participants also completed an anonymous survey to detail their experiences with the hybrid delivery model. Thirty participants completed the program. Total average attendance of 83.64%; 58.93% and 24.71% of the attended sessions were on Zoom and in-person, respectively. On post-program surveys, 36.67% reported preferring Zoom sessions, followed by 33.33% preferring both formats equally. No adverse events were reported. From the anonymous program feedback surveys, common reasons for preferring the Zoom sessions included convenience; not having to wear a mask; not worrying about COVID exposure; and not feeling self-conscious about exercising with others. Commonly reported reasons for preferring the in-person sessions were increased motivation from group energy; social support; more space to move around; and better engagement with instructors. Collectively, these findings show a hybrid aerobic exercise program is feasible and safe for OAs to engage in and is overall well-accepted. Findings are encouraging for the design of future exercise programs for OAs, who continue to remain a vulnerable population during the pandemic but need a structure to remain sufficiently active.
VARIATIONS IN BENEFITS OF INTERGENERATIONAL TUTORING IN THE “NEW NORMAL”
Authors: Sun Peter , Morrow-Howell Nancy , Click Mary , Minch Kendra
Published: December 2022

This study explored variations in self-perceived benefits of intergenerational tutoring. The study’s sample consisted of 329 older adults who tutored children in-person in the 2021–2022 school year. Due to the COVID-19 pandemic, some of the respondents had experienced a period in which volunteering was remote, virtual, or not possible. Demographic information was collected in a fall pre-test survey, identifying first-time volunteers (first time volunteering in ten years), caregivers (100 or more hours in the last two years helping someone who needed assistance), and male volunteers. Self-perceived benefits of tutoring (physical, emotional, and cognitive health, increased social activities, use time more productively, contribute to the well-being of children, and feel better about myself) were collected in a spring post-test survey. Being a first-time volunteer was significantly associated with improved health (X2 = 4.17, p = 0.041, Cramer’s V = 0.11), even after controlling for baseline self-reported health (p = 0.020). A larger proportion of first-time volunteers (34.2%) reported improvements in at least two areas of health (physical, emotional, and cognitive) due to their involvement in the intergenerational tutoring program, compared to non-first-time volunteers (18.5%). There were no significant differences in perceived benefits for caregivers or males. These findings suggest that targeting non-volunteers for involvement in tutoring programs may maximize health benefits of engagement. Specifically targeting males and caregivers may not be necessary, given that they benefit similarly to other populations.
TRAIT SELF-CONTROL AND ATTACHMENT ANXIETY IN RETIREES’ DEPRESSIVE SYMPTOMS AND EMOTIONAL WELL-BEING
Authors: Paoletti Jensine , Wu-Chung E Lim Lydia , Brown Ryan , Chen Michelle , LeRoy Angie , Fagundes Christopher
Published: December 2022

Trait self-control (TSC) is a well-known predictor of well-being. TSC may reduce distraction from hedonistic pursuits and enable more effective goal-directed behavior. Attachment anxiety (AA) is a trait that predicts lower relationship quality and lower well-being; people high on AA are characterized by hyper-sensitivity, proximity-seeking and excessive rumination. In retirement, these traits may interact to predict wellbeing. Methods: 120 retired participants took part in data collection (M = 62.37 years old; SD = 10.07 years; 68% women, 70% white). Data collection included self-reported AA (Experience in Close Relationships), TSC (Brief Self-Control Scale), depressive symptoms (Center for Epidemiological Studies Depression Scale) and emotional well-being (RAND 36-Item Health Survey). We conducted hierarchical linear regressions and accounted for demographic and health-related covariates. Results: TSC was negatively related to depressive symptoms and positively related to emotional well-being. AA was positively related to depressive symptoms and negatively related to emotional well-being. We found an interaction predicting depressive symptoms such that participants with low TSC and high AA had the highest depressive symptoms (p = .036). This interaction was not significant for emotional well-being. Discussion: After retiring, maintaining a healthy social life may be more effortful, as there are fewer ‘built-in’ social interactions (i.e., with coworkers). Retirees with higher TSC may be able to maintain their social life more effectively than those with lower TSC. Similarly, people with lower AA may be able to obtain more enjoyment from their social lives. Together, lower AA and higher TSC may be protective mechanisms for depressive symptoms.
BASELINE PURPOSE IN LIFE PREDICTS FUNCTIONAL HEALTH ACROSS 16 WEEKS IN OLDER ADULTS WITH PROGRESSIVE VISION LOSS
Authors: Mak Wingyun , Sörensen Silvia
Published: December 2022

Greater purpose in life is associated with various positive outcomes in later life, such as, lower mortality risk, protection against cognitive decline, and lower spending on medical care and emergency room visits. Recent research from the Health and Retirement Study has shown that older adults with greater purpose in life have fewer physical limitations after four years. There has been no research to investigate purpose in life in older adults with progressive vision loss. The aim of this study is to examine whether purpose in life predicts functional health (i.e., activities of daily living) across a 16-week period of time in a sample of older adults (aged 60–96) with vision loss due to macular degeneration who were enrolled in a resilience building program (Nf 122). A repeated measures GLM showed that functional health did not change across 16 weeks (ns). Age (F(1, 112)=8.91, p=.003, ηp2=.07) and purpose in life (F(1,112)=13.21, p < .001, ηp2= .11) were significant overall predictors of functional health across time. Gender, education, cognition, marital status, depression, and loneliness at baseline were not associated with overall functional health. People who were younger were more likely to have better functional health over 16 weeks; purpose in life added 11% of explained variance. Because purpose in life is malleable and also significantly associated with better functional health in older adults with progressive vision loss, future interventions that enhance purpose in life should be studied with this population.
EXERCISE SLOWS NEURAL STEM CELL AGING AND AD RISK WITH CLONAL SELECTION
Authors: Xiang Wang , Peng Lei , Bay Maxwell , Liu Michelle , Levi Jonathan , Ding Tianli , Pan Fifi , Bonaguidi Michael
Published: December 2022

Exercise acts as a countermeasure against aging and Alzheimer’s disease (AD). Several lines of evidence indicate that the beneficial effects of exercise target neurogenesis and synaptic plasticity. However, how exercise shapes neural stem cell (NSC) function to maintain lifelong hippocampal plasticity remains unknown. Here, we utilize single-cell technologies to uncover exercise slows NSC aging and reduces AD risk. In vivo single-cell lineage tracing revealed that exercise promotes clonal selection by activating quiescent NSCs for self-renewal and depleting neurogenic NSCs. Interestingly, NSC symmetric self-renewal compensated for those lost to differentiation allowing for enhanced neurogenesis without prematurely depleting the overall NSC pool. Prolonged clonal tracing further showed that the selected self-renewed NSCs are more resistant to aging-related NSC depletion. Single-cell RNA-sequencing and multiple bioinformatic analyses determined that exercise slows NSC molecular aging. In particular, exercise mitigates an age-associated increase of AD risk gene expression within NSCs. Our results demonstrate a new regenerative function of exercise to promote healthier brain aging.
TRANSPORTATION AND MOOD: THE ROLE OF TRIP CHARACTERISTICS
Authors: Dabelko-Schoeny Holly , Field Noelle , Traver Anthony , Murphy Ian , White Katie
Published: December 2022

Safe and affordable transportation has a positive impact on the health and well-being of older adults. What is less understood are which factors influence these outcomes. To examine the impact of trip characteristics on the mood of older adults, residents in three neighborhoods in Franklin County, Ohio (n = 32) were provided tablets and used an app (MyAmble) to document their travel. During a 14-day period, 1,190 trips were recorded; 71% of which were completed by car. Participants reported 72% of the trips improved their mood. Perceived importance of the trip, challenges associated with the trip, and trip destinations to social activities and to employment/education explained 33% of the variance in mood. Challenges associated with the trip was the strongest predictor of impact on mood. Identifying trip characteristics that impact mood provides new insights for the design and implementation of travel interventions for older persons.
DO ADVERSE ADULT LIFE EVENTS MODERATE THE IMPACT OF CHILDHOOD ADVERSITY ON COGNITION AFTER AGE 50?
Authors: Johnson Kimson
Published: December 2022

Population-based studies of childhood adversity and adulthood trauma have shown varying prevalence and incidence rates due to differences in conceptualization and assessment of these events. Adverse childhood and adult events are prevalent in the general population and have deleterious effects on adult health over the life course. Exposure to adverse childhood events (ACEs) (i.e., household dysfunction) and adverse adult events (AAEs) (i.e., history of military combat or incarceration) can shape health behaviors, overall health, and disease trajectories. Despite the well-known lasting health effects of ACEs and AAEs, little is known about these events’ singular and cumulative effects on cognitive health in mid to late life. The objective of this study is to examine if AAEs moderate the relationship between ACEs and cognitive functioning. Data was utilized from the 2010–2018 waves of the Health and Retirement Study (HRS) (N =3,320). Latent Growth Curve Modeling indicated that one or more ACEs were associated with a significant decrease in cognitive functioning (β=-0.19, p < .05). However, one or more AAEs were not significantly associated with a decrease in cognitive functioning (β=-0.19,p>.05). Finally, moderation analysis shows that AAEs do not significantly moderate the relationship between ACEs and cognitive functioning (β=-.32, p>.05). A better understanding of the timing and distribution of exposures to ACEs and AAEs can support targeting interventions and prevention screening measures. Inclusion of ACEs and AAEs in cognitive assessments could provide information about modifiable risk factors to reduce the potential negative impact of these stressors on cognitive aging trajectories in mid to late life.
DISPARITIES IN LATE-STAGE BREAST/COLORECTAL CANCER DIAGNOSIS AMONG HISPANIC, WHITE, & BLACK TX MEDICARE PATIENTS
Authors: Nicot-Cartsonis Mathilda , Raji Mukaila , Kuo Yong-Fang , Digbeu Biai
Published: December 2022

Disparities in late-stage breast or colorectal cancer diagnosis in younger populations are associated with Social Determinants of Health-SDOH (education, poverty, housing, employment). We hypothesized that—in older Medicare beneficiaries—disparities in late-stage cancer diagnosis between Hispanics, non-Hispanic Blacks (NHB) and non-Hispanic white (NHW) would be associated with SDOH, comorbidities and primary care-PCP access. We thus used 2005–2017 Texas Cancer Registry data linked with Medicare data for patients aged ≥66 (Nf86,501). Variables included were age at diagnosis, sex, comorbidities, poverty level, education, primary care provider, and breast/colorectal cancer screening within 1 year. For breast cancer in women (Hispanic n=6380, NHW n=39, 225, non-Hispanic Black n=4055), fully adjusted model showed significantly higher odds of late-stage cancer diagnosis only in NH Black patients (OR= 1.11 95% CI= 1.01–1.22) compared with NHW; adjustment for comorbidities and SDOH partially decreased the odds of late-stage diagnosis relative to NWH. Interaction terms between race-ethnicity and poverty were not significant. For colorectal cancer, fully adjusted multivariate model showed significantly higher odds of late-stage diagnosis among Hispanics (n=6053, OR=1.07;95% CI= 1.00–1.15) and NH-Black patients (n=3318, OR=1.29 95% CI= 1.19–1.40) relative to NHW (n=27,470); adjustment for SDOH was associated with a partial decrease in the high odds of late-stage diagnosis in Hispanic and NH Black patients. Interaction terms between race-ethnicity and poverty were not significant. Racial disparities in late-stage breast and colorectal cancer diagnoses remained after adjusting for SDOH and other clinically-relevant factors, underscoring needs for studies on optimizing access to screening and timely cancer treatments in racial/ethnic minorities.
LONELINESS AND SELF-RATED DAILY SLEEP QUALITY: RESULTS FROM THE EINSTEIN AGING STUDY
Authors: Kang Jee eun , Buxton Orfeu , Hyun Jinshil , Sliwinski Martin
Published: December 2022

Poor sleep quality is a common problem and has profound physical and mental effects on older adults. Loneliness, another common and harmful condition for older adults, is associated with heightened levels of vigilance and feeling unsafe, which may contribute to poor sleep. Although some studies show that trait loneliness is related to compromised sleep, there are few studies examining whether and how day-to-day variations in loneliness relate to sleep quality. The current study aimed to examine within- and between-person associations of loneliness and daily self-rated sleep quality using ecological momentary assessment (EMA) approach. Community-dwelling participants (n=317, Mage=77 (range=70–90), 56% white) reported loneliness and self-rated sleep quality during a 14-day EMA study via mobile phones. Trait loneliness was measured once prior to EMA. Unexpectedly, multilevel modeling showed that the amount of loneliness experienced on a given day did not predict sleep quality, however lower levels of prior night sleep quality predicted elevated levels of loneliness (p < .01). Regarding the between-person association, individual differences in trait loneliness were not related to sleep quality, but differences in average levels of EMA loneliness were related to sleep quality, such that people who felt higher levels of loneliness on average during the 14 days reported worse quality of sleep during that time period than others (p < .0001). These results suggest that worse sleep quality may be a factor that increases loneliness, and may not be a consequence of loneliness. Potential benefits of using EMA loneliness in research of daily sleep quality in older adults will be discussed.
SEX DIFFERENCES IN LIFESPAN RESPONDING TO EARLY AND LATE ONSET DIETARY RESTRICTION
Authors: Jiang Nisi , Diaz Vivian , Strong Randy , Nelson James
Published: December 2022

Dietary restriction (DR) extends lifespan in many animal models. In mice, a range of factors affects the magnitude of the pro-longevity effect of DR, including the strain, restriction level, sex, and age of treatment onset. Early onset DR dramatically prolongs lifespan, whereas DR started later in life has diminished or no significant effect. The lifespan responses of males and females to DR also differ. Whether there is a sex difference in the lifespan response to the age of onset of DR has not been examined. Probing the basis for the variable response to DR can help elucidate the underlying mechanisms that mediate lifespan extension. We diet restricted UM-HET3 mice of both sexes from either 5 months (early-onset) or 20 months (late-onset) of age and monitored their survival. Early onset DR significantly prolonged lifespan in both males and females, which increased median lifespans by 54% and 18.5%, respectively. By contrast, although late onset DR prolonged lifespans in both sexes, the magnitude of increase in males (1.4%) was significantly lower than in females (15.8%, p=0.0474). Moreover, the decrease in the magnitude of the response to late-onset DR compared to that of early-onset DR is more dramatic in males than females. Further analysis found a significant interaction (p=0.0001) between early and late-onset DR in males but not in females (p=0.3818). Together, these results indicate that the lifespan response to delayed onset of DR diminishes more in males than in females, providing another model to probe the underlying mechanisms of DR.
FOOD AND SUPPLEMENT COMBINATIONS TO PREVENT OR POSTPONE AGING, MCI, AND ALZHEIMER’S DISEASE
Authors: Pruchnicki Alec , Kavasch Barrie , Sachs Barrie , Schnoll Roseanne , Martin Rolf
Published: December 2022

Evidence of many interacting causes of aging has renewed interest in food and nutrient combinations that may blunt the main causes[PMC9184560, PMC8889622] and postpone aging, mild cognitive impairment and Alzheimer’s (“A-MCI-Alz”) in contrast to prior failures[PMC9232186]. We present an updated list of anti-aging/pro-longevity strategies to address limitations of previous food/nutrient combinations. Our list has two unusual features: (i) all interventions should be administered concurrently so no fundamental causes of A-MCI-Alz are without remediation and can inflame and leave smoldering important causal factors, (ii) all interventions should be provided daily or weekly to help avoid re-ignition of key factors driving A-MCI-Alz. These two features can help explain past longevity-trial failures[PMC9310407]: no previous study to our knowledge has included most or all of the following interventions, so untreated causes of A-MCI-Alz likely remained active[PMC9114803]. Our recommended interventions include intermittent-or-continuous calorie restriction or fasting[PMID: 33138875, PMC9351392, PMC7956384], protein- and/or methionine-restriction[PMC9197402, PMC4023024, PMC9197406], consumption of moderately-strong metal chelators (e.g. polyphenols in blueberries[PMC1413581], other berries[PMC8271923], grapes[PMC7096489, PMC6386230], cherries[PMC8745076], fruits with hesperidin/hesperitin [PMC9310407] like oranges, soybeans with genistein [PMC4286753], ginger [PMC5852742], ginseng [PMC9358063, PMC3830124, PMC6874434], green/rooibos/oolong teas[PMC6567241, PMIDs: 33285593, 19996359], coffee[PMC4926853, PMC9145055], chocolate[PMC9287426]), antioxidant-rich foods[PMC7530501], B vitamins including vitamin B5 (pantothenic acid[PMC9232186, PMC8725342, https://doi.org/10.3181%2F00379727-99-24442]) to help metabolize partly-toxic aldehydes[PMC6802361] and improve/lower lactate/pyruvate and NAD+/NADH ratios[PMC7346061], ingesting adequate-to-high amounts of longevity-correlated tyrosine[PMC6681387], cysteine[PMID: 20191258], glutathione[PMC8912885, PMC5005830], niacin, nicotine acid and/or NADH[PMC7346061, PMC6982340], spermidine[PMC8436989], anti-inflammatory NSAIDS[PMC4270464], autophagy inducers[PMC6191153] fiber[PMC8705837] and fluids[PMID: 21585170] to help remove excess metals, toxic metabolites and damaged organelles, while limiting methionine-rich, other pro-aging foods[PMC4023024].
ADVANCE CARE PLANNING MOTIVATED BY THE COVID-19 PANDEMIC
Authors: Thomas Karuna , Sahawneh Fursan , Carpenter Brian
Published: December 2022

The COVID-19 pandemic has exposed older adults to complex healthcare situations, via personal experience or media stories about serious illness. Hearing about lengthy intubation, sedation, rapid decline, and distress at the end of life has the potential to prompt people to reevaluate their perspective on their own end-of-life care. This study explored advance care planning (ACP) among older adults and whether COVID-19 experiences altered their healthcare preferences and planning. One hundred and fifty-one respondents (M age = 71.2 yrs, range = 55–93) completed an online survey about ACP completion, ACP conversations, and life-prolonging interventions. Respondents were mainly female (78%), White (71%), and well educated (77% with at least a bachelor’s degree). A substantial proportion had not completed an advance directive (31%) or chosen a medical power of attorney (33%), and 78% of them intended to complete them in the next year or had initiated ACP. Among those who had completed ACP, a quarter intended to make changes, with 13% less open to life-prolonging medical treatments and 13% more open to them. Despite these intentions, a small proportion of people had ACP conversations since the start of the pandemic with their spouse/partner (37%), children (25%), siblings, (19%), friends (27%), primary care physician (16%), or other healthcare provider (12%). Results of this study suggest that now may be a critical moment to encourage older adults to have ACP conversations, in light of how their experience during the pandemic has motivated a reconsideration of treatment preferences.
PHENOME-WIDE SEARCH OF COGNITIVE RESERVE PROXIES ACROSS AGE COHORTS
Authors: Zheng Anqing , Wadsworth Sally , Friedman Naomi , Reynolds Chandra
Published: December 2022

Cognitive reserve (CR) refers to adaptability allowing for better cognitive outcomes given the degree of brain changes or other risk factors for cognitive decline. Despite significant research efforts, our knowledge of cognitive reserve proxies remains limited. Studies predominantly use a single sociodemographic variable (e.g., education attainment) as a proxy measure when CR can manifest in multiple domains. Studies also tend to rely on older samples, whereas adversity factors of cognitive performance may have differing onset ages, suggesting different risk or protective mechanisms at different ages. We examine two cohort datasets spanning from early adolescence (Adolescent Brain Cognitive Development study, N = 5559) up to the cusp of mid-adulthood (Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging; CATSLife, N = 1327) to evaluate the role of CR proxies across over 100 variables. Defined as a moderator between a cognitive outcome and structural brain measure, these variables cover behavioral, environmental, physical and mental health, and psychological trait domains. Using cross-validated regularized regression, we identified dozens of factors acting as CR proxies (e.g., leisure reading as protective and screen usage as a risk factor during adolescence). We then use a within-family design to examine the moderation effect over and above genetic and environmental covariates. For example, adolescents who read more tend to show better cognitive performance given their gray matter volume (b = .093, 95%CI = [0.035, 0.152]). This study aims to identify factors that could be targeted with scalable prevention and intervention efforts earlier in life to maximize cognitive functioning.
CHARACTERIZING PERFORMANCE VARIABILITY ACROSS COGNITIVE TASKS IN OLDER ADULTS WITH AND WITHOUT ADHD
Authors: Klepacz Laura M , Cerino Eric , Kok Almar A L
Published: December 2022

Most research on cognitive performance among individuals with Attention Deficit/Hyperactivity Disorder (ADHD) focuses on younger persons and on cognitive variability within speeded response-time tasks. Dispersion, i.e., variability across a range of cognitive domains, is emerging as a promising indicator of age-related and pathological cognitive impairment. However, there has yet to be an evaluation of differences in dispersion among older adults with and without ADHD. We address this gap by assessing associations of age and ADHD status with dispersion. We hypothesize older adults will exhibit greater dispersion than comparatively younger adults and explore whether individuals with ADHD exhibit greater dispersion than individuals without ADHD. In a sample of 231 adults from the Longitudinal Aging Study Amsterdam (Average age=71.64 years, SD=7.7, 59% female), 23 individuals met DSM-IV criteria for ADHD and 208 were classified as neurotypically functioning. Participants completed 13 tasks spanning domains of attention, fluency, memory, processing speed, and reasoning. Dispersion across the tasks was calculated as an intraindividual standard deviation. We regressed dispersion on age and ADHD status and adjusted for sex. Older age was significantly associated with greater dispersion (Est =0.06, SE=0.03, p=0.01). However, dispersion profiles did not vary as a function of ADHD status (Est.=-0.25, SE=0.67, p>05). Preliminary results suggest that dispersion across cognitive tasks may not be a sensitive marker of ADHD in older adults, although statistical power to detect differences was relatively low in the current study. As expected, age was a significant predictor of increased dispersion, consistent with accounts of age-related changes in neurological integrity.
ASSOCIATION OF COGNITIVE STATUS AND CONSUMPTION OF UNPROCESSED AND ULTRA-PROCESSED FOODS IN BRAZILIAN OLDER ADULTS
Authors: Silva Graziele , Freiria Carol , Brito Tábatta , Borim Flávia Arbex Silva , Corona Ligiana P
Published: December 2022

The decrease in consumption of fresh or minimally processed foods and the increase in ultra-processed foods are being observed in the diet of older adults and these changes may lead to worsening health status and cognition. We aimed to evaluate the association between cognitive status and food consumption according to the level of processing in Brazilian older adults. Cross-sectional study, with a sample of 585 older adults (≥60 years). Cognition was evaluated using the Cognitive Skills Screening Instrument (CASI-S), considering cognitive deficit when scores < 23 in participants aged 60–69 and < 20 in those aged ≥70 years. Foods reported in 24-hour food recall were classified according to their processing level into four groups of NOVA proposal: 1) unprocessed/minimally processed foods, 2) culinary ingredients, 3) processed foods (products made only from groups 1 and 2); and 4) ultra-processed foods. We estimated the means of total CASI-S score and its four domains according to the quartiles of intake of each food group, and evaluated the association between cognitive decline and each food group intake using logistic models adjusted for gender, age, schooling. Individuals in the highest quartile of unprocessed/minimally processed foods intake had higher scores in temporal orientation (p=0.034), verbal fluency (p=0.002), and total CASI-S score (p=0.004). The scores did differ according to the intake of the other food groups. The ultra-processed was the only group associated with cognitive deficit (OR:1.02; p=0.002). Results suggest nutritional counselling for older adults should focus in reducing ultra-processed and increasing unprocessed foods to help preventing cognitive deficit.
EVERYDAY FUNCTION PROFILES IN PRODROMAL STAGES OF MOTORIC COGNITIVE RISK SYNDROME: A PROSPECTIVE COHORT STUDY
Authors: Kravatz Nigel , Adhikari Dristi , Ayers Emmeline , Verghese Joe
Published: December 2022

Assessment of everyday function is crucial to diagnosing pre-dementia and dementia syndromes in older individuals. Prodromal stages of mild cognitive impairment (MCI) are associated with mild limitations in complex activities of daily living. It is unknown whether such limitations exist in the prodromal period before criteria is met for motoric cognitive risk syndrome (MCR), a pre-dementia syndrome defined by subjective cognitive complaints and slow gait speed. We compared complex everyday functional profiles at baseline in 46 community-dwelling older individuals (aged 65+) with normal cognitive performance at baseline who went on to develop incident MCR (‘pre-MCR’) with 265 older individuals who remained cognitively normal over follow-up. Patients diagnosed with MCI and global cognitive function scores more than 1.5 standard deviations below the mean at baseline were excluded. The mean number of limitations on complex everyday function at baseline was 3.52±3.1 in the pre-MCR cases and 1.78±2.2 in the 265 normal controls (OR 1.28; 95% CI 1.14–1.43). After adjusting for demographic factors, comorbidities, and follow-up time, the overall number of limitations remained significantly higher in the pre-MCR participants compared to the normal participants (OR 1.18; 95% CI 1.02–1.37). Of the limitations, difficulty completing hobbies and handling finances were associated with pre-MCR after adjustments. Limitations on complex everyday functions in individuals occur before they meet criteria for incident MCR on longitudinal follow-up. Such limitations over time will help clinicians identify individuals at-risk for dementia early in clinical practice.
COMFORT COMMUNICATION IN HOME HEALTH: FEASIBILITY, ACCEPTABILITY, AND PRELIMINARY EFFECTIVENESS
Authors: Bigger Sharon , Zanville Noah , Wittenberg Elaine , Towsley Gail , Glenn Lee
Published: December 2022

Home health is the fastest-growing long-term care setting in the U. S.. However, evidence on effective clinician-patient-family communication in home health is lacking. This prospective, two-arm, pre-post randomized controlled trial aimed to assess feasibility, acceptability, and preliminary effectiveness of the COMFORT (Connect, Options, Meaning-making, Family Caregiver, Openings, Relating, and Team) communication model in home health interprofessional staff (IHHS). IHHS (n = 18) were randomized into two groups: Group 1 (control) (n=10) received seven asynchronous modules, and Group 2 (intervention) (n = 8) received the same modules plus a 2-hour synchronous class with interactive slide presentation and exercises. Measures included completion rates, acceptability ratings, comfort with communication in palliative and end-of-life care (C-COPE), and moral distress in health professionals (MMD-HP). Regardless of group, COMFORT was highly acceptable (>4) to IHHS. COMFORT was positively correlated with improved C-COPE scores (p = 0.037). Moral distress scores did not differ before and after the intervention; however, baseline moral distress scores were found to be higher in IHHS when compared to an academic medical center sample from a previous study. Levels of acceptability of COMFORT were significantly related to clinician levels of considering leaving a job due to moral distress (chi square = 7.6, p = 0.02, Kruskal-Wallis rank sum test). Findings suggest that COMFORT training increases IHHS comfort with palliative and end-of-life communication, especially among clinicians with histories of considering leaving a job or having left a job due to moral distress.
COMMUNITY-BASED ORGANIZATIONS CONTRACTING WITH HEALTH CARE PARTNERS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH
Authors: Graham Robert , Karmacharya Isha
Published: December 2022

Community Based Organizations (CBOs), such as Area Agencies on Aging, play a vital role in their communities by offering a range of services that address the health-related social needs of older adults and people with disabilities. As health care entities (HCEs) become more aware of the effects of unmet social needs on health outcomes, there has been a significant increase in the number of HCEs contracting with CBOs to provide a wider range of services and care coordination for older adults and people with disabilities. Using findings from four waves of the national Aging and Disability Business Institute’s CBO-Health Care Contracting Survey (2017–2021), presenters will describe trends in CBO/HCE contracting, including increased diversification of partnerships with health care payers and providers, services provided, and populations served. Results suggest that more CBOs are forming integrated networks to improve contracting with HCEs, and that assessment for SDOH is the most common service.
IN THEIR VOICES: A QUALITATIVE STUDY OF OLDER ADULTS’ PERSPECTIVES OF COVID-19 PANDEMIC
Authors: Liou Chih-ling
Published: December 2022

Older adults are a very heterogeneous group and are likely to experience the pandemic in a variety of ways. This study is to give older adults voices to share their experiences of this pandemic. Data were collected in spring 2022 using semi-structured interviews with 46 adults (74% females) aged 66 and 97 residing in the Midwestern United States. Participants were asked to share how the pandemic affects them, their vision for the future, and how they cope during the pandemic. Participants expressed both positive and negative effects of pandemics. Although they shared more information and examples of the negative effects, most of them did express an optimistic view of the future. The most reported negative effects were few contacts with family and friends, isolation/loneliness, and confinement/restrictions. The most reported positive effects were having more time, getting things done, driving less, and becoming more appreciative. Their perspectives toward the COVID-19 pandemic are varied: some believed that the effects of the pandemic are just temporary, and others compared it to the wars that were much worse. Findings reveal that oldest-old (85+) and old-old (75–84) participants are better at regulating their negative effects compared to the young-old (65–74). Older adults during the pandemic are not just passive help receivers but can be proactive helpers to give advice and coping strategies as well as provide emotional support to others. Older adults’ adaptability during the COVID-19 pandemic should be better understood to reverse the image of their vulnerabilities and promote late-life coping during crises.
PERCEPTIONS OF THE GEROPSYCHOLOGY WORKFORCE
Authors: Moye Jennifer , Ma Flora , Schmidt Nicholas , Heintz Hannah , Allen Rebecca , Carpenter Brian
Published: December 2022

There is a longstanding shortage of teaching faculty and clinicians trained in psychology and aging (Moye et al. 2019). Further, there are few marginalized group members in the geriatric workforce. To better understand this issue, a survey was distributed to psychology and aging listservs in preparation for the “Building Bridges” conference. Problems noted by respondents (N=275) included fewer applicants for aging-related positions (42%), decreased interest in aging by students (32%), loss of aging-related positions (18%); 24% thought workforce problems are worse than 5 years ago. Similar themes emerged in qualitative comments including: (1) lack of applicants/ interest, (2) lack of or decline in the training/ education opportunities, (3) lack of finances/ funding/ resources, (4) lack of professional positions, and (5) positive experiences/ actions/ change. Themes specific to marginalized group members to support diversity, equity, and inclusion include mindful commitment, education (e.g., mentorship), and recognizing not doing enough.
CLINICIANS’ PERSPECTIVES ON THE EVOLUTION OF PALLIATIVE CARE DELIVERY DURING THE COVID-19 PANDEMIC
Authors: Silva Laura Quintero , Schwingel Andiara , Bobitt Julie , Raj Minakshi
Published: December 2022

Palliative care has been primarily delivered to patients in person since its inception. During the Covid-19 pandemic, providing palliative care was especially challenging for clinicians due to public health measures to contain the virus that required them to interact virtually with patients and families. While the rapid implementation of telehealth has been examined in other clinical contexts, limited research has studied the impact of the pandemic on palliative care delivery. This study examined the experiences clinicians faced when providing palliative care to older adult patients during the pandemic. Between April 2021 and March 2022, we interviewed 29 geriatricians and palliative care specialists from 11 institutions across the US. We asked clinicians about their experiences with palliative care during the pandemic, including challenges and opportunities related to the changing nature of palliative care delivery. We analyzed interviews using reflexive thematic analysis. The following three themes emerged from the analysis: (1) Clinicians’ challenges adjusting to virtual care; (2) System-level barriers, restrictions, and uncertainties about Covid-19; and (3) Older adult patients’ context and vulnerability (i.e., loss of social engagement, isolation, loneliness, delayed access to care) that increased the complexity of their health conditions. In conclusion, clinicians’ experiences during the pandemic shed light on the evolution of palliative care delivery and the importance of preparing them for new care models that account for virtual delivery and that address the diverse needs of older adults that emerge during public health crises.
ULTRASOUND MUSCLE THICKNESS AS AN EASY METHOD TO ASSESS LEAN MASS AND GRIP STRENGTH IN OLDER ADULTS
Authors: Vilar Fernandes Lara , De Oliveira Gabriela Benatti , Junqueira Vasques Ana Carolina , Andrade Flavia , Yu Xia , Chen Summer , Corona Ligiana P
Published: December 2022

Ultrasound is emerging as an effective method for measuring muscle mass in older adults, being more cost-effective than other image methods, such as Dual-energy X-ray absorptiometry (DXA) and computed tomography, and more accurate than bioelectrical impedance and anthropometry. We aimed to evaluate the correlation between measurements of muscle thickness (MT) measured by a portable A-mode ultrasound, the total lean mass (TLM) measured by DXA, and grip strength (GS) among community-dwelling Brazilian older adults. This is a cross-sectional pilot study with 30 participants (9 men and 21 women) aged 60–78. MT was assessed in five anatomic sites (triceps, biceps, anterior and posterior thigh, calf) using a portable A-mode ultrasound (BodyMetrix BX-2000 - IntelaMetrix, Inc.); TLM was assessed by DXA (GE Healthcare’s Lunar iDXA), and GS was assessed using a Saehan dynamometer. Pearson′s test was used for correlation analysis between each site MT and TLM; linear regressions were estimated to verify the association between GS and each site MT, controlling for age. Lower limb measurements (anterior and posterior thigh, calf) were not associated with TLM and GP. Triceps MT was significantly correlated to TLM (r=0.565; p=0.001) and associated to GS (β=0.699; p=0.004); biceps MT was also correlated to TLM (r=0.425; p=0.019) and associated to GS (β=0.652; p=0.012). Our results suggest that upper limb ultrasound measurements using portable equipment can be a helpful cost-effective indicator of muscle mass and function in older adults. Further results and conclusions will be reported after completing the study with the total planned sample (n=150).
PREDICTORS OF INDIVIDUAL TRANSPORTATION ALTERNATIVES IN THE TRANSITION TO NON-DRIVING
Authors: Hansmann Kellia , McAndrews Carolyn , Robert Stephanie
Published: December 2022

For older adults who transition to non-driving, successful coping includes maintaining mobility. Individual transportation alternatives, e.g. rides from friends and family, are important coping factors in the transition to non-driving. However, it is unclear to what extent social network composition predicts the accessibility of these individual transportation alternatives. We examined whether various aspects of social networks (including living with a spouse/partner; having a child; living with a child; having other household members; having anyone to talk to about important things) were associated with the actual receipt of rides from family and friends. Using the National Health and Aging Trends Study (NHATS), a nationally representative cohort of Medicare beneficiaries ages 65 and older, we conducted a cross-sectional analysis using a subsample of community-dwelling older adults whose driving status was known at the baseline interview in 2015 (n = 5,889). We used logistic regression to estimate the association between social network indicators with the odds of receiving a ride from a family member or friend. When adjusting for biopsychosocial characteristics and current driving status, we found that having a spouse or partner was associated with a significant odds of having received a ride (adjusted OR, 95% CI = 1.41, 1.05–1.90) as was being able to name at least five people the participant could talk to about important things (adjusted OR, 95% CI = 1.65, 1.14–2.38). Our findings support previous evidence that marital status and support from social network members outside one’s household may be particularly important for accessible individual transportation alternatives.
PHYSICAL SYMPTOM TRAJECTORIES OF OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Lee Dylan , Choun Soyoung , Lee Hye Soo , Kurth Maria , Aldwin Carolyn
Published: December 2022

Older adults experience increased risk for morbidity and mortality during the COVID-19 pandemic (CDC, 2021). Social distancing and lockdown to prevent contagion may affected physical and mental health. We examined the fifteen physical symptom trajectories of older adults during the early months of the COVID-19 pandemic. We also examined age, gender, and marital status differences in each physical symptom trajectory. The sample consisted of 247 older adults (Mage = 71.1, SD = 7.3, 88.7% White, 73% women, 73.4% married), who participated in eight weekly longitudinal online surveys from April 28 to June 23, 2020. Random-effects logistic regression analysis controlling for age, gender, marital status, and depressive symptoms showed that the nine physical symptoms (headache, constipation/diarrhea, muscle soreness, shortness of breath, tightness of chest, backache, heart pounding, congestion, and sore throat) significantly decreased in the first few weeks, but then six symptoms (constipation/diarrhea, shortness of breath, tightness of chest, heart pounding, congestion, and sore throat) increased in later weeks of the study period. Middle-aged participants reported higher number of headache, tightness of chest, heart pounding, and nausea/upset stomach than older participants. Women experienced more constipation/diarrhea, trembling/shaking, and sore throat than men. Those who were not married responded with higher number of shortness of breath, backache and poor appetite compared to married participants. Higher depressive symptoms were significantly related to each physical symptom. The results suggest that healthcare providers should evaluate physical symptoms focusing on the patients who are at greater risk of poor health during the pandemic.
FEASIBILITY OF INTEGRATED TECHNOLOGIES TO PROMOTE LEISURE ACTIVITY ENGAGEMENT AMONG ASSISTED LIVING RESIDENTS
Authors: Gaspar Phyllis , Do Elena , Kim Junhyoung , Chow Angela , Sobol Adam , Francisco Raia , McFarland Lisa
Published: December 2022

Research suggests that advanced technologies, such as wearable technology and tablets, can serve an important role in the cost-effective, accessible delivery of health promotion that is individualized, immersive, and engaging for users. The present study was designed to test the feasibility and acceptability of two integrated technologies among assisted living facility residents: CareBand’s wearable technology and Eperture’s RememberStuff (R/S) tablet platform. The purpose of the qualitative component of the project was to provide preliminary information from the perspective of the assisted living facility participants on these two technologies. Another goal was to assess the challenges of their participation. Drawing on qualitative thematic analyses of data collected from semi-structured interviews with 16 participants (four staff members and 12 residents) prior to and following the 6-week integrated technology program, three themes emerged as positive outcomes of the technology experiences: (a) leisure activity engagement, (b) exploration of tablet features, and (c) cognitive stimulation. This finding suggests that these technologies may enhance leisure engagement and cognitive function. On the other hand, there were three challenges that participants experienced while participating in the program: (a) inability to grasp functionality, (b) need for continued education for the technology, and (c) negative stereotypes toward technology use. These challenges provide guidance for future protocol design in follow-up studies to further explore the integrated technology efficacy for older adult users. The practical implications of this study and suggestions for health professionals are discussed.
TRUST IN GOD AND THE CHURCH, NOT NEIGHBORS: EXPLORING SOCIAL COHESION AMONG AGING HIV+ INDIVIDUALS
Authors: Vu Thi , Dunham Katherine , Lin-Schweitzer Anna , Girma Meron , Lee Megan , Ransome Yusuf
Published: December 2022

Rates of new HIV diagnoses among people 55+ years old remained unchanged between 2015–2019, suggesting potential HIV prevention challenges in the aging population due to co-morbidities, social isolation, and age-related stigma. Socio-cultural factors play a strong role in influencing HIV outcomes. Social cohesion — including appraisals of trust in neighbors and levels of belongingness to a community — has been shown to be an important channel for HIV prevention in the general population. However, there is scant evidence about how social cohesion relates to HIV prevention and care engagement among older adults. We employed a convergent, parallel mixed-methods study to investigate this topic among a sample (n =17) of adults aged 50+ living with HIV in New Haven, CT. We conducted semi-structured interviews which were analyzed using thematic analysis in NVivo.v12. We also collected quantitative data in RedCap and calculated descriptive statistics in STATA.v16. Participants were on average 57 years of age (SD=4); 53% female, and 69% Black/African American. Participants’ trust in their neighborhoods was low [mean=2.61 (range 1 - 5, where 5 indicates high trust)]. In interviews, trust did not significantly influence one’s HIV status disclosure or care management. Instead, participants often identified their faith in God or relationship with local churches as significant sources of social and informational support they often rely on for their HIV-related needs. Our results show that investigating the impact of religious belonging on outcomes may be a fruitful path of research to improve HIV outcomes among the aging population.