bluuebunny/crossref_metadata_2025 huggingface dataset:
Hearing Care Disparities in Dementia: Access and Usability in the Coming Era of OTC Hearing Aids
Authors: Nieman Carrie , Deal Jennifer , Czaja Sara , Oh Esther
Published: December 2020

Age-related hearing loss is highly prevalent among persons with dementia (PwDs) and is associated with an increased risk of neuropsychiatric symptoms. However, few use hearing aids and disparities exist. PwDs and, in particular, minority older adults, have some of the lowest rates of hearing aid use. Recent federal legislation created the designation of over-the-counter hearing aids, which will debut by 2020-2021, and represents an opportunity to advance accessibility. This presentation will share estimates of hearing aid use among community-dwelling PwDs from two cohorts, where hearing aid use ranges from 7-11% among African Americans versus 33-45% among whites. To explore this gap, the presentation will share findings from semi-structured interviews with care partners of PwDs and hearing loss around barriers and facilitators of hearing care, including device usability. With growing understanding of sensory health, a changing hearing care landscape represents a critical opening to increase access to hearing care for PwDs. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.
Beyond Sex: Gender, LGBTQ, and Alzheimer’s Disease and Related Dementias
Authors: Shaaban C Elizabeth , Mielke Michelle
Published: December 2020

Sex and gender are important sources of variation in Alzheimer’s disease and related dementias (ADRD) and associated caregiving. Women comprise 2/3 of ADRD cases and the majority of ADRD caregivers. Sex encompasses biological differences due to sex chromosomes, reproductive tract, and hormones, while gender constitutes socioculturally constructed psychosocial aspects of sex. Several lines of research have begun to interrogate sex differences, but less is known about the relation of gender and lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) status with ADRD. In this symposium featuring both trainees and faculty we highlight novel research addressing these factors from multiple perspectives. Two presentations address how psychosocial characteristics and their strengths of association with brain health may vary by gender. C. Elizabeth Shaaban presents analyses testing whether gendered psychosocial factors explain sex differences in white matter hyperintensities, a neuroimaging marker of cerebral small vessel disease and risk factor for ADRD. Justina Avila-Rieger presents results testing region of birth-based spatial patterning of dementia risk among Black men and women. Next, Jason Flatt presents prevalence estimates of subjective memory problems and dementia and describe factors associated with dementia among LGBTQ older adults. Finally, gender may also impact perceptions of individuals with dementia. Shana Stites explores gender differences in AD stigma and discuss implications for who is willing to be an AD caregiver. Michelle Mielke, an expert in sex and gender differences in neurodegenerative and age-associated diseases will facilitate conversation about these results and place them in the context of current sex and gender-based ADRD research.
Telomere Dysfunction and Aging: Insights From Pulmonary Fibrosis
Authors: Newton Chad
Published: December 2020

Telomeres are specialized genomic elements located at the ends of chromosomes that protect protein-encoding DNA from progressive loss during cellular replication. Telomeres shorten with age; therefore, telomere dysfunction is of particular relevance for understanding age-related disease mechanisms. Telomere disorders produce multisystem degenerative organ dysfunction that largely resembles aging phenotypes, including pulmonary fibrosis (PF), emphysema, cirrhosis, bone marry dysfunction, immunosenescence, and premature hair graying. The degree of telomere shortening influences age of disease onset, involved organs, and disease severity. Notably, the most common manifestation of telomere biology disorders is PF. Subsequently, PF is a model for translating telomere biology into clinical practice. I will discuss the genetics of telomere dysfunction and the clinical manifestations that overlap with age-related phenotypes, focusing on PF. Next, I will discuss how short leukocyte telomere length is an informative prognostic, and potentially theragnostic, biomarker in patients with a range of PF subtypes.
Existing Datasets to Study the Impact of Internal Migration on Caregiving Arrangements
Authors: Xu Hanzhang , Pei Yaolin , Dupre Matthew , Wu Bei
Published: December 2020

Massive rural-to-urban migration in China has a significant impact on caregiving arrangements among Chinese older adults. To stimulate research on the intersection of migration and caregiving, we conducted an inventory of longitudinal aging survey datasets that included older adults from mainland China. Large public available datasets that included measures related to migration and caregiving were searched and reviewed for eligibility. Key characteristics of each dataset, including study design, sample size, and measures, were extracted. Seven eligible datasets were identified, and five included national representative samples. Measures for migration varied across datasets. Some datasets included information on the migration history of older adults, whereas others focused on the migration of adult children. Similarly, caregiving was measured using different questions in each dataset. Caregiving activities were assessed with regard to their type, source, and amount. High-quality datasets exist to support research on migration and caregiving arrangements among Chinese older adults.
Use of Technology in an Internet-Delivered Intervention for Older Adults With Mild Cognitive Impairment
Authors: Mattos Meghan , Barnes Laura , Davis Eric , Manning Carol , Quigg Mark , Ritterband Lee
Published: December 2020

Internet-based interventions using technology can promote access to treatment and reduce participant burden for sleep disorders. However, preliminary studies examining technology use and compliance in older adults with mild cognitive impairment (MCI) are needed prior to undertaking large-scale interventions. Older adults with MCI were recruited from hospital-based memory and sleep disorders clinics and enrolled in a single-arm intervention pilot study. An Internet-delivered cognitive behavioral therapy for insomnia program collected daily sleep diary data and delivered the automated intervention over nine weeks. Sleep diaries and wrist-worn actigraphs collected sleep data for 14 days, pre- and post-intervention. Descriptive statistics for participant technology use are presented. We have recruited 12 subjects with MCI. Most subjects with MCI accessed the intervention program daily; however, actiwatch compliance varied. Incorporating technology for intervention delivery and data collection in this population is promising, and future work should consider using reminders with wearable technology to increase compliance.
Effect of Vitamin D Supplementation on Falls, Physical Function, and Activity: Results From the STURDY Trial
Authors: Schrack Jennifer , Appel Lawrence , Lipsitz Lewis
Published: December 2020

Each year, 2.8 million older adults are treated for falls, with over 800,000 hospitalized. Evidence suggests vitamin D supplementation might reduce the risk of falls, potentially through improvements in skeletal muscle function; however, results are inconsistent. In 2013 the NIA issued a request for applications to assess the efficacy and dose-response of vitamin D supplementation for fall prevention across a range of doses and serum 25(OH)D concentrations, resulting in the funding of STURDY (Study To Understand Fall Reduction and Vitamin D in You). STURDY was a seamless dose-finding and confirmatory, double-masked, response adaptive Bayesian randomized trial designed to find the best dose of vitamin D supplementation for fall prevention. Participants (n=688, ≥70 years with serum 25(OH)D of 10-29 ng/mL) were randomized to 200 (control), 1000 , 2000, or 4000 IU/day of vitamin D3.The first participant was randomized on 10/30/2015 and data collection ended on 5/31/2019. The primary outcome was time to first fall or death, and the secondary outcome was gait speed. Dr. Appel will present the main findings of the effect of vitamin D supplementation on time to first fall. Dr. Wanigatunga will present a more detailed analysis of the effect of vitamin D supplementation on fall characteristics, including indoor vs. outdoor falls, consequential falls, and repeat fall risk. Dr. Guralnik will present the effect of vitamin D supplementation on physical functioning, including gait speed, SPPB, 6-minute walk, and TUG performance. Dr. Schrack will present the effect of vitamin D supplementation on objectively measured physical activity.
Multi-Sensor Measurement of Physical Behavior in the Finnish Retirement and Aging Study
Authors: Stenholm Sari
Published: December 2020

Retirement is a life transition that is accompanied by changes in time use and removal of work-related exposures. The Finnish Retirement and Aging study (FIREA) was established in 2013 to examine changes in 24-hour physical behavior, lifestyle factors, health and functioning by following aging workers annually from full-time work to retirement. FIREA activity substudy includes 1200 participants (mean age 63.2 years, 85% women) and their physical behavior has been measured annually with multiple accelerometers (wrist ActiGraph, thigh Axivity and hip SenseDoc including GPS). The mean number of measurement days is seven at each measurement wave with a valid wake wear time 16.0 hours before retirement and 15.6 hours after retirement. Currently, information is available from 3-5 measurement waves. Transition to retirement induced changes in 24-h physical behavior towards increased sleep and less physical activity among women, especially in those retiring from manual occupations.
Emerging Nutritional Interventions for Age-Associated Cellular Decline
Authors: Singh Anurag
Published: December 2020

Aging is associated with a progressive decline in cellular health leading to dysfunction in organs with a high metabolic demand. A key feature of age associated cellular decline is impairment of mitochondrial quality control pathways such as mitophagy. Deficits in optimal functioning of these pathways results in a compromise in cellular bioenergetics that ultimately leads to mitochondrial dysfunction. Promising nutritional interventions have emerged that boost mitochondrial health such as nicotinamide riboside (vitamin B3 precursor) and Urolithin A (gut metabolite of compounds found in pomegranates), that act via different mechanisms of action to improve overall mitochondrial health. Recent literature on the evidence behind these interventions will be presented and discussed during this symposium. We will also share recent clinical evidence from double-blind placebo-controlled studies with Urolithin A. Our results suggest that nutritional interventions such as Urolithin A are promising approaches that can be employed to manage age associated cellular decline.
Frailty Phenotype and Healthcare Costs in Women in Late Life: The SOF study
Authors: Langsetmo Lisa , Kats Allyson , Schousboe John , Vo Tien , Taylor Brent , Ensrud Kristine
Published: December 2020

We used data from 1324 women (mean age 83) at the 2002-2004 exam linked with their Medicare claims to determine the association of the frailty phenotype with healthcare costs. The frailty phenotype was categorized as robust, pre-frail or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims. Functional limitations were assessed by asking about difficulty performing IADL. Total direct healthcare costs were ascertained during 36 months following the exam. Compared with robust, pre-frailty and frailty were associated with higher costs after accounting for demographics, multimorbidity, functional limitations and the frailty indicator (cost ratio 1.37 [1.10-1.71] among pre-frail and 1.63 [1.28-2.08] among frail). Discrimination of high-cost (top decile) women was improved by adding the phenotype and functional limitations to a model containing demographics and the claims-based measures. Findings suggest that assessment of the phenotype may improve identification of individuals at higher risk of costly care.
Patient Engagement in Research Design and Implementation: Moving From Infancy to Adolescence
Authors: Geary Carol , Roes Martina , Abbott Katherine
Published: December 2020

Patient (also referred to as User or Older Adult) engaged research is a unique approach to research design, implementation, and dissemination. The practice of engaged research, in its broader sense, involves service recipients, caregivers, clinicians, and other stakeholders in prioritization of research questions, approach, and practice translation to ensure strong stewardship of funds, valid and reliable methods, and practical application. Patient engaged research also aligns with tenets of person-centered care in the inclusive nature and the expectation that the practice will improve the processes and the outcomes of research. Likewise, GSA’s focus on diversity of thought through interdisciplinary work strongly aligns with inclusion of patient and stakeholder voices in the performance of interdisciplinary research. Although patient and stakeholder engagement in research is a new approach for many, globally, funders increasingly require evidence of “meaningful” engagement in project proposals. In the United States, the Patient-Centered Outcomes Research Institute (PCORI) is well-known for funding engaged research and the National Institute on Aging (NIA) has demonstrated use of “collaborative” methods central to patient engagement within the IMPACT Collaboratory. Patient engagement literature, while growing, does not yet provide adequate guidance for replication of current or development of new approaches to patient engagement in research. Therefore, the purpose of this symposium is to frame patient engagement through a historic lens (Roes) and discuss the ethics of engagement (O’Sullivan). In addition, we will share program outcomes from three patient engagement programs: the Leading Age LTSS Center, Rural Patient & Stakeholder Engagement, and Sages in Every Setting. Patient/Person Engagement in Research Interest Group Sponsored Symposium.
Examining the When and How of Physical Activity Patterns in Older Adults: The Women’s Health Study
Authors: Shiroma Eric
Published: December 2020

Using data from the Women’s Health Study (N = 17,708, mean age = 72 years), we investigated the relative importance of physical activity volume, intensity, frequency of sessions, and session duration. We calculated the mortality hazard ratio for varying patterns and combinations of physical activity intensities and sedentary behavior. In separate analyses, we compared participants who engaged in activity regularly throughout the week to those who focused on one or two days a week, and the relative importance of session frequency and duration. These characteristics of activity patterns and their impact on health may help design interventions and public policy.
Greater Social Engagement and Greater Gray Matter Microstructural Integrity of Aging Adults
Authors: Felix Cynthia , Rosano Caterina , Zhu Xiaonan , Flatt Jason , Rosso Andrea
Published: December 2020

Social engagement reflects habitual social roles in aging adults and may protect against dementia. Cross-sectional associations of social engagement (SE) index with gray matter (GM) microstructure was studied in regions of interest relevant to social cognition among community-dwelling older adults [n=293, mean age: 82.8 years (SD: 2.8), 43% males] using linear regression models. Greater SE was significantly related to lower mean diffusivity (MD) (greater GM microstructural integrity) [shown as standardized estimate (p-value)] in: left middle frontal gyrus-orbital part: -0.168 (0.005), left caudate nucleus: -0.141 (0.02), left temporal pole-middle temporal gyrus: -0.136 (0.03), right middle frontal gyrus: -0.160 (0.006), right superior frontal gyrus-orbital part: -0.187 (0.002), right middle frontal gyrus, orbital part: -0.124 (0.04), adjusted for demographic attributes. Associations were robust to adjustment for hearing or ADL difficulty. Findings were generally stronger in females than in males. Social engagement may prevent GM integrity loss and build brain reserve in dementia-related regions. Part of a symposium sponsored by Brain Interest Group.
How Cognitive Impairment Affects Medication Management in Dental Settings
Authors: Chen Xi , Madiloggovit Jirakate , Jacobson Lisa , Tranel Daniel , Comnick Carissa , Xie Xianjin
Published: December 2020

Mishandling medications is commonly seen in persons with dementia, which can lead to poor treatment outcome and serious complications. Whether individuals with cognitive impairment can appropriately manage dental-related medication remains unknown, raising a liability concern for dentists who fail to recognize the patients at risk for mishandling their medications. To address this concern, we conducted a study with 51 participants with various cognitive impairment to describe their ability to handle dental-related medications. After cognitive assessment, participants were asked to set up an antibiotics pill-box and use a mouthwash as instructed, and their performance were scored. Number and type of prompts given to facilitate task completion were also documented. Mishandling of dental-related medications was common in participants with cognitive impairment. As expected, participants with poor cognition needed more assistance on handling their medications. Dentists should be aware of this concern and take it into consideration when treatment plan for these individuals. Part of a symposium sponsored by the Oral Health Interest Group.
Detection of Alzheimer’s Disease-Related Cognitive Change With the Mobile Cognitive App Performance Platform
Authors: Mechanic-Hamilton Dawn , Lydon Sean , Miller Alexander , Halberstadter Kimberly , Lane Jacqueline , Das Sandhitsu , Wolk David
Published: December 2020

This study investigates the psychometric properties of the mobile cognitive app performance platform (mCAPP), designed to detect memory changes associated with preclinical Alzheimer’s Disease (AD). The mCAPP memory task includes learning and matching hidden card pairs and incorporates increasing memory load, pattern separation features, and spatial memory. Participants included 30 older adults with normal cognition. They completed the mCAPP, paper and pencil neuropsychological tests and a subset completed a high-resolution structural MRI. The majority of participants found the difficulty level of the mCAPP game to be “just right”. Accuracy on the mCAPP correlated with performance on memory and executive measures, while speed of performance on the mCAPP correlated with performance on attention and executive function measures. Longer trial duration correlated with measures of the parahippocampal cortex. The relationship of mCAPP variables with molecular biomarkers, at-home and burst testing, and development of additional cognitive measures will also be discussed.
Geroscience Brings New Focus on the Life-Course Approach to Health in Humans
Authors: Ferrucci Luigi
Published: December 2020

The geroscience paradigm stands on two assumptions: 1. Major changes in health are caused by accelerated aging; 2. The rate of aging can be modified by interventions with significant effects on health span. These simple statements change dramatically the portrayal of aging research in medicine. In the past, aging was considered fixed and irreversible, and the study of aging a speculative science, closer to anthropology than to physiology. However, if biological aging is the root cause of chronic disease and if the rate of aging can be changed, then the study of aging becomes the most important branch of medical research. The last twenty years of research support this view and suggest that the rate of aging is set during early development but is modifiable by appropriate interventions. These findings suggest that the architecture of disease development and subsequent loss of function may be more easily influenced by early interventions.
How Do Employers Span the Generations?
Authors: Rudolph Cort
Published: December 2020

The concepts of “generations” and “generational differences” are nearly ubiquitous phenomena. Organizational policy makers often face questions about the purported influence of generations and differences assumed to exist between them for a variety of issues. Given the sheer volume of work dedicated to the topic, both academic and in the popular press, it can be difficult to parse correct from incorrect answers to such questions. In the present article, we pose and answer 10 common questions about generations and generational differences in an attempt to “clear the air” about common thinking, (mis)conceptions, and myths surrounding these phenomena. We offer this work with the goal of clarifying the truth about generations and generational differences, with an eye toward helping organizational policy makers navigate the complexities of these issues and making better decisions about the (assumed) role that generations play across different contexts.
GSA COVID-19 Task Force: Supporting Those in Practice
Authors: Brown Lisa
Published: December 2020

The GSA COVID-19 Task Force developed multiple materials to assist older adults, those who care for them, and policy makers in understanding a variety of topics, including aging and immunity, ageism, the process of developing a vaccine, and how to social distance. Members of the group also undertook development of a decision aid on whether to engage in activities outside the home. The process of developing the decision aid according to Ottawa Research Institute guidelines will be explained.
AAA Research Methodology I: Overcoming Linguistic and Cultural Barriers in Aging Research Among Asians
Authors: Li Wenjun , Hou Su-I
Published: December 2020

Asians are the largest and the fastest growing segment of the world population. Asian immigrants are the second largest immigrant population in the U.S. However, their age-related social and health issues are understudied. Because studies on older Asians are often scattered geographically and small-sized and study instruments are usually inconsistent in context, language and culture, it is difficult to synthesize findings from different studies on Asians. Little data exist to support health promotion, policy evaluation and clinical practice in this population. To advance research into aging among Asians, a fundamental step is to create content-relevant, linguistically and culturally appropriate research instruments, and encourage use of these consistent and comparable instruments across studies. This symposium brings together four abstracts that report the development and adaptation of linguistically and culturally appropriate survey instruments for health and behavioral studies in older Asians. The topics range from development of new scales for generative concern and acts in older Singaporeans, assessment of appropriateness of health literacy measurements among East Asian older adults, validation of Health Aging Instrument in Southeastern Asian older adults. Based on the experiences in these studies, the group will discuss the need and strategies to develop an international network to promote resource sharing and research collaborations across geographic boundaries and disciplinary divisions. By bringing together the isolated but talented Asian health researchers, the new network may accelerate the growth of research on Aging Among Asians. This symposium is a collaborative effort of the Aging Among Asians Interest Group.
Virtual Reality Use Among Persons With Dementia: An Integrative Review
Authors: Sefcik Justine , Petrovsky Darina , Cacchione Pamela , Oh Sungho , Demiris George
Published: December 2020

It is not well understood how virtual reality (VR) is currently used by older adults who have cognitive deficits due to dementia. The aim of this integrative review was to examine and report on published research exploring VR use among older adults with dementia. We searched 3 data bases for publications and used Whittemore and Knafl’s methodology for data extraction. Out of 122 articles we identified 24 that met our inclusion criteria, 15 published in 2012 and later. Most articles (12) used VR for assessment, and the others used VR for cognitive training (5) and as an intervention (3) (i.e., for exercise). Sample sizes were 30 or fewer persons with dementia. There is heterogeneity in the types of VR equipment, experiences, and foci of assessment through VR use. We identify opportunities to further explore VR as an intervention for persons with dementia to improve quality of life.
Multi-Level Resources to Support Health Behavior Maintenance
Authors: Hughes Susan , Bettger Janet , Raj Mina , Hughes Jaime
Published: December 2020

Although behavior change is largely thought to occur on the individual level, maintenance of health behaviors also depends upon factors at the community and population levels. As discussed in earlier presentations, health behaviors can be influenced by social support, environmental context, and population-level policies. For example, maintaining a physical activity regimen is made easier when an older adult has access to a safe environment, support of family and friends, and/or ongoing access to a program that is continuously offered, or sustained, at a local community center. This presentation will focus on the importance of discussing sustainability when considering long-term maintenance of health behaviors. Specifically, this presentation will use examples from the evidence-based Fit & Strong! program, now being offered in 32 states, to explore sustainability of programs at the participant and community level and will provide an overview of barriers and facilitators faced by community organizations.
Implementation of MOVE UP and Effect on Outcomes
Authors: Lori Kieffer , Semler Linda , King Jennifer , Boak Brandi , Venditti Elizabeth , Newman Anne , Albert Steven
Published: December 2020

The MOVE UP behavioral activation program, consisting of 32 sessions over 12 months, was delivered by trained community health workers (CHWs) at 26 sites. 300 participants completed a mean of 21.5 sessions. Change in body weight was associated with site attendance: among 9 sites with mean attendance < 70%, participants lost a mean of 5.3%; among 12 sites with 70-80% attendance, 5.6%; and among 5 sites with > 80% attendance, 9.2%. Completion of activity and diet logs followed a similar pattern (34.9%, 56.2%, and 72.7%, respectively), as did retention for 13-month outcome assessment (70%, 85%, and 88%, respectively). CHWs at the high-performing sites were more likely to have prior or current employment in weight management and fitness (90% vs. 41.7% and 44.4%), but did not differ in education, age, race, or employment by sites. CHW experience, not sociodemographics, affected outcomes.
Group Music Intervention for Persons With Dementia in Assisted Living: A Pilot Study
Authors: Meng Hongdao , Bugos Jennifer , Dobbs Debra , Lee Soomi , Risal Punam , Veal Britney , Patterson William
Published: December 2020

Dementia is the third leading diagnosis among US residents in assisted living communities (ALCs), and agitation is a major challenge for residents, families, and staff. While music interventions in nursing homes and the community have generated promising findings, little evidence of acceptability or efficacy data are available in ALCs. This pilot study tested the acceptability and preliminary efficacy of a staff-led group music intervention among ALC residents with dementia (n=19). We used a mixed-methods pre-post study design. The primary outcome measure was the Cohen-Mansfield Agitation Inventory-Short Form (CMAI-SF), and facilitator focus group interviews were conducted to gain additional insight into intervention acceptability and facilitators/barriers to implementation among activity staff. Seventeen (89.5%) participants completed the intervention with a 77% overall session attendance rate. Results suggest that the intervention is well-received by management, family, and activity staff, Implications for intervention design, efficacy testing, and contextual factors related to implementation will be discussed.
HIV and Aging Comes into the Spotlight: 2012 to 2015
Authors: Brennan-Ing Mark
Published: December 2020

I had the privilege of serving as Principal- and Co-Convener of the HIV, AIDS and Older Adults Special Interest Group (SIG) for four years (2012 through 2015). During this era, when the proportion of U.S. older adults with HIV was projected to surpass 50%, we witnessed a number of milestones including the NIH Office of AIDS Working Group on HIV and Aging recommendations for critical research focus publication (JAIDS, 2012), the first CDC Surveillance Report on people 50 and older with HIV (2013), and the first UNAIDS report on HIV and aging (2013). During this period, the SIG was very successful in raising awareness about HIV and aging through numerous GSA presentations. Topics covered ranged from sexual health, to cognitive function, psychological well-being, social isolation, successful aging, and resilience. These presentations highlighted research findings that have been critical in developing interventions and shaping policy initiatives to support this growing population. Part of a symposium sponsored by the HIV, AIDS and Older Adults Interest Group.
Developing an Exergame Intervention to Prevent Alzheimer’s Disease
Authors: Yu Fang , Salisbury Dereck , Plocher Tom
Published: December 2020

Delaying the onset of Alzheimer’s Disease by five years could save the U.S. ~$89 billion by 2030. Aerobic exercise and cognitive training are two promising interventions for AD prevention and the two together may have a synergistic cognitive effect than either alone. The purposes of this study were to develop an integrated virtual-reality cognitive training (VRCT) and cycling intervention known as exergame and test its feasibility in older adults with subjective cognitive decline (SCD). The VRCT included grocery shopping from a list, flower shopping from a list, dinnerware sorting, book sorting, and postage estimation. Twelve participants enrolled in the 1-month program (12 sessions) achieved 81.2% session adherence and 81.4% adherence to the exercise prescription. The exergame was well accepted by 75% of the participants and 100% were satisfied with the exergame quality and delivery. To conclude, exergame is a flexible intervention that is feasible for older adults with SCD.
Challenges and Perspectives on Breast Cancer Survivorship: The Journey Continues
Authors: Raveis Victoria , Kwon Simona
Published: December 2020

Women have a 1-in-8 lifetime risk of breast cancer. Earlier diagnosis and treatment advances have improved 15- and 20-year survival rates. Increased survival can mean coping with the effects of cancer and its treatment over an extended period of time, while experiencing age-related changes in functioning and the emergence of other health issues. To explore breast cancer survivors’ perspectives on their issues and concerns across the life-course, focus groups were conducted with a culturally diverse sample (N=18) of survivors (72% white, 28% Black, 11% Hispanic). Participants were 44-82 years old. Most, 83% were 50 and older, 56% were 60 and older. The majority (83%) were diagnosed in their 40’s and 50’s. Two were diagnosed in their early 30’s and one at age 68. Participants reaffirmed the necessity, as a breast cancer survivor, of being a life-long health advocate on their own behalf, and the importance of being self-informed. As one woman commented: “Knowledge is power”. Survivors shared that their emergent health issues were complicated by their cancer history, and, that, as a cancer survivor, “I never stop worrying”. A widespread concern was not knowing if the health issues and co-morbidities they experienced (such as joint pain, neuropathy, tendinitis, heart disease), were age-related, a consequence of their cancer, or a late treatment effect. An overriding sentiment expressed was that clinicians have not recognized the importance of quality of life in cancer survival. As a survivor succinctly stated: “We are living longer, but we need to live long with quality of life.”
Spatio-Temporal Gait Variable Differences Between Independent and Assisted Living Older Adults
Authors: Nightingale Christopher , McNulty Jennifer , Butterfield Stephen
Published: December 2020

As the US population continues to age, it is important to gain a better understanding of factors that differ between independently living older adults and those that require assisted living. Accidental falls contribute to decreased quality of life for many older adults, and considerable research has been conducted examining measures of fall-risk and potential interventions. In this pilot study, we investigated fall-risk via assessment of spatio-temporal variables associated with gait in independent and assisted-living older adults aged 65+. Two gender-matched groups of participants were tested on seven gait variables (step length, stride length, contact time, contact phase, foot flat, propulsive phase, and average speed) utilizing Opto-Gait technology. Each group included sixteen participants. Independent living participants were recruited through word of mouth and flyers at local senior centers. Assisted living participants all resided in one local health care facility and were recruited via word of mouth and flyers posted in the facility. A one way ANOVA with an alpha level of .05 revealed significant differences between groups in contact time, foot flat, propulsive phase, and average speed. The independent living group performed better on each variable. These findings indicate that older adults living in assisted living facilities may be at much greater risk of accidental fall than their independent living counterparts. While this study identified several key factors related to instability among old adults, additional investigation is warranted to further examine the relationships among gait, fall-risk, and differentiators between independently living and assisted living older adults in these variables.
Interventions to Reduce Stigma of Dementia: First Insights From a Rural Community-Based Participatory Study
Authors: Bacsu Juanita , Johnson Shanthi , O’Connell Megan , Viger Marc
Published: December 2020

Age is the greatest risk factor for dementia, and the number of rural older adults is rising. Although dementia-related stigma is widely documented, few studies focus on ways to reduce stigma, especially within rural communities. This late breaker presentation aims to: 1) explore the contributing factors of dementia-related stigma in rural communities; and 2) identify interventions to reduce stigma of dementia in rural communities. Drawing on a community-based participatory approach, data were collected through semi-structured interviews with 18 older adults, and a focus group with 7 community leaders in rural Saskatchewan, Canada. Thematic analysis was used to identify key themes and patterns within the data. Contributing factors of dementia-related stigma ranged from fear to lack of dementia knowledge. Several anti-stigma interventions were identified including: forming support groups; hosting educational workshops; inviting guest speakers with dementia; talking openly about dementia; learning more about dementia; asking questions; sharing your lived-experiences; being inclusive; developing inter-generational programs; and avoiding assumptions and hurtful jokes. As the rural population ages, there is a growing need for interventions, programs, and policies to address stigma of dementia. Engaging in rural partnerships and collaborative research is essential to developing community-informed strategies to reduce dementia-related stigma and improve the quality of life for people with dementia.
Senior Adults: Does Body Image Matter?
Authors: Larsen Keri , Graves Myia , Bowers Ashley , Saba Valerie , Himel Lauren
Published: December 2020

Through the theoretical framework of the Social Comparison Theory, the current study will examine general attitudes and perceptions of body image in senior adults who are currently participating in organized recreational activities. Participants between the ages of 50 years of age and older participating in organized recreational programs in the Southeast will be administered the Sociocultural Attitudes Toward Appearance Scale (SATAQ) to measure participants’ body image as influenced by general media, athletic and sport figures, as well as pressure to conform to the media ideal. The Figure Rating Scale will be administered, and is composed of nine drawings of bodies that progressively increase in size from very thin to overweight. Pearson product moment coefficient of correlation will be used to determine the association of scores between the SATAQ and Figure Rating Scale.
The Long-Term Effect of Job Loss on Mortality
Authors: Song Qian , Lim Emily
Published: December 2020

The associations between job loss and health were established. However, these associations were usually biased estimates of causality, as individuals with adverse health were self-selected into job loss. To address such selectivity, we take advantage of the case of massive layoffs of State-Owned Enterprise (SOE) workers in urban China, which was driven by policy change rather than individual characteristics and mimicked a quasi-experiment. We employ China Health and Nutrition Survey (1991-2015) that span more than two decades and survival analysis to analyze the effect of job loss on individual mortality. Our analyses with 3,494 SOE workers show that over the past twenty years, job loss has accelerated mortality (hazard ratio = 1.50; p<0.05) for SOE workers in urban China. Further, these accelerated moralities occurred mostly for workers who lost their jobs between 30-39 (hazard ratio = 2.52, p<0.05) and 40-50 (hazard ratio = 1.77, p<0.1) years old, highlighting the adverse consequences of job loss for the young and middle-aged workers. Our analyses established the causality of job loss and mortality over an extended time, and identified the most vulnerable groups to job loss for policies to target to in an effort to improving the well-being of workers later in life.
“Doing the Impossible with the Inadequate”: COVID-19 Response in U.S. Assisted Living Settings
Authors: Dys Sarah , Winfree Jaclyn , Carder Paula , Dugle Kaylin , Zimmerman Sheryl , Thomas Kali
Published: December 2020

The COVID-19 pandemic has disproportionately affected long-term care operators, staff, residents and their families; although much attention has been given to nursing homes, largely lost in the discourse are assisted living, residential care, and dementia care (AL) communities. As part of a broader, ongoing study assessing states’ AL regulations regarding medical and mental health care for residents with Alzheimer’s and related dementias (ADRD), stakeholders across the United States were recruited in July and August 2020 for semi-structured interviews to provide their perspectives on AL policies and practices specific to COVID-19 response. Stakeholders (n=32) consisted of state healthcare and trade association representatives, clinical practitioners, operators, researchers, and dementia care experts experienced in AL-related operational, healthcare, and regulatory affairs. Using thematic analysis, we describe several emerging topics regarding the opportunities, challenges, and innovations of responding to COVID-19 within the unique context of AL. States’ public health responses to COVID-19 lacked an understanding of the broader long-term care system, especially AL’s scope and purpose, workforce, capacity to implement infection control practices and policies, and unintended consequences of social isolation for older adults, specifically residents living in dementia care units. Despite these challenges, stakeholders described opportunities to expand telehealth infrastructure, communication and collaboration across states and among operators, and several innovations to mitigate the effects of social isolation. It is imperative for policymakers to understand the nuances of the AL context and design regulations and public health responses grounded in a whole-person perspective and in partnership with operators during, and beyond, pandemic circumstances.
Brief telephone intervention for caregivers of medically complex patients during COVID-19
Authors: Stevens-Carr Mary , Sethi Kevin , Cochran Channing , Bencomo-Rivera Margaret , Marceaux Janice
Published: December 2020

The VA Home Based Primary Care (HBPC) program consists of an interdisciplinary team, including psychology, serving veterans with complex medical conditions who are supported by live-in caregiver(s). HBPC psychologists may work with caregivers to address caregiver stress. Some veterans enrolled in HBPC attend Adult Day Care (ADC) programs, allowing respite for caregivers. At the onset of COVID19 pandemic, ADC centers closed to minimize spread of the virus. The authors identified these caregivers to be at high risk for burnout and sought to develop a protocol to assist these caregivers via telephone and evaluate outcomes. PreCOVID-19 caregiver stress was known via a 4-item Zarit Caregiver Burden annual screening (Bédard et al., 2001). Following ADC closures, caregivers of veterans enrolled in ADC programs were contacted and re-administered the Zarit to determine impact of COVID-19 on caregiver stress. Caregivers of veterans not attending ADC were also contacted for comparison. Contacted caregivers were provided a brief CBT-based intervention via telephone, and post-intervention Zarit screening was administered after two weeks. Ultimately, 4 ADC caregivers and 4 non-ADC caregivers were contacted and provided with services before ADC centers reopened. Statistical analysis via mixed model ANOVA did not yield significant results, likely due to small sample size, although there was a large effect size (η_p^2 =.566). ADC caregivers generally reported increased stress from baseline following ADC closure and reduced stress following provision of intervention. The authors will present caregiver feedback about aspects of telephone intervention that were helpful, and not helpful, as well as authors impression.
Older Adults’ Attitudes Toward Virtual Volunteering During the COVID-19 Pandemic
Authors: Sun Peter , Morrow-Howell Nancy , Pawloski Elizabeth , Swinford Emma
Published: December 2020

This study explored older adults’ attitudes toward virtual volunteering during the COVID-19 pandemic. A 22-item survey was administered to 229 volunteers who previously worked with children through the Oasis Intergenerational Tutoring program in St. Louis. Questions focused on technology use patterns and attitudes toward virtual volunteering. Most respondents have used a computer, a smartphone, and the Internet before at home (90.3%), but 22.8% of respondents feel uncomfortable or very uncomfortable when using the Internet. Video conferencing software such as Zoom or Skype was not used before by 14.0% of the respondents, the top reasons being because they prefer other forms of communication (48.4%) or find it too difficult to keep up with technology (19.4%). If tutoring becomes virtual-only, 60.6% of the participants responded they were somewhat likely or very likely to participate, with significant variation by school districts (X2 = 21.92, p < .05, Cramer’s V = 0.33) ranging from 42.6% to 96.0% (Bonferroni post hoc p < .05). Tutors from school districts that were less likely to tutor virtually had lower levels of education and higher levels of discomfort when using the Internet. The respondents also voiced that while virtual tutoring may eliminate barriers to in-person tutoring, such as commuting to schools and inclement weather, they were concerned about establishing a personal connection with their students online. These findings suggest that tutors anticipate both benefits and challenges with virtual volunteering and efforts to engage older adults virtually should factor in prior use of technology and variations by geography.
Understanding the relationship between age and information-seeking in the context of COVID-19
Authors: Chu Li , Pauly Theresa , Garza Elizabeth Zambrano , Gerstorf Denis , Hoppmann Christiane
Published: December 2020

Socioemotional selectivity theory proposes that older adults engage in less information-seeking than younger adults as future time perspective becomes more limited and expansive goals are prioritized less. However, gathering information is crucial in emergencies like the COVID-19 pandemic, especially for older adults, who are particularly vulnerable to the virus. This study aims to better understand the association between age and information-seeking patterns during the current pandemic. Two hundred and sixty-six participants (age range = 18 – 84, Mage = 38.86, female = 77.06%, received postsecondary education = 83.08%, born in Canada = 73.68%) completed an online study between May and August 2020. We found that older age was associated with more information-seeking time (b = .45, SE = .16, p < .001). We then investigated whether perceived worries of getting COVID-19 might provide insights into this association. Findings point to a partial mediation with a significant direct effect (b = .37, SE = .16, p = .02, 95% bootstrap CI=[.07, .68]), a marginally significant indirect effect (b = .08, SE = .04, p = .06, 95% bootstrap CI=[-.003, .18]) and a significant total effect (b = .46, SE = .16, p < .001, 95% bootstrap CI=[.14, .77]). That is, older adults engaged in more information-seeking than younger adults in contexts in which information-seeking was personally relevant as indicated by perceived worries. These findings shed light on key correlates of information-seeking in older adulthood and highlight the importance for government and health organizations to make suitable information accessible for older adults.
“We are Scapegoats”: Front-Line Nursing Home Staff Experiences During the COVID-19 Pandemic
Authors: White Elizabeth , Wetle Terrie , Reddy Ann , Baier Rosa
Published: December 2020

The COVID-19 pandemic is an unprecedented challenge for nursing homes, where staff have faced rapidly evolving circumstances to care for a vulnerable resident population. To document these healthcare professionals’ experiences during the pandemic, we used social media and professional networks to disseminate an electronic survey with closed- and open-ended questions to a convenience sample of long-term care staff from May 11 through June 4, 2020. Four investigators identified themes from qualitative responses for 152 nursing home staff respondents from 32 states. Key themes included: constraints on personal protective equipment (PPE) and testing; burdensome regulations and guidance; concern for self, family, and residents; workforce burnout; organizational communication and teamwork; and public lack of recognition. Respondents described ongoing constraints on testing, and reliance on crisis standards for extended use and reuse of PPE. Administrators discussed implementing sometimes confusing or contradictory guidance from numerous agencies. Direct-care staff expressed fears of infecting themselves and their families, and expressed empathy and concern for their residents. They described burnout due to increased workloads and the emotional burden of caring for residents facing isolation, illness, and death. Respondents cited the presence or lack of organizational communication and teamwork as factors influencing their ability to work under challenging circumstances. They also described the demoralizing impact of negative media coverage of nursing homes, contrasting this with the heroic public recognition given to hospital staff. These challenges added significant burden to an already strained workforce and are likely to contribute to increased burnout, turnover, and staff shortages in the long-term.