bluuebunny/crossref_metadata_2025 huggingface dataset:
PATTERNS OF HEAVY ALCOHOL USE AMONG OLDER MARRIED AND COHABITING COUPLES
Authors: Curl Angela , Bulanda Jennifer , Roberts Amy
Published: December 2022

Heavy drinking has increased among older adults in recent years. Research suggests romantic partners influence each other’s alcohol use, but this influence may vary by partnership type and relationship quality. Heavy drinkers are more likely to form cohabiting versus marital unions and, relative to marriage, cohabitation is linked with a higher risk of heavy episodic drinking. Although some studies have explored older married couples’ alcohol consumption, we lack research on older cohabitors despite the substantial growth in this form of partnership during later life. We use data from the 2014-2018 waves of the Health and Retirement Study to examine drinking behavior among a sample of older married and cohabiting couples (n=1,876) using Actor-Partner Interdependence Models (APIM). Heavy drinking is measured as consuming more than 3 drinks on a given day or 7 drinks per week for women, or 4 drinks on a given day or 14 per week for men (NIAAA, 2021). Compared to first marriages, being in a cohabiting union is associated with significantly higher odds of one (OR=5.22) or both (OR=3.82) partners becoming heavy drinkers over the observation period, but there are no significant differences between those in first marriages and remarriages. Relationship quality is also a significant correlate of heavy drinking risk, with male partners’ negative relationship quality and female partners’ positive relationship quality associated with a higher risk of heavy drinking over time. Results suggest the importance of accounting for partnership type and relationship quality in understanding partners’ drinking behavior.
DEVELOPMENT OF A BEHAVIORAL FRAMEWORK FOR DEMENTIA CARE PARTNERS’ FALL RISK MANAGEMENT
Authors: Zhou Yuanjin , Berridge Clara , Hooyman Nancy , Sadak Tatiana , Mroz Tracy , Phelan Elizabeth
Published: December 2022

Although older adults living with dementia (OLWD) are at high risk for falls, few strategies that effectively reduce falls among OLWD have been identified. Dementia care partners may have a critical role in fall risk management (FRM). However, little is known in what ways care partners behave that may be relevant to FRM and how to effectively engage them in FRM. Semi-structured, in-depth interviews were conducted with 14 primary care partners (Age: 48-87; 79% women; 50% spouses/partners; 64% college-educated; 21% people of color) of community-dwelling OLWD to ascertain their own behaviors and those of care partners who were secondary in the caring role. The analysis of interview data suggested a novel behavioral framework consisting of eight domains of FRM behaviors adopted across four stages. The domains were 1. functional mobility assistance, 2. assessing and addressing health conditions, 3. health promotion support, 4. safety supervision, 5. modification of the physical environment, 6. receiving, seeking, and coordinating care, 7. learning, and 8. self-adjustment. Four stages of FRM included 1. supporting before dementia onset, 2. preventing falls, 3. preparing to respond to falls, and 4. responding to falls. FRM behaviors varied by the care partners’ caring role. Primary care partners engaged in behaviors from all eight domains. Secondary care partners were reported to assist in health promotion support, safety supervision, modification of the physical environment, and receiving, seeking, and coordinating care. This multi-domain and multi-stage framework will inform intervention development to engage care partners in managing fall risk for community-dwelling OLWD.
SIGNIFICANCE OF SECOND YEAR MEDICAL STUDENTS PARTICIPATING IN THE 48-HOUR HOSPICE HOME IMMERSION PROJECT, 2017–2018
Authors: Hanlon Samuel , Packard Benjamin , Gugliucci Marilyn
Published: December 2022

Medical education on palliative medicine and end-of-life care is generally lacking in the medical curricula. The University of New England College of Osteopathic Medicine (UNECOM) Learning by Living: 48 Hour Hospice Home Immersion Project is an immersion-based learning model whereby UNECOM 2nd year students live in an18-bed acute care hospice house to care for dying patients, provide family support, and conduct post-mortem care. This project determined if and in what ways immersion experiences were valuable in augmenting student medical end-of-life care education during AY 2017-2018.Retrospective ethnographic/autobiographic data were analyzed from the eight randomly selected student hospice immersion journals (approx. 200 pages) who participated during academic year 2017-18. Pre-fieldwork, fieldwork, post-fieldwork journals were reviewed and analyzed using manual content analysis followed by NVivo 12+ analysis. Thematic coding resulted in representative quotes, key words, and native concepts. Inter-rater reliability was established with the use of a codebook and agreed upon thematic definitions. Four key themes included: Subversion of End of life (EOL) Expectations; Character Development/Introspection; Exposure to Diverse Cultural/Spiritual Perspectives; and Skills to Bring into Future Practice. Proximity to death/dying resulted in reflections on values and priorities, and a renewed sense for compassionate patient care. Students developed skills for future practice, including competency in EOL and post-mortem care, navigating difficult, emotionally laden family dynamics, and contributing to an interprofessional staff team even in uncomfortable situations. This immersion positively affected student perspectives about death and end-of-life care; creating life-altering experiences in patient-centered-care. Students stated significant impacts to employ as a physician.
CONSIDERATIONS OF AGE-FRIENDLY 4M PRINCIPLES IN DEPRESCRIBING INTERVENTIONS: A SCOPING REVIEW
Authors: Wang Jinjiao , Shen Jenny , Conwell Yeates , Nathan Kobi , Yu Fang , Ramsdale Erika , Fick Donna , Simmons Sandra
Published: December 2022

The 4Ms – Medication, Mentation, Mobility, and What Matters - represent the key components in the Age-Friendly Health Systems initiative and provide a conceptual framework for research in the older adult population. Over 40% of older adults experience polypharmacy, which can be addressed by deprescribing unnecessary medications. This review aimed to assess the degree to which the 4Ms were considered in intervention design, sample selection, and outcome assessment in deprescribing trials by keyword search in six databases and snowballing. Thirty-seven of the 564 trials identified met the review eligibility criteria. Imbalanced consideration of 4Ms in the deprescribing trials was observed. Intervention design: “Medication” was considered in all trials; “Mentation” was considered in 8 trials; “Mobility” (n=2) and “What Matters” (n=6) was less often considered. By targeting providers, most of the trials lacked consideration of patient-centeredness - aligning what matters most to older adults and their families with deprescribing decision making and implementation. Sample selection: “Medication” was considered in 15 trials (e.g., samples including patients taking ≥ 5 medications or specific types of medications), whereas “Mentation” (n=6), “Mobility” (n=6) and “What Matters” (n=0) were less often considered. Outcome assessment: “Medication” was the most commonly assessed outcomes (n=33), followed by “Mobility” (n=13) and “Mentation” (n=10) outcomes, with no study examining “What Matters” outcomes. 4Ms were not purposefully considered in the intervention design, sample selection, and outcome measurement of existing deprescribing trials. Future deprescribing trials need a more balanced and complete consideration of the 4Ms in the trial design and implementation.
TRAJECTORIES OF K-12 SCHOOLS IN THE 1930S-1960S AND COGNITIVE AGING: VARIATION BY RACIAL COMPOSITION
Authors: Yu Wenshan , Smith Jacqui
Published: December 2022

Besides information about the highest degree, little information about early-life education is available in population surveys. We identified K-12 education trajectories among older adults in the Health and Retirement Study and examined their association with cognitive function. Drawing on 2017 Life History Mail Survey (n = 4,325), we used sequence analysis to determine and classify trajectories of school majority race. We identified five clusters: 1) mostly White schools (n = 3,027), 2) mostly Black schools (n = 673), 3) mostly Hispanic schools (n = 499), 4) partly missing on majority race (n = 267), and 5) mostly Mixed-race schools (n =113). Adding the cluster variable significantly improved the model regressing cognitive function on race, gender, number of years in schools, birth cohort, number of years since starting schools, and school locations (F=12.066, p<0.001). Future research should study heterogeneity of K-12 education using information other than the highest degree.
A DEDICATED APPROACH TO PALLIATIVE DEMENTIA CARE
Authors: Meijers Judith , Bolt Sascha , Zwakhalen Sandra , Khemai Chandni , Schols Jos , Janssen Daisy , van der Steen Jenny , Biesmans Jesper
Published: December 2022

Nursing staff play a central role in the palliative care for people with dementia. Development of their palliative care competences may support timely recognition and addressing of individual needs of persons with dementia and their family caregivers in long term care. In the DEDICATED (Desired Dementia Care Towards End of Life) project, we aim to develop materials to support nursing staff in providing palliative dementia care. The first step of the project concerned a needs assessment, mapping the perspectives of nursing staff, family caregivers and people with dementia (scoping review, surveys and semi-structured interviews). Using these studies’ results as a starting point, an intervention (the DEDICATED approach) was built, using an iterative co-creation approach involving nursing staff and educators (N=12). These ‘ambassadors’ were also trained to disseminate the approach within their care teams and nursing curricula. First reactions from the pilot study regarding the DEDICATED-materials are positive and nurses and nurse educators are eager to use the materials (www.dedicatedwerkwijze.nl). Currently the DEDICATED-approach is being evaluated using a mixed methods pretest-posttest controlled design comparing three groups: a design group (12 wards), a test group (28 wards, 28 new-trained ambassadors) and a control group (12 wards). The main outcomes of study are e.g. self-efficacy, empowerment and engagement in providing palliative care for people with dementia. A secondary outcome involves longitudinal trends of the quality of dying of persons with dementia within the group.
ASSESSING INTERPROFESSIONAL ORAL HEALTH EDUCATION AND PRACTICE FACILITATION OUTCOMES WITHIN LONG-TERM CARE
Authors: Crittenden Jennifer , Coleman Rachel , Wihry David , Nelligan Labrini , O'Connell Denise
Published: December 2022

Older adults residing in long-term care (LTC) settings are at an increased risk of poor oral health due to comorbidities and limited ability to provide self-care. Routine oral care is essential for maintaining overall health. Coupled with resident vulnerability is a traditional lack of training and focus on oral health care in LTC. MOTIVATE (Maine’s Oral Team-Based Initiative: Vital Access to Education) is a pilot (N = 8 sites) interprofessional education program focused on daily oral health care within LTC, providing education and technical assistance to advance staff knowledge, skills, and attitudes about oral health. An evaluation was carried out using a pre/post survey design with instruments administered immediately before and after learning module completion along with a survey administered one month after implementation. Knowledge, attitudes, and oral health practices were assessed. A statistical comparison between baseline (N = 491) and post-launch (N = 215) scores revealed a statistically significant improvement (p < 0.001) across all knowledge and attitudes measures including the perceived importance of oral health, understanding of interprofessional roles among the care team, the role of oral health in supporting resident dignity and quality of life, and confidence in providing oral health care. Factors facilitating the transfer of knowledge to practice (N = 478) included personal interest in the topic (46.4%), knowing where to obtain information when needed (47.6%), and knowing how to apply learning to LTC daily care responsibilities (62.4%). Findings underscore the importance of oral health training and implications for practice transformation in an interprofessional context.
STATE-LEVEL DESEGREGATION EFFORTS IN THE U.S. SOUTH POST-BROWN AND DEMENTIA RISK AMONG BLACK AND WHITE OLDER ADULTS
Authors: Walsemann Katrina , Farina Mateo , Ailshire Jennifer
Published: December 2022

Although education is a key protective factor against dementia, older U.S. adults experienced vastly different educational contexts. One of the most consequential legal decisions impacting educational contexts was Brown v. Board of Education, which declared ‘separate but equal’ schools unconstitutional. School desegregation in the U.S. South was inconsistent, however, and many states delayed implementation for years. State resistance to school desegregation created school environments for Black children that were stressful and discriminatory. Thus, state variation in exposure to school desegregation may serve to differentiate individuals in their risk for dementia. Our project links historical data on state-level school desegregation efforts to the Health and Retirement Study, a nationally representative sample of U.S. adults over 50. We determine if state-level variation in the timing and completeness of school desegregation explains Black-White disparities in transition to cognitive impairment and dementia among older adults who attended school in the US South post-Brown.
PERCEIVED NEEDS, FELT CONCERNS, AND QUALITY OF LIFE OF OLDER ADULTS IN MISSISSIPPI: AN INTERGENERATIONAL APPROACH
Authors: Riaz Muhammad , Downey Laura , Adams-Price Carolyn , Peterson Donna , Staton Lori , Hardman Alisha
Published: December 2022

The purpose of the study was to identify felt needs and concerns of older adults living in their own homes in Mississippi using intergenerational perspectives. This mixed-methods study used snowball sampling to collect data through semi-structured interviews and structured questionnaires that asked about the quality of life and current and future problems among aging adults. Three generations of Mississippians participated in the study, including grandparents (N = 22), adult children (N = 23), and grandchildren (N = 19). Quantitative data were analyzed using SPSS, while qualitative data were managed with MaxQDA. Respondents identified concerns with physical health, difficulty living independently, and mental health problems affecting life satisfaction and quality of life. Incongruently with the intergenerational stake hypothesis, adult children were more invested in their children than their parents. Older adults who live closer to significant others and family were more resilient despite having physical and mental issues. Physical issues related to mobility, access to daily need services, and help with basic tasks like food preparation and mowing lawns, and issues related to mental health seemed less pronounced. Consistent with other research studies, older adults showed a positive sense of self. Similarly, parents showed resilience without being intrusive and overbearing while considering themselves as support for their children. Results could inform the development of programs or initiatives for grandparents, adult children, grandchildren, and others involved in caregiving activities and planning for older adults in Mississippi.
ASSOCIATION BETWEEN INCREASED CAREGIVER BURDEN AND MENTAL HEALTH DURING THE COVID-19 PANDEMIC IN JAPAN
Authors: Nakamoto Isuzu , Murayama Hiroshi , Takase Mai , Muto Yoko , Saito Tami , Tabuchi Takahiro
Published: December 2022

During the COVID-19 pandemic, informal caregivers’ mental health was more deteriorated than non-caregivers. The objective of this study was to examine the association between increased caregiver burden and severe psychological distress (SPD) during the pandemic. We used cross-sectional data from a nationwide internet survey conducted between August and September 2020 in Japan. Of 25,482 participants aged 15–79 years, 1,920 informal caregivers were analyzed (mean age, 52.3 ± 15.9 years; men, 48.8%). SPD was defined as the Kessler 6 Scale (K6) ≥ 13. The self-rated change in caregiver burden was measured with the single question item. A binary logistic regression analysis was used to examine the association between SPD and increased caregiver burden, adjusted for demographic, socioeconomic, health, and caregiving variables. To examine the differential association between increased caregiver burden and SPD, interaction terms were added and binary logistic regression was separately conducted in all variables. Of total caregivers, 56.7% reported the increased caregiver burden and 19.3% were SPD. Increased caregiver burden was significantly associated with SPD, with an adjusted odds ratio 1.90 (95% confidence interval 1.37–2.66). The association between increased caregiver burden and SPD was stronger among married caregivers, with disease treatment, and with their care-receiver’s care need level 1–2 (Japanese long term care service levels). This study demonstrated that increased caregiver burden was associated with SPD during the pandemic. Therefore, measures against mental health for the caregivers with increased caregiver burden need to be implemented immediately.
POSITIVE CAREGIVING AND CAREGIVING RELATIONSHIP ASSOCIATION WITH MENTAL HEALTH AND PERCEIVED GENERAL HEALTH
Authors: de Rosa Cristina , Holmes Ashleigh , Wang Weijun , Chang Yu-Ping
Published: December 2022

Caregiver burden is well understood as an important contributor to caregiver health. However, little is known about how positive aspects of caregiving (i.e., personal growth, gratitude, finding meaning) and the quality of caregivers’ relationships with care recipients might play a role in caregiver health. The study aimed to examine whether positive caregiving and caregivers’ relationship with care recipients were associated with caregiver mental health (depression and anxiety) and perceived general health. The sample consisted of 2,652 family caregivers in the National Study of Caregiving (NSOC) III (2017) providing care to older adults. A series of multiple regression models with covariate adjustments (i.e., caregiver’s age, sex, and race/ethnicity) were performed to examine the associations. Results indicated that positive aspects of caregiving predicted caregiver mental health but did not predict perceived general health. Caregivers’ relationship with care recipients and caregiver burden significantly predicted caregiver mental health (b = 0.285 [S.E. = 0.045], p < .001) and perceived general health (b = 0.096 [0.016], p < .001). After controlling for caregiver burden, only caregivers’ relationship with care recipients remained a significant predictor of caregiver mental health (b = 0.182 [0.041], p < .001) and perceived general health (b = 0.077 [0.018], p < .001). Our results suggest that positive caregiving perceptions and quality of relationships between caregivers and care recipients are linked to better caregiver mental health. Interventions to reduce caregiver burden, including strategies to help caregivers maintain positive attitudes and positive relationships with care recipients, might be beneficial to improving caregiver health.
PSYCHOLOGICAL WELL-BEING AND PHYSICAL HEALTH ON SUBJECTIVE AND OBJECTIVE MEMORY IN OLDER ADULTS
Authors: Liu Zhong-xu , Whitehead Brenda , Botoseneanu Anda
Published: December 2022

Self-report measures of memory, often used in survey studies of older adults, are heavily influenced by stress, depression, and life satisfaction; this makes it difficult to tease memory performance apart from psychological well-being, and highlights the value of shifting to remotely-administered objective memory tasks when feasible. This study investigates how indicators of psychological well-being, psychological distress, and physical health differentially influence the subjective and objective memory measures in order to compare the extent to which they are explained by participants’ psychological and physical health profile. 404 adults aged 55 and older without diagnosed cognitive impairment participated in an online survey which involved measures of physical health (PHY; multimorbidity, BMI), psychological well-being (PWB; life satisfaction, positive and negative affect), psychological distress (PDS; perceived stress, anxiety, depression) and subjective memory complaints (SM), along with remotely-administered objective memory tasks (OM). Regression analyses found all three health/well-being composite variables (PHY, PWB, PDS) maintained significant effects on SM (p < .01); PWB and PDS had no significant effects on OM, whereas PHY maintained significance on OM throughout (p = .02).So, SM measures are highly influenced by the psychological profile of the participant, highlighting the importance of controlling for these factors when relying on subjective memory measures. That physical health was the only significant predictor of the OM tasks in this study not only reveals remotely-administered OM tasks to be more immune to participants’ psychological profile, but also supports previously-established links between physical health and brain function.
WHO NEEDS THEIR NEIGHBORS? EXPLORING NEIGHBORHOOD DISPARITIES IN COGNITIVE FUNCTION THROUGH PATH ANALYSIS
Authors: Gan Daniel Rong Yao , Best John
Published: December 2022

Neighborhoods are diverse and may or may not present opportunities for stress reduction or social engagement depending on their qualities. Based on the stress connectome (Dum et al., 2019), psychosocial stress may accelerate cognitive aging, which explains place-based disparities in cognitive function. This study examines two attributes of the neighbourhood environment, and their potential to influence cognitive function through semantic fluency.Using aggregated baseline (cross-sectional) data from N=1,010 neighborhoods with 5 or more respondents in the Canadian Longitudinal Study on Aging, we examined the effects of neighborhood greenness and cohesion on aggregates of age-, sex-, and education-adjusted cognitive test scores. Participants were community-dwelling adults aged 44 and above. Semantic fluency was assessed using the Animal Fluency Test (AFT). Delayed recall was assessed using Rey’s Auditory Verbal Learning Test (RAVLT), whereas executive function was assessed using Mental Alternation Test (MAT). Neighborhood qualities were found to affect delayed recall (B=.34, p<.001) and executive function (B=.42, p<.001) through semantic fluency (B=.08, .10, p<.01). Semantic fluency fully mediated the effects of neighborhood attributes on cognitive function. Further stratifying these neighborhoods by socioeconomic status showed that cohesion has stronger effects in poorer neighborhoods (B indirect=.104) than richer neighborhoods (B indirect=.066). The effect of greenness was no longer significant upon stratification. Neighborhoods offer an important social arena for adults in mid- and late-life to practice conversing, especially in poorer neighborhoods, which improves cognitive function. Creating opportunities for socialization by improving cohesion and neighborhood parks may reduce place-based disparities in cognitive health. Causality remains to be ascertained.
THE EFFECT OF MOOD ON SELF-REPORTED COGNITION FOR INDIVIDUALS WITH HIV
Authors: Ertle Emilee , Simon Darby , Vogt Jax-Patrick , Mast Benjamin , Barve Shirish
Published: December 2022

Older adults with HIV may experience cognitive changes. The Patient Assessment of Own Functioning Inventory (PAOFI) is a self-report measure of cognitive abilities with memory, language, and cognitive/intellectual functions domains. Self-reported cognition can be influenced by many factors. This study examined the relationship between demographics, performance-based cognitive tests, mood, and self-reported cognition in a sample of 23 HIV-positive individuals (mean age=56.7). The PAOFI memory domain positively correlated with depression (PHQ-9; r=.64, p=.001) and anxiety (GAD-7; r=.48, p=.019), but not tests of cognition. The PAOFI cognitive/intellectual functions domain also positively correlated with the PHQ-9 (r=.65, p=.001) and the GAD-7 (r=.66, p=.001), but not cognitive tests. Regression analysis found similar models for both domains. Both models included education, race, anxiety, and delayed recall. Depression was the only unique variable in the memory model, F(5, 17)=4.09, p=.013, R2=.55, and word reading was unique to the cognitive/intellectual functions model, F(5, 15) = 6.91, p = .002, R2 = .70. In contrast, the language domain correlated negatively with four cognitive measures: word reading (r=-.46, p=.038), learning of a word list (r=-.47, p=-.024), delayed recall of a word list (r=-.51, p=.012), and verbal fluency (r=-.49, p=.045). Regression analysis found age, gender, depression, word reading, and delayed recall predict PAOFI language scores, F(5, 15)=6.27, p=.002, R2=.68. These findings suggest mood, demographics, and performance on cognitive tests are related to self-reported cognition. Mood is likely a better predictor of self-reported memory and higher-level cognitive abilities, and cognitive tests may better predict self-reported language abilities.
LONGITUDINAL ASSOCIATIONS BETWEEN PERSONAL GROWTH AND COGNITIVE FUNCTIONING IN ADULTHOOD
Authors: Toyama Masahiro
Published: December 2022

While personal growth has been found to be associated with multiple aspects of health in adulthood, its associations with cognitive functioning have not been fully understood. The present study aimed to assess both directions of such longitudinal associations. Using data from the second wave (T1) and third wave (T2) of the Midlife in the United States (MIDUS) study (N = 4,206; mean age = 56.0 [SD = 12.3]), a longitudinal measurement model containing latent variables of episodic memory and executive function was first constructed. Built on the measurement model, a structural equation model was analyzed to assess cross-lagged relationships between personal growth and the two areas of cognitive functioning, in which T1 personal growth predicted residualized changes in episodic memory and executive function, and T1 episodic memory and executive function predicted change in personal growth, controlling for covariates. The results indicated that T1 personal growth significantly predicted smaller decreases in episodic memory, whereas it did not predict change in executive function. T1 episodic memory, but not T1 executive function, significantly predicted smaller decreases in personal growth. The present findings were unique, particularly implying potential longitudinal reciprocity between personal growth and episodic memory. These findings and implications can inform future research aimed at exploring approaches to promoting personal growth and cognitive functioning among aging adults.
RELIGION AND TRAJECTORIES OF COGNITIVE FUNCTION AMONG WHITE, BLACK, AND HISPANIC OLDER ADULTS
Authors: Sauerteig-Rolston Madison , Barnes Lisa , Thomas Patricia , Ferraro Kenneth
Published: December 2022

Most prior research on the relationship between religious involvement and cognition among older adults is based on cross-sectional data and yields inconsistent results. We use longitudinal data from 14,161 older adults in the Health and Retirement study (HRS) to investigate whether religious involvement, measured by attendance, integration, and religiosity (i.e., beliefs, meanings, and values) is associated with trajectories of cognitive function from 2006 to 2016 among a diverse sample of respondents. We find that religiosity is associated with lower levels of cognition at baseline among White adults (b=-0.12, p < 0.001), but higher levels of cognition among Black adults (b=0.18, p < 0.05). In addition, growth curve analysis reveals that religious attendance is associated with higher cognition over time for Hispanic respondents (b=0.07, p < 0.001). Religious involvement is associated with later-life cognition, but this relationship differs for White, Black, and Hispanic older adults.
COGNITIVE AGING AND SUCCESSFUL AGING: THE ROLE OF MEMORY
Authors: Ruvalcaba Neyda Ma Mendoza , Arias-Merino Elva Dolores , Díaz Melina Rodríguez , Flores-Villavicencio Maria Elena
Published: December 2022

The cognitive functioning as a general measure, is a criterion commonly used to define and operationalize successful aging(SA). This study aims to explore the specific contributions of the memory and meta-memory to understanding successful aging (SA).(Project-Conacyt-256589)Population based, random sample included n=656 community-dwelling older adults 60-years and older (mean age=72.8, SD=7.6 years, 58% women). Memory was measured with the Digit span test backward (WAIS-IV). and meta-memory through self-report. Objective SA was operationalized as no important disease, no disability, physical functioning, cognitive functioning, and being actively engaged. Subjective SA was an appreciation if they considered themselves as successful agers. Sociodemographic and health data were also asked. Pearson′s correlation test and MANOVAs were performed.In total 11.2% met the criteria for SA, although 76% considered themselves as successful agers. 54.8 has a bad perception of their own memory, while 41.9% have objective decline. Results of the multiple regression analysis emerged on a significant model using the entered method:F=1.13,p<.01, explaining 14.9% of the variance of SA. Specifically, memory and meta-memory explained 19.5% of the variance of objective and 14.4% od subjective SA, 18.4% of the variance in the criterion of life engagement. Knowledge generated by this study reveals the specific role of the memory and metamemory on the SA, both objective and subjective. Besides, sets a scenario to promote successful and healthy aging, through alternatives centered in the improvement of memory and the judgment that is made about the own memory in older adults.
FACTORS ASSOCIATED WITH SUBJECTIVE COGNITIVE FUNCTION IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Kim Min Jung , Fritschi Cynthia , Cho Eunhee
Published: December 2022

Subjective cognitive decline (SCD) could be an indicator of future cognitive impairment in older adults. Diabetes is a well-known risk factor of cognitive impairment, but little is known whether sleep and psychological problems common in older adults with diabetes can contribute to SCD. The study aimed to investigate whether self-reported sleep (sleep impairment and disturbance) and psychological problems (depressive symptoms and diabetes distress) were associated with subjective cognitive function in adults aged ≥ 60 years with type 2 diabetes. Sleep, depressive symptoms, and subjective cognitive function were self-reported using The Patient-Reported Outcomes Measurement Information System. Diabetes distress was assessed using the Diabetes Distress Scale. Covariates (age, sex, race/ethnicity, body mass index, and diabetes duration) were self-reported, and glycemic control (A1c) was measured using a fingerstick test kit. A total of 82 older adults were included (mean age = 68.32 ± 5.29 years, White 76.83%, female 56.1%). Multivariate regression analyses revealed that, after controlling for covariates and A1c, increased sleep impairment was associated with increased concerns on cognitive function reported by older adults (r = -.47, β = -.56). Increased depressive symptoms were also associated with decreased cognitive function perceived by older adults (r = -.44, β = -.47). Sleep disturbance and diabetes distress were not associated with subjective cognitive function. Sleep impairment and depressive symptoms were the two strongest predictors affecting subjective cognitive function. Improving sleep quality and addressing depressive symptoms could be an effective strategy to prevent SCD and potentially delay severe cognitive impairment in older adults with diabetes.
EXPLORING CULTURALLY RESPONSIVE PHYSICAL ACTIVITY AS A RECRUITMENT AND RETENTION TOOL FOR AFRICAN AMERICAN WOMEN
Authors: Ogunrinde Joyce
Published: December 2022

Physical activity (PA) is associated with lower cognitive decline and incident dementia for older adults. Yet, PA data (interventions) on older African American (AA) women, a population disproportionately affected by premature aging, are lacking. This limitation reduces the efficacy of PA to reduce cognitive decline, particularly for people of color and more so women of color whose race and gender create unique spaces for PA engagement. Although AA women desire to engage in PA, they face social, structural, and behavioral barriers to PA, challenges that parallel those faced in preventing premature aging (Li et al., 2018). Extant literature on AA women’s PA investigates social determinants of health (SDoH) and calls for more attention as to how these factors intertwine to shape these women’s PA over time (Fleury & Lee, 2006). Culturally responsive physical activity programs (CRPA) offer a framework for addressing these factors synergistically to promote PA in a way that is desirable to AA women. Specifically, CRPA provides a strength– based approach to explicate the ways PA can redress social, structural, and behavioral causes of cognitive decline and barriers to PA (cf., Joseph et al., 2020). The purpose of this poster is to explore the benefits of CRPA interventions on preventing cognitive decline. Implications include refining current models of PA as premature aging prevention measures by increasing our knowledge of the sociocultural factors shaping AA women’s aging and PA behavior and providing greater insight into the mechanisms for recruiting and retaining AA women into PA- based cognitive decline interventions.
LEFT OUT TO DRY: UNMET NEEDS AND RISK OF DEPRESSION AMONG OLDER ADULTS
Authors: Wang Haowei , Verdery Ashton , Margolis Rachel , Patterson Sarah
Published: December 2022

Pre-pandemic research has shown adverse consequences of having unmet care needs for older adults’ mental health. Due to the broad psychological distress and increased caregiving challenges during COVID-19, older adults’ vulnerabilities to unmet needs may be amplified by the pandemic, especially for those with functional limitations and intense care needs. This study aims to examine (1) the associations between unmet needs and depression among older adults before and during the COVID-19 and (2) whether the excess mental health consequences from unmet needs and COVID-19 vary by older adults’ dementia status. We pool data from the 2018, 2019, and 2020 rounds of National Health and Aging Trends Study, a nationally representative sample of U.S. Medicare beneficiaries. We analyze N=6,273 older adults aged 70 years and older who had limitations with self-care, household activities, or mobility. Results show that older adults with functional limitations experienced increased risk of depression over time. Before and during the pandemic, older adults with unmet needs and older adults with probable dementia had higher risks of depression compared to their counterparts, respectively. The risk of depression was highest among older adults who had probable dementia and could not have their care needs met. For older adults without dementia, their risks of depression increased significantly from pre-pandemic to COVID-19 if they had unmet care needs. Findings demonstrate the disproportionate impacts of COVID-19 on mental health among older adults. Older adults who have cognitive impairments and unmet needs are in particular need of mental health support.
CONVERSATIONS ON THE COSTS OF CAREGIVING: COMPARING CAREGIVERS’ AND FINANCIAL ADVISORS’ PERCEPTIONS
Authors: Balmuth Alexa , Miller Julie , Cerino Lauren , Felts Adam , D'Ambrosio Lisa , Coughlin Joseph
Published: December 2022

Costs of caregiving go beyond physical, mental, and emotional; the financial costs are astronomical. On average, family caregivers spend 26% of their income on caregiving (AARP 2021). As the need for family caregivers grows due to longer lifespans (AARP 2020), incorporating the topic of caregiving into financial planning for longevity conversations becomes increasingly necessary. Drawing on data from the MIT AgeLab Caregiver Panel, a research panel of over 1400 family caregivers, and from the MIT AgeLab Preparing for Longevity Advisory Network, a research panel of over 900 financial professionals, this presentation will describe mixed methods research findings that highlight caregivers’ and financial professionals’ attitudes and perceptions toward caregiving as a topic within client-advisor conversations. Results demonstrate that many caregivers wish they had financially planned for the costs of caregiving more than they did. However, caregivers rarely turn to their financial advisors for support; many perceive their value to be strictly financial and are unaware of their advisors’ ability to support them. Despite caregivers’ doubts, most financial professionals feel equipped and willing to have caregiving-related conversations with clients. Additionally, while over three-quarters of financial professionals reported making referrals to outside resources for caregiving-related support, some critical avenues – including social workers and therapists, support groups, and respite care providers – were underutilized. Implications of these findings for caregivers and professionals of various industries will also be discussed.
CONTEXTUAL FACTORS RELATED TO CAREGIVER IDENTITY DISCREPANCY IN EMERGING ADULT CAREGIVERS
Authors: Canell Anastasia , Caskie Grace I L
Published: December 2022

Approximately 12-18% of unpaid family caregivers to older adults in the U.S. are 18-25 years old, yet minimal research focuses on this subgroup of caregivers (Levine, 2005). Because caregiver identity theory postulates that the extent to which informal caregivers integrate their caregiving roles and duties into their identity may relate to caregiver distress (Montgomery & Kosloski, 2012), contextual factors related to higher reported caregiver identity discrepancy should be assessed. In a sample of 135 emerging adult informal caregivers, the current study compared caregiver identity discrepancy across two factors: level of caregiving responsibility and caregiver gender. Caregiving responsibility had four groups: (1) primary with minimal help (n=54), primary but receiving some help (n=51), secondary (n=18), or shared (n=12). Caregiver identity discrepancy was measured using the five subscales of the Family Caregiver Identity Scale (Eifert et al., 2019). Caregiver identity discrepancy differed significantly by caregiving responsibility (p<.001) and gender (p=.046). Emerging adult caregivers identifying as women reported statistically more caregiver identity discrepancy in family obligation (p=.003) and master identity (p=.036) domains than men. Caregiving responsibility showed statistically significant differences in role engulfment (p<.001), loss of shared identity (p<.001), family obligation (p=.013), and master identity (p=.010) domains of identity discrepancy. Emerging adult caregivers identifying as the primary caregiver with minimal help from others reported significantly more identity discrepancy than all other groups across subscales. These results demonstrate that young caregivers who have little support in task responsibilities and identify as a woman may be at particular risk for experiencing caregiver identity discrepancy.
TRAJECTORIES OF SKELETAL MUSCLE MASS AND FAT MASS AND THEIR IMPACTS ON MORTALITY IN OLDER JAPANESE ADULTS
Authors: Seino Satoshi , Taniguchi Yu , Narita Miki , Abe Takumi , Nofuji Yu , Yokoyama Yuri , Shinkai Shoji , Fujiwara Yoshinori
Published: December 2022

Skeletal muscle mass and fat mass have differential impacts on mortality between men and women. We aimed to determine age-related trajectories of skeletal muscle mass index (SMI) and fat mass index (FMI) among men and women and to examined their impacts on mortality risks. This prospective study included 1,770 (863 men and 907 women) aged ≥65 years who participated in health check-ups; the total number of observations was 6,110. SMI and FMI were determined using segmental multi-frequency bioelectrical impedance analysis, and their age-related trajectories from age 65–90 years were examined using group-based semiparametric mixture models. SMI and FMI age-related trajectories for all-cause mortality were determined by multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). SMI and FMI trajectories were classified into three trajectories in both sexes: the low- (28.6% and 34.0%), middle- (56.0% and 47.5%), and high-trajectory (15.4% and 18.5%) groups in men and the low- (27.6% and 40.9%), middle- (51.6% and 48.1%), and high-trajectory (20.8% and 11.0%) groups in women. The median follow-up was 5.3 years; 101 (11.7%) men and 56 (6.2%) women died. Compared with the low-trajectory groups, male multivariate-adjusted HRs for mortality in the middle- and high-trajectory groups were 0.89 (95% CI: 0.57–1.39) and 0.34 (0.13–0.93) for SMI, and 0.76 (0.47–1.23) and 1.13 (0.60–2.14) for FMI, respectively. Corresponding female multivariate-adjusted HRs were 1.00 (0.50–2.02) and 1.64 (0.62–4.36) for SMI, and 0.74 (0.38–1.43) and 0.37 (0.12–1.14) for FMI. Maintaining high skeletal muscle mass is important for prolonging life expectancy, especially in men.
THE IMPACT OF EARLY CONDITIONS ON THE PREVALENCE OF DIABETES ACROSS THREE COHORTS OF OLDER ADULTS IN MEXICO
Authors: Samper-Ternent Rafael , Zazueta-Borboa Jesús-Daniel , Mehta Neil , González Cesar , Wong Rebeca
Published: December 2022

In low-and-middle-income countries like Mexico the impact of disadvantaged early childhood conditions (ECC) on later-life health in not well known and may be changing across birth cohorts. Our objective is to examine the impact of ECC on the propensity to have diabetes in three different cohorts of older adults aged 60-69 (born in 1930-1939, 1940-1949, 1950-1959). We examine to what extent differences in ECC, sociodemographic characteristics, and lifetime obesity explain the differences in the prevalence of diabetes across the cohorts. We use five waves of data from the Mexican Health and Aging Study (n=10,313). We estimate a series of logistic regression models and use counterfactual analyses to identify the roles of ECC and lifetime obesity on cohort-specific diabetes prevalence and on differences in diabetes prevalence across cohorts. Our results suggest that improvements in ECC would decrease prevalence of diabetes by 12.5% in the 1930-1939 cohort and 10% in the 1950-1959 cohort. However, the rise of obesity at age 50 counters this effect and leads to higher prevalence of diabetes in both cohorts. Our models show that if everyone had a normal weight at age 50, the prevalence of diabetes would decrease by 31.3% for the 1930-1939 cohort, 27.3% for the 1940-1949, and 26.7% for the 1950-1959 cohort. Despite improvements in socio-economic conditions during childhood in Mexico, the increase in lifetime obesity appear to offset the benefits derived from better ECC resulting in higher rates of diabetes.
OLDER ADULT’S PERCEPTION OF PRIMARY HEALTH CARE REFORM IN A LOW-MIDDLE-INCOME COUNTRY (LMIC): IMPACT ON GERIATRIC CARE
Authors: Abah Theresa
Published: December 2022

Health reforms are intended to provide equitable and beneficial care across population groups, it also transforms service delivery. We sought to identify current or potential implementation gaps that divert improvement efforts in service delivery, and practices that prevent holistic approaches in caring for older adults, especially in developing nations. This study examined a major health reform initiative in a LMIC aimed at integrating defragmented health organizations under one management, it also looked at extent to which reform agendas align with primary health care (PHC) principles. Using purposeful random sampling design, this quantitative study obtained participants’ views of care received in 12 sites and 2 states in Nigeria. A total of 218 participants aged 50 years and older in both rural and urban areas. Partial correlations were carried out after accounting for other variables of interest. Findings show there was no significant differences in attributes of primary care received by geography, gender or by state. Although Ondo state scored higher than Federal Capital Territory in previous performance evaluations (66% and 43% in 2015), respondents from both states received only two out of the seven primary care attributes recommended by the World Health Organization. First contact (access to care) and Care continuity, p <.01 and p, 0.5, (d = 0.202 and 0.179) were significant. Overall, our findings suggest that performance improvement at management level dominated reform efforts over service delivery. It is unclear how this aligns with providing older adults with the health care that they need.
BUDGET IMPACT ANALYSIS OF NONPHARMACOLOGICAL INTERVENTIONS FOR COMMUNITY-DWELLING PEOPLE LIVING WITH DEMENTIA
Authors: Jutkowitz Eric , Mendez Mauricio Lopez , Shewmaker Peter
Published: December 2022

Non-pharmacologic dementia care interventions significantly reduce the risk of a nursing home admission for people living with dementia. We used an evidence-based mathematical model to evaluate the budget impact for a healthcare payer that independently implemented four non-pharmacologic dementia care interventions that reduce the risk of transitioning to a nursing home for people living with dementia: 1) MIND, an at-home care coordination intervention; 2) NYU Caregiver (NYUCI), provides caregivers with counseling and ad-hoc support; 3) Alzheimer’s and Dementia Care (ADC) program, a clinic based care coordination intervention; and 4) Adult Day Services Plus (ADS-Plus), an adult day based care coordination intervention. Healthcare payer costs included Medicare and Medicaid expenditures. We simulated a cohort of 302,630 community-dwelling people with dementia, which is the number of people who were diagnosed with dementia in 2018. We applied each intervention’s inclusion criteria to determine the proportion of the cohort that would receive the interventions. Some people may die or enter a nursing home before receiving the interventions. MIND, NYUCI, ADC, and ADS-Plus reduced annual payer expenditures (relative to $25,000, which is the average amount Medicare-Medicaid pay per person with dementia) on average by 0.67%, 0.23%, 0.13%, and 0.58%, respectively over 5 years. Cost savings for the interventions varied by demographics. African American females between ages 95-100 who received NYUCI had the largest cost savings ($2,750.57). White females between ages 65-70 who received ADC had an increase in payer costs ($2,397.07). On average, non-pharmacologic dementia care intervention do not increase a healthcare payer’s budget.
DIFFERENCES IN LIFE COURSE PATHWAYS TO DEMENTIA INCIDENCE FOR BLACK AND WHITE OLDER AMERICANS
Authors: Farina Mateo
Published: December 2022

Black Americans are 2-3 times more likely to have dementia than White Americans. Studies have evaluated how differences in exposures to life course risk factors, such as level of education, may be contributing to this disparity. When using this approach, substantial reductions in cognitive health inequality across race were accounted for, but not completely explained. However, this research assumes an underlying similarity in life course pathways to cognitive impairment risk across race groups. We used longitudinal data from the Health and Retirement Study (2000-2016) to evaluate life course pathways to dementia risk across race groups. We find substantial differences across race groups. Dementia risk for older black adults is greatly shaped by southern birth and education. For older white adults, adulthood factors such as wealth, health behaviors, and cardiometabolic conditions has a greater role. Our findings support calls for a closer examination of within group analysis among minoritized populations.