bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between Prior Cancer Diagnosis and All-Cause Dementia Progression Among U.S. Adults
Authors: Fowler Mackenzie , Wright Nicole , Triebel Kristen , Rocque Gabrielle , Irvin Ryan , Kennedy Richard
Published: December 2021

Cancer-related cognitive impairment is a common effect of cancer that shares symptoms with dementia. Only one study examined cancer’s longitudinal association with dementia. This analysis expands to a larger clinical sample. Electronic health record data were extracted from July 2003-February 2020. Baseline cognition/progression on the Alabama Brief Cognitive Screener (ABCs) by cancer history were assessed using linear mixed effects models, with interaction by race. After adjustment for demographics/socioeconomics, those with cancer history had higher baseline cognition (□: 1.49 [0.91-2.07]), and declined slower (□: 0.40 [0.08-0.71]) than those without. Health behaviors/comorbidities attenuated this association. Non-Hispanic Blacks with cancer history demonstrated lower cognition throughout follow-up compared to non-Hispanic Whites / other race/ethnicities with cancer history and participants without cancer history. Health behaviors/comorbidities confound and race modifies the relationship between cancer and dementia. Exploring the role of health behaviors/comorbidities on this association and causes of racial disparities is needed.
Emerging Scholars and Junior Faculty Present New Strategies for Student Engagement in Gerontology
Authors: Hahn Sarah , Kinney Jennifer
Published: December 2021

With the rapid aging of the population, the need for gerontological educators to identify pedagogical strategies to increase interest and prepare students continues to grow. Innovative approaches and educational practices contribute greatly to student success in the gerontological classroom. Literature on gerontological pedagogy has shed light on the success of high-impact practices, creative assignments, pedagogical interventions, and even different course modalities when it comes to effectively delivering gerontological content and engaging students. Additionally, the Academy for Gerontology in Higher Education (AGHE) provides a wealth of suggestions for creating and implementing effective gerontology courses and assignments. However, while we are familiar with these practices, we are not familiar with how specific groups of academics, such as emerging scholars and junior faculty, are utilizing them. Emerging scholars and junior faculty experience several major transitions as they prepare for life in academia. To ensure that emerging scholars and junior faculty are well prepared, we need to continue to empower these individuals to foster growth. This can be done by highlighting how emerging scholars and junior faculty have met the goals of maximizing and optimizing student learning. As such, the purpose of this symposium is to examine innovative approaches used by emerging scholars and junior academics in the gerontological classroom that have optimized student learning. This includes presentations on strategies for team-based learning, using intersectionality as a theoretical lens, and two creative written assignments, The Gerontological Movie Database Review and Interview an Elder.
Flipping the Script About Aging Through Films: The Gerontological Movie Database Review
Authors: Hackett Sara
Published: December 2021

Education about the heterogeneity of the older adult population is an important step for reducing ageist attitudes. As many undergraduate students view gerontology as an unrelatable discipline, educators are tasked with identifying innovative strategies to make course content engaging. The purpose of this presentation is to share an emerging educator’s experience with creating a novel essay assignment. Based off the International Movie Database (IMDb), the Gerontological Movie Database (GMDb) Review encourages students to use their knowledge to evaluate how older adults are portrayed in films. Explicitly, students must 1) choose a film that focuses on older adult characters and 2) apply key gerontological concepts (e.g., the life course perspective) to critique the film’s representation of aging. Though movie reviews are not a typical genre of writing, this assignment increases students’ understanding of how their perception of aging, coupled with master narratives embedded within today’s culture, influences the construction of age.
Virtual Transitions and Opportunities in LTSS education Post-Pandemic
Authors: Towsley Gail , Telonidis Jacqueline , Brunker Cherie , Edelman Linda
Published: December 2021

The Utah Geriatric Education Consortium Learning Community transitioned to the Age-Friendly Long-Term Services and Support (LTSS) ECHO with support from Comagine Health, our local QIN-QIO. ECHO sessions utilize case-based learning and mentorship to help community providers gain the expertise required to provide needed care and/or services to older adults. Since March 2020, and in response to the needs of our partners, four ECHO sessions (average of 47 attendees per session) have focused on COVID-19 training including COVID-19 briefings, infection prevention, positive thinking and coping with stress. With our partners, we also co-created a 3-part LTSS telehealth ECHO series to illustrate how telehealth can address the unique challenges of COVID-19. We will discuss 1) how we met the educational needs of our partners during a health crisis 2) the process we took to develop the LTSS telehealth ECHO series, and 3) opportunities for continued virtual education application.
Home and Community Based Service Use Among Veterans With Dementia Living in Rural Virginia
Authors: Savla Jyoti , Sapra Mamta , Hagemann Lauren , Luci Katherine
Published: December 2021

Despite the overall expansion of rural Veteran health care facilities, older Veterans in these areas are still underserved and face challenges and barriers to access services. Using data from 60 family caregivers of persons with dementia (PwD; Mean Age = 67 years, Range = 39-84; 92% White; 71% Spouse) we examined the types of home-based and community services they utilized. We also examined reasons that family caregivers provided for not using these services. Next, we applied Andersen's Behavioral Model of Health Services to examine how predisposing factors such as demographics, available resources, and PwD’s needs were associated with the use of services. We found that Veterans living in rural counties had lower access to caregiver support groups, homemaker services, adult day centers, and home-based respite services. The top three reasons for not using services were that the family caregiver chose to do it themselves, the PwD did not want the service or the service provider to help, or it was too far from the caregiver’s home. Regression analysis further showed that caregivers caring for PwDs with greater ADL challenges and memory and behavior problems were more likely to need and utilize paid services. Disparities based on gender, age, and race were also explored. Findings suggest the need to develop effective service promotion strategies and destigmatizing the use of paid services among Veteran families to reduce health disparities in rural regions.
Coping in Centenarians: Patterns and Correlates
Authors: Uittenhove Kim , Jopp Daniela , Boerner Kathrin
Published: December 2021

Coping strategies are a source of resilience, yet little is known about their use in centenarians. We examined patterns in coping strategy use and determined how these patterns were associated with characteristics such as personality, cognitive status, quality of life, and health. We analyzed data from the Fordham Centenarian Study (N = 119), where centenarians responded to 40 items covering 10 coping dimensions (e.g., active problem-solving, support seeking, reappraisal). Findings revealed two clusters which differed in amount and strategy types: One was characterized by high use of many strategies which addressed the problem and its appraisal. The other was characterized by a smaller strategy repertoire, with very limited use of problem-focused strategies. The more varied and problem-focused coping pattern was associated with other characteristics, such as personality (e.g., extraversion) and quality of life (e.g., well-being). Findings suggest variation in coping profiles associated with resilience in centenarians.
Centenarians’ Experience of the COVID Pandemic in Switzerland
Authors: Jopp Daniela , Cavalli Stefano , von Gunten Armin , Herrmann François , Da Rocha Carla Gomes , Ziade Garnelle , Uittenhove Kim
Published: December 2021

Being considered as individuals with elevated risk of severe health reactions to the COVID19 infections, governments around the world have put in place wide-ranging measures to protect very old individuals from the virus. In the present study, we investigated centenarians’ experience of the COVID19 pandemic, to reach a better understanding of their vulnerability and resilience. As part of the SWISS100 study, we conducted telephone interviews with 30 centenarians and 40 family members. While almost all centenarians felt not, qualitative data suggested the existence of two groups: One included centenarians lived rather withdrawn and isolated before the crisis and therefore did not experience major changes. The other group included centenarians who suffered substantially from no longer being able to see family and friends and missed valued activities. Family members reported challenges, including centenarians’ decline in mental and physical health. Findings highlight the importance of different vulnerability profiles and lock-down side effects.
The Impact of COVID-19 on Adult Day Services' Closures and Programming
Authors: Parker Lauren , Marx Katherine , Gaugler Joseph , Gitlin Laura
Published: December 2021

Nationally, adult day services (ADS) were forced to closed due to the COVID-19 pandemic. The forced closure of ADS programming consequentially impacted the services provided to clients. Many ADS continued to provide telephonic/remote services to clients, despite limited reimbursement from national and state sources for these services. Using data from ADS sites participating in the ADS-Plus Program (n= 22), this presentation examines the effects of COVID-19 on ADS closures and programming provided during the closure. About 86% (n=19) of the centers reported having to closed due to COVID-19. One-hundred percent of the sites reported offering telephone support to clients. Nearly 45% (n=10) of the centers reported not being reimbursed for this service. As ADS is a vital community-based resource for many families, it is important to demonstrate the crucial services provided by ADS to inform policymakers of the essentiality of day centers.
The Impact of Short-Term Dietary Restriction on Stem Cell Function
Authors: Unnikrishnan Archana
Published: December 2021

Stem cells play a critical role in the maintenance of tissue function and their proliferative/regenerative capacity is essential to this role. Because stem cells persist over the lifespan of an animal, they are susceptible to gradual accumulation of age-associated damage, resulting in the loss of regenerative function that can impair organ function. Understanding the mechanism(s) that regulates stem cell function is essential for retarding the aging process, and stem cells are attractive targets for aging interventions. Dietary restriction (DR), the most robust anti-aging intervention to-date, has been shown to enhance the activity and integrity of stem cells in a variety of tissues (e.g., muscle, bone marrow, and intestine), and it is believed that effect of DR on stem cells plays an important role in the anti-aging action of DR. For example, DR has been shown to preserve and increase the number of intestinal stem cells (ISCs) and enhance their regenerative capacity in young animals. Data from my lab shows that ISCs from old mice have limited proliferation activity and form few if any organoids in vitro (a surrogate for a fully functional crypt) and that ISCs isolated from old mice on life-long DR show an improved ability to form organoids. While it is well accepted that life-long DR increases lifespan and has anti-aging effects an important aspect of DR that has been largely overlooked is that DR implemented only for a short time early in life can increase lifespan of rodents even when rodents are fed ad libitum the remainder of their life. In line with this, we recently found that ISCs from old mice fed DR for only a short-period resulted in a dramatic increase in ability of the ISCs to form organoids. This is the first evidence that short-term DR administrated late in life can rescue the loss in ISC function that occurs with age.
Digital Divide Magnified for Older Veterans Living Off the Grid
Authors: Nearing Kathryn , Pimentel Camilla , Dryden Eileen , Kernan Laura , Moo Lauren
Published: December 2021

Compared to urban Veterans, rural Veterans are more likely to be older (55-74), not employed, have less education, more service-related disabilities and unmet healthcare needs. Interviews with a national sample of community-based outpatient clinic providers described highly-rural Veterans who are “off the grid.” These Veterans, by choice and/or circumstance, do not have access to reliable internet, associated devices or knowledge/skills. Providers described the difficulties of connecting with these Veterans even by phone. The healthcare shift to virtual telehealth modalities in response to COVID-19 highlights the digital divide as a social determinant of health. For “off-the-grid” Veterans, past experiences and present-day circumstances converge to perpetuate and exacerbate inequalities in accessing healthcare. Their situation underscores that telehealth is not a panacea for increasing access to care and confronts us with the moral imperative to reach those with whom it may be most difficult to connect to span social, geographic and digital divides.
Socioeconomic Inequalities and Mild Cognitive Impairment: Evidence From England and Japan
Authors: Gireesh Aswathikutty , Almeida-Meza Pamela , Hideki Hashimoto , Steptoe Andrew , Cadar Dorina
Published: December 2021

Japan is the world’s fastest ageing population, with a higher prevalence of dementia than in the UK. Less clear is the role of socioeconomic inequalities in neurocognitive disorders between these countries. This study aims to assess comparatively the relationship between education, a marker of cognitive reserve, and income in relation to mild cognitive impairment (MCI) and dementia in England and Japan. We ascertained MCI using a validated algorithm based on one standard deviation below the mean on two standardised cognitive tests. Multinomial logistic regression models were used to study the associations between socioeconomic markers and MCI/dementia. The prevalence of MCI was almost twice as high among English adults compared to Japanese. Results suggest that nations are similar in overall socioeconomic inequalities of MCI/dementia, but this might differ across socioeconomic markers. Considerable variability in the health inequalities could be attributed to the country-specific socio-cultural-political factors, which remains to be further explored.
Technology to Support Self-Regulation in Older Adulthood: Insights From Design to Implementation
Authors: Meija Shannon , Wahl Hans-Werner
Published: December 2021

Across the lifespan, individuals adapt to change through the careful monitoring and adjustment of goals, demands, and performance—processes of self-regulation. Technology in support of self-regulatory processes may compensate for deficiencies in the ability to set, monitor, and work toward goals. Our purpose in this symposium is to forward the discourse on how health technology—from design to implementation—can assist older adults in their efforts to support their health and well-being in daily life. Our symposium begins with design considerations for technologies that support processes of information seeking, reflection, and action. Chin presents a process for designing conversation agents that guide dialogues with older adults to support informal self-regulated learning of health information. Nie and colleagues synthesize the literature on visual feedback to provide a framework that illustrates how visual design elements can link feedback to action. The symposium continues with papers that speak to older adults’ experiences using technology to accomplish their goals. Mejía and colleagues use insight from older adults who had self-assessed their balance for 30 consecutive days to explore themes of self-monitoring accuracy and feedback preferences. Francis and colleagues use data from the Detroit-based Social Relations Study to illustrate how technology use and its implications vary when older adults engage with their weaker social ties. The symposium will conclude with a discussion led by Wahl, who will situate the papers, and the discourse on health technology design and application, within lifespan developmental and action perspectives on aging.
Investigating the Cortical Correlates of Singing: Potential Neural Benefits of Choir for Persons With Dementia
Authors: Tamburri Nicholas , Sheets Debra , Halliday Drew , Smith Andre , MacDonald Stuart
Published: December 2021

Through leveraging the known advantages of musical engagement and socialization, choir interventions are known to facilitate psychological and cognitive benefits for persons with dementia (PwD). Surprisingly, no research has explored whether social singing may also confer neurological advantages. In this study, we employed functional near infrared spectroscopy (fNIRS) to investigate the cortical correlates of both social and solo singing in PwD (n=13). Paired-sample t-tests were used to evaluate within-person differences in frontal cortical activation between the social vs solo singing. Results showed significant activation differences in three frontal channels, with social singing requiring comparatively less frontocortical activation. These findings indicate potential neural benefits of social singing – with less frontal activation being a proxy for greater reliance on intact proceduralized systems – and serve to highlight the utility of fNIRS in better understanding the neural correlates underlying the benefits of social singing interventions for PwD.
The Diverse Spirit: Spiritual Care Perspectives and the Implications for Older Adults in Various Settings
Authors: Manning Lydia , Federwitz Chad , Patrick Julie Hicks
Published: December 2021

Religiosity and spirituality are commonly supported and viewed as essential elements of well-being in old and very old age, particularly at end of life. These essential elements often include the exploration of the meaning in life, inner peace, belonging, contentment, and near-end-of-life-completion. The positive outcomes of religious and spiritual beliefs and practices have been well established. However, these experiences and related positive outcomes may not always include a diverse array of older adults. The spiritual care of older adults is becoming more culturally diverse and includes differing perspectives on what constitutes spiritual care, both in approach and practice. This symposium will explore the current state of spiritual care for older adults through a lens of cultural diversity and inter-religious/spiritual perspectives. A focus on the current practices of spiritual care for older adults and future implications will also be considered. Recommendations pertaining to future gerontological inquiry in the importance of spiritual care, as well as diverse approaches within gerontological practice will be highlighted and discussed.
Spirituality Training as an Essential Element of Person-Centered Care
Authors: Kheirbek Raya
Published: December 2021

Palliative Medicine, built on the biopsychosocial-spiritual model of care, has long recognized the critical role of spirituality in the care of patients with complex, serious, and chronic illnesses. We conducted focus groups to arrive at a consensus definition of “spiritual care.” Additionally, we collected and compared frameworks and models that recognize that providers cannot be made compassionate simply through the imposition of rules; methods were needed to achieve behavior change. The created curricula covered the definitions of spiritual care, self-awareness, cultural sensitivity, assessment, and skills. As part of ongoing curriculum development processes, training included evaluation tools to accompany competency standards. Results demonstrated improvements in self- reported abilities to (a) establish appropriate boundaries with patients; (b) apply the concept of compassionate presence to clinical care; (c) understand the role of spirituality in professional life; (d) identify ethical issues in inter-professional spiritual care. Clinicians need to address patients’ spiritual needs.
Employers’ Support of Older Adults Facing Ageism in the Workplace: A Scoping Review of the Literature
Authors: Bull Amanda , Mirza Raza , Gardiola Andrea , Klinger Christopher , Hsieh Jessica
Published: December 2021

As the Canadian population continues to age rapidly, addressing the social structures that negatively impact older adults is of increasing importance. The most prominent of these social structures is the workplace, which can be a potential source of age discrimination. The goal of this scoping review was to analyze the literature that addresses strategies for employers to support older workers experiencing ageism, in order to answer the research question: How can employers support older adults (50+) facing ageism in the workplace? Following Arksey and O’Malley’s five-step framework, an electronic database and grey literature search was conducted between September and December 2020. Thematic content analysis was performed to establish key themes. The search revealed 3,635 peer-reviewed and grey literature sources that were evaluated by three investigators. Thirty-six articles, published between 2006 and 2020, met inclusion criteria and examined various support strategies for employers. Five major emerging themes were identified from the literature: (1) Recruitment practices, (2) Training opportunities, (3) Education for managers, leaders, and employees in the workplace, (4) Flexible employment opportunities, and (5) Methods to change the psycho-social environment of the workplace. Implementation of these interventions is required to support older adults who may be experiencing workplace ageism. Longitudinal research of these interventions is required to determine the lasting effects of these strategies; however, the existing literature supports the implementation of these supportive actions, which is vital to ensuring that older adults are able to attain and maintain valuable work, in healthy environments, now and into the future.
Aging in Place for Older Subsidized Housing Residents: The Influence of Social Connection and Social Environment
Authors: Brown Rebecca , Reyes-Farias David , Finucane Erin , Watson Amanda , Jahan Momana , Pandit Sonia , Reid Carolina , Resnick Barbara
Published: December 2021

Older adults living in subsidized housing experience health disparities including disproportionate rates of social isolation and nursing home admission. Little is known about how social relationships and social environment influence aging in place for this population. We interviewed 58 residents aged 62 or older. Qualitative thematic analyses revealed that social relationships both inside and outside the building contributed to residents’ experience of aging in place. Relationships with other residents and staff members provided social support, while connections to family and friends outside the building “opened up” the residents’ world and provided a sense of connection to the larger community. Social and physical environment also contributed, with residents’ ability to move between private and public spaces leading to feelings of freedom and independence. Discussion focuses on expanding definitions of aging in place to encompass residents’ experiences and implications for improving aging in place for this population.
Food Insecurity Among Older Urban Subsidized Housing Residents: The Importance of Social Connectedness
Authors: Gonyea Judith , O'Donnell Arden , Curley Alexaandra
Published: December 2021

Poverty and food insecurity are associated with poor health in later life. Although housing is recognized as a social determinant of health; relatively little research has explored food insecurity in the marginalized population of older subsidized housing residents. In this study, we examined factors associated with food insecurity and particularly how social connectedness was associated with food insecurity. We hypothesized that social connection measures (i.e., loneliness, sense of belonging) independent of sociodemographic, health and food program variables would contribute to food insecurity. Our data are from interviews with 216 residents ages 55-plus (50% Black, 45% LatinX). The 6-item USDA Household Food Security Survey found high rates of food insecurity, 40% for ages 55-69 and 20% for ages 70-plus. Multivariate logistic regression models revealed that loneliness was significantly related to food insecurity even after other factors were controlled. Discussion centers on strategies for addressing social risk factors to ameliorate food insecurity.
Building on Existing Technology to Enhance Remote Assessments of Brain Health
Authors: Bazzano Lydia , Fernandez Camilo , Hwang Philip , DeAnda-Duran Ileana , Senko Enejda , Lin Honghuang , Kolachalama Vijaya , Au Rhoda
Published: December 2021

Tablets, smartphones, linked devices have features such as high-fidelity microphones, accelerometers, GPS locators, and gyroscopes can be used to capture brain health-related data. Collection of data remotely is especially important given the vulnerability of older adults to COVID and the need to protect from such exposure. As part of an American Heart Association/Gates Venture Strategically Funded Network, a number of remote assessments are being deployed to capture information related to brain health in a subset of the Bogalusa Heart Study cohort (mean age 51.4, SD 5.3). The Linus Health Platform includes applications that measure cognitive abilities, and collect digital voice features and phone sensor data that can be derived into surrogate measures of cognitive function and mood. A readily available suite of games (Lumosity) is also being used to assess cognitive health. These devices and applications offer a largely unexplored opportunity for acquiring and assessing data related to brain health.
Novel Positional and Biological Candidate Gene for Grip Strength in Older Adults: The Long Life Family Study
Authors: Santanasto Adam , Wojczynski Mary , Cvejkus Ryan , Wang Lihua , Thyagarajan Bharat , Christensen Kaare , Daw E Warwick , Zmuda Joseph
Published: December 2021

Grip strength is a robust indicator of overall health, is moderately heritable and predicts longevity in older adults. Using genome-wide linkage analysis, we identified a novel locus on chromosome 18p linked to grip strength in 4534 individuals from 582 families (age 70.0 ± 15.8, range 24–110 years; 54% women). DNA sequencing was completed to identify single nucleotide variants (SNVs) in the 3.44 – 4.04 mega-basepair region on chromosome 18p. Using the sequencing data, we performed association analyses between the 7312 SNVs in the region and grip strength in families exhibiting evidence for linkage. Models were adjusted for age, age2, sex, height, field center and population substructure. There were 23 families (263 individuals) that contributed to the linkage peak (cumulative logarithm of the odds [LOD] score = 12.4). Six families (112 individuals) accounted for most of the linkage signal (LOD = 6.4). In these 6 families, we found highly significant associations between SNVs in the Disks Large-associated Protein 1 (DLGAP1) gene and grip strength (lead SNV: β= -0.75kg ± 0.15, p-value= 4.3*10-6). Correcting for the top SNV in DLGAP1 reduces the LOD by 72% in these families. Further, the effect allele frequency is much higher in these 6 families (39.7%) compared with both the NHLBI’s Trans-OMICs for Precision Medicine (23.5%) and 1000Genomes (28.0%) references panels. The DLGAP1 gene plays an important role in post-synaptic density of neurons; thus, it is a novel positional and biological candidate gene for follow-up studies aimed at uncovering genetic determinants of muscle strength.
Pleiotropic Genes for Pulmonary Function and Aging-Related Traits: The Long Life Family Study (LLFS)
Authors: Feitosa Mary , Wojczynski Mary , Anema Jason , Daw E Warwick , Wang Lihua , Nygaard Marianne , Santanasto Adam , Province Michael
Published: December 2021

Pulmonary function progressively declines with aging. Forced expiratory volume 1-second (FEV1) and forced vital capacity (FVC) are predictors of morbidity of cardiovascular diseases and all-cause mortality. Reduced pulmonary function has shown association with elevated chronic low-grade systemic inflammation and low muscle strength, and glycosylated hemoglobin (HbA1c). We evaluated whether FEV1 and FVC share common genetic factors with interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), body mass index (BMI), handgrip strength, plasma glucose, and HbA1c employing correlated meta-analysis (CMA) in up to 3888 individuals (age range: 26-106). CMA tests whether combining genome-wide association (GWA) P-values from two or more traits enhances the ability to detect variants concomitantly influencing such traits. We considered a variant pleiotropic if the univariate GWA P≤1.0x10-02 and CMA P≤5.0x10-08. We identified pleiotropic loci for FEV1 (or FVC), IL-6 and hsCRP within CYCS, CALN1, TRIM9, AXIN2, MICAL3, and CMIP; FEV1 (or FVC) and BMI within CYP2U1, LINC00871-RPL10L-MDGA2, and LOC105372472; FEV1 (or FVC) and grip strength within XXYLT1 and MAL2; FEV1 and FPG within MAF; and FVC and HbA1c within HDHD3. Some loci were reported as GWAS suggestive (P<10-6) for pulmonary function. Additionally, the identified loci harbor genes with roles in pro-inflammatory cytokine production, immune and inflammatory pathway, T-helper signaling pathway, transforming growth factor-beta, and T-cell receptor-alpha enhancer. Our findings suggest that inflammation is a feature of reduced pulmonary function with IL-6, hsCRP, BMI, low muscle strength, glucose, and HbA1c. Pleiotropic genetic associations across these traits may explain part of the correlated genetic architecture between pulmonary function and aging-related traits.
Moderating Effects of Loneliness on COVID-19-Related Stress and Anxiety in Middle and Later Life in South Korea
Authors: Yoon Sukyung , Choi Soo Chan
Published: December 2021

Many people have suffered from psychological distress in the form of stress, loneliness, and anxiety resulting from the COVID-19 epidemic (Havnen et al., 2020; Luchetti et al., 2020). Along with these factors, physical health (hereafter health), resilience, and living arrangements as protective factors were examined. The research aims were to investigate 1) factors affecting the association between COVID-19-related stress (hereafter stress) and anxiety, and 2) moderating effects of loneliness on this association. Data was collected on 450 middle-aged and older adults (ages 45 through 76) living in South Korea during COVID-19. A multi-group path analysis was employed. Measurement invariance was examined by comparing unconstrained and fully constrained models. Both models fit. Moderating effects of loneliness existed. Stress was negatively associated with health and living arrangements for people with both higher and lower levels of loneliness. Health was positively associated with resilience for both groups. Resilience was negatively associated with anxiety for both groups. For people with higher levels of loneliness only, stress and health were negatively associated with resilience and anxiety, respectively. The association between stress and anxiety was significant for both groups. However, the impact of stress on anxiety was significantly larger for people with higher levels of loneliness than for people with lower levels of loneliness. Health practitioners and service providers should develop programs to maintain and promote resilience, social support, and good health among middle-aged and older adults in South Korea to mitigate negative mental health consequences during the pandemic.
An International Aging Research Collaboration During The COVID-19 Crisis: Mitigating Global Health Consequences
Authors: Thiamwong Ladda , Chong Wayne , Kwan Rick , Roopsawang Inthira , Gautam Ramraj , Vivian W Q Lou
Published: December 2021

There are several reasons for forming an aging international research collaboration; however, creating a successful and productive research team during the global crisis may require extensive planning and efforts. Our team consists of ten scholars from five countries, including Hong Kong, Nepal, Singapore, Thailand, and the United States. To accomplish this initiative, we employ ten simple rules for establishing international research collaborations proposed by R. de Grijs (2015). We aim to examine impacts of the pandemic on physical activity, frailty, falls, depression and social networks in diverse older adults. We collect data by online survey and/or face-to –face survey using questionnaires including fear of the COVID, face mask use, Social Network, Rapid Assessment of Physical Activity, a simple frailty questionnaire, CDC fall risk checklist, short Fall-Efficacy Scale International and Patient Health Questionnaire-9. Topics of discussion included: research progression, lessons learned and barriers to international collaboration during the COVID-19 crisis.
The Impact of Declining Enrollment and Re-Careering on Community College Gerontology Programs
Authors: Phillips Judith Robertson
Published: December 2021

According to Inside Higher Ed (2020), community college enrollment declined by 10.1% during the fall 2020 semester and this decline in enrollment continued into the spring 2021 semester for many community colleges. Gerontology programs within community colleges were among curriculums impacted by this downswing in enrollment. This presentation will discuss what this means for community college Gerontology programs across the United States in a time when the older adult population is rapidly increasing, and a qualified workforce is needed to fill the multiple fields serving this aging population. One area of discussion will be the number of returning adults who are re-careering into Gerontology, some because of the impact of a family caregiving situation while others are motivated to change careers because of their interest in the numerous career pathways available in the field of aging. Suggestions for encouraging and supporting these newly returning adults will be discussed.
Role of Disease-Specific Incidence and Survival in Disparities in Life Expectancy in the United States
Authors: Kravchenko Julia , Yu Bin , Akushevich Igor
Published: December 2021

There are persisting geographic and racial disparities in life expectancy (LE) across the United States (US). We used 5% Medicare Claims data (2000-2017) to investigate how disease incidence and survival contribute to such disparities. Disease-specific hazard ratios (HRs) were calculated for Medicare beneficiaries living in the US states with the lowest LE (the states with the highest LE were used as a reference group), in gender- and race-/ethnicity-specific populations. Analysis of incidence showed that the greatest contribution to between-the-state disparities in LE was due to higher incidence (HRs≥1.30) of atherosclerosis, heart failure, influenza/pneumonia, Alzheimer’s disease, and lung cancer among older adults living in the states with the lowest LE. The list of diseases that contributed most to LE through the differences in their survival substantially differed from the above listed diseases: namely, diabetes, chronic ischemic heart disease, and cerebrovascular disease had HRs≥1.28 for their respective survival rates, with the highest HRs for lung cancer (HR=1.37, in females) and prostate cancer (HR=1.30). Respective race-/ethnicity-specific patterns of incidence and survival HRs were investigated and diseases contributed most to racial disparities in LE were identified. Study showed that when planning the strategies targeting between-the-state differences in LE in the US, it is important to address both 1) primary and secondary prevention for diseases demonstrating substantial differences in contributions of incidence, and 2) treatment choice, adherence to treatment, and comorbidities for diseases contributing to LE disparities predominantly through the differences in survival. Such strategies can be disease-, race-/ethnicity-, and geographic area-specific.
Slowdown in Life Expectancy Improvements for European Countries From 2000 to 2019
Authors: Steel Nicholas , Ford John , Schmidt Jurgen
Published: December 2021

Life expectancy improvements have slowed across Europe since around 2010 for unknown reasons. We aimed to assess the contribution of specific conditions and risk factors to changes in life expectancy. We compared Global Burden of Disease (GBD) 2019 estimates for life expectancy at birth, years of life lost to premature mortality (YLLs) and population attributable fractions (PAFs) for risk factors, for 17 European Economic Area (EEA) countries from 2000 to 2010 and from 2010 to 2019. All 17 countries experienced a slowdown in life expectancy improvements after 2010, after decades of improvement. Denmark experienced the smallest drop in improvement from 2000 to 2010 compared to 2010 to 2019 (0.75 years drop), followed by Norway (0.79), Iceland (0.86), Finland and Sweden (both 0.89). The 5 countries with the largest drop in improvement were Spain (1.6 years drop), the Netherlands (1.88), Portugal (1.92), the United Kingdom (UK) (2.13), and Ireland (2.77). Ischaemic heart disease and stroke made the biggest contribution to the slowdown in life expectancy. Important risk factors for mortality varied by country and included tobacco, drug and alcohol use, and high fasting plasma glucose. The Nordic countries have maintained improvements in life expectancy substantially better than other European countries. The different patterns in different countries suggest multiple factors are contributing to the changes, including specific conditions, risks and behaviours, and broader societal determinants of health. Large scale, international, co-ordinated research is needed to better understand these changes and inform policy actions, particularly as the COVID-19 pandemic will increase international differences.
The Sage Resource Project: Readying Researchers to Transform Research through Engagement
Authors: Lessem Rachel , Berman Rebecca , Bella Jesse , Danilovich Margaret
Published: December 2021

The Sage Model enables engagement of older adults receiving Long Term Services and Supports (LTSS), a group typically excluded in research. This presentation focuses on lessons learned from The Sage Resource Project, a Patient Centered Outcomes Research Institute funded project. We collaborated with RCMAR and Roybal centers to encourage NIH-affiliated researchers to embrace stakeholder engagement through promotion of the Sage Model. Few studies include an assessment of researcher needs when it comes to stakeholder engagement. We conducted a needs assessment (n=103) finding <50% of researchers presented work to older adults and only 41% interacted with older adults receiving LTSS. However, >90% were likely to attend webinars to learn more. Additionally, 70% of respondents were interested in setting up their own Sage Model research advisory boards. We identify opportunities for transforming LTSS research by including older adults as well as directions for future research on engagement, based on researchers’ identified needs.
Engaging Direct Care Providers in the Implementation of Montessori Programming for Dementia
Authors: Douglas Natalie
Published: December 2021

There is a need to engage direct care providers such as certified nursing assistants (CNAs) explicitly in efforts to implement innovative programming in long-term care environments. This presentation will outline engagement strategies that supported the implementation of Montessori programming in a community of 20 individuals living with severe dementia. Examples about positioning the CNA at the center of decision making, negotiating and building trust, cultivating opportunities for mutual consultation, creating spaces for new ideas to emerge, and synthesizing diverse perspectives will be highlighted. Although the program achieved positive outcomes on a number of measures including decreased responsive behaviors from people living with dementia, decreased negative qualities of relationships between CNAs and persons with dementia, and increased positive qualities of relationships between CNAs and persons with dementia, this presentation will focus on the “how” of engagement between the project team and the CNAs by highlighting qualitative data.
Testing the Usefulness of the Evidence Integration Triangle for Implementation of EIT-4-BPSD
Authors: Resnick Barbara
Published: December 2021

The effectiveness of evidence-based practices, such as use of behavioral interventions, can be improved when delivered under conditions of an implementation framework. This pragmatic trial used the Evidence Integration Triangle (EIT) which is a parsimonious, community-engaged participatory framework that brings evidence and facility stakeholders together. Active engagement empowers key stakeholders to integrate evidence into practice using a simple three-pronged framework: (1) A participatory implementation process which was done via monthly meetings and weekly emails between stakeholders and a clinical expert as they worked on facility based goals; (2) Implementation of the four steps delineated in the EIT-4-BPSD; and (3) evaluation using practical progress measures. There was some evidence of implementation of the EIT-4-BPSD based on participation in Stakeholder team meetings, settings working towards goal achievement, and increased use of behavioral interventions among staff. The EIT approach is a useful implementation framework to help change staff behavior in long term care.
Associations of Central Auditory Processing With Brain Volumes
Authors: Jiang Kening , Coresh Josef , Hayden Kathleen , Jack Clifford , Mosley Thomas , Pankow James , Lin Frank , Deal Jennifer
Published: December 2021

We investigated the cross-sectional associations of speech-in-noise performance with magnetic resonance imaging brain volumes among 588 cognitively normal participants (77±4 years, 56% female) from the Aging and Cognitive Health Evaluation in Elders Study (randomized trial embedded in the Atherosclerosis Risk in Communities (ARIC) Study) baseline in 2018-19 (N=427, with hearing loss) and ARIC (N=161, normal hearing) Visit 6/7 in 2016-17/2018-19. Central auditory processing was measured by Quick Speech-in-Noise (QuickSIN) test; range: 0 to 30, lower scores=worse performance. In models adjusted for demographic and disease covariates, every 5-point decrease in QuickSIN score was associated with smaller volumes of the temporal lobe overall (-0.07SD, 95% CI:-0.13,-0.01) as well as subregions including but not limited to those important for auditory processing (amygdala:-0.13SD, 95% CI:-0.21,-0.04; middle temporal gyrus:-0.08SD, 95% CI:-0.15,-0.00; superior temporal gyrus:-0.08SD, 95% CI:-0.15,-0.01). Further research is needed to understand the mechanisms underlying these observed associations.
The Ethical Dilemma of Safety Versus Self-Determination in Long-Term Care Community Residents During COVID-19
Authors: Davis Rebecca , Monturo Cheryl , O'Reilly Maria , Sturdevant Diana
Published: December 2021

The pandemic profoundly affected the care of older adults in long term care communities (LTCC) across the world. More than one third of pandemic deaths were linked to nursing homes. Most nations and states had strict guidelines on visitation, with many, especially in the United States, totally prohibiting visitation for over an entire year. Well-intentioned measures to protect through isolation caused a profound ethical tension between safety and self-determination. The aim of the project was to examine this dilemma using a case study and the Madison Collaborative Ethical Reasoning in Action Framework. Eight key questions of fairness, outcomes, rights, responsibilities, character, liberty, empathy, and authority were applied in the context of federal and state mandates in the US and Australia. Results highlighted issues of ageism, paternalism vs empathy, regulatory vs family authority, a focus on short-term outcomes while forfeiting long-term outcomes, community responsibilities to the resident trumped individual resident rights, the potential loss of community character in lieu of basic care provision, a loss of personal freedoms, and the emphasis of physical well-being over holistic well-being. The results of this analysis can inform future policy and provide lessons learned for the future.
Role of Physiological Resilience in Aging: Challenges and Opportunities
Authors: Huffman Derek
Published: December 2021

Lifespan and healthspan remain a cornerstone of documenting efficacy in aging research. However, it is becoming increasingly appreciated that housing rodents in conventional, unprovoked conditions, rather than exposed to the same variety of stressors normally encountered by free-living humans, has limited our understanding of how these strategies can be translated. Resilience can be defined as the ability of an organism to respond to a physical challenge or stress and return to homeostasis. Indeed, physiologic resilience is recognized to decline with age from a weakening of interactions among multiple physiologic regulatory functions. Here, we have attempted to optimize stress assays as a means of measuring physiologic resilience in mice. Our data demonstrate that these assays can readily detect age-related deficits in recovery, are amendable to geroprotector strategies, including rapamycin, while acute exposure to a stress can accelerate aging and mortality, thereby serving as a potentially useful paradigm for testing age-delaying interventions.
Validation of Self-Reported Cancer Diagnosis by Cognitive Status in the Health and Retirement Study
Authors: Mullins Megan , Kler Jasdeep , Eastman Marissa , Kabeto Mohammed , Wallner Lauren , Kobayashi Lindsay
Published: December 2021

Exploring the relationship between cognition and cancer is increasingly important as the number of older adults in the US grows. The Health and Retirement Study (HRS) has longitudinal data on cognitive status and self-reported cancer diagnoses, but these self-reports have not been validated. Using HRS linked to Medicare Fee for Service (FFS) claims (1998-2016), we evaluated the validity of self-reported cancer diagnoses (excluding non-melanoma skin) against Medicare claims by respondent cognitive status. We included 8,280 Medicare-eligible HRS participants aged ≥67 with at least 90% FFS coverage. Cognitive status was ascertained from the HRS interview following the date of cancer diagnosis (or reference claim date) using the Langa-Weir method and was classified as normal, cognitive impairment no dementia (CIND), or dementia. We calculated the sensitivity, specificity, and Cohen's kappa for first incident malignant cancer diagnosis by cognitive status group. The majority (76.4%) of participants scored as cognitively normal, 9.6% had CIND, 14.0% had dementia and, overall, 1,478 had an incident cancer diagnosis. Among participants with normal cognition, sensitivity of self-reported cancer diagnosis was 70.2% and specificity was 99.8% (kappa=0.79). Among participants with CIND, sensitivity was 56.7% and specificity was 99.8% (kappa=0.66). Among participants with dementia, sensitivity was 53.0% and specificity was 99.6% (kappa=0.64). Results indicate poor validity of self-reported cancer diagnoses for older adults with CIND or dementia. These findings suggest researchers interested in cancer and cognition should use the HRS-Medicare linkage to ascertain cancer diagnosis from claims, and they highlight the importance of cognitive status in research among older adults.