bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ROLE OF MULTIDOMAIN IDENTITY AND SOCIAL BACKGROUND FACTORS FOR AGING OUTCOMES
Authors: Drewelies Johanna , Duezel Sandra , Demuth Ilja , Steinhagen-Thiessen Elisabeth , Lindenberger Ulman , Goebel Jan , Stadler Gertraud , Gerstorf Denis
Published: December 2022

Domains of social privilege are predictive of a number of key aging outcomes, such as physical and cognitive functioning. However, less is known about the dynamic interplay of - related but distinct- domains of privilege and how they are associated with cognitive and physical functioning. In the following project, we aim to close this gap by examining the role of multidomain identity and social background factors for initial levels and subsequent changes in psychological, cognitive and physical functioning. Specifically, we identified predefined social privileges within the Berlin Aging Study II (BASE-II) sample (e.g., gender identity, gender conformity, sexuality, education, socioeconomic status, religion) and related these categories, interactively, to markers of physical health (multimorbidity), perceptual speed (digit symbol), and psychosocial functioning (loneliness). Results highlight the dynamic interplay (i.e., intersectionalism) of multidomain identity and social background factors with aging related outcomes across a number of key domains.
DIVERSITY, DISCOVERY, AND AGING REIMAGINED: A CHAT WITH NIA SENIOR LEADERSHIP
Authors: Kelley Amy , Kelley Amy
Published: December 2022

The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, is the federally designated lead agency on aging research and supports research to understand the nature of aging and to extend the healthy, active years of life. In the last six years, NIA has experienced a tripling of its budget. In keeping with NIA’s scientific mission, funding includes significant investments in Alzheimer’s disease (AD) and AD-related dementias research, as well as in non-AD research. This symposium will provide a forum for exploration of the implications of the NIA budget for the general research community. NIA’s senior staff will discuss research priorities and programs supported by the Institute. A question-and-answer session will follow these remarks on current funding and future priorities and research directions of NIA.
USING MULTIDIMENSIONAL SCALING IN COMBINATION WITH CLUSTER ANALYSIS TO STRUCTURE THE PELI-D QUESTIONNAIRE
Authors: Bergmann Johannes-Michael , Stacke Tobias , Purwins Daniel , Manietta Christina , Rommerskirch-Manietta Mike , Stroebel Armin , Roes Martina
Published: December 2022

Background

One way to contribute person-centered care is the use of a preference-based approach. In our project PELI-D the original PELI USA-version for Nursing Homes was (1) translated into German (2) and structured to explore construct validity of the instrument. Objective and Method: The PELI-D instrument (72-items) is used to illustrate how structuring procedures can be used for concept analysis. The approach allows to analyze the instrument from the perspective of the professional caregivers and to identify theoretical relations in further steps, which can be finally validated. For this purpose, the data of 58 professional nurses are analyzed.

Results

We computed a three-dimensional concept map of preferences enabled us in a second step to identify an appropriate cluster solution. The five-cluster solution, which explained 79 percent of the total variance, seemed to offer the best balance between statistical analysis and detailed categorisation through qualitative interpretation.
USING MULTICORRESPONDENCE ANALYSES AND CLUSTER ANALYSIS TO CONSTRUCT TYPES OF CARE ARRANGEMENTS
Authors: Dreyer Jan , Bergmann Johannes-Michael , Koehler Kerstin , Hochgraeber Iris , Pinkert Christiane , Roes Martina , Holle Bernhard
Published: December 2022

Most persons with dementia live at home and are cared for by family carers and professional carers. Together, they form care arrangements to address the needs of persons with dementia. The aim of this study is to (1) uncover the underlying structures of home-based care arrangements for persons living with dementia, (2) construct types of these care arrangements, and (3) compare these types with regard to their stability. In this secondary analysis, data from 320 care arrangements for persons with dementia are analysed using multiple correspondence analysis and hierarchical cluster analysis. The multiple correspondence analysis identified 27 axis that explained the entire variance between all care arrangements. The subsequent cluster analysis identified four types of care arrangements. Two types included spouse-centred care arrangements, and two types included child-centred care arrangements at different phases of the dementia and care trajectory. The types differ with regard to their stability.
EXPLORING STRATEGIES FOR IMPROVED COORDINATION AND INNOVATION IN TRANSPORTATION FOR OLDER PEOPLE
Authors: Silverstein Nina , Jansen Taylor , Bayne Alycia
Published: December 2022

Communities across the nation have outgrown their capacities to meet the transportation needs of older people. While a struggle in the past, for many communities it now is a crisis given an increase in older people with impairments in critical driving skills that lead to driving cessation and/or limitations that preclude them from successfully navigating public transit. It is time for new strategies and innovations to meet these growing challenges. Jansen will describe a pilot study of a regional transit authority’s use of customized software with four Councils on Aging to increase riders’ trips and destinations, improve efficiencies in reporting and dispatching, and increase shared rides across the communities. Gleason will present results of a qualitative study of paratransit managers across the U.S. and their attempts to innovate and adapt to evolving market expectations spurred on by the emergence of transportation network companies (TNC) like Uber and Lyft. Schwartz describes a mixed-methods study of Project TRIP, a rural transportation program designed to increase access to healthcare and other locations for low income and vulnerable populations in rural eastern North Carolina. Lynott introduces AARPs RideSheet, an open-source ride scheduling software application designed for small, demand-responsive transportation providers that incorporates a transactional data specification (TDS) enabling two or more providers to interoperate more efficiently, improving service for their clients. Bayne concludes as discussant bringing in her own work with the CDC on barriers and facilitators to ride sharing and reflecting on the themes presented. Transportation and Aging and Qualitative Research IGs collaboration.
GERONTOLOGICAL BIOSTATISTICS AS THE FOUNDATION OF INTERDISCIPLINARY DATA SCIENCE IN AGING
Authors: Travison Thomas
Published: December 2022

Explosive growth in computing power has increased by orders of magnitude the complexity of data structures and the number of analyses that may be performed per unit time. Contemporary gerontology utilizes diverse data ranging from continuous longitudinal assessments (e.g. motion capture) to complex single-timepoint assessments (e.g. bioimages) to systems-level administrative descriptions of the healthcare delivery environment. Paradoxically, this abundance of resources presents a considerable challenge, as the availability of information threatens to overwhelm mechanistic models of aging supportive of intervention development. To inform precision medicine, gerontological biostatistics therefore embraces the opportunity of collaborating with allied quantitative disciplines to bolster the coherence, reproducibility, and generalizability of findings. This presentation will demonstrate the salient advantages of such interdisciplinary collaborations using the example of design and analysis of an intensely longitudinal study of wearable and environmental sensors, conducted with teams in exercise science and architectural design.
CHRONIC PHYSICAL HEALTH CONDITIONS, DEPRESSIVE SYMPTOMS, AND SELF-RATED HEALTH IN GRANDMOTHERS
Authors: Henrich Christina , Musil Carol , Zausniewski Jaclene , Burant Christopher , Tracy Elizabeth , Jeanblanc Alexandra
Published: December 2022

Grandmothers often participate in caregiving to grandchildren, ranging from informal caregiving to having responsibility for raising grandchildren, but health problems may affect their ability to do so. To better understand potential health problems in grandmother caregivers, this secondary analysis examined 1) longitudinal relationships between chronic physical health conditions, depressive symptoms, and self-rated health with race, age, & marital status, and 2) causal ordering of depressive symptoms and self-rated health, controlling for baseline race, age, marital status, and chronic conditions of 328 Ohio grandmothers across 3 time points over 2 years. The study was guided using Lenz’s Theory of Unpleasant Symptoms. Measures included chronic physical health conditions (modified Charlson), depressive symptoms (CES-D), self-rated health (SF-36), and demographic variables of race (white/nonwhite), age, and marital status (married-partnered/not married). Analyses included correlations and structural equation modeling. Pearson product moment correlations indicated significant relationships (ranging from 0.26 to 0.56) between chronic conditions, depressive symptoms and self-rated health at all three time points. Next, a bivariate autoregressive model was tested using structural equation modeling. The data fit the model well. The goodness of fit results included: Chi square=55.39, TLI=0.94, CFI=0.97, and RMSEA=0.07. Results indicated consistency of depressive symptoms and self-rated health over time, and these were affected by chronic conditions; the causal order indicated that self-rated health impacts depressive symptoms. This study contributes new knowledge about the relationships and causal sequence of self-rated health and depressive symptoms. Implications on practice and research are discussed.
JOINT TRAJECTORIES OF SOCIAL ISOLATION AND LONELINESS AND THEIR EFFECTS ON ACCELERATED BIOLOGICAL AGING
Authors: Qi Xiang , Belsky Daniel , Yang Yang , Ng Ted , Wu Bei
Published: December 2022

Social isolation and loneliness (SI/L) are associated with a variety of physical and mental health conditions. Biological aging is a proposed mechanism through which psychosocial factors drive health disparities. However, it is not known how SI/L separately and jointly affect biological aging. Using longitudinal data (N=1,965 adults, aged 50+) in Health and Retirement Study (2006 to 2016), we tested the joint trajectories of SI/L and their differential effects on biological aging as quantified by five DNA Methylation clocks (Horvath, Hannum, PhenoAge, GrimAge, and DunedinPoAm). A group-based mixture modeling approach was used to fit the joint trajectories of SI/L. Biological aging was measured using residuals from regressing each clock on chronological age. Linear regressions were used to test associations of joint trajectories of SI/L with biological aging. Four SI/L trajectories were identified, including Rarely isolated and rarely lonely (47.8%), Moderately isolated and rarely lonely (15.5%), Rarely isolated and severely lonely (20.2%), and Persistently isolated and lonely (16.5%). Of all joint trajectory groups, the Rarely isolated and rarely lonely group had the youngest biological age as estimated by the Hannum, PhenoAge, and GrimAge clocks. Compared with the Rarely isolated and severely lonely group, the Moderately isolated and rarely lonely group had higher age acceleration for PhenoAge (β=0.10; 95% CI=0.01, 0.19), and GrimAge (β=0.20; 95% CI=0.06,0.33), and DunedinPoAm (β=0.21; 95% CI=0.09,0.33). Different trajectories of SI/L convey differential risks to biological aging. Future research is needed to investigate the differences and similarities of SI/L trajectories and identify intervention targets for ameliorating aging.
HEALTHY AGING: POLICIES AND RESOURCES TO SUPPORT AN AGE-FRIENDLY ECOSYSTEM
Authors: D’Antonio Patricia , Lindberg Brian
Published: December 2022

Our public health system is advancing activities to prioritize the health and well-being of older adults and recognizes the importance of policies to support us all as we age. Faculty will discuss national efforts underway to inform and support an age-friendly ecosystem.
BUILDING OUR LARGEST DEMENTIA INFRASTRUCTURE FOR ALZHEIMER'S ACT: POLICIES ADVANCING HEALTHY AGING
Authors: McGuire Lisa
Published: December 2022

While public health experts cannot yet say how to prevent Alzheimer’s disease and related dementias (ADRD), emerging science indicates that ADRD may be slowed through risk reduction strategies, early diagnosis, and better education and training of front-line health care professionals. Recognizing these scientific advances, the National Plan to Address Alzheimer’s Disease: 2021 Update added a new goal, Goal 6, to the 10-year-old plan emphasizing risk reduction and healthy aging: Accelerate Action to Promote Healthy Aging and Reduce Risk Factors for Alzheimer’s Disease and Related Dementias. CDC is authorized through Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act (P.L. 115-406) to create a uniform national public health infrastructure through BOLD Program and Public Health Centers of Excellence. This presentation will highlight CDC activities that not only build a uniform national public health infrastructure but also promote healthy aging consistent with Goal 6 of the 2021 National Plan.
ELEVATING HEALTHY AGING: HOW PUBLIC HEALTH IS SUPPORTING OLDER ADULTS
Authors: Phillips Karon , Wolfe Megan
Published: December 2022

Trust for America’s Health (TFAH) leads the national Age-Friendly Public Health Systems initiative which focuses on expanding the public health role in healthy aging. The roles of public health include creating and leading policy, systems, and environmental changes; connecting and convening multi-sector stakeholders to improve older adult health and well-being; and collecting and translating data on older adult health to inform interventions in communities and states. TFAH will share examples of how public health departments are elevating healthy aging as a core function.
ASSOCIATIONS BETWEEN SOCIAL ISOLATION AND HOSPITAL STAYS, NURSING HOME ENTRY, AND MORTALITY OVER TIME
Authors: Pomeroy Mary Louise , Gimm Gilbert , Cuellar Alison , Ihara Emily , Cudjoe Thomas
Published: December 2022

This study examined social isolation as a risk factor for hospitalization, nursing home stays, and mortality among a longitudinal sample of 12,860 community-dwelling older adults ages 65+ between 2006-2018. Using seven waves of Health and Retirement Study (HRS) data, we examined associations between social isolation and hospitalization, nursing home stays, and mortality. Social isolation scores ranged from 0-6 using an established typology with six objective measures of social interactions: 1) marital status; 2) living arrangement; 3) monthly communication with children; 4) family; 5) and friends; and, 6) monthly participation in groups, clubs, organizations, or religious services. Covariates included fixed demographics and time-variant characteristics including loneliness, depression, Medicaid enrollment, lifestyle behaviors, activities of daily living, number of chronic conditions, and Alzheimer’s disease or related dementias. Logistic regression analyses were conducted with panel data and random effects to examine associations between social isolation and each outcome over time. About 15% of the sample was socially isolated, with an average isolation score of 1.29. Social isolation significantly increased the odds of having a nursing home stay (OR = 1.22, p < 0.001) and mortality (OR = 1.14, p < 0.001). However, it was not significantly associated with overnight hospitalizations (OR = 0.97, p = 0.09). Social isolation may put older adults at greater risk for nursing home stays and mortality over time, as compared to social integration. Policies and practices to reduce social isolation can support aging at home or the community, delay nursing home entry, and reduce the risk of mortality.
LEVELING THE PLAYING FIELD: ONBOARDING AGING FELLOWS REPRESENTING DIVERSE DISCIPLINES
Authors: Kim Catherine , Latimer Nia , Bowers Katherine , Anderson Loretta , Martin Diane
Published: December 2022

The transdisciplinary Innovations in Aging Graduate Fellowship program brought together graduate students from medicine, nursing, pharmacy, and social work. As a result, fellows entered the program with a range of exposure as to how aging impacts the body, social interactions, health needs, and society. Therefore, onboarding modules were utilized to provide an integrated perspective on aging. Topics for these onboarding modules included ageism, dimensions of wellness, and health and well-being in later life. Through these modules, fellows were able to customize their learning to meet their unique educational needs and goals related to their involvement in the fellowship program. In this session, we will share development of the fellowship program and highlight factors, such as the onboarding modules, that led to the program’s success.
INSIGHTS INTO HEALTH-RELEVANT INTERPERSONAL DYNAMICS IN AGING COUPLES FROM THE LAB AND DAILY LIFE
Authors: Pauly Theresa , Kolodziejczak Karolina , Röcke Christina
Published: December 2022

Emerging research demonstrates that long-term and daily health indicators are closely linked in aging partners. Yet, not much is known about exactly how partners get under each other’s skin. This symposium investigates different positive and negative interpersonal contexts, including physical intimacy, positive and negative emotional experiences, and couple conversations (e.g., conflict, recounting distressing memories, discussing enjoyable topics), and their link with neuroendocrine and cardiovascular markers. The four talks feature a variety of study designs ranging from laboratory research to ambulatory assessment methods which recruited couples in midlife and old age. Kolodziejczak et al. use ambulatory assessment data to examine links between (experienced and wished for) physical intimacy, affect, and cortisol in older couples. Pauly et al. pool data from three ambulatory assessment aging studies to analyze how own and partner positive and negative affective states are intertwined with everyday cortisol secretion in old age. Wilson et al. invited middle-aged to older couples to engage in two different conversations (recounting a difficult memory, conflict) and investigated concurrent changes in affect and cardiovascular activity. Meier and colleagues make use of automated language analysis to examine how positive and negative emotion word use during a positive and negative conversation in the laboratory relates to cardiovascular reactivity in middle-aged couples. The discussion by Christina Röcke will delineate insights gained from these four papers, discuss their strengths and limitations, and outline directions for future inquiry.
REASONS OLDER ADULTS START ATTENDING CONGREGATE MEAL PROGRAMS AND WHO ATTENDS FOR SOCIALIZATION
Authors: Robinson Kristen , Palmer Lauren , Gasdaska Angela , Hayes Michael , Nderitu Sara
Published: December 2022

The Older Americans Act Nutrition Services Program’s congregate meals support food security and nutrition, promote socialization, and improve quality of life. Understanding what drives people to first attend a congregate meal program may support efforts to increase involvement. This study used the 2019 National Survey of Older Americans Act Participants to analyze the open-ended survey responses of congregate meal participants (N=1,072) on why they started attending the program. The top three reasons were that they sought socialization (36.3%), had a medical or age-related need (18.7%), or accompanied or were referred by a friend or relative (12.3%). We conducted descriptive analyses on differences in the demographic, socioeconomic, and health characteristics of those attending for socialization compared to others. Results indicated a relationship between attending congregate meals for socialization and several characteristics: these individuals are more often non-Hispanic white (p< 0.05), widowed (p< 0.05), aged 75 to 84 (p< 0.05), and have at least a high school education (p< 0.01). People who attend for socialization are also less likely to be lower income (p< 0.01), living in cities (p< 0.001), have food insecurity (p< 0.01), and living with three or more ADLs (p< 0.01). Findings suggest two subpopulations of congregate meal attendees: those who have the choice to attend and do so for socialization, and those who attend because of unmet needs (e.g., food insecurity or disability). Identification of different categories of participants and what drives them to attend congregate meal sites has implications for improvements to advertising congregate meal services, targeting of certain populations, and ultimately to increasing participation.
SIMULATING WELL-BEING AND LITERACY INTERVENTIONS TO REDUCE ELDER SCAM SUSCEPTIBILITY
Authors: DeLiema Marguerite , Sur Aparajita
Published: December 2022

Finanical fraud targeting older adults is on the rise, with annual losses in the billions of dollars. There is little longitudinal research on the causal relationships between known risk factors and scam susceptibility, including poor psychological well-being and poor health and financial literacy. Interventions designed to enhance well-being and/or literacy may reduce scam susceptibly among older adults. In this study, we use repeated measures from the Rush Memory and Aging Project to simulate how different trajectories in well-being and literacy might impact scam susceptibility among older adults alive over a seven year period. We simulated the effects of interventions of varying degrees -- 10%, 50%, and 100% increase in well-being/literacy from baseline scores. Simulations were performed for all participants as well as by education and income subgroups. Simulation models show that intervening on well-being causes a greater reduction in average scam susceptibility over time compared to intervening on total literacy. Even a 10% increase in baseline well-being significantly reduces scam susceptibility over time, regardless of participants’ baseline income or educational attainment. Both interventions caused slightly greater reductions in susceptibility for those who are not college educated and those with an annual household income of less than $30,000. This study suggests that interventions that target self-efficacy and sense of purpose may help reduce older adults’ scam susceptibility even more than interventions that improve health and financial literacy, but that both are promising targets for intervention.
PRESIDENTIAL SYMPOSIUM: REIMAGINING AGING AND LONG-TERM CARE FOR HEALTH EQUITY DURING AND POST-COVID-19: A HEALTH SCIENCES FOCUS
Authors: Corazzini Kirsten , Bakerjian Deb
Published: December 2022

In line with the theme of the conference, this symposium highlights exemplars of health sciences scholars who are identifying key issues and opportunities to re-imagine aging and long-term care, through a health equity lens, as highlighted by COVID-19. This lens is inclusive of the wide range of long-term care stakeholders whose well-being and health outcomes have been affected throughout the COVID-19 pandemic, including older adults, family caregivers, and the healthcare workforce. We focus in particular on vulnerable aging populations, such as older adults who are living with neurocognitive disorders, racial/ethnic minority older adults, and older adults receiving palliative care. Finally, we consider these issues at both individual and systems-levels. Our first presenter examines person and family engagement in assisted living for older adults living with ADRD and the impact of COVID-19. The second presenter provides insights into palliative care needs in nursing homes, and the implications for transition to an endemic. The third presenter examines long-term care needs in the community, with a focus on the consequences of unmet needs for racial/ethnic minority older adults. The fourth presenter highlights the role and capacity of the nurse practitioner in nursing homes during COVID. Our final presenters provide a systems-level look at the COVID-19 response, focusing on self-organizing community coalitions to support nursing homes. Presentations reveal how re-imagining aging and long-term care in health sciences, requires consideration of health inequities experienced throughout COVID-19, whether newly emerging inequities, or long-standing challenges and inequities that have been exacerbated by COVID-19.
THE LONG-TERM CARE STAFFING CRISIS AND COVID-19: ROLE OF THE NURSE PRACTITIONER
Authors: McGilton Katherine
Published: December 2022

The residential long-term care sector has historically suffered from seemingly intractable staffing challenges in terms of ensuring adequate clinical expertise and a supportive work environment to address the complex health care needs of residents. Considerable evidence has demonstrated the devastating effect of COVID-19 on this fragile residential long-term care staffing structure, resulting in adverse outcomes among staff and residents alike, with the potential for permanent devastation without directed intervention. Drawing upon data from an Ontario-based study of nurse practitioner deployment during COVID-19, this talk will share an emergent approach to re-shaping expertise and capacity in Ontario, Canada through embedding nurse practitioners in residential long-term care homes. Results of this work helped to inform health policy action in the province to scale-up the use of nurse practitioners in long-term care homes, in order to enhance staff expertise and tackle the significant inequities of access to care among nursing home residents.
WHEN YOU GET TO A FORK IN THE ROAD, TAKE IT: SHOULD STATES FOLLOW YOGI'S ADVICE ON MANAGED LONG-TERM SERVICES?
Authors: Applebaum Robert
Published: December 2022

Today’s Medicaid challenges, coupled with the baby boom demographics, have every state in the nation recognizing the need to do something different in their Medicaid programs. Although achieving a better balance between institutional and home and community-based services has been an important reform in many states, it does not appear to be enough to create a working system. Medicaid managed long-term care and efforts to integrate Medicare and Medicaid is a growing option. Designed to control the acute and long-term care costs of older people and individuals with disability, the approach also is directed at linking the two disparate systems. A review of the array of studies examining this area shows mixed results, despite the popularity of this option at the state level. This paper introduces the evaluation of Ohio’s MyCare integrated care demonstration, raising questions about the important elements of these initiatives for policy makers, providers, and consumers.
EVALUATING EXPENDITURES AND UTILIZATION OF OHIO'S INTEGRATED MEDICARE AND MEDICAID PROGRAM
Authors: Bowblis John , Applebaum Robert , Nelson Matt
Published: December 2022

In 2014, 29 of 88 Ohio counties implemented MyCare, which integrated Medicare and Medicaid for dually eligible Ohioans. Using an intent-to-treat, difference-in-difference framework we examined medical expenditures and utilization associated with the implementation of MyCare. Specifically, we compared dually eligible Ohioans in MyCare counties to those in non-MyCare counties from 2012 to 2018. Overall medical expenditures were lower in the MyCare counties post implementation compared to non-Mycare counties, with most of the difference attributed to Medicaid. The effects were larger for individuals in the community compared to long-term services and supports (LTSS) users. The implementation of MyCare is associated with a decrease in the use of nursing homes, a large increase in hospice, and among LTSS users not in a nursing home decreases in the utilization of home and community-based services. Interestingly, the proportion of individuals in MyCare counties classified as an LTSS user increased after the implementation of MyCare.
PROGRAM THEORY VERSUS IMPLEMENTATION: THE IMPORTANCE OF PROCESS IN UNDERSTANDING PROGRAM IMPACT
Authors: Heston-Mullins Jennifer , Koumoutzis Athena , Abbott Katherine , Bennett Dayna , Williams Karen
Published: December 2022

An extensive MyCare Ohio process evaluation was conducted to understand factors affecting everyday implementation. This involved a review of MyCare membership enrollment data and qualitative interviews and focus groups with state-level stakeholders (n=29), regional stakeholders comprised of Area Agency on Aging and MyCare Ohio Plan personnel and HCBS service providers (n=418), and MyCare members (n=40); which were audio-recorded, transcribed, and checked for accuracy prior to coding in Dedoose. Results show that while MyCare was originally envisioned as a program to coordinate Medicare and Medicaid services for dual-eligible, physically-disabled older adults, many MyCare members are under age 65 (47%), have opted out of the Medicare Advantage portion of MyCare (42%), and live with behavioral health diagnoses. This presentation will discuss how process evaluation is instrumental to understanding program impact and how younger members, members with behavioral health concerns, and opted-out members have shaped the implementation of MyCare Ohio.
THE BLACK BOX OF CARE MANAGEMENT IN MANAGED LONG-TERM SERVICES AND SUPPORTS
Authors: Abbott Katherine , Heston-Mullins Jennifer , Koumoutzis Athena , Bennett Dayna , Williams Karen , Applebaum Robert
Published: December 2022

Within Ohio’s MyCare demonstration, two distinct care management models were selected by the participating MyCare Ohio health plans (MCOPs): fully-delegated waiver care management and waiver service coordination. The purpose of this presentation is to describe the components of care management operating in MyCare Ohio. Qualitative interviews with n=91 Area Agency on Aging (AAA) and n=131 MCOP care management personnel were audio-recorded, transcribed, and checked for accuracy prior to thematic coding in Dedoose. Results indicate that comprehensive care management is the core element of MyCare Ohio. Fully-delegated care management models were viewed by participants as beneficial to reducing confusion for members however ‘scope creep’ challenged the already strained AAAs. Effective teamwork was identified for waiver service coordination models but the division of labor and communication needed between the AAA and MCOP care management personnel created tensions. The discussion will focus on practice recommendations for training, caseloads, and support staff.
REVISITING THE ROLE OF PERCEIVED TIME HORIZONS IN SOCIOEMOTIONAL SELECTIVITY THEORY
Authors: Chu Li , Carstensen Laura
Published: December 2022

This symposium will consider the ways that time horizons may influence motivation and emotional well-being. Socioemotional selectivity theory postulates that goals and motivation shift from ones about learning and exploration to ones about emotional meaning as time horizons grow constrained as people age. This theory maintains that a focus on emotional goals explains why older adults tend to show better emotional well-being compared to younger adults. Many studies use the Future Time Perspective scale developed by Carstensen and Lang (1996) to measure perceived time left in life. However, several studies find more limited future time perspective does not contribute to better emotional well-being nor more positivity bias in cognitive processing and in some cases predicts poorer emotional well-being. The first presentation will focus on the future time perspective scale and its underlying structure. The second presentation will discuss the association between future time perspective and psychosocial well-being during the COVID-19 pandemic. The third presentation will review different measures of time perception and examine the relationship between future time perspective on age-related positivity effect. The last presentation will introduce a new concept and measurement, time savoring. Laura Carstensen will synthesize findings and offer insights regarding future life-span research on motivation and well-being.
THE DIMENSIONALITY OF FUTURE TIME PERSPECTIVE
Authors: Grühn Daniel , Knight Rebekah
Published: December 2022

There have been suggestions that the measure of future time perspective shows a two-factor structure. However, the two-factor structure coincides with positively- and negatively-framed items potentially indicating a method factor rather than a content factor. By using reversed-scored items in an adult sample (N = 1421, aged 19 to 79, M = 39.1, SD = 11.1), we found evidence that the two-factor structure is mainly due to the framing of the items representing method factors rather than representing separate content factors. Item framing might be more important in aging-related research than expected.
TIME HORIZONS VERSUS TIME SAVORING: WHICH BEST PREDICTS AGE-RELATED IMPROVEMENTS IN EMOTIONAL WELL-BEING?
Authors: Matteson Tyler , Chu Li , Carstensen Laura
Published: December 2022

Previous research has shown that time horizons, as measured by the future time perspective (FTP) scale, yields mixed findings about the relationship between perceived time and emotional well-being. Expansive time horizons often predict better well-being than limited time horizons, raising questions about a core postulate of socioemotional selectivity theory (SST). The present study introduces a more nuanced construct about perceived time and introduces a new scale, time savoring, which captures the heightened value of time as time becomes more limited. Based on 1,384 participants (Mage = 54.55, age range = 18-96), time savoring and age are positively correlated (r(1,382) = .23, p < .001). Time savoring partially mediates age and well-being (i.e., greater happiness, lower depressive symptoms, and higher life satisfaction). Parallel mediation with multiple mediators demonstrated the measure’s discriminant validity from FTP and personality measures (e.g., agreeableness and conscientiousness), offering a promising way to measure heightened value of time.
REGULATORY PROFILES AND POTENTIALLY BURDENSOME TRANSITIONS AMONG ASSISTED LIVING DECEDENTS
Authors: Wang Xiao (Joyce) , Smith Lindsey , Teno Joan , Rosendaal Nicole , Dosa David , Gozalo Pedro , Thomas Kali , Belanger Emma
Published: December 2022

Potentially burdensome transitions at the end of life (i.e. repeated hospitalizations or transitions in the last 3 days of life) are common among assisted living (AL) residents, and are associated with lower care satisfaction by family members. AL regulations vary widely within and between states. This study aimed to describe the rate of burdensome transitions by AL regulatory profile, using a retrospective cohort study combining state AL regulations and multiple administrative claims data. The sample included 4,911 ALs serving 67,319 residents, who 1) died between 2017 and 2019; 2) resided in AL 120 days before death; 3) were continuously enrolled as fee-for-service one-year before death; and 4) resided in ALs with 25+ beds. The independent variable was a categorical variable indicating AL regulatory profile (i.e. housing, hybrid, hospitality, healthcare, rebalancing, hybrid healthcare), identified with a previously published methodology. These profiles differ in the allowance of third-party services, skilled nursing, medication administration, and requirements for medication review and licensed nursing staff. We first ran regression models to estimate the rate of burdensome transitions, accounting for AL-level resident demographic, socioeconomic, case-mix, and market characteristics. Results showed ‘hybrid’ ALs (i.e. low prevalence of skilled nursing allowed) had the highest rate of burdensome transitions (24.9%), whereas ‘healthcare’ ALs (i.e. high specificity for all types of services) had the lowest rate (22.2%). The rate of potentially burdensome transitions did not differ much by AL regulatory types, requiring more work to determine the drivers for burdensome transitions beyond AL regulations.
THE EXPERIENCES OF PEOPLE WITH COGNITIVE IMPAIRMENT DURING THE COVID-19 PANDEMIC IN ENGLAND
Authors: Beach Brian , Zaninotto Paola
Published: December 2022

The COVID-19 pandemic presented challenges that may have impacted people with cognitive impairment in disproportionate ways. Using the ELSA COVID-19 sub-study collected in 2020, we examined the experiences of people across three cognitive function groups (no impairment, mild impairment, and dementia) with respect to a range of social and health outcomes, including: shielding and self-isolation; access to health and care services; changes in lifestyle behaviours during the pandemic, and the impacts on mental health, wellbeing, and other psychosocial measures. Differences among cognitive function groups varied according to both outcomes and time. For example, people with dementia were around 2.4 times more likely to be shielding in June/July than those with no impairment, but no difference was found for November/December. On many measures, people with dementia fared similarly to those with no impairment once controlling for other factors.
ASSOCIATION OF HEALTH BEHAVIORS WITH WEIGHT AND OBESITY DURING THE COVID-19 PANDEMIC AMONG THE UK OLDER POPULATION
Authors: Zhu Jingmin , Gessa Giorgio Di , Zaninotto Paola
Published: December 2022

Using a sample of 4,182 UK adults aged 50 and above, this study explored the association of changes in health behaviours with weight and obesity during UK lockdown in Jun/Jul and Nov/Dec 2020. Over 30% adults reported more sitting, more TV watching or less exercise. Around 20% adults were engaged in eating more or sleeping less. More alcohol drinking happened in 12.3% adults. Results suggested that more sedentariness, more TV watching, less exercise, more eating and more alcohol drinking were associated with a significant increase in weight. Meanwhile, less sedentariness or less eating significantly reduced weight in Nov/Dec 2020. A higher risk of obesity was found in adults sitting, eating, or sleeping more than usual. Considering potential health risks associated with obesity in older population, weight management is necessary nationwide.
USE OF RWD TO GENERATE RWE IN THE ALZHEIMER'S DISEASE SETTING: CHALLENGES AND FUTURE DIRECTIONS
Authors: DiBello Julia
Published: December 2022

There is considerable interest by many stakeholder groups in developing new therapies in Alzheimer’s disease (AD). Increasing interest in the treatment of pre-clinical disease and measurement of associated long term outcomes using RWD is being explored as the use of RCTs in this context can be limited. Many challenges exist in generating RWE to support regulatory submissions in this disease population including lack of important clinical variables such as disease severity and progression in existing data sources. We will discuss the AD RWD landscape with a focus on challenges and future directions for the use of RWD to generate RWE supportive of regulatory submissions for pharmaceutical products.
SENESCENCE AND INFLAMMATION
Authors: Schafer Marissa
Published: December 2022

Cell senescence and inflammation are interconnected mediators of aging and age-related disease. Recent advances in molecular and cellular profiling methods and research models are aiding in our ability to decipher mechanisms through which senescent cells drive inflammatory dysfunction, and inversely, to discover mechanisms through which aging immune cells may drive senescence, inflammation, and pathology. This symposium will feature exciting advances that span the emerging conceptual framework of how senescence and inflammation influence mammalian aging. Dr. Birgit Schilling will discuss the use of advanced mass spectrometric methods for profiling the senescent cell proteome, which reveal new insights into protein pathways and mechanisms of aging and disease. Dr. Matt Yousefzadeh will share how endogenous DNA damage can invoke cellular senescence, which enhances inflammation in both a cell autonomous and non-autonomous manner to drive tissue dysfunction and impact health. Dr. Daniel Tyrrell will discuss discovery of a novel population of age-associated CD8 T-cells that enhance local tissue senescence and inflammation and promote atherosclerosis. Dr. Xu Zhang will share a characterization of senescent cells in skeletal muscle using single-cell RNA-sequencing and the potential recruitment of immune cells by senescent fibroadipogenic progenitors. Dr. Marissa Schafer will discuss cell senescence as a mediator of age-related brain inflammatory cell composition and senescent cell targeting as a strategy to prevent cognitive decline. Importantly, discoveries discussed in this symposium may reveal new avenues for therapeutic development, to ultimately improve human healthspan.
CUEING EFFECT ON DUAL TASK COORDINATION AMONG YOUNGER AND OLDER ADULTS
Authors: Hu Yue , Fung Helene
Published: December 2022

Dual task coordination, which refers to the ability to coordinate the cognitive processes involved in performing two tasks with a temporal overlap, is evident in many if not all situations in the daily life of the older adults. The dual-task performance of older adults has been shown to be associated with driving performance, risk of falls, risk of car accidents and the absence of mild cognitive impairment. However, some researchers found that healthy older adults had worse dual-task performance than their younger counterparts, whereas other researchers found no age difference in dual-task performance. To address the mixed findings, the present work examined the effect of cue words on dual task coordination based on the selection, optimization, and compensation model. A total of 65 younger adults (24 females, mean age 21.80±1.99) and 91 older adults (36 females, mean age 65.38±5.61) were recruited via the platform Prolific. All participants judged the orientation of two arrows displayed with a shorter or longer temporal overlap. Before the onset of the first arrow, “difficult”, “easy” or a blank screen occurred on the computer screen. A significant cue effect was detected among younger adults regardless of the cue word. Yet, older adults had better dual-task performance under the condition of “difficult” cue word as compared with the other conditions. The findings highlight the potentially crucial role of higher expected task difficulty in preparing older adults to compensate for their age-related decline in dual-task coordination.
STATE AND TRAIT INFLUENCES OF REPETITIVE NEGATIVE THINKING ON WORKING MEMORY PERFORMANCE
Authors: Harrington Karra , Slayday Riki , Scott Stacey , Sliwinski Martin
Published: December 2022

Repetitive negative thinking (RNT) has been associated with faster cognitive decline and accumulation of Alzheimer’s disease pathology in otherwise healthy older adults. According to the cognitive debt hypothesis, RNT functions as a psychological mechanism that depletes cognitive resources and increases vulnerability for dementia. The aim of this project was to examine trait and state RNT influences on working memory performance in daily life. Data for this project were drawn from the ESCAPE study, a systematic probability sample recruited from residents of the Bronx, NY. Participants (n = 265, aged 25-65, 64.9% female) completed brief ecological momentary assessments on a smartphone five times per day for 14 days, including ratings of current thought valence (pleasant-unpleasant) and a brief working memory task. Multi-level models were used to disaggregate trait (between-person) and state (within-person) effects of thought valence on working memory performance, while controlling for demographic and contextual covariates. The models also included linear and quadratic functions of time and session number to account for time of day and retest effects on working memory performance across the assessment period. At moments when individuals were experiencing more unpleasant thoughts than usual (state RNT), they made significantly more errors on the working memory assessment (β= 0.013, SE = 0.004, p = .002). However, there was no significant relationship between trait RNT and working memory performance. The results of this study provide support for the potential for RNT to deplete cognitive resources in the moment, thus contributing to poorer cognitive performance.
SHIFT IN ACTIVITY PATTERNS AMONG OLDER ADULTS BEFORE AND AFTER THE COVID-19 PANDEMIC: A SEQUENCE ANALYSIS
Authors: Huang Wenxuan , Yu Jiao
Published: December 2022

Background

Previous research has discovered significant heterogeneity in older adults’ activity patterns, as well as its associations with well-being. Studying activity pattern during the COVID-19 pandemic sheds new light on infection risks and coping strategies stratified by socioeconomic status. This study answers two research questions: (1) what are the typical activity patterns among older adults in the U.S.? and (2) how do different sociodemographic groups react to the COVID-19 pandemic by alternating activity pattern? Data: This study used data from the American Time Use Survey (2019 and 2020) to create an analytic sample of 5,068 older adults aged 65 and older. Method: First, we classified daily activity sequences into five typical activity patterns using cluster analysis. Second, we conducted multinomial logistic regression by including survey year and key covariates interactions to examine shifts between sociodemographic characteristics and activity pattern. Findings: We identified five distinct activity patterns including versatile (involves diverse types of activities), housework (daytime occupied by housework activities), work-centered (daytime dominated by paid work), leisure-intensive (long time spent in social and leisure activities), and inactive (intensive TV watching). Our findings show that SES does not affect predicted membership of the versatile group in pre-pandemic time, while an educational gradient becomes salient in 2020. Highly educated older adults are more likely to maintain the diversity of daily activities. Furthermore, the racial difference is more pronounced in the inactive group during the COVID-19 pandemic.

Conclusion

Our findings suggest a buffering effect of social advantages on the impact of public health crisis.
DETERMINANTS AND CONSEQUENCES OF LEISURE ACTIVITY ENGAGEMENT AND CONSTRAINTS IN OLDER ADULT POPULATIONS
Authors: Sardina Angie , Gamaldo Alyssa , Gamaldo Alyssa
Published: December 2022

Older adults engage in approximately 7.1 hours/day in leisure activities; however, much of the leisure activity engagement comprises of passive activity engagement (e.g., watching TV). An increasing amount of literature suggests that regular engagement in cognitively and physically stimulating activities, rather than strictly passive activity engagement, is associated with better physical and mental health as well as maintenance of social networks. As the aging population continues to increase and levels and types of activity engagement are shifting across our more diverse older adult populations, it is imperative to understand levels and types of activities older adults are participating in, as well as the psychosocial and contextual factors related to leisure activity engagement. This symposium will include presentations from studies that explore the following: (1) leisure activity interests, engagement, and constraints; and (2) determinants and/or consequences of leisure activity engagement. Specifically, Sardina and colleagues examined daily variability between affect and leisure engagement, and explored potential sociodemographic moderators for these associations. Tian and colleagues explored the association between leisure activities and modes of transportation. Tian and colleagues explored leisure activity engagement with prospective daily diary methods, and examined associations between leisure activities and physical health. Janke and colleagues explored associations between facilitators, constraints, and constraint negotiation and self-reported physical activity levels for older adults with arthritis.