bluuebunny/crossref_metadata_2025 huggingface dataset:
A DIVERSE LIFE IS A BETTER LIFE? THE ASSOCIATION BETWEEN ACTIVITY DIVERSITY AND PSYCHOLOGICAL WELL-BEING IN HONG KONG
Authors: Lin Zhixuan , Fung Helene
Published: December 2023

The debate between the devotedness and evenness of activity participation has long existed. On the one hand, the theory of selective optimization with compensation (Baltes & Baltes, 1990) argues that successful aging depends on concentrating one’s participation on fewer domains of activities. On the other hand, the social integration perspective (Rosow, 1967) posits that diversity indicates extensive knowledge and a sense of purpose, which contributes to well-being. A previous study found a positive relationship between activity diversity and older adults’ psychological well-being in a U.S. sample (Lee et al., 2018). However, it might not be the case for people living in extremely hot weather as diverse activities might increase the risk of exposure to the heat. The current study examines their relationship in the hot summer months in Hong Kong, a tropical Asian city. Community-dwelling participants aged 60 years or above (N = 344, Mage = 67.15, SDage = 5.26) completed surveys 3 times each day over 10 days, reporting their activities, positive and negative affect, meaning and engagement of each activity, and loneliness. The regional heat-risk index was acquired from Hua et al. (2021). Results showed that activity diversity negatively correlated with positive affect, meaningfulness and engagement of daily activities, and positively correlated with loneliness. Heat risk did not moderate the relationship, but it correlated with less positive and more negative affect. Our findings suggest that Hong Kong older adults benefit from focused rather than broad participation in activities.
LEVERAGING NEIGHBORHOOD EXPOSURES AS MODIFIERS OF INDIVIDUAL RISK FACTORS FOR COGNITIVE DECLINE AND DEMENTIAS
Authors: Carlson Michelle , Rosso Andrea , Lovasi Gina
Published: December 2023

There are numerous ways in which neighborhood environmental factors have been shown to contribute to adverse health. More remains to be done to link long-term neighborhood exposures, such as social and physical activities, to modifiable individual risk factors for cognitive decline and dementia. Individual interventions are usually small in scale and conducted in those with higher socioeconomic status (SES). Additionally, increases in healthy behaviors, such as walking, have been difficult to promote and sustain. Each of these risk factors is known to be influenced by environmental features. This symposium will explore the roles of neighborhood-level social (nSES, affluence, cohesion, discrimination) and physical (air pollution) factors as drivers of cognitive aging and dementia across multiple longitudinal studies of community-based aging. Studies span urban and rural communities, including the Health ABC Study, the Cardiovascular Health Study, and the Think Phresh study. These studies are important to evaluating the role of neighborhood features on cognitive aging by expanding beyond cross-sectional data and by studying residentially stable older adults most likely to be affected by their local context. Those neighborhood factors that impact individual activity, cognitive aging, and Alzheimer’s disease risk will be further discussed for differences by race/ethnicity.
NEIGHBORHOOD SOCIOECONOMIC STATUS AND CHANGES IN COGNITIVE FUNCTION IN OLDER ADULTS: FINDINGS FROM HEALTH ABC STUDY
Authors: Cheng Greta Jianjia , Godina Sara , Fan Erica , Rosso Andrea
Published: December 2023

Neighborhood socioeconomic status (NSES), an overall marker of neighborhood condition, may influence multiple aspects of health and well-being in older adulthood, including cognitive function, though results regarding neighborhood and cognition have been largely cross-sectional. We examined the association between NSES and changes in cognitive function using 610 participants from the Pittsburgh site of the Health, Aging, and Body Composition (Health ABC) Study, a longitudinal cohort of community-dwelling, Black and white adults aged 70 and older. Changes in cognitive function were measured annually over a 6-year follow-up (2006-2012) using the Modified Mini-Mental State Examination (range: 0-100, 3 visits on average per person). Using baseline home address, NSES was calculated for census tracts by summing z-scores of six 2010 census variables representing wealth/income, education, and occupation, and divided into tertiles. Multivariate mixed-effect linear regression models assessed associations, adjusting for individual-level sociodemographic and health-related covariates. In the fully adjusted model, the lowest NSES tertile (vs. the highest) was not associated with baseline cognitive function (β: -0.99, 95% CI: -3.86, 1.87) but was associated with a faster rate of decline in cognitive function (β: -1.54, 95% CI: -2.67, -0.41). No significant differences in baseline cognitive function or rates of change were observed in the middle (vs. the highest) NSES tertile. There was no evidence of effect modification by race. The results indicate that exposure to adverse neighborhood socioeconomic environments may accelerate cognitive decline in late life. The findings add to existing literature concerning the role of environments in the context of aging.
“AN INHUMANE LACK OF RESOURCES”: PERSPECTIVES ON PALLIATIVE AND HOSPICE CARE FOR UNHOUSED OLDER ADULTS
Authors: Ingle M Pilar , Cutforth Asia , Matatall Elise
Published: December 2023

Palliative and end-of-life (PEOL) care offer many benefits to those with life-limiting illness; however, older unhoused individuals face barriers in accessing these types of care. The purpose of this study was to explore healthcare and social service providers’ perspectives on approaches and challenges to addressing PEOL needs among unhoused individuals in Colorado. A descriptive, convergent mixed-methods design was used, including an online survey and semi-structured interviews. Participants were eligible if they worked in healthcare or social services in Colorado and provided direct care/services to adults. Guided by the Behavioral Model for Vulnerable Populations, the survey assessed satisfaction with care provided and identification of challenges in providing care along predisposing, enabling, and need contexts. Interviews focused on deeper accounts of provider experiences. Thematic analysis was used to evaluate qualitative data. Sixty-seven providers completed the survey, and 17 participated in interviews. Only 30% were satisfied with care provided to unhoused individuals with life-limiting illness within their organization. Lack of informal care support, mental illness, substance use, complex care needs, and lack of community resources were most frequently identified in the survey as challenges in providing care. Interviews highlighted person-centered and holistic approaches to care, as well as challenges of providing complex care in the context of an inhumane lack of resources. Tailored PEOL interventions, including street-based palliative care and social model hospice homes, were discussed as possible solutions. This study highlights humanizing approaches within structural challenges to providing PEOL care for unhoused individuals, and highlights potential opportunities to improve access to care.
INTERROGATING THE SKILLED NURSING STAYS OF HOMELESS AND SERIOUSLY ILL OLDER ADULTS
Authors: Mukherjee Namrata , Johnson Ian , Light Michael
Published: December 2023

The culture change movement has fostered an intentional move away from restrictive ethos of care in hospitals, post-acute rehabilitation, and skilled nursing. However, for the millions in the United States who are uninsured, Medicaid-insured, or dual-eligible are less likely to access ‘deinstitutionalized’ healthcare environments. This presentation presents findings from a constructivist grounded theory study, Research and Supportive Care at Later-life for Unhoused People (RASCAL-UP), on the role of skilled nursing in the experiences of palliative care patients with histories of homelessness. Through provider interviews (n=30), field observations (n=12), and longitudinal chart documentation of a subset of homeless palliative care patients with stays in skilled nursing (n=13), this presentation will reflect on major findings: (1) barriers to skilled nursing entry; (2) successes and challenges in transitioning into skilled nursing residence; (3) acts of resistance to (re)institutionalization; and (4) discharge options and outcomes. Results showcase a need to fill the residential service gap between supportive housing and skilled nursing care and policy change that incentivizes consumer-directed practices for all.
USING PHOTOVOICE TO UNDERSTAND SOCIAL MODEL HOSPICE FROM RESIDENTS’ PERSPECTIVES
Authors: Jensen Francine
Published: December 2023

Individuals who experience homelessness and are diagnosed with six months or less to live are disadvantaged at a critical time of life. Many people choose to die at home using hospice services supported by family or close friends, but those without stable housing are unable to access hospice, demonstrating inequitable access at the end of life. For some, social model hospice (SMH) care is being provided free of charge by communities to increase access to hospice services for these individuals. The literature about SMH is growing, but currently missing are the voices of those receiving this care and its impacts on their end-of-life experiences. Using photovoice, a community-based participatory method, three residents shared their first-person perspectives using disposable cameras to document meaningful aspects of care, both positive and negative, and helped researchers analyze themes. Until this study, photovoice had not been used with people experiencing homelessness at the end of life. We found participants eager to take part in all aspects of photovoice as their health permitted. Their perspectives documented and informed the humanistic side of SMH care, illuminating the value of respect, care, autonomy, meeting physical needs, and forming supportive relationships; few criticisms were offered. Consistent with photovoice aims, this method is a powerful research tool involving a disadvantaged group who provided visual commentary on what is working and what could improve at one SMH location. Findings can inform policy decisions for communities interested in starting SMHs and help functioning SMHs make programmatic decisions to support vulnerable residents.
THE ROLE OF DEMENTIA AND SERIOUS ILLNESS IN RECEIPT OF PAID CARE
Authors: Reckrey Jennifer , Kleijwegt Hannah , Kelley Amy , Ornstein Katherine
Published: December 2023

Little is known about receipt of paid care for individuals living at home with dementia and other non-dementia serious illnesses. This retrospective cohort study sought to characterize receipt of paid care among individuals with impairment in self-care activities and/or other manifestations of serious illness in the context of family caregiving and socioeconomic status. Data from participants ≥65 years enrolled in the Health and Retirement Study between 1998-2018 with new-onset need for help in ≥1 self-care task was linked to fee-for-service Medicare claims (sample n=2,521). We found that those who received paid care experienced higher healthcare utilization than those without paid care. Receipt of paid care was highest among those with multiple manifestations of serious illness: 41.7% of those with self-care impairment, dementia, and non-dementia serious illness received ≥40 hours of paid care per week. When present, paid care accounted for 54% of total caregiving hours. In multivariable models, those with Medicaid were more likely to receive paid care (p<0.001), but those in the highest income quartile received more hours of paid care (p=0.05.) Those with non-dementia serious illness were more likely to receive paid care (p<0.001), but those with dementia received more hours of paid care (p<0.001). The role of paid caregivers grows as people experience multiple manifestations of serious illness and high care hours are common among those with dementia. Future work should explore how paid caregivers can collaborate with families and healthcare teams to improve the health and well-being of the seriously ill living at home.
PAID CAREGIVERS PROVIDE SOCIAL SUPPORT TO FAMILY CAREGIVERS OF OLDER ADULTS WITH DEMENTIA
Authors: Quach Emma , Franzosa Emily , Moo Lauren , Hartmann Christine
Published: December 2023

Family caregivers support older adults with dementia to age in place but often experience caregiver strain, though sharing the care with paid caregivers could reduce such strain. We investigated the potential synergy between family caregivers and paid caregivers. In summer 2021, we conducted 14 interviews with family caregivers (6), home care workers (3), and social workers who work with family caregivers and home care agencies (5). We audio-recorded, transcribed, and thematically analyzed our interviews. Our analysis revealed 4 types of support family caregivers received from paid caregivers: 2 centering on the family caregiver as an individual (“person-centered”) and 2 on the relational role the individual holds as a family caregiver (“relationship-centered”). (1) Family caregivers felt positive, emotional bonding with paid caregivers, describing them as “part of the family”. (2) Family caregivers valued instrumental aid from paid caregivers, paradoxically for tasks that are beyond their formal responsibilities, e.g., feeding pets. (3) Family caregivers recognized and valued expert personal care provided to their loved ones by highly experienced paid caregivers. (4) Family caregivers valued paid caregivers’ sharing information about their loved ones and their living situations, especially when family caregivers lived separately from their loved ones. Paid caregivers may reduce or prevent family caregiver strain by providing person- and relationship-centered to family caregivers. Home care agencies should foster the relationship between paid caregivers and family caregivers.
DYADIC PROFILES OF COUPLES’ SELF-PERCEPTIONS OF AGING: IMPLICATIONS FOR MENTAL HEALTH
Authors: Huo Meng , Kim Kyungmin
Published: December 2023

The way older adults perceive their own aging processes influences their mental health, but we know little about how this occurs in a dyadic context, where spouses’ perceptions and health are often intertwined. The current study aims to identify dyadic profiles of self-perceptions of aging (SPA) in couples and examine how certain dyadic profiles are associated with each partner’s mental health over time. A pooled sample of 3,850 heterosexual couples aged 50+ in the Health and Retirement Study (2012/2014–2016/2018) rated positive and negative SPA and provided data on demographic characteristics, couple relationships, and health. Latent profile analysis revealed four profiles of couples’ SPA: similarly positive (32%), similarly negative (10%), wife positive–husband negative (38%), and wife negative–husband positive (20%). Physical health and marital quality differentiated couples and predicted profile membership. Couples with similarly positive SPA reported fewer depressive symptoms over time than did couples in other profiles; couples with similarly negative SPA fared worse mental health. We observed a gender difference when comparing the two opposite profiles, such that wives in the wife positive–husband negative profile reported increasingly fewer depressive symptoms than wives in the wife negative–husband positive profile. Husbands in those two profiles did not differ in mental health. This study adds to the emerging literature that advocates for an interpersonal approach to SPA. Findings revealed risk and resilience in couples as they experience and perceive aging and inform dyadic interventions that aim to protect older adults’ mental health in the long run.
NEGATIVE AGING STEREOTYPES: FEAR OF DEPENDENCY EFFECTS ON ANXIETY AND DEPRESSION IN MIDDLE AND OLDER ADULTS
Authors: Mackenstadt Darby , Adams-Price Carolyn
Published: December 2023

Negative stereotypes of aging tend to depict older adults as frail or a burden on society. According to Stereotype Embodiment Theory, adults who believe negative aging stereotypes tend to internalize these thoughts, and have been found to experience negative physical and mental outcomes, in later life. One aspect of these internalized stereotypes is the fear of being dependent on other people, which highlights the older adults’ worry of being seen as incompetent or child-like. Participants were aged 50 to 82-years-old (M=58.5), and primarily White (87%) women (62%). This study explored the relationship between Fear of Dependency Scale (FoD) and anxiety and depression, evaluating gender, age, and physical health as moderators. FoD was related to higher ratings of depression and anxiety in women, with age and physical health acting as moderators. When reporting a high fear of dependency, middle-aged women and women reporting poor physical health had the highest reported anxiety and depression. The early impact of FoD on women is intriguing. FoD was positively associated with higher ratings of depression for men but not anxiety, with only physical health acting as a moderator. Men with high FoD scores and poor physical health reported the highest levels of depression. It appears the negative views of aging can affect individuals, even before they reach older adulthood, and especially if they have poor perceptions of their physical health. Having negative perceptions of aging can negatively impact individuals as they age, and some groups may be more at risk for these outcomes than others.
FEELING ALONE TOGETHER: LONELINESS IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT AND THEIR CAREGIVERS WITH LOW MASTERY
Authors: Sung Pildoo , Lim-Soh Jeremy , Chan Angelique
Published: December 2023

Loneliness can be contagious because lonely people tend to share their loneliness with others. According to this perspective, loneliness in older persons with cognitive impairment (PCI) may beget loneliness in their family caregivers. However, not all caregivers of lonely PCI experience loneliness. This may be because caregivers have buffering resources that mitigate the contagion of loneliness. Nevertheless, empirical evidence on whether and how PCI and caregiver loneliness are related is lacking. Therefore, we examined the association between PCI loneliness and caregiver loneliness, and the moderation role of caregiver mastery on this association. We used dyadic data from 135 PCI and their family caregivers in Singapore. Descriptive statistics and bivariate correlation showed that PCI reported higher levels of loneliness than their caregivers, and PCI and caregiver loneliness were weakly related. Multivariable regression showed that PCI loneliness was not associated with caregiver loneliness, taking other covariates into account. Nevertheless, we found that the interaction between PCI loneliness and caregiver sense of mastery was significant, such that PCI loneliness was significantly associated with caregiver loneliness when caregivers had low mastery. In conclusion, lonely PCI may share their loneliness with their caregivers, and this may lead to caregiver loneliness if caregivers have low mastery. Tailored interventions should be designed to reduce loneliness among PCI and their caregivers and improve caregiver mastery as a protective factor against the spread of loneliness between PCI and caregivers.
RACIAL DIFFERENCES IN THE ASSOCIATION BETWEEN SENSE OF CONTROL AND SOCIAL SUPPORT: A CROSS-LAGGED PANEL ANALYSIS
Authors: Kim Eunbea , Lee Gina , Lee Jeong Eun
Published: December 2023

While it is widely acknowledged that having a sense of control and social support are crucial elements in promoting both physical and mental health among older adults, the relationship between these two factors and how they operate in diverse racial/ethnic settings is still unclear. To address this gap, we examined the bidirectional relationship between sense of control (constraints and mastery) and support received from three different resources (spouses, children, and friends) using cross-lagged panel regression analyses. Participants are White and Black Americans from four waves of Health and Retirement Study (N = 7,846 White; 944 Black). We found racial differences in the cross-over effects between social support and sense of control. In terms of constraints, while White Americans showed negative bidirectional associations between constraints and support from all resources across four waves, such associations were not observed in Black Americans. Additionally, positive bidirectional associations between mastery and support from all resources were found among White participants, whereas Black Americans showed only spill-over effects for mastery and support received from spouse and children across four waves. Notably, Black Americans’ support received from friends positively predicted their mastery across four waves. These findings underline the importance of considering racial/ethnic differences in understanding the complex interplay between social support and sense of control. Future studies should illuminate the causal relation and examine differential mechanisms in White and Black American older adults.
ASSOCIATION OF CHILDHOOD EXPOSURE TO SCHOOL RACIAL SEGREGATION WITH LATE-LIFE COGNITION AMONG AMERICAN ADULTS
Authors: Lin Zhuoer , Wang Yi , Gill Thomas , Chen Xi
Published: December 2023

Racial segregation may contribute to enduringly worse health outcomes and aging. Prior research mainly focuses on residential segregation, yet the long-term effects of school segregation and the effects for different racial/ethnic groups are largely unknown. Linking measures of primary school segregation using administrative data with a nationally representative population survey in the US, we examine how childhood exposure to school racial segregation shapes the late-life cognitive function. 23,752 non-Hispanic White (White), 6,364 non-Hispanic Black (Black) American adults aged 50 and older were identified from the Health and Retirement Study; and state-level school dissimilarity indexes in late 1960s were linked to participants’ latest wave of cognitive assessment using childhood residence. Multivariate regression analyses demonstrated that exposure to White-Black school segregation had strong, negative effects on cognitive outcomes for both White and Black participants. One standard deviation increase in dissimilarity index was associated with lower cognitive score (White: = -0.16 [95%CI, -0.22, -0.11]; Black: = -0.42 [95%CI, -0.53, -0.30]) and more cognitive impairment (White: Odds Ratio (OR) = 1.10 [95%CI, 1.06, 1.13]; Black: OR = 1.21 [95%CI, 1.14, 1.27]) adjusting for age and sex. Educational attainment and other socioeconomic characteristics explained most associations (40-70%), and the effects remained significant even after accounting for a rich set of late-life factors. Overall, these findings suggest that childhood exposure to school segregation has long-lasting effects on late-life cognition for both White and Black Americans. Educational policy and reform should be promoted to reduce school racial segregation within and between school districts to address health inequities.
RELIGIOSITY, RELIGIOUS BELIEFS, AND COGNITIVE STATUS AMONG BLACK AND WHITE MEN WITH SIMILAR INCOMES
Authors: Bruce Marino , Beech Bettina , Marshall Gillian , Phillips Nicole , Jones Harlan , Pettigrew Corinne , Thorpe Roland J
Published: December 2023

Black men experience multiple stressors linked with cognitive impairment and have higher risks for Alzheimer’s Disease and related dementias than their White peers. Yet, few studies have focused on coping resources. Religious beliefs and institutions are thought to have health benefits; however, no study to our knowledge has examined religious practices or beliefs and their association with cognitive impairment disparities among Black and White men. The purpose of this study was to examine the association between religious practices and/or beliefs and cognitive status among Black and White men in the Health and Retirement Study (HRS). Data were drawn from Black and White men who reported incomes at or below $50,000 and completed the Core and Leave Behind Questionnaires in the 2016 HRS. The primary outcome was any cognitive impairment, a dichotomous variable derived from a modified version of the Telephone Interview for Cognitive Status (TICS). Religious service attendance, private prayer frequency, and religious beliefs were the primary independent variables. The proportion of Black men was 24.2% and had a larger proportion of individuals with any cognitive impairment than their White peers (47.2% vs 29.4%). Results from race-stratified Modified Poisson Regression models indicated that occasional religious service attendance was beneficial for White men (PR=0.68, CI:0.52-0.89) while private prayer (PR=0.71, CI:0.52-0.98) and religious beliefs (PR=0.90, CI:0.83-0.97) were inversely related to any cognitive impairment among Black men. Full-scale studies of Black men with robust religiosity measures are needed to further examine the association between religious factors and cognitive functioning among this group.
POLICY SERIES: PUBLIC HEALTH AND AGING POLICY: EXPERIENCE OF 2023 GSA SUMMER POLICY INTERNS
Authors: D’Antonio Patricia , Lindberg Brian
Published: December 2023

The Gerontological Society of America (GSA) is home to an established summer policy internship program. Aimed at emerging scholars, these professional development opportunities are named in memory of Kathryn Hyer, MPP, PhD, FGSA, FAGHE, and Greg O’Neill, PhD, who were policy scholars and long-time GSA members. Interns participate in an 8-week in person experience in Washington, DC. Interns will share how their experiences have impacted their research and their future career goals in gerontology.
INSIDE PAHPA: A GSA POLICY INTERN’S JOURNEY TO THE INTERSECTION OF POLICY AND PREPAREDNESS
Authors: Thompson Alisha , Brekke Bailee , Mu Christina , D’Antonio Patricia
Published: December 2023

Public health and safety are facing increasingly severe threats from natural disasters, infectious diseases, and emergencies caused by human actions, both intentional and unintentional. These incidents now impact a larger number of people and cover broader geographical areas compared to the past. Chief among those most affected are older people, as highlighted during the COVID-19 pandemic and other crises. Addressing these disparities is crucial, and the federal government plays a pivotal role in tackling this issue. Much of my research up to this point has focused on preparedness among older people for emergencies that threaten public health. My experience as a GSA Summer Policy Intern has significantly influenced my understanding of the relationship between public health emergencies and aging policy. Through witnessing the legislative process at the national level, monitoring resource allocation in the federal budget, and attending Congressional hearings, I gained valuable insights into the complexities of this field. My perspective was further shaped by closely monitoring, synthesizing, and disseminating information about the 2023 Reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA). Additionally, I provided valuable feedback on the relevance of this bill to the interests of GSA and contributed to comments on a bipartisan discussion draft related to this legislation. Equipped with this newfound insight and understanding, I am confident that I will be a more effective advocate and scholar in the field of aging policy.
HEALTH EQUITY, INTERSECTIONALITY, AND CLIMATE CHANGE: PUBLIC HEALTH CONSIDERATIONS FOR RESEARCH
Authors: Mu Christina , Thompson Alisha , Brekke Bailee , D’Antonio Patricia
Published: December 2023

With the rapidly growing aging population, we are faced with an increasingly diverse population of older people. In the 2023 MedPac Report, the Commission found that health disparities by race/ethnicity and income persist. Black Medicare beneficiaries and people with low-income subsidies are at higher risk of poor health outcomes (e.g., increase hospitalization, readmission, and emergency department visits) compared to non-Hispanic White, Asian, and higher income beneficiaries. In the coming years, the aging population will be faced with novel challenges that threaten individuals’ pursuit of health, well-being, and life. The focus of this presentation will be to discuss three emerging research areas including health disparities, intersectionality, and climate change. All are distinctly important and interconnected with health research more broadly. As a GSA summer policy intern, I researched legislation and synthesized literature related to these topics. For instance, I monitored and reviewed the Pandemic All Hazards Preparedness Act, Survival Aid for Emergencies Through Medicare Act, and MedPac recommendations to promote health equity. Additionally, I reviewed and contributed to GSA sign-on letters for congressional legislation. Within my own research focused on the joint associations of sleep and pain, this internship experience has provided new insights in line with my dissertation, which also seeks to uncover differences by age, sex, and race/ethnicity, as well as understand how contextual factors may influence the individual’s health. Looking forward, researchers may have vested interested in contributing to gaps in knowledge regarding health disparities and climate change.
FORMING AGING RESEARCH TEAMS THROUGH SPECIAL INTEREST GROUPS: THE GRADUATE STUDENT EXPERIENCE
Authors: Urbanski Dana , Lakshminarayan Kamakshi , Steele Maritza , Baig Farah , Rivera-Leon Adrianna , Berning Michelle , Gaugler Joseph
Published: December 2023

The study of aging is inherently interdisciplinary, requiring formation of collaborative research teams that span a variety of fields and disciplinary backgrounds. This team approach is essential for answering complex, multifaceted questions about human aging; however, it may serve as a significant barrier to entry for graduate students interested in obtaining training and expertise in aging research. By and large, many graduate students are highly centralized in single academic departments and lack sufficient resources and opportunities to gain interdisciplinary research training and experience. The University of Minnesota Center for Healthy Aging and Innovation (CHAI) has created Special Interest Groups (SIGs) to facilitate team science and interdisciplinary collaboration by providing infrastructure and community for faculty, post-doctoral fellows, and—importantly—graduate students from across campus who have shared interests in aging. Here, we discuss a research project developed and organized by CHAI’s Aging and Chronic Disease Management SIG which has drawn substantial graduate student engagement. Together, eight graduate students representing four University of Minnesota colleges are working with faculty to conceptualize and complete a systematic literature review on caregiving for older adults with hypertension. Drawing on this example, we share early lessons learned as well as key challenges and opportunities for engaging graduate students in interdisciplinary aging research through SIGs. Additionally, we highlight student experiences and perspectives participating in CHAI SIGs, along with recommendations for recruitment and inclusion of graduate students in aging research teams.
DEPRESSIVE SYMPTOMS AND SUBJECTIVE COGNITIVE FUNCTION IN OLDER ADULTS WITH MULTIMORBIDITY
Authors: Mindlis Irina , Revenson Tracey
Published: December 2023

Among older adults with multimorbidity (MM), depression has been associated with poorer cognitive function and vice versa; however, evidence for this temporal association is limited. Further, while the relationship between depression and cognitive function is commonly studied with dementia, less is known about the relation of depression to cognitive impairment (SCI) in older populations without dementia. We compared bidirectional models of the relationship between depressive symptoms and SCI among community-dwelling older adults with MM. Adults ≥ 62 years with MM (n = 107) recruited through a national health volunteer registry completed validated scales twice, six months apart, assessing chronic illnesses, SCI (PROMIS Cognitive Function Short Form 4a), and depressive symptoms (Geriatric Depression Scale 15). Regression analyses examined two models of depressive symptoms and SCI over time (comparing causal direction), adjusting for age, gender, and number of diseases. Participants were 63-87 years old and living with multiple illnesses (M = 4.2; range: 2-9); 21% reported moderate-to-severe depressive symptoms. Depressive symptoms at the first time point significantly predicted SCI six months later after controlling for baseline SCI (β = -.335; p < .001), such that greater depressive symptoms were associated with poorer SCI in adjusted six-month models. In comparison, SCI at baseline was not a significant predictor of depressive symptoms after controlling for initial depressive symptoms (β = -.057; p = .53) in adjusted models. Among older adults with MM, depressive symptoms may be a risk factor for future SCI or a prodromal symptom of cognitive impairment.
THE TELEPHONE INTERVIEW FOR COGNITIVE STATUS (TICS): LATENT STRUCTURE OF COGNITION IN DOD-ADNI VIETNAM WAR VETERANS
Authors: Tupler Larry , Akushevich Igor
Published: December 2023

The Telephone Interview for Cognitive Status (TICS) is a convenient, user-friendly neuropsychological tool developed to correlate with the MMSE and screen for dementia. Typically, thresholding supports diagnostic inferences despite the arbitrary assignment of individual item contributions to the score. Furthermore, although partially validated with World War II veterans, little subsequent psychometric work with aging military cohorts exists. We therefore deconstructed and analyzed the TICS dataset from the DoD-ADNI study recruitment for neuroimaging of Vietnam War veterans with traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD) compared with deployed controls (N=1,828; mean age 69.4±4.5 years). Both disorders constitute putative risk factors for Alzheimer’s disease and related dementias. SAS statistics revealed raw and standardized Cronbach’s alpha with and without inclusion of missing values in the mid .70 range of internal-consistency reliability, with a dispersion of 0.55%–99.29% items incorrect. Exploratory factor analysis applying the Oblimin rotation of van den Berg et al. (2012; MEDLINE UI: 22384819) yielded results similar to that study of healthy civilians analyzing TICS section totals assigned a priori (e.g., temporal orientation, list learning). However, neuropsychological component processes were more subtly differentiated with our enrichment of analyses with deconstructed individual items, e.g., a factor structure reflecting primary versus secondary memory and speech-language. We discuss the advantage of differentiating this proposed latent structure of the TICS in achieving more precisely characterized neuropsychological domains of cognitive impairment underlying specific neurodegenerative and trauma-related dementias. We later apply these results to the longitudinal examination of cognitive aging, TBI, and PTSD in this cohort.
FATIGABILITY, FITNESS, AND CHRONO-NUTRITION: RESULTS FROM THE STUDY OF MUSCLE, MOBILITY AND AGING (SOMMA)
Authors: Glynn Nancy , Kritchevsky Stephen , Schrack Jennifer
Published: December 2023

The Study of Muscle, Mobility and Aging (SOMMA) is a new longitudinal cohort study conducted at the University of Pittsburgh and Wake Forest University School of Medicine, coordinated by the San Francisco Coordinating Center, with management of biological specimens by the Translational Research Institute at AdventHealth. SOMMA aims to provide the foundation for discoveries in the biology of human aging, mobility and other age-related phenotypes. SOMMA enrolled 879 older women and men; mean age 76.3±5.0 years (range 70-94); mean walking speed 1.04±0.20 m/s; 59.2% women, and 15.8% identify as other than Non-Hispanic White. Our symposium will introduce novel baseline SOMMA findings on key measures related to fatigability, fitness, and chrono-nutrition. First, Dr. Schumacher will share results on the association between perceived physical and mental fatigability and cognitive function. Next, to begin to decipher how skeletal muscle energetics impact aging phenotypes, Ms. Gay will examine the relation between skeletal muscle energetics (ATPmax and maximal complex I&II supported oxidative phosphorylation [maxOXPHOS]) and age-related physical fatigability. Our next two presentations will focus on cardiorespiratory fitness (VO2peak) measured by gold standard treadmill cardiopulmonary exercise testing (CPET), which declines with age. Ms. Moffit will explore whether a usual-paced 400m walk can predict VO2peak, and Dr. Erickson will examine the association between CPET measured VO2peak and circadian functions derived from rest-activity-rhythms extracted from wrist-worn accelerometers. Lastly, Dr. Farsijani will explore chrono-nutrition behaviors and their association with muscle health (i.e., D3-creatine, leg power). Discussant, Dr. Jennifer Schrack will provide insight to SOMMA’s novel work.
ASSOCIATIONS OF PERCEIVED PHYSICAL AND MENTAL FATIGABILITY WITH COGNITIVE PERFORMANCE
Authors: Schumacher Benjamin , Rosano Caterina , Qiao Yujia (Susanna) , Rosso Andrea , Cawthon Peggy , Kritchevsky Stephen , Glynn Nancy
Published: December 2023

Greater perceived fatigability has been associated with neurological diseases, but we do not know whether there are associations with cognition among at-risk older adults. At baseline, SOMMA participants completed the Pittsburgh Fatigability Scale (PFS) Physical and Mental subscales (each range 0–50; higher scores = greater fatigability; clinically meaningful increment=4-point physical, 3-point mental) and four cognitive function assessments [Digit Symbol Substitution Test (DSST), Montreal Cognitive Assessment (MoCA), Trail Making Test Part B (TMT-B), and California Verbal Learning Test-Second Edition, Short Form (CVLT-II SF)]. Linear regression quantified associations between PFS subscales and cognitive assessment scores adjusting for site, age, sex, race, education, marital status, and history of stroke, cancer, heart failure, and lung disease. In the 873 participants (59.2% women; age 76.3+/-5.0 years; 85% White), 54% had greater physical fatigability (PFS Physical≥15) and 23% had greater mental fatigability (PFS Mental≥13). Prevalence of cognitive impairment was 2% moderate (MoCA 10-17) and 0% severe ( <10). After adjustments, for each 4-point higher PFS Physical score participants had 0.8 fewer correct DSST items [Beta coefficient and 95% confidence interval: -0.8 (-1.2, -0.4); n=866] and 2.0 seconds slower TMT-B time [2.0 (0.1, 3.8); n=835]. Associations were similar for each 3-point higher PFS Mental score [DSST: -0.7 (-1.1, -0.4) and TMT-B time: 2.5 (1.0, 4.1)]. Neither PFS subscale was associated with MoCA or CVLT. Our results suggest that higher perceived physical and mental fatigability scores may both be indicative of cognitive impairment, particularly in processing speed.
CARDIORESPIRATORY FITNESS IS ASSOCIATED WITH CIRCADIAN BEHAVIORAL PARAMETERS OF PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Erickson Melissa , Blackwell Terri , Mau Theresa , Farsijani Samaneh , Sparks Lauren , Glynn Nancy , Cummings Steven , Esser Karyn
Published: December 2023

Cardiorespiratory fitness (VO2peak) declines with age, and this may be due in part to weakened circadian functions. Rhythmic patterns of rest-activity behavior over 24h represents a novel feature of physical activity, indicative of circadian behavior. Whether VO2peak relates to rest-activity rhythms (RAR) is unknown. We determined cross-sectional associations between VO2peak and RAR in SOMMA (N=714, Age: ≥70 yrs). Activity data from wrist-worn accelerometry (ActiGraph GT9X) were collected in one-minute epochs, over 8, 24h periods. An extension to the traditional cosine model was used to map RAR to activity data, calculating these parameters: strength of the rhythm (amplitude); robustness of rhythm (pseudo-F statistic); and timing of peak activity (acrophase). RAR parameters were expressed as quartiles. Linear models examining associations of RAR and VO2peak were adjusted for potential confounders (age, race, height, comorbidities and lifestyle). Interactions of RAR predictors with sex were examined. Associations between VO2peak and rhythmic amplitude appears to differ by sex (p-interaction=0.07). Among men, VO2peak was positively associated with amplitude (adjusted mean Q1: 21.3 vs. Q4: 23.9, p-trend=0.005)-even after adjusting for moderate-to-vigorous physical activity levels (MVPA)-although associations were more modest and not significant in women. Those with higher VO2peak had an earlier acrophase (time of peak activity) (adjusted mean: Q1 <1:30PM: 21.0 vs. Q4>3:09PM 19.3, p-trend <0.0001) and no sex interaction was observed. There were no associations between the robustness of RAR and VO2peak. Analyses reveal that better cardiorespiratory fitness relates to features of circadian behavior independent of MVPA, supporting emerging research that circadian-based interventions promote healthy aging.
SPIRITUAL NEEDS OF AGING: BRIDGING RESEARCH AND PRACTICE TO IMPROVE HEALTH OUTCOMES IN OLDER ADULTS
Authors: Britt Katherine , Federwitz Chad , Hamilton Jill
Published: December 2023

Accumulating research reports that spiritual and religious practices are associated with better mental and physical health and support successful aging. Spiritual and religious practices often include the exploration of meaning and purpose in life, connectedness, inner peace, belonging, contentment, and near-end-of-life completion, all of which are tied back to health and health outcomes. However, these experiences and related positive outcomes may not always be meaningfully explored or considered. Social distancing and isolation studies have emphasized the importance of supporting the spiritual needs of older adults for connectedness and meaning. Less is known about how to support these spiritual needs in practice and how to provide spiritual care. This symposium will explore the current status of practices, research, and tools that address the spiritual needs of older adults, particularly in connection to health concerns and quality of life. A focus on current practices towards spiritual care for older adults and future implications regarding research and practice will also be considered. Recommendations for future gerontological inquiry into the importance of spiritual care and diverse approaches within gerontological practice will be highlighted and discussed. Dr. Zhao will describe the spiritual needs of persons living with dementia (PLWD). Dr. Epps will present the effectiveness of a culturally relevant and faith-based home toolbox for Black caregivers of PLWD. Dr. Lekhak will highlight the role of compassionate love in mediating the relationship between meditation practice and mental health. Dr. Britt will present religious attendance associations with better sleep quality in older adults to support cognitive function. This is a Religion, Spirituality and Aging Interest Group Sponsored Symposium.
FAITH-BASED HOME ACTIVITY TOOLBOX FOR BLACK FAMILIES AFFECTED BY DEMENTIA
Authors: Epps Fayron , Pierson Katie , Sainz Mayra , Gore Janelle
Published: December 2023

The purpose of this study is to explore the effectiveness of a culturally relevant and faith-based home toolbox, Faith-HAT, for Black caregivers of people living with dementia (PLWD). Caregivers face high levels of stress, anxiety, caregiver burden, and depression, and engaging in religious activities often serves as a protective factor to promote better mental health. Despite the significant role of religiosity among caregivers, few resources exist for religious Black caregivers. A toolbox was developed to improve the physiological health of Black caregivers and provide caregivers and PLWD with meaningful activities to engage in. Participants were recruited from the Atlanta Metropolitan Area (n=16). Caregivers all cared for a family or friend experiencing moderate to severe dementia and had a history of participating in religious activities. Over 6 weeks, the caregiver and PWLD engaged in Faith-HAT, selecting different activities to complete three times a week. Journal entries were made a total of 12 times (at the beginning and end of each week), and caregivers met online with a research team member for weekly updates and baseline, midline, and end-line interviews. Preliminary results suggest engaging with the toolbox has reconnected the caregiver and PLWD, cultivated religious connectedness, and supported continuation of caregiving activities. This faith-based, family-oriented, person-centered approach is geared towards enhancing the quality of life for families affected by dementia and draws on powerful Christian principles from within the black community to achieve this goal.
MANAGING ANXIETY DURING THE COVID-19 PANDEMIC: THE SIGNIFICANCE OF MEDITATION AND COMPASSIONATE LOVE
Authors: Lekhak Nirmala , Bhatta Tirth , Kahana Eva , Snyder Joel
Published: December 2023

Background & Significance

Prior research has consistently established the role of meditation as a coping resource to mitigate the adverse impacts of stressful life situations on mental health. Yet, our understanding of mechanisms that transmit the positive effects of meditation on mental health among older adults is limited. Specifically, little research has examined the impact of meditation on positive emotions such as compassionate love and its subsequent effect on later-life psychological well-being. Purpose: We rely on Fredrickson’s broaden-and-build theory of positive emotions to assess the role of compassionate love in mediating the relationship between meditation practice and mental health.

Methods

Using data from our nationwide web-based survey (n=1,861), we conducted a mediation analysis to assess the indirect effect of meditation on mental health outcomes (depressive symptoms measured with a 10-item Center for Epidemiologic Studies Depression scale and anxiety measured with a 6-item PROMIS Emotional Distress-Anxiety Scale) via compassionate love.

Results

Our ordinary least squares regression (OLS) model estimates suggest that older adults who practiced meditation (compared to those who did not) had significantly higher feelings of being loved (b = 0.11, p<0.05) and those who experience more love had lower symptoms of depression (b = -2.10, p<0.001) and anxiety (b = -0.99, p<0.001). We documented significant indirect effects of meditation (via compassionate love) on depressive symptoms (b = -0.23, p<0.05) and anxiety (b = -0.11, p<.05). Conclusion/Implications: Our study underscores the need for contemplative interventions that can foster compassionate love to improve mental health among older adults.