bluuebunny/crossref_metadata_2025 huggingface dataset:
TRAINING AT WORK: THE IMPACT OF INTERNALIZED AGEISM
Authors: Vickerstaff Sarah A , van der Horst Mariska F
Published: November 2019

It is well documented that seniors receive less work based training than younger counterparts. Studies have assessed the extent to which managers afford access to training because of stereotypes about older workers being less trainable or interested in training. Less is known about the degree to which individuals have internalised age stereotypes and self-stereotype which impacts their attitudes about training. In this work place based study, through analysis of interviews with older workers we examine the extent to which internalised ageism is an inhibitor for seeking further training. We examine the role of gender and work setting. The data includes 185 participants in five different UK organisations in blue collar, white collar, managerial, manufacturing and services sectors. There is some evidence that older workers may feel that they are less deserving and less capable of training and development with implications for policy in this field.
OLD-AGE DEPRESSIVE SYMPTOMS: THE ROLE OF EARLY-LIFE FINANCIAL STRAIN AND LATE-LIFE SOCIAL ENGAGEMENT
Authors: Triolo Federico , Sjöberg Linnea , Vetrano Davide , Darin-Mattsson Alexander , Bertolotti Marco , Fratiglioni Laura , Dekhtyar Serhiy
Published: November 2019

It remains unclear if childhood socioeconomic disadvantage is associated with depression in old age. This study aims to investigate the effect of childhood financial strain on depressive symptoms in old age, and to examine whether late-life social engagement modifies this association. Data from the Swedish National study of Aging and Care in Kungsholmen, a community-based longitudinal study of aging, spanning clinical assessments over 15 years of follow-up were used. Information on financial strain in childhood was collected at baseline. Repeated measures of the Montgomery–Åsberg Depression Rating Scale were used to define depressive trajectories. A social engagement index comprised information on baseline social network and leisure activities. Linear mixed models were used to estimate depressive trajectories. Childhood financial strain was associated with a higher level of depressive symptoms (β = 0.36; p<0.05), but not the rate of symptom accumulation over time. Relative to those with a combination of no financial strain and active social engagement, the level of depressive symptoms was progressively increased in those without financial strain but with inactive social engagement (β = 0.29; p<0.05), as well as in those with both financial strain and inactive engagement (β= 0.83; p<0.05). Individuals with financial strain who had active social engagement exhibited a similar burden of symptoms as those without financial strain and with rich social engagement. Early-life financial strain may have a lasting effect on old age depressive symptoms, although its detrimental consequences may be modified by active social engagement in late life.
THE POWER OF LOOKING AHEAD? A FIXED-EFFECTS MODEL OF FUTURE ASPIRATIONS OVER THE LIFE COURSE AND INCOME
Authors: Sendroiu Ioana , Upenieks Laura
Published: November 2019

Perceived life trajectories are rooted in structural systems of advantage and disadvantage, but individuals also shape their futures through setting goals and expectations. “Future aspirations” have typically been used in life course research to refer to one’s conception of their chances of success across life domains and can serve as a resource to help individuals persevere in the face of hardship. Taking a life course approach and using three waves of data from the MIDUS study, we utilize hybrid fixed effects models to assess the relationship between future aspirations and income. We find that, net of age, health, and a host of other time-varying factors, more positive future aspirations are indeed related to higher income over time, but that this relationship takes different shapes in different contexts. In particular, in lower quality neighborhoods, higher future aspirations lead to worse economic outcomes over the life course, while in higher quality neighborhoods, higher aspirations are indeed related to higher incomes. We thus argue that aspirations are only helpful in some contexts, and are inherently contextual not just in their sources but also in their effects.
HARNESSING THE POWER OF OLDER AMERICANS: INDEPENDENCE CENTER NETWORKS TO DEVELOP TECHNOLOGIES PROMOTING MOBILITY
Authors: Hall Katherine S , Caves Kevin , Alexander Neil
Published: November 2019

Information communication technology (ICT) refers to various technologies encompassing software, networking, the Internet, telecommunications, information systems, and more. As healthcare organizations adopt ICT devices and platforms, patients and providers will have more tools available to improve access to monitoring, telehealth, and timely interventions. The use of alternative methods of collecting, recording, and displaying data (e.g., smart speakers, chat bots, wearables) promise to improve health outcomes for the older adult population. As the U.S. population ages, opportunities for development designed specifically for older adults should be a focus for healthcare organizations. While there are challenges and barriers to enabling new technology within this population, research shows that older adults are adopting new technology. This symposium is focused on these emerging technologies and will showcase diverse examples of ICT implemented across various older adult populations and clinical application areas. The first paper describes the validation of Gaitbox, a walking speed measurement device. The second paper describes using multiple sensors to capture real-world loss of balance and recovery responses. The third paper reports the feasibility of using fitness gamification with a Virtual Reality Treadmill in older adults. The fourth paper describes a smartphone-based assessment of dual task standing and walking. The fifth paper describes wearable sensor-based assessment of falls risk of Timed Up-and-Go test. The Claude D. Pepper Centers maintain year-round coordination and collaboration through a national coordinating center. This powerful network, working towards the common goal of improving the lives of older Americans, has sparked technologic advances that will be highlighted here.
SENSOR-BASED ASSESSMENT OF FALLS RISK OF THE TIMED UP AND GO IN REAL-WORLD SETTINGS
Authors: Quinn Charlene C , Greene Barry R , McManus Killian , Redmond Stephen J , Caulfield Brian
Published: November 2019

Falls are the leading cause of older adult injury and cost $50bn annually. New digital technologies can quantitatively measure falls risk. Objective is to report on a validated wearable sensor-based Timed Up and Go (QTUG) assessment detailing 11 measures of falls risk, frailty and mobility impairment in older adults in six countries in 38 clinical and community settings. Second objective is to generate individual targeted falls prevention programs. 14,611 QTUG records from 8,521 participants (63% female) (72.7±10.7 years) available for analysis. QTUG time was 13.9±7.4 s; gait velocity was 101.9±32.5 cm/s. 25.8% of patients reported falling in previous 12 months; 26.2% of patients were at high fall risk. 21.5% not reporting a fall, were high fall risk. Participants had slow walking speed (29.8%); high gait variability (19.8%); problems with transfers (17.5%). Easily captured and interpreted sensor data is useful in a population-based approach to quantify falls risk stratification.
MENTORSHIP AND CAREER PATHS IN GEROPSYCHOLOGY
Authors: Jacobs Lindsey , Allen Rebecca S , Strong Jessica , Shumaker Elizabeth
Published: November 2019

Mentoring is a critical process for guiding the next generation of geropsychologists into career paths that fit their goals and needs. However, the context and content of mentorship in geropsychology is not well-documented. Understanding geropsychologists’ experiences may provide some insight into how mentorship is executed in academia versus clinical settings and which factors are relevant to career decision-making. We conducted a qualitative analysis of 28 transcripts from individual telephone interviews with geropsychologists and geropsychology trainees, focusing on mentorship and how it influenced their career path. Themes were differences in the focus of mentorship (e.g., immediate projects versus career goals), frequency of career-focused mentorship, length of mentorship (years versus months), and mentors’ openness to share opinions and experiences (e.g., academic mentors are more open about negative aspects of academia, while clinical mentors “guard” trainees from the negative aspects of clinical work). Subthemes and recommendations will be discussed.
HEALTH INSURANCE LITERACY, HEALTH STATUS, AND CONCERNS ABOUT AFFORDABILITY OF HEALTH INSURANCE NEAR RETIREMENT
Authors: Scherer Aaron M , Solway Erica , Malani Preeti , Luster Jamie , Kullgren Jeffrey , Kirch Matthias A , Singer Dianne , Tipirneni Renuka
Published: November 2019

Results from the NPHA highlight the link between health insurance affordability concerns and delaying/forgoing health care near retirement. We sought to determine factors associated with health insurance affordability concerns for US adults age 50-64. We regressed little/no confidence in health insurance affordability in retirement/within the next year on health insurance literacy, age, gender, race/ethnicity, income, employment, education, and health status. Factors associated with greater health insurance affordability concerns included lower health insurance literacy—measured via confidence knowing health insurance terms (aOR=1.78, p=0.035), identifying covered services (aOR=1.81, p=0.038), and finding out service costs (aOR=2.69, p<0.001)—female gender (aOR=1.73, p=0.001), and fair/poor health (aOR=1.88, p=0.020). Factors associated with fewer health insurance affordability concerns included African-American race (aOR=0.55, p=0.038) and higher income (aOR=0.34, p<0.001). These results suggest that it may be possible to reduce health insurance affordability concerns and delayed/forgone care by improving adults’ confidence in understanding and using health insurance.
CHANGES IN HEALTH CARE UTILIZATION FOR LOW-SES ADULTS NEAR RETIREMENT AFTER THE ACA MEDICAID EXPANSION
Authors: Tipirneni Renuka , Langa Kenneth M , McCammon Ryan J , Zivin Kara , Luster Jamie , Ayanian John Z
Published: November 2019

Low-SES Americans approaching retirement are experiencing rising morbidity and mortality. We examined longitudinal changes in health care access, utilization, and health for low-SES adults age 55-64 before (2010-2012) and after (2014-2016) ACA Medicaid expansion using the HRS. With a longitudinal difference-in-differences (DID) approach adjusting for demographics and the complex survey design, we found that low-SES adults age 55-64 had increased rates of Medicaid coverage (+10.7 percentage points [pp] in expansion states, +3.4 pp in non-expansion states, DID +7.3 pp) and increased likelihood of hospitalizations (+9.9 pp in expansion states, -1.2 pp in non-expansion states, DID +11.1 pp) in Medicaid expansion compared with non-expansion states. There were no other significant differences in access, utilization or health trends between expansion and non-expansion states. After Medicaid expansion, low-SES adults age 55-64 were more likely to be hospitalized, suggesting poorer baseline access to chronic disease management and associated pent-up demand for health care services.
STRUCTURAL DISCRIMINATION AND MRI-ASSESSED BRAIN ENDPOINTS: HANDLS BRAINCHILD
Authors: Beatty Moody Danielle L , Gullapalli Rao P , Davatzikos Christos , Sun Shuyan , Katzel Lesile , Zonderman Alan , Evans Michele , Waldstein Shari R
Published: November 2019

Emerging evidence demonstrates that exposure to race-related adversity, specifically, individual-level discrimination, in middle-age is adversely linked with white matter lesion volume, a prospective marker of future cerebrovascular disease as indicated on Magnetic Resonance Imaging (MRI). It remains unclear whether exposure to indices of neighborhood-level structural discrimination (e.g., residential segregation, % of population employed & with high school diploma/equivalency), are linked to MRI-assessed brain pathology and how these linkages may be patterned by key sociodemographic characteristics (e.g., race, age, sex, class). Knowledge of this linkage may help us further understand well-documented racial disparities in multiple clinical brain health endpoints including stroke, dementia, cognitive decline, functional disability, and subclinical brain pathology in adulthood. Thusly, this talk will focus on work that examines whether neighborhood-level structural discrimination is associated with MRI-brain assessed indicators of subclinical brain pathology and the role of key sociodemographic factors, with emphasis on the role of race.
INDIVIDUAL AND DYADIC PREDICTORS OF TECHNOLOGY ADOPTION: IMPLICATIONS FOR HEALTH AND WELL-BEING
Authors: Chopik William J , Cotten Shelia R
Published: November 2019

Technology has the ability to enhance and enrich the lives of older adults by facilitating better relationships, health, and well-being. However, older adults vary in how often—and even whether—they use information and communication technologies (ICTs). Further, interactions and relationships with people in their immediate social networks might have implications for whether or not older adults adopt ICTs. In two studies of individuals (N=595 participants; Mage=67.09; 56% Female; 69.2% White) and couples (N=542 couples; Mage=63.65; 50% Female; 83.9% White), I examined individual and dyadic predictors of technology adoption among older adults. Among a wide array of individual difference constructs, the most reliable predictor of technology adoption in both individuals and their spouses was need for cognition (.08 ≤ r ≤ .23). The results will be discussed in the context of how individual differences modulate adoption and the benefits accrued from ICTs across the lifespan.
THE IMPLICATIONS OF DIGITAL SOCIAL INTERACTIONS FOR OLDER ADULTS’ EXPERIENCES OF WELL-BEING IN DAILY LIFE
Authors: Mejia Shannon T , Turner Shelbie , Hooker Karen
Published: November 2019

Digital communication technologies expand opportunities for social interactions and as a result have the potential to either amplify or dampen the coupling of social interactions with well-being in daily life. We use data from the 100-day Personal Understanding of Life and Social Experiences project (n = 99, age = 50 – 88) to examine variation in the sensitivity of older adults’ daily reports of well-being to the quality of social interactions with their five closest social partners across digital (email/social media) and analogue (in person/by phone) interactions. Digital interactions were more common among less-close social partners. Multilevel random coefficient models showed days with more digital interactions than normal to be characterized by a) lower well-being and b) less sensitivity in well-being to the quality of social interactions with close social partners on that day. The implications of our findings are discussed within a life-span perspective of social relationships and well-being.
TRAJECTORIES OF HEALTH SYSTEM USE AND TRANSITIONS IN OLDER ADULTS WITH DEMENTIA
Authors: Bronskill Susan E , Maclagan Laura C , Walker Jennifer , Guan Jun , Wang Xuesong , Ng Ryan , Vermeulen Marian J , Maxwell Colleen J
Published: November 2019

Health systems strive to enable persons with Alzheimer’s and related dementias to remain at home to maximize their quality of life. There is limited evidence describing long-term trajectories of health system use by persons with dementia as they remain in the community over time. A cohort of 62,622 community-dwelling older adults was followed for seven years and matched to persons without dementia (controls) based on age, sex and comorbidities. Overall, persons with dementia were more likely than controls to use health services, particularly home care and hospitalizations with discharge delay; and were more likely to be admitted to a nursing home. As they remained in the community over time, persons with dementia used home care at an increasingly intensive rate. Our approach to examine trajectories of health system use among persons with dementia is of particular value to capacity planning initiatives to anticipate future health service needs of this population.
CHRONIC PAIN, FEAR OF FALLING, AND RESTRICTED ACTIVITY DAYS IN AN OLDER POPULATION
Authors: Leveille Suzanne
Published: November 2019

Both chronic pain and fear of falling can lead to activity restriction and increased fall risk among vulnerable elders. Little is known about pain characteristics that may be associated with fear of falling, contributing to restricted activity. We studied 765 adults aged ≥65y (mean=78.9y) in the MOBILIZE Boston Study, to evaluate the cross-sectional relationship between pain characteristics and fear of falling measured using the Falls Efficacy Scale (FES). In addition, we examined the impact of pain and fear of falling on restricted activity. We measured 3 domains of global pain: pain distribution (none, single site or multisite pain), and Brief Pain Inventory subscales of pain severity and pain interference. Restricted activity days (RADs) refer to the count of self-reported days of reduced activity due to illness or injury in the previous 12 months. We performed multivariable logistic regressions predicting fear of falling (FES<90/100) adjusted for sociodemographics, fall history and fall risk factors. Participants with multisite pain or moderate-to-high pain interference ratings were more likely to have fear of falling (adj.OR 1.97, 95%CI 1.05-3.67; adj.OR 4.02, 95%CI 2.0-8.06, respectively). Pain severity was not associated with FES. Older adults with multisite pain and fear of falling reported significantly more RADs than those with multisite pain without fear of falling (79±135 and 26±74 RADs, respectively; test for pain x FES interaction, p=0.01). Older adults with chronic pain have greater fear of falling which may contribute to restricted activity. Efforts are needed to increase activity and falls efficacy among older adults with chronic pain.
CROSS-SECTIONAL ASSOCIATION OF FALLS AND POST-TRAUMATIC STRESS IN CANADIANS ACROSS LEVELS OF FRAILTY
Authors: Theou Olga , Pérez-Zepeda Mario Ulises , Armstrong Joshua , Godin Judith , Andrew Melissa , Kirkland Susan , Rockwood Kenneth
Published: November 2019

Frail older adults are vulnerable to stressors and are more likely to experience adverse outcomes. Post-traumatic stress is common in older adults, and can be related to common adverse outcomes, such as falls. We examined whether falls are associated with post-traumatic stress in middle-aged and older Canadians, by levels of frailty. We conducted cross-sectional analysis of the baseline assessment of the Canadian Longitudinal Study on Aging’s tracking cohort, comprising 21,241 individuals, aged 45 to 85 years. We constructed a 60-item frailty index (FI) and defined post-traumatic stress using the primary care post-traumatic stress disorder four-item tool (score 3 as the cut-point). Logistic regressions with post-traumatic stress as the dependent variable and at least one fall in the past year as the independent variable, were adjusted for socio-demographic variables and stratified according to FI 0.1 groups. Prevalence of post-traumatic stress and falls was of 6.5% and 5.0%, respectively for the whole sample. Among those who did not fall prevalence of post-traumatic stress ranged across frailty levels from 3.2% (FI<0.1) to 24.5% (FI≥0.3). Among those who fell, post-traumatic stress ranged from 3.4% (FI<0.1) to 36.9% (FI≥0.3). Falls were not significantly associated with post-traumatic stress among people who had an FI<0.3, but among those with an FI≥0.3 the odds ratio for having post-traumatic stress for those who fell was 2.25 (95% CI 1.2-4.23, p=0.011) compared to non-fallers. In conclusion, high levels of frailty can impact how a stressor, such as a fall, can be associated with an adverse psychological outcome.
EFFECT OF A HOME-BASED EXERCISE PROGRAM ON SUBSEQUENT FALLS IN SENIORS AFTER A FALL: A RANDOMIZED CLINICAL TRIAL
Authors: Liu-Ambrose Teresa , Davis Jennifer C , Best John R , Dian Larry , Cook Wendy , Madden Kenneth , Hsu Chun Liang , Khan Karim M
Published: November 2019

We assessed the efficacy of the home-based Otago Exercise Program (OEP) as a secondary falls prevention strategy in seniors referred to a falls prevention clinic after an index fall. We conducted a 12-month randomized controlled trial of 344 adults, aged 70 years and older, with = or > 1 fall resulting in medical attention in the prior 12 months. Participants were randomized to OEP or standard of care (CON). The OEP is a home-based strength and balance training program delivered by a physical therapist. All participants received AGS Guideline Care for falls prevention from a geriatrician. Differences in falls rate was tested with a negative binomial regression model. The rate of falls was lower in the OEP group vs the CON group (incident rate ratio [IRR] = 0.64, 95% CI 0.46 to 0.90). The estimated incidence rate of falls per person-year was 1.4 (95% CI 0.1 to 2.0) in the OEP group and 2.1 (95% CI 0.1 to 3.2) in the CON group, with an absolute incidence rate difference of 0.74 (95% CI 0.04 to 1.78) falls per person-year. DSST performance also increased in the OEP group by a mean change of 1.1 points (95% CI 0.02 to 2.1) vs the CON group. Improved DSST was associated with fewer falls (IRR = 0.80, 95% CI 0.68 to 0.95). These findings support the use of the OEP for secondary falls prevention.
SEDENTARY BEHAVIOR AND PHYSICAL ACTIVITY IN THE ADULT CHANGES IN THOUGHT (ACT) STUDY
Authors: Rosenberg Dori E , LaCroix Andrea Z , Guralnik Jack
Published: November 2019

Few epidemiologic studies have examined device-measured sitting patterns and health outcomes. Furthermore, there is a need to continue understanding the role of prospectively measured physical activity in relation to older adult health. The Adult Changes in Thought (ACT) study is an on-going epidemiologic study of adults age ≥65 years that began in 1994. Participants complete biennial assessments including a self-reported measure of physical activity. Starting in 2016, ACT participants could enroll in a physical activity sub-study that involved wearing a thigh-worn activPAL device and maintaining sleep logs for 7 days. Of those approached to participate in the sub-study, 64% agreed (N = 1139). A total of 961 had valid wear time (≥4 days with 10-20 hours of data per day) and completed survey collecting measures on pain and built environments (56% female, 57% > age 75, 89% non-Hispanic white). Participants who consented to the sub-study were generally younger and had fewer chronic conditions than those who did not consent. After removing sleep time, mean daily activPAL measures calculated included hours sitting and standing, number of sitting bouts lasting 30 minutes or more, number of breaks from sitting, and steps walked. The first session in this symposium will present historical self-reported physical activity trajectories in relation to cognitive function. The subsequent sessions will present novel cross-sectional data examining activPAL variables with measures of physical function, pain, and perceived built environments. This symposium will provide new insights on the roles of sedentary behavior and physical activity in aging and health.
AGENCY IN LATE-CAREER TRANSITIONS: THE IMPACT ON ADJUSTMENT AND SATISFACTION
Authors: Solinge van
Published: November 2019

In research on late career transitions agency is implicitly assumed. The extent to which older adults are able to shape their late career in the face of external constraints, such as a rising state pension age, may however be limited. Constraint agency may have impact on well-being. Using data from a panel study among 5,300 older workers in the Netherlands, we examined the impact of agency in the work-retirement transition on adjustment and life satisfaction. Results show that adjustment to a the higher retirement age is more challenging than adjustment to retirement. Life satisfaction increased among those who retired, but not among those who remained working. One third experienced constrained agency (involuntary retirement or non-retirement). The negative association between constrained agency and life satisfaction was stronger for participants still in the labor force than for retirees. Our findings demonstrate that involuntary non-retirement has stronger implications for well-being than involuntary retirement.
IS THERE A RIGHT TIME TO RETIRE? AFFECTIVE DIS/ENGAGEMENT FROM WORK IN A LONGITUDINAL QUALITATIVE STUDY FROM GERMANY
Authors: Wanka Anna
Published: November 2019

Recent retirement research has argued that the once predictable pattern associated with retiring is becoming increasingly differentiated by the age at which it occurs, if it is gradual of abrupt, voluntary or involuntary, etc. (Moffatt & Heaven 2017). Even though research suggests that retirement legislation and statutory retirement ages influence the subjective perception of a ‘right time to retire’ (cf. Jansen, 2018), many people don’t feel ready to retire when they should and hence retire involuntarily (Steiber & Kohli, 2017). This paper focuses on the dis/engagement processes that lead to feeling ‘ready’ to retire at a certain time, or not. Drawing on data from a qualitative longitudinal study in Germany, results suggest (1) that readiness to retire is a continuum, rather than a binary, which is influenced by a variety of actors, and (2) that it is and a process that changes multiple times in the retirement transition.
TECHNOLOGY AND AGING FUTURES: DISCOVERING THE CONSUMER ELECTRONICS SHOW (CES) 2019
Authors: Katz Stephen
Published: November 2019

The growing field of technology and aging or gerontechnology has largely been considered from a health perspective on technological intervention to ameliorate conditions of isolation, disconnection, inactivity, and loneliness, as well as provide efficient alert systems, transportation coordination, and emergency services. Contesting the image of a ‘digital divide’ separating younger from older generations, the recreational industry has also produced a seniors market of technological games, toys, apps, exercises, and social media. The four papers in this symposium, however, are individual critical reflections by a group of social scientists who visited the Consumer Electronics Show (CES) in January 2019 (Las Vegas) as part of an ethnographic project about the politics of the technical turn in gerontological studies. In particular, the authors gathered evidence from the CES to support their interests in four trends: a) The collecting, aggregating, and sharing of personal data by home surveillance, artificial intelligence monitoring, and self-tracking systems for commercial, insurance and work-place purposes, b) The popularization of healthy lifestyles based on technical and exclusionary models of ‘smart’, ‘fit’, and ‘optimal’ standards, c) The technical rhetoric that infuses designs for efficiency, speed, and convenience with anti-aging and ageist ideologies, d) The challenges to older people to manage their lives against the health risks, interventions, and expectations posed by technology-driven austerity programs. The papers have in common their creative interpretations of CES materials and shared concern about the many older groups whose insufficient access, skill, and resources will deny them participation in the technological imaginary of aging futures.
GROWING UP WITH OPEN SCIENCE
Authors: Pfund Gabrielle N
Published: November 2019

While a novel concept for many, pre-registration is an outlet growing in prevalence that allows researchers to systematically work through future studies from start to finish by laying out research questions, relevant hypotheses, and study design. “Growing up” as a researcher with Open Science, I never felt that pre-registration limited me, my ability to think and ask questions, or any opportunities to explore new ideas with old data. Instead, it strengthened me as a researcher by giving me a methodical perspective to take when considering why I needed to ask a question and how I planned to answer it. In this talk, I will define what pre-registration is and discuss my experiences with it as an early career researcher. Furthermore, I will present different concerns and conceptions people have about it and expound upon the inherent benefits it provides to both critical thinking and study design.
COHORT DIFFERENCES IN COGNITIVE AGING: THE ROLE OF PERCEIVED WORK ENVIRONMENT
Authors: Hueluer Gizem , Ram Nilam , Willis Sherry L , Schaie K Warner , Gerstorf Denis
Published: November 2019

Studies of historical change on cognitive aging generally document that later-born cohorts outperform earlier-born cohorts on tests of fluid cognitive performance. It is often noted how advances in educational attainment contribute to this finding. Over the last century, work demands and characteristics have changed profoundly, with shifts from a manufacturing to service and technical economy. We used data from the Seattle Longitudinal Study to compare trajectories of cognitive change between earlier-born (1901-1938) and later-born cohorts (1939-1966). Our findings show that (a) later-born cohorts had higher levels of performance on most cognitive tasks and exhibited less decline in word fluency, (b) had more enriched perceived work environment as indicated by higher levels of worker control and innovation, with no cohort differences in work autonomy (c) these experiences were associated with higher levels of cognitive performance independent of education and consistently across cohorts. We discuss potential mechanisms underlying these associations.
THE ROLE OF RETIREMENT IN COGNITIVE AGING: RESULTS FROM THE SWEDISH ADOPTION/TWIN STUDY OF AGING
Authors: Andel Ross , Finkel Deborah , Pedersen Nancy L
Published: November 2019

Retirement is a major life transition that may influence the aging process. Using a two-slope growth curve model with retirement age as the pivot point, we studied change in major cognitive domains before and after retirement. Participants were 393 members of the Swedish Adoption/Twin Study of Aging who retired after the age of 50 (mean=63 years, range 51-75 years) and who were followed for over 20 years with seven testing occasions. After controlling for age, sex, and education, we observed no change in memory pre-retirement (p=.935) and significant memory decline post-retirement (Estimate=-0.17, p=.001); decline in speed, which more than doubled after retirement (Estimate=-0.20, p=.001 before, Estimate=0.54, p<.001 after); improvement in verbal abilities before (Estimate=0.15, p=.020) and decline in verbal abilities after retirement (Estimate=-0.11, p<.001); and some decline in spatial abilities before (Estimate=-0.18, p=.059) followed by accelerated decline after retirement (Estimate=-0.33, p<.001). Retirement may be a good target for intervention.
TOWARD A NETWORK OF CHANGE: PROMOTING AGE-FRIENDLY COMMUNITIES FROM THE INSIDE OUT
Authors: Versey Shellae , Greenfield Emily
Published: November 2019

The experience of aging is often framed by the communities in which we live, work and play. At the same time, these communities are also impacted by individuals as they age in place. This symposium presents research using community-partnered methods to highlight the agency of local actors—including older residents themselves—as they work to change their local communities. At the broadest level of geographic scale, Black illustrates how information from population surveys with older adults can be leveraged to mobilize public-private partnerships from the local to state level to advance policy and practice on housing and transportation to support aging in place. Focusing regionally in New Jersey, Greenfield and Reyes analyze longitudinal, qualitative interview data from leaders of age-friendly community initiatives to develop empirically-grounded theory on the range of roles of older adults in aging-friendly community change processes. The final two papers present depth in understanding how older adults actively construct their own sense of community vis-à-vis more micro-social processes. Yeh uses Photovoice methodology to understand how older adults aging in place manage the societal trends of urbanization and social inequalities as they manifest within their own city. Versey examines how older adults aging in place in the context of neighborhood gentrification mobilize networks to preserve a community “sense of place” when sociocultural resources are displaced. Consistent with a community gerontology framework, the presentations demonstrate how community-level dynamics around aging are shaped not only by macro-social influences, but also micro-social interactions including, and sometimes initiated by, older residents themselves.
PLACEKEEPING AND SENSE OF PLACE: USING PHOTOVOICE TO HIGHLIGHT NEIGHBORHOOD DISPLACEMENT
Authors: Versey Shellae
Published: November 2019

There has been growing interest in the use of community-based participatory research (CBPR) in gerontology. Photovoice, one of several qualitative methods utilized in CBPR, pairs participants with photography to identify and represent issues of importance. This paper explores photovoice as a tool for meaning making and preserving a ‘sense of place’ in a gentrifying context in New York City. Older residents describe pending neighborhood displacement due to gentrification using photographs. Using these themes and a range of visual media, older adults mobilize preservation and resistance efforts to gentrification. The paper concludes with implications and directions for future research.
FROM PROGRAM PARTICIPANT TO AGING ADVOCATE: THEORIZING OLDER ADULTS' ROLES IN AGE-FRIENDLY COMMUNITY INITIATIVES
Authors: Greenfield Emily , Reyes Laurent
Published: November 2019

Major professional organizations in health and aging have identified older adults’ involvement as a defining feature of aging-friendly community initiatives (AFCIs), yet there is very little research on this aspect of the initiatives. Our study utilizes five waves of data from in-depth interviews with leaders of nine AFCIs across northern New Jersey. The study was conducted as part of a multi-year, community-partnered project on the development of these philanthropically supported initiatives. Multi-phase coding yielded four types of roles for older adults: (a) program participants, (b) informants and consultants, (c) volunteers assisting with programs, events, and administrative tasks, and (d) aging-friendly champions and advocates. Across role types, AFCI leaders reflected on the challenges of engaging particular subgroups of older adults, as well as how ambivalent age identities impeded involvement. We discuss implications for advancing research and evaluation on community-level interventions that seek to simultaneously serve and empower people as they age.
PROMOTING AGING IN PLACE VIA RESEARCH, POLICY, AND PRACTICE IN AGE-FRIENDLY COMMUNITIES
Authors: Black Kathy
Published: November 2019

The majority of Americans overwhelmingly prefer to age in place and in the communities in which they reside. Age-friendly communities support aging in place by focusing attention on features both inside and outside of the home. The global age-friendly community model provides a framework that requires assessing community-based older adults’ needs and preferences about, and developing subsequent action towards, features of the social, service and built environment including housing and transportation which are considered essential to aging successfully at home. This presentation discusses the intersect between research, policy and practice in an age-friendly community which utilized micro-level findings from older adults (n = 1, 172) to enact macro-level collaborations across local and statewide government and professional groups to facilitate aging in place across the domains of housing and transportation.
BACK TO BASICS: HOPELESSNESS AS THE MEDIATING FACTOR FOR COMPLETED SUICIDE AMONG OLDER ADULTS
Authors: Hernandez Silvia C , Overholser James C , Lavacot James , Philips Kristie L , Stockmeier Craig A
Published: November 2019

Individuals 65 years and older are at high risk for completing suicide. Though risk factors have been established in the literature, the dominant atheoretical approach has left the field at an impasse. The present study aimed to integrate core risk factors of hopelessness, depression, physical illness, and social isolation by proposing a biopsychosocial framework of older adult suicide. A psychological autopsy was used to compare individuals 65 years and older who died either by suicide (n = 32) or natural causes (n = 45). Structural equation modeling results suggested that hopelessness was the only factor directly associated with suicide (B = .01, β = 0.84, SE = 13.31, p ≤ .001), fully mediating the relationships between suicide and social isolation, negative attitudes about physical health, and depression. The proposed model adequately fit the data, explaining 71% of the variance in cause of death. Advanced age (75+ years) moderately increased social isolation, which weakly increased hopelessness, contributing to suicide in a smaller magnitude than expected. Though individuals in the advanced age group had a wider range of physical illnesses, this did not increase risk. Rather, negative perceptions of health increased risk for all individuals 65 years and older via depression and hopelessness, irrespective of the presence of impairing physical illness. Findings support the claim that hopelessness plays a pivotal role in the progression from suicidal ideation to completion among older adults. Directly targeting hopelessness could help prevent at-risk older adults from acting on their thoughts of suicide.
BODY TYPES AND ASSOCIATION WITH DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS: FINDINGS FROM NHANES 2013-2016
Authors: Chukwurah Queendaleen C , Bazzano Lydia
Published: November 2019

Older Americans are increasingly affected by overweight and obesity now as compared to previous decades. We examine the prevalence rates and association of Depressive Symptoms (DS) across body types created using the National Heart, Lung, Blood Institute recommended body mass index /waist circumference (WC) anthropometric cut off values among older Americans. 3,132 participants, 50 years and older from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 was used for this analysis. Six body types were created using the anthropometric cut off values- normal weight with normal WC, overweight with normal WC, obese with normal WC, normal weight with high WC, overweight with high WC, and obese with high WC. The PHQ-9 score was used to create DS categories (1-4, 5-9, 10-14, 15-19, ≥20). The relationship of body types to DS categories was assessed using weighted multinomial logistic regression. The mean (SD) sample age was 63.4 (9.2). Approximately 12.9% of participants had a PHQ-9 score of at least 10. After adjusting for age, gender, race/ethnicity and poverty-income ratio, overweight with high WC (OR 7.61, 95% CI 2.37-24.48) had high odds of moderately severe DS. Obese with high WC had high odds of mild DS (OR 1.76, 95% CI 1.22-2.52), moderate DS (OR 2.14, 95% CI 1.09-4.20) and moderately severe DS (OR 5.59, 95% CI 2.75-11.39) compared to normal weight with normal WC. We demonstrate an association of body types with DS in an aging American population and these findings would not be identified if anthropometric measures were examined separately.
ASSOCIATION OF WELL-BEING WITH ANXIETY, DEPRESSION, AND FUNCTIONAL IMPAIRMENT FOLLOWING REHABILITATION SERVICES
Authors: Simning Adam , Seplaki Christopher L
Published: November 2019

Millions of older adults receive rehabilitation services yearly that aim to restore, sustain, or limit decline in functioning. Older adults who receive rehabilitation comprise a vulnerable population that is unfortunately at elevated risk for anxiety, depression, and functional impairment. We hypothesize that lower levels of wellbeing prior to rehabilitation services are associated with a greater risk of having clinically significant anxiety or depressive symptoms, or worsening impairments in self-care or household activities, following rehabilitation. This study uses data from 2015 and 2016 waves of the National Health and Aging Trends Study, and includes 853 participants with information on rehabilitation services, wellbeing, anxiety and depression, and functional impairment, as well as demographic characteristics, socioeconomic status, and health variables. In a series of multivariable logistic analyses with wellbeing serving as our primary independent variable, older adults in the lowest quartile of wellbeing (compared to those in the highest quartile of wellbeing) had greater odds for having anxiety symptoms (OR=3.04; 95% CI: 1.24-7.46), depressive symptoms (OR=6.54; 95% CI: 2.80-15.25), and worsening impairment in self-care (OR=2.15; 95% CI: 1.09-4.23), but not in household activities (OR=1.49; 95% CI: 0.67-3.32). This study’s findings suggest that older adults with low levels of wellbeing at baseline may be more susceptible for having mental illness and functional impairment at follow-up. Conversely, the findings suggest that perhaps those with high levels of wellbeing may be able to experience significant health events with fewer residual consequences. The mechanism by which wellbeing may affect these outcomes is unclear and warrants further investigation.
A TALE OF TWO CASE STUDIES: ACCELERATED RESOLUTION THERAPY FOR COMPLICATED GRIEF IN OLDER ADULTS
Authors: Buck Harleah G , Hernandez Diego F , Mason Tina , Tofthagen Cindy , Kip Kevin E
Published: November 2019

Complicated grief (CG) is characterized by lengthy, intense, and functionally impairing grief which disproportionately affects older adults. Accelerated Resolution Therapy (ART) is a brief, protocol driven, exposure/imagery rescripting therapy which uses lateral left-right eye movements. ART, unlike traditional psychotherapy, directs the person to perform two tasks simultaneously (e.g. re-experiencing the grief experience and performing eye movements), taxing limited working memory capacity. Importantly, this may force memory traces representing events, emotions, and sensations to compete for permanence, as well as reduce the vividness and emotional intensity of the original grief. Two CG case studies are presented (expected; unexpected death) with their response to ART. Stake’s instrumental case study methodology was used to identify and study cases which reflect a range of CG. Additionally, CG was measured by the Inventory of Complicated Grief (ICF). ICF’s range is 0-76 with scores > 24 indicating CG. Case 1 was a spousal caregiver with a single, expected death where helplessness, guilt, shame, and a life alone had resulted in CG (baseline ICF 33). Her ICF at 8 weeks post-ART was 10. Case 2 was an adult child caregiver with multiple (parent, sibling), unexpected deaths in quick succession where loss, guilt, anger, and helplessness had resulted in CG (baseline ICF 25). Her ICF at 8 weeks post-ART was 9. Both participants were able to process the distressing sensations that emerged during the imaginal exposure component facilitated with the use of eye movements. This suggests that ART may be a powerful new mind-body treatment for CG.
SOCIAL ISOLATION AND MENTAL HEALTH CHALLENGES AMONG HIGH-NEEDS VETERANS
Authors: Dang Stuti , Muralidhar Kiranmayee , Wang Kaicheng , Ruiz Diana , Gomez-Orozco Carlos , Valencia Willy Marcos
Published: November 2019

Using predictive analytic modeling, the Veterans Affairs has identified vulnerable Veterans, labeled as High Need High Risk (HNHR), as those who need greater services and support. To better understand their need gaps, we assessed function, mobility, mood, and caregiver status using a mailed needs assessment questionnaire to 1112 HNHR Veterans. Among the 341(30.7%) respondents, they were primarily 274(80.4%) Non-Hispanics; 210(61.6%) Whites, and 119(34.9%) Black or African Americans; average age was 69.5±9.6 years old; 310(90.4%) had ≥high school education. The average Barthel ADL score was 81.5±22.8 and average Lawton IADL score was 5.8±2.2. Walking or balance issues were present among 260(75.8%), 227(66.2%) said they use an assistive device, and 167(48.7%) had suffered ≥1 fall, 43(12.5%). Regarding depression, 117(34.3%) screened positive (PHQ2 score≥3). These were significantly younger (66.7±9.1) than those who did not (70.8±9.3, p≤0.01). They were also significantly lower functioning (5.37±2.1 vs.6.38±2 Lawton IADL score, p≤0.01), more dependent (77.8±23.1 vs 86±19.2 Barthel ADL score, p≤0.01). We also observed significant differences in their telephone contact with family (never to once/week) [35(29.9%) vs. 27(13.4%), (p≤0.01)]; in meeting with friends or relatives ≥3times a week [12(10.3%) vs. 69(34.3%), (p≤0.01)]; and in likelihood of attending meetings with clubs or other organizations [94(80.3%) vs. 138(68.7%), p=0.040]. Detecting depression is a priority among HNHR Veterans. There is an urgent need to devise viable strategies to offer interventions that incorporate mental health needs and reduce social isolation, potentially addressing mobility, function, and transportation.
TEACHING ABOUT GERONTOLOGY AND AGING THROUGH INTERPROFESSIONAL EDUCATION AND COLLABORATION
Authors: Jurkowski Elaine T , Heitkamp Ruth , Kelly Cherie , Smaga Sharon
Published: November 2019

Repeatedly as multidisciplinary professionals we are concerned about the individual patient we serve. Inter-professional collaboration across disciplines such as primary care medical practice, physician assistants, social workers and psychologists does not occur naturally, since educational programs are often taught independently of each other, but these disciplines are required to work collaboratively with each other. The objective was to promote communication across disciplines (Medicine, Social Work, Physician Assistant and Psychology) and help each discipline understand the roles played in promoting mental health and general health for older adults. An educational seminar was conducted using cases and guide questions focused on identifying strategies for care. The teams consisted of Medical Residents, a Social Work student, a Psychology student and a Physician Assistant student. A series of guide questions were provided, and teams were asked to discuss and identify a care plan. Debriefing followed to discuss the outcomes across all teams. Pre-post test results examined variables related to interdisciplinary collaboration. Findings suggest professionals were surprised at what they learned from the other disciplines they were collaborating with. They also learned about community based resources available as well as strategies to promote health outcomes. All participants felt that the opportunity to collaborate outside of their disciplines would strengthen their impact when working with older adults and their families. In conclusion, a problem based learning approach coupled with the opportunity to collaborate with other disciplines through (IPE) is a venue to improve overall collaboration across professionals and ultimately improve mental health outcomes of consumers.