bluuebunny/crossref_metadata_2025 huggingface dataset:
OLDER PARENTS’ PATTERNS OF AGREEMENT AND INFORMATION SHARING WITH ADULT CHILDREN AND THEIR EMOTIONAL OUTCOMES
Authors: Toyokawa Noriko
Published: December 2023

The current study examined the effect of older parents’ pattern of agreement/disagreement with their adult children’s perceptions of their functional ability and their information disclosure/non-disclosure to their adult children on their ambivalent, positive, and negative emotions. Older parents, N=263, Mage=75.06, SD=5.49, participated in an online survey. Participants’ agreement with adult children’s ideas and caregiving practice to support 10 life issues were assessed by five categories: 1=agree, 2=disagree, 3=it depends, 4=it is not my issue, and recorded into 0=agree, 1=fully/partially disagree/not my issue. Participants’ information sharing on the same items was assessed by 1=openly share, 2=leave out critical points, 3=avoid talking about, 4=lie or making a story, 5=It is not my issue, and recoded to share 1=openly and 0=not openly share. The median dichotomized the mean scores of 10 items to create four patterns: disagree-do not disclose, disagree-disclose, agree-do not disclose, and agree-disclose. Positive, negative, and ambivalent emotions toward adult children have been assessed by the scales and formula used by Lendon et al. (2013). A series of one-way ANOVA, F(3, 260)=4.41, p=.005, η=.05, revealed that participants in agree-do not disclose the pattern, M=3.15, SD=.90, reported the highest level of ambivalence. A post hoc test showed it was significantly higher than that of participants in disagree-did not share, M=2.16, SD=1.10. Disagree-do not disclose group reported the lowest score in positive and negative emotions among groups. Frequency of contact predicted disclosure in auxiliary analysis. The need for within and between differences in older parents’ agreement and disclosure patterns was discussed.
PREDICTORS OF FAMILY FUNCTIONING IN CUSTODIAL GRANDFAMILIES: A SYSTEMIC PERSPECTIVE
Authors: Patel Khushbu , Scott-Poe Deneisha , Dolbin-MacNab Megan
Published: December 2023

According to the U.S. Census, there are approximately 2.5 million grandparents raising grandchildren. Previous research has examined factors associated with grandparent and grandchild well-being; yet, few studies have considered the functioning of the grandfamily unit. Guided by family systems and attachment theories, the purpose of this study was to examine individual and relational predictors of grandfamily functioning, as reported by 95 custodial grandmothers raising adolescent (ages 12 to 18) grandchildren. Survey data were collected in-person or over the telephone from custodial grandmothers residing in the Southern U.S. To analyze the data, we conducted a hierarchical multiple regression. The first model included grandchild gender, the second model added grandmothers’ parenting stress and attachment, and the final model further added grandmothers’ reports of grandchildren’s attachment, emotion regulation, and internalizing and externalizing behavior problems. The first model was not significant, but the second model was significant [F (3, 91) = 8.85, p < .001; R2 Δ = .22, p < .001], and explained 23% of the variance in grandfamily functioning, with less grandmother parenting stress predicting better grandfamily functioning. More secure grandmother attachment approached significance. The final model accounted for 34% of the variance in grandfamily functioning [F (7, 87) = 6.35, p < .001; R2 Δ = .11, p = .008], with better grandfamily functioning being predicted by less grandmother parenting stress and better grandchild emotion regulation. More secure grandmother attachment and greater grandchild internalizing problems emerged as trends. Implications for future research and systemic practice with grandfamilies will be discussed.
THE GEOGRAPHY OF FAMILY CAREGIVING IN AN AGING SOCIETY: WHO MOVES CLOSER AND WHY
Authors: Mudrazija Stipica , Peters Elizabeth , Lepe Fernando Hernandez
Published: December 2023

An emerging literature examines the dynamic aspect of the link between parental health and parents-adult children geographic distance, yet who moves when a parent needs care—the parent or the child—and why remains unexplored. Using pooled 2004-2014 data from the Health and Retirement Study on respondents age 65 years or older and their adult children and detailed geographic information, we analyze who moves when parents and children move in together or move closer without coresiding, and who benefits from such moves. Preliminary results reveal that children are roughly four times more likely to move in with parents than parents move in with children, and moving primarily benefits those who move: 89.2 percent of parents who moved reported that either they were the sole beneficiary of the move or that both they and their children benefited, and the same was true of 92.8 percent of children movers. However, as parents’ health declines, they increasingly benefit from the proximity-enhancing moves regardless of who moves. For example, about half of all children who move in with parents following the onset of parents’ health decline reports doing was to benefit their parents, either exclusively of in conjunction with them. Next, we will fit regression models of who moves for newly coresident dyads and dyads moving closer, respectively, as well as models of who benefited from such moves. This research provides new policy-relevant insights because the caregiver supports needed could be different depending on whether it was the parent or the child that moved.
DECLINES IN CONTROL BELIEFS OVER TIME: THE ROLE OF PERCEIVED DISCRIMINATION AND INEQUALITY
Authors: Agrigoroaei Stefan , Berceanu Denisa Cristina-Alina
Published: December 2023

Higher control beliefs represent a key protective factor for healthy aging, broadly defined. If the benefits of control beliefs are well documented, fewer studies have focused on the antecedents of changes in control. There is empirical evidence that social stress, such as being treated unfairly or discriminated against, may erode personal control. The goal of this study was to examine perceived discrimination and inequality in relation to long-term change in control beliefs, in a national sample, using data from the Midlife in the United States (MIDUS) longitudinal study (Waves II and III, N = 2540, MIDUS II age range: 30-84, Mean=55.53, SD=11.21). Perceived discrimination was quantified as the sum of 9 items capturing experiences of daily discrimination. Perceived inequality was measured in three settings: work, family (relationship with children), and home. Both mastery and perceived constraints were used as indicators of control beliefs. The results revealed a significant decline in control between the two waves. Controlling for age, gender, education, self-rated physical health, and baseline control beliefs, higher daily discrimination and perceived inequality were significantly associated with lower control beliefs, 8 to 10 years later. There were not significant interactions with age and the patterns of results persisted when other relevant factors, such as cognitive performance and physical activity, were considered. The findings suggest that interventional programs should target (sources of) perceived discrimination and inequality and that changes in control beliefs could be considered a potential mechanism of the association between social stress and trajectories of healthy aging.
LONGITUDINAL ASSOCIATION OF COGNITIVE IMPAIRMENTS WITH LATE-LIFE WEALTH CHANGES AMONG OLDER AMERICANS
Authors: Esiaka Darlingtina , Westrick Ashly , Rooks Ronica , Meier Helen , Manning Mark , Tarraf Wassim
Published: December 2023

Disparities in wealth in the US are linked to disadvantageous health outcomes over the lifecourse. Cognitive impairment can widen wealth disparities. We examine how cognitive impairment influences change in wealth starting in mid-life and into older adulthood and the role of social determinants of health in wealth loss due to cognitive impairment. We use biennial longitudinal data (Health and Retirement Study: 2000-2018) on Non-Hispanic White (NH-W), NH-Black (NH-B), and Hispanic (H) middle-aged adults (51-64 years and cognitively healthy in 2000; unweighted n=3,651) to model wealth change (measured as the relative (%) difference in reported wealth between 2000-2018 [in 2018 dollars]) as a function of cognitive status (using three latent phenotypes derived from longitudinal latent class analyses: cognitively healthy [CH; 77%], increasing cognitive impairment [ICI; 19%], and increasing dementia [ID; 4%]). We fit racial/ethnic stratified regression models to examine relationships between cognitive phenotypes and wealth change, adjusting for covariates. Using Blinder-Oaxaca decomposition techniques, we examined the contributions of predisposing (e.g. race/ethnicity), health enabling (e.g. insurance source), and health needs (i.e. chronic conditions) factors in wealth change by cognitive phenotypes. Results show NH-Ws had higher levels of reported wealth in both 2000 and 2018, compared to NH-Bs and Hs. However, the relative rate of change in wealth was not-significantly different across race/ethnic groups. Education, insurance, and health explained most differences in wealth change related to cognitive impairment. Yet, nearly 50% of group differences in wealth changes remained unexplained. Future work should further elucidate sources of these unexplained differences, overall and by race/ethnicity.
RACIAL DIFFERENCES IN CORRESPONDENCE BETWEEN OBJECTIVE HEARING AND SUBJECTIVE HEARING RATINGS
Authors: Lewis Charity , Elayoubi Joanne , Arnold Michelle , Jang Yuri , Sanchez Victora , Toman Julia , Haley William
Published: December 2023

Background

Hearing loss and hearing health are underrecognized public health urgencies affecting over 70% of adults aged 70 and older. Untreated hearing loss has its association with higher prevalence of adverse physical and cognitive health outcomes. Current literature reveals racial disparities in hearing aid utilization. Based on the Health Belief Model suggesting that subjective beliefs are predictive of health behaviors, the present investigation focused on the correspondence between objective and subjective ratings of hearing in older Blacks and Whites. We identified groups that are concordant and discordant (overestimation and underestimation) in their ratings and explored determinants of the group membership.

Methods

We included participants over age 50 from the Health and Retirement Study (N = 2,495). Subjective and Objective hearing loss relation to race and age was determined via Chi-square analysis. Hierarchical linear regression models were completed to identify odds ratios for overestimation and underestimation of hearing.

Results

Whites aged 50-64 and 65-75 were significantly more concordant in their ratings than Blacks. Blacks aged 65-75 had significantly higher rates of overestimation of hearing. In a fully adjusted model for overestimation of hearing, Blacks had significantly greater odds of overestimation of hearing than Whites (OR = 1.47), and overestimation was significantly greater with higher age (OR = 1.03) and with tobacco use (OR = 1.29).

Conclusion

While mechanisms explaining lower hearing aid utilization in Black older adults need further study, perceived severity (consistent with the Health Belief Model) may be one component of reduced hearing aid use in Black older adults.
SLEEP PROBLEMS MEDIATE THE ASSOCIATION BETWEEN CHILDHOOD ADVERSITY AND LATE-LIFE COGNITIVE FUNCTIONING
Authors: Ahn SangNam , Xian Hong , Scherrer Jeffrey , Mahmood Asos , Ahn Eunhye , Kim Seonghoon , Beck McKenzie , Slavich George
Published: December 2023

The negative health impacts of childhood adversity have been well documented. However, little is known about the pathways linking childhood adversity with cognitive functioning later in life. We addressed this issue by examining the extent to which lifetime sleep problems mediated the effects of childhood adversity on late-life cognitive functioning. We used the 2002-2018 waves of the Health and Retirement Study in which participants were 20,607 adults (58.1% female), aged ≥50 years (Mage=68.9±9.5 years). Cognitive functioning was based on: 1) a 10-word immediate and delayed recall test of memory; 2) a serial 7s subtraction test of working memory; and 3) counting backwards to assess attention and processing speed. Sleep problems (e.g., difficulty initiating sleep) were assessed with the Jenkins Sleep Scale, and seven items of childhood adversity (e.g., physical abuse) were included from the list of lifetime potentially traumatic events. Path analysis revealed that there was a small but significant indirect relationship between childhood adversity and poor cognitive functioning through sleep problems (coefficient = -.014; p=.001). Indeed, about 3% of the effect of childhood adversity on cognitive functioning is mediated by sleep problems (i.e., 0.014 [indirect effect] / 0.476 [total effect]). Our findings can help policymakers and public health practitioners better understand the risk and protective factors of cognitive functioning later in life in relation to sleep problems among those individuals with childhood adverse events. Further research is warranted to determine if childhood adversity contributes to cognitive decline in those with trauma and PTSD compared to those with trauma alone.
CARE TRAJECTORIES AND WELLBEING OUTCOMES OF OLDER CARERS
Authors: Keating Norah , Fast Janet , Kim Choong
Published: December 2023

The UN Decade of Healthy Ageing states that family carers should not be held responsible for care. Yet families continue to provide the majority of care to members with long term health problems and disabilities. Their contributions to the economy remain unrecognized; their costs noted but relegated to private family matters. The purpose of this presentation is to determine wellbeing outcomes of older Canadians with diverse life course trajectories of care. Data are from the 2018 Statistics Canada nationally representative survey on caregiving. Sample for this study is ≈3000 people 65+ with one or more care episodes across their life course. Based on earlier conceptual and empirical work, we recreated 5 care trajectories. Wellbeing was measured based on material, relational and subjective domains. We conducted multivariate analyses (OLS, logistic and ordered logistic regressions) appropriate to the nature of the dependent variable) to assess whether care trajectory type predicted later life wellbeing. Results show significant differences in wellbeing among trajectory types. Serial carers had longest years of care and most care episodes. They experienced the most negative wellbeing outcomes compared to carers with other trajectory types in material wellbeing (poorer physical and mental health, lower employment income), and subjective wellbeing (higher stress). There were no significant differences across care trajectory types in relational wellbeing (loneliness). We discuss the place of public policy in addressing patterns of cumulative disadvantage in life courses of family care; and call for the development of indicators of wellbeing domains that best reflect these outcomes.
CONTINGENCY PLANNING AND STYLES OF PREPARATION FOR FUTURE CARE BY OLDER GRANDPARENT CAREGIVERS
Authors: Peterson Tina
Published: December 2023

The COVID-19 pandemic heightened attention to contingency planning in every area of life including family caregiving. Extended time in the caregiver role can increase problem-solving abilities; yet low rates of traditional contingency planning exist among custodial grandparents. This research applied Steele and colleagues’ four styles of preparation for future care (2003)—avoider, thinker, planner, or consenter—to older custodial grandparents raising adolescent grandchildren. Nineteen grandparents participated in face-to-face interviews. Criteria were: primary caregiver for a grandchild 12 or older; grandchild in home at least 3 days weekly; and grandparent 40 or older. Recruitment included word of mouth, newspapers, and flyers. Participants were asked “What is your thinking about caregiving arrangements for your grandchild in case you are no longer able to provide care? What actual steps, if any, have you taken to begin these caregiving arrangements?” Interviews were audiotaped, transcribed verbatim, and analyzed using conventional content analysis. The racial and ethnic composition of the grandparents were white (n=10), Black/African American (n=7), Native American (n=1), and Filipino (n=1). Most respondents were married (58%), white (53%), grandmothers (84%), with some college education or higher (79%), and an average age of 66 years. Grandparents identified as thinkers (42%), planners (32%), consenters (21%), and avoiders (5%). Two married grandfathers reported conflicting preparation styles (thinkers) in comparison to their spouses (planners). Grandparents often relied on oral opposed to formal written plans. Findings suggest research, practice, and education is needed to assess factors inhibiting aspects of contingency planning for future care among thinkers and avoiders, particularly older grandfathers.
EFFECTIVE SOLUTIONS FOR CAREGIVERS OF OLDER ADULTS: A RAPID UMBRELLA REVIEW
Authors: McHugh Molly , Munsterman Ellen , Cho HanNah , Naylor Mary
Published: December 2023

The negative health impacts confronting over 35 million informal caregivers of older adults in the U.S. are well documented. Although targeted interventions aimed at informal caregivers have demonstrated efficacy in mitigating poor caregiver outcomes, gaps in the literature regarding cost, scalability, and the impact of policy remain. Such knowledge is essential, given the projected growth in the need for caregiving associated with a rapidly aging population coupled with the shrinking of the caregiving workforce. This rapid umbrella review aims to synthesize findings from systematic reviews of randomized clinical trials of interventions that targeted caregivers and specified caregiver outcomes. The National Institute on Minority Health and Health Disparities research framework guided this review to identify gaps in existing intervention research. Databases from diverse disciplinary perspectives, including PubMed, Scopus, APA PsycINFO, ABIM, ATLA, Sociological Abstracts, PAIS, and EconLit, were searched from 2018 to 2023. A total of 52 systematic reviews that met inclusion criteria and were published in English were included in the final review. Reviews described interventions targeting caregivers of older adults with the following conditions: dementia (30), stroke (4), cancer (4), heart disease (1), renal disease (1), mental illness (1), and mixed-diagnoses (11). Major findings reveal varied effects on caregiver burden, quality of life, and mental health, and the growing integration of telehealth interventions. Studies were commonly limited by heterogeneity of interventions and outcomes and small effect sizes. Future intervention development should consider targeting the specific needs of diverse caregivers and scaling effective interventions to broader caregiver populations.
LIFESTYLE TRAJECTORIES PREDICT LATER COGNITIVE FUNCTION AMONG OLDER PEOPLE IN TAIWAN
Authors: Hsu Hui-chuan
Published: December 2023

Purpose

The purpose of this study was to identify the group-based trajectories of lifestyles and to predict the later cognitive function among older people in Taiwan.

Methods

The data were from five waves of the “Taiwan Survey on Aging “ (1999-2015). Only those who completed the last wave of cognitive function were used for analysis (n=1314). The cognitive function was measured by 8 items of SPMSQ, reverse numbers and recall 10 words, with score ranged 0-19. Nineteen lifestyle behaviors (healthy behaviors, leisure activities, lifelong learning and social participation) across waves were analysed by group-based trajectory analysis first, and then the effects of lifestyle trajectories on cognitive function were analysed by linear regression.

Results

Each lifestyle variable was identified as 2 to 6 trajectory groups. Significant lifestyle trajectories on later cognitive function included gardening (high), drinking (increasing), providing instrumental support (increasing), playing chess (high), reading (middle & high), outdoor activities (high), group activities (yes), political participation (no), volunteering (yes), and stress (high vs. lowest). After controlling for covariates, cognitive function was related to gardening (high) (B=0.642), playing chess (high) (B=0.855), reading (high) (B=1.699), group activities (B=0.640), and lower stress (high stress B=−0.806). Other significant variables for better cognitive function included younger age, living with less family members, having less physical function difficulties, having lower depressive symptoms, and being more religious.

Conclusion

Long-term lifestyle trajectories may affect later cognitive function. Having more social participation, more cognitive-related leisure, having less stress and being physically healthier are protective for cognitive function.
MEDIATING ROLE OF REST–ACTIVITY RHYTHM ON THE RELATIONSHIP BETWEEN DEPRESSIVE SYMPTOM AND COGNITION IN OLDER ADULTS
Authors: Zhang Meina , Moon Chooza , Hoth Karin
Published: December 2023

Depressive symptoms and cognitive impairments are common problems in older adults. Rest-Activity Rhythm (RAR) encompasses sleep, physical activity, and rest in 24 hours. Often, individuals with depressive symptoms present altered RAR. The purpose of the study is to investigate the mediating role of RAR on the relationship between depressive symptoms and cognition in older adults using path analysis. Sixty community-dwelling older adults wore the actigraphy for two weeks (mean age ± SD=70 ±7.3, female n =32(53%)). We assessed RAR using nonparametric RAR metrics, such as interdaily stability (IS) (the similarity of one 24-hour cycle to the next), intradaily variability (IV) (the fragmentation of RAR within 24-hour periods), and relative amplitude (RA) (physical activity difference between the least active 5 hours and the most active 10 hours period). Participants completed 90 minutes’ neuropsychological assessments (11 tests) across five domains to assess cognition and the Center for Epidemiologic Studies Depression scale to assess depressive symptoms. After adjusting for age, gender, and years of education, greater depressive symptoms were directly associated with reduced cognition (β= -0.406, P= 0.0001) as well as reduced IS (β= -26.9, P= 0.022). We also found direct positive relationships between IS (β=6.68, P=0.013), IV (β= 3.36, P=0.017), RA (β=3.42, P=0.015) and visuospatial memory, as well as IS (β=1.98, P=0.005), IV (β=3.77, P=0.004) and psychomotor speed. The indirect effect of depressive symptoms on cognition through RAR was not significant . Further research should be undertaken using a large, diverse sample, and prospective design.
MEDITERRANEAN DIET ADHERENCE PROSPECTIVELY PREDICTS NINE-YEAR CHANGES IN EPISODIC MEMORY
Authors: Parker Kelly , McGrath Ryan , Rhee Yeong , Hamm Jeremy
Published: December 2023

Mediterranean diet (MD) adherence has been shown to foster cognitive function during aging. Methods for measuring adherence to the MD typically provide or withhold points for foods consumed. Few investigations have examined how adherence to a Western adaptation of the MD may influence cognitive function over time in the United States. A modified MD that includes dairy products, whole grains, and plant-based proteins with limited consumption of sugar-sweetened beverages may be more attainable for many Americans than the traditional MD. This secondary analysis examined whether adherence to a modified MD was predictive of episodic memory and executive function over a 9-year study period. The second wave of the Midlife in the United States Study assessed general diet qualities with a food frequency questionnaire, and cognitive function was measured at both waves 2 and 3 (N = 816; age: 46 +/- 12 years; 56% female). Regression analyses were conducted to determine whether MD adherence predicted 9-year regressed change in cognitive function while controlling for age, sex, race, socioeconomic status (SES), and biomarkers of glucose homeostasis (hemoglobin a1c, insulin, and blood glucose). MD predicted changes in episodic memory (β = 0.075, p = 0.013) but not executive functioning (β = -0.028, p = 0.210). Exploratory moderator analyses suggested that MD associations with episodic memory were observed for only younger and middle-aged adults, females, White individuals, and persons with lower SES. Increased MD adherence may serve as a modifiable factor that supports cognitive function and preserved episodic memory during aging.
PERCEIVED SOCIO-EMOTIONAL BENEFITS TO GAMEPLAY FOR MILD COGNITIVE IMPAIRMENT–CARE PARTNER DYADS
Authors: Mumma Kara , Griffiths Patricia , Harris Frances , Gandy Maribeth , Kerssens Chantal
Published: December 2023

Mild Cognitive Impairment (MCI) can increase social isolation by making it difficult to engage in once enjoyable activities with others, which in turn, can exacerbate cognitive decline. Games offer stimulating cognitive and social activity, but many are not designed for individuals with MCI. A structured interview was conducted to aid in the co-design of an adaptive game for individuals with MCI and their care partners. Preliminary results on the specific barriers and facilitators affecting game play to inform design and improve accessibility were previously reported (Kerssens et al., 2020). Here we report on the perceived socio-emotional benefits identified by seven dyads who were interviewed regarding game play experience and perceptions. The dyads comprised of an individual with a clinical diagnosis of MCI (85.7% male; age range 62-85 years) and a care partner (85.7% female; age range 41-76 years). The interviews were transcribed and analyzed thematically, independently coded, and reviewed until consensus was reached. The dyads iterated many “social,” “emotional,” and “impacts” of gameplay, prompting an examination of subjective elements of game play. For example, they enjoy the simplicity and familiarity of playing games – either as a playful diversion from their everyday routine or as part of a routine. Quantitative results are reported across dyads and themes. Descriptive quotes and individual qualia are presented to illustrate specific examples of benefits and detriments to gameplay. Results are discussed in terms of the implications of game play for fostering meaningful, potentially therapeutic social activities for individuals with MCI and their care partners.
PHYSICAL ACTIVITY AS A MEDIATOR BETWEEN RACE/ETHNICITY AND CHANGES IN COGNITION
Authors: Newsom Jason , Kroeck Mallory , Trubits Em , Saucedo Jennifer , Botoseneanu Anda , Allore Heather , Nagel Corey , Quiñones Ana
Published: December 2023

Racial/ethnic disparities in the rate of cognitive decline in older age have been established. Studies also report differences in physical activity across racial/ethnic groups. We investigated whether racial/ethnic differences in changes in cognition over a 12-year period (2006-2018) were mediated by physical activity using data from the Health and Retirement Study (N = 16,777, mean baseline age = 66.0 years). Structural equation modeling was used to estimate a latent growth curve model of changes in cognitive scores (27-item TICS) and investigate whether the relationship of race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White) to change in cognition was mediated by physical activity after controlling for age, sex, education, marital status, personal wealth, and insurance coverage. Results indicated that Blacks engaged in significantly lower levels of physical activity than Whites (b = -.176, ♌ = -.123, p < .001), but there were no differences between Hispanics and Whites (b = .028, ♌ = .017, ns). Physical activity significantly predicted higher initial cognitive scores (b = 5.205, ♌ = .610, p < .001) and less decline in cognitive scores over time (b = 1.063, ♌ = .796, p < .001). The indirect (mediational) effect for the Black vs. White comparison on changes in cognitive score was significant (b = .187, ♌ = .152, 95% CI [.135,.244]). These results provide important new information for understanding how physical activity, a modifiable lifestyle factor, may help explain racial/ethnic disparities in cognitive decline in middle and later life, suggesting greater need to reduce sedentary behavior and increase activity.
THE IMPACT OF LEISURE ACTIVITIES ON OLDER ADULTS’ COGNITIVE FUNCTION
Authors: Lee Jungjoo , Oh Seokmin , Rodriguez Miriam , Kim Junhyoung
Published: December 2023

The purpose of the present study was to investigate the relationship between types of leisure activities (i.e., Leisure-Time Physical Activity (LTPA), intellectually stimulating activities, and community-based activity and the cognitive functions of older adults. We extracted 3,767 samples from the 2020 Health and Retirement Study (n = 15,723). Cognitive functions: (a) memory was assessed by both immediate and delayed recall tests, b) working memory was measured by a subtraction-by-7 test, and (c) attention and processing speed was assessed by the counting back word test. Hierarchical regression analysis was used to investigate the relationship between types of leisure and cognitive functions. LTPA, intellectual leisure, and community-based leisure were significantly associated with improved memory function. The intellectual activity was significantly associated with improved working memory and improved attention and processing speed. This finding provides practical implications for healthcare providers and therapists to design and implement various types of leisure for older adults.
AGING IN PLACE FOR OLDER HOMELESS VETERANS LIVING IN VA SUPPORTIVE HOUSING
Authors: Maitra Medha , Brown Rebecca
Published: December 2023

Aging in place, defined as the ability to live comfortably, safely, and independently in one’s own home and community, is a priority for many older adults and a growing focus of research and policy efforts. However, little is known about perspectives on and experiences of aging in place among the growing population of older adults with experiences of homelessness, whose perspectives may differ from adults in the general population. Using qualitative interviews with veterans living in U.S. Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) apartments and focus groups with HUD-VASH staff members, we explored perspectives on and experiences of aging in place, including barriers and facilitators to aging in place in this setting.
EDITING CDKN1A AND RASD1 IN A CELL CULTURE SYSTEM
Authors: Vue Hope , Agrimson Kellie
Published: December 2023

As an individual ages, there is a higher incidence of cancer and infertility. Testicular germ cell cancer rates have been rising year after year. According to the American Cancer Society 1 of every 250 males will develop testicular cancer during their lifetime. In this research project, we aim to develop a molecular toolbox to analyze gene function in male germinal cells using a CRISPR/Cas9 cell culture system. This biotechnology allows for the targeted alteration and cutting of specific DNA strands. To achieve this, we will utilize cancer cell lines (SUSA and NT2/D1 testicular cancer cell lines) and knock out two genes of interest: cyclin-dependent kinase inhibitor 1 (CDKN1A) and ras-related dexamethasone-induced 1 (RASD1). Our objective is to investigate the effects of gene knockout on cell proliferation. For this purpose, we designed primers and single-guide RNAs using bioinformatic databases: Benchling and Chop Chop. The tools we used were employed to amplify human genomic DNA and assess the effectiveness of the guide RNAs through in vitro cutting of our genes of interest, followed by gel electrophoresis observations. Based on the results obtained from these experiments, our next step is to electroporate the guide RNA and Cas9 complex to alter gene function in our cell culture system. Through a better understanding of gene function in testicular cancer cell lines, we hope to inform future therapeutic targets for both testicular cancer and age-related infertility.
A PORTABLE TECHNOLOGY-BASED BALANCE ASSESSMENT PREDICTS FALL RISKS IN LOW-INCOME COMMUNITY-DWELLING OLDER ADULTS
Authors: Trahan Evette , Komalasari Renata , Thiamwong Ladda
Published: December 2023

Despite strong evidence on the association between balance performance and fall risks, there is a need for further studies among racially diverse low-income communities. Sixty-two healthy, low-income community-dwelling older adults (mean 74.11, SD: 6.34, 61-88 years old) in Central Florida were recruited and administered the BTrackS Balance Tracking System (BBS) for measuring balance performance. BBS is a postural sway-based balance performance assessment, where participants were guided to stand still on the BBS plate with hands on hips and eyes closed for about 1-2 minutes. Fall risk was assessed by the Centers for Disease Control and Prevention (CDC)’s twelve-item self-assessment checklist, Stopping Elderly Accidents, Deaths & Injuries (STEADI). About 58% of participants were African Americans, completed high school (54.8%), lived alone (67.7%), and earned just enough financially (54.8%). The simple regression results indicated that the model explained 14.9% of the variance (R2=.149, F (1,60) = 10.47, p =.002). Higher BBS scores (β = .100, p =.002) were significantly associated with higher fall risk scores. As older adults had reduced balance, their fall risks increased. The findings of this study confirmed the benefits of using a combination of a simple fall risk checklist and a portable assessment technology in enhancing the accessibility of balance and fall risk screening. Furthermore, a technology-based balance performance assessment is key in tailoring fall interventions for older adults with poor balance.
A SCOPING REVIEW OF SOCIAL DETERMINANTS OF HEALTH IN CHARLES BONNET SYNDROME RESEARCH
Authors: Strong Joe , Amano Takashi , Hoàng Isabella , Amaza Hannatu , Tilsen Rachel
Published: December 2023

Charles Bonnet Syndrome (CBS) is a neurological condition featuring pseudohallucinations that affects previously sighted individuals, many of whom are older adults. The CBS literature primarily concerns prevalence estimates, neurological studies, and experiences of people living with the condition; it is not clear what is known concerning social determinants of health (SDoH). We conducted a scoping review guided by Healthy People 2030 SDoH categories including Economic Stability, Education Access & Quality, Health Care Access & Quality, Neighbourhood & Built Environment, and Social & Community Context. Research articles included in this study represent 5 countries on 5 different continents. Sample size ranged from 5 to 88 across all included studies (M = 40.25, Median = 33). Two studies did not report enough info to extract mean age; Mean of mean age across the remaining 6 studies is 63.25 (Range: 27.8-79.47). Across the 8 included articles, 9 different SDoH variables were identified, representing 4 of the 5 Healthy People 2030 SDoH categories, with the exception of Health Care Access & Quality. All studies reported age and gender, most reported education (n = 6, 75%) and living arrangement (n = 5, 62.5%), and half (n = 4) reported marital status. Few studies, however, reported race (n = 2, 25%), loneliness/social life (n = 2, 25%), occupational status (n = 1, 12.5%), and living environment (n = 1, 12.5%). This study highlights the need for expanded inclusion of SDoH variables in CBS research to fill gaps in the knowledge base in this understudied condition.
“THERE IS A SHORTAGE AND MISUSE OF TERTIARY NURSING”: PERSPECTIVES OF NURSING ASSISTANTS IN ACUTE CARE
Authors: Wagner Jennifer , Miller Vivian , Maziarz Lauren , Burek Melissa , Bell Julia , Perry Kaley
Published: December 2023

The primary role of nursing assistants (CNAs) in the acute care setting is to provide direct care to patients. As frontline workers, they are often the first to report changes in condition to the licensed staff. The U.S. Bureau of Labor Statistics projects an increased employment need for nurse aides over the next ten years. However, the annual rate of nurse aide turnover is over 120 percent. A study conducted in 2015 by Brady suggests that there is a 36% turnover rate nationwide in acute care. Guided by a socio-ecological model, qualitative findings from 17 nurse aides (N=17) reveal interpersonal factors, such as relationships with others at the workplace and relationships with patients, as impacting turnover. Institutional and Community factors were also found to impact turnover, including staffing levels, resources, education, and compensation. Informed by the interview findings, a quantitative study was created. CNAs (N=230) from a variety of health care settings participated. Twenty-five percent were from the acute care system (N=56). More than seventy percent (N= 40) have considered leaving their employment. The top two reasons were pay (N=15) and to pursue other things (N=9). The top two work challenges were providing direct care to bariatric patients (N=28) and not enough supplies (N=13). The favorite part of working in acute care is getting to know the patients (N=26). Little research has been conducted on the turnover of CNAs in the acute care setting. CNAs are vital to caring for patients in the acute care system.
ADDRESSING BARRIERS TO A FULL RANGE OF EVIDENCE-BASED OBESITY CARE FOR OLDER ADULTS: A GSA ROUNDTABLE DISCUSSION
Authors: Batsis John , Lofton Jason , Pendrey Anna , Starr Kathryn Porter , Pettis Jennifer , Tracy Karen
Published: December 2023

Obesity is identified as a chronic disease by the American Medical Association and several professional societies such as the American College of Cardiology, the American Heart Association, The Obesity Society, and the American Gastroenterological Association. These organizations have all established clinical guidelines on caring for individuals with obesity and overweight. However, there is a critical lack of appropriate and individualized treatment strategies for older adults with obesity. To address this issue, in June 2023 The Gerontological Society of America (GSA) convened 15 multidisciplinary leaders in a roundtable discussion on Addressing Barriers to Accessing a Full Range of Evidence-Based Obesity Care Options by Older Adults. Roundtable participants identified how to overcome obesity/overweight perceptions, communicate appropriately with older adults about their body size, address cultural differences in obesity care, provide care in conjunction with common comorbidities that are faced by older adults, collaborate with an interprofessional team to care for older adults with obesity, overcome barriers to implementation of lifestyle changes including diet and exercise, incorporate medical and surgical interventions, and align needs of older adults with community resources. This poster will illustrate key findings from this roundtable discussion.
ADOPTING A STRENGTH-BASED, PERSON-CENTERED RISK ASSESSMENT CLINICAL DECISION SUPPORT TOOL: WHAT ARE THE BENEFITS?
Authors: MacLeod Heather , Provencher Véronique , Kessler Dorothy , Egan Mary , Giroux Dominique , Kergoat Marie-Jeanne , Krystina Lewis , Nathalie Veillette
Published: December 2023

Most older adults want to age in place even if changes in their health results in home safety concerns. A consistent approach to assessing both the physical and psychological risks associated with the decision to remain at home is lacking. The Living with Risk: Decision Support Approach (LwR:DSA) is a recently validated innovative clinical tool that supports a balanced, systematic and person-centered assessment of risks, by analyzing their negative and positive consequences. The aim of this mixed-method study was to understand the barriers and facilitators to using the LwR:DSA during usual care to determine how best to support widespread adoption. Twenty-two hospital- and community-based clinicians used the LwR:DSA for eight weeks. Individual interviews were performed to document the factors that hindered and helped the use of the LwR:DSA in their clinical setting. The interviews were analyzed using Qualitative Description and the positive impact of using the LwR:DSA emerged as one of the facilitator themes. The participants described that using the LwR:DSA in practice improved their clinical decision making, communication and their ability to provide person-centered care. More specifically, the LwR:DSA 1) helped the clinicians understand the risk level and the context, causes, and consequences of the safety concern; 2) guided them to co-create with the older adult, agreeable recommendations to reduce the risk of adverse outcomes; 3) decreased clinician discomfort and 4) supported authentic conversations with the older adult. Understanding the benefits of using the LwR:DSA provides key information for clinicians by challenging the status quo of their current practice.
ALCOHOL CONSUMPTION AND DECREASED SERUM Α-KLOTHO, AN ANTI-AGING HORMONE, LEVELS AMONG US ADULT PARTICIPANTS
Authors: Fromm Dylan , Zhu Jianmin , Kim Wonjun , Wei Yudan
Published: December 2023

Background

The Klotho protein is widely accepted to be a prominent anti-aging biomarker for health and longevity. The relationship between alcohol intake and serum levels of soluble ɑ-Klotho is not well understood.

Methods

In this study, we explored this relationship in a nationally representative sample of US adults. A total of 3970 male and female adults aged 40-79 years from the 2013-2016 National Health and Nutrition Examination Surveys were analyzed using multiple general linear models. Participants were classified as non-drinkers, light drinkers (consumed on average < 4 drinks in males and < 3 drinks in females per day), and heavy drinkers (consumed on average ≥4 drinks in males and ≥3 drinks in females per day), according to a national guideline.

Results

Significantly decreased serum ɑ-Klotho levels were found in both light drinkers and heavy drinkers, with the weighted geometric mean of 785.18 pg/mL (p = 0.0007) in light drinkers and 750.96 pg/mL (p = <.0001) in heavy drinkers, compared to that in non-drinkers (827.19 pg/mL). After adjusting for covariates, light drinking was associated with a 3.66% (p = 0.0081) decrease in serum ɑ-Klotho levels, and heavy drinking with an 8.07% decrease (p = <.0001) in ɑ-Klotho levels, as compared with non-alcohol drinking. Similarly, binge drinking was also associated in a 5.22% (p = <.0001) decrease in serum ɑ-Klotho, compared to non-binge drinking.

Conclusion

This study demonstrates a significantly inverse relationship between alcohol consumption and serum ɑ-Klotho levels in middle-aged and older adults. Prospective studies are warranted to elucidate these interactions.
ALZHEIMER’S DISEASE RISK REDUCTION HEALTH COACHING: COMPARATIVE ANALYSIS
Authors: Zanjani Faika , Battle Brian , Richardson Joann
Published: December 2023

Recent guidelines point to lifestyle change as a tool for decreasing Alzheimer’s disease (AD) risk. To address the limited practice of AD risk reduction and the greater AD prevalence in minority groups, this study aimed to explore the feasibility of a community-level lifestyle intervention targeting high-risk groups. Diverse older adults (60+) living in the Richmond, VA local area, with incomes below $12,000/year and managing diabetes/cardiovascular disease were offered weekly lifestyle telephone-health coaching for 12-weeks in 2019-2020 (Phase 1). The health coaching sessions provided AD lifestyle risk reduction education and goal setting/planning. The intervention sample (n=40, mean age 68 years (range: 60-76 years)) was 90% African American/Black (n=36), 45% males (n=18). Thereafter 2021-2022, n=37 individuals in the same area were recruited as a comparison group and not given health coaching (Phase 2), mean age 65.5 years (range: 57-83 years) was 92% African American/Black (n=34), 50% males (n=18). Demographic differences across groups, indicated that the intervention group was more likely to live alone (p<.01). Repeated measures intervention effects were seen for cognitive ability, indicating greater gains in the intervention group (p<.01). Significant difference score effects indicated greater cognitive ability (p<.01) and physical activity (p<.001) gains in the intervention group; with less physical activity gains (p<.02) for subjective cognitive decline group. This preliminary work creates the impetus for future large-scale AD risk reduction investigations to improve modifiable risk among diverse older adults. Our positive trends in AD risk reduction support the feasibility of telephone-based health coaching AD risk reduction interventions.
AN INTERACTION EFFECT OF INTERNET USE AND SOCIAL PARTICIPATION ON LITERACY ABOUT FRAILTY IN OLDER JAPANESE
Authors: Fujiwara Natsumi , Akagi Yuya , Yoshida Hiroko , Kamide Kei , Koetaka Hanayo , Kido Michiko , Li Yaya , Kabayama Mai
Published: December 2023

Objectives

This study aimed to analyze the age difference of the interaction effect of internet use and social participation on literacy about frailty in older Japanese.

Methods

Data were collected from community-dwelling older adults aged 65-89 years randomly selected from residential registration by self-reported postal questionnaires (n=5005, response rate 49.0%). We asked them about their background, whether they use the internet to obtain health information, and whether they know the term of frailty（know what it meant / don’t know what it means but have heard of it or never heard of it and don’t know）.Logistic regression stratified by age (65-74 and 75-89 years) was used to evaluate the association of literacy about frailty with internet use and social participation adjusted for gender,education, frailty status, physical activity. The interaction between internet use and social participation on literacy about frailty was also assessed.

Results

Results showed that in both age groups, the interaction revealed that a combination of social participation and internet use was associated with a high literacy about frailty (65-74 years: OR=1.64,95%CI=1.28-2.11; 75-89 years: OR=1.92,95%CI=1.45-2.56). Only in the 75-89 age group, Internet use alone without social participation was significantly associated with a high literacy about frailty (OR=1.60,95%CI=1.12-2.30).

Conclusion

Our findings suggest that internet use may be beneficial for improving literacy about frailty especially for the elderly over 75 years old, however, social participation should also be taken into consideration for those. Longitudinal research is needed.
ARE RURAL OLDER VETERANS SATISFIED WITH VIRTUAL COMPREHENSIVE GERIATRIC ASSESSMENTS?
Authors: Sawyer Linda , Keller Hallie , Howell Teresa , Cervantes Maria , Dunlap Janette , Cigolle Christine , Sullivan Dennis
Published: December 2023

Rural older Veterans (ROV) have limited access to comprehensive geriatric assessments (CGA). VA Video Connect (VVC) can potentially overcome this access barrier. A standardized process was developed and piloted, to conduct CGAs by VVC. It was found to be feasible and facilitated access to CGAs. The purpose of this study was to assess ROVs’ satisfaction with CGA via VVC. The team developed a 10-item questionnaire with good face and content validity to assess satisfaction with the CGA and process. All ROVs who completed a CGA via VVC were telephoned. They were asked to rate each item on a Likert scale. Caregivers were allowed to assist but the final answer came from Veteran themselves. The results are summarized as percentage of respondents who “agree” or “strongly agree”. ROVs also provided comments. Of the 79 ROVs who completed the CGA via VVC, 63 OVs completed the questionnaire. Most were white (82.8%) males (95.4%), with mean(±SD) age 75.7(±6.5). Most felt it was easy to communicate with the providers (95.2%) and understood the information they were given (98.4%). Most felt comfortable using the technology (75.8%) and that the visit was private enough (96.8%). Although many commented they would prefer in-person visits, most agreed that they would do virtual visits again if offered (71.4%). Overall, they “agreed that they would not change anything about the CGA process (95.2%). The results suggest that ROVs were satisfied with CGA via VVC. More research is needed to determine the outcomes, benefits, and limitations of CGAs performed by VVC.