bluuebunny/crossref_metadata_2025 huggingface dataset:
COGNITION ON THE GO: UNIQUE INSIGHTS INTO BRAIN HEALTH FROM HIGH-FREQUENCY COGNITIVE APPROACHES
Authors: Oravecz Zita , Germine Laura
Published: December 2023

High-frequency ambulatory cognitive assessments offer the opportunity to examine cognitive change at multiple timescales. When deployed multiple times per day via pervasive mobile technology (e.g., smartphones), ambulatory cognitive assessments allow us to conduct semi-continuous monitoring of cognitive changes while individuals go about their daily lives. Variation in performance that occurs over these short timescales may be associated with a wide range of contextual factors (e.g., our thoughts, emotions, and behaviors) including the way we respond to challenges presented by our everyday environments. Short-term change and variation may also reveal information about overall brain health and risk for cognitive decline over longer timescales. This symposium focuses on how high-frequency, ambulatory cognitive assessments can generate new insights into cognitive aging, psychological processes, and risk for neurocognitive decline by revealing detailed patterns of cognitive change and variation over short timescales (hours to weeks). The talk by Sliwinski et al. gives an overview of high-frequency cognitive assessment approaches. The talk by Harrington et al. will show how dimensions of experienced affect may influence short-term changes in multiple domains of cognition. The talk by Hakun et al. will show how short-term cognitive variation may predict how we respond to everyday stressful experiences. The talk by Oravecz et al. will show how to extract substantively meaningful predictors of long-term cognitive change from short-term processes such as retest learning.
ASSOCIATION BETWEEN PROVIDER DISCONTINUITY AND QUALITY OF CARE FOR NURSING HOME RESIDENTS
Authors: Yun Hyunkyung , Unruh Mark , Jung Hye-Young
Published: December 2023

Discontinuity in outpatient care has been associated with lower quality care in community settings, but little is known about discontinuity of care in nursing homes (NHs). We examined discontinuity in clinician care and care quality for NH residents using Medicare fee-for-service claims for a 20% national sample of beneficiaries (January 1, 2012 to December 31, 2019). For residents with NH stays of ≥2 years, we examined changes in attributed clinicians during the first two years of their stays. Residents were attributed to the physician or advanced practitioner with a plurality of visits provided to them in the NH in a given year. Estimates were adjusted for resident, clinician, and NH characteristics. The determinant of interest reflected whether there was a change in the attributed clinician from the first to the second year. Among 280,831 residents in our sample, 37.6% (105,551) were attributed to a different clinician in their second year. On a quarterly basis, these residents had a 0.2 percentage point [pp] (95%CI, 0.2-0.3; p-value <.001) higher likelihood of an ambulatory care sensitive (ACS) hospitalization, a 0.2 pp (95% CI, 0.1-0.3; p-value <.001) higher likelihood of an ACS emergency department (ED) visit, and $609 (95% CI, $548.4-$669.5; p-value <.001) higher health care costs in their second year compared to residents without a clinician change. Compared to baseline rates, these represent relative increases of 14.2% in ACS hospitalizations, 11.5% in ACS ED visits, and 8% in costs. Discontinuity in care is associated with lower-quality care for NH residents.
LOWERING THE AGE FOR MEDICARE ELIGIBILITY: WHO BENEFITS?
Authors: Sneed Rodlescia
Published: December 2023

Advocacy groups and government officials have recommended lowering the Medicare eligibility age to increase health equity and promote utilization of preventive services. Consequently, policy analysts have begun to evaluate the impact of such a policy change. The purpose of this study was to determine who would benefit most from reducing the Medicare eligibility age. Using data from the 2018 Health and Retirement Study, we calculated the number of individuals who would become insured if the Medicare eligibility age was reduced to 60, 55, or 51. We also examined health profiles for such individuals, comparing them to their insured counterparts. Complex survey procedures were used to generate population estimates. We estimate that 1.43 million Americans would become insured if the Medicare eligibility age were reduced to 60. Lowering the age to 55 or 51 would insure 3.45 million and 4.59 million people, respectively. Evaluating data for those ages 51-64, those currently uninsured reported less preventive health screening than their insured counterparts, including lower screening for high cholesterol, cervical cancer, and prostate cancer. They also had lower vaccination rates for influenza and shingles. Of those currently uninsured, 36.5% reported having no usual place where they received care. Hypertension prevalence was similar among insured and uninsured individuals, but the uninsured were less likely to be on antihypertensive medications. Taken together, our findings suggest that lowering the Medicare eligibility age would result in new healthcare coverage for individuals who underutilize the healthcare system, which could have important implications for health.
THE ROLE OF FRAILTY ON THE IMPACT OF SOCIAL RELATIONSHIPS ON HEALTH OUTCOMES: RESULT FROM THE FRÉLE LONGITUDINAL STUDY
Authors: Mehrabi Fereshteh , Béland François
Published: December 2023

The link between social relationships and health is well-established as per Berkman and Krishna’s theory. However, the biological mechanisms by which social relationships impact health, such as frailty, remain unknown. This study aimed to examine whether the effects of changes in social relationships on changes in physical, mental, and cognitive health outcomes varied among frail older adults compared to robust peers. Data were from three waves of the FRéLE study among 1643 Canadian community-dwelling older adults aged 65 years and over. We performed latent growth curve models (LGMs) to test our objectives with the assumption of missing not at random. We measured social isolation through social participation, social networks, and support from different social ties (e.g., children, friends). We assessed frailty using the phenotype of frailty. Health outcomes include disability, chronic diseases, depression, and cognitive decline. The results revealed that increasing changes in social participation, social contact with friends, and social support from different social ties were associated with greater changes in cognitive and mental health, but not physical health, among frailer older adults compared to those who were more robust. This longitudinal study suggests that social support has a protective and compensatory role in enhancing mental health among frail older adults, but not among robust peers. Public health policies and interventions should focus on ameliorating social connectedness among physically frail older adults to enhance mental health outcomes. Future research studies could explore other risk factors that impact the relationships between social connectedness and health among older populations.
DENTAL-RELATED DECISION-MAKING CAPACITY IN OLDER ADULTS WITH VARIED COGNITIVE FUNCTIONS
Authors: Chen Xi , Madiloggovit-Lower Jirakate , Comnick Carissa
Published: December 2023

Background

Decision-making is often impaired in individuals with cognitive impairments. However, how cognitive impairment affects dental treatment decision-making remains unclear. We sought to describe dental-related decision-making capacity in older adults with varied cognitive functions.

Methods

Sixty-five participants, including 14 healthy controls and 51 with documented cognitive impairment, were categorized into healthy controls, mild cognitive impairment (MCI), mild dementia, moderate dementia and severe dementia. A hyperthetical dental problem along with three treatment options were presented. Participants were first asked to identify the problem, related treatment options and the pros and cons of each option. They were then asked to choose a treatment using the given funds. Visual and verbal cues were provided if participants failed to complete the task independently. Participants were scored based on their performances. Data was analyzed using the Kruskal- Wallis test and Holm method for multiple comparisons and a linear regression model for the multivariate analysis.

Results

Ninety-six percent of the participants with cognitive impairment showed some sorts of deficits in treatment decision-making. Sixty percent of those with MCI and 70% of participants with mild dementia could not explain pros and cons of the treatment choices, significantly higher than that in the healthy controls (10%). The decision-making capacity significantly differed across groups (p< 000.1). Compared to the health controls, decision-making capacity decreased 18%, 33%, 71% and 86% in the MCI, mild dementia, moderate dementia and severe dementia groups, respectively.

Conclusion

Dental-related decision-making deficits was highly prevalent in older adults with cognitive impairment and occurred as early as MCI.
CONTRAST SENSITIVITY AND BRAIN NETWORK COMMUNITY STRUCTURE IN THE BRAIN NETWORKS AND MOBILITY STUDY
Authors: Thompson Atalie , Tanase Alexis , Miller Michael , Williamson Jeff , Hugenschmidt Christina , Chen Haiying , Kritchevsky Stephen , Laurienti Paul
Published: December 2023

Contrast sensitivity (CS) is the ability to perceive differences in shades of light and dark, which is important for pattern recognition and depth perception. We have previously shown that impaired CS is associated with poor performance on the expanded short physical performance battery (eSPPB), and that performance on the eSPPB is associated with sensory motor cortex (SMC) connectivity at rest. We hypothesized that brain networks are important to the relationship of CS with eSPPB. Participants (n=192) were cognitively unimpaired older adults (mean age=76.5±4.7 years; 56.5% female, 9.4% black) with good visual acuity who completed CS testing. We applied graph theory to characterize the cross-sectional relationship of binocular CS to functional brain networks generated from fMRI both at rest and during a motor imagery (MI) task and determined the spatial patterns of SMC, visual (VIS) and default mode (DMN) network connectivity. Regression analyses were used to assess associations of CS with brain network connectivity without and with adjustment for sex and eSPPB. Lower CS (p=0.009) was significantly associated with degraded SMC connectivity at rest even in models adjusted for eSPPB and sex. Similarly, lower CS was significantly associated with degraded VIS and DMN connectivity during the MI task (all p< 0.005) when controlling for eSPPB and sex. These results indicate that low CS and poor eSPPB are both associated with connectivity in the SMC at rest and with VIS and DMN during MI in older adults. These findings may be important for understanding the relationship between age-related visual and mobility dysfunction.
ADDRESSING CURRICULUM DESIGN CHALLENGES: THREE DELIVERY DESIGN OPTIONS FOR UNDERGRADUATE AGING AND HEALTH COURSE
Authors: Pagan Mary Theresa , Seo Minjung
Published: December 2023

Providing a comprehensive gerontology course to diverse academic majors is a curriculum design challenge. Current research indicates students seek out the delivery option best suited to their needs, requiring educators to design or modify courses to provide face-to-face, hybrid, and online opportunities. Further, gerontologists are challenged with initial student knowledge and views on aging, aging processes, and health disparities shaped primarily by personal/life experiences with older adults and media representations of aging. Significant design and quality assurance were minimized by utilizing the recognized work of established gerontologists providing the overall framework for a comprehensive aging course Segmenting the course into two sections, social determinants of health utilizing Deborah Carr’s Golden Years? Social Inequalities in Later Life and target population research, Grandmothers at Work, Juggling Families and Jobs by Madonna Harrington Meyer. As a research design, a mixed method design (questionnaire and interview was used on seventy-eight students (Male: 27, Female: 51) enrolled in face-to-face, hybrid, and online delivery options. As a result of attending the three-credit course, significant knowledge-base increases were found in four key content areas: 1) social determinants of health (83%), 2) theories (sociological and biological)-(90%), 3) socioeconomic (SES) variations (80), and 4) mixed methods research design (62%). A curated library of online resources (youtube, Ted Talks, documentaries, news reports) supplemented the course textbooks for each learning module, resulting in a ninety-six percent resource satisfaction evaluation average for the three delivery methods.
NURSING STUDENTS’ RESPONSE TO THE AGE-FRIENDLY HEALTH SYSTEMS 4MS FRAMEWORK CURRICULUM
Authors: O’Connor Timothy , Pandya Naushira , Tewary Sweta , Shnayder Oksana
Published: December 2023

Problem

There is a shortage of registered nurses, especially those choosing to work in long-term care. Providing interdisciplinary education on age-friendly health care to nursing students offers long-term care as a career option post-graduation. To evaluate the effectiveness of teaching nursing students about age-friendly health care, the students must provide adequate feedback on the educational content they receive. Purpose: This project is part of the Age-Friendly Health Systems 4Ms project and identified why nursing students did not complete a comprehensive survey after receiving an interdisciplinary educational session based on the Age-Friendly Health Systems 4Ms Framework. Research design: A focus group design was used, and subjects were recruited from nursing students who received the educational session but did not complete the comprehensive survey. Questions for the focus group discussion were derived from the content received during the academic session and from the comprehensive survey. The focus group interview was audio-recorded, and the recordings were transcribed verbatim. Data analysis: Focus group transcripts were analyzed using descriptive content analysis to determine themes.

Results

The outcome of this study provided researchers with insight into why nursing students did not complete the comprehensive survey. The results of this study will help improve future comprehensive survey response rates for the remainder of the Age-Friendly Health Systems 4Ms project. Significance: The findings of this study enhances the validity and reliability of the comprehensive survey results and informs researchers across disciplines on how to avoid low survey response rates.
SIMULATION IN AGE SUIT: AN INNOVATIVE NURSING EDUCATION INTERVENTION TO INCREASE THE UNDERSTANDING OF OLDER ADULTS
Authors: Gillsjö (Gillsjo) Catharina , Stjernetun Björn Bouwmeester , Hallgren Jenny
Published: December 2023

Background

Negative attitudes towards older adults are often recognized in society, especially among health care providers. Lack of education in gerontology and geriatrics and limited practical training in nursing education have been identified as influencing aspects. Simulation in education through age suit has been recognized to increase empathy and reduce negative attitudes towards older adults. An innovative education intervention with simulation in age suit with a follow up reflection seminar was developed to counteract ageism and increase the understanding of aging, age related health problems, older adults and to influence the willingness to provide care to older adults.

Methods

The intervention with simulation in age suit, grounded in the pedagogy experiential learning, was implemented in the fourth semester in the three-year nursing education program. The simulation was conducted in a highly accessible home environment equipped with welfare technology and other technical aids. The nursing students were assigned a persona, a person with different health problems, and performed scenarios consisting of daily chores. Research on nurses’ experiences of the intervention and its sustainability through the education program and on perceptions of providing care for older adults, is conducted qualitatively and quantitatively in a doctoral project.

Conclusion

The learning acquainted through simulation in age suit became embodied both physically and psychologically. The simulation in age suit conveyed new insights as need of time and patience. The technology in the environment both hindered and facilitated activities in daily life. Implications suggested the need for all health and social care providers to carry out this simulation.
A 13-YEAR TREND OF THE ABUSE OF OLDER PEOPLE IN SOUTH KOREA
Authors: Kwon Jenny
Published: December 2023

Compared to the growing number of the older population in South Korea, there is a scarcity of literature investigating issues about the abuse of older people, as well as effective prevention programs. To fill this gap, this study aimed to identify annual changes in patterns of the abuse of older people including the number of reported abuse cases; the type of abuse; and the characteristics of the subject. Data were drawn from the Korean Statistical Information Service (KOSIS), the public national statistical database. The present study used 13-year data during the period of 2008-2020. Descriptive analyses were conducted via SPSS. The number of abuse cases has increased every year from 2,369 in 2008 to 6,259 in 2020 and 10% of the reported cases in 2020 were repeated cases. The most common type of abuse reported was psychological abuse followed by physical abuse and neglect over 13 years. Physical abuse increased substantially from 22.4% to 40.0%. The majority of subjects are consistently women, accounting for 68.4% in 2008 and 75.3% in 2020. One in fourth of the subjects are older people living with dementia in 2020. Considering the serious impact of abuse including depression and suicide, abuse of older people is no longer a single individual or family problem. To protect the older population and improve their rights in society, collaborative efforts are critical. Micro-level movements such as increasing social awareness and national-level initiatives such as implementing policies and developing relevant legislation should be necessary.
THE EFFECT OF DUAL-TASKS ON WALKING SPEED IN HEALTHY OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Heselton Hyeon Jung , Rosen Adam , Boron Julie Blaskewicz
Published: December 2023

Normative age-related changes occur in both walking and cognitive performance; non-normative changes could lead to decreased mobility, loss of autonomy in daily life, and increased fall risk. This systematic review and meta-analysis aimed to assess the effects of completing a dual-task on overground walking speed in healthy older adults. Database searches were carried out in three electronic databases (PubMed, PsycINFO, ProQuest) from inception through October 2022 to find studies that assessed healthy older adults who completed a walking test and a walking task combined with a neurocognitive assessment (dual-task). Methodological quality and risk of bias was assessed via the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Cohen’s d effect size with a 95% confidence intervals, Cochrane’s Q, I2, and Fail-safe N statistics were calculated between the single- and dual-task walking speeds. The initial search yielded 459 articles; six were included in the final review after completing all screening procedures. Included studies had relatively high STROBE scores (19.97±0.82). Eight individual effects across the six articles (total sample size=5627) were calculated. Walking speed significantly decreased in dual-task conditions with cognitive tasks (walking speed Δ=1.03; 95%CI 0.65 to 1.40; p<.001); individual effects were higher during high load cognitive tasks (i.e., serial 7’s subtraction, TMT part B). Dual-tasking with a cognitive component clearly affected walking speed in aging adults. Studying different age groups will help create a model of the aging process to understand when changes begin, as well as the rate of change; this could be useful for earlier fall-prevention interventions.
COVID-19 AND DEMOGRAPHIC PREDICTORS OF CAREGIVER BURDEN AND DEPRESSION
Authors: Montoro-Rodriguez Julian , Ramsey Jennifer , Gallagther-Thompson Dolores
Published: December 2023

Family caregivers are at increased risk for negative impacts on their health including higher depression compared to non-caregivers. The COVID19 pandemic presented challenges to adults with health conditions and exacerbated the demands that caregivers faced to continue providing care, support, services, and managing negative emotions. Our team in North Carolina adapted an evidence-based psychoeducational program “Coping with Caregiving” developed from the REACH II studies, and created the “Caregiver Thrive, Learn & Connect” to assist caregivers to manage stress, learn skills and connect with others. Caregivers attended workshops early in 2021 up to 2023 (https://caregivertlc.org/). COVID-19 research shows that burden, social support, education, income and age are predictors of depression. Using the initial data (pre-program intervention, Time 1) from the Caregiver TLC intervention we examined the impact of COVID-19 on the caregivers’ level of burden and depression. Our sample includes 107 informal caregivers (age mean=63; female=84%; White=66%; Black 33%; living with spouse=68%; and median income of $75-$89K). Predictors of depression were regressed on the caregiver burden, the COVID19 severity exposure (2021 vs. 2022/23), the caregiver age, race (Blacks), education, income and perceived health. We also explored predictors of burden. Results indicated moderate adjusted R2 for depression (.42%) and burden (.16%). COVID-19 was a significant predictor for depression (-.33), along with the caregivers’ health (-.20). Burden was negatively impacted by the caregivers’ health (-.22), age (-.20) and for Blacks (-.20). Caregivers’ depression was impacted by the early stage of COVID19 in addition to their level of burden.
WORKPLACE AND PERSONAL ATTRIBUTES AFFECTING WORKPLACE PSYCHOLOGICAL BURDEN OF MATURE AND AGING WORKERS IN HONG KONG
Authors: Lai Daniel W L , Bai Xue , Lee Vincent W P , Cheung Kin , Luk Calvin W , Lee Chi-Ko
Published: December 2023

Older employees are valuable human resources for society. However, changes in cognitive abilities and mental health in older persons may affect their ability to work, as well as their safety and health at work. The purpose of this study is to investigate the effects of older workers’ personal attributes such as demographics and lifestyle, physical health status, mental health status, labour intensity of employment, and experience of occupational and health risks on their psychological burden at work. A quantitative telephone survey was conducted with a stratified random sample of 1,225 workers aged 40 or above. The results of multiple linear regression analysis indicated that the men and workers with better sleep quality tended to suffer less from psychological burden at work. Older workers with longer weekly work hours and incidents of work-related injuries tended to have a higher level of psychological burden, whereas a safer work environment perceived by the older workers was associated with a lower psychological burden. To accommodate their needs, employers are recommended to allow the older employees choices of reducing work hours and flexible work arrangements. The application of assistive devices and relevant technologies for minimizing the threats to safety and health for the sake of the employees’ long-term psychological well-being is important for institutions and employers to consider.
GEROTRANSCENDENCE INTERVENTIONS FOR CAREGIVERS: A SCOPING REVIEW
Authors: Ribeiro Oscar , Araujo Lia , Abreu Taiane , Teixeira Laetitia
Published: December 2023

According to Tornstam, gerotranscendence is a psychosocial adaptive theory of aging that postulates over a gradual mindset shift that occurs from middle age and progresses during old age, with individuals becoming less materialistic and more transcendental in actions and thoughts. Despite being a natural process, interventions based on gerotranscendence have been associated with improvements in well-being and are starting to receive attention among professionals working with older adults. This study aims to map interventions based on gerotranscendence targeting older adults’ caregivers and summarize their main outcomes. Six databases were searched, and three final studies were selected and analyzed based on the Template for Intervention Description and Replication (TIDieR). All studies took place in nursing homes and long-term care (LTC) facilities with staff members. Two studies presented a long-term intervention with a qualitative approach, while one presented a short-term intervention with a quasi-experimental approach. All interventions had a moment of group instruction about the gerotranscendence theory, in which participants were informed about gerotranscendence signs that could be recognized and/or promoted in older adults. All three studies reported positive outcomes suggesting that informing and training caregivers on gerotranscendence can contribute to a higher quality of care and to an improvement of the caregiving relationship.
DISABILITY CHARACTERISTICS AND ABLEIST MICROAGGRESSION EXPERIENCES AMONG AGING ADULTS WITH DISABILITIES
Authors: Serpas Dylan , Zettel-Watson Laura , Cherry Barbara , Ignacio Daniel
Published: December 2023

People with disabilities (PWD) report experiencing overt and subtle interpersonal disability-based discrimination that is related to poorer functional and health outcomes. Moreover, associations between disability-based discrimination and mental and physical health outcomes are stronger among younger middle-aged than older adults. However, differences in this pattern across disability characteristics and mental health have not been explored. This study investigated associations between disability visibility, age, ableist microaggressions, and mental health symptoms among middle-aged and older adults with disabilities. Participants included 236 middle-aged and older adults recruited online using Amazon’s Mechanical Turk whose ages ranged from 45 to 70 (M=51.44; SD=5.68). Participants were largely non-Hispanic, white, female, employed full-time, graduate educated, and most reported a mobility/physical disability. Participants provided personal demographics and perceived disability visibility (visible, sometimes visible, not visible) and self-reported ableist microaggression experiences and mental health symptoms. A linear multiple regression model controlling for key demographics examined differences in the association between ableist microaggressions and mental health symptoms moderated by age and disability visibility. Results showed a main effect of microaggressions on mental health symptoms (b=.16, p=.044, f2=.02). An interaction effect was found between age and microaggressions (b=.02, p=.003) indicating that as age increased, the association between microaggressions and mental health symptoms increased as disability visibility decreased. Findings illustrate the importance of considering disability characteristics when evaluating subtle disability discrimination among aging adults. Disability discrimination impedes health outcomes and equity, and future research is needed to explore stigma-reduction interventions at local and policy levels.
LIFE PROBLEMS, PROVIDING ADVICE, AND DAILY MOOD IN LATE LIFE
Authors: Gao Sibo , Zhang Shiyang , Fingerman Karen
Published: December 2023

Older adults often experience life problems (e.g., health conditions, financial crises) that may be detrimental to their well-being. Yet, meaningful social connections and support exchanges may mitigate the negative effect of life problems on older adults’ emotional health. This study used data from the Daily Experiences and Well-being Study to investigate how providing and receiving advice influence the association between life problems and mood. Participants aged 65+ (Mage = 74.15, N = 293) completed an initial interview in which they indicated whether they had different types of life problems (health, financial, legal). Participants then completed an ecological momentary assessment in which they reported their negative and positive mood every 3 hours for 5 to 6 consecutive days. They also reported whether they provided or received advice from any social partner at the end of each day. Results showed that participants with more life problems reported higher negative mood throughout the day. Multilevel models revealed a significant interaction between life problems and providing advice on mood, such that the number of life problems was positively associated with negative mood on days that participants did not give advice, whereas life problems were not associated with negative mood on days that participants gave advice. Receiving advice did not reduce the adverse effect of life problems on negative mood. Findings underline that providing (but not receiving) advice may promote generativity among older adults and thus benefit their well-being. The study provides important implications for improving older adults’ well-being especially when they face life problems.
LIFELONG LEARNING AND SELF-EFFICACY OF PHYSICAL ACTIVITY ENGAGEMENT IN SEDENTARY OLDER ADULTS: A QUALITATIVE STUDY
Authors: Wang Claire , Li Mengchi , Huang Jing , Tufa Yeabsira , LI Junxin
Published: December 2023

Societal-level norms play an essential role in later-life sentiments surrounding learning. While there is a wealth of literature on the benefits of learning new skills in improving health and physical capacity, there is a gap in how learning perceptions can influence willingness to learn in contemplation, action, and outcome. With sedentary lifestyles increasing, improving learning and self-efficacy will be crucial for physical activity engagement. In a randomized-controlled trial study, we explore the interface between lifelong learning and aging self-efficacy in the “third age,” where participants were asked to learn about wearable activity trackers and strengthening exercises. Twenty-nine older adults (mean age 71.1 ± 4.5, sleep problems, exercising ≤ 2x per week, sedentary activity > 6h/day) were included in semi-structured post-study interviews after participating in the 24-week intervention. Qualitative data was analyzed through NVivo, applying a grounded theory approach, while coding categories were produced inductively. Topics of diminished later-life learning and self-efficacy were tied to age-related social norms like retirement, value in age rather than wisdom, and a decline ideology of age. Ambivalence in action was another critical finding related to how participants felt conflicting emotions regarding whether they could complete or learn in the intervention (self-efficacy). However, given both opportunity and encouragement, these same participants learned new skills and thrived in the intervention. This research calls for inclusive approaches to learning that combat ageism-related societal norms and provide conducive environments for hedonic learning motivation. It provides insight into intervention adherence, capacity-building, and manifestations of internalized ageism on later-life learning outcomes.
SPOUSAL SUPPORT AND PERCEIVED RESPONSIVENESS IN THE LINK BETWEEN DAILY RUMINATION AND SLEEP: FINDINGS FROM THE NSDE
Authors: Molli Sam , Wilson Stephanie
Published: December 2023

The Cognitive Model of Insomnia suggests that increased cognitive arousal may negatively influence sleep. Prior work has supported this theory, indicating that both negative affect and rumination may be negatively related to sleep. However, recent empirical evidence suggests that social support may buffer this impact. Yet, much of the current literature focuses on rumination as a trait characteristic. We set out to investigate both between and within-person rumination and its relation to sleep and negative affect. We also tested whether support, both perceived and received, may buffer the relation between rumination and outcome variables. The sample consisted of partnered participants (n=612, Mage= 62, SD=9.73) from the National Study of Daily Experiences in the MIDUS project. Participants reported daily levels of sleep, rumination, negative affect, and received support; as well as perceived partner responsiveness (PPR) and depressive symptoms at baseline. In multilevel models that controlled for sex, age, race, education, and depressive symptoms and included random person-level intercepts, a significant interaction arose between daily rumination and PPR on daily negative affect (b = -0.0061, SE = 0.0021, p = .004), such that participants reporting higher PPR reported a weaker association between daily rumination and negative affect. Trait or daily received support was not a significant moderator of any outcome and PPR did not significantly moderate the relation between rumination and sleep. These findings further add to our understanding of the distinctions in type of support from a partner. Moreover, this suggests that knowing support is available may buffer distress from rumination.
THE EFFECT OF ENACTED AND PERCEIVED SOCIAL SUPPORT ON THE WELL-BEING OF KOREAN OLDER ADULTS BY GENDER
Authors: Kim Meeryoung
Published: December 2023

Social support is important for the well-being of older adults. However, different kinds of social support have different effects on well-being. This study investigated enacted social support which is “the actual use of social support,” and perceived social support, in which people think they can get help when they need it. In short, enacted social support is action-oriented. Perceived social support is experience-oriented. For the effects, we looked at whether there were gender differences in the well-being of older adults. This study used the seventh additional wave (2018) and eighth wave (2019) of the Korean Retirement and Income Study. The subjects of this study were 60 and older. The sample size of this study is 4,338. Multiple regressions were used for data analysis. Demographic variables were controlled. This study used enacted social support and perceived social support as independent variables. Health and life satisfaction were used as well-being variables. Research shows that enacted emotional support is important for health. However, perceived emotional support is only significant for men, and perceived instrumental support is only important for women. All kinds of social support affected older women’s life satisfaction. For men, however, instrumental support did not affect life satisfaction. These findings imply that emotional support, whether enacted or perceived, is important for the health of older adults. Except enacted instrumental support, every support was significant for older adults regarding life satisfaction. Therefore, when providing social support, it is important to consider what type of support is effective for each gender.
USABILITY OF THE SMARTWATCH AS A REMINDER AID FOR OLDER ADULTS WITH DIVERSE COGNITIVE ABILITIES
Authors: Sanders Edie , Boot Walter
Published: December 2023

Smartwatches have potential to provide support for prospective memory, the ability to remember and carry out an intention in the future, crucial for maintaining health, independence, and social connections. Little is known about how older adults, particularly those with cognitive impairment, might interact with smartwatches. This study aimed to understand 1) the types of challenges older adults with and without cognitive impairment experience when using a smartwatch, and 2) the potential for smartwatches to serve as reminder aids for this population. Participants were twenty-seven older adults (age 60+) with normal cognitive functioning or cognitive impairment due to mild cognitive impairment, traumatic brain injury, or stroke. Participants were asked to use a smartwatch’s reminder notifications to remember to complete a daily survey for 10 days and completed demographic, neuropsychological, technology acceptance, and usability measures. Half were first asked to use their usual memory strategies without the smartwatch to remember to complete the daily survey for 10 days. Participants gave relatively low usability ratings for the smartwatches overall and reported a variety of challenges. The smartwatches did not appear to significantly help or hurt participants’ abilities to remember to complete the daily survey. Perceived usefulness of the smartwatches was significantly associated with subjective memory, suggesting that perceived memory challenges may play an important role in the adoption of smartwatches. Results suggest that the smartwatches used in this study may not be the best fit for supporting prospective memory and can inform the development of future efficacy tests and interventions involving smartwatches.
EFFECT OF SELF-GUIDED INTERVENTIONS ON MENTAL HEALTH OF INFORMAL DEMENTIA CAREGIVERS: A SYSTEMATIC REVIEW
Authors: Ko Eunjung , Wongvibul Thanchanok , Rose Karen , Jun Jin
Published: December 2023

Informal caregivers of people living with dementia often experience emotional and mental distress due to the demands of caregiving. Self-guided interventions aimed at improving the mental health of these caregivers have emerged, but their effectiveness remains understudied. We systematically examined the effects of self-guided interventions on stress, burden, and mental health of informal caregivers of people living with dementia. PubMed, CINAHL, PsycINFO, Scopus, and Embase databases were searched using relevant search terms for the study aims. Included articles focused on informal caregivers of people living with dementia and self-guided interventions to improve psychological or mental health. Sixteen articles and 1,182 samples were included in this review. Self-guided interventions covered topics on caregiving skills, emotional self-care, and/or information on social or financial resources related to caregiving. Outcomes of each study included stress, burden, depressive symptoms, anxiety, distress, quality of life, self-efficacy, positive aspects of caregiving, and loneliness. Depressive symptoms and burden were the most frequently measured outcomes. Stress was generally reduced after the interventions, whereas the results of burden and mental health from each intervention were inconsistent. Interventions lasting shorter than three months were more likely to be effective compared to longer interventions. Self-guided interventions may be useful for improving mental health of informal caregivers of people living with dementia due to its low time burden, ease-to-access, and affordability. Future research is needed to determine the optimal length and components of self-guided interventions and to collaborate with clinicians for wider distribution to informal caregivers of people living with dementia.
LOCALIZATION OF Β-AMYLOID PLAQUES IN THE BRAINS OF WAR VETERANS, PARTICIPANTS OF THE DOD-ADNI STUDY
Authors: Nikitin Stanislav Kolpakov , Yashkin Arseniy , Akushevich Igor
Published: December 2023

We examined the allocation of β-amyloid (Aβ) plaques in the brains of Veterans, long-time survivors of traumatic brain injury (TBI), and those, who did not report brain trauma, and compared it with a spatial distribution of Aβ plaques in the brains of participants of the ADNI program as well as with the pattern of the spatial distribution of Aβ in the brains of participants of ADNI with Alzheimer’s disease. This study included 675 community-dwelling male participants from the ADNI and DoD-ADNI databases (137 veterans, 131 cases of TBI, and 123 AD cases) 62 years old or older. We performed regression analysis, using a pseudo-randomization algorithm, and propensity-score inverse-probability weighting to equalize the subsamples for fourteen outcomes, 12 standardized uptake value ratio variables, and 0.79 and 1.11 cutoffs. Race, educational level, geriatric depression score, age when florbetapir-18 (18F) PET scans were performed, APOE genotype, and Modified Hachinski Ischemic Score were used as predictors. The pattern common for AD showed the highest levels of β-amyloid in the cingulate cortex as well as in the frontal, parietal, and temporal lobes. Veterans have shown a statistically significant increase of 18F concentration in the cerebellum gray matter along with a lower concentration of it in the whole cerebrum as well as in neocortical regions than patients, who did not participate in combats. The continuous exposition to micro-TBI events, which does not necessarily suppose the loss of consciousness or severe contusion likely can explain the high concentration of 18F in cerebellum gray matter in ex-combatants.
SUPPORTING OLDER ADULTS WHO LIVE ALONE: UNDERSTANDING THEIR UNMET NEEDS USING NHATS SURVEY DATA
Authors: Bergh Marissa , Raval Aasha , Travers Jasmine
Published: December 2023

Research suggests that older adults living alone in the community are at higher risk for poor health-related outcomes due to lack of cohabitants to support their health needs. Using National Health and Aging Trends Study (NHATS) data, we identified community-residing older adults (≥65 years) with assistance needs for Instrumental Activities of Daily Living (IADLs), Activities of Daily Living (ADLs), or mobility. We used bivariate analyses to compare the unmet needs related to IADL, ADL, and mobility tasks between those living alone and those living with others. Of the 3,458 individuals identified, 28.9% (n=1001) lived alone. Those living alone were more likely to be women, unpartnered, and lacking informal caregivers. There was no difference in perceived overall health scores between the groups. Individuals living alone experienced more mobility and IADL-related unmet needs. In the month prior to survey completion, those living alone were more likely to forgo getting out of bed (p=0.031), grocery shopping (p< 0.001), cooking (p< 0.001), and paying bills (p=0.025) due to lack of available assistance. Our findings suggest that older adults living alone may need higher levels of formal assistance with IADLs to remain living in the community. Given the key role IADLs play in promoting quality of life and a person’s ability to remain independent and engaged in the community, it is important to consider IADLs in addition to ADLs when assessing formal care needs for those living alone. Policy makers should prioritize the specific needs of those living alone when developing national aging strategies.
“IT CAN BE A CHAMELEON”: LEWY BODY DEMENTIA PRESENTATION WITH AN ELUSIVE CLINICAL PROFILE—CASE REPORT AND DISCUSSION
Authors: Barney Javier Malcolm , Moya Mario , Martin Jessica , Dentino Andrew
Published: December 2023

Lewy body dementia is a progressive neurodegenerative disease and is considered to be the second most common cause of dementia in the population above 65 years of age. It remains a challenging and complicated disease process to profile clinically with an elusive diagnosis that shares similarities with Alzheimer’s, leading to patients being misdiagnosed. The decline is compounded by inappropriate coordinated care efforts, and therefore ill preparing the patient and negatively affecting their relatives and support groups. We describe the case of an 83-year-old Hispanic male who over the course of 32 months sustained multiple injuries due to falls landing him in the emergency department; receiving numerous consultations from hospitalists, surgeons, infectious disease specialists, neurologists, psychiatrists, and radiologists. A combined blend of inpatient and outpatient visits was not enough to circumvent the recurrent theme that plagues similar cases worldwide with non-reliable criteria that can identify Lewy Body Dementia early in the presentation of the disease. The first mention of DLB was almost at the 32 months mark into the patient’s journey at this particular Hospital System. A multidisciplinary approach with enhanced communications and round table discussions should be a quality of care improvement initiative to help better serve this population of patients. DLB’s rapid progression and sensitive drug therapy parameters should place this as equally scalable as other multi-specialty collaborations such as tumor board, limb salvage committee, ethics, and Trauma review.
INTEGRAL ROLE OF SOCIAL WORKERS WITHIN A COMPREHENSIVE GERIATRIC ASSESSMENT
Authors: Schwartzkopf Ashley , Myers Jennifer , Schubert Cathy , Penney Lauren , Damush Teresa , Preddie Aliana , Bravata Dawn
Published: December 2023

Comprehensive geriatric assessment (CGA) programs are expanding to support the wellbeing of community-dwelling older adults. Although a variety of CGA models have been described, the specific contributions of social work in CGA programs has not been rigorously evaluated. We examined the role of social work within a well-established, interdisciplinary, home-based geriatric program at one large, midwestern VA Medical Center. Semi-structured interviews were conducted with the VA-Geriatric Resources for Assessment and Care of Elders (GRACE) team to understand their perspective on social work expertise within a geriatric interdisciplinary team. Nine VA-GRACE team members were interviewed: 1 geriatrician, 1 pharmacist, 4 advanced practice nurses, and 3 social workers. VA-GRACE social workers participated in home-based CGAs by identifying psychosocial barriers that affected patients’ medical care and quality of life, and engaging in ongoing case management. VA-GRACE team members valued the social workers problem-solving skills which were critical to ensuring that: patients received needed home services; caregiver needs were met; home safety and equipment issues were addressed; and patients received appropriate cognitive services. The VA-GRACE team members valued social workers for their perceived positive work ethic, as well as their critical knowledgebase which they apply to training new staff, supporting nurses (especially during periods of staff shortage), promoting patient enrollment, and developing and implementing cohesive care plans. In conclusion, these results support the integral role of social work in an interdisciplinary team providing comprehensive geriatric assessments and highlight unique contributions that social workers make to promote the health and wellbeing of older adults.
A CALL TO ACTION FOR FALL INJURY PREVENTION: QUALITY IMPROVEMENT IN THE DEPARTMENT OF VETERANS HEALTH ADMINISTRATION
Authors: Barrett Blake , Chavez Margeaux , Bradley Sarah , Arriola Nora , Broderick Vianna , Ramrattan Anita , Bulat Tatjana , Cowan Linda
Published: December 2023

The rates of inpatient falls in the Department of Veterans Health Administration (VHA) have been declining steadily over the last 10 years, but the rates of major fall-related injuries have remained stagnant. This poster describes quality improvement (QI) efforts in the VHA to evaluate and improve implementation of fall injury prevention practices. It also describes the importance of focusing on fall injury prevention, in addition to fall prevention. QI efforts were led by an interdisciplinary team using mixed methods. Objectives included: 1) determine best practices in fall injury prevention in VHA inpatient units, 2) determine the utility of current methods for evaluating implementation of fall injury prevention practices, and 3) improve fall injury prevention practice implementation by co-designing an evaluation tool with VHA staff who are its intended users. Findings suggest the need to raise awareness of and use of fall injury prevention practices, that is distinct from fall prevention practices. Staff do not typically separate fall injury prevention practices from general fall prevention, making it challenging to implement tailored prevention practices (e.g., hip protectors or helmets directed at fall injury prevention vs. fall prevention). Furthermore, staff reported difficulty implementing and evaluating fall injury prevention practices. Staff preferred tools using a formal evaluation process with interdisciplinary teams to outline standards and document barriers and facilitators to reducing fall injuries. Our findings support need for a validated tool to evaluate and improve implementation of fall injury prevention practices (above and beyond fall prevention) to improve care and reduce Veteran fall-related injuries.