bluuebunny/crossref_metadata_2025 huggingface dataset:
The Challenges of Being a Family Caregiver During the COVID-19 Pandemic in Canada
Authors: McGhan Gwen , McCaughey Deirdre
Published: December 2021

The COVID-19 pandemic has impacted all of our lives, but the population most at risk are older adults. Canadians over the age of 60 account for 36% of all COVID-19 cases but 95% of the deaths, and over two-thirds of ICU admissions. Older adults with chronic health conditions are especially at risk. Prior to COVID-19, family caregivers (FCGs) for older adults were managing their caregiving duties at the limits of their emotional, physical and financial capacity. As such, FCGs need special consideration during these times of uncertainty to support them in their role and enable the continuation of care for their older adult family members. This symposium will report on independently conducted studies from across Canada that have examined how the pandemic and associated public health measures have influenced resource utilization by FCGs and the older adults for whom they provide care. McAiney et al’s study examines the deleterious effect of reduced services on community dwelling FCGs and the wellbeing of their family member with dementia. Parmar & Anderson examined the effect of pandemic restrictions on FCGs of frail older adults and found they were experiencing increased distress and decreased wellbeing. Flemons et al report on the experiences of FCGs managing caregiving without critical services and the effect of restrictive visiting policies and the well-being of the caregiving dyad (FCGs and family member with dementia). Finally, McGhan et al will share how FCGs evaluated the efficacy of public health measures and the public health messaging about the pandemic.
Factors That Motivate Older Adults to Participate in Research: Typologies and Implications
Authors: Carr Dawn , He Zhe , Lustria Mia , Tian Shubo , Agharazidermani Maedeh , Boot Walter
Published: December 2021

A key challenge for scholars who study aging is identifying a pool of research volunteers willing to participate. Toolkits and strategies acknowledge the differences in recruitment needed for older adults relative to younger adults, but there is little information about variations among older adult research volunteers. Based on a community sample of older adults age 60+, this study evaluates differences across seven specific motivators across three broad categories: values/altruism, personal growth/improvement, and immediate gratification. We then identify and evaluate four typologies of older adult volunteers based on the combinations of motivations the older adults in our sample identify as important to participation in research studies. Based on these analyses, we describe how our results might inform recruitment and retention practices in aging studies. Further, we will discuss how these results will help shape our technology-based reminder system with a greater understanding of motivations.
The Effect of Reminder Message Tailoring on Cognitive Intervention Adherence
Authors: Zhang Shenghao , Dieciuc Michael , Dilanchian Andrew , Boot Walter
Published: December 2021

To examine the potential impact of tailored messaging on adherence and attitudes toward text message reminders, a pilot study conducted in advance of the APPT randomized controlled trial systematically manipulated the match between text message content and participants’ self-reported motivations to participate in a cognitive intervention study. Older adults (n=40) were asked to engage in cognitive training, in the form of gamified neuropsychological tests, 30 minutes a day for 10 consecutive days, and adherence was tracked remotely over time. Critically, each day text message reminders alternated between messages consistent or inconsistent with participants’ previously reported motivations for entering the study. This talk presents results, derived from multilevel modeling, that explore the effectiveness of this simple and cost-effective message tailoring approach for facilitating adherence and engendering positive attitudes toward the reminder system, and implications for programs requiring long-term adherence.
Standards and Guidelines for Undergraduate Programs in Gerontology
Authors: Andreoletti Carrie , Donorfio Laura , Kopera-Frye Karen , Maiden Robert
Published: December 2021

Undergraduate programs (majors, minors, certificates) and continuing education programs in gerontology prepare students for entry-level careers in aging and increase competitiveness for graduate work in a variety of fields. Job growth in the field of gerontology is high, especially for positions requiring a bachelor’s degree and less. Gerontology education at this level is essential for meeting the growing demand for workers in social services and health services who understand the opportunities and challenges that come with increased longevity and global aging. This presentation will highlight the new recommendations for competency-based gerontology education for undergraduate and continuing education credentials outlined in the latest edition of AGHE Standards and Guidelines. Whether you are developing a new curriculum or revising an old one, we will offer suggestions for using the AGHE competencies and guidelines to ensure that your program adequately prepares students and offers them a competitive edge in today’s job market.
Age-Friendly Community Practice: Understanding the Role of Community Events
Authors: Pope Natalie , Greenfield Emily , Pestine-Stevens Althea , Scher Clara
Published: December 2021

To advance an emerging empirical knowledge base for age-friendly community initiatives (AFCIs), we conducted a qualitative descriptive study to explore one manifestation of age-friendly practice: community events (CEs). We aimed to illuminate how AFCI core teams describe CEs as part of their practice and how they perceive the value of CEs for age-friendly progress. Using inductive coding, we analyzed data from semi-structured interviews (n=24) with eight core teams across three time points spanning the early to mid-implementation phases of the AFCIs. Two predominant themes emerged. First, CEs were described as important for working toward age-friendly goals concerning older residents’ social participation and inclusion. Second, core teams described the longer-term strategic value of CEs, such as building interorganizational partnerships; providing deeper insight on aging in community; and fostering older adults’ leadership as part of the initiative. We discuss implications for advancing transdisciplinary program theory to guide more sustainable and effective AFCIs.
Investigating Everyday Prospective Memory in Younger and Older Couples
Authors: Haas Maximilian , Meier Tabea , Huber Zilla , Kliegel Matthias , Horn Andrea
Published: December 2021

Daily events are not simply individual concepts, but shared by the social environment we live in. The present study investigates the role of romantic partners in the co-regulation of cognitive functioning by the example of prospective memory (PM), the ability to remember and correctly execute future intentions. In this context, we examined the impact of social proximity (i.e., physical closeness and psychological intimacy) on interpersonal regulation. Over the course of 21 days, 64 younger couples (18-33 years) and 52 couples of older adults (57-87 years) completed an ambulatory assessment comprising a daily pseudo-randomized PM task. Results reveal that couples’ PM performance was higher for younger than for older participants. Further, dyadic PM was correlated with psychological intimacy for both age groups, but the impact of time spent together on intimacy and PM performance, respectively, was stronger in older adults. Possible moderating factors and explanations for these findings will be discussed.
Aging Predisposes B cells to Malignancy by Activating c-Myc and Perturbing the Genome and Epigenome
Authors: Shindyapina Anastasia , Castro Jose , Barbieri Alessandro , Paulo João , Strelkova Olga , Sedivy John , Manis John , Gladyshev Vadim
Published: December 2021

Age is the single major risk factor for human cancer, but naturally occurring cancers are rarely studied in aging models. Like humans, mice spontaneously develop cancer with age, and standard laboratory strains are predisposed for B-cell lymphoma. Here, we uncover how B-cell lymphoma develops as a consequence of the aging immune system. We found that aged B cells acquire somatic mutations in tumor suppressors and oncogenes (e.g. Trp53, Pim1, and Myh11) and undergo monoclonal expansions, with some clones representing 86% of splenic B cells. Clonal B cells had hypermethylated promoters and globally silenced expression, suggesting a role of DNA methylation in clonal selection of premalignant B cells. B-cell size, spleen weight, and a novel population of B cells, which we named Myc+ cells, emerged as convenient markers of malignancy. High-throughput analyses of clonal B cells and the use of genetic mouse models revealed that c-Myc drives B-cell size increase and clonal expansion with age. Phoshoproteome and co-culture experiments revealed that c-Myc is activated by signals from the aging microenvironment. Moreover, single-cell RNA-seq suggested that clonal B cells originate from age-associated B cells, further underlying the importance of aging environment in cancer transformation. Longitudinal analyses demonstrated a negative impact of premalignant B cells on mouse lifespan and linked it to age-related myeloid bias. Together, our study revealed cell-autonomous changes that cooperate with the aging microenvironment to give rise to preneoplastic B cells. This stidy established a novel model to study how aging predisposes cells to cancer transformation.
Changes in GPS-Derived Community Mobility After Motor Skill Training in Older Adults
Authors: Dunlap Pamela , Crane Breanna , Moored Kyle , Carlson Michelle , Perera Subashan , Brach Jennifer , Klatt Brooke , Rosso Andrea
Published: December 2021

The study purpose was to identify the effects of a motor skill training intervention to improve gait speed on community mobility among community-dwelling older adults. The study included 249 participants randomized to standard physical therapy or a standard plus motor skill training program. Community mobility was measured using the Life Space Assessment (LSA) and GPS at baseline, 12 (post-intervention), 24 and 36 weeks. There were 124 participants (M age=77.4±6.7; 68.6% female; LSA: 76.2±17.6) randomized to the standard plus and 125 (M age=77.4±6.4; 62.4% female; LSA: 74.3±18.2) to the standard group. There was no significant between-group difference in pre- or post-intervention LSA scores and no significant pre- to post-intervention change over time in either group. GPS results are pending. While there were no differences in self-reported LSA, we anticipate objective GPS measurement of community mobility will better capture post-intervention changes and differences between groups.
Creative Arts Therapies to Enhance Mental Health Over the Course of Aging: Research and Implications
Authors: Keisari Shoshi , Sajnani Nisha , Harel Dovrat
Published: December 2021

The creative arts therapies (CATs) are health care professions that involve the intentional and systematic use of the creative and expressive process of art making to optimize health and well-being. Visual arts, music, dance-movement, drama and poetry provide means of expression to help individuals understand, make sense of, and cope with life challenges within a therapeutic relationship. Older adults develop a better attitude toward CATs, as the creative processes position them as active productive contributors in their own communities, instead of “patients” or “clients”. In this sense, CATs encourage participation, and address the negative attitudes and stigma that are sometimes associated with mental health services. This symposium aims to present a diverse picture of studies on CATs for the aging population. Dr. Nisha Sajnani will present a systematic review of studies on CATs for older adults experiencing depression; Dr. Dovrat Harel will present findings from a qualitative study that explored poems written by poetry groups of men in residential care facilities; Dr. Shoshi Keisari will present an evidence-based model that integrates life-review and drama therapy; Silvia Piol, Talia Elkarif and Giada Mola will present a cross-cultural study that explored the experiences of Italian and Israeli participants during an online intervention that focused on the creation of digital photo-collages during COVID-19; Finally, Racheli Lital Gvili will present a study focused on intergenerational music intervention, as a vehicle to bridge the gap between grandparents and grandchildren, which was conducted at the onset of the COVID-19 pandemic.
Lost Work Opportunity Score Predicts Health in Retirement
Authors: Voss Maren Wright , Hung Man , Richards lorie , Li Wei , Price Pollie , Terrill Alexandra , Wadsworth Lori
Published: December 2021

Objectives: Under-reporting of unemployment or forced retirement has consequences for measuring the impacts of job changes on health at retirement. We analyzed a comprehensive three-part measure of lost work opportunity for evidence of impact on health.

Methods: We combined variables from the Health and Retirement Study for 2,576 respondents assessing unemployment, forced retirement, and earlier than planned retirement into a single lost work opportunity score (LOS). We evaluated the reliability and unidimensionality of the LOS. We conducted multivariate regression to assess health impacts controlling for age, gender, education, race, ethnicity, and prior health status.

Results: The Cronbach’s Alpha for the LOS was a = 0.76 and the LOS variables primarily loaded onto a single component demonstrating undimensionality. The LOS significantly predicted self-reported health (□= .16; p < .001) with higher lost work associated with negative health outcomes (Cox and Snell R2 = 0.07). The LOS score significantly predicted mental health declines (□ = .07; p = .002)(Cox and Snell R2 = 0.07).

Discussion: Population-level data indicates that health declines following both unemployment and retirement, but there is ample evidence that early or planned retirements do not show the same negative health impacts. We examined the health impact of retirement using the construct of lost work opportunity rather than voluntary or involuntary retirement, per se. Our findings indicate that as much as 7% of negative health changes in the early retirement years could be attributable to employment changes that were unplanned or experienced as outside the retiree's control.
Seven-State Study of Assisted Living and Healthcare Providers’ Responses to COVID-19
Authors: Zimmerman Sheryl , Sloane Philip , Hickey Johanna , Wretman Christopher , Carder Paula , Thomas Kali
Published: December 2021

COVID-19 has inordinately affected assisted living (AL), such that the proportion of fatalities to cases has been 21% in AL versus 2.5% for the general population. Understanding how AL administrators and medical and mental health providers have responded to COVID-19 can inform health care going forward. Using a seven-state stratified random sample of 250 communities, administrators were interviewed and providers completed questionnaires regarding COVID-19 practices. Preliminary data indicate that 79%, 44%, and 62% of administrators reported serving meals in rooms to segregate residents, using telemedicine, and providing extra pay for staff, respectively. Perceived use/effectiveness of practices differed based on dementia case-mix (e.g., face coverings, social distancing). Providers reported less access to patients (82%), more telehealth (63%), and less ability to provide care (43%). However, they uniformly reported high confidence in AL staff ability to prevent (94%) and respond to outbreaks (96%). Discussion will summarize points important for future care.
Loneliness and Social Connectedness Among Rural Older Adults Since the COVID-19 Pandemic Onset
Authors: Henning-Smith Carrie , Meltzer Gabriella , Kobayashi Lindsay , Finlay Jessica
Published: December 2021

Rural areas have a higher proportion of older adults aging in place. Rural areas also face structural barriers to supporting social connectedness among older adults, including transportation barriers, greater geographic distances, and access to technological connectivity. This research aims to discuss rural-specific risks of loneliness and social isolation among older adults, as well as rural/urban differences in loneliness and social isolation among older adults using the national COVID-19 Coping Study. Cross-sectional bivariate analyses highlight rural/urban differences in social activities during the pandemic. For example, rural older adults were more likely to use social media daily, compared with urban older adults (67% vs. 61%, p<0.05), but were less likely to have phone or video calls with others daily (21% vs. 26%, p<0.001). We will also share results of differences within rural older adults in loneliness, isolation, and social activities by socio-demographic characteristics in order to design targeted interventions to improve connectedness.
Impact of Social Isolation Due to COVID-19 on VA Home-Based Primary Care Veterans and Caregivers
Authors: Haverhals Leah , Manheim Chelsea , Solorzano Nelly , Barnard Juli , Wyte-Lake Tamar
Published: December 2021

In December 2020 we began conducting phone interviews with Veterans, and their caregivers, receiving care through the United Sates (US) Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) program. Our goal was to describe experiences of Veterans and caregivers managing changes in care delivery related to the COVID-19 pandemic and navigating increased social isolation due to social distancing. We interviewed 38 Veterans (average age 78) and caregivers (average age 62) across seven VA HBPC programs. Findings showed those living in their own homes found increased isolation more manageable than those living in assisted living facilities, which restricted visitors. Caregivers had a harder time managing isolation than Veterans, as Veterans were used to being primarily homebound. Veterans and caregivers relied on increased phone communication with their HBPC teams, with some began participating in virtual visits. Implications include insights into better supporting older, homebound adults and their caregivers during disasters.
Student Perspective: Internship Exploring Intellectual and Social Benefits of Adult Study Abroad
Authors: Redlich Kim
Published: December 2021

Older adult participation in lifelong learning programs – such as university continuing education opportunities and the Age-Friendly University global network – has grown steadily over the last few years. Many of these programs are characterized by mixed-age classrooms in which undergraduate students share space and learning, remotely during Covid, with older adult participants who pay a nominal fee. Survey findings will be presented from older students involved in two university programs in this category: Temple University’s “senior scholars” program and Georgetown University’s “senior auditors” program, specifically related to the concept of adult study abroad. Adult study abroad is a new offering that combines the intellectual and social benefits of stimulating coursework with the transformative power of travel, and how the merging of these pursuits can produce purpose, meaning and community, especially for older adults. It is typically residential, academic, intergenerational, and of longer duration than a typical tourist experience.
Momentary Working Memory and Momentary Activities in Healthy Older Adults: The Mediating Role of Affective States
Authors: Luo Minxia , Moulder Robert , Röcke Christina
Published: December 2021

Research has shown cognitive ability in older age is associated with activity engagement, but little is known about what psychological mechanisms are linking the two constructs. This study investigates an emotional pathway, in which affective states mediate the temporal associations between momentary working memory and momentary activities in older age. We examined data from 153 healthy older adults aged 65 to 91 who completed a smartphone-based ambulatory assessment survey seven times a day over 15 days. In each assessment point, participants reported their momentary activities (e.g., social activities, mentally stimulating activities) and affective states (i.e., positive affect, negative affect) and took a working memory task. Initial results suggest that during an approximate time period of six hours (i.e., across three assessment points), working memory performance influences subsequent likelihood of social activity engagement. Moreover, positive affect mediates this temporal association. Results will be discussed in the context of cognitive aging research.
Switching up How You Get in Your Steps: Daily Activity Diversity and Cognitive Functioning
Authors: Brown Colette , Jeon Sangha , Ng Yee To , Lee Soomi , Charles Susan , Fingerman Karen
Published: December 2021

Active lifestyles are related to better cognitive health. More work is needed, however, to examine whether participating in a variety of daily activities (i.e., activity diversity) has unique importance beyond amount of activity. The current study examined associations between daily activity diversity and cognitive functioning among community-dwelling older adults (N = 313, ages 65-90). Participants completed a cognitive battery, then responded to ecological momentary assessments of their participation in 10 common activity types (e.g., exercise, chores, social visits, volunteering) every 3 hours for 5-6 days, and wore accelerometers to track daily step counts and duration of activity. Multiple regression models revealed that greater daily activity diversity related to higher overall cognitive functioning, executive functioning, memory, and crystallized intelligence. These associations remained significant after adjusting for step count and duration of activity. Findings suggest daily activity diversity has unique importance beyond sheer amount of activity for cognitive health in later adulthood.
Novel Genetic and Cognitive Findings From the Long Life Family Study
Authors: Wojczynski Mary , Glynn Nancy W , Hadley Evan
Published: December 2021

The Long Life Family Study (LLFS), funded by the National Institute on Aging, is an international collaborative study of the genetics and familial components of exceptional longevity and healthy aging. We phenotyped 4,953 individuals from 539 two-generational families (1,727 proband; 3,226 offspring) at baseline (2006-2009). A second visit (2014-2017) was conducted for 2,904 (478 proband; 2,426 offspring) participants. The longitudinal, comprehensive in-person visits measured domains of healthy aging, including physical performance, cognition, and blood markers. Extensive genetic analyses were performed using the baseline blood draw, including genotyping with the Illumina 2.5M Human Omni array, linkage analyses with the families, whole genome sequencing using the TopMED protocol, and metabolomic assays. Collectively, this symposium will present novel findings that elucidate new potential genes and genetic interactions, investigate metabolomics profiles among APOE4 carriers, and refine phenotypic cognition definitions. Specifically, Dr. Santanasto will share results flanking the mesothelin gene associated with longitudinal gait speed. Then, Dr. An will share his findings of a new intronic variant in PKD1L2 gene associated with adiponectin, a marker of insulin resistance. Next, Dr. Arbeev will discuss genetic interactions between candidate genes for physiologic dysregulation and candidate genes for Alzheimer’s disease (AD, UNC5C gene). Ms. Yao will examine metabolomic profile differences between APOE4 carriers who develop AD and those who do not. Lastly, Mr. Xiang will introduce a method for combining multiple cognitive tests into a more sensitive overall cognitive score. As Discussant, Dr. Evan Hadley will share insights and propose future directions for LLFS.
Linkage Guided Sequence Analysis Revealed a Novel Gene PKD1L2 for Adiponectin: The Long Life Family Study (LLFS)
Authors: An Ping , Lee Joseph , Anema Jason , Wang Lihua , Daw Warwick , Christensen Kaare , Zmuda Joseph , Province Michael
Published: December 2021

Adiponectin is involved in regulating insulin resistance (IR) and is a potential regulator of healthy aging and lifespan. To identify novel variants associated with adiponectin, we further assessed our previously identified linkage peak on 16q23.2 (LODs=3.8). We used sequence data of 632 participants (age, 24-110 years) from 47 families of European ancestry in the Long Life Family Study, a study with familial clustering of exceptional longevity in the US and Denmark. Adiponectin levels were log-transformed, and adjusted for age, sex, sites, and PCs for ancestry. We found a variant in the PKD1L2 (rs527459046, p=2e-8, MAF=3%, r2=1.5%, accounting for linkage=28%). The PKD1L2, 1.4 Mb upstream of the CDH13 (adiponectin receptor gene) is expressed in heart, liver, and adipocytes, known to function as an ion-channel regulator or a GPCR regulator for aging-related lipolysis, IR, and adiponectin/leptin secretion. Haplotyping, epistatic and bioinformatic analyses will be engaged to capture additional/functional variants and regulatory networks.
Hospital-Associated Disability Associated With Delirium Among Older Adults
Authors: Kennedy Richard , Freeman Hyun , Martin Roy , Whittington Caroline , Osborne John , Markland Alayne , Buford Thomas , Brown Cynthia
Published: December 2021

Hospital-associated disability (HAD), defined as a loss of activities of daily living (ADLs) occurring during hospitalization, is a common complication among older adults. Delirium is also a common complication during hospitalization and is associated with multiple long-term sequelae. We sought to determine the effect of delirium and known covariates on the risk of incident HAD in hospitalized older adults. We examined electronic health record (EHR) data for 35,201 older adults ≥ 65 years of age admitted to the general inpatient (non-ICU) units of UAB Hospital from January 1, 2015 to December 31, 2019. Delirium was defined as a score ≥ 2 on the Nursing Delirium Screening Scale (NuDESC) during hospital admission, and HAD defined as a decline on the Katz ADL scale from hospital admission to discharge. Generalized linear mixed models were used to examine the association between delirium and HAD, adjusting for covariates and repeated observations for individuals with multiple admissions. We found that 21.2% of older adults developed HAD during their hospitalization and experienced higher delirium rates as compared to those not developing HAD (25.2% vs. 16.3%). Presence of delirium, medical comorbidity score, baseline cognitive status, and baseline ADL function were associated (all p <0.001) with incident HAD. Mediation analyses also showed that 8% of the effect of comorbidity on incident HAD was due to delirium (p < 0.001). Reducing rates of delirium can be one component of a comprehensive approach to reduce rates of HAD in older adults.
Predicting Unscheduled Emergency Department Revisits Leading to Acute Hospital Admissions Among Older Adults
Authors: Rosen Tony , Huang Yufang , McCarty Matthew , Stern Michael , Zhang Yiye , Barchi Daniel , Sharma Rahul , Steel Peter
Published: December 2021

Background: Unscheduled emergency department (ED) revisits leading to acute hospital admission (RVA) are tantamount to a failed discharge, associated with physician error, mis-prognosis, and inadequate care planning. Previous research has shown RVA to be associated with adverse outcomes such as ICU admissions, long hospitalizations and mortality. Given the limited impact of pre-existing screening tools for older adults, we developed and validated a machine learning model to predict individual patient risk of RVA within 72 hours and 9 days of index ED visits. Method: A machine learning model was applied to retrospective electronic health record (EHR) data of patients presenting to 2 geographically and demographically divergent urban EDs in 2019. 478 clinically meaningful EHR data variables were included: socio-demographics, ED and comorbidity diagnoses, therapeutics, laboratory test orders and test results, diagnostic imaging test orders, vital signs, and utilization and operational data. Multiple machine learning algorithms were constructed; models were compared against a pre-existing adult ED-RVA risk score as a baseline. Results: A total of 62,154 patients were included in the analysis, with 508 (0.82%) and 889 (1.4%) having 72-hour and 9-day RVA. The best-performing model, combining deep significance clustering (DICE) and regularized logistic regression, achieved AUC of 0.86 and 0.79 for 72-hour and 9-day ED-RVA for older adult patients, respectively, outperforming the pre-existing RVA risk score (0.704 and 0.694). Discussion: Machine learning models to screen for and predict older adults at high-risk for ED-RVA may be useful in directing interventions to reduce adverse events in older adults discharged from the ED.
Preparing for the New Normal: Chronicling the Impact of COVID-19 on Older Adults and Providers
Authors: DiMaria-Ghalili Rose Ann , Sefcik Justine
Published: December 2021

COVID-19 and social distancing heralded an unprecedented change in the way older adults and health care providers live, work, socialize and manage their health. Early “calls-to-action” included the call for researchers to chronicle the impact of the COVID-19 pandemic on care of older adults to inform models of care and best practices in the new normal. This symposium explores the impact of COVID-19 on the health of older adults across the care continuum and healthcare delivery augmented by technology. The perspectives of older adults living in the community and providers who care for this population are highlighted. Additionally, there is a focus on the most vulnerable, those living in skilled care facilities and continuing care retirement communities. Fisher analyzes the key themes in 37 COVID-19 video communiques over 11 months at a continuing care retirement community. Sefcik explores coping strategies including outdoor activities among community-dwelling older adults. DiMaria-Ghalili examined patterns of physical and mental health, technology usage and loneliness in older adults, including those living in the community and a continuing care retirement community. Using longitudinal data and COVID-19 supplemental survey data from the National Health and Aging Trends Study, Huh-Yoo discusses disparities in online patient-provider communication and implications for the Post-COVID era. Coates discusses the facilitators and barriers perceived by interdisciplinary providers deploying telehealth during the COVID-19 pandemic and implications for healthcare delivery in older adults. The symposium will conclude with a discussion by Dr. Sefcik on the implications for research, practice and policy in the post COVID-19 era.
Recruiting and Conducting Online Dyadic Semi-Structured Interviews With LGBTQ+ Couples Facing Advanced Cancer
Authors: Bybee Sara , Cloyes Kristin , Ellington Lee , Baucom Brian , Supiano Katherine , Mooney Kathi
Published: December 2021

In this study, LGBTQ+ adult couples facing advanced cancer were recruited online. Eligible couples were sent a direct link to electronic consent and surveys in REDCap®. Participants were then invited to complete a 45-minute dyadic semi-structured interview regarding their experience of coping with cancer as a couple. This study faced difficulties in recruiting LGBTQ+ couples, and also faced the challenge of identifying and managing online responses from individuals misrepresenting themselves, and from automated accounts or “bots”. LGBTQ+ aging scholars must acknowledge how conducting research remotely with LGBTQ+ adults may necessitate changes in study design, such as changes to recruitment and more comprehensive eligibility screening designed to prevent and detect the collection of untrustworthy data. Ultimately, protecting the integrity of participant data in online research supports research accessibility and inclusion for LGBTQ+ older adults, and is the first step in conducting research that promotes health equity.
Qualitative Research With HIV+ Older Adults Living in Rural Areas: Methodological Considerations During COVID-19
Authors: Robinson Erin
Published: December 2021

Older adults living with HIV/AIDS (OALWHA) in rural areas of the U.S. are a highly marginalized community. Intersectional stigma related to age, HIV status, geography, sexual orientation, gender identity, and race oftentimes create a complex lived experience for this population group. While there is a significant need for qualitative research that highlights the intersecting stigmas experienced by OALWHA in rural areas, recruitment challenges exist. Fear of being outed in their rural communities, due to their HIV status and LGBTQ+ identities, makes many OALWHA reluctant to participate in research. However, there is much resiliency in the population as well, especially during the COVID-19 pandemic. In fact, as research approaches have pivoted to phone/virtual data collection during the pandemic, this can help promote anonymity among this population group. This presentation will detail methodological considerations for recruitment, data collection, and analysis for qualitative research with OALWHA in rural areas of the U.S.
User-Centered Design of a Dementia-Friendly Privacy Policy for the FindMyApps Intervention
Authors: Neal David , Kerkhof Yvonne , Ettema Teake , Dijkstra Karin , Dröes Rose-Marie
Published: December 2021

The ability of people with dementia and their caregivers to successfully navigate online environments is increasingly important to their social health. However, uncertainty about privacy online is an important barrier. Theoretically, access to published privacy policies should allow users of websites or software applications to make informed decisions. In practice, such documents are often complicated texts, and consequently even less accessible to people with cognitive impairment than to the general population. We present results from a multi-stakeholder, user-centred design process, towards an accessible alternative: a ‘dementia-friendly privacy policy’. Three design sprints took place in 2021, led by participants of the ‘Smart Solutions Semester’ at Saxion University of Applied Sciences in the Netherlands, in collaboration with cognitively unimpaired laypeople, people with dementia, informal caregivers, and expert stakeholders. Outputs were specifications for the solution, low-fidelity prototypes and high-fidelity prototypes, respectively. The dementia-friendly privacy policy is now ready for implementation and further evaluation.
Addressing the Adverse Effects of Climate Change on the Human Rights of Older Persons
Authors: Burk-Leaver Erin
Published: December 2021

The common consequences of climate change events include: displacement, loss of sustainable shelter and housing, and limited access to medical care and other resources such as food, clean water, and sanitation services. These adverse effects coincide to an alarming degree with the human rights most essential to those in vulnerable or marginalized groups, including older populations. Whether through displacement or disruption of supply, the stressors of climate change events greatly exacerbate older populations’ vulnerability, especially when compounded by negative social determinants of health, such as existing social, political, and economic barriers to successful aging. Using the SDGs as a framework to develop policies around (13) climate action and the use of improved (9) industry, innovation, and infrastructure to create (11) sustainable cities and communities, it is possible to establish (10) reduced inequalities to promote overall (3) good health and well-being in our older populations.
Empowering Caregivers in the Midst of Climate Change
Authors: Cox Carole
Published: December 2021

More than 2.7 million children in the United States are raised in kinship families, with the majority of these caregivers, grandparents. Nationally, 1 in 11 children is raised in a kinship family, among Black children, the ratio is 1 in 5. Many of these families struggle economically, welcoming their young relatives into small, often substandard public housing where nonexistent or inadequate heating and cooling exacerbate attempts to moderate extreme temperatures in crowded apartments. For others, responsibility for the children follows the loss of life or permanent disruption of family composition due to weather events such as hurricanes or tornadoes. Grandparent resilience is reflected in their commitment to the well-being of these children, especially observed throughout COVID-19. This presentation will demonstrate that a Grandparent Empowerment Program is an effective strategy to tap into their strength as advocates for adequate health care, educational opportunity, resources, and a world free from climate disruption.
The 9th Decade and Beyond: The Perils of the Narrative of Decline
Authors: Eliopoulos Elaine
Published: December 2021

Twenty-three participants ranging in age from 80-102 years living on remote islands in the Pacific Northwest, USA reported the privileges of their current years. The aim of the study was to explore lived bodily experience and its impact on social exclusion. Participants utilized a unique visual methodology by photographing their experiences which highlighted daily life. While acknowledging that their years ‘before’ were different, and that life going forward may present unwelcome challenges, life in the now brought new joys and self-determination, despite various bodily compromises. Their perceptions of their bodies defied the dominant narrative of decline. These important findings warrant further investigation of the ways in which this emerging cohort views the challenges of aging bodies and their ability to remain socially connected. The role the dominant narrative of decline plays in their lives may prove to misdirect supports.
A Delirium Risk Stratification Tool and Interdisciplinary Rounds to Prevent Delirium in Hospitalized Older Adults
Authors: Woodward Jennifer , Byrnes Tru
Published: December 2021

Delirium is a disturbance of attention accompanied by a change in baseline cognition that is commonly seen in acute care settings, and effects up to 80% of ICU patients. The development of delirium has adverse effects on patient outcomes and high health care costs. Of patients aged 65+ admitted to our hospital in 2019, non-delirious patients had a five-day length of stay (LOS) compared to a 10-14 days LOS in delirious patients. A five days LOS increase adds an additional $ 8,325 per patient for an extra annual cost of 15 million dollars. Additionally, delirium is often not recognized. A prior retrospective study showed that 31% of older adults seen by a Geriatrics provider were diagnosed with delirium, while only 11% were detected by nurse’s CAM screen. Given the need to improve delirium detection and management, a QI project was undertaken with a goal to recruit an interdisciplinary team, create a risk stratification tool to identify patients at substantial risk for developing delirium, and develop a delirium prevention protocol. Patients with a score of ≥ 4 were initiated on a nurse driven delirium protocol that included a delirium precaution sign and caregiver education. 6 months data has shown increased delirium detection of 33%, a reduction in 7.7 days LOS, reduced SNF discharge by 27%, and a significant LOS saving of 231 days. The results were statistically significant, p < 0.04 for LOS reduction. The cost avoidance in LOS alone were $384,615 for delirium patients.
Predicting Factors of Clinical Outcomes in Traumatized Adults and Older Adults
Authors: Suyasith Pornthip , Chayaput Prangtip , Thosingha Orapan , Leveille Suzanne G , Sirikun Jatuporn
Published: December 2021

To investigate factors predicting hospital mortality and hospital length of stay (LOS) in traumatized adults and older adults, we conducted a three-year retrospective study at an academic hospital, Bangkok, Thailand. We reviewed medical records of 627 trauma patients admitted to the ED. Subjects were classified into 2 groups: adults (□55y), and older adults (□55y). Data were collected for demographic and clinical characteristics, physiologic deterioration using the Modified Early Warning Score (MEWS), severity of injury using the Circulation Respiration Abdomen Motor and Speech Score (CRAMS), and outcomes of hospital mortality and LOS. Multivariable logistic and linear regression models were performed. For hospital mortality, an elevated MEWS (Older adults [n= 267]: MEWS≥3, OR=4.80, 95%CI, 1.02-22.56 vs Adults [n = 360]: MEWS≥4, OR=11.63, 95%CI, 1.94-69.82) and CRAMS (Older adults: CRAMS≤9, OR=19.21, 95%CI, 2.78-132.98 vs Adults: CRAMS≤6, OR=18.58, 95%CI, 3.40-101.65) were strongly predictive, adjusted for demographic and clinical data. For LOS, road traffic accident (RTA) (Older adults: β=0.80, 95%CI, 0.31-1.29, p < .01 vs Adults: β=0.44, 95%CI, 0.21-0.67, p < .001) and falls (Older adults: β=0.88, 95%CI, 0.44-1.32, p < .001 vs Adults: β=0.33, 95%CI, 0.02-0.65, p < .05) were associated with LOS, adjusted for demographic and clinical data. MEWS and CRAMS predicted hospital mortality, and RTA and falls predicted LOS in both age groups. Results support the need for interventions for close monitoring and medical management for older traumatized patients based on CRAMS and MEWS assessment to decrease the risk of death, and targeting those sustaining falls and RTA to reduce prolonged LOS.
Toward interventions to reduce internalized ageism
Authors: Steward Andrew
Published: December 2021

Ageism is an insidious form of injustice that is internalized from an early age with accumulating negative health impacts across the lifespan. Internalized ageism is associated with numerous public health outcomes, including physical and mental health, functional impairment, cognition, cardiovascular stress, hospitalizations, and longevity. Research has begun to document how ageism negatively impacts health through psychological, behavioral, and physiological pathways. Yet, limited research has addressed interventions to reduce internalized ageism. This study integrates stereotype embodiment theory, theories of successful and productive aging, and recent scholarly literature to present a conceptual model with potential downstream, midstream, and upstream interventions at micro, meso, and macro levels. Micro interventions include: social, physical, and cognitive engagement, as well as stress management. Meso interventions include: education, intergenerational contact, and narrative reframing. Macro interventions include anti-ageism policy, such as amendments to the Age Discrimination in Employment Act (ADEA). The conceptual model is described in detail, and implications for practitioners are discussed. The need to examine how policy influences health through the three pathways in stereotype embodiment theory is discussed. This study provides a working model for scholars and practitioners to use when considering paths toward reducing internalized ageism and optimizing well-being for aging adults.
Awareness of age-related change and its relationship with inductive reasoning and ageism
Authors: Voelkner Abigail , Caskie Grace
Published: December 2021

Subjective aging is important due to its relationship with well-being. Diehl and Wahl (2010) proposed Awareness of Age-Related Change (AARC) as a measure of subjective aging; their theoretical model proposed that cognition’s relationship to AARC is mediated by ageist experiences. The current study tests this model and proposes an alternative model where cognition is hypothesized to mediate the relationship of ageist experiences to AARC. Inductive reasoning was used to measure cognition due to its susceptibility to ageism. Participants were 283 older adults aged 66-90 years (M=69.08, SD=3.36) without a dementia diagnosis or cognitive impairment. Inductive reasoning was measured by Word Series, Number Series, Letter Sets, and a composite score. AARC total losses, cognitive losses, total gains, and cognitive gains were used. Age, gender, and education covariates were included. Analysis of Diehl and Wahl’s (2010) model showed that the composite and individual reasoning measures had negative direct effects on all AARC measures. Ageism mediated the effect of the composite and individual reasoning measures on AARC total and cognitive losses. In the alternative model, ageist experiences had positive direct effects on AARC total and cognitive losses. The composite, Number Series, and Letter Sets mediated the effect of ageism on all AARC measures. Word Series mediated the effect of ageism on total and cognitive losses. Overall, inductive reasoning seems to play an important role in understanding the relationship of ageism with AARC. Thus, inductive reasoning abilities may be a potential intervention point to cultivate well-being. Future research should assess additional domains of cognition.
Different Strokes for Different Folks? Examining a New Measure for Age-Relative Sexual Attitudes
Authors: Graf Allyson , Bryant-Lees Kinsey , Cohn Tracy , Syme Maggie
Published: December 2021

Recent research suggests increasingly permissive attitudes towards sexual activity in later life. Harboring more conservative beliefs especially as one reaches older age, however, may translate into how one views and navigates sexual health changes. A sample of participants (N = 706; Mage = 52.72 years, SD = 9.57, range = 36-79; 60.8% male) was recruited through Amazon’s Mechanical Turk to complete a survey on sexual beliefs about age and aging. Participants completed two versions of the Relative Sexual Attitudes Scale (RASA), wherein they were prompted to consider either “someone their own age” or “an older person” in response to items assessing sexual attitudes. Multi-group confirmatory factor analysis was used to confirm the original five-factor structure, reduce the total items from 31 to 25, and establish measurement equivalence for the 36-54 year-old and 55+ year-old samples. Through a series of profile analyses investigating each subscale, scores did not significantly differ between the two prompts, although significant age-group differences were found with the 36-54 year-old age group reporting more open attitudes than the 55+ year-old age group across all subscales, except the traditional mores subscale. Sexual attitude subscale scores also differed by gender, engagement in partnered sexual activity, and whether one had spoken to a health professional about their sexual health in the past year. The findings support use of the RASA for adults 36 and older and highlight applications to understanding differences in sexual health into later life.
Lacking Warmth and Competence: How Younger Adults Utilize “OK Boomer” According to the Stereotype Content Model
Authors: Frey Katelyn , Vale Michael , Bisconti Toni
Published: December 2021

Younger adults have coined the popular retort “OK Boomer,” referring to the 76 million Baby Boomers born between 1946-1964. The Stereotype Content Model (SCM) is a framework used to assess stereotypical perceptions of various groups, and older adults generally fall in the paternalistic “high warmth/low competence” quadrant. The stereotypes behind “OK Boomer” could correspond to any of the four quadrants of the SCM. The present study's goals were to determine the parameters for using the phrase, how hostile and benevolent ageism may underlie its use, and whether or not the eponymous “Boomer” fits into the same cluster in the SCM as older adults in general. In a sample of 316 participants (18-33; M = 23; SD = 5.25), we found that age was related to using “OK Boomer” such that being younger is associated with feeling more comfortable using the phrase in front of anyone (r = -.208, p < .01), using the phrase more frequently (r = -.218, p < .01), and sharing “OK Boomer” memes, pictures, and jokes online (r = -.203, p < .01). Hostile ageism, but not benevolent, was associated with an increased likelihood of saying “OK Boomer” in front of anyone (r = .256, p < .01), to use it more frequently (r = .242, p < .01), and to share “OK Boomer” jokes online (r = .301, p < .01). Content analysis results indicate that “OK Boomer” does not correspond to the paternalistic quadrant of the SCM due to Boomers’ perceived low warmth.