bluuebunny/crossref_metadata_2025 huggingface dataset:
DEMENTIA CARE COORDINATION FOR CAREGIVERS OF VETERANS DIAGNOSED WITH DEMENTIA: AN INNOVATIVE VA INITIATIVE
Authors: Howe Judith , Gottesman Eve , Koufacos Nicholas
Published: December 2022

There are expected to be 335,425 Veterans with dementia by 2033. Dementia has a significant impact on families, especially caregivers. Caregivers often report high levels of stress and burden, which can cause them to develop physical and mental illness, impacting the care they provide to family members with dementia. In 2021, under a Veterans Health Administration (VHA) directive, the Bronx VA Geriatric Research, Education and Clinical Center developed a Dementia Care Coordination program, funded by the VHA Office of Rural Health sponsored Geriatric Scholars Program. Led by a Dementia Care Coordinator (DCC), who is also a clinical social worker, the program identified caregivers of Veterans with dementia who reported experiencing stress and burnout while caring for Veterans with dementia. The DCC provided support via telephone and VVC and also shared resources focused on stress reduction, relaxation techniques, and coping with grief. During 2021, 23 caregivers of diverse racial and ethnic backgrounds were enrolled in the program and 17 were found to have significant caregiver burden. Over 100 support calls were made on the topics of stress reduction, problem solving and community resources. Common problems reported by caregivers included sundowning, sleep problems, grief, and increased social isolation due to the COVID-19 pandemic. Caregivers showed a willingness to participate in the program, indicating that the information, resources and support provided by the DCC helped reduce their stress levels and allowed them to provide ongoing care. Recent program developments, findings from an IRB approved survey of participants, and expansion plans will be reported.
TRAINING PHYSICIAN-SCIENTISTS IN SOCIAL AND BEHAVIORAL SCIENCE: INDIANA ADRD MEDICAL SCIENTIST TRAINING PROGRAM
Authors: Fowler Nicole , Herbert Brittney-Shea , Callahan Christopher , Peng Siyun , Perry Brea , Yoder Karmen , Landreth Gary , Truitt William
Published: December 2022

There is a critical need to grow and strengthen the pipeline of physician scientists who have expertise in sociomedical and behavioral research and are dedicated to addressing the nation's challenges posed by Alzheimer's disease and related dementias (ADRD). In 2021 The Indiana ADRD Medical Scientist Training Program (IADRD MSTP) was designed to meet this need and is built on the infrastructure of a robust portfolio of ADRD research, graduate training programs in medical neurosciences and sociology, and our existing MD-PhD program at Indiana University School of Medicine. The Aims of the IADRD MSTP are: 1) To recruit and train a competitive pool of diverse students who have an interest and commitment to social and behavioral research and patient care focused on ADRD; 2) To engage MD-PhD students early in mentored sociomedical and behavioral research that integrates IUs systems-based medical training curriculum with our cutting edge ADRD research that reinforces commitment and minimizes attrition of physician-scientists ADRD; and 3) To graduate students with dual MD-PhD degrees with strong methodological training in social and behavioral science and experts in ADRD who will be successful independent investigators at the best academic medical centers nationwide. The program includes rigorous didactic training in social, behavioral, and clinical research methods, with flexibility to allow students to focus their effort on one methodological area of interest; early initiation of ADRD research experiences with multidisciplinary teams of mentors and advisors; and the provision of educational experiences that enhance students' abilities to become independent researchers.
OLDER BLACK LESBIANS' NEEDS AND EXPECTATIONS IN RELATION TO LONG-TERM CARE FACILITY USE
Authors: Singleton Meki , Adams Mary Anne , Poteat Tonia
Published: December 2022

The older adult sexual minority (SM) population encompasses a vast array of individuals from diverse backgrounds. However, there is a dearth of gerontological research that focuses on the experiences of SM subgroups, particularly older Black lesbians. The purpose of this study was to explore older Black lesbians’ needs and expectations in relation to the utilization of long-term care (LTC) facilities. We conducted secondary data analysis using data from 14 focus groups (n=100) that discussed health and aging with older Black lesbians. Transcriptions were analyzed in NVivo 12 using content analysis and structural coding. Three major themes were identified in relation to needs and expectations for LTC facility use: (1) consideration of or plans established to utilize a LTC facility, (2) concern for care facility environment, and (3) a desire to build one’s own community instead of LTC use. Within these themes, prominent topics included having to rely on LTC due to a lack of family or social support, the possibility of being isolated and stifling their lesbian identity and creating communities of mutual support to avoid facility-based care. These findings illustrate how older Black lesbians are planning for a potential need for LTC, their concerns about utilizing LTC, and alternative approaches to avoid LTC use. There remains a continued need for LTC communities that are inclusive and supportive of SM older adults as well as more SM-only communities where older adults can live openly and authentically.
ASSESSING TELEHEALTH USE AMONG OLDER ADULTS WITH LIMITED RESOURCES DURING THE COVID-19 PANDEMIC
Authors: Dezine Marie , Pandya Naushira , Damier Sashah , Tewary Sweta
Published: December 2022

The COVID-19 pandemic created new barriers to accessing primary care services, particularly among older adults who has faced barriers related to access to care, transportation, health literacy, and social isolation. Nova Southeastern University South Florida Geriatric Workforce Enhancement Program (NSU SFGWEP) partnered with primary care clinics and a local community partner to conduct wellness calls to older adult patients identified through clinic EHR. This project aimed to provide educational and telehealth support to vulnerable adults with limited resources in the Tri-County region of Florida. Wellness calls were made to determine educational and technical support needs of the older adults designated as underprivileged. We identified 44 participants to receive telehealth devices. Samsung tablets were mailed with educational resources, developed by NSU SFGWEP related to COVID-19 pandemic. The information included health, vaccine education, and instructions to access telehealth services. They had the tablets for six months. We conducted bi-weekly calls to offer peer training to access the educational materials. The participants were asked a series of questions to assess the effectiveness of the peer training support. Among participants, 36% (n=16) found the education materials impactful. Most participants, 89% (n=39), used the tablet, and 23% (n=10) reported using it daily. 11% (n=5) used it for telehealth, 7% (n=3) to connect with friends and family, and 7% (n=3) to connect with faith. This pilot project suggests that tablets were beneficial in assisting the participants in accessing education materials and resources encouraging the use of telehealth appointments and eliminating some of the social isolation.
PARTICIPATORY RESEARCH APPROACH FOR EVALUATING HOME ENVIRONMENT FOR OLDER ADULTS WITH DISABILITIES
Authors: Tissot Juliana , Ramadhani Widya , Vergara Lizandra , Rogers Wendy
Published: December 2022

Regardless of where they live, older adults’ ability to retain their independence depends on their health and capacity. Considering that older adults are more likely to experience disabilities, there are opportunities for built environmental intervention to help them conduct everyday activities to achieve successful aging in place. We conducted participatory research with designers, architects, and aging specialists to identify aspects and characteristics of the physical space that can support or limit older adults’ ability to do everyday activities. The research was conducted at the McKechnie Family LIFE Home, a home simulation facility. Participants were asked to walk through the home spaces and identify potential challenges and solutions for older adults with different disabilities (i.e., mobility, cognitive, sensory, socio-emotional), followed by a group discussion. Preliminary findings showed that the bathroom and kitchen had the most barriers. Recommendations to improve bathroom safety include installing high friction flooring, grab bars on both toilet sides, adequate wheelchair maneuvering space, and color contrast. Cooking was mentioned as a difficult activity and solutions included appliances at waist level, layout in “C” or a “U”, lights under cabinets, and in the foot space. Also, the cabinets doors should be translucent to allow them to check what is inside. The house floor plan should be designed with considerations of users’ everyday activities and the relationship between these activities, such as having the bathroom nearby bedroom, laundry nearby the kitchen to improve users ‘mobility. We have developed a protocol for designers to follow when evaluating home spaces.
INTERACTIONS WITH PEOPLE WITH DEMENTIA, LEARNING EXPERIENCES, AND PUBLIC STIGMA AGAINST DEMENTIA
Authors: Noguchi Taiji , Nakagawa Takeshi , Komatsu Ayane , Shang Erhua , Murata Chiyoe , Saito Tami
Published: December 2022

Overcoming stigma around dementia is a global challenge. This cross-sectional study examined the association of experiences of interacting with people with dementia (PwD) and learning about dementia, with the public-stigma against dementia. We recruited—via an internet survey—710 Japanese adults (mean age = 46.3 years; 49.3% females) without any medical or welfare license, or dementia-related work experience. Public-stigma against dementia was assessed using the Japanese version of Phillipson et al.’s scale (2012) exploring dementia-related attitudes in the context of “personal avoidance,” “person centeredness,” “fear of labeling,” and “fear of discrimination.” Multivariable linear regression analysis was employed to examine the association of interacting with PwD and learning regarding dementia as explanatory variables with dementia stigma score, adjusting for sociodemographic variables. Regarding interactions with PwD, talking or activities with PwD were associated with low “personal avoidance” (β = -1.47, p = 0.002), “fear of labeling” (β = -0.96, p = 0.020), and “fear of discrimination” (β = -0.396, p = 0.043). Experiences of living with PwD were associated with low “personal avoidance” (β = -2.35, p = 0.002) and “fear of discrimination” (β = -0.789, p = 0.013). Learning experiences at school regarding dementia were associated with low “personal avoidance” (β = -4.01, p < 0.001), and self-learning experiences were associated with low “personal avoidance” (β = -1.73, p = 0.049) and high “person centeredness” (β = 1.27, p = 0.037). However, workplace learning was not associated with any area. Interacting with PwD and learning about dementia might reduce associated public-stigma.
SOCIOECONOMIC PRIVILEGE IN CHILDHOOD AND LATER LIFE COGNITION
Authors: Williams-Farrelly Monica
Published: December 2022

Prior studies have demonstrated the effects of early socioeconomic status on later life cognition; yet the degree to which this effect operates directly, or indirectly through adult factors, is not well documented. Drawing from accumulation theories, we use longitudinal data from the Health and Retirement Study and its Life History Mail Survey (N=11,761) to examine the extent to which childhood socioeconomic privilege protects against later life cognitive decline and whether this effect is direct or indirect through measures of adult socioeconomic position. Analyses reveal that, among childhood privilege measures, consistent attendance in private school, participation in college preparation, foreign language, and multiple clubs in high school were most protective of later life cognition. The effect of cumulative childhood privilege on later life cognition is both direct and indirect through increased wealth and education credentials and the strength of this relationship is particularly robust for those demonstrating upward social mobility.
ASSOCIATIONS BETWEEN DAILY DRINKING AND DAILY MEMORY LAPSES AMONG MIDDLE-AGED AND OLDER ADULTS IN THE MIDUS STUDY
Authors: Miller Sara , Mogle Jacqueline , Linden-Carmichael Ashley , Almeida David
Published: December 2022

Alcohol use predicts short- and long-term memory impairment. However, it is unclear how alcohol influences subjective memory, which refers to perceptions of one’s own memory functioning. This study examined associations between daily alcohol use and memory lapses (i.e., subjective memory) and evaluated perceived impact of memory lapses on daily life. Participants (n=953; Mage=55.2) were non-abstaining adults from the Midlife in the United States (MIDUS) study who participated in the 8-day daily diary project. Survey items included number of drinks and 9 memory lapse items (1=yes). After each reported memory lapse, participants indicated memory lapse irritation (range=1-10) and interference (range=1-10). Covariates included age, gender, race, education, and cognitive functioning. Multilevel logistic regression analysis revealed that within-person alcohol use (OR=1.07; p< 0.01), but not between-person alcohol use (p>0.05), was associated with greater odds of reporting any memory lapses. When assessing retrospective and prospective lapses separately, only the prediction of prospective lapses from between-person alcohol use was significant (OR=1.11; p=0.01). Finally, multilevel linear regression analysis indicated that neither within-person nor between-person alcohol use was predictive of reported irritation or interference from memory lapses (p>0.05). Study findings revealed between- and within-person associations between alcohol use and subjective memory. At the daily-level, individuals were more likely to notice memory lapses on days they drank more than usual. At the person-level, people who drank more relative to others were more likely to report prospective memory lapses. Future studies should assess how associations between alcohol use and subjective memory relate to objective cognitive functioning outcomes.
DEMENTIA CAREGIVERS: THE IMPACT OF SOCIAL DISTANCING ON RELIGIOUS AND SPIRITUAL PRACTICE AND BEHAVIORAL SYMPTOMS
Authors: Britt Katherine , Radhakrishnan Kavita , Fry Liam , Richards Kathy
Published: December 2022

Prevalent among older adults with Alzheimer’s disease related dementia (ADRD), behavioral symptoms can cause adverse consequences for those with ADRD and their caregivers. Prompting earlier institutionalization and increased rapid cognitive decline, behavioral disturbances are difficult to manage. Social isolation prompted by the COVID-19 pandemic limited social and religious activities utilized by caregivers and older adults with ADRD for coping and may have affected behavioral symptoms and overall well-being. This qualitative study aimed to explore the impact of the pandemic on behavioral symptoms, religious and spiritual (R/S) utilization for coping, and well-being in caregivers and older adults with ADRD. A purposive sample of 7 home family caregivers and 7 nursing home caregivers (4 indirect family caregivers, 3 nurse practitioners) actively caring for an older adult with ADRD participated in semi-structured telephone interviews. Directed content analysis was used to analyze data. While behavioral symptoms increased overall for older adults with ADRD and social R/S practice abruptly declined, they still utilized individual R/S resources for coping such as prayers, reading religious texts, and holding a prayer book which provided a calming effect, decreased their anxiety, and prompted memories. Caregivers participated in R/S virtual groups which calmed them, connected them with others, helped them transition to sleep, and prompted mindfulness. Resources and interventions utilizing social and individual R/S for coping are warranted as they have the potential to promote cognitive stimulation, connection with others, decrease neuropsychiatric symptoms, and decrease stress.
4MS AGE-FRIENDLY HEALTHCARE INITIATIVE IMPLEMENTATION ON AN ACUTE CARE FOR ELDERS UNIT
Authors: Wilson Lucy , Rick Chelsea , Welch Sarah , Nelson Sarah , Lawson Olivia , Boren Hannah , Duggan Mariu
Published: December 2022

Although evidence supports 4Ms [Medication, Mentation, What Matters Most (WMM), Mobility] care for older adults, successful implementation at an academic hospital is not well described. The aim of this study was to describe the implementation methods and process measures for 4Ms delivery on the Acute Care for Elders (ACE) unit at an academic hospital. We used the Institute for Healthcare Improvement’s Model for Improvement to guide efforts. We set SMART goals for each M: best possible medication reconciliation, identification of potentially inappropriate medications, and recommendations to deprescribe (medication), delirium screen documented 2x/day and delirium nonpharmacologic protocol in place (mentation), documentation of WMM and care alignment (WMM), Johns Hopkins-Highest Level of Mobility screen assessed during the patient’s hospitalization, mobilization of patient 3x/day offered and documented, and restraints avoided (mobility). We mapped current and ideal workflows. We sought community grant funding to expand the implementation team, supporting a nurse educator to train the unit and data analyst to extract real-time data from the electronic medical record to inform improvement processes. Multiple Plan-Do-Study-Act cycles were run iteratively and discussed at weekly team meetings. We included patients >65 years old, admitted for >48 hours, and excluded patients admitted on hospice. Of 519 eligible patients admitted from 04/2021-01/2022, goals were met by 454 (87%) for medication, 187 (36%) for mentation, 130 (25%) for WMM, and 6 (1%) for mobility. We found implementing 4M care processes at an academic hospital to be feasible. Further exploration of barriers to meeting the mobility target is warranted.
DEVELOPMENT OF A HOPE-BASED HEALTH PROMOTION PROGRAM TO IMPROVE HEALTH BEHAVIORS AMONG DIVERSE OLDER ADULTS
Authors: Howell Britteny , Worthington Amber , Redmond Leslie
Published: December 2022

Studies have shown that health education can improve dietary intake, exercise, and energy balance, which improves health outcomes and quality of life. However, diverse low-income older adults may have low self-efficacy coupled with potentially negative opinions regarding the aging process. Emerging research suggests that asset-based approaches utilizing persuasive and hopeful messages may be particularly effective with diverse populations of older adults who may be struggling with negative perceptions of self-efficacy. Research also shows that health behavior change interventions are most likely to be successful among diverse populations when they incorporate messages of resilience and facilitate information sharing and diffusion among participants. This presentation outlines the program curriculum development process of a student-led health promotion program by an interdisciplinary team of university researchers. Public health, dietetics, and communication faculty utilized Persuasive Hope Theory (PHT) and Self-Efficacy Theory to create a 15-week program to improve fruit and vegetable intake and physical activity among low-income adults aged 55+ living in Anchorage, Alaska. We will also detail the curricular components for this NIA-funded program which will be delivered in Fall 2022.
PATIENTS’ SPIRITUAL CONCERNS AND NEEDS DURING GOALS OF CARE CONVERSATIONS: HEALTHCARE CHAPLAINS’ PERSPECTIVES
Authors: Kwak Jung , Rajagopal Shilpa , Dronamraju Neha , Handzo George , Hughes Brian
Published: December 2022

Healthcare chaplains are critical members of interdisciplinary healthcare teams and routinely facilitate advance care planning (ACP) and goals of care conversations with patients with serious illnesses. These conversations involve discussion of one’s deeply held personal values and beliefs as well as uncertainty, fears, and hopes for current and future health care needs. However, there is limited empirical data on how patients’ spiritual concerns and needs are addressed during these conversations. An online survey of 563 board-certified chaplains was conducted from March to July 2020 to identify chaplains’ roles in facilitating goals of care conversations and included three open-ended questions about patients’ hopes and fears and how chaplains addressed them. Quantitative data and written qualitative responses from 244 chaplains were analyzed using descriptive analysis and content analysis, respectively. Majority of participants were white (83.6%), female (59%), Protestant (63.1%), employed full-time (82%), and worked in community hospital settings (45.5%) or academic medical centers (32.8%). Six major themes emerged from chaplains’ qualitative responses: (1) the utility of ACP; (2) focus on the present moment; (3) achieving a personally defined "good death"; (4) spiritual and religious matters and beliefs; (5) caring for and connection with family; and (6) how to address hopes and fears during ACP. ACP and goals of care conversations reflect profound human desires and needs; they require deeper listening and engagement by interdisciplinary team members to provide adequate spiritual and psychosocial support in addition to providing medical information to fulfill the intended meaning and purpose of ACP.
HEALTH SYSTEM IMPLEMENTATION, SCALING, AND IMPACT OF THE 4MS FRAMEWORK TO ADVANCE AGE-FRIENDLY CARE
Authors: Adler-Milstein Julia , Lyles Courtney , Rogers Stephanie
Published: December 2022

There is a critical need to redesign the healthcare system to provide more effective and tailored care to older adults. The 4Ms Framework (What Matters, Medication, Mentation and Mobility) offers a blueprint to guide health system efforts to deliver more age-friendly care. We sought to characterize and assess real-world implementation experiences with the 4Ms in three health systems (University of California, San Francisco, University of Utah, & Anne Arundel Medical Center). Specifically, we conducted semi-structured interviews (N=29) with diverse stakeholders from each site to characterize the approach to operationalize the framework and assess the implementation experience. Via cross-site content analysis of interview transcripts, we identified four themes. First, the 4Ms offer a compelling conceptual framework around which to organize health system efforts to advance age-friendly care, but each “M” required distinct, complex implementation work that resulted in a fragmented implementation experience. Second and relatedly, inpatient and ambulatory efforts to implement the 4Ms became disconnected, with missed opportunities for synergies and gave little attention to the 4Ms during care transitions. Third, non-physician leadership was key to initiating 4Ms implementation efforts, but obtaining physician buy-in, which often came later, was essential to full implementation. Fourth, sustained 4Ms implementation efforts required both top-down vision and communication from leadership as well as bottom-up culture change that engaged and motivated frontline workers. As efforts to spread the 4Ms Framework advance, these results offer important implementation guidance and also suggest domains in which the Framework may need to be adapted to accommodate real-world implementation experiences.
OBJECTIVE HEARING, SUBJECTIVE HEARING, AND PHONE-BASED MEMORY TESTING
Authors: Atkinson Taylor , Andel Ross
Published: December 2022

Hearing impairment may make responding to phone-based memory tests difficult. Words with fricative consonants may pose particular difficulty, as telephones exclude high-frequency sounds necessary for their intelligibility. We hypothesized that recall would be impacted by hearing ability and word type (fricative vs. non-fricative) in a phone-based word list task.Participants (N=1,352, mean age=69.1) in the 2016 and 2018 waves of the Health and Retirement Study completed a phone-based word list recall task evenly split (5 each) between fricative and nonfricative words. Hearing was measured objectively (OH) and subjectively (SH), and each were dichotomized into ‘good’ and ‘poor’ hearing. Covariates included age, sex, race, education, depression, a subjective health rating, and functional limitations. Separate mixed-design ANCOVAs were used for OH and SH, where word type recall was within-subject, and hearing ability was between-subject. For OH, there was a main effect of word type (F(1,1341)=5.67, p=.02) and hearing ability (F(1, 1341)=87.76, p<.001) but no interaction (p>.05). Participants recalled 0.35 fewer fricative words than nonfricative words, and participants with poor OH recalled 0.12 fewer words on average (ps<.001). For SH, there was still a main effect of word type (F(1,1341)=5.39, p =.02), but no effect of hearing ability (p>.05). OH and SH classifications had low agreement (Kappa=.22, p<.001). Hearing ability and word acoustic properties can affect word recall in phone-based tests. Objective hearing tests are important, as subjective ratings do not necessarily agree. Researchers should be careful when constructing telephone-based cognitive tests in order to avoid memory impairment misestimation.
THE INTERPLAY BETWEEN MEMORY SPECIFICITY AND COGNITIVE INHIBITION
Authors: Chien Jessie , Eich Teal
Published: December 2022

Pattern separation studies suggest age-related declines in discriminating between a newly and a previously encountered overlapping mental representations. However, when similar experiences occur contemporaneously, shared features may serve as intrinsic factors that interfere with the ability to encode and retrieve events as distinct memories. If so, successful inhibition of competitors might also be necessary to maintain memory specificity. Here, we investigated the interplay between memory specificity and inhibitory control in younger (20-35;n=34) and older (65+;n=37) adults by testing whether and how presenting a target item with a lure item (varied in its similarity to the target) influenced recognition accuracy, probed using a 3-item (target, lure, and a non-presented control) forced-choice recognition test. Surprisingly, we found no age-related differences, including in target accuracy, which was high in both groups (young=80.25%; older=77.86%). While not age-specific, we did find that the pattern of errors varied as a function of the level of similarity between the items at encoding. When target and lure were highly similar, a greater proportion of control items were falsely-recognized relative to lure items. It is possible that inhibition of the lure spread to the target, leaving both inaccessible at retrieval (e.g., a retrieval-induced forgetting effect). When the target and lure were less similar, participants false alarmed more to lure than control, potentially because the lure provided less competition and thus did not necessitate inhibitory control. These results shed light on how inhibitory processes might be differentially involved, but age-invariant, depending on the similarity of encoded items.
AGE-RELATED CHANGES IN CUED TASK SWITCHING
Authors: Lydon Elizabeth , Mudar Raksha
Published: December 2022

The task switching paradigm is widely used to examine cognitive switching, a critical subcomponent of cognitive control. Studies on aging suggest that switching is particularly vulnerable to age-related changes in cognition. However, the effects of manipulating the stimulus dimension on task switching performance is relatively understudied. In this study, 13 younger adults (YA; 11F; Mean Age= 22.31) and 13 older adults (OA; 8F; Mean Age= 65.85) completed a novel cued task-switching paradigm requiring speeded same-different judgments based on a perceptual (color) or conceptual (animal) dimension of the stimuli. Task switching performance was measured using switch cost, which is the difference in accuracy between switch and repeat trials. Overall both YA and OA exhibited switch costs, indicating increased cognitive demand when switching between judgments compared to repetition of the same judgement. In regard to group differences, YA and OA performed similarly when performance was collapsed across the stimulus dimensions; however, when examined separately, OA exhibited worse performance than YA when making conceptual judgements. These results highlight the importance of examining carefully manipulated stimulus-related factors in task switching paradigms to advance our understanding of cognitive control and aging.
COGNITIVE PROFILES OF SPOUSAL AND PARENTAL CAREGIVERS: AN HRS STUDY
Authors: Singer Katelyn , Katz Benjamin
Published: December 2022

Previous work analyzing the health and wellbeing correlates of caregiving has found increased rates of depression (Caputo, Pavalko, & Hardy, 2016), anxiety (Joling et al., 2015), and elevated risks of health problems, specifically cardiovascular-related incidents like hypertension (Capistrant, Moon, & Glymour, 2012), cardiovascular disease (Capistrant et al., 2012), and strokes (Haley et al., 2010). Research on specific cognitive effects that this responsibility may elicit has been less of an area of focus, especially when examining domains related to executive functioning. The present research investigated whether executive functioning mechanisms (such as processing speed, recall, and attention) are impacted in caregivers and if their function is mediated by interpersonal factors like birth year, gender, education, and depressive symptomology. Using the Health and Retirement Study, we compared spousal and parental caregivers of persons with medical conditions (n = 143) and non-caregivers (n = 975) who completed the 2015 Consumer and Activities Mail Survey (CAMS). Additional demographic and cognitive performance information was paired from the corresponding RAND 2016 data and the 2016 Harmonized Cognitive Assessment Protocol (HCAP) data. Preliminary ANCOVA results indicated, surprisingly, that spousal/parental caregivers were more likely to exhibit better executive function performance (p < .05) compared to non-caregivers, while delayed recall measures were not linked to caregiving status. These results indicate that intact executive function might be linked to one’s ability to provide caregiving for parents and/or spouses; while the HCAP was only administered at a single time point, future research should examine the longitudinal effects of caregiving on cognitive function.
EVERYDAY PROSPECTIVE MEMORY LAPSES AND INFLAMMATION IN OLDER ADULTS
Authors: Harrington Erin , Graham-Engeland Jennifer , Sliwinski Martin , Katz Mindy , Van Bogart Karina , Mogle Jacqueline , Lipton Richard , Engeland Christopher
Published: December 2022

Prospective memory (PM) refers to our memory for future intentions, such as attending an appointment or taking medication. Research suggests that PM deficits can distinguish healthy older adults from those in early stages of dementia. However, limited work has examined PM and biological markers associated with pathological memory decline. The current study examined older adults’ everyday PM lapses and inflammation. Older dementia-free adults (n =237, Mage=76.86 years), enrolled in the ongoing Einstein Aging Study, completed a two-week ecological momentary assessment (EMA) as part of the first wave of data collection. Participants provided two blood samples (pre/post EMA) and self-reported daily PM lapses during nightly surveys. Inflammatory levels quantified from blood were averaged and included in regression analyses predicting total number of PM lapses (covarying for: age, education, race, health, BMI, depressive symptoms). Reporting more PM lapses was associated with higher circulating levels of interleukin [IL]-8 (p=.007); no significant associations emerged with C-reactive protein or other circulating or stimulated (ex-vivo) cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-a). Gender moderated the observed link between IL-8 and PM lapses (p=.015); specifically, higher levels of IL-8 were associated with more PM lapses among men (95%CI=[0.54, 4.72]) but not women (95%CI=[-1.56, 1.25]). Other researchers that found poor cognitive performance in association with elevated IL-8 have suggested that this relation may be indicative of neurodegeneration and future pathology. Future studies should continue to examine daily PM lapses and inflammation across genders to identify mechanisms through which these constructs may relate to neurodegeneration and dementia risk.
DAILY STRESS, DYADIC COPING, AND COGNITIVE FUNCTIONS IN MIDLIFE SAME- AND DIFFERENT-SEX MARRIAGES
Authors: Wang Yiwen
Published: December 2022

Little is known about same-sex couples’ stress experience and cognitive performance at older ages as compared to different-sex couples. Sexual minority older adults may be at greater risk of cognitive impairment and dementia than their non-LGB counterparts due to life-long exposure to the discrimination and stigma associated with sexual minority status. In this study, I use daily dyadic longitudinal data from the Health and Relationships Project (HARP) to explore the patterns of daily cognitive functioning (memory failures and unconstructive repetitive thinking) among spouses in same-sex and different-sex marriages within the United States (N = 836 individuals, 419 couples). The primary focus of this study is to assess how daily stress—as reported by each spouse—is associated with cognitive function, and how these associations vary for women and men in same- and different-sex marriages. To examine how dyadic coping (the process through which couples manage stress together) matters, I also test whether collaborative dyadic coping buffers the health impact of daily stressors on cognitive function. Results suggest that same-sex couples experience more daily stress and have worse cognition compared to different-sex couples. While both respondent- and spouse-reported daily stress are negatively associated with cognitive function, the association between spouse-reported stress and cognition is stronger for women in same-sex marriages compared to men in different-sex marriages. Both men and women in same-sex marriages are more likely to cope with stress collaboratively than their counterparts in different-sex marriages, which helps buffer the negative consequences of daily stress on cognition.
FIRST-YEAR OCCUPATIONAL THERAPY STUDENTS KNOWLEDGE OF AGING; SUGGESTIONS FOR CURRICULUM REQUIREMENTS
Authors: Traywick LaVona , Saviers Brittany , Griffin Terry , Brown Teressa
Published: December 2022

There is a rising shortage of allied healthcare professionals, including occupational therapists, to meet the current and expected needs of the senior adult population. To educate occupational therapy students, there are national standards that all programs have to meet. Inconsistency occurs because there is not a set national curriculum. It is assumed that students will enter their respective occupational therapy programs with a base knowledge of aging due to prerequisite requirements. With IRB approval, that assumption was measured over four consecutive years at one prominent OT program. 192 first-semester occupational therapy students were administered the Facts on Aging Quiz along with additional questions regarding birth year and anticipated employment. Results showed that first-year occupational therapy students’ knowledge of aging was poor (67.9% mean) regardless of their age or population work preference. Only 11.5% stated geriatrics was their preferred population with which to work; most students stated pediatrics. Statistical tests indicated a trend of decreasing mean scores of the cohorts. If this trend of decreasing gerontological literacy exists in occupational therapy, other health care disciplines may be experiencing similar fates. It appears there is a considerable gap between the needs of society and the knowledge base/desired population work preference of those entering healthcare education. Strategies to address that gap need to be addressed to prepare occupational therapy students and other health care practitioners to best meet the needs of the current population. Based on these study results, more emphasis needs to be placed on gerontological literacy for new occupational therapy students.
SLEEP DURATION MEDIATES THE RELATIONSHIP BETWEEN LETTER FLUENCY AND COGNITION
Authors: Kim Hyeon Jung , Banerjee Subhranshu , Boron Julie Blaskewicz
Published: December 2022

Changes in cognition are a normative part of aging. Verbal fluency is widely used for assessing cognitive function, including predicting mild cognitive impairment. As people age, sleep duration and quality decrease. This has been associated with cognitive decline; individuals with low-quality sleep (fewer hours and difficulties with initiation or maintenance of sleep) are more likely to complain of poorer cognition. Lack of sleep is detrimental to verbal fluency (word production). Longer sleep has been linked to memory deficits and is a potential indicator of mild cognitive impairment. This study aimed to address the relationship between verbal fluency and cognitive function as mediated by sleep duration. Participants included 31 middle-aged adults (female, n=19;age=53.55±7.18yrs) and 24 older adults (female=14; age=70.33±3.69yrs). The MoCA assessed cognitive functioning. Verbal fluency (90 seconds each) was measured via category word (animals; semantic verbal fluency) and letter word (phonemic verbal fluency; F,A,S). Mediation models used Baron and Kenny’s (1986) approach for estimating mediation effects, controlling for age and education. Category results were non-significant. However, sleep duration partially mediated the relationship between letter fluency for each letter and cognitive function, respectively (F:F(2,52)=7.31, p=.002, R2=.22; A: F(2,52)=3.80, p=.029, R2=.18; S: F(2,52)=5.47, p=.007, R2=.17). Sleep hours were negatively associated with letter fluency, meaning fewer hours of sleep improved fluency performance, which in turn was positively associated with MOCA scores (F: b=-.378, 95%CI [-0.64, 0.02]; A: b=-.172, 95%CI [-0.42, 0.01]; S: b=-.24, 95%CI [-0.64, 0.02]. This coincides with the abovementioned literature and helps further understand how sleep and cognitive performance are related.
IMPROVING CAREGIVER ASSESSMENT AND COMMUNICATION ABOUT PAIN IN RELATIVES WITH DEMENTIA
Authors: Riffin Catherine , Brody Lilla , Mukhi Priya , Reid Cary , Herr Keela , Pillemer Karl
Published: December 2022

Pain is under-detected and poorly managed in persons with dementia (PWD). Family caregivers are well situated to detect and facilitate management of pain in PWD, but they receive little guidance and training in these tasks. Our group developed the Pain Identification and Communication Toolkit (PICT), a manualized, multicomponent intervention to help caregivers recognize pain in their care recipients and communicate their observations to healthcare providers. PICT includes a) training in administering an observational pain assessment tool, b) coaching in effective pain communication, and c) building caregivers’ skills through practice. To evaluate PICT’s acceptability, feasibility, and preliminary efficacy, we conducted a pilot randomized controlled trial of N=34 caregivers (n=18 randomized to PICT; n=16 randomized to a control condition). Participants were from diverse racial and ethnic backgrounds (14% Black; 15% Hispanic; 8% Asian; 8% multiracial). Of the caregivers enrolled in the intervention group, 66.7% reported that PICT improved their confidence in identifying pain symptoms, and 83.3% reported that PICT improved their confidence in communicating pain-related concerns to providers. Retention was excellent: 100% of caregivers in the PICT group completed all intervention sessions (4 total); only 5% prematurely terminated the study (did not complete the 12-week post-assessment questionnaire). Notably, caregivers in the PICT group showed a significant improvement in confidence communicating with healthcare providers from baseline to 12-week follow-up (M=3.9 vs. M=4.4; p<.01). Collectively, these findings suggest PICT’s potential as an intervention to help caregivers recognize and communicate about pain in PWD and that a full-scale efficacy trial with larger sample is warranted.
STEPS TOWARD RAISE: CO-DESIGN OF COMPETENCY-BASED EDUCATION TO ENGAGE FAMILY CAREGIVERS AS PARTNERS
Authors: Parmar Jasneet , Anderson Sharon , Duggleby Wendy , Lobchuk Michelle , Drance Elisabeth , L'Heureux Tanya , Lowther Johnna , Crowder Kim
Published: December 2022

Meeting the needs of a growing population of older people living with complex conditions is highly dependent on healthcare providers partnering with family caregivers (FCGs). FCGs provide 90% of the care yet are marginalized within healthcare systems. Educating healthcare providers to support FCGs is a necessary step towards addressing the inconsistent system of supports for diverse FCGs throughout variable care trajectories. Current research suggests that co-design benefits stakeholders, produces superior outcomes, and facilitates moving knowledge efficiently into healthcare practices. Currently, moving best practices into healthcare is a time-consuming process (10-17 years). This presentation will discuss a feasible three-phase co-design process that included 120 multilevel interdisciplinary stakeholders including FCGs, educators, researchers, not-for-profit and healthcare providers/leaders, educational designers, and policy influencers/makers: 1) Developing relationships and insights; 2) Translating insights into education design; and 3) Planning the implementation, spread, and scale-up. The research tools used included literature reviews, qualitative and survey research on specific topics, consultations (symposia, modified Delphi process, co-design meetings), and mixed methods evaluation. Three modules, Foundational, COVID-19, and Advanced have been developed. Learners report high satisfaction, relevance, and significant knowledge gains upon completion. This successful education co-design required three critical elements: 1) an engaged co-design team led by people knowledgeable about healthcare and FCGs; 2) team access to collaborators/staff with the appropriate theoretical, research, and facilitation skills; and 3) an educational design team to bring stakeholders’ ideas to life. Leveraging stakeholders’ insights are a critical step towards the RAISE act goal of educating healthcare providers to include FCGs as partners-in-care.
THE ROLE OF SUPPORT IN THE LIVED EXPERIENCE OF DEMENTIA CAREGIVERS: A SYSTEMATIC REVIEW AND THEMATIC SYNTHESIS
Authors: Seyyedmirza Paria , Benson Clark , Emily Diane Ploch , Linden Anna , Gilmore-Bykovskyi Andrea
Published: December 2022

People living with dementia have complex care needs, which are primarily met by unpaid family caregivers. Family caregivers are often underprepared and under-supported in these roles and often experience negative health impacts associated with their caregiving responsibilities. Research suggests caregiving experiences and associated outcomes can be improved through the use of supportive resources which vary widely in design, access, and implementation. Yet how dementia caregivers perceive, identify, and experience supports in the context of their lived experience is less well understood. Understanding caregivers’ un-proscribed conceptualizations of “support” holds important implications for the optimal design of supportive interventions, which are often under-utilized. The objective of this qualitative evidence synthesis was to systematically identify, appraise, and synthesize evidence regarding dementia caregivers’ conceptualization of support through qualitative studies focused broadly on eliciting caregivers’ reports of lived experience. Forty-one qualitative studies were analyzed and synthesized according to methods suggested by Sandelowski (2007) and Graneheim & Lundman (2004). Six themes were identified and synthesized across included studies which include a range of domains from accessibility, awareness, usability, and match of informal and formal support for caregivers' needs and the needs of their care recipient. Caregivers conceptualized support broadly, extending beyond traditional resources to address aspects of their caregiving role. Findings demonstrate that caregivers readily distinguish between formal and informal support, but do not necessarily evaluate them uniformly and are perhaps focused on the fit of support that extends beyond the caregiving role and is more aligned with how caregivers view support in their daily lives.
THE LONGITUDINAL EFFECT OF FINANCIAL DIFFICULTY ON CAREGIVER DEPRESSION
Authors: Mage Susanna , Wilber Kathleen , Benton Donna
Published: December 2022

Informal caregivers are the backbone of the long-term healthcare system in the United States and crucial in supporting the rapidly increasing aging population. Previous studies have illustrated the negative effects that the caregiving role can have on caregiver mental health, but few studies have examined the singular role of experiencing financial difficulty on caregiver mental health. The aim of this study was twofold: to measure how financial difficulty in 2015 correlates with caregiver depression in 2015, and to examine whether financial difficulty in 2015 can predict caregiver depression in 2017. We used two-wave panel data from the National Study on Caregiving (N=1,125) to conduct both regression and lagged dependent variable (LDV) regression analyses to investigate the cross-sectional and longitudinal effect of financial difficulty on caregiver depression, respectively. Caregiver depression was measured using the 2-item version of the Patient Health Questionnaire-9 (PHQ-2), and financial difficulty was self-reported. Results show that caregivers who did not experience financial difficulty in 2015 had 0.46 times the odds of not being depressed (CI 0.30-0.70, p-value= 0.00) in 2015, compared to those who noted that they did experience financial difficulty. In performing a LDV analysis, outcomes showed that financial difficulty in 2015 was significantly associated with caregiver depression in 2017 (p-value< 0.05), implying that current reported financial difficulty may influence caregiver depression two years later. Conclusions from this work provide support for the development of financial interventions for caregivers experiencing financial difficulty that could play a role in alleviating their depressive symptoms.