bluuebunny/crossref_metadata_2025 huggingface dataset:
Person, Place, and Time Effects on Cognitive Function Among Older People in Taiwan
Authors: Hsu Hui-chuan , Bai Chyi-Huey
Published: December 2021

Purpose: Individual’s factors across time or combined with area characteristics related to cognitive function for older people have been widely explored, but little research examined person, place, and time effects altogether. The purpose of this study was to examine the effects of individuals, cities, and time on older people’s cognitive function in Taiwan. Methods: A nation-representative longitudinal individual data were from Taiwan Longitudinal Survey on Aging (TLSA) 1999-2015 panel data (analysis sample n=6349 persons, observations=12042). Cognitive function was scored 0-19. Individual’s factors included demographics, health conditions and health behaviors, mental health and stress, social support and social participation, etc. Eleven city-level indicators were based on 22 cities and data were from the government open data sources. Mixed linear modeling analysis was applied. Results: Better cognitive function was significantly related to individuals’ working, ethnicity, younger age, better education level, better self-rated health, less psychological stress, receiving more emotional support, having higher economic satisfaction at the intercept. Sex, ethnicity, age, education, self-rated health, physical function, and social connectedness were significant at the time slope. When controlling for individuals’ factors, population density and green land were significant at the intercept and at the time slope. Interactions of individual- and city-level factors were not significant. Discussion: Individual’s social participation and social support are protective factors of cognitive function for older adults. And an age-friendly environment providing appropriate cognitive stimulation and chances of social participation may be beneficial for cognitive function.
Chronic Stress Patterns Among Older Adults and Associations With Cognitive Functioning
Authors: Wang Kun , Suntai Zainab , Chen Xiayu
Published: December 2021

Chronic stress has been associated with several adverse cognitive outcomes, including impaired judgement, executive functioning, and memory. Chronic stress has also been linked to several neurological conditions, including Dementia and Alzheimer’s. While several biomedical measures of stress exist, stress is often subjective, and research has shown that the ability to cope with stress-known as stress reactivity-is more indicative of stress burden that the actual stressor itself. As such, this study aimed to identify the association between different patterns of stress and cognition among older adults. Data were derived from the 2016 Health and Retirement Study, a nationally representative study of older adults aged 50 and older living in the United States. Latent class analysis was used to identify different classes of stress and hierarchical linear regressions were conduced to identify the associations between identified stress classes and cognition. The latent class analysis resulted in four stress classes: high stress, financial stress, secondary stress, and low stress. The sequential logistic regression models revealed that while high stress and financial stress classes resulted in cognitive decline, the significance was mitigated after controlling for health and body functioning factors. This suggests that older adults are experiencing stressors mostly from health impairments and interventions should target improved health management and financial support for health conditions as an indirect way of reducing disparities in cognitive functioning resulting from chronic stress.
Executive Functioning, Emotion Regulation, and Negative Emotion in Suicidal Older Adults
Authors: Waldman Rachel , Liles Brian , Kiosses Dimitris , Zweig Richard
Published: December 2021

Deficits in executive functioning, emotion regulation, and negative emotion have all been linked to suicidality. Yet, the complex interactions between these three factors and their relationships to suicidal behavior in older adults remain unclear. Participants (N = 39) were depressed middle and older adult (M = 62.0, SD = 9.41) inpatients with recent suicidal attempt or ideation, without psychotic depression or moderate or greater cognitive impairment (DRS>90). Participants were administered measures of executive functioning (Stroop and COWAT), emotion regulation (ERQ Suppression and Reappraisal; RRS-Brooding; UPPS- Premediation Scale), and negative emotion (PANAS-X), in addition to measures of depression (MADRS) and suicidality (C-SSRS). Results indicated that executive functioning was not significantly related to emotion regulation or negative affect, but measures of emotion regulation were related to negative emotion and frequency of suicidal ideation in bivariate analyses. Lower ERQ reappraisal tended to be associated with negative emotion (ß = -.392, p = .067) in multivariate analyses. Although comparisons were non-significant, effect sizes revealed that those who experienced daily suicidal ideation (C-SSRS) had lower reappraisal and higher brooding scores (Cohen’s d = 1.014 - 1.456), as well as higher executive functioning (Stroop Color-Word trial) and overall cognition (DRS) scores (Cohen’s d = 0.625 – 0.792) than less frequent ideators. Findings suggest that older inpatients with frequent suicidal ideation have poorer emotion regulation but may have more intact cognition and executive functioning than those with less frequent suicidal ideation.
Mind-Body Practice, Personality Traits, and Cognitive Performance: A 10-Year Study in US Adults
Authors: Bhattacharyya Kallol Kumar , Hueluer Gizem , Dobbs Debra
Published: December 2021

It is widely established that physical activity is associated with better cognitive outcomes, and accumulating evidence suggests that mind-body practice (MBP) may yield similar benefits. Personality is related to both daily activities and cognition, but its role in the association between MBP and cognition is not well understood. The current study examines bidirectional temporal associations between personality traits, MBP, and cognition in healthy adults. We used data from waves 2 and 3 (2004-2014) of the Midlife in the United States (MIDUS) study from a total of 2,050 individuals (age: M=64 years, SD=11, range=42 to 92; 56% women). We applied a cross-lagged regression analysis to examine bidirectional effects between MBP, Big Five personality traits, and two cognitive domains (episodic memory and executive function) and controlled for sociodemographic factors, health, and functional status covariates in wave 2. After controlling for covariates, MBP was independently associated with a more favorable change in episodic memory, but not in executive function. Regarding cross-lagged effects of cognitive function, episodic memory was related to subsequent MBP and agreeableness, and executive function was related to subsequent MBP, openness, and conscientiousness. Agreeableness had a negative effect on subsequent executive function. The findings point toward bidirectional associations between cognitive function MBP, while there was no evidence for cross-lagged associations between personality and MBP. Future research should guide us whether MBP can counteract cognitive decline as an alternative and complementary practice and the role that personality can play in such interventions.
Retirement Age Modifies the Association Between Education/Occupation and Cognition
Authors: Nelson Monica , Andel Ross
Published: December 2021

Introduction: According to the cognitive reserve and use-it-or-lose-it hypotheses, engagement in stimulating activities seems to benefit cognition, with engagement often associated with more education or higher occupational position. However, whether retirement may modify the association between education/occupation and cognition is unclear. We aimed to assess how age at retirement may modify the relationship between education/occupation and cognition. Methods: Older adults (n=360) from the Alzheimer’s Disease Neuroimaging Initiative who were cognitively normal and retired at baseline participated. Linear regression was used to assess how educational attainment (high/low) or occupational position (managerial, intermediate/clerical, routine/manual) related to executive functioning (EF) or memory, controlling for age, sex, depressive symptoms, and health status. Effect modification by retirement (early, on-time, late). Results: High education (EF: b=0.37, SE=0.08, p<.001; memory: b=0.22, SE=0.05, p<.001), intermediate (EF: b=0.26, SE=0.11, p=.019; memory: b=0.18, SE=0.08, p=.018) and managerial (EF: b=0.23, SE=0.12, p=.045; memory: b=0.16, SE=0.08, p=.045) occupations (compared to routine/manual occupations) were associated with better EF and memory performance. High education was significantly associated with better EF and memory for participants who retired early (EF: b=0.43, SE=0.12, p<.001; memory: b=0.29, SE=0.10, p=.004) or on-time (EF: b=0.51, SE=0.15, p=.001; memory: b=0.24, SE=0.10, p=.014), but not for participants who retired late (EF: b=0.19, SE=0.15, p=.200; memory: b=0.09, SE=0.09, p=.334). Intermediate occupations were associated with EF only for participants who retired on-time (b=0.58, SE=0.21, p=.007). Conclusion: Education and occupational position may influence cognition after retirement differently based on retirement timing, with effects most apparent for on-time retirement and substantially reduced for late retirement.
Marginal Effects of Multiple Years of Volunteering on Objective and Subjective Measures of Cognition
Authors: Wang Yi , Amano Takashi , Wong Roger , Shen Huei-wern
Published: December 2021

Volunteering is conducive to older Americans’ physical and mental health; however, the effect of volunteering on cognitive health is less studied. Using four waves (2010-2016) of the Health and Retirement Study, this study examined the incremental effect of volunteering engagement on older adults’ cognitive health. We included10,718 cognitively unimpaired, community-dwelling individuals aged 51+ in 2010 and were alive through 2016. Volunteering engagement was measured by the number of times respondents participated in volunteering throughout the four waves. Objective cognition was assessed using the Telephone Interview for Cognitive Status (TICS), a standardized test of cognitive functioning. The TICS score was further categorized into three statuses: “No impairment,” “Cognitive impairment no dementia (CIND),” and “Dementia.” Subjective cognition referred to self-rated memory on a 5-point Likert scale. With sampling weights, ordered logit regression was performed controlling for health-related variables (e.g., health conditions, depression), SES (e.g., income, assets), contextual features (e.g., neighborhood safety, urbanicity), and sociodemographics. The average marginal effects (AMEs) were produced. Results show that more volunteering engagement significantly reduced the likelihood of CIND or dementia (OR=0.88, p<0.001). Specifically, every one-time increase in volunteering increased the probability of remaining cognitively normal by 0.01 (p<0.001), whereas it decreased the probability of CIND by 0.008 (p<0.001) and dementia by 0.001 (p<0.001). For subjective cognition, there was no significant relationship with volunteering. Our findings address gaps in literature by adding evidence of the incremental health benefits of volunteering on cognitive functioning. Differences in the findings for subjective and objective cognition warrant further investigation.
Socially Relevant Approaches to the Detection of Dementia in Minority Older Adults
Authors: Sargent Lana , Lageman Sarah , Thacker Leroy , Russell Sally , Mackiewicz Marissa , Price Elvin
Published: December 2021

Substantial gaps remain in the scientific literature regarding low-income minority older adult populations with Alzheimer’s disease and related dementias (ADRDs). Access to care and early cognitive screening are often barriers to advancing ADRD detection in low socioeconomic status (SES) minority older adults. Additionally, there is the need for demographically (age, education, sex, race, ethnicity, and income) corrected normative scores in cognitive measures. Our cross-sectional study evaluated the psychometrics of the Mini-Mental State Exam-2 (MMSE-2) and the NIH Toolbox Cognition Battery (NIHTB-CB). The sample consisted of n=80 community-based older adults without a diagnosis of dementia living in low-income high-rise housing units. Acceptability is assessed with a brief 6-item acceptability survey, multiple linear regression is used to get predicted cognitive scores adjusted for age, education, income, ethnicity, race, and sex, and t-test comparison of the adjusted scores found in this study to established norms. Results found a mean age of 73, 70% black, 48% with < 12th-grade education, 51% have a monthly income of < $1,000, and 49% with undiagnosed cognitive impairment (CI) by both measures. When applying demographic adjustments in the NIHTB-CB 1) standard scores; 2) age-corrected scores, and 3) demographically correct scores all remained significant (p > 0.0001). Participants reported high (80-95%) acceptability for the community-based cognitive screening, 18% reported concerns with cultural appropriateness of the questions in the NIHTB-CB as compared to 5% with the MMSE-2. This research lays the foundation for a community-based cognitive screening and care coordination program for the low SES minority older adult population.
Provider Communication and Loneliness in Senior Living Communities During the COVID-19 Pandemic
Authors: Wilkinson Lindsay , Masters Julie , Boron Julie Blaskewicz
Published: December 2021

Prior research has demonstrated the impact of the COVID-19 pandemic on feelings of loneliness, but relatively little is known about loneliness in the context of senior living communities (SLCs). Indeed, the pandemic has led SLCs to enact new safety precautions, including visitor restrictions, intended to reduce the spread of COVID-19, which may have serious consequences for the psychosocial well-being of residents. Drawing on a sample of 733 adults ages 54 to 100 living in one of nine SLCs in December 2020 (response rate = 60%), linear regression models were used to examine whether perceived communication between SLCs and residents during the COVID-19 pandemic influenced feelings of loneliness. Analyses also considered whether this association varied as a function of education. Our findings reveal that 53% of respondents were very lonely during the pandemic. However, older adults who perceived that their SLC had been helpful to their understanding of the pandemic were significantly less lonely (p < 0.01), adjusting for sociodemographic and health characteristics. Moreover, we found that less educated older adults derived the greatest benefit from effective communication about the pandemic (p < 0.05). Those with less education reported feeling lonelier if they did not perceive that their SLC communicated in a way that helped them better understand the pandemic; there was no such association for those with higher education. The findings from this study provide support for the resource substitution hypothesis and demonstrate the importance of communication in alleviating feelings of loneliness during the COVID-19 pandemic.
Exploring the “New Normal”: Older Adults’ Coping Strategies During COVID-19 Pandemic
Authors: Nurain Novia , Huber Lesa , Caldeira Clara , Connelly Kay
Published: December 2021

COVID-19 stay-at-home orders resulted in social isolation and psychosocial challenges for older adults around the world. To understand their lived experiences during the pandemic, we conducted a qualitative study using semi-structured interviews with 15 older adults living in community settings. Qualitative thematic analysis of the collected data identified themes and patterns of the “new normal” for these participants: ways of living, communication with family and friends, sense of autonomy, psychological responses, coping strategies, and perceived social support. This presentation focuses on participants’ coping strategies. Participants used common coping strategies, customized to the unique challenges of stay-at-home orders. We categorized coping strategies as problem-focused, meaning-focused, and emotion-focused. Participants’ problem-focused strategies aimed to reduce the risk of infection. Meaning-focused strategies included purposeful errands such as going to grocery stores. Emotion-focused strategies emphasized connecting with support networks (e.g., via Zoom) and efforts to maintain psychosocial and emotional well-being (e.g., seeking professional counseling). They also employed self-enhancing comparisons to increase self-concept and self-esteem. At the beginning of the pandemic, some temporarily used distraction/avoidance strategies such as eating comfort food and avoiding news about COVID-19 to maintain a positive emotional state. Our findings imply the applicability of frameworks such as life course perspective and selective optimization with compensation to highlight the successful adaptive strategies developed by older adults through experience. We argue against the ageist view of older adults as vulnerable. Rather, this study suggests that older adults can flexibly employ resilient coping strategies crafted over a lifetime of experiences in response to crises.
Challenges with Conducting an Investigational Drug Study in Older Adults in Nursing Homes During a Pandemic
Authors: Davidson H Edward , Han Lisa , LaMantia Melissa , Trout Michelle , Mannick Joan , Gravenstein Stefan
Published: December 2021

In the early months of the pandemic, SARS-CoV-2 infected nursing home residents in explosive and deadly outbreaks. Nursing home residents disproportionately accounted for over 40% of COVID-19 mortality nationally. This national emergency drove scientific and public health experts to develop and implement administrative, clinical, and research programs to limit the pandemic’s impact, especially for high-risk individuals, such as those hospitalized or living in nursing homes. Nursing home policies, prompted by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) guidance, severely restricted access beginning in March 2020 in an effort to limit disease exposure. In July 2020 we began the process to conduct an investigational SARS-CoV-2 post exposure prophylaxis study of nursing home residents, incorporating FDA guidance developed for conducting investigational drug trials in the context of COVID-19. Our research teams adapted our nursing home engagement, resident consenting and research data collection strategies accordingly. We remotely screened residents living in any of 28 nursing homes for eligibility to participate, ultimately consenting and randomizing individuals in 11 facilities. Of the 2,683 nursing home residents 65 years or older we screened, 48 (1.8%) agreed to consent individually or through proxy, most often a legally authorized representative. We will describe our research methods, with emphasis on how we addressed challenges presented due to performing all research tasks remotely and identify strategies that can qualitatively improve the remote nursing home research experience.
Discriminant COVID-19 Outcomes Based on Safety Adherence in an Active Lifestyle Retirement Community
Authors: Roberts Mitchell , Sappington Erica , Guerra Leonardo , Collins Lindsey , Yalcin Ali , VandeWerd Carla , Lowenkron Jeff
Published: December 2021

Compliance with preventive behaviors recommended by public health officials plays a critical role in the control and prevention of COVID-19. Data were collected from those living in The Villages, FL, and surrounding communities via The Villages Health COVID-19 Rapid Testing Program in partnership with The UFHealth Precision Health Research Center. A descriptive ecological study was conducted to model COVID-19 positivity result variations by age, sex and adherence to CDC safety recommendations using chi-square tests. 9,993 tests were performed using Abbott's BinaxNOW™ COVID-19 Ag Card, and 931 (9.30%) positive cases were confirmed between 10/19/2020-2/26/2021. Median age was 69 years (range:12-103), and 5,578 (55.8%) individuals were female. No significant differences were found in positive test status (≥65=9.8%,<65=8.8%) amongst those over 65 (n=6567) and under 65 (n=3180) years old [X2 (1, N=9847)=2.49,p=.114]; however, positive test result differed by sex with males (10.6%) testing positive at higher rates than females [8.3%, X2(1, N =9993)=14.888, p< .001)]. A significant relationship between preventative behaviors and positive test status was also found. Not engaging in regular handwashing (p< .001) and failing to stay 6 feet or more away from others outdoors (p< .001) was significantly associated with positive test status. Further, not wearing a face mask in businesses/shops (p<.001) or indoors around 6+ people, (p<.001) was significantly associated with positive test status. In light of debate around the efficacy of mask wearing, these findings signal the importance of following CDC recommended public health behaviors for all ages across the lifespan to reduce the spread of COVID-19 infection.
Exploring Caregiver Challenges And Coping Mechanisms In The Midst Of Covid 19
Authors: Chandran Devyani , Eaton Marie
Published: December 2021

This paper reports on the the challenges faced and coping strategies employed community-based care providers in a mid sized city in the Pacific Northwest in the midst of the Covid 19 pandemic. Researchers from a Palliative Care Institute conducted six online focus groups using the zoom platform. The project aimed at gathering important information on the experiences of caregivers as well as providing a virtual space where caregivers could support each other. A purposive sampling technique was used to gather data where participants were not chosen randomly but because they could best answer the research question. Membership of the focus groups included representatives from skilled nursing facilities, home-care agencies, elder law services, memory-care facilities, adult family homes, medical supply facilities, chaplains and nutritionists. Data gathered from the focus group were transcribed. A constant comparison method of analysis were employed and categories and themes were created from open coded data. Six key themes were identified which included: dealing with the impact of social isolation on caregiver-client relationships, assessing personal risk when dealing with clients living with dementia, facing challenges seeking continuing employment, struggling with social support and self care, using technology for professional and personal support and grappling with the challenges reentering a face to face environment once the pandemic is controlled.. Findings point to the importance developing and sustaining technological innovations that support workforce retention, fostering communication between the larger community, care providers and clients in various care settings and planning for safe reentry into a post Covid world.
Mobility and Muscle Strength Trajectories: The Effect of Mediterranean Diet, Physical Activity, and Social Support
Authors: Saadeh Marguerita , Prinelli Federica , Vetrano Davide , Xu Weili , Welmer Anna-Karin , Dekhtyar Serhiy , Fratiglioni Laura , Calderón-Larrañaga Amaia
Published: December 2021

Decline in physical function varies substantially across older individuals due to several biological and extrinsic factors. We aimed to determine the effect of modifiable factors -such as dietary patterns, physical activity and social support- and their interaction with mobility and muscle strength decline after age 60. We analyzed data from 1686 individuals aged 60+ from the population-based Swedish National study on Aging and Care in Kungsholmen. The Mediterranean Diet Score was calculated based on a validated food frequency questionnaire. Physical activity was categorized based on current recommendations, and social support was measured according to participants' perceived material and psychological support. Participants’ physical function was assessed over 12 years through changes in walking speed (m/s) and chair stand time (s). Linear mixed models adjusted for socio-demographic and clinical factors were used. Subjects with high adherence to Mediterranean diet were <78 years (82.3%), women (56.1%), married (61.1%), with university education (52.8%), high levels of social support (39.3%) and health-enhancing physical activity (51.5%). One-point (over nine) increase in the MDS was associated with a slower annual worsening in walking speed (β*time=0.001; p=0.024) and chair stand time (β*time=-0.014; p=0.008). The protective effect of Mediterranean diet was highest among subjects reporting high social support (β*time=-0.065, p=0.026 for chair stands) and high physical activity (β*time=0.010, p=0.001 for walking speed), beyond the effect of each exposure individually. A higher adherence to Mediterranean diet, especially in combination with recommended levels of physical activity and high social support, contribute to delay the decline in physical function observed with aging.
Technology Use Among Older Adults to Manage their Health During a Global Pandemic
Authors: Tefera Gashaye M , Robinson Erin , Park Geunhye
Published: December 2021

Risk of severe COVID-19 illness increases with age, and older adults are more likely to be hospitalized and die from COVID-19 and related complications as compared to their younger counterparts. This reality, combined with pandemic-related lockdown and social distancing policies, has increased in-home isolation for older adults. This includes cancelling in-person healthcare appointments and conducting many appointments via tele-health. As older adults have had to quickly pivot to learning new technologies, little is known about their experiences with navigating virtual healthcare during the pandemic. Therefore, this qualitative study aims to address that gap. One-on-one interviews (N=29) were conducted with older adults (Mean age=71.5; 86% female) via phone/Zoom. Participants were asked about their healthcare experiences during the pandemic and the role technology played. Interviews were transcribed and thematically analyzed using Nvivo12 software. Findings demonstrate that participants used technology to schedule medical appointments, engage in virtual visits with their providers, set reminders to take medications, and undertake their daily exercise routine. Post-lockdown, some participants preferred in-person visits due to the nature of their diagnosis, personal preference, or unfamiliarity with the needed technology. Older adults encountered challenges including cancelled appointments, miscommunication with providers, and lack of skill to use technologies. Cancellation of appointments and postponement of treatments affected the health of some of the participants. Implications of this research can inform tele-health approaches with older patients, as well as provider communication and coordination of care. Leveraging technology for preventative health approaches can also assist older adults in ongoing health maintenance and promote well-being.
Loneliness During COVID-19 and Modes of Social Contact Use Among Older Adults
Authors: Dhakal Usha , Koumoutzis Athena
Published: December 2021

Due to social distancing and isolation recommendations, COVID-19 resulted in older adults’ greater reliance on technology to contact friends and families. While the mental health of older adults during COVID-19 has been well explored, less is known about how changes in modes and frequency of social contact is associated with loneliness. Using the National Health and Aging Trends Study COVID-19 data, this study assessed how the frequency of varying modes of contact (e.g., phone/email/text, in-person visits, videocalls) during the pandemic was associated with feelings of loneliness during COVID-19 among community-dwelling Medicare beneficiaries (n = 2149). Participants were asked if they felt lonely "more often," "less often," or "about the same" compared to before the outbreak started. Multinomial regression analyses indicated that, compared to those who reported daily in-person visits, the odds of having more feelings of loneliness as compared to about the same as pre-COVID-19 was significantly higher among those who reported having in-person visits a few times (OR=2.17,CI=1.08-4.36), at least once (OR=2.37,CI=1.11-5.04), and never/less than once a week (OR=3.37, CI=1.59-7.16) while controlling for demographics, household, and social network size. Compared to daily use, use of phone/email/text at least once (OR=0.44, CI=0.201-0.965) or a few times (OR=0.76,CI=0.58-0.99) a week was associated with lower odds of reporting more feelings of loneliness versus about the same. Results suggest that greater use of technology that promote social engagement improves social connectedness and decreases COVID-19 related loneliness among older adults, and highlights the importance of older adults’ access to technology, including reliable internet.
Family Proximity as a Moderator of Spousal Associations of Depression among Mexican Older Adults
Authors: Newkirk Katie , Aranda Maria , Mourgues-Codern Catalina , Quiñones Ana , Samper-Ternent Rafael , Monin Joan
Published: December 2021

Depression among older adults is a public health issue, and a large literature highlights the importance of close relationships as both a risk and protective factor for depression. Research in U.S. samples suggests that one spouse’s depressive symptoms can increase their partner’s depressive symptoms, especially for women (Kouros & Cummings, 2010; Tower & Kasl, 1996). Little is known about interpersonal associations in depression, mitigating factors, and the role of gender among older couples in Mexico. This study examined (1) the effects of an individual’s depressive symptoms on their spouse’s symptoms and 2) whether living close to family buffered depression associations using data from the Mexican Health and Aging Study (n=4,071 dyads, age 50+ at initial interview). Depressive symptoms were measured in 2001, 2003, 2012, 2015, and 2018 using a modified 8-item version of the Center for Epidemiologic Studies-Depression Scale. Multilevel modeling was used to fit a dual-intercept growth model (centered at 2012) of husbands’ and wives’ depressive symptoms over time, controlling for age and education. Results showed a partner effect for husbands and wives, such that having a spouse with greater depressive symptoms in 2001 was associated with greater subsequent depressive symptoms, but not with rate of change in symptoms, in 2012. There was also a moderation effect such that the deleterious effect of husbands’ depressive symptoms on wives’ symptoms, as well as rate of increase in symptoms, was higher when family lived nearby, suggesting family may potentially exacerbate depression associations among spouses rather than a buffering them as hypothesized.
Elder Abuse During the COVID-19 Pandemic: Prevalence, Risk, and Protective Factors
Authors: Chang E-Shien , Levy Becca
Published: December 2021

It has been assumed that the pandemic has brought with it a surge in elder abuse due to heightened health and interpersonal stressors. However, empirical evidence is lacking. This study aimed to estimate the prevalence of, and risk and resilience factors of elder abuse during the pandemic. In a web-based survey of a socio-demographically diverse sample of 897 older persons, one in five older persons (n = 191; 21%) reported elder abuse, an increase of 84% from prevalence estimates before the pandemic. In the multivariate logistic regression models, sense of community was a persistent protective factor for elder abuse (OR= 0.89, 95% CI 0.85–0.93). At the relational level, physical distancing was associated with reduced risk of elder abuse (OR= 0.94, 95% CI 0.90–0.98). At the individual level, financial strain was associated with increased risk of abuse (OR= 1.08, 95% CI: 1.02–1.14). Implications for prevention strategies will be discussed.
Changes in Elder Mistreatment Risk Factors Reported by Caregivers of Older Adults During the COVID-19 Pandemic
Authors: Makaroun Lena , Beach Scott , Rosen Tony , Rosland Ann-Marie
Published: December 2021

This study aimed to assess how the COVID-19 pandemic has impacted caregiver (CG)-related risk factors for elder mistreatment (EM) in a community sample of CGs. A non-probability sample of 433 CGs caring for care recipients (CRs) age ≥60 years completed a survey on COVID-19 impacts in April-May 2020. Compared to before COVID-19, over 40% of caregivers reported doing worse financially, 16% were experiencing new financial hardship, 19.4% were a lot more worried about their financial situation, 15% reported drinking more alcohol, and 64% had somewhat or greatly increased feelings of social isolation and loneliness. CGs reported that COVID-19 had made caregiving more physically (18.7%), emotionally (48.5%) and financially (14.5%) difficult and interfered with their own healthcare (19%). Differences found between younger and older caregivers will be presented and implications of these increased CG-related EM risk factors for healthcare and social service providers discussed.
A Nationwide Study on How COVID-19 Changed APS Policies and Practices
Authors: Teaster Pamela
Published: December 2021

The purpose of this inquiry by the Virginia Tech Center for Gerontology and WRMA, Inc., was to explore changes being implemented by APS programs across the country in response to the COVID-19 pandemic. With input from the Administration for Community Living, the research team used a three-step process (e.g., telephone interviews with state-level APS administrators, a national online survey, and in-depth interviews with local and APS) to capture information on changes caused by efforts to mitigate the spread of COVID-19. This presentation concerns changes in APS policy and practice that the pandemic caused, including modifications in-person visits and adjustments to timeline requirements. Discussion of alterations in policy and practices during the first five months of the pandemic can eludicate APS and other services and planning for older adults in future emergency situations.
Strengthening Collaborations for Geriatrics Knowledge: Twitter Journal Club for Geriatric Fellows
Authors: Manocha Gunjan , Morton Casey , Chapman Elizabeth , Pellecer Daniel , Zeitlow Kahli , Kaur Tanjeev , Jurivich Donald
Published: December 2021

The pandemic has challenged training programs in numerous ways, specifically in the ability to conduct group based teaching sessions. To overcome this challenge Twitter was examined as a vehicle for engaging Geriatric Fellows in education about critical appraisal of clinical research. A secondary objective was to develop educational synergy among university-based programs. To achieve these aims, 5 Midwestern Geriatric and Palliative Medicine Fellowship programs agreed to enroll their fellows into a monthly Geriatrics Twitter Journal Club, that commences on Twitter Tuesday and lasts a week. Each month, an assigned fellow selects an article to discuss and creates a short video to introduce it. A Twitter meister deliveres structured questions to guide fellows’ collective input on the article being critiqued. Over a 3 month roll out of @GeriatricJC, the twitter account of the journal club has gained 144 followers that includes 20 fellows, 63 geriatricians/geriatric faculty, 28 organizational accounts, 5 students and around 28 other providers and experts. From December 2020- February 2021, account generated tweets resulted in an average of 397 impressions/day with 2548 visits to the account profile per month. Videos posted have averaged 73 views/video. Discussion in journal club using #GeriJC has garnered 178 tweets from participants. This project shows that Twitter is a feasible platform for a fellowship journal club among several training programs, thus expanding expertise in evidence-based medicine while lowering the administrative burden of preparing journal club within a single program and increasing both faculty and trainee convenience of learning.
To Clarify The Duration and Characteristics of the Continuation of Home Care for Older People With Dementia
Authors: Kanaya Reiko , Oyama Asuka , Toki Hiroshi , Yamamoto Ryohei , Yamakawa Miyae
Published: December 2021

As populations age worldwide, older people with dementia are increasing. Caregivers are also aging, necessitating arrangements like social services. How to prolong the home care desired by older people remains unclear. Using data from the Osaka National Health Insurance Database from 2012 to 2017 on insured persons’ registers, medical notes, and care benefits, this study included 9591 people aged ≤74 years with first dementia drug prescription between April 2013 and December 2017. Using the prescription as baseline and hospitalization or nursing home admission as outcomes, home care duration and characteristics of medical and nursing care services during the year before baseline were evaluated. Survival was compared by Kaplan–Meier curves and the log-rank test. Multivariate analysis was performed using the Cox proportional hazards model. During follow-up, the outcomes were observed in 1473 patients : 317 admission , 1145 hospitalized and 11 both. Mean duration of home care in patients with the outcomes was 11.5 months, which differed significantly from patients without these outcomes. When patients were grouped by hospitalization in year before first prescription, the survival curves differed significantly. In multivariate analysis, sex, renin-angiotensin system agonists, hyperlipidemia drugs, hospitalization history in past year, care level, and diabetes drugs were significantly associated with the outcomes. Taken together, hospitalization history, female sex, and diabetes were associated with home care disruption. Those undergoing cardiovascular disease treatment continued to live at home. For people with dementia, it is important to intervene by focusing on past medical and nursing care to continue life at home.
Social Trust, Literacy, and Lifelong Learning: A Comparison of the U.S. and Nordic Countries
Authors: Van Vleet Samuel , Cummins Phyllis , Helsinger Abigail
Published: December 2021

Societal social trust has been shown to be related to economic growth and equality. Low levels of social trust are especially consequential in aging societies and can result in low levels of social capital and greater inequality at older ages. Nordic countries are known for their greater social trust, access to education, economic productivity, and social equality. To better understand social trust promoters, we explored data from the 2012/2014 Program for the International Assessment of Adult Competencies (PIAAC) to examine relationships among social trust, basic skills (i.e., literacy), and non-formal education (NFE) participation for adults ages 45 to 65, in the U.S., Denmark, Finland, Norway, and Sweden. Additionally, through 19 key informant interviews and a review of the literature, we investigated the structure and availability of NFE across the five nations. As compared to the U.S., adults ages 45 - 65 in Nordic countries have higher levels of social trust (all Nordic countries; p < 0.001), lower rates of poor literacy skills (Finland, Norway, and Sweden; p <.001), greater rates of participation in NFE (Denmark and Sweden; p < 0.05). Through the availability of NFE, such as folk high schools and learning circles in Nordic countries, adults can participate in NFE at little or no cost. Similar programs are not available in the U.S. This research informs policy and practice for the provision of NFE, which is critical to increase levels of social trust, and in turn, to promote economic development, social equality and positive aging in the U.S.
Elder family financial exploitation: Family relationships are never the same
Authors: Chan Athena Chung Yin , Stum Marlene
Published: December 2021

Millions of families are affected by elder family financial exploitation (EFFE), but the consequences for lifelong intergenerational family relationships and family functioning remain largely unexamined (i.e., parent/child, siblings). This study examines the consequences of experiencing EFFE on the quality of family relationships from the perspective of non-victim, non-perpetrator concerned family members (CFMs). Data from a larger EFFE mixed-methods study were utilized. A voluntary sample of 28 CFMs who had experienced EFFE participated in semi-structured, in-depth interviews and brief surveys. Analysis included identifying quality of family relationship themes from data related to differences EFFE has made in their family. Participating CFMs were primarily adult children of older victims, and siblings of the primary perpetrators. The findings reflect three patterns of changes in quality of family relationships between the CFMs and other family members, including: (a) Restoring trust and recovery within the family, (b) Alliances and taking sides, and (c) Estrangement and cutoff. While families were never the same after experiencing the exploitation, for some was a healing process to accept the family situation and restore and repair trust. Redefining who would be family moving forward was a focus for some families when perpetrators and CFMs took sides and formed allies with others. In the most dramatic changes, siblings, parents and others became cutoff and isolated from other family members. While a loss of relationship quality was common, strengthening of relationships also occurred. Understanding EFFE from an ecological family systems perspective can help to inform needed EFFE interventions, both processes and outcomes.
Recognition of Affective Faces of Different Age Groups
Authors: Jinhwi Kim , Park Seunghee , Kim Jongwan
Published: December 2021

It has been found that valence and arousal are the core affect dimensions in emotional structure. In this study, we hypothesized that there might be differences between different age groups in emotional structure using six facial expression stimuli (angry, disgusted, fearful, neutral, happy, and sad) of three age groups (young, middle-aged, and old). Unlike previous studies asking participants to rate subjective ratings or similarities between stimuli, participants in this study were required to determine whether stimulus pairs were the same or different emotions and reaction time and accuracy were measured for further analyses. We assumed that it would be harder when the stimulus pair is similar whereas it would be easier when the pair is different. The results showed that for the same emotion pair condition, the sad-sad pair had the lowest accuracy and the longest reaction time, while the happiness-happiness pair had the highest accuracy and the shortest reaction time. For the different emotion pairs, angry-disgusted and disgusted-sad was the lowest accuracy and the longest reaction time. For age of the stimuli effect, responses to the old faces had the lowest accuracy and the longest reaction time. The results suggest that identification of emotional stimuli might be affected by emotion category and age. Further study may need to recruit various age groups, because participants in the current study were mostly young adults.
Death and Dying: Boundaries and Roles of Families and Healthcare Workers During Patient End of Life
Authors: Thompson Amber , Utz Rebecca
Published: December 2021

While death and dying often occur within or adjacent to the healthcare setting, grief & support of patients at end-of-life (EOL) remain largely within the realm of the family. Given this division of roles, healthcare workers intentionally set professional boundaries that balance their need to be empathetic and compassionate for patient and their families during EOL, while also maintaining a sense of objectivity and detachment which allows them to cope with patient loss and manage the competing demands of their workday. Tensions occur when healthcare workers are required to cross boundaries at EOL, either voluntarily or involuntarily. Using unobtrusive digital ethnography of a publicly accessible online forum for healthcare providers, this research investigates the boundaries set by families and healthcare workers at EOL, and how EOL circumstances sometimes require healthcare workers to cross or violate these professional boundaries. We suggest that the needs of the family at EOL (not necessarily the patient) serve as the catalyst for both boundary crossing & boundary violations for healthcare workers. Our data reveal that (1) boundary setting and training ought to address the patient-physician-family relationship (not just patient-physician), since the family members are such an integral part of EOL; (2) these EOL dynamics apply beyond the physician and should include all healthcare workers (nurses, etc.). As a result, patient & family centered care may not be fully achieved at EOL due to the ambiguity in the expected roles played by both families and healthcare workers during patient death and dying.
Higher Childhood Adversity Reduces Environmental Satisfaction Among Older Adults
Authors: Danielson Ramona , Ray-Degges Susan
Published: December 2021

Background: Childhood adversity (CA) is associated with increased physiological and psychological challenges in adulthood. Normal aging comes with changes that may put adults with a history of CA at increased risk of a poor quality aging experience. Because suitable person-environment fit is an important component of well-being, the present study explored two hypotheses: 1) Higher CA is associated with lower perceived neighborhood quality, and 2) Higher CA is associated with higher perceived inequality in home. Methods: Using MIDUS 2011-2014 Refresher Survey (for this study, N=1,017 adults ages 55-76), Spearman’s rho correlation coefficients were run to explore the associations between a previously validated CA score and two environmental satisfaction indices. Perceived inequality in home comprised ratings on six items and perceived neighborhood quality comprised ratings on four items. Results: Hypothesis 1: There was a significant positive association between the perceived inequality in home and cumulative CA, rs(998) = .200, p < .001. Hypothesis 2: There was a significant negative association between the perceived quality of neighborhood index and cumulative CA, rs(998) = -.182, p < .001. The strength of the associations were weak. Conclusions: Higher cumulative experiences of CA were associated with increased feelings of home environment inequality, and decreased feelings of neighborhood quality. Significant differences were evident after decades had elapsed, demonstrating the long-lasting reach of CA. Further research exploring policy and practice approaches to mitigating the effects of CA is needed to allow aging adults to achieve better person-environment fit and equitable access to successful aging.