bluuebunny/crossref_metadata_2025 huggingface dataset:
STUDENTS HELPING OLLI BUILD A MORE DIVERSE MEMBERSHIP WITH AN ASSESSMENT OF AVAILABLE TRANSPORTATION OPTIONS
Authors: Donorfio Laura
Published: January 2025

An undergraduate adulthood and aging class partnered with Osher Lifelong Learning Institute’s (OLLI) Diversity Committee to identify transportation resources available for seniors in their community to potentially increase the diversity of the OLLI membership. A needs assessment research framework was used to put a semester long, four-phase research project into place, each with specific goals and milestones. General milestones included researching available transportation resources and organizations for seniors; documenting target audiences and associated difficulties using said resources; exploring potential solutions and providing recommendations for future pilot projects. The Director of the OLLI program attended monthly report outs to assist in the creation of a doable pilot project, helping identify key constraints and logistics. The semester ended with a formal research report out, executive summary, and the university career counselor attending to help students brainstorm and create solid resume entries. The presentation will finish by describing what was learned via best practices and practices to avoid, particularly intergenerational “gaps” that surfaced on how to collect research, the types of research, and the breadth and depth of the research. Lastly lessons learned as a teacher on how to be in the “middle” of both generations and the OLLI director to help make the project a success and how to get student “buy in” by continually reviewing the importance of participating in a service-learning class project for future career aspirations.
SHORT EDUCATION INTERVENTION MITIGATES AGEISM IN EARLY ADOLESCENCE
Authors: Suberry Assaf , Okun Sarit , Ayalon Liat
Published: January 2025

This study explored the effectiveness of a 90-minute workshop in reducing ageism and fostering social activism among 318 Israeli teenagers (11-15 years old, 73.4% female). The workshop aimed to provide accurate information, counter-stereotypes, and peer discussion through activities like talks, games, videos, and meme creation to promote a more inclusive society. The intervention significantly improved familiarity with the concept of ageism, with teenagers drawing parallels to discrimination and racism. The Children’s Attitudes Towards Elderly (CATE; Seefeldt et al., 1977) was administered before and after the intervention. A dependent samples t-test indicated a significant mean difference in age stereotypes within the same participants, with a medium effect size, (t(317)=-11.91, p<.001, Cohen’s d=.51). Building on prior findings, this study adds to the evidence that educational interventions can improve attitudes towards older adults. Interestingly, while a wider range of age stereotypes emerged post-workshop, a shift towards positive perceptions was observed, particularly among females. Importantly, two-thirds of the teenagers’ created memes targeted ageism against older adults, highlighting its prevalence. However, nearly 20% promoted age-inclusivity, and 17% addressed ageism towards younger generations. These findings suggest the intervention’s potential in fostering social change and highlight the need for further exploration of ageism in youth populations.
MODERATORS OF TREATMENT EFFICACY IN SOCIAL INTELLIGENCE TRAINING WITH CUSTODIAL GRANDMOTHERS
Authors: Smith Gregory , Dolbin-MacNab Megan , Infurna Frank , Hu Luxin
Published: January 2025

In a previously reported randomized clinical trial (RCT), we found that online social intelligence training (SIT) was superior to an attention control (AC) condition at improving psychological and relational well-being within a national sample of 349 custodial grandmothers (CGM). However, because the corresponding effect sizes (ES) were modest (range =.22 -.41) and effects waned over time, the present investigation used the same RCT data to investigate moderators of differential treatment efficacy for psychological and relational outcomes at both immediate (T1) and nine-months (T5) post intervention. Multiple potential moderators (including CGM adverse childhood experiences, key contextual/demographic factors, and baseline values of all study outcomes) were first entered simultaneously into classification and regression tree analyses to identify predictors of treatment efficacy within the SIT condition at T1 and T5. Less favorable baseline values of the study outcomes emerged as the only significant predictors of treatment-related change in the SIT condition, with generally large effect sizes (.50 - 1.44) observed. To establish whether these predictors were true moderators of differential treatment efficacy, a series of MANOVAs were then conducted to see if these predictors interacted significantly with RCT condition. At T1 and T5, moderation was scarce across psychological outcomes (i.e., depressive and anxious symptoms, self-esteem, and loneliness) but plentiful across relational outcomes (i.e., prosocial behavior, attachment with grandchild, and peer and grandchild relational quality). We conclude that, SIT is a promising intervention for enhancing the relational well-being of CGM, especially for those with poorer baseline levels. [Funded by R01AG054571]
DEMENTIA KNOWLEDGE IN CHINESE NEWSPAPERS (2005–2020): A TOPIC MODELING ANALYSIS
Authors: Chen Lin , Tian Felicia F , Fu Yu
Published: January 2025

How public policies convey dementia is an important source of the public’s understanding of dementia, and newspapers are critical to depicting and disseminating this information to the public. The present study used topic modeling strategies to analyze Chinese newspaper portrayals of dementia from 2005 to 2020 to trace changes in key areas of dementia knowledge in relevant policies. Using WiseNews, the largest Chinese media database, we chose 45 newspapers from mainland China and identified 12,719 articles related to dementia. Using latent Dirichlet allocation (LDA), we performed a topic modeling analysis and identified the six most prevalent topics on dementia across articles: lifestyle recommendations, neighborhood life, foundational scientific research, celebrity and media portrayals, dementia caregiving, and pharmaceutical innovations—all related to the dementia knowledge scale’s four dimensions. Findings suggest a steady increase in the number of articles on dementia caregiving and a decline in lifestyle recommendations from 2005 to 2020. However, newspapers continued to stigmatize aging by regularly co-depicting dementia and old age and by using biased terminology. Among the first to investigate dementia’s portrayals in mainland Chinese newspapers, this study illuminates the need for expanding mass media campaigns to raise the country’s dementia knowledge to foster a dementia-inclusive society.
POLICY SERIES: HEALTH AND AGING POLICY FELLOWS: CONNECTING EXPERIENCE TO POLICY
Authors: Henry Maureen , Liu Pi Ju
Published: January 2025

For health and aging policy to be effective, it must link an understanding of how systems impact individuals to an understanding of how policy influences the systems. Systems such as health care and social service delivery, family caregiving, lifelong learning, zoning laws, and the housing market influence older people and their families. Policy can make these systems better - or worse - for supporting the health and wellbeing for older people. The Health and Aging Policy Fellows program provides experts with real-life experience the opportunity to learn how policy works so they can better support older people. This symposium will describe how current fellows are addressing federal policy within congress and administrative agencies, state policy through a non-profit organization comprising state aging officials, and across government through a non-profit organization focused on caregiving policy. The 2024 reauthorization of the Older Americans Act is an area of focus across all settings. Fellows are also working on care and payment models in primary care and geriatrics; assisted living facilities; direct care workforce; family caregiving policy and research agendas; elder justice, including Adult Protective Services, the Long-Term Care Ombudsman, guardianship). During the symposium, fellows will discuss these and related topics the context of their fellowship experiences.
EMBRACING OPPORTUNITIES TO ENGAGE IN WORK ON POLICIES AND PROGRAMS ON ELDER RIGHTS
Authors: Teaster Pamela
Published: January 2025

The Health and Aging Policy Fellowship (HAPF) provides fellows with an unprecedented opportunity to understand, to experience, and to delve into various dimensions of policy making with the goal of improving the health and well-being of present and future older adults and their families. The purpose of this presentation is to discuss opportunities that my fellowship placement afforded to work on elder rights policies with staff of the Administration for Community Living. First, I will provide an overview of ACL activities and responsibilities. Then, specifically, I will discuss policy making challenges and opportunities related to the projects on which I worked: Adult Protective Services, the Long-Term Care Ombudsman Program, and guardianship. I will conclude the presentation with how the experiences I had with the HAPF have shaped my present and future research, instruction, and outreach.
ADVANCING FAMILY CAREGIVER HEALTH AS A KEY PUBLIC HEALTH PRIORITY
Authors: Polenick Courtney
Published: January 2025

The Health and Aging Policy Fellowship (HAPF) offers exposure to the development and implementation of health policies at both the state and national levels. As a family caregiving researcher and the first Ralph C. Wilson, Jr. Foundation HAPF Caregiving Policy Track Fellow, my HAPF placements included the Office of U.S. Congresswoman Debbie Dingell and the National Alliance for Caregiving (NAC). These placements provided various opportunities to learn more about translating research findings into policies and actions that improve services and supports for older adults and their family caregivers. Based on extensive research showing that caregiving can lead to negative health effects, it is critical to consider family caregiver health as an important public health priority. My placement with the Office of Congresswoman Dingell focused on advancing legislation to enhance home and community-based services (HCBS), including supports for family caregivers. My placement with NAC focused on building upon their public health framework and further promoting family caregiver health as a key public health issue. We synthesized common priorities within existing public health frameworks that are applicable to family caregiving across the lifespan. We also identified upstream intervention and system change approaches for implementing parts of the 2022 National Strategy to Support Family Caregivers to advance family caregiver health within the public health landscape.
DEEP DIVES INTO STATE POLICY: LOCATING LEVERS TO IMPROVE CARE FOR ADULTS AGING ALONE
Authors: Lowers Jane
Published: January 2025

The Health and Aging Policy Fellowship facilitates fellows’ exposure to the intricacies of policy development and implementation in a variety of settings. My HAPF placement at ADvancing States provided an opportunity to investigate how individual states define “family” in regard to caregiving for older adults, both through regulations and Medcaid waivers. For state aging and disability directors, this analysis offered insight into how state policies aligned with federal policies, including the Older Americans Act, and opportunities to adapt other states’ efforts to support unpaid caregiving networks. As a researcher, this fellowship work provided insight into the types of evidence needed to advocate for equitable services and supports for adults aging without biological family. This presentation will provide an overview of HAPF placement focused on state-level policies.
HEALTH RESILIENCE AND FORTITUDE FACTORS IN THE HRS
Authors: Allen Rebecca , Smith Jacqui
Published: January 2025

This symposium presents data from recent waves of the Health and Retirement Study, a nationally representative sample of older adults in the United States, examining environmental transition and health variables as they relate to fortitude. Using stress process models and the Meikirch model of health as theoretical underpinning, these presentations examine fortitude by focusing on 1) transitions in place of residence and loneliness (inverse of fortitude), 2) relationship quality and pain intensity, and 3) sleep disorders, relationship quality, and life satisfaction. The first presenter found that subjective health, transitional threat, and social and community engagement all were significantly related to self-reported loneliness. However, the interaction between engagement and transitional threat did not explain additional variance in the model. The second presenter found that the association between perceived spousal support (personally acquired potential) and well-being significantly decreased when controlling for the intensity of pain (biologically given potential) experienced by the respondent. Similarly, using the Meikirch model of health, the third presenter conducted simple linear regression analyses to assess the relations between sleep disorders, perceived life satisfaction, and perceived spousal relationship quality. Having a sleep disorder significantly predicted life satisfaction and perceived problems in spousal relationships. Thus, perceived stress due to environmental transition and the interplay between biologically given potential and personally acquired potential explain significant variance in fortitude, as measured by loneliness (inversely), well-being, and life satisfaction. The discussion will address strengths and challenges in examining fortitude as a construct of interest in the nationally representative Health and Retirement Study dataset.
THEY’VE GOT MY BACK: THE ROLE OF PAIN INTENSITY AS A MEDIATOR BETWEEN PERCEIVED RELATIONSHIP QUALITY AND RESILIENCE
Authors: Carranza Erick , Peeples Landon , Buxton Michael , Jacobs M Lindsey , Allen Rebecca
Published: January 2025

Recent increases in the population of aging adults reflect a dire need to examine the social contexts that influence their experiences in relation to physical and mental health, especially during the ongoing coronavirus pandemic. Previous work identifies how perceived care partner relationships play a role in reducing psychological distress for aging adults facing a chronic illness (Schroepfer, 2008). Evidence also suggests that perceived relationship quality is associated with experiencing greater pain and disability (Campbell, 2012). However, little is known about the dynamic interplay between perceived relationship quality, pain intensity, and resilience. This presentation aims to draw upon the Meikirch model of health examining pain intensity as a biologically given potential and relationship quality as personally acquired potential while experiences during COVID-19 may be interpreted as environmental determinants of health. The objective is to understand how relationship quality influences levels of resilience (i.e., psychological well-being) and is then mediated by the intensity of pain. The mediation analysis was conducted using a secondary data approach with responses (N = 2686) from the 2020 wave of the Health and Retirement Study, a nationally representative sample of older adults in the United States. Results revealed a significant indirect effect, indicating that the association between perceived spousal support and resilience decreased when controlling for the intensity of pain experienced by the respondent. Future directions include examining responses from spouses to compare dyadically the perceptions of relationship quality and how these perceptions relate to pain intensity within one partner and dyadic perceptions of couple resilience.
RESILIENCE IN HEALTH ADVERSITY: THE ROLE OF COMMUNITY ENGAGEMENT AND TRANSITIONAL THREAT
Authors: Fromenthal Ashley , Allen Rebecca
Published: January 2025

Older adulthood is a time of many transitions and oftentimes comes with challenges such as financial difficulties, functional health decline, and a decrease in social support. Together, these challenges may accentuate feelings of loneliness in older adulthood. These challenges may be exacerbated when older adults face threats within their environment such as having housing issues or moving to a “worse” neighborhood. The current study aimed to explore community-based resilience factors for older adults facing transitional threats and functional health struggles centered around Lazarus and Folkman’s Transactional Model of Stress and Coping. Using 2020 data from 4,688 participants in the Health and Retirement Study (HRS), multiple linear regressions were conducted to examine whether the relationship between subjective health and loneliness is mediated by transitional threats, and if social and community engagement moderate the mediating relationship. Results of the regressions show that the overall model is significant F(2,4546) = 78.11, p <.001, and that each of the predictor variables were significantly related to feelings of loneliness. However, results show that the interaction term (engagement x threat) did not explain a significant amount of variance in the model. This may be due to the measurement of these constructs within the HRS. Specifically, trait-dependent measurement of dynamic constructs such as feelings of loneliness and behavioral engagement may not be sensitive enough to detect moderated mediation effects within the context of transitional threats.
SLEEP DISORDERS AND THEIR IMPACTS ON OLDER ADULT SPOUSAL RELATIONSHIP
Authors: Geisser Sophia , Fromenthal Ashley , Carranza Erick , Hilgeman Michelle , Snow A Lynn
Published: January 2025

Aging is associated with biological and psychosocial impairments that affect individuals’ sleep and quality of life. Approximately half of older adults suffer from a sleep disorder. Daytime consequences such as fatigue, excessive sleepiness, irritability, mood swings, and/or cognitive difficulties may be present with sleep disorder diagnoses, impacting interpersonal relationships. There is limited research on associations between sleep disorder and spousal relationship quality in older adults. The need to expand the field of research in sleep disorders is urgent, as sleep disorder diagnoses are expected to rise with the growing older adult population. The objective of this presentation is to describe a conceptual model of sleep disorders and relationship quality informed by the Meikirch model of health: sleep disorders represent biologically given potential, relationship quality represents personally acquired potential, and the COVID-19 pandemic represents the environmental determinants of health. Applying this theoretical underpinning, the Health and Retirement Study data from 2020 was analyzed via simple linear regression analyses to assess the relationships between sleep disorders and perceived life satisfaction in spousal relationships. Results show that having a sleep disorder significantly predicted life satisfaction: F(1,4647) = 40.49, p <.001. (b =.09, S.E. =.02, t = 6.36, p <.001, 95%CI[.06,.13]); and having a sleep disorder significantly predicted perceived problems in spousal relationships: F(1,4560) = 15.49, p <.001 (b = -.12, S.E. =.03, t = -3.94, p <.001, 95%CI[-.17,.06]). Understanding sleep-related associations may inform interventions to promote well-being and life satisfaction for older adult couples.
PERSON-ENVIRONMENT FIT UNDERLYING PERSONALITY DEVELOPMENT IN MIDDLE AND LATE ADULTHOOD
Authors: Beam Christopher , Sharp Emily Schoenhofen
Published: January 2025

The corresponsive principle and the niche-picking principle have been used to explain personality development across adulthood. The corresponsive principle posits that reciprocal effects between people and their environments intensify personality traits because environments are selected based on these traits while the niche-picking principle posits that these reciprocal effects simply maintain existing trait levels. Using a longitudinal sample of twins from the Swedish Adoption/Twin Study of Aging (SATSA), we tested whether the corresponsive principle or the niche-picking principle better explained longitudinal within-family differences in neuroticism, extraversion, and openness to experience across two stages of adulthood development: middle adulthood (36--56 years) and older adulthood (56--91 years). Using exploratory data analysis and multilevel structural equation modeling, we show that niche-picking rather coresponsivity tends to provide a better overall description of the development of neuroticism, extraversion, and openness in middle and older adulthood. Within families, twins generally preserve their rank-order stability but do not diverge over time. Instead, there is a generally tendency for twins to maintain within-family differences over time or even become more alike, regardless of whether twins are identical or fraternal. Nevertheless, the role that niche-picking might play in the personality development across adulthood generally is low, as the majority of the total variance of neuroticism, extraversion, and openness is attributed to stable genetic and environmental variance, particularly in older adulthood. Taken together, these findings suggest that environmental variance - whether independent of or correlated with genotype - takes on an increasingly stronger role in personality development over the lifespan.
LONELINESS AND SOCIAL ISOLATION AMONG VULNERABLE, DIVERSE, AND MINORITY GROUPS: NOVEL RESEARCH AND PRACTICAL INSIGHTS
Authors: O’Sullivan Roger , Victor Christina , Cudjoe Thomas
Published: January 2025

Loneliness and social isolation are global public health challenges with concerning implications for mental, cognitive, and physical health. Extensive evidence documents the prevalence, incidence, and negative health outcomes associated with loneliness and social isolation. In contrast, there is a dearth of research offering focused insights into three under-researched ‘at-risk’ populations: those with severe mental health illness, different racial and minority groups, and people who identify as LGBT. This symposium will address this gap by examining the experience of loneliness in these three populations and providing evidence to inform the development of future public health, policy, and service interventions. Pomeroy provides context with an overview of issues constraining progress in the field, including measurement inconsistency and the lack of diversity in studies of loneliness and social isolation. O’Sullivan, Taylor, and Victor highlight the importance of studying loneliness and social isolation within subpopulations and at-risk groups. O’Sullivan describes qualitative interviews with mental health patients to examine their conceptualization and lived experience of loneliness. Taylor’s paper examines the issue of race, neighborhoods and their confluence on feelings of loneliness among older adults in the United States. Victor using longitudinal data reports that rates of chronic loneliness over three years are twice as high amongst LGB and minority ethnic groups compared with the general population aged 50+. Cudjoe, as discussant, highlights the implications for policy, services, and future research in this area and the need for focused public health solutions to tackle loneliness and social isolation.
THE LANGUAGE OF LONELINESS: DEFINITIONS, EXPERIENCES, AND CONCEPTUALIZATION: THE VOICE OF MENTAL HEALTH SERVICE USERS
Authors: O’Sullivan Roger
Published: January 2025

Loneliness is an important public health issue that describes a complex subjective personal experience of one’s desired and actual or perceived social and/or emotional connections. In recent years we have seen a rise in the study of loneliness especially from a quantitative perspective. However, our qualitative understanding of what it means to be lonely and the everyday language best used to capture the personal experience of loneliness remains limited. This presentation based on life story interviews, with older adult mental health service users (18), objectively defined as lonely, gives voice to their definitions, personal experiences and overall conceptualization of loneliness. It sets out a thematic analysis of responses to the question “What does loneliness mean to you? Responses include subjective and objective aspects, frequency, duration and intensity as well as social; emotional and existential loneliness. Loneliness was not defined by participants in a singular manner and was discussed alongside social isolation, depression, grief, as well as feelings of emptiness, boredom and hopelessness. The insights are important to inform how we frame loneliness in research, policy and practice and highlights that our language needs to be sufficiently diverse to capture the complexity of loneliness not only for work with mental health service users but in society as a whole.
LONELINESS TRANSITIONS AMONG MINORITY ETHNIC AND LGB POPULATIONS IN THE UK
Authors: Victor Christina , Rippon Isla
Published: January 2025

Loneliness has been identified as a major public health problem. Although there is a substantial body of research about loneliness in older adults in the UK, there is a significant evidence gap reporting experiences of loneliness among older people from ethnic minorities and those who identify as lesbian, gay, or bisexual (LGB). We focus upon the experiences of loneliness for adults aged 50+, from LGB and minority ethnic communities. Using waves 9-12 of the annual UK Household Longitudinal Study (UKHLS/Understanding Society) we measured loneliness using the three-item UCLA scale with a score of 6+ out of 9 defining loneliness. 7,646 respondents completed the loneliness measure at each wave. 1.7% of participants identified as LGB and 4.3% as Asian, 2.5% as black and 1.4% as mixed /other ethnicity. We grouped respondents into three categories: (a) consistently lonely; (b) consistently not lonely and (c) fluctuating loneliness. A higher proportion of LGB respondents were consistently lonely (16.4% vs 9.2%), compared to heterosexual respondents. Respondents from black (14.1%), Asian (11.2%) and other ethnic minorities (17.5%) were more likely to be consistently lonely in comparison to white respondents (8.9%). Shortcomings in data available on these groups of interest limit our analytical power to examine the importance of micro, meso and macro-level risk factors. Preliminary findings suggest that socio-demographic predictors for fluctuating or persistent loneliness differ in our groups of interest in comparison with white or heterosexual respondents. The higher level of persistent loneliness in the two groups has potential implications for their health and wellbeing.
THE IMPACT OF THE COVID-19 PANDEMIC ON TEMPORARY AGENCY CARE STAFF USE IN OREGON ASSISTED LIVING
Authors: Dys Sarah , Tunalilar Ozcan , Levchenko Yuliana
Published: January 2025

Temporary agency staff (TAS) use in long-term care has become a spotlight issue due to workforce shortages and increased dependence during the COVID-19 pandemic. Nursing homes (NH) and assisted living communities (AL) rely on TAS to maintain compliance with staffing standards and meet residents’ needs. Settings with high TAS utilization have been associated with more deficiency citations and lower quality ratings. While recent NH studies show a substantial increase in chronic use of TAS, no similar studies document ALs’ use and change of TAS. Using data from a representative sample of Oregon ALs in 2016 and 2023, we compare differences in and organizational (license type, size, Medicaid contracts, profit status, rurality) correlates of TAS use by estimating linear and logistic regression models. Share of ALs with any TAS use increased significantly from 13% in 2016 to 22% in 2023 (p=0.012). In 2016, there were no differences in the likelihood of ALs using any TAS, except for size. In 2023, ALs with Medicaid contracts and in rural areas were 46% and 44% less likely to report using any TAS, respectively. TAS mix used also differed between 2016 and 2023. TAS use decreased for registered nurses (53.8% vs. 25.9%; p=0.005) and increased for licensed practical nurses (0.8% vs. 10.2%; p=0.060) and certified nursing assistants (6.5% vs. 38.2%; p<.001), with no significant difference in personal care aides. Findings contribute to understanding how ALs utilize TAS and can potentially add to policy debates around more stringent regulations for NH and AL staffing.
HOW TO TRAIN ENOUGH PROFESSIONAL DEMENTIA CAREGIVERS IN CHINA TO MEET THE FAST GROWING NEED?
Authors: Gong Zengliang , Cai Gege , Xu Chunjuan
Published: January 2025

Purpose

This paper try to establish an effective system for training dementia caregivers basing on the practices of a leading provider in China. Method: 1. Establish a holistic memory care program and curriculum system, and deliver them through a set of training programs to cover both first-line caregivers and managers, such as an 8-hour orientation session for newcomers, 23-hours on-job training per year, 40-hour training for new managers. 2. Estabilish a case competition among all communities of the provider across China, so that the team could learn from the specific care practices and from each other. 3. Test different training programs empirically to improve training effectiveness.

Results

1. The memory care team in the provider has grown substantically, and the number of certified trainee of 8-hour orientation session has increased to 1400 since 2021. 2. The turnover rate of caregivers in the memory care area is 5% lower than the overall turnover rate of the care building. The turnover rate for memory care managers dropped from 57% in 2021 to 21% in 2023. 3. The experimental group that learned the concept and values of “person-centered care” first was significantly better than the control group in learning knowledge and skills in dementia care.

Conclusion

Systematic and practice-based training programs are conducive to quickly cultivating professional caregivers for dementia care. The Chinese government and the senior care industry should invest more resources in establishing similar training programs to meet the urgent needs of people with dementia and their families.
OLDER ADULT FALLS AND LIMITATIONS IN ACTIVITIES OF DAILY LIVING
Authors: Haddad Yara , Rice Ketra , Chen Jufu , Kakara Ramakrishna
Published: January 2025

Falls among older adults (65+) often lead to injury and loss of independence. Our study aimed to estimate the odds of developing limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) after a fall. We used 2015-2020 Medicare Current Beneficiary Survey data to estimate the odds of developing ADL/IADL limitations in the year following a fall and examined risk and protective factors for developing them. Using logistic regression, we calculated crude and adjusted odds ratios (OR) and 95% Confidence Intervals (CI), adjusting for demographic, economic, comorbidity, and physical activity variables. Older adults reporting a fall had twice the odds of developing limitations in ADLs (OR=2.02; CI:1.70-2.39) or IADLs (OR=2.01; CI:1.72-2.34) the following year compared with those who did not fall. Among those who fell, adjusted ORs for developing ADL or IADL limitations were significantly higher for adults aged 75+ compared with those 65-74 but were significantly lower for adults who engaged in moderate or vigorous activity for ≥ 2 hours per week during baseline compared with those who did not. Although the likelihood of developing limitations after a fall may increase with age, results suggest engaging in moderate or vigorous physical activity of ≥ 2 hours per week may be protective. Regular physical activity with structured strength and balance exercises has been shown to reduce falls risk. The Stopping Elderly Accidents Deaths and Injuries (STEADI) initiative encourages health care providers to screen and assess for falls risk and intervene using strategies such as physical therapy.
MOBILITY ABILITIES MEDIATE THE ASSOCIATION BETWEEN A MORE ACTIVE LIFESTYLE WITH MOBILITY DISABILITY
Authors: Lange-Maia Brittney , Wang Tianhao , Oveisgharan Shahram , Hausdorff Jeffrey , Bennett David , Buchman Aron
Published: January 2025

Few studies have analyzed sensor-derived metrics of both mobility abilities and total daily physical activity (TDPA). We sought to determine if sensor-derived mobility metrics and quantitative indices of TDPA were independently associated with prevalent and incident mobility disability. Quantitative mobility metrics from 724 ambulatory adults (mean age 82 years, 77.4% female) were derived from a belt-worn sensor. A wrist-worn sensor worn quantified TDPA (up to 10 days). Mobility disability was characterized at baseline and longitudinally using the Rosow-Breslau scale. We examined cross-sectional association of the mobility metrics and TDPA with the odds baseline of disability using logistic regression, and incident disability using Cox models. Several mobility metrics (e.g. step time variability, turning angular velocity) and TDPA were significantly related to prevalent and incident mobility disability when examined in separate models. When examined together, however, the association of TDPA with mobility disability was attenuated. Mediation analysis indicated that the mobility metrics individually mediated between 7%-47% (p< 0.001) of the association between TDPA and cross-sectional mobility disability, and between 20%-40% of the association between TDPA and incident mobility disability. As a group, mobility metrics mediated 58% of the association between TDPA and cross-sectional mobility disability, and 53% of the association with TDPA and incident mobility disability (p< 0.001 for all). Sensor-derived mobility metrics may distinguish different aspects of mobility disability and partially link a more active lifestyle with reduced disability. These findings can inform the design of intervention studies to develop targeted therapies to maintain ambulation and independent living in late life.
SEX-RELATED DIFFERENCES IN PHYSICAL ACTIVITY PATTERNS OF OLDER INDIVIDUALS LIVING IN THE SARDINIAN BLUE ZONE
Authors: Pau Massimiliano , Brandas Benedetta , Fastame Maria Chiara
Published: January 2025

Previous studies demonstrated that individuals born and resident in the Blue Zones (i.e, areas of exceptional longevity) exhibit reduced levels of depressive symptoms, better life satisfaction levels, and adopt more effective coping strategies to deal negative life events. However, few data is available regarding their physical activity (PA) profiles and, in particular, it is not known whether they are sex-related. Based on these considerations, in the present study we explored the effect of sex on a set of metrics which describe amount and intensity of physical activity (PA) in older people living in the Blue Zone of Sardinia (Italy). To this aim, 109 community-dwelling participants (Mage = 81.7 years old, SD = 8.1 years) were monitored for 7 days using a clinically validated wearable accelerometer which provided raw body accelerations as well as percentage of time spent in activities of different intensity namely sedentary behavior (SB), light PA (LPA) and moderate-to-vigorous PA (MVPA). The results showed that women exhibit a better PA profile with respect to men, characterized by significantly higher time spent in MVPA (+37%, p =.008) and reduced SB (-10%, p =.001). Also, those living in the Blue Zone exhibit higher PA levels with respect to peers resident in urban areas of Sardinia, thus suggesting that they adopt a more active lifestyle, which is thought to play a pivotal role in promoting functional and cognitive health in late adulthood. At the same time, futher studies are needed to clarify the nature of sex-related differences here observed.
MOBILITY DEVICE USE MODERATED BIDIRECTIONAL ASSOCIATION OF FEAR OF FALLING WITH HOMEBOUND STATUS
Authors: Li Qianyuan , Peng Wenting , Wang Shuomin , Yang Huili , Zhang Haihong , Liu Minhui
Published: January 2025

Previous studies showed fear of falling (FOF) is associated with homebound status, given that they have shared risk factors such as falls. However, the bidirectional relationship between fear of falling and homebound status and possible moderators remain unknown. Using the Year 2015-2019 waves of the National Health and Aging Trends Study, our sample included 3,983 community-dwelling older adults who had completed data on FOF and homebound status. We aimed to examine 1) whether FOF was associated with homebound status bidirectionally and 2) whether mobility device use moderated this bidirectional association. FOF was categorized as no FOF, FOF without fear-related activity restriction (FAR) and FAR. Based on the frequency, difficulty, and independence of outdoor mobility, homebound status was classified as non-homebound, semi-homebound, and homebound. The lagged generalized estimation equation models revealed that FOF without FAR (OR=1.34, 95% CI=1.19-1.52) and FAR (OR=1.62, 95% CI=1.38-1.91) increased the risks of semi-homebound/homebound status. Mobility device use moderated the longitudinal effects of FAR on homebound status with a statistical significance. Additionally, semi-homebound predicted the risks of FOF (OR=1.36, 95% CI=1.21-1.53), and its association was moderated by mobility device use. Overall, FOF is a risk factor for homebound status, and vice versa, and the risks may differ by the use of mobility devices. To prevent the progression of homebound status or FOF, future targeted strategies or community-based interventions should consider the fear of falling and homebound status simultaneously and identify the high risks of older adults who do not use mobility devices.
ASSOCIATION OF SEDENTARY BEHAVIORS WITH PERCEIVED PHYSICAL FATIGABILITY
Authors: Garcia Reagan , Johnson Eileen , Cawthon Peggy , Nicklas Barbara , Goodpaster Bret , Newman Anne , Glynn Nancy
Published: January 2025

Greater perceived fatigability is a phenotype of poor energy regulation and is associated with physical activity, cardiovascular fitness, and mitochondrial energetics. However, it is unclear whether time spent in low energy expenditure activities, i.e. sedentary behaviors, contribute to greater perceptual feelings of fatigue. We examined whether sedentary behaviors were associated with perceived physical fatigability using cross-sectional data in the Study of Muscle, Mobility and Aging (SOMMA). Participants wore an activPAL on their right thigh for 7 consecutive 24-hour periods (valid wear=≥1 day with ≥10 hours). Total min/day sedentary time, time per sedentary bout (min/day), and number of sit-to-stand transitions were calculated using mean of out-of-bed intervals. Perceived fatigability was measured using the Pittsburgh Fatigability Scale Physical subscale (PFS, score 0-50, higher=greater fatigability, more severe=≥15). Logistic regressions were adjusted for age, sex, body mass index, Short Physical Performance Battery (range 0-12), and cost-capacity ratio (VO2 from 0.67 m/s 5-min walk/VO2peak *100). Participants (n=685; 76.4±5.1 years, 58% Women, 85.1% Non-Hispanic White, 54.9% PFS Physical score ≥15) had mean 619.1±113.1 min/day sedentary time, mean 15.2±5.8 min/day per sedentary bout, and 45.9±13.4 sit-to-stand transitions/day. One standard deviation higher mean sedentary time was associated with 26% greater odds of reporting more severe perceived physical fatigability after full adjustment (OR=1.26, 95% CI: 1.05-1.52). Mean time per sedentary bout and sit-to-stand transitions were not associated with perceived physical fatigability. Sedentary behavior has modest associations with perceived fatigability. Our work supports that interventions to reduce fatigability severity could be modestly enhanced if overall sedentary time is reduced.
DISCOVERING BIOENERGETIC AND FITNESS PROFILES OF COMBINED PERCEIVED AND PERFORMANCE FATIGABILITY
Authors: Gay Emma , Rosano Caterina , Coen Paul , Garcia Reagan , Goodpaster Bret , Marcinek David , Newman Anne , Glynn Nancy
Published: January 2025

Demographic characteristics, skeletal muscle energetics, cardiorespiratory fitness (VO2peak), walking energetics, physical activity, and mobility are all independently associated with perceived and performance fatigability. Perceived and performance fatigability are distinct measurements that are complimentary to each other, and together could provide novel insight into potential targets for healthy aging interventions. We hypothesized that individuals with lower scores on both fatigability measurements (i.e., lower perceived/lower performance) will exhibit better cellular energetics and physical performance profiles compare to individuals with higher scores on both fatigability measurements (i.e., higher perceived/higher performance). Using a sample from SOMMA (n=799), we classified individuals using established severity cutpoints for the perceived-based Pittsburgh Fatigability Scale (PFS, range 0-50, lower<15, higher≥15) and the performance-based Pittsburgh Performance Fatigability Index (PPFI, 0-100%, men: lower<5.4%, higher≥5.4%, women: lower<3.5%, higher≥3.5%). Skeletal muscle energetics were measured in vivo via magnetic resonance spectroscopy and ex vivo (biopsies) via high-resolution respirometry. Daily activity count was measured with wrist-worn accelerometry. We assessed VO2peak during a maximal treadmill cardiopulmonary test and walking energetics (cost-capacity ratio [VO2 from 0.67 m/s 5-min walk/VO2peak*100]). Compared to those with higher PFS/higher PPFI (n=73, 9.1%), individuals classified as lower PFS/lower PPFI (n=331, 41.4%) were 2 years younger, 33% more likely a man, 16% more activity, had 18.5% (0.19 m/s) faster 4m gait speed, 15-25% higher muscle energetics, 26% (5.2 mL/kg/min) higher VO2peak, and 11% lower cost-capacity ratio, all p<0.05. Combining fatigability status revealed striking differences between lower PFS/lower PPFI vs higher PFS/higher PPFI, providing insight into targets (e.g., physical activity, bioenergetics, fitness) for intervention.
LEARNING YOGA ONLINE: PERSPECTIVES FROM OLDER WOMEN ENROLLED IN A CLINICAL TRIAL FOR URINARY INCONTINENCE
Authors: Nicosia Francesca , Chesney Margaret , Kaplan Celia , Arreguin Berty , Perez-Aguilar Giselle , Huang Alison
Published: January 2025

Yoga is increasingly used as a therapeutic modality for aging-related health conditions but the feasibility of engaging older adults in yoga is unclear. We conducted a multisite randomized trial of a therapeutic yoga intervention for ambulatory older women with urinary incontinence. The trial included twice weekly group instruction in Hatha yoga techniques delivered via interactive, synchronous, videoconference-based instruction. To assess barriers and facilitators to online instruction for this population, we used mixed methods. Structured questionnaires administered at 12-weeks measured convenience, audio-visual elements, and social connection, each on a 4-pt scale (1: Poor, 4: Excellent). Interviews examined the experience of learning yoga through synchronous video instruction at home. A hybrid deductive/inductive thematic approach was used to analyze interview transcripts. Among the 51 participants completing questionnaires (age range 49-81; 16% Asian, 16% Latina, 71% White), ratings of convenience were high (90.3% “good-excellent”); ratings of perceptions of personal connection with other participants were lower (60.8% “good-excellent”). Among the 24 participant interviews (age range 45-90; 21% Asian, 17% multiracial; 17% Latina, 54% White), common challenges were audio-visual and physical space limitations. For some, privacy of the home setting mitigated incontinence stigma. Increased body awareness and perceived effectiveness in reducing incontinence and stress facilitated sustained participation. Participants identified effective online teaching strategies including reinforcement of verbal instructions with visual demonstrations about body position during yoga postures and individualized attention. Despite challenges with online delivery, the convenience and privacy of the at-home setting provides opportunities to engage diverse, older women in movement-based therapeutic yoga interventions.
SLEEP AND ITS TREATMENT: EFFECTS ON PHYSICAL AND PSYCHOSOCIAL WELL-BEING
Authors: Kaufmann Christopher , Lee Soomi , Stone Katie
Published: January 2025

Sleep disturbances, dysregulated circadian rhythms, and related disorders can impact multiple aspects of life, including physical health, mobility, mental well-being, and other outcomes of relevance to aging populations. Treatments for specific disorders, such as Continuous Positive Airway Pressure (CPAP) for sleep apnea, are also important for promoting positive health outcomes. Therefore, it is crucial to conduct research that clarifies the relationships among sleep, its treatments, and overall health. In this symposium, we examine the complex interplay of sleep, sleep disorders, and circadian rhythms, with physical and psychosocial well-being in older populations and their caregivers. Our first presentation uses data from the National Health and Aging Trends Study to evaluate sleep health characteristics as risk factors for physical frailty, including gender differences in this relationship. Our second presentation evaluates the influence of disrupted rest/activity circadian rhythms (measured by wrist actigraphy) on metabolic syndrome among older adult participants in the Baltimore Longitudinal Study of Aging. Our third presentation evaluates sleep quality in family caregivers and whether psychological resilience moderates the association of caregiving status with sleep quality. Our fourth and final presentation, using data from the Health and Retirement Study, identifies the comorbid chronic health conditions that may predict CPAP discontinuation in older adults with sleep apnea to identify populations requiring greater monitoring to improve treatment effectiveness. Overall, this symposium emphasizes the importance of sleep and its role in promoting positive health and well-being in aging and diverse populations.
ASSOCIATIONS OF CIRCADIAN REST/ACTIVITY RHYTHMS WITH METABOLIC SYNDROME IN MIDDLE-AGED AND OLDER ADULTS
Authors: Yue Yiwei , Rabinowitz Jill , An Yang , Kaizi-Lutu Marc , Liu Chunyu , Simonsick Eleanor , Schrack Jennifer , Spira Adam
Published: January 2025

Circadian rhythm disturbances often co-occur with adverse cardiometabolic outcomes, including high blood pressure, obesity, and diabetes. However, the links between disrupted circadian rhythms and metabolic syndrome (MetS) are understudied in later life. This study examined associations between actigraphic circadian rest/activity rhythm (CRAR) metrics and MetS in 388 Baltimore Longitudinal Study of Aging participants who completed 6.6±1.0 nights of wrist actigraphy (Mean age=72.6±10.1, 20.6% Black adults, 54.1% women) and measures of MetS. Predictors were relative amplitude (RA), interdaily stability, intradaily variability, midpoint of total activity during the least active continuous 5 hours, and midpoint of total activity during the most active continuous 10 hours (M10 time). Participants were classified as having MetS if they had ≥3 of the following: triglycerides >150 mg/dL; fasting blood glucose ≥100 mg/dL; high-density lipoproteins <40 mg/dL for men and <50 mg/dL for women; blood pressure ≥130/85 mmHg; waist circumference ≥102 cm for men and ≥88 cm for women. Overall, 39 participants had MetS at baseline and 24 developed MetS over 4.5±2.0 years of follow-up. Adjusting for demographics, physical activity, depressive symptoms, time, and interactions of time with covariates, higher RA was cross-sectionally associated with 29% lower odds of MetS (per SD, B=0.71, p=0.046). Longitudinally, a later M10 time was associated with a faster rate of increase in the odds of developing MetS (per SD, B=1.14, p=0.014). Findings link weaker and more phase-delayed CRARs to higher odds of MetS in middle-aged and older adults. Studies are needed to identify mechanisms linking disrupted CRARs to metabolic disorders.