bluuebunny/crossref_metadata_2025 huggingface dataset:
Chromosome-scale genome assembly of Glycyrrhiza uralensis revealed metabolic gene cluster centred specialized metabolites biosynthesis
Authors: Rai Amit , Hirakawa Hideki , Rai Megha , Shimizu Yohei , Shirasawa Kenta , Kikuchi Shinji , Seki Hikaru , Yamazaki Mami , Toyoda Atsushi , Isobe Sachiko , Muranaka Toshiya , Saito Kazuki
Published: December 2022

A high-quality genome assembly is imperative to explore the evolutionary basis of characteristic attributes that define chemotype and provide essential resources for a molecular breeding strategy for enhanced production of medicinal metabolites. Here, using single-molecule high-fidelity (HiFi) sequencing reads, we report chromosome-scale genome assembly for Chinese licorice (Glycyrrhiza uralensis), a widely used herbal and natural medicine. The entire genome assembly was achieved in eight chromosomes, with contig and scaffold N50 as 36.02 and 60.2 Mb, respectively. With only 17 assembly gaps and half of the chromosomes having no or one assembly gap, the presented genome assembly is among the best plant genomes to date. Our results showed an advantage of using highly accurate long-read HiFi sequencing data for assembling a highly heterozygous genome including its complexed repeat content. Additionally, our analysis revealed that G. uralensis experienced a recent whole-genome duplication at approximately 59.02 million years ago post a gamma (γ) whole-genome triplication event, which contributed to its present chemotype features. The metabolic gene cluster analysis identified 355 gene clusters, which included the entire biosynthesis pathway of glycyrrhizin. The genome assembly and its annotations provide an essential resource for licorice improvement through molecular breeding and the discovery of valuable genes for engineering bioactive components and understanding the evolution of specialized metabolites biosynthesis.
CAREGIVER CONTRIBUTION TO OCCUPATIONAL THERAPY VIDEO VISITS
Authors: Gately Megan , Waller Dylan , Metcalf Emily , Moo Lauren
Published: December 2022

Caregivers’ role facilitating older adults’ participation in diverse health care services delivered using video telehealth (i.e., live sessions) is not well-understood. This study surveyed occupational therapy (OT) practitioners across Veterans Health Administration (VHA) about caregiver participation in VA Video Connect (VVC), VHA’s videoconferencing platform. 293 OT practitioners participated in the survey, with 47% reporting that caregivers participated in VVC often. The foremost reported patient factors necessitating caregiver participation in video visits were patient lack of technical skills (76%) and cognitive impairment (72%). Barriers to caregiver participation in video visits included poor connectivity and caregivers’ own age or health related impairments, while benefits included increased collaboration with family (87%). This study enhances our understanding of caregivers’ participation in video telehealth, highlighting factors driving caregiver participation and suggesting strategies to optimize this service delivery format for older adults.
FACTORS INFORMING CLINICIAN CHOICE OF TELEHEALTH MODALITY TO SUPPORT DEMENTIA CAREGIVERS
Authors: Quach Emma , Franzosa Emily , Hartmann Christine , Moo Lauren
Published: December 2022

In summer 2020, 68 clinicians in the New England area caring for Veterans with dementia as part of a specialty team were surveyed regarding caregiver support services, with a 46% response rate (n=31). When faced with the need to abruptly discontinue in-person dementia support services, the majority of respondents offered caregivers support via telephone rather than video telehealth. Only 4 of 31 (13%) mentioned offering video visits for the first time to replace face-to-face visits. Clinician choice of modality largely reflected shifts among preestablished communication modalities/patterns and were influenced by clinician perception that older patients and their caregivers would prefer the telephone. Clinicians without experience using video telehealth with older adults were unlikely to offer video visits despite evidence that many older adults are willing and able to participate. Assessing caregiver wish/ability to participate in video visits may inform and shape clinician choice of telehealth modality.
FACTORS INFLUENCING WHERE AFRICAN IMMIGRANTS PLAN TO SEEK CARE FOR A RELATIVE WITH DEMENTIA
Authors: Nkimbeng Manka , Russel Wynfred , Shippee Tetyana , Gaugler Joseph
Published: December 2022

Many African immigrants did not hear about dementia until they migrated to the United States, which limits understanding of the disease and awareness of community resources. We examined the relationship between being a caregiver, care recipient country of residence, and seeking care using data from 152 African immigrants. Most participants (90%) were caregivers, 12% of the care recipients resided in Africa, and 59% reported that they would seek care within the formal health system. After controlling for age, gender, income and participant place of birth, caregivers were more likely (aOR: 2.31, 95% CI 0.37, 13.39) to seek care from community networks alone, as were those providing care to a recipient in Africa (aOR: 1.94, 95% CI 0.56, 6.71), but these were not statistically significant. These findings which trend toward preferences for seeking care through informal community networks (friends, religious organizations etc.), can inform dementia education and outreach for this community.
UNDERSTANDING AGING DIVERSITY THROUGH HUMANIST VALUES OF AGING: LOVE, HOPE, PEACE, AND STEWARDSHIP
Authors: Fogle Stephen
Published: December 2022

Humanist values of aging are relevant for understanding diversity in gerontological education because they are manifested across all cultures and ages. This paper proposes attention to four humanist values of aging: Love, Hope, Peace, Stewardship. This paper seeks opportunities for students to understand aging diversity in half century context: from traditional frames of race and sexuality to global conversations on language and geography. Drawing from stories about older adults this paper gathers diverse opportunities for understanding of humanist values of aging. Selections strive toward expanding representation of aging diversity and accessibility for students. Teaching with stories of love, hope, peace, and stewardship as humanist values of aging matches AGHE initiatives for incorporating humanities into gerontological education and opens opportunities for recognizing diversity representation in our society for all ages. Understanding aging diversity through stories of older adults engaged with humanist values of aging promises enriching educational experiences for lifelong learning.
PILOTING AN INTERGENERATIONAL ECOSYSTEM: THE GEN2GEN INNOVATION FELLOWSHIP AND RESULTS FROM YEAR 1
Authors: Halvorsen Cal , Nichols Eunice Lin , Oh Janet
Published: December 2022

Intergenerational service has a long history in the U.S., highlighting the positive health and well-being outcomes of bringing the generations together. In recent years, private foundations have increased their focus on intergenerational initiatives, yet the creation of an “intergenerational ecosystem” that is designed to spark, grow, and support new intergenerational initiatives has not been nationally tested. In response, Encore.org launched the Gen2Gen Innovation Fellowship in 2020 to pilot and hone a 9-month fellowship model that supports a diverse group of leaders of intergenerational initiatives. To assess the impact of the Fellowship, we employed a mixed-methods approach with subjective and objective data sources, including interviews and monthly and post-Fellowship surveys. Among the first cohort of 15 Fellows, results suggest that the cohort-style model encouraged peer-to-peer support and that the Fellowship positively influenced their intergenerational efforts. We conclude by describing lessons learned to inspire future efforts to strengthen the intergenerational ecosystem.
IMPACT OF LEISURE ACTIVITIES ON COGNITION IN OLDER BREAST CANCER SURVIVORS AND NONCANCER CONTROLS
Authors: Doyle Cassidy , Small Brent , Schwarzberg Arielle , Ahles Tim , Carroll Judith , Mandelblatt Jeanne
Published: December 2022

Older adults represent the largest segment of cancer survivors and may be particularly susceptible to poor cognitive outcomes. This project examines the impact of leisure activities on cognitive performance in non-metastatic breast cancer survivors and healthy controls from the Thinking and Living with Cancer (TLC) Study. Additionally, this project investigates if genetic polymorphisms (APOE, COMT, BDNF) limit the benefits of leisure activities on cognitive performance. A battery of neuropsychological tests was used to create composite scores for learning and memory (LM) and attention, processing speed, and executive functioning (APE). Leisure activity participation was associated with better LM and APE composite scores. Age differences in LM and APE were not statistically significant among the most active participants. Regarding genetic polymorphisms, persons with APOE-ε4 exhibited greater cognitive performance benefits compared to non-ε4 carriers. Future research should examine the extent to which leisure activities can buffer longitudinal declines.
AGE-FRIENDLY CARE: A FRAMEWORK TO ADDRESS HEALTH DISPARITIES IN NURSING HOMES
Authors: Waters Leland , Berish Diane , Rhodes Annie , Bellantoni Michele
Published: December 2022

Three Geriatrics Workforce Enhancement Programs (Johns Hopkins, Penn State and Virginia Commonwealth) within Health and Human Services Region-3, implemented a project providing tailored educational content designed to meet the regional needs of nursing home staff, residents, and carepartners within the context of the COVID-19 pandemic. Semi-Structured, recorded focus groups were conducted with direct care workers, and family and resident counsels. All groups were interviewed about familiarity and comfort with the 3Ds (Dementia, Delirium, and Depression) as well as what mattered most to them as workers, residents and care partners. The overall goal was to enhance development of the nursing home workforce thus creating a meaningful clinical improvement in care. We aim to go beyond the improvement of routine clinical care and address the long-standing behavioral and mental health disparities observed in this resident population. Policy implications around education, engagement of workforce, resident, and carepartner voices will be discussed.
ADDRESSING THE NEEDS OF NURSING HOMES USING MULTIPLE APPROACHES TO EDUCATION AND SUPPORT
Authors: Cotton Sam , Faul Anna , Yankeelov Pamela , Gordon Barbara , Magnuson Justin , Henage Cris , Hubbard Jennifer , Roberts Ellen
Published: December 2022

At the University of Louisville and University of North Carolina Geriatric Workforce Enhancement Programs (GWEPs), we have collaborated to develop and implement a multi-faceted program to training to address the pressing challenges within NHs and foster community. We have created a Project ECHOs series for NH administers and nursing staff to foster support, while providing education on critical topics including age-friendly healthcare, vaccine hesitancy and infectious disease control, and ways to address health disparities. Additionally, we have developed videos for CNAs and direct support staff. For NH residents and families, we are designing education and offering services to address the disparities related to mental health needs. The UofL and UNC GWEPs mission is to provide a more holistic approach to NH care and opportunities for support and community. Implications for changes in policy and future practice within NHs and the use of collaborative approaches will be discussed.
FROM KNOWING TO DOING: WHAT IS NEEDED TO SUPPORT PATIENTS IN CHANGING PHYSICAL ACTIVITY
Authors: Thackeray Anne , Hamilton Tonua , Morse Janice , Hess Rachel , Conroy Molly , Fritz Julie
Published: December 2022

Physical therapists often treat pain and functional limitations associated with chronic musculoskeletal conditions common in aging adults. While patient report improvement after physical therapy, these results do not translate to sustained physical activity. This is a lost opportunity to support aging adults in adopting behaviors proven to improve quality of life and reduce comorbidity burden. We conducted semi-structured interviews with 30 physical therapists to understand how they support adoption of physical activity and identify what is needed to improve uptake. Physical therapists endorse physical activity as essential in the management of MSK conditions. Eliciting motivation, addressing psychosocial needs, and empowering patients to actively engage in solutions were identified as significant challenges in the effort to change physical activity. At the clinician level, physical therapists identified the need for improved skills in motivational interviewing and person-centered communication. Improved coordination with mental health providers and community resources were identified as environmental needs.
LONELINESS AND ACCELERATED COGNITIVE DECLINE: MEDIATION EFFECTS OF RESILIENCE AND PURPOSE OF LIFE
Authors: Pei Yaolin , Qi Xiang , Wang Sammy , Wu Bei
Published: December 2022

Drawing from the Conservation of Resources Theory, we aim to understand the implications of loneliness on psychological resources (i.e., resilience and purpose in life) and cognitive health in later life. This study utilizes data (2006-2018) from the Health and Retirement Study to examine pathways, both direct and indirect through psychological resilience and purpose in life, from loneliness to cognitive trajectories over time. Respondents reporting higher levels of loneliness had worse initial cognitive function (β=-0.43; P<0.01) and accelerated cognitive decline (β=-0.05; P<0.01). Feeling lonely is associated with reduced resilience (β=-0.23; P<0.01) and purposed in life (β=-0.17; P<0.01) which, in turn, are associated with worse cognitive health. Finally, pathway analyses confirm that loneliness is indirectly associated with initial cognitive health and accelerated cognitive decline through deteriorating phycological resources. Positive psychological interventions can be beneficial by promoting resilience and purpose in life and subsequently improve cognitive health.
DEMENTIA CARE PARTNER SELF-CARE: A FRAMEWORK TO ILLUSTRATE MECHANISMS OF FACILITATORS AND BARRIERS
Authors: Sadak Tatiana , Cho Susie , Ishado Emily , Borson Soo
Published: December 2022

Dementia care partner (CP) self-care is an important intervention target to enhance resilience and reduce risk of negative physical and psychological outcomes, such as illness, functional decline, depression and anxiety. Yet few studies have explored CP perceptions of what helps vs prevents them from consistently engaging in self-care activities. This exploratory study examined data from 100 semi-structured CP interviews on the barriers and facilitators to self-care. Inductive thematic analysis identified multiple facilitators and barriers that can be characterized as actual (did affect self-care) or potential (would affect self-care). CP capacity to participate in self-care activities was influenced by internal (e.g. setting boundaries) or external (e.g. social support) factors. We developed a framework to illustrate these mechanisms and guide interventions for optimizing self-care behaviors.
VALIDATING A BEHAVIORAL FRAMEWORK OF RESILIENCE IN DEMENTIA CARE PARTNERS: AN ABDUCTIVE THEMATIC ANALYSIS APPROACH
Authors: Zhou Yuanjin , Hasdemir Dilara , Ishado Emily , Borson Soo , Sadak Tatiana
Published: December 2022

One barrier to developing resilience-enhancing interventions for dementia care partners is a lack of an objective measure to capture resilience-related behaviors. To validate a behavioral framework of resilience in dementia care partners for future measure and intervention, we conducted semi-structured interviews with 26 care partners who experienced challenges created by a health crisis of their care recipients. We used abductive thematic analysis to identify 14 resilience-related behaviors care partners adopted to recover from care challenges. These behaviors included four problem-response behaviors, three help-related behaviors, three self-growth behaviors, two compassion-related behaviors, and two learning-related behaviors. Twelve care partners reported full recovery from the effects of their challenging experiences. Ten care partners reported partial recovery in the face of PLWD’s declining health and their own unmet needs, and four care partners felt not at all recovered. This finding suggests new intervention targets for enhancing care partner resilience.
PROVIDING INPATIENT CARE BEYOND HOSPITAL WALLS: GEOGRAPHIC FACTORS IN ACUTE HOSPITAL CARE AT HOME WAIVER PROGRAMS
Authors: Franzosa Emily , Gorbenko Ksenia , Baim-Lance Abigail , Schiller Gabrielle , Wurtz Heather , Masse Sybil , Ornstein Katherine , Leff Bruce
Published: December 2022

The Centers for Medicare and Medicaid Services’ (CMS) Acute Hospital Care at Home waiver offers hospital-level reimbursement to provide acute hospital-level care in patients’ homes for the first time. While this initiative may make acute care at home more financially viable for health systems, it also requires aligning Hospital at Home (HaH) operations with inpatient, rather than outpatient, regulatory requirements. We aimed to understand how participating HaH programs adapted to these requirements. We conducted semi-structured interviews with multiple leaders from 14 HaH waiver programs (n=18 clinical/medical, operational and program directors) varying in size, urbanicity, structure, and region, examining data through thematic analysis. Both urban and rural participants described geographic effects of waiver requirements. For instance, to ensure response to patient emergencies within 30 minutes, programs contracted with paramedic services to expand service areas, added program locations or moved primary locations to other system hubs. Programs maximized staff capacity across service areas by “leasing” staff from other home-based programs, focusing on urban hubs with more staff, balancing in-person visits with remote monitoring, and providing “hybrid” in-person/video appointments. However, travel time, length of acute care visits, staffing shortages, the need for new skills (e.g., acute care nurses, dietitians) and limited state scope of practice regulations, particularly for paramedics, limited the area and populations served. Adapting to waiver requirements required significant efforts to address staffing, logistical and regulatory challenges. Future waiver improvements should explicitly consider the unique resources needed to expand hospital-level care in geographically diverse ambulatory environments.
DIMENSIONS OF IMPLEMENTATION FOR DEMENTIA-FRIENDLY COMMUNITY INITIATIVES
Authors: Scher Clara , Greenfield Emily
Published: December 2022

Dementia-friendly community (DFC) initiatives are a community-level approach to support individuals living with dementia and their care partners. DFC initiatives engage in a range of activities including raising awareness about dementia, enhancing local services, and advocating for inclusive public facilities and spaces. There is significant variation in the implementation of DFC initiatives worldwide which creates challenges for both process and outcomes evaluation. We used data from qualitative interviews with DFC leaders in Massachusetts to develop a framework to assess the implementation of DFC initiatives. Qualitative descriptive analysis yielded distinct dimensions such as robustness of multisectoral action teams, diversity of strategies for outreach to older adults, and degree of focus on coordinating care. Building on the tradition of using radar charts to evaluate DFC initiatives, we visualized the shape of implementation across the various dimensions. This framework can help to advance research, practice, and policy as part of the DFC movement.
DEVELOPING A MEASURE OF COMMUNITY-LEVEL DEMENTIA FRIENDLINESS IN FAITH COMMUNITIES
Authors: Epps Fayron , Bender Alexis , Gore Janelle , Gunn Grayson , Markert Dana , Moore Miranda
Published: December 2022

As the prevalence of dementia rises, modifying built and social environments of persons living with dementia (PLWD) becomes increasingly essential. Although there is a call to rigorously evaluate dementia-friendly community initiatives, no known comprehensive evaluation tools exist to assess small communities (churches and community centers). Therefore, we are developing a person-centered Dementia-Friendly Community Assessment tool. This tool will consist of new and validated scales to assess the level of dementia-friendliness among churches enrolled in a dementia-friendly congregation program based in African American communities. A draft of a theory-informed survey instrument is being shared with stakeholders (church leaders, caregivers, and PLWD) during focus groups who will provide feedback on their understanding and relevance of questions on the instrument. The tool will then be modified based on feedback and the final instrument will be piloted with broad church membership. Our aim is to enable programs to quantify their dementia-friendly community initiative’s impact.
COMMUNITY CONTEXT OF OLDER ADULT CARE: A CASE STUDY DURING THE COVID-19 PANDEMIC
Authors: Skemp Lisa
Published: December 2022

Introduction

Expectations for older adults (OA) to live in the community and prevent costly long-term care assume OAs’ informal network members are available, able, and willing to fill this need. Yet, little is known about the processes whereby OAs construct care networks, especially during COVID-19.

Methods

A longitudinal case study of one OA male who participated in the ethnographic community Older Adult Care study in one urban Chicago neighborhood is described. The OA male described his network on three occasions: 2/2018, 1/2021 and 9/2021. The care networks were described by size, density, and transitivity. Data analysis was performed using the R programming language. Adjacency networks were constructed using the network package, then visualized using the sna package.

Results

The OA’s network went from 23 members pre-pandemic in time one to 13 in time two and 8 members in time three. As network size contracted, the network density increased from 25% in time two to 46% at time three, indicating a more interconnected network. Clustering varied over time and was at its lowest in time 2 (27%) and increased by time 3 (67%). Friends and church connections were 72% of his network in time one, whereas 71% of his network were family and neighbors in time three.

Conclusions

Our OA’s large, relatively disconnected social network tightened to fewer, more closely connected members during COVID-19 months. Contextual variables (environment, health guidelines, fear, pets) influenced the networks. It is essential to understand OA care networks to promote healthy aging in community.
CHARACTERIZING HOME AND COMMUNITY-BASED SERVICE ENROLLEES IN MINNESOTA’S MEDICAID WAIVER PROGRAM
Authors: Blackburn Justin , Baggett Sharon , Burton Ellen , Snyder Yonda
Published: December 2022

Medicaid waivers allow states’ provision of home and community-based services (HCBS), leading to variations in design and delivery. States monitor expenditures, but cannot easily anticipate growth. Understanding the needs of this population can aid in early identification and improve service delivery. We conducted a Partitioning Around Medioids cluster analysis of first-time enrollees in Minnesota’s Elderly Waiver HCBS program during 2019 to identify trajectories of entry and characterize activities of daily living (ADL) and instrumental activities of daily living (IADL) needs at enrollment. Administrative data collected via long term care consultation assessments provided enrollment, ADL/IADL needs, living arrangements, and other clinically relevant information that was linked to other sources including Minnesota health care program enrollment and utilization, Minimum Data Set skilled nursing facility (SNF) assessments, and calls to the Senior LinkAge Line (SLL)—a free long-term care counseling service. Of 5,284 first-time enrollees, most had prior engagement with state programs—nearly two-thirds had called the SLL, 36% had a SNF stay, and 56% had prior Medicaid enrollment. We identified six clusters representing three levels of living arrangements and two levels of need: 1) lived alone, low needs (32%), 2) lived with others, moderate needs (20%), 3) congregate living, moderate needs (14%), 4) congregate living, high needs (14%), 5) lived with others, high needs (11%), and 6) lived alone, high needs (9%). Lacking caregivers and prior Medicaid were possible exacerbating reasons for HCBS enrollment. The magnitude of the differences between clusters highlights the constellation of factors leading to enrollment in HCBS.
HOME HEALTH AIDE CONTINUITY AMONG HOME-BASED LONG-TERM CARE CLIENTS
Authors: Reckrey Jennifer , Russell David , Fong Mei-Chia , Ornstein Katherine
Published: December 2022

Many older adults with functional impairment rely on paid caregivers (e.g., home health aides) to remain living at home. Continuity in the provider of healthcare services is known to impact care-recipient outcomes in settings like primary care; however, limited quantitative research has explored variability in provider continuity among home-based long-term care services. We conducted a retrospective pooled cross-sectional study using a secondary analysis of managed long-term care and home care agency records in order to: 1) describe home health aide continuity among a population of older adults receiving Medicaid-funded home-based long-term care using the Bice-Boxerman index, and 2) identify factors associated with greater home health aide continuity using multivariate regression. Among 3,864 older adults who received claim-paid home health aides services between January 1, 2018 and March 10, 2020, average home health aide continuity scores were lower (i.e., worse continuity) as care hours increased: 0.71 among those receiving < 3 service hours/day (n=1221), 0.62 among those receiving 3-7 service hours/day (n=1622), and 0.41 among those receiving >7 service hours /day. Among those with the highest care hours (>7 hours /day), increases in the level of ADL impairment and cognitive impairment were significantly associated with decreases in continuity scores. While clients with the highest care needs are the most dependent on their home health aides and may benefit most from stable paid caregivers, home health aide continuity scores are the lowest among this group. Future work will explore the impact of home health aide continuity on long-term care-recipient health outcomes.
ACCOUNTING FOR DIVERSITY IN COGNITIVE STATUS IN THE DESIGN AND EVALUATION OF INCLUSIVE PROSPECTIVE MEMORY SOLUTIONS
Authors: Sanders Edie , Boot Walter , Stuart Robin
Published: December 2022

Technology holds tremendous promise for supporting older adults' performance of important everyday activities. However, truly inclusive design of technology-based solutions must account for diversity with respect to cognitive status. This talk will focus on empirical studies conducted under the umbrella of the Enhancing Neurocognitive Health, Abilities, Networks, & Community Engagement (ENHANCE) Center with an emphasis on designing inclusive prospective memory solutions for older adults with cognitive impairments. Initial usability studies will be discussed examining the usability and efficacy of novel technology solutions, including the use of smartwatches and digital assistants, to support prospective memory, the ability to remember and carry out an intention in the future, which is crucial for maintaining health, independence, and social connections.
DEMENTIA CARE IN NURSE PRACTITIONER-LED CARE MANAGEMENT FOR COGNITIVELY VULNERABLE OLDER ADULTS
Authors: Fortinsky Richard , Ladda Shawn
Published: December 2022

Care management approaches are being widely tested in the Medicare-eligible population to manage chronic conditions, but few have focused on cognitive vulnerability as the pathway to optimizing independence in the community-dwelling older population. Cognitive vulnerability refers to living with dementia, depression, and/or a history of delirium. This presentation features a nurse practitioner-led team care management model (3D Team) to address cognitive vulnerability, tested in an ongoing clinical trial with older adults in a Medicare Advantage population. For older adults with dementia and their families served by the 3D Team, the nurse practitioner works closely with occupational therapists (OTs) delivering a nonpharmacological dementia care intervention. Preliminary results presented will include: characteristics of dyads that have received the dementia care intervention (N=70 dyads to date), how the nurse practitioner and OTs communicate, how the nurse practitioner reinforces dementia care skill-building strategies introduced by OTs, and process evaluation results to date.
DAILY EVENING ELECTRONIC MEDIA USE, SEDENTARY BEHAVIORS, AND SLEEP IN LATER LIFE
Authors: Kim Yijung , Richards Nicole , Fingerman Karen
Published: December 2022

Sleep complaints and disorders are two of the most common disturbances to health and well-being in later life. This study examined how evening electronic media use and daytime sedentary behaviors affect subsequent sleep hours and perceived sleep quality, and whether consistent sleep hours (i.e., sleep regularity) moderate these associations. Data were drawn from 241 older adults (Mage = 74.02) from the Daily Experiences and Well-being Study who completed ecological momentary assessments and wore an accelerometer for four days on average. A series of conditional fixed-effects models indicated that older adults reported more sleep disturbances on nights following the evening computer use. Sedentary behaviors and evening television viewing were not associated with sleep quantity and quality. Older adults with more consistent hours of bedtime reported better sleep quality regardless of their evening electronic media use and daytime sedentary behaviors, thereby highlighting the importance of sleep regularity in later life.
NONLINEAR ASSOCIATIONS OF DAILY STRESS REACTIVITY WITH HEALTH AND WELL-BEING
Authors: Rush Jonathan , Ong Anthony , Piazza Jennifer , Charles Susan , Almeida David
Published: December 2022

Research has repeatedly demonstrated that greater affective reactivity to daily stressors is associated with detrimental health outcomes (e.g. inflammation, mortality). However, most research has only considered linear effects, which precludes an examination of whether moderate levels of stress reactivity may be beneficial. Using daily diary data from the National Study of Daily Experiences (N=2,018) we fit multilevel SEMs to simultaneously model daily within-person associations between stress and negative affect (i.e., stress reactivity), and individual differences in the linear and quadratic associations between stress reactivity and life satisfaction, psychological distress, and chronic conditions. Significant quadratic effects were found for each of the three outcomes (estimates=-20.23; 11.49; 20.81, ps<.001, respectively), indicating a U-shaped pattern where both low and high levels of stress reactivity were associated with poorer health, whereas moderate levels of daily stress reactivity predicted better health outcomes. The results suggest that some affective response to daily stressors can be beneficial.
EMBRACING THE DIVERSITY OF GRANDFAMILIES: UNDERSTANDING THE INFLUENCE OF CULTURE AND RACISM
Authors: Mendoza Nancy , Yancura Loriena
Published: December 2022

In line with this year’s conference theme, we examine diversity in different forms, such as racial, cultural, and familial diversity. We discuss the importance of diversity’s influence on the experiences of grandfamilies and the impact it has on their members. Findings from a study with Latinx grandparent caregivers suggest that those raising grandchildren often do not view themselves as “raising,” but instead “helping.” Such findings highlight the importance of understanding cultural norms to appropriately tailor services and resources. In an exploration of the experiences of Korean custodial grandparents, findings demonstrated the influence of patrilineality and stigma surrounding divorce for Korean grandparent-headed families, indicating the importance of considering a grandparents’ position in the family when providing services. In a study with custodial grandparents during the COVID-19 pandemic, researchers examined the role of racial discrimination on grandparents' depressive symptoms and access to health services. Results indicated a higher level of perceived racial discrimination was associated with more depressive symptoms. These results imply the need to address racial/ethnic disparities experienced by these caregivers. Similarly, in a study of emerging adults raised by grandparents, race moderated the influence of attachment on symptoms of racial discrimination. Findings support the use of interventions addressing attachment and ethnic identity to decrease symptoms of racial trauma in grandfamilies. Together these four studies reiterate the diversity of grandfamilies, enrich our understanding of these families, and encourage us to reimagine how to best serve them.
ESPO AND HEALTH SCIENCES SECTION SYMPOSIUM: INCLUDING DIVERSE STAKEHOLDERS IN HEALTH INTERVENTION DESIGN: LESSONS LEARNED FOR ADVANCING HEALTH EQUITY
Authors: Nguyen An , Moored Kyle , Moored Kyle
Published: December 2022

The COVID-19 pandemic exposed persistent disparities in the effectiveness of healthcare services and long-term care among the older adult population. For example, significant gaps disproportionately affected older adults living in rural areas, racial and ethnic minorities, individuals with cognitive impairments, and those from low socioeconomic backgrounds. To improve health equity, research is needed to design, implement, and disseminate health interventions that address the heterogeneity of older adults and caregivers. Reflecting on lessons learned from including underrepresented key stakeholder groups in intervention research may reveal strategies to design health interventions that are more accessible and effective for diverse populations of older adults and their caregivers. This symposium highlights five studies that included diverse populations of older adults and/or caregivers in the design of health interventions. Dr. Schiaffino will share how disparities in co-morbid cancer and dementia across racial, ethnic, and age groups will inform improvements to care delivery processes for this population. Ms. Crane will discuss barriers to designing exergame interventions that are accessible to older adults with multiple chronic conditions and functional limitations. Dr. Díaz-Santos will describe results of piloting and refining a social connection intervention to reduce loneliness among Latinx older adults at risk for dementia. Dr. del Pino will highlight strategies to improve implementation of a screening intervention for at-risk drinking among African American older adults living with HIV. Mr. Cotton will present results of tailoring a crisis intervention to improve cultural fit for African American caregivers of people with dementia.
DETERMINING FEASIBILITY FOR USE OF GERIATRIC COGNITIVE SCREENINGS BY MEDICAL CASE MANAGERS SERVING OLDER (50+) PLWH
Authors: Maly Monica , Burk-Leaver Erin
Published: December 2022

Cognitive impairment (CI) is a significant age-related risk exacerbated by HIV. However, AIDS Service Organizations (ASO) have not implemented effective screening tools for detection of CI in older adults living w/HIV (OALH). This study examined feasibility for use of those tools by medical case managers (MCM) serving OALH. MCMs from nine Colorado ASOs self-administered a questionnaire measuring baseline knowledge of warning signs and risk factors (WS/RF) of CI in OALH, evaluating familiarity with screening of/response to WS/RF of CI within this population. Data from 24 MCMs showed OALH comprised 47% of all clients, and 68% of respondents reported no related training. Similarly, 67% reported not feeling confident identifying WS/RF. 100% of respondents reported not screening for CI, and many endorsed limited awareness/availability of screening tools (87%), referral resources (87%), and training (83%). This identified a need and desire for use/implementation of cognitive screening tools to improve ASO care for OALH.
DISABILITY STATUS, FINANCIAL STRAIN, AND SUBJECTIVE HEALTH AND WELL-BEING FOR PEOPLE WITH LTSS NEEDS IN CALIFORNIA
Authors: Chen Lei , Kietzman Kathryn , Torres-Gil Fernando
Published: December 2022

Many people with needs for Long-Term Services and Supports (LTSS) are vulnerable to financial strain, a chronic economic stressor that may negatively affect a person’s well-being. This study examines the extent to which financial strain mediates the relationship between people’s disability status and subjective health and well-being, controlling for select demographic characteristics. Disability status refers to the intensity of disabilities that people report, including cognitive impairments, and/or difficulties performing activities of daily living and/or instrumental activities of daily living. Financial strain measures the number of challenges that participants incurred during the last year in acquiring food, housing, health care, and other basic needs. We use the first cycle of data (2019-2020) from the California Long-Term Services and Supports (LTSS) survey, merged with select data from the California Health Interview Survey (CHIS) (N = 2,030). Drawing from Pearlin’s Stress Process Model, we use Conditional Process Analysis (CPA) to examine the hypothesized mediation relationships. Findings show that the intensity of disability status has a direct association with self-rated health (c’ = -.2054, p < .0001) and psychological distress (c’ = .7247, p < .0001). Furthermore, financial strain experienced by people with LTSS needs mediates the relationship between their disability status and 1) self-rated health (ab = -.0178, BootCI= -.0285 to -.0082) and 2) psychological distress (ab = 0.19, BootCI= .1323 to .2648). These results have policy and practice implications for national and state programs, such as Medicaid, the Universal Basic Income (UBI) program, and the Master Plan for Aging in California.
EVALUATING IMPLEMENTATION OF AN ONLINE INTERGENERATIONAL TECHNOLOGY PROGRAM
Authors: Juris Jill , Scrivano Rachel , Bouldin Erin , Uva Katherine
Published: December 2022

Social isolation and loneliness contributed to poor health outcomes among rural older adults prior to COVID-19. Physical distancing protocols during COVID-19 exacerbated social disconnect of rural older adults and paused in-person intergenerational programs. Pilot data from a Cyber-Seniors program that was adapted for virtual delivery and participation during the pandemic (2020-2021) indicates positive health outcomes for older adults (improved social isolation and loneliness). This presentation will address a gap between outcomes and the implementation process of the intergenerational technology program. Multi-method data on student experiences as technology mentors working at a distance suggest a need for an evaluation of program implementation. The type 1 effectiveness-implementation hybrid design includes quantitative measures of student outcomes (ageism, social isolation, and loneliness) and qualitative analysis of students’ program implementation experiences. Students identified challenges accessing and working with the online platforms, scheduling meetings with older adults, and providing support with online systems by phone.
INDIGENOUS UNDERSTANDINGS AND APPROACHES TO SUCCESSFUL AGING
Authors: Lewis Jordan , Kim Steffi
Published: December 2022

Indigenous peoples worldwide face unique challenges growing old. Many of these challenges are founded in historical colonization practices, present oppressive systems, racism, and underrepresentation in research, service provision, health education, and successful aging theories. The focus of this symposium is to discuss specific barriers and challenges related to Indigenous aging in rural and urban communities, as well as community strategies supporting aging well. The first presentation by Zayla Asquith-Heinz and colleagues will share the results of what successful aging or “Eldership” means in the Norton Sound southern subregion of Alaska. Results indicate that family plays a central role within the Norton Sound model of successful aging. The second presenter, Steffi Kim and Jordan Lewis, are discussing the role of cultural influences and Elder identity on successful aging in the context of Alaska Native Elders migrating from rural traditional communities to a western urban community. The third and fourth presentations by Sarah Russell and Rachel Quigley will share the results on what aging well means within Torres Strait Islander people. The results suggest that the availability and accessibility to traditional practices, language and foods can facilitate aging well within these communities. They will also describe the development and implementation of a toolbox of culturally appropriate screening tools and interventions. Lastly, Jordan Lewis will explore the Indigenous concept of “doing” successful aging rather than having good health. He will outline differences and similarities with BIPOC studies on successful aging.
INTEGRATING AGE INCLUSIVITY WITH DEI EFFORTS ON AGE-FRIENDLY UNIVERSITY (AFU) CAMPUSES
Authors: Montepare Joann , Farah Kimberly , Lichtenberg Peter
Published: December 2022

The pioneering Age-Friendly University (AFU) initiative, endorsed by GSA’s Academy for Gerontology in Higher Education (AGHE), calls for institutions of higher education to respond to shifting demographics and the needs of age-diverse, older populations through more age-friendly programs, practices, and partnerships. Over 85 institutions in the United States, Canada, European countries, and beyond have joined the global network and endorsed the 10 AFU principles, with even more showing interest in becoming partners in the movement. One key foundational area identified by AFU research efforts and partners is integrating age inclusivity with ongoing diversity, equity, and inclusion (DEI) efforts on campuses. This symposium explores the need for this integration featuring AFU partners who will offer their observations and recommendations. Bowen and colleagues will open the session with data from their national study of age-friendliness in U.S. institutions to describe their insights regarding the state of age diversity on campuses and the experiences of students, faculty, and staff that call for greater age inclusivity. Morrow-Howell and colleagues will present data from interviews with DEI officers that identify institutional considerations for inclusion efforts. Andreoletti and colleagues will offer specific curricular and related strategies for connecting age-inclusivity efforts with DEI campus efforts. Gugliucci will discuss considerations regarding age-inclusive images and messages in health professions education including the inclusion of identifiable DEI objectives in syllabi. As discussant, GSA president Lichtenberg will comment on age-inclusivity efforts in higher education within GSA’s broader commitment to diversity, equity, and inclusion.
STRATEGIES FOR CONNECTING AGE INCLUSIVITY TO DEI EFFORTS: A CAMPUS CASE STUDY
Authors: Andreoletti Carrie , June Andrea
Published: December 2022

We’ve employed a multi-pronged approach to connecting our AFU initiatives, which promote age inclusivity, to our university’s DEI efforts. First, we asked our DEI office if they would collaborate. They agreed to link our AFU webpage to the DEI webpage and supported Ageism First Aid training for faculty and staff. Second, we participated in equity, justice, and inclusion (EJI) efforts on campus by ensuring that gerontology courses qualified for the EJI designation. This helps expand aging education across the curriculum as all students must take one EJI designated course. We also volunteered to speak about ageism to the first cohort of John Lewis Institute Scholars. Third, we partnered with our Center for Teaching and Innovation to offer programming on age inclusivity and generational diversity in the classroom. Taken together, these efforts have helped us to expand our reach and ensure that age is part of DEI conversations on our campus.
DETERMINANTS OF RETIREMENT-AGE WOMEN’S LABOR FORCE PARTICIPATION: A RUSSIA AND THE US COMPARISON
Authors: Dikhtyar Oksana
Published: December 2022

Factors such as one’s health, education, marital status, and family caregiving were found to be associated with people’s retirement timing. Few studies looked at those factors separately for men and women and few cross-cultural studies were conducted on the topic. Women tend to accumulate less income and retirement savings throughout their working careers compared to men due to having more intermittent careers and lower paying jobs. Women, in general, live longer than men and are more likely to be divorced or widowed at older ages. Thus, they must spend fewer financial resources over a longer time in retirement. One possible solution is to continue employment after reaching pensionable age. Therefore, it is important to know factors that affect women’s labor force participation at or after pensionable age.This quantitative study examines the relationship between women’s personal and family factors and their labor force participation after reaching pensionable age in Russia and the U.S. Using data from the Background Questionnaire of the Program for the International Assessment of Adult Competencies (PIAAC) survey, we analyzed a sample of Russian women ages 55 and older and American women ages 66 and older.For retirement-age Russian women, having highest level of education, living in a larger household, and having spouse or partner in the labor force were positively associated with women’s labor force participation. Likewise, American women of pensionable age with more education and a working spouse were more likely to be in the labor force. Implications for policy and future research are discussed.
MITIGATING LONG-TERM CONSEQUENCES OF COVID-19 ON OLDER ADULTS IN HONG KONG, SINGAPORE, THAILAND, AND THE US
Authors: Thiamwong Ladda , Lou Vivian Wei Qun
Published: December 2022

The impact of COVID-19 on older adults goes beyond a higher risk for serious infection to long-term consequences such as decreased well-being and disability. In 2020, we formed an international and interdisciplinary research group and adopted a biopsychosocial model as a conceptual framework to guide our collaboration. Our ultimate goal is to mitigate the long-term health consequences of the pandemic and utilize affordable technology-based interventions to enhance the quality of life for older adults in Hong Kong, Singapore, Thailand, and the US. Five empirical studies will be presented with topics ranging from quality of life, fear of falling, attitudes toward technology, and the utilization of technology-based interventions. A path analysis from the first study indicated that physical frailty was the strongest direct power on quality of life followed by depressive symptoms, and life-space mobility. The second study found that fear of falling was predicted by falls risk, resistance, COVID fear, and health conditions. The third study revealed a strong connection between the COVID severity and positive attitudes toward technology, and social support facilitates the adoption of technology. The fourth study reported the benefits of using a technology-based body-mind intervention to alter a mismatch between fear of falling and actual fall risk and to increase the accessibility of the fall intervention. The final study indicated that utilizing an alternative online exercise program during the pandemic increased exercise regularity and enhanced motivation. Together, all five studies contribute to strategic implications on global mitigating long-term health consequences and essential issues for further research.