bluuebunny/crossref_metadata_2025 huggingface dataset:
CULTURALLY RESPONSIVE INTERVENTIONS FOR OLDER ADULTS: FROM DEVELOPMENT TO ADAPTATION
Authors: Nkimbeng Manka , Cotton Quinton , Parker Lauren
Published: December 2023

Culture is an important aspect of health and healthcare because it influences perceptions and health seeking behaviors, but many health interventions are developed without consideration of the cultural needs or do not include the voices of the of the target population. Yet culturally responsive interventions have been proven to be more effective than generic interventions. Opportunely, there is a growing understanding of the need for culturally responsive interventions but limited understanding of the process. This symposium will offer an overview of the process of developing culturally responsive interventions. It will present three unique projects that are in different stages and on different levels on the continuum of culturally responsive interventions and programs. African MADE is a culturally tailored dementia education program that was developed with the African immigrant community, while “Community-Organization Based Intervention Planning for Older Latine Adults: Lessons Learned” describes the co-development process employed in the design of an intergenerational respite program for older adults within the Latine community. Finally, we will present findings of a feasibility study of an evidence based intervention that was adapted for African American women with pain and depression.
EVALUATION OF THE DEMENTIA FRIENDLINESS OF AIR TRAVEL—A CANADIAN PILOT STUDY
Authors: Garcia Linda , Chiareli Alexandra , Robitaille Annie , Mulvey Michael , Primossi Valentina
Published: December 2023

An earlier initiative involving various stakeholders in the air travel industry, disability advocates, researchers, and individuals living with dementia and their travel partners identified five key areas to reduce the challenges faced by travellers living with cognitive limitations: there was a need for information and awareness on the topic, a discussion on disclosure and identification, a readjustment of processes and spaces, a need for formal training and standardized processes across jurisdictions. Next, focussing on current and planned initiatives for reducing these obstacles, the research team determined what might be available to consumers living with dementia and their families at Canadian airports. This symposium presentation will focus on the design and benefits of a citizen science approach for addressing the identified obstacles and the accessibility of the stated airport initiatives through the lens of passengers with dementia and their travel partners. Moreover, a prototype tool, adapted from the citizen science tool used in other presentations in this symposium, that includes data from the findings of both the stakeholder group and the airport analyses symposium will be presented and discussed in terms of its appropriateness and usefulness to evaluate the dementia-friendliness of air travel.
BEHAVIOR-RELATED RISK FACTORS AND WORKING LIFE EXPECTANCY IN ENGLAND
Authors: Zaninotto Paola
Published: December 2023

Over the past decades, the UK has introduced pension and labour market reforms that aimed at increasing the length of working life among the older working population. Behaviour-related risk factors such as low physical activity level, alcohol consumption, smoking as well as obesity are associated with labour market participation and early retirement. However, the extent to which the co-occurrence of these behaviour-related risk factors predict how long people stay in employment (working life expectancy) has not yet been investigated. We used a large nationally representative sample of older people in England participants of the English Longitudinal Study of Ageing (ELSA), from 2002 to 2018. We applied multistate life table models to repeated measures to estimate sex-specific working life expectancy from the age of 50. We considered the following behaviours: smoking, daily alcohol consumption, being physically inactive and being obese. At the age of 50, men with no behaviour-related risk factors could expect to work on average 11 years (95%CI:10.96; 11.44) longer (9 for women, 95%CI:8.98;9.44), whereas men with 2+ behaviour-related risk factors could expect to work on average 9.2 additional years (95%CI:9.19; 9.85) (7.4 for women, 95%CI:7.3; 7.8). Men and women engaging in one behaviour-related risk factor had slightly higher lower working life expectancy than those not engaging in any behaviour-related risk factors.
IMPLEMENTATION AND EFFECTIVENESS OF VIRTUAL REALITY PROGRAMS IN LONG-TERM CARE SETTINGS
Authors: Savundranayagam Marie , Williams Kristine
Published: December 2023

Virtual reality (VR) is an immersive technology that allows users to experience a computer-generated simulation of a three-dimensional environment. It is used in healthcare for education and training purposes, as therapeutic interventions, and for social engagement. However, there are few studies exploring the use of VR in long-term care settings. The purpose of this symposium is to share lessons learned on the implementation and effectiveness of VR programs in long-term care settings. All studies use the Consolidated Framework for Implementation Research to guide their exploration of the facilitators and barriers to implementation. They use qualitative methods, such as interviews, focus groups, and ethnographic observation, to collect data on the experiences of staff and residents participating in the programs. Study one highlights the critical need to engage decision makers to assess organizational readiness prior to creating an implementation strategy. Study two showcases the iterative process involved in translating an in-person, person-centered communication training into a VR training program for frontline healthcare workers. Study three features the benefits and challenges of using VR with older residents. Study four explores staff perspectives on facilitators and barriers to adopting VR in long-term care. The studies highlight the potential benefits of VR in enhancing communication skills, social engagement, and support for residents’ personhood. They also identify factors for successful implementation, such as staff champions, sufficient technological infrastructure, and organizational support for infrastructure and human resources. The studies offer valuable insights for researchers and practitioners working to implement novel VR interventions in long-term care settings.
GOOD FOR HEALTH, BAD FOR SUBJECTIVE WELL-BEING: EFFECT OF CONTINUING WORK ON JAPANESE OLDER ADULTS
Authors: Katagiri Keiko
Published: December 2023

Recently, the labor force rate of Japanese older adults has been increasing. The white paper of Japan’s Cabinet Office shows that half of the people in their late 60s are employed in 2022. Previous literature has indicated that work has positive effects on health and cognitive functions; however, the work environment is not age-friendly. Most companies set the mandatory retirement age at 60, after which people must work under a worse labor contract. This study aims to explore the effect of work on Japanese older adults’ subjective well-being and to examine whether social participation and civic activity can buffer work’s negative effects. Random sampling survey was conducted in 2019 on people living in the Tokyo and Hyogo prefectures. The response rate was 43.0% (N = 1,063, aged 50–74). Analyses of covariance were conducted on well-being, depression, anxiety, loneliness, and life satisfaction. We found that work has negative effects on anxiety and life satisfaction, with civic activity moderating the negative effect on life satisfaction. Gender differences were observed regarding anxiety and loneliness. Women showed higher anxiety, and men showed higher loneliness. Regarding age difference, people in their late 60s exhibited the lowest depression and those in their late 50s higher anxiety. It is argued that Japan’s third agers live in more difficult work circumstances than ever before, and it is thus necessary to explore age-friendly labor conditions for older adults.
INNOVATIVE VOLUNTEER PROGRAMS TO SUPPORT FAMILY CAREGIVERS AND PERSONS LIVING WITH DEMENTIA
Authors: Fields Noelle , Xu Ling , Gibson Allison
Published: December 2023

There is a continued need for accessible and cost-effective community-based services and supports for family caregivers and persons living with Alzheimer’s disease and related dementia (ADRD). Utilizing trained volunteers may offer a scalable approach to filling gaps in ADRD care and support. This symposium will provide evidence for utilizing trained volunteers in innovative interventions designed for family caregivers and persons living with dementia. The first paper presents findings from the Senior Companion Program Plus, an intervention using lay providers to deliver a culturally informed psychoeducational intervention with African American ADRD family caregivers. The second paper highlights the Faith Care Family Project which utilizes trained church volunteers from predominantly African American churches to reach African American ADRD family caregivers. The third paper explores the PorchLight Project, a dementia-capable training and respite delivered by volunteers for older people living in the community throughout Minnesota and in select regions of North Dakota. The fourth paper presents findings from an intervention using trained, experienced Chinese dementia caregivers to be volunteer mentors to newer dementia caregivers in the same ethnic community. The final paper presents findings from a telephone-based, intergenerational reminiscence intervention with college student volunteers and persons living with cognitive impairment that incorporates digital storytelling. The symposium will conclude with a critical reflection on the empirical contributions needed to advance scholarship on leveraging volunteers to meet the needs of family caregivers and persons living with ADRD.
LAUNCHING THE PORCHLIGHT PROJECT
Authors: Gaugler Joseph , Albers Elizabeth , Louwagie Katie , Fields Noelle , Jutkowitz Eric , Nkimbeng Manka , Shippee Tetyana , Roth David
Published: December 2023

The Porchlight Project (PLP) is a 5-year study designed to evaluate the real-world efficacy of dementia capable training and respite delivered by volunteers for older people living in the community throughout Minnesota and in select regions of North Dakota. Volunteer regions managed by the Lutheran Social Services of Minnesota (LSS-MN) throughout Minnesota and North Dakota were randomly assigned to receive the dementia training and volunteer support of PLP or the usual care control condition with standard volunteer training. The purpose of this presentation is to describe the process involved in establishing the PLP within LSS-MN’s routine programming for volunteers and embedding key outcome measures within LSS-MN’s standard data collection process for volunteers, their clients, and their clients’ caregivers. Various challenges to PLP integration included: human subjects research categorization for an evaluation such as the PLP; achieving survey response rate goals; and establishing a baseline data collection interval prior to volunteer training completion. Strategies to proactively address these challenges to promote successful embedding of the program include creation of a PLP coordinator position within LSS-MN, who is responsible for the day-to-day programming of the project, as well as the development of a robust, yet flexible protocol. The flexibility allows for navigating LSS-MN programmatic activities, such as changes to the LSS-MN internal database, fluctuation in staffing and/or volunteers, revisions to survey follow-up procedures and correspondence, and consideration for those who will not complete training (e.g. non-English speakers, etc.). This presentation will also feature baseline descriptive data from the evaluation.
A PILOT STUDY OF A PEER MENTORING SUPPORT INTERVENTION FOR CHINESE AMERICAN DEMENTIA CAREGIVERS
Authors: Liu Jinyu , Cheung Ethan Siu Leung , Lou Yifan
Published: December 2023

Objectives

Although many older Chinese Americans are expected to need intensive care because of cognitive impairment, a large gap exists in development of culturally sensitive interventions to reduce stress among caregivers in Chinese American communities. Informed by the sociocultural stress and coping model, we developed and tested a peer mentoring program. In the intervention, experienced Chinese caregivers are recruited and trained to be volunteering mentors, who provide three-month mentoring support to newer caregivers in the same ethnic community.

Methods

A pilot randomized controlled trial was conducted among 38 Chinese American caregivers in New York City. During the three-month intervention, the 19 caregivers in the intervention group were paired with and weekly supported by 8 mentors via telephone calls. The control group received educational materials on caregiving skills and self-care. Three outcome variables, caregiving competence, loneliness, caregiver burden and depressive symptoms, were measured at the baseline, the 3-month follow-up and the 6-month follow-up.

Results

T-test results show no significant differences in any outcome measures at the baseline between the two groups. Compared to the control group, the intervention group had larger reduced scores in loneliness at the 3-month follow-up (p=0.047) and caregiver burden (p=0.057) and depressive symptoms at the 6-month follow-up (p=0.057). We did not identify any significant differences in caregiving competence changes identified between the intervention and control groups.

Conclusion

The pilot results indicate the potential effectiveness of empowering existing human resources of experienced caregivers in the same ethnic community in reducing stress of Chinese American dementia caregivers.
EAST MEETS WEST: INNOVATIVE APPROACHES TO GERONTOLOGY EDUCATION AND TRAINING
Authors: Inoue Megumi , Amano Takashi , Morrow-Howell Nancy
Published: December 2023

The global population is aging at an increasingly fast pace compared to past generations. Although the magnitudes and rates of aging in the United States and Japan differ, the drastic change in population structure has resulted in common challenges for both countries. One challenge is preparing people and society for living a long life while promoting well-being in old age for everyone. Combating ageism, delivering accurate information about aging, and encouraging people to have a balanced view of the aging process are all important topics for living in an aging society. Therefore, gerontology education and training plays a critical role. In this symposium, we will present examples of current efforts and research findings on aging education and training in both the United States and Japan. The first presenter will discuss their efforts on promoting gerontology education through redesigning communities with interdisciplinary collaboration in Japan. The second presenter will explain gerontology curriculum and degree programs in Japan. The third presenter will introduce an international gerontology education course designed for United States graduate students. The last presenter will report findings from a scoping review on intergenerational activities in higher education. Implications for future gerontology education will also be discussed.
HOW CAN WE ADVANCE THE FIELD OF GERONTOLOGY BY LEVERAGING OUR LIVED EXPERIENCES AS GERONTOLOGISTS AND GERIATRICIANS?
Authors: Donorfio Laura
Published: December 2023

Reflecting on my development as a professor of gerontology has become a normative part of my mid-life career. Through this reflection, I have identified 4 stages of career progression, none of which were planned nor anticipated. I have labeled the stages: 1. Content and Logistics; 2. Confidence and Innovation; 3. Generativity and Meaning; and 4. Being the Other. This last stage, which I presently float in and out of, has made me very aware that my teaching about aging has intersected with my personal aging and unexpectedly, has shaped my personal pedagogy in profound ways--increased empathy, sensitivity, and social awareness. I am living the subject matter I thought I intimately knew. I am the other. Has my teaching been inauthentic? Hypocritical? Ageist? Aging and ageism are now personal. Others have written about this mental transition or awakening (Brody, 2010; Cohen et al., 2022; Greenberg, 2022; Pruchno, 2017; Scheidt, 2017), but very little scholarship has been directed towards this phenomenon. O’Neill (2016) also brings attention to this shares, “Although geriatric medicine is widely perceived as an advocate for older people, it is striking how little scholarship has been directed towards the attitudes and personal beliefs of geriatricians toward ageing and, in particular, towards their own future narratives.” This presentation will draw from the existing literature to frame this emergent 4th stage of career progression and begin the discussion about how this insight can be leveraged to advance the fields of gerontology/geriatrics and teach the next generation of scholars.
QUALITY OF CARE INTERACTIONS IN ACUTE CARE
Authors: McPherson Rachel
Published: December 2023

Care interactions are verbal or nonverbal exchanges between staff and patients and promote quality of care and optimize outcomes for hospitalized patients living with dementia. Care interactions vary regarding quality and are differentiated between positive interactions (e.g., interactions that provide beneficial companionship or appropriate care communication for residents), neutral interactions (e.g., brief, indifferent interactions), or negative interactions (e.g., interactions that restrict residents due to safety concerns or interactions that are restrictive for no justified reason). Patients exposed to negative care interactions, particularly those that are living with dementia, are at risk for negative outcomes such as increased resistiveness to care, anxiety, depression, and apathy. The Quality of Care Interactions Survey (QuIS) is an observation measure used to evaluate interactions between staff and patients based on definitions of positive social, positive care, neutral, negative protective, or negative restrictive interaction. Scores range from 0 to 7, with higher scores indicating more positive care interactions between staff and residents. Nursing interactions with the first 365 patients in the FFC-AC-EIT study indicated that on admission the majority of the care interactions were positive (82%), half were neutral (50%), and a small percentage were negative protective (7%) and negative restrictive (6%). By discharge, there was a decrease in neutral interactions to 47%, negative protective to 6% and negative restrictive to 5%. Ongoing oversight and education is needed to decrease neutral and negative interactions between staff and patients using techniques provided in our function focused care intervention.
DEFINING METABOLIC BALANCE BETWEEN SUGAR AND FAT METABOLISM, AND THEIR ROLES IN DEVELOPMENT AND FERTILITY”
Authors: Henne Mike
Published: December 2023

Animals store excess nutrients in two major forms: triglycerides (TGs) held within lipid droplets (LDs) and carbohydrates in the form of glycogen. These nutrient reserves can serve specialized roles in animal development and homeostasis, but how they uniquely contribute to animal growth, bioenergetics, aging, and fertility is poorly understood. Furthermore, it is unclear how loss of one nutrient storage pool influences the other, and whether metabolic remodeling can occur to bypass loss of fat or carbohydrates. Here, we utilize Drosophila as a genetically tractable model system to dissect the tissue-specific contributions of fat and glycogen storage in animal development and fertility. We define metabolic remodeling in carbohydrate metabolism that occurs in Drosophila models nearly devoid of fat. Intriguingly, we find that loss of specific LD subpopulations in the Drosophila fat body lead to metabolic remodeling of carbohydrate metabolism, as well as alterations in female fertility and development. Our work indicates functional crosstalk and active sensing between fat and carbohydrate pools, and indicates that animals can re-wire nutrient storage pathways to facilitate development.
INTERDEPENDENCE OF CYTOSOLIC PROTEOSTASIS, LYSOSOMAL ACIDIFICATION, AND MITOCHONDRIAL FUNCTION
Authors: Zhou Chuankai (Kai)
Published: December 2023

Loss of proteostasis, mitochondrial dysfunction, and lysosome defects are conserved hallmarks of aging. One common consequence of cytosolic proteostasis stress is the formation of protein aggregates that are attached to the mitochondrial outer membrane. It remains unknown why cytosolic protein aggregates are attached to the mitochondria. Here we show that Tom70, a conserved receptor for mitochondrial import, moonlights to nucleate the aggregation of cytosolic proteins through some of the newly synthesized mitochondrial proteins. As the cytosolic accumulation of these aggregate-nucleating mitochondrial proteins causes proteostasis stresses, cells balance their import and synthesis through a TOM70-FKH1/2 pathway to regulate the biogenesis of mitochondrial proteins. The reduction of Tom70 during aging causes age-dependent mitochondrial defects in the biogenesis of mitochondrial proteins and attachment of cytosolic protein aggregates, both of which can be rescued by overexpressing TOM70. Additionally, we observed an unexpected rescue of vacuole/lysosome dysfunction in the cells with mitochondrial function preserved during aging. Further investigation revealed a novel conserved mitochondria-to-vacuole/lysosome axis of organelle crosstalk. Our results estabslih novel connections among different cellular compartments related to three hallmarks of aging.
CAREGIVING EXPERIENCES OF ADULT DAUGHTERS WITHOUT SIBLINGS IN UFA, RUSSIA
Authors: Ermoshkina Polina , Kahana Eva
Published: December 2023

This study is focused on the informal caregiving experiences of a unique group of women: only children of single mothers from Ufa, a metropolitan city in the Ural Mountains. Twenty middle-aged (M=40.75, SD=3.43), college-educated women participated in a two-hour, semi-structured interview. The average age of care recipients (mothers) was 65.3 (SD=3.85). Since the retirement age in Russia is 55 for women and 60 for men, all care recipients were retired. Inductive thematic analysis revealed three themes: incongruence of mothers’ needs with the microenvironment, aging in the “cement box,” and distrust of outsiders. Previous studies found that person-environment congruence is a determinant of older adults’ well-being. A discrepancy between older adults’ needs and preferences and environmental presses can become a source of chronic stress. This study found that both microenvironment (apartments) and larger environmental units (apartment buildings and neighborhoods) were incongruent with the needs of both older women and their caregivers. The majority of the housing stock in Russia is from the Khrushchev era: five-story buildings with no elevators or nine-story buildings with one small elevator. Older adults are trapped in their apartments due to steep stairs and a lack of elevators. Furthermore, adult daughters had to deal with conflicting cultural values and norms of care including the daughter’s duty and moral obligation to care for the aging parents and their own work-related and personal needs. Mothers’ dissatisfaction, in spite of daughters’ best efforts, resulted in unsatisfactory caregiving efforts and frustration by both caregivers and care receivers.
THE IMPACT OF GRANDCHILD PROBLEMS ON CORESIDENTIAL GRANDMOTHERS’ SITUATIONAL APPRAISALS
Authors: Jeanblanc Alexandra , Musil Carol
Published: December 2023

The lives of coresidential grandmothers and their families are often complicated by grandchild health, behavioral, and educational problems Using data from a nationwide sample of 342 American grandmothers living with and raising grandchildren, we examine the effect of grandchild physical, behavioral, and educational problems on co-residential grandmothers’ appraisals of: how positive their living situation is for themselves and for their grandchildren and their self-appraised stress and reward related to living with and caring for grandchildren. Participants lived with 1-7 grandchildren under the age of 18 (mean=1.82, SD 1.04), and grandchild problems were dichotomized on the basis of whether they were reported for any co-residential grandchild. We ran independent t-tests comparing grandchild problems against participants’ responses to the 4 situational appraisals (measured on a 10 point visual analog scale). The presence of grandchild health problems did not affect grandmother’s appraisal of their own living situation or their caregiving reward, but was significantly associated with a lower mean appraisal of how positive their living situation was for their grandchildren (8.39vs8.80) as well as higher reported caregiving stress. Grandchild behavioral problems were significantly associated with lower appraisals of grandmother’s own living situation (6.69vs7.53), grandchild living situation (8.45vs8.91), lower caregiving reward (7.36vs8.31)and higher caregiving stress (8.09vs6.81). Educational problems were significantly associated with lower appraisals of grandmother’s own living situation (6.70vs7.34), grandchild living situation (8.18vs8.93), lower caregiving reward (7.41vs8.06)and higher caregiving stress (8.18vs7.06). These analyses show the complex interaction between grandchild problems and grandmother perceptions of their own and their grandchildren’s’ lives.
A SPOTLIGHT ON ADAPTATION: PREIMPLEMENTATION OF MONTESSORI-BASED APPROACHES IN VA LONG-TERM CARE
Authors: Madrigal Caroline , Mills Whitney , Pimentel Camilla , Hartmann Christine , Snow A Lynn , Camp Cameron , Hilgeman Michelle
Published: December 2023

Effectively adapting evidence-based interventions for nursing home (NH) implementation is a critical, yet under-examined, component of improving care quality. Montessori-based activity programming (MAP) is an evidence-based intervention that promotes person-centered care, engages persons living with dementia, and mitigates distress behaviors. Currently, there is sparse examination of MAP in Department of Veterans Affairs NHs (i.e., Community Living Centers, CLCs). We report on the use of the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to track adaptations made to MAP – providing a pre-implementation exemplar for NH clinicians and implementation scientists. Qualitative and quantitative data were collected across two phases (i.e., pre-implementation and pilot implementation) at eight VA CLCs between 2017-2019. We used an iterative, rapid content analytic approach to triangulate findings across data sources (e.g., advisory panel, staff interviews, training evaluations, field notes, fidelity assessments) and identify needed adaptations for the CLC setting and population. More than 300 frontline VA CLC staff participated in qualitative interviews and/or provided feedback on quantitative staff training. Thirty-six adaptations were made. Most adaptions occurred during the pre-implementation phase, were reactive, focused on training/evaluation, and involved researchers, intervention developers, and practitioners. All were fidelity-consistent with MAP. The most common goal across adaptations was increased reach/engagement of the intervention. CLCs and community NHs can use findings to support intervention adaptation, and adapt and implement MAP to improve meaningful engagement for persons living with dementia and other residents. Future research should further evaluate and standardize FRAME for diverse users of complex interventions.
THE EFFECT OF INCOME SECURITY IN OLD AGE ON HEALTH OUTCOMES: A COMPARISON BETWEEN CHINA AND THE US
Authors: Wu Heng
Published: December 2023

This paper examines the social determinants of health, particularly the social, political, and economic context of socioeconomic status and health outcomes. Many studies on the political economy of health have highlighted the effects of welfare states on health and health inequalities, typically using welfare state regimes as proxies for social policies. Few research studies have described the association between frailty phenotype and financial wellbeing, however, particularly considering the three-legged stool of retirement income security (public pensions, private pensions, and personal savings/assets) across different welfare state regimes. This study investigates the effects of old-age income disparities on frailty among older adults in the United States and China. Specifically, this paper examines the associations between different sources of old-age income (public and private pensions, personal savings and assets, earnings, workplace subsidies, worker’s compensation, household subsidies, and unemployment insurance benefits) and the five-item frailty phenotype from the RAND Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS). The findings reveal that health outcomes measured by the Fried’s frailty phenotype vary considerably by country and income type.
RISE: A CONCEPTUAL MODEL OF INTEGRATED AND RESTORATIVE ELDER ABUSE AND SELF-NEGLECT INTERVENTION
Authors: Burnes David , Connolly M T , Salvo Erin , Kimball Patricia , Rogers Geoff , Lewis Stuart
Published: December 2023

Despite a growing number of elder abuse and self-neglect (EASN) cases nationwide, community-based EASN response programs such as Adult Protective Services (APS) lack a conceptually driven, defined, prolonged intervention phase to address these complex situations. This presentation provides a conceptual overview and developmental description of RISE, a community-based model of EASN intervention that works alongside APS or other systems that interact with older adults who are at risk of or experiencing EASN. RISE was developed in consultation with APS caseworkers and supervisors, as well as practitioner and research stakeholders and experts from numerous sectors in Maine and nationwide, building bridges among varying stakeholders. Informed by ecological-systems, relational, and client-centered perspectives and adapting evidence-based or promising modalities from other fields (including motivational interviewing, restorative justice, teaming, supported decision making, goal attainment scaling, and engagement), the RISE model intervenes at levels of the individual older adult victim and others, including the alleged harmer, their relationship, and the systems of informal and formal support surrounding the victim-harmer dyad. The RISE model addresses an intervention gap in response systems to better meet the wishes and needs of EASN victims and others in their lives, leading to more sustainable outcomes. RISE has fostered new research partnerships between researchers and community advocates, who have become both research allies and contributors. RISE supports people with cognitive impairment to make their own decisions. RISE also empowers both older people and younger people in their lives, motivating change, and strengthening and restoring the relationships among them.
OUT OF THE MEDICINE CABINET: NONPHARMACOLOGICAL APPROACHES TO IMPROVE COGNITION AND ASSOCIATED FUNCTIONS
Authors: Curtis Ashley , Visovsky Constance
Published: December 2023

There is a lack of pharmacological agents for improving cognition, and the negative impact of polypharmacy on cognitive and physiological functioning in aging adults is well established. This has prompted investigation of non-pharmacological interventions aimed at improving cognition and associated functions. This symposium will provide a comprehensive evaluation of several of these promising evidence-based behavioral approaches. Paper 1 will describe several computerized cognitive training programs for improving cognition and sleep in middle-aged and older adults. Paper 2 will evaluate short-term complex music training versus music listening on cognitive function in older adults. Paper 3 will describe the impact of cognitive behavioral and virtual reality treatments for insomnia on sleep, cognition, arousal, and mood in several primarily middle-aged and older adult populations with chronic insomnia. Paper 4 will examine physical differences in gait function of older adult breast cancer survivors, providing insight into fall risk indicators, and targets for behavioral intervention. Paper 5 will describe results from a randomized clinical trial evaluating a mindfulness-based stress reduction for improving self-reported and objective cognition as well as fatigue. As Discussant, Dr. Constance Visovsky will integrate research findings and discuss areas for future research investigation. In sum, this symposium will provide unique insight into the impact of alternative approaches ‘beyond the medicine cabinet’ for improving not only cognition, but other areas of associated functioning in mid-to-late life. Thus, this session will help to inform interventions that can be delivered online and in the community to help mitigate risk and/or delay onset of cognitive decline.
SHORT-TERM MUSIC TRAINING ENHANCES INHIBITION IN AGING
Authors: Bugos Jennifer
Published: December 2023

Music training was shown to benefit inhibition in adults; however, little is known about the benefits of specific types of music training and the dosages necessary to demonstrate gains in older adults. Based on the ADAM model, professional musicians use predictive temporal extrapolation to anticipate and perform coordinated bimanual movements. We applied this model to beginning adult musicians by isolating the effects of bimanual coordination when compared with non-motor standardized music interventions. We evaluated the effects of two standardized music programs (piano training, music listening instruction) on inhibition in novice adults after four-week intervals. Older adults (N=18) were recruited and randomly assigned to a manualized piano program (Keys to Staying Sharp) or music listening instruction (Music Listening Today, standard protocol). Participants completed a battery of standardized measures including measures of inhibition (Flanker, Cued Color Word Stroop) at pretesting and at each of the three follow-up intervals: 4 weeks, 8 weeks, and 12 weeks. Results of a Repeated Measures Group X Time ANOVA for the first four months of training showed reduced error rates, F(1, 14)=6.48, p=.023, and faster reaction times, F(1, 14) =5.27, p=.038 for piano training as compared to music listening instruction. Increased differences were prominent after eight-weeks of training for the piano group as compared to music listening. Data suggests that music training interventions while manualized are not created equal. Benefits from complex music performance are evident after short-term manualized music interventions. Short-term bimanual music interventions may increase cognitive performance beyond music listening instruction due to cognitive load.
PERCEIVED AGE DISCRIMINATION IN THE SECOND HALF OF LIFE: AN EXAMINATION OF AGE, PERIOD, AND COHORT EFFECTS
Authors: Ayalon Liat , Bramajo Octavio
Published: December 2023

The present study aimed to examine variations in perceived age discrimination in the second half of life. Perceived age discrimination is different from objective age discrimination as it depends on respondents’ recognition, acknowledgement, and willingness to report the discriminatory event. We adopt a comprehensive approach which examines whether perceived age discrimination varies by age (chronological time from birth), period (when data were collected), or cohort (a group of people with shared life events experienced at a similar age) across gender and ethnic origin. Relying on psychosocial data from Health and Retirement Survey between 2006 and 2018. Our findings show that perceived age discrimination increases with age. In addition, older cohorts of women are more likely to report perceived age discrimination, whereas White women born around 1940 are less likely to report perceived age discrimination. White men, in contrast show a slight increase in perceived discrimination. Results are discussed from an intersectional perspective, which considers societal life course events.
IN THEIR OWN WORDS – HOW STUDENT RESPONSES TO OPEN-ENDED QUESTIONS CAN IMPROVE GERONTOLOGY EDUCATION
Authors: Sadeq Nasreen
Published: December 2023

In gerontology education, we know that there are many benefits to assigning students open-ended questions. They allow students to think more critically and can lead to a better understanding of course concepts. Student responses can also help us identify gerontology topics that are not well understood or need reinforcement, as well as topics that can generate interesting in-class discussions. Examining students’ answers can help us fill the gaps in current gerontology education and improve our teaching practices. In this lecture, I will share how I have used content analysis to examine students’ responses from several assignments, and how I have modified lectures and assignments in response. In addition, I will share how I have added some of these assignments to our general education gerontology courses to help students challenge ageist beliefs and acquire an appreciation for gerontology.
HEALTH AND AGING AMONG LATIN AMERICAN OLDER ADULTS: FINDINGS FROM STUDIES IN BRAZIL, CHILE, COLOMBIA, AND MEXICO
Authors: Osuna Margarita Maria , Ailshire Jennifer
Published: December 2023

Aging in Latin America is occurring rapidly, in a context of high levels of poverty, low education and limited knowledge on the health conditions of older adults. This symposium is focused on heath-disparities found in some of Latin America’s largest middle-income countries, Mexico, Brazil, Chile, and Colombia. The symposium explores various health-related topics associated with aging, that may have significant implications for longevity, overall health, and disease risk. The papers in this symposium examine a variety of health-related dimensions and disparities among older Latinos that include major chronic health conditions, such as diabetes, hypertension, cardiovascular diseases and cognition. Using data from the Brazilian Longitudinal Study of Aging, Farina examines the relationship between childhood conditions and older adult health. Using the Mexican Health and Aging Study (MHAS) and the Health and Retirement study (HRS), Cantu compares cognitive measures and their association with gender in Mexico and the US. Using mortality data, Sandoval studies how healthy life expectancy varies among the largest indigenous group in Chile compared to non-indigenous populations. Lastly, Osuna uses data from the Colombian Survey of Health, Well-Being, and Aging to examine how diseased life expectancy varies from self-reported data compared to measured data among older Colombians. Results underline what populations in Latin American have increased risk of experiencing poorer health outcomes and disparities that may exist. The findings highlight the importance of understanding the conditions under which Latin American older adults are aging and the implications this can have in the future.
ESTIMATING CARDIORESPIRATORY FITNESS USING A USUAL-PACED 400 M–LONG DISTANCE CORRIDOR WALK IN OLDER ADULTS
Authors: Moffit Reagan , Cawthon Peggy , Goodpaster Bret , Toledo Frederico , Forman Daniel , Nicklas Barb , Newman Anne , Glynn Nancy
Published: December 2023

Cardiopulmonary exercise testing (CPET) is the gold standard to measure cardiorespiratory fitness (CRF), assessed as peak oxygen consumption (VO2peak), yet is not always feasible in older adults due to cost, safety, and participant burden. Usual-paced 400-m Long Distance Corridor Walk (LDCW), a measure of mobility, may be an alternative to traditional CPET. We examined whether usual-paced 400-m LDCW was associated with VO2peak among older adults using cross-sectional data in SOMMA. Participants (N=820, age = 76.2±4.9, 58% women, 86% White) completed a usual-paced 400-m LDCW (seconds) and a treadmill CPET using a modified symptom-limited protocol at baseline. VO2peak (mL/kg/min) was defined as the highest 20-second average O2 consumption achieved during CPET. Mean VO2peak was 20.2±4.8 mL/kg/min and mean usual-paced 400-m LDCW time was 388.8±69.7 seconds. Usual-paced 400-m LDCW time was moderately inversely correlated with VO2peak (r=-0.52, p<0.0001). Potential covariates considered for the step-wise linear regression included age, sex, body mass index (BMI), Borg Rating of Perceived Exertion (RPE, range 6-20) at end of usual-paced 400-m LDCW, min/week moderate-vigorous physical activity (MVPA, CHAMPS questionnaire), 4-m gait speed, and Short Physical Performance Battery (range 0-12). The final parsimonious model included usual-paced 400-m LDCW time, age, sex, BMI, RPE, and MVPA. Every 30-second higher usual-paced 400-m LDCW time was associated with a 1.98 mL/kg/min lower VO2peak (p < 0.001), explaining 30.5% of the 55.7% total variance in VO2peak. Usual-paced 400-m LDCW was a strong estimator of CRF (VO2peak) after adjustment, providing an inexpensive and safer alternative among older adults across ranges of physical function and fitness.
FEASIBILITY OF A COMMUNITY-LEVEL PHYSICAL ACTIVITY STRATEGY FOR OLDER ADULTS WITH MOTORIC COGNITIVE RISK SYNDROME
Authors: Reid Kieran
Published: December 2023

The motoric cognitive risk syndrome (MCR) is a pre-dementia syndrome characterized by slow walking speeds and subjective memory complaints. To date, the feasibility of a community-based physical activity (PA) program for improving outcomes in MCR has not been examined. To address this knowledge gap, we conducted a translational randomized controlled trial (RCT) of 24-weeks of PA or a healthy aging education (HE) control intervention delivered within the existing infrastructure of an urban senior center in Greater Boston. A senior center employee was trained to administer the multimodal group-based PA program that included moderate-intensity aerobic walking, strength, flexibility and balance training. A total of 79 older adults attended the senior center for a screening visit of whom 25 met the MCR criteria and were randomized to PA or HE (mean age: 74.4 ± 7 yrs; BMI: 32.4 ± 7 kg/m2; 85% female; 3MSE score: 92.4 ± 7; gait speed: 0.52 ± 0.1 m/sec; SPPB score 4.8 ± 1.9). Due to COVID-19 the study was terminated early, however participants successfully completed baseline and follow-up study assessments that included objective tests of physical function and an iPad-based cognitive testing battery. Participants could appropriately adhere to the study interventions (overall attendance rate: PA: 69.3% vs. HE:70.1% at study termination). No study-related adverse events occurred. Trends for improved executive cognitive performance were exhibited in PA compared to HE. Our study provides important preliminary information to aid the design of larger-scale RCTs to preserve the independence of vulnerable older adults with MCR in community-based settings.
SERUM SOLUBLE ALPHA-KLOTHO AND COGNITIVE FUNCTIONING IN OLDER ADULTS AGED 60 AND 79
Authors: Ge Song , Dong Fanghong , Tian Chong , Wei Jingkai
Published: December 2023

Objectives

We aimed to examine the association of serum soluble alpha-klotho with cognitive functioning among older adults using a nationally representative sample of U.S. older adults. Method: A total of 2,173 U.S. older adults aged 60-79 years in the National Health and Nutrition Examination Survey 2011 to 2014 were included. Serum soluble alpha-klotho was measured in the laboratory. Cognitive function was measured using the Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest (CERAD-WL) immediate and delayed memory, the Animal fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Test-specific and global cognition z-scores were calculated based on sample means and standard deviations. Multivariable linear regression models were applied to examine the association of quartiles of serum soluble alpha-klotho with test-specific and global cognition z-scores. Subgroup analysis was conducted by sex. The following covariates were included in the analysis- age, sex, race/ethnicity, education, depressive symptoms, smoking status, body mass index (BMI), physical activity, stroke, prevalent coronary heart disease, total cholesterol, and systolic blood pressure.

Results

Serum soluble alpha-klotho level in the lowest quartile was associated with lower z-scores for DSST (beta [β] =-0.13, 95% confidence interval [CI]: -0.25, -0.01). For subgroup analysis, serum soluble alpha-klotho level in the lowest quartile was associated with lower z-scores for DSST (β=-0.16, 95% CI: -0.32, -0.003) and global cognition (β=-0.14, 95% CI: -0.28, -0.01) among female participants. No significant association was found among male participants.

Conclusions

Lower serum soluble alpha-klotho level was associated with poorer cognitive functioning among older women.
LONGITUDINAL USE TRAJECTORIES OF SEDATIVE-HYPNOTICS AND RISK FOR DEMENTIA AMONG MEDICARE BENEFICIARIES
Authors: Kaufmann Christopher , Jones Bobby , Wang Grace Hsin-Min , Fernandes Deanna , Shorr Ronald , Lo-Ciganic Wei-Hsuan
Published: December 2023

Research suggests use of sedative-hypnotic medications (Benzodiazepines [BZDs; e.g., diazepam] and non-BZD hypnotics [e.g., zolpidem]) to be associated with incident Alzheimer’s disease and related dementias (ADRD). We identified longitudinal dose and duration use patterns of these medications and their associations with ADRD risk. This retrospective cohort study used 2016-2018 claims data from a 15% national sample of fee-for-service Medicare beneficiaries and included beneficiaries aged ≥65 years initiating use of a) BZDs only, b) non-BZDs only, or c) BZDs+non-BZDs concurrently. We excluded beneficiaries with ADRD diagnosis 6 months before and 12 months after first BZD/non-BZD prescription date. Based on average weekly diazepam milligram equivalent dose (low: <15, moderate: 15-30, high: >30), we used group-based multi-trajectory models to identify distinct trajectories of BZD/non-BZD use over 12 months after initiation (i.e., trajectory period). We estimated risk of time to first occurrence of ADRD after trajectory period associated with these trajectories using inverse propensity score weighted Cox proportional hazards models. Among 131,574 beneficiaries (mean age=74 years, 68% female, 89% White), we identified 11 trajectories (4 BZD only [78% of cohort], 4 non-BZD only [18%], and 3 concurrent users [4%]). Compared to beneficiaries with low-dose discontinuing non-BZD only use, trajectories associated with an increased risk of ADRD included: stable moderate-dose BZD use with concurrent stable low-dose non-BZD use (HR=2.28, 95%CI=1.62-3.21) and high-dose declining BZD only use (HR=1.57, 95%CI=1.26-1.96). Results highlight a need to assess not only patterns of BZD and non-BZD use alone, but also concurrent use, when considering risk for ADRD.