bluuebunny/crossref_metadata_2025 huggingface dataset:
CHARACTERISTICS OF OLDER ADULTS' LEISURE ACTIVITIES: A DAILY DIARY INVESTIGATION
Authors: Tian Junyan , Stephan Abigail , Ross Lesley
Published: December 2022

Leisure activity engagement in older adults’ daily lives is well-documented, however, relatively few studies include participant-reported activities using prospective daily diary methods. The goal of the study was to examine the proportion of three types of reported leisure activities and how physical health moderated such activities. Two weeks of self-reported leisure activities examined among healthy sedentary community-dwelling adults from the Cognitive and Physical Exercise Study (N=33, 65-81 years, 442 unique data points). Each day, participants listed leisure activities performed, estimated time spent on each activity, and labeled the activities as cognitive, physical, and/or social. Physical health was assessed by the SF-12 at baseline. Across 14 days, 25.14% of reported activities were labeled as cognitive activities, 26.61% were labeled as social activities, and 22.97% were labeled as physical activities. Multilevel models indicated participants’ engagement in different domains of activities were not influenced by physical health and did not change over time.
DIVERSITY, DISCOVERY, AND AGING REIMAGINED: NIA SESSION FOR EARLY-CAREER RESEARCHERS
Authors: Kelley Melinda , Kelley Melinda
Published: December 2022

The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, supports biomedical and behavioral research with a lifespan focus. NIA research seeks to understand the basic processes of aging, improve prevention and treatment of diseases in later life, and improve the health of older persons, in addition to a focus on Alzheimer’s disease and related dementias. NIA also supports the training and career development of scientists focusing on aging research and the development of research resources. This symposium, meant for junior faculty and emerging scholars, will provide an update on the latest research findings from NIA followed by a segment on funding mechanisms and strategies. An opportunity will be provided to meet and consult with NIA extramural staff.
COGNITIVE DIFFICULTIES AMONG ASIAN AMERICAN OLDER ADULTS: RESULTS FROM THE AMERICAN COMMUNITY SURVEY
Authors: Nguyen Duy , Liu Rui , Lee Yookyong
Published: December 2022

While Asians are the fastest growing racial group in the United States, limited research exists on their health needs, especially among older adults. Cognitive difficulties increase disease and caregiving burdens, but little is known about patterns of cognitive health among Asian American older adults. This study fills the knowledge gap by using data from the 2015-2019 American Community Surveys to examine the relationship between Asian ethnicity and gender on cognitive health. This analysis focuses on respondents aged 65 and over from the six most populous Asian American groups: Chinese, Filipino, Indian, Japanese, Korean, and Vietnamese (n=100,538). Weighted, adjusted logistic regression analyses tested for the effects of Asian ethnicity and gender on cognitive difficulties. Multivariate analyses showed Filipino, Indian, and Vietnamese older adults were more likely than Chinese to report cognitive difficulties. Additionally, Asian American women were more likely to report cognitive difficulties compared to Asian American men. Joint effect analyses were statistically significant, thus we examined separate regression analyses by Asian ethnicity. Results showed that Vietnamese women were more likely than Vietnamese men to report cognitive difficulties. Across Asian ethnic groups, family relationships and economic factors play a major role in having a cognitive difficulty. Overall, the results suggest that ethnic-specific analysis of the Asian American reveals a fuller picture of health in older adulthood. Future research needs to dive more deeply into the sociocultural and economic dimensions of health. Further, culturally appropriate policy and practices are needed to promote successful aging among older Asian Americans.
A CONCEPTUAL MODEL OF ORGANIZATIONAL READINESS FOR IMPLEMENTATION OF EMBEDDED PRAGMATIC DEMENTIA RESEARCH
Authors: Boltz Marie , Van Haitsma Kimberly , Baier Rosa , Sefcik Justine , Hodgson Nancy , Kolanowski Ann
Published: December 2022

Organizational readiness for implementation refers to the collective willingness and efficacy of people, processes, and internal and external contexts within study sites to implement an intervention; it is a salient consideration when planning and conducting embedded pragmatic trials. This paper examines the conceptual and theoretical underpinnings of organizational readiness for implementation and the operationalization of the construct. We synthesize the literature to offer a conceptual model for explicating and measuring organizational readiness for implementation and describe the unique characteristics and demands of implementing evidence-based interventions targeting persons with dementia and/or their care partners. Our model was derived from the Consolidated Framework for Implementation Research (CFIR), and Weiner’s Determinants and Outcomes of Organizational Readiness for Change. We discuss how it can serve as a guide when planning and conducting embedded pragmatic implementation trials in settings that care for persons with dementia.
ACHIEVING SUSTAINABILITY IN HOUSING WITH SERVICES: INSIGHTS FROM R3 PROGRAM
Authors: Nadash Pamela , Miller Edward , Simpson Elizabeth , Wylie Molly , Shellito Natalie , Lin Yan , Jansen Taylor , Cohen Marc
Published: December 2022

There has been a long-standing interest in developing housing models that integrate the supportive services that older people need to remain at home as long as possible. This approach has boomed for better-off people who can afford the cost of private-pay independent living and assisted living environments. For those with fewer resources, however, options are limited, given that they are largely dependent on public financing. This study focuses on how to develop sustainable models of housing with services for low-income older people. Using data from 31 key informant interviews and three focus groups, it reports and analyzes expert perspectives on how programs such as R3 can achieve financial sustainability. Four major themes emerged: (1) funding as the key to sustaining housing with services; (2) funding housing with services through participating health plans; (3) other potential funding sources for housing with services; and (4) gaining buy-in for housing with services.
WHEN AND WHERE: LESSONS LEARNED ABOUT TECHNOLOGY FROM AN INTERVENTION FOR CAREGIVERS OF PERSONS WITH HEART FAILURE
Authors: Saylor Martha Abshire , Clair Catherine , Pavlovic Noelle , Nelson Katie , DeGroot Lyndsay , Taylor Janiece , Szanton Sarah
Published: December 2022

Use of technology in older adult populations is growing, therefore it is important to understand opportunities for healthcare initiatives that support older adults using technology. The aim of the pilot study was to test Caregiver Support, a self-care and social support intervention, for caregivers of persons living with heart failure (N=24). Originally, the protocol was designed with in-person visits. We expected this option to reduce participant burden: the caregiver would not have to travel, and the interventionist would gain more insight about the home context to aid with intervention delivery. However, due to the COVID-19 pandemic, it became necessary to conduct the visits virtually. All participants completed the 5-component intervention via virtual meeting and there were no dropouts related to technology use. When asked about the virtual modality, participants emphasized the flexibility of virtual meetings. In summary, the intervention visits conducted virtually were perceived as a caregiver-centered approach.
INTRODUCTION TO THE STUDY OF MUSCLE, MOBILITY, AND AGING (SOMMA) AND PRELIMINARY RESULTS
Authors: Cummings Steven , Newman Anne
Published: December 2022

SOMMA is a new cohort study conducted at Wake Forest and University of Pittsburgh, coordinated by the San Francisco Coordinating Center, with management of biological specimens by Adventist Health Research Institute. We aim to discover the biological basis of mobility disability and have collected tissues and measurements for future studies of the biology of human aging. SOMMA has enrolled ~875 older men and women (aged □70 years), and will follow-up participants by phone and in-person every six months for up to three years. An additional cohort of younger adults (aged 30-69) is being enrolled. In this symposium, we will describe the underlying conceptual construct for the study; the baseline characteristics of the cohort; recruitment techniques to enroll participants. We will present preliminary data from ~425 participants, including the association between mitochondrial energetics and muscle function (strength and power); the interrelationship between physical and cognitive measures; and the association of D3Cr muscle mass with strength and walking speed. Finally, we will describe how to obtain data and specimens for analyses and ancillary studies.
PRELIMINARY SOMMA DATA: MITOCHONDRIAL ENERGETICS, LEG POWER, AND CARDIORESPIRATORY FITNESS
Authors: Mau Theresa , Coen Paul , Kritchevsky Stephen , Newman Anne , Distefano Giovanna , Hepple Russell T , Goodpaster Bret , Cummings Steven
Published: December 2022

To assess mitochondrial function, max OXPHOS (maximal complex I and II supported state 3 respiration) was determined in vitro by high-resolution respirometry of permeabilized muscle fibers from thigh muscle (vastus lateralis) biopsies, and ATPmax was determined in vivo by 31P magnetic resonance spectroscopy (n=468, mean=76.9yr). Max OXPHOS was strongly associated with leg power (β= 10.7 Watts per 1 SD increment, p<0.001) and peak VO2 (β= 83.7 mL/min, p<0.001). ATPmax had weak associations with leg power (β= 4.2 Watts per SD increment, p=0.13). In contrast to its weaker relationship with leg power, ATPmax was strongly associated with VO2 peak (β= 70.1 mL/min per SD increment, p<0.001). Skeletal muscle mitochondrial energetics were significant determinants of leg power and VO2 peak in older adults.
PRELIMINARY SOMMA DATA: D3CR MUSCLE MASS AND STRENGTH AND WALKING SPEED IN OLDER MEN AND WOMEN
Authors: Cawthon Peggy , Kritchevsky Stephen , Newman Anne , Mau Theresa , Hepple Russell T , Coen Paul , Goodpaster Bret , Cummings Steven
Published: December 2022

D3Cr muscle mass, grip strength, leg extension 1-rm max (Keiser), and walking speed (400m usual walk) were collected with standardized protocols. We calculated sex-stratified unadjusted Pearson correlation coefficients, and partial Pearson correlation coefficient adjusted for body size (height, weight). D3Cr muscle mass was positively correlated with grip strength (men: unadjusted r=0.28, p<.001; women: unadjusted r=0.16, p=0.02) and leg extension strength (men: unadjusted r=0.44, p<.001; women: unadjusted r=0.31, p<.001). D3Cr muscle mass was correlated with 400-m walk speed only after adjustment for body size among both men (partial r=0.29, p<.001) and women (partial r=0.16, p=0.02). Associations of total thigh muscle volume by MRI with strength and walking speed were of similar magnitude to the association between D3Cr muscle mass with strength and walking speed.
TWO DECADES EVALUATING EXERCISE TREATMENTS FOR ALZHEIMER'S DISEASE: THE ANECDOTES OF AN EVIDENCE-BASED PATH
Authors: Heyn Patricia
Published: December 2022

The last 20 years have produced accumulative evidence supporting the benefits of regular exercise to improve cognition in older adults with cognitive impairments (OAwCIs). Thus, multiple systematic reviews, including meta-analyses, have contributed to the current literature. Although the field advanced significantly our understanding of the role of exercise on AD, still there is limited information on the overall prescription effectiveness. Thus, a novel overview review to evaluate the available meta-analysis studies from the randomized exercise trials for OAwCI will help in synthesizing the best evidence to generate prescription precision. Dr. Heyn will discuss her path, her studies, and the future of AD research and exercise prescription.
AN INNOVATIVE MEDICAL LEGAL PARTNERSHIP TO SERVE COMMUNITY-DWELLING OLDER ADULTS
Authors: Lessem Rachel , Groman Tamara Kushnir
Published: December 2022

According to the Legal Services Corporation, each year, 56% of older adults have at least one civil legal problem yet 87% receive inadequate or no professional legal help for their civil legal problems. Unmet legal needs can have cascading catastrophic effects on the health and well-being of older adults. To address this, we took the innovative approach of creating a Medical-Legal Partnership (MLP) within a community based social service agency on aging. MLPs have been successful by addressing the social determinates of health. However, previous studies have not investigated MLPs aimed at older adults. We used a single arm, pretest-posttest design to investigate the effects and feasibility of providing legal services to community dwelling older adults. The MLP served over 88 clients referred both internally from the agency as well as external partners. The participants had a mean age of 73, (age range 45-98, n=88), were 60% female. African Americans represent 9% of the clients, 7% are Hispanic/Latino and 74% Caucasian. Additionally, 5% were veterans. 52% of clients were at or below the Federal Poverty line at baseline. 50% of clients reported greater financial stability as a result of legal services. 75% reported improved health of between 1 and 3 points on a 5 point likert scale (pre-test=2.75; post-test 3.9 p<.01). This pilot project demonstrates a successful intervention to work across professional silos coordinating lawyers, medical providers and social workers to better meet the legal needs of older adults by creating MLPs in social service agencies to support their well-being.
DOES RACE MATTER IN HEALTH MESSAGING? IMPACT OF RACE CONCORDANCE ON PALLIATIVE CARE KNOWLEDGE SCORE
Authors: Hoe Deborah , Zhang Mutian , Enguidanos Susan
Published: December 2022

Palliative care (PC) programs have expanded rapidly across the United States in the last decade. However, there remains a wide disparity in access to PC among ethnic minorities. Therefore, it is necessary and critical to develop specific health-related educational tools targeted for the vastly diverse, community-based older adult population. This study seeks to investigate how race concordance in health-related messaging might affect changes in PC knowledge scores among Black and White, English-speaking, community-based adults aged 50 and older. We recruited 406 Black and White adults online and from community-based sites. Sixty-four percent were shown race concordant patient stories, the remainder were shown videos of opposite race patients. Pretest-posttest study design was employed and participants completed a 20-question survey about PC knowledge, intent to seek PC, and perceptions about the videos. Regression analysis was conducted to test if race concordance improved knowledge after viewing patient stories.PC knowledge score (max=13) improved from an average of 5.70 to 11.23 (t=23.2, p< 0.001). Participants that watched same-race videos for both Black and White registered greater significant score increases (White:1.26±0.36 points, p=0.001; Black:0.95±0.38 points, p< 0.05) compared with those who watched different-race videos. Further, intent to enroll oneself in PC revealed statistically significant relationships in all groups except among White participants who viewed different-race videos (p=0.157, Fisher’s exact test, two-tailed). This study suggests that while PC role model stories improved PC knowledge across the board, the improvement is greater in race concordant groups, which also has implications for changes in intent to enroll in PC.
EVALUATING IMPLEMENTATION COSTS FOR A TRANSITIONAL PALLIATIVE CARE INTERVENTION TO SUPPORT RURAL CAREGIVERS
Authors: Kaufman Brystana , Holland Diane , Vanderboom Catherine , Ingram Cory , Chun Alice , Langan Erica , Baer-Benson Henry , Griffin Joan
Published: December 2022

Compared to urban caregivers, rural caregivers experience greater burdens accessing coordinated care for their loved ones during and after hospital discharge. The impact of technology-enhanced transitional palliative care (TPC) on patient and caregiver outcomes is currently being evaluated in a randomized control trial. This study evaluates resource use and health system costs of this caregiver-focused TPC intervention. Rural caregivers of hospitalized patients in Minnesota, Wisconsin, and Iowa were enrolled in an 8-week intervention consisting of video visits, conducted by a registered nurse, supplemented with phone calls and texts (n=207). Labor costs were estimated using the Bureau for Labor Statistics median hourly rate for a registered nurse and compared to a scenario analysis using a nurse practitioner or social worker wages. Hours spent conducting the visits and charting were calculated using study data. A one-way sensitivity analysis estimated resource use over a range of visits per caregiver and time per visit. Caregivers received 8.8 visits on average over the study period at 45 minutes per visit. In the base case, TPC cost $330 per caregiver facilitated by a registered nurse, compared to $281 and $489 if facilitated by a social worker or nurse practitioner, respectively. The number of visits had the greatest influence on total costs of the intervention (low of $198, high of $463). TPC is a feasible, low cost strategy to enhance caregiver support in rural areas. These results pose an opportunity to consider reimbursement mechanisms to evaluate the sustainability of transitional palliative care interventions to support caregivers.
AGING-RELATED HUMAN MONOCYTE TRANSCRIPTOMIC PATHWAYS PREDICT WORSENING MULTIMORBIDITY
Authors: Ding Jingzhong , Lohman Kurt , Bertoni Alain , Shea Steven , Post Wendy , Pankow James , Kritchevsky Stephen , Liu Yongmei
Published: December 2022

In a cross-sectional analysis, we identified aging-associated monocyte transcriptional modules associated with the multimorbidity in the Multi-Ethnic Study of Atherosclerosis (MESA) study. Here we examine whether these modules predict worsening multimorbidity over time. Transcriptomic profiles were determined in circulating monocytes from 1,264 MESA participants aged 55-94 (51% female, 53% minority). The multimorbidity index was defined as the number of prevalent diseases: cardiovascular disease, type-2 diabetes, hypertension, cancer, dementia, chronic kidney disease, chronic obstructive pulmonary disease, and hip fracture. The mean index at baseline was 1.0 (33%, 45%, and 22% with 0, 1, and 2-6 diseases respectively). At baseline, the index was associated with 5 co-expressed transcriptional modules (FDR< 0.05). During a 6-year follow-up, 449 individuals developed new morbidities. In Cox proportional hazards regression models, 4 (p< 0.05) of these 5 modules including those enriched for downregulation of apoptosis (RH=1.11 per SD increment, p=0.03) and upregulation of complement subcomponent C1q (RH=1.14, p=0.005) predicted incident morbid diseases after adjusting for age, sex, race/ethnicity, study site, and the baseline multimorbidity index. Persons having above the median expression of both modules developed an average of 0.63 new diseases, while those with both below the median developed an average of 0.40 new diseases. These two modules predicted increasing morbidities independently of one another and IL6 levels (p< 0.05). In conclusion, transcriptomic analysis of human immune cells provided evidence that decreased apoptosis and increased immune response predict the onset of a variety of age-related diseases. Whether targeting these pathways will change morbidity risk remains to be demonstrated.
EIGHT-YEAR CHANGES IN DEFICIT ACCUMULATION FRAILTY: RELATION TO GLYCEMIC CONTROL AND DIABETES MEDICATION USE
Authors: Simpson Felicia , Boyko Edward , Ferris Chloe , Justice Jamie , Kritchevsky Stephen , Mccaffery Jeanne , Pilla Scott , Espeland Mark
Published: December 2022

Type 2 diabetes mellitus (T2DM) has been linked to accelerated biological aging and the accumulation of health deficits. It is unknown whether glycemic control can slow the progression of aging, as expressed by deficit accumulation frailty indices (FIs). We examined the cross-sectional and longitudinal associations that glycemic control, diabetes medication use, and weight change (predictors) had with a FI calculated as the percent of 36 deficits in behavioral, functional, and clinical characteristics (outcome). We drew data from 4177 participants across 8 years of follow-up in the Look AHEAD clinical trial of a multidomain intensive lifestyle intervention in individuals aged 45-76 years with T2DM and overweight or obesity. At baseline, the means(SD) FI(as a percent) for participants grouped as HbA1c< 7%, 7-7.9%, and >8% were: 19.93(6.45), 20.82(6.89), and 21.53(7.27), p< 0.001. Compared with HbA1c>8%, HbA1c< 7% at baseline was associated with 23% less mean 8-year FI progression: 2.42(7.35) vs 3.14(8.02), p< 0.001). Maintaining average HbA1c< 7% vs >8% during follow-up was associated with 47% less 8-year FI progression: 2.05(7.35) vs 3.14(8.02), p< 0.001. With adjustment for HbA1c, sustained weight loss >5% compared with weight gain >5% was associated with an 81% reduction in 8-year FI progression: 1.18(7.25) vs 3.89(8.09), p< 0.001. Use of metformin across >50% of annual visits was associated with a 30% reduction in 8-year progression of FI as compared with less use or no use: 2.25(7.27) vs 3.22(7.90), p=0.002. We conclude that better control of HbA1c, and sustained weight loss (>5%) and metformin use, may slow the accelerated aging associated with T2DM.
PREPARING FOR THE FUTURE OF TECHNOLOGY TO SUPPORT OLDER ADULTS: PERSPECTIVES FROM THE CREATE CENTER
Authors: Heyn Patricia
Published: December 2022

The rapid advancement of technology promises new opportunities to help older adults maintain health, wellbeing, community and productive engagement, and purpose in life. However, the potential of technological innovation will not be met unless technology solutions account for the needs, preferences, and abilities of older users and involve older adults in all stages of the design process. This has been the primary focus of the Center for Research and Education on Aging and Technology Enhancement (CREATE). This symposium will discuss threats to the promise of these solutions and approaches to overcome these barriers. This session will start with N. Charness presenting an overview of digital inequity and the current state of the age-related "digital divide." J. Sharit will then present an experimental study examining older adults' willingness to adopt new technologies and attitudinal barriers to adoption. W. Boot will discuss CREATE research that has focused on the potential of virtual reality to improve the lives of older adults and potential facilitators and barriers to successful virtual reality experiences among older adults. W. Rogers will discuss the potential of voice interfaces for emerging technologies, challenges related to the success of this approach, and research gaps. Finally, S. Czaja will conclude with a broad discussion of future applications of technology to support older adults, including how developments in artificial intelligence, sensing technologies, and robotics that can be used to foster everyday activities, cognitive, physical, and emotional health.
ACHIEVING DIGITAL EQUITY FOR OLDER PERSONS WITH EMERGING TECHNOLOGY: THE CASE OF NORTH AMERICA
Authors: Charness Neil
Published: December 2022

The United Nations’ theme for the International Day of Older Persons 2021 was “Digital Equity for All Ages”. I define digital equity, then compare progress in North America, focusing on Canada, the USA, and Mexico for internet, smartphone, and broadband access. An age-related digital divide for internet and computer use, first identified in the USA in 1999, persists. Where year-to-year comparisons are available, I also discuss the impact of the pandemic on technology adoption. National data sets measuring internet use show that there are similarities and differences in the USA and Canada in factors influencing adoption. For smartphone ownership, Mexico showed gender differences favoring men, unlike the case in the USA and Canada. For broadband access in the USA inequity was seen as a function of age, race/ethnicity, education and income, and urban/rural residence. I discuss potential reasons for inequitable access and potential approaches to achieve greater equity.
OLDER ADULTS' WILLINGNESS TO ADOPT TECHNOLOGIES: AN EXPERIMENTAL STUDY
Authors: Sharit Joseph , Moxley Jerad , Czaja Sara
Published: December 2022

Understanding why older adults are willing to consider using technology is critical for ensuring that that the advantages of technology for improving the quality of their lives can be realized. Prior emphasis in this area has primarily been on questionnaire studies directed at capturing relatively general attitudes older adults have toward technology. We report on an empirical study that included 187 male and female adults 65-92 years of age who were given presentations on each of five technologies spanning domains that included transportation, leisure, health, and new learning. Each presentation was followed by a series of ratings on measures hypothesized to influence participants’ willingness to adopt the technology. We will overview the Technology Assessment Procedure, the methodology developed to evaluate willingness to adopt a technology, and measures that were collected. We will also present a model used to predict willingness to adopt the technology and provide some initial findings.
STRATEGIES FOR INTEGRATING ANTIRACIST PEDAGOGY INTO GERONTOLOGICAL EDUCATION
Authors: Karasik Rona , Kishimoto Kyoko
Published: December 2022

Talking about diversity in gerontology is not new. Documenting racial disparities among older adults is not new. So what is different about applying antiracist pedagogy to teaching about aging and why should gerontology educators embrace it? Anti-racist pedagogy seeks to move beyond simply incorporating racial content into gerontology coursework. It involves acknowledging structural racism’s existence and relation to aging, uncovering its root causes in historical and political context, and studying its impact not just over the life course, but from generation to generation. Anti-racist pedagogy challenges students to learn how racial disparities among older adults emerged, why they persist, and what can be done about them. Applying anti-racist pedagogy can also challenge gerontological educators, who must find/prepare appropriate materials, as well as engage students in work that is potentially unfamiliar and/or uncomfortable. This presentation offers some strategies, examples, and pitfalls to avoid when incorporating anti-racist pedagogy into the gerontological curriculum.
EXPLORING DEI IN A GLOBAL PERSPECTIVE: AGHE INSIGHTS INTO OUR WORK SUPPORTING GERONTOLOGY AND GERIATRIC EDUCATORS
Authors: Bradley Dana , Howe Judith
Published: December 2022

Gerontologists across the globe make a sincere effort to create a learning, teaching, and research space that promotes the dignity of older persons. Indeed, this impetus imbues our work where all are treated with dignity and respect. The authors (AGHE chair and past chair) reached out to international educators to better understand how AGHE is supporting their efforts and how we may do so in the future. Our starting point was the GSA policy on Diversity, Equity, and Inclusion (2021). These policies laid out a groundwork that embraces inclusive membership cultivates practices that build a culturally inclusive workforce, foster research practices, and ensure that people from disproportionately affected and marginalized communities thrive in GSA. This paper offers insight into how our international community is thinking about DEI and incorporating it into teaching, research and engagement work.
REIMAGINING ADRD IN CONTEXT
Authors: Ajrouch Kristine , Antonucci Toni , Martin Damali
Published: December 2022

This symposium embraces diversity and discovery to address contextual issues in aging, specifically issues of race and ethnicity in the study of cognitive health and Alzheimer's Disease and Related Dementia (ADRD). Rooks and colleagues compare dementia risk among African American and White men and women in the context of work using the longitudinal Health, Aging, and Body Composition data. They consider the effects of productive activities on dementia risk in gender stratified models, adjusting for socio-demographic and genetic factors. Siddiq and colleagues consider the contexts of migration. Using a multi-method approach, they establish priorities for interventions addressing ADRD risk among older adult immigrants and refugees from Afghanistan and the Middle-East and North Africa (MENA) in California. Sayed also investigates the context of migration, and uses qualitative data (N=31) to identify the psychosocial impact of COVID-19 on cognitive aging in Middle Eastern/Arab Americans immigrants and refugees in Michigan. Finally, Meier and colleagues consider contexts of metal exposure for cognitive decline among Latinos aged 65 and older using the Sacramento Area Latino Study on Aging. In total, this symposium highlights the benefits of reimagining contextual factors that influence ADRD to improve our understanding and the potential to reduce health disparities research in underrepresented racial and ethnic populations.
ALZHEIMER'S DISEASE AND RELATED DEMENTIAS RISK AND PSYCHOSOCIAL HEALTH NEEDS OF OLDER ADULT IMMIGRANTS AND REFUGEES
Authors: Siddiq Hafifa , Kayali Nahla , Ajrouch Kristine
Published: December 2022

To establish priorities for an intervention addressing Alzheimer’s Disease and Related Dementias (ADRD) risk among older adult immigrants and refugees from Afghanistan and the Middle-East and North Africa (MENA). A multi-methods Community-Based Collaborative Action Research design was employed to gather qualitative and quantitative data. Twenty community leaders and stakeholders participated in interviews and community needs survey responses of 124 ethnically diverse adults over age 55 were examined. We analyzed community needs survey data using descriptive statistics. A step-wise Thematic Analysis was used to analyze interview transcripts. A major theme and standout priority was identified: needing culturally-sensitive services and resources addressing social isolation among the elderly. Other psychosocial priorities included: accessibility needs, caregiving support, safety and end-of-life resources, digital literacy, and English language services. This study exemplifies a priority-setting partnership between clinician-researchers and refugee service providers. The priorities highlighted ADRD risk factors and guide the collaborative development of a community-based intervention.
IMPACT OF OBJECTIVE AND SUBJECTIVE SEP ON AGING TRAJECTORIES OF FUNCTIONAL CAPACITY
Authors: Finkel Deborah , Nilsen Charlotta , Sindi Shireen , Kåreholt Ingemar
Published: December 2022

Long-term stress is associated with adverse health outcomes in aging. It is important to identify not only factors that influence functioning in late adulthood, such as accumulated stress, but also the timing of such factors. The aim of the current analysis was to examine how socioeconomic stressors throughout the life course are associated with aging in functional capacity. Data were available from 740 adults ranging in age from 40 to 83 at intake (mean = 62.4, SD = 8.2) who participated in up to 8 waves of data collection (mean = 3.9, SD = 2.4). A Functional Aging Index (FAI) was created by combining measures of sensory, pulmonary, gait, and grip functioning. Both childhood and adulthood measures of objective socioeconomic position (SEP) and perceived SEP (financial strain) were available. Latent growth curve models (corrected for twinness) were used to estimate the trajectory of change in FAI over age and the impact of child and adult SEP measures on the trajectories. Results indicated that both childhood and adult objective SEP independently influenced rates of change in FAI in adulthood: higher SEP was associated with higher mean functioning and slower rates of decline. In combination, model fitting indicated that if SEP is above the median in adulthood, then childhood SEP has no impact on FAI trajectories; however, if SEP is below the median in adulthood, then childhood SEP can play a role. In addition, results indicated possible long-term effects of childhood financial strain on rates of change in FAI in adulthood.
COMMUNITY DISADVANTAGE AND WORKFORCE PARTICIPATION AMONG LATE MIDDLE-AGED MEDICAID BENEFICIARIES
Authors: Sneed Rodlescia
Published: December 2022

There have been numerous efforts to increase workforce participation among Medicaid beneficiaries in an effort to reduce program costs. We know little, however, about whether Medicaid beneficiaries with low workforce participation live in communities that support employment. The purpose of the current study was to determine if community disadvantage was associated with workforce participation among late middle-aged Medicaid beneficiaries, an age group that commonly faces difficulty entering the workforce. Participants were 1418 Medicaid beneficiaries ages 51-64 who participated in the 2016 wave of the Health and Retirement Study, a population-based study of community-dwelling adults aged >50. Community disadvantage was measured using the Social Vulnerability Index (SVI). We evaluated the association between community social vulnerability and reduced workforce participation (defined as working < 20 hours per week). We performed additional analyses to determine if the association between community disadvantage and reduced workforce participation was driven by any one of four subthemes of the SVI:(1) community socioeconomic status, (2) household composition/disability, (3) minority status & language and (4) housing type & transportation. Community disadvantages was associated with reduced workforce participation (OR: 2.82; 95% CI: 1.05-7.56). Analyses by SVI theme showed that the association between community disadvantage and reduced workforce participation was largely driven by community socioeconomic status (SES). Those living in low SES communities were more likely to report reduced workforce participation than those living in high SES communities: (OR: 5.48; 95% CI: 3.28-8.18). Policy interventions that focus on disadvantaged communities are likely needed to improve employment rates among late middle-aged Medicaid beneficiaries.
THE POWER OF RURAL PARTNERSHIP: MEETING NEEDS AND FOSTERING INNOVATION THROUGH THE WYOMING GWEP
Authors: McKibbin Christine , Carrico Catherine
Published: December 2022

The challenges of supporting the health and social needs of older adults and caregivers in rural and frontier areas are well-documented. It is common for rural older adults to experience barriers in accessing geriatric specialists, care coordination services, and caregiver support and education programs. The Wyoming Geriatric Workforce Enhancement Program (WyGWEP) is an innovative partnership comprising an academic geriatrics program, primary care delivery sites, single-unit on aging representing community-based organizations, and a tribal health program. This partnership, funded by the Health Resources and Services Administration, provides the infrastructure to assess needs, provide education and training, create programs to address gaps in care, implement practice innovation, and advocate for needs of rural older adults. This symposium includes five presentations detailing the unique projects of the WyGWEP partnership and the impact of this collaborative work on a variety of stakeholders. The results of a mixed-methods evaluation of the WyGWEP partnership will describe the benefits to the partners and areas for growth. A collaborative effort to assess the needs of older adults informs recommendations to support rural aging in place. Schenck et al. will describe the adaptation of the widespread ECHO model for use with dementia caregivers in rural and remote locations. Representatives from Wyoming’s only Program for All-Inclusive Care of the Elderly (PACE) will explain the cost of a recent decision to de-fund and close this important program. Finally, the impact of a novel Chronic Care Management implementation program will be discussed, including sustainable billing revenue produced by rural primary care clinics.
EVALUATING THE WYOMING GWEP PARTNERSHIP
Authors: Carrico Catherine , Lujan Irene , Anastasia Trena , McKibbin Christine
Published: December 2022

The goal of the Wyoming Geriatrics Workforce Enhancement Program (WyGWEP) is to utilize partnerships to improve health outcomes for older adults by developing a healthcare workforce trained to address unmet health and social determinant needs of Wyoming’s older residents. The purpose of this presentation is to report results from the novel mixed-methods evaluation of the WyGWEP partnership. Data were gathered from WyGWEP stakeholders through the Partnership’s Self-Assessment Tool (n=17; Center for the Advancement of Collaborative Strategies in Health, 2002), which assesses domains of Synergy, Leadership, Resource Sharing — Non-financial and Financial, Benefits and Drawbacks, Decision Making, and Administration/Management and Satisfaction. Semi-structured interviews (n=12) with partnership participants provided additional information and context. Evaluation results indicate that WyGWEP partners are highly satisfied across all domains of the Partnership’s Self-Assessment Tool. WyGWEP partners from Eastern Shoshone Tribal Health will share what has contributed to a successful collaborative. Additional results related to how this type of partnership has influenced participants’ ability to complete objectives and activities will be reviewed.
COLLABORATIVE NEEDS ASSESSMENT OF RURAL OLDER ADULTS AND PRIORITIES FOR AGING IN PLACE
Authors: Steinman Bernard , Tabler Jennifer , Clark Jeff , Osvold Lisa
Published: December 2022

To assess aging-related needs of state residents, the Wyoming GWEP collaborated with the state’s Department of Health--Aging Division to conduct a state-wide survey as the basis for Wyoming’s 4-year state plan on aging. Survey items addressed concerns related to community living and caregiving, as well as general concerns related to aging in Wyoming’s rural setting. Results suggest older residents are committed to aging at home; and when that is not feasible, wish to remain in their communities when possible. Concerns were identified regarding attributes of the state that place older residents at risk for poorer physical/mental health, dependence, financial jeopardy, social isolation, and negative secondary outcomes that are comparatively more costly to address in institutional settings. We discuss the collaborative needs-assessment process, as well as priorities for future service delivery that promote good social support, transportation options, and home modifications to increase independence and safety.
WELL-BEING DURING THE COVID-19 PANDEMIC: THE ROLES OF DEMOGRAPHICS, PERSONALITY, AND SOCIAL TIES
Authors: Ryan Lindsay , Fuller Heather , Sherman Aurora
Published: December 2022

The COVID-19 pandemic continues to exert widespread impacts on individuals, particularly older adults (Tyrrell & Williams, 2020). This symposium capitalizes on a variety of data sources to advance our understandings of the psychosocial impact of the pandemic on older adults. The first two papers consider the importance of personality characteristics in understanding the effects of social distancing. Fiori et al. highlight the potential for sociability to act as a liability during times of social distancing, finding that sociability exacerbated the effects of social distancing on mental health outcomes in a sample of community-dwelling older adults. Ryan’s paper focuses on the Big Five Personality traits, age, and population density as key characteristics explaining differences in subjective well-being during the pandemic. Next, Van Vleet et al. apply a mixed-methods approach to investigate when older adults expect life to go back to normal, finding that expectations about the future became more positive with the passage of time. The final two papers consider the importance of adults’ home social context during the pandemic. Newton examines relationships between living alone and well-being outcomes among older Canadian women, finding that perceived COVID-19 impact was significant only at T1 and living alone was linked to poorer well-being by T2. Birditt et al. examine how individuals’ and partner’s COVID-19 stress and couples’ racial composition are related to affective experiences measured via ecological momentary assessments, finding that husbands’ stress impacted both partners’ well-being, and that associations differed by race. Sherman will lead a discussion to synthesize these new findings.
OLDER CANADIAN WOMEN'S LIVING ARRANGEMENTS AND WELL-BEING DURING COVID-19
Authors: Newton Nicky
Published: December 2022

Living alone has been associated with lower COVID-related well-being over the course of the pandemic, although the results for women – particularly older Canadian women – depend on myriad factors. This study examines relationships between COVID-19 impact, living arrangement, and two types of well-being – psychological well-being and meaning in life – among Canadian women (N = 106) with Mage = 70.11 in two waves of data (July-September 2020 and March-May 2021). There were no differences in levels of well-being between T1 and T2, although regression analyses showed that correlates differed for type of well-being measured. Surprisingly, COVID-19 impact was only significant for psychological well-being at T1. Additionally, while levels of well-being did not differ by living arrangement at T1, by T2 both were lower for those living alone. Findings suggest adaptation to COVID-19 constraints and highlight changes in factors associated with well-being as well as the necessity of measuring well-being in multiple ways.
PANDEMIC-RELATED STRESS AND DAILY WELL-BEING AMONG MIDDLE-AGED AND OLDER COUPLES: RACE AND GENDER DIFFERENCES
Authors: Birditt Kira , Turkelson Angela , Oya Akari
Published: December 2022

Pandemic-related stress may have important implications for well-being among middle-aged and older couples and these effects may vary by race. Participants included 30 married/cohabiting couples (10 Black, 23 White, 2 Mixed race) ages 44 to 84 who completed baseline interviews and 5 days of ecological momentary assessment (EMAs) 6 times a day. Every three hours individuals reported how stressed they felt about COVID-19 and negative affect. Actor-partner interdependence models revealed that greater pandemic stress among Black husbands was associated with their own and their wives greater negative affect (b = 0.22, SE = 0.08, p < .01; b = 0.16, SE = 0.08, p < .05). Greater pandemic related stress among White husbands was associated with wives’ lower negative affect (b = -0.15, SE = 0.07, p < .05). Findings are consistent with structural racism theory indicating that Black individuals may be more negatively affected by pandemic-related stress than White individuals.
SELF-PERCEPTIONS OF AGING, SUPPORT FROM CLOSE SOCIAL TIES, AND HEALTH GOAL PROGRESS IN EVERYDAY LIFE
Authors: Mejía Shannon , Hooker Karen
Published: December 2022

Subjective aging is interpersonal, it embodies processes of thinking about the self in relationship to others. We utilize data from the 100-day microlongitudinal Personal Understanding of Life and Social Experiences Project (N = 99; observations = 7,049; Mage = 63, range = 52-88) to explore how self-perceptions of aging differentiate the processes by which older adults shape interactions with close social ties to support progress toward a meaningful health goal in everyday life. Those with more positive self-perceptions of aging identified more friends among their closest social ties and reported a higher levels of goal progress and support toward that goal during the study period. Further, multilevel random coefficient models showed that goal progress on a given day was more sensitive to received support on that day among those with more positive self-perceptions of aging. The implications for adult development and shared experiences of aging within friendship networks is discussed.
JOY AND STRESS DURING THE COVID-19 PANDEMIC: FINDINGS FROM THE NATIONAL POLL ON HEALTHY AGING
Authors: Finlay Jessica , Kobayashi Lindsay , Solway Erica , Singer Dianne , Kirch Matthias , Kullgren Jeffrey , Malani Preeti
Published: December 2022

This poll aimed to better understand the complex impacts of the COVID-19 pandemic on the emotional and mental health of older adults. In August 2021, the National Poll on Healthy Aging surveyed a national sample of adults age 50–80 about joys, stresses, and resilience during the pandemic. Most reported feeling a lot (30%) or some (53%) joy these days, while 17% reported feeling very little or no joy. Reports of joy and stress differed substantially by age, sex, physical health, mental health, and household income. For example, people age 50–64 were more likely to report feeling a lot of stress compared with those age 65–80 (25% vs 13%), as were women compared with men (24% vs 15%). The findings may inform public health and policy efforts to support older adults at-risk for poor emotional and mental health, and help cultivate resilience during and after the pandemic.
THE FLYNN EFFECT IN SHORT-TERM COGNITIVE DECLINES OF AMERICANS AGED 65 YEARS AND OLDER: SMARTER AND MAYBE SLOWER
Authors: Zhang Yun , Rodgers Joeseph , O'Keefe Patrick , Terrera Graciela Muniz , Voll Stacey , Mann Frank D , Hofer Scott , Clousten Sean
Published: December 2022

To contribute to our understanding of cohort differences and the Flynn Effect in cognitive declines, this study aims to: 1) describe and compare cognitive decline trends of two nationally representative American older cohorts; 2) investigate significant determinants of cognitive declines and the cohort differences. The analysis used data from the National Health and Aging Trends Study (NHATS, 2011-2019), including one nationally representative cohort of older Americans in 2011 and another from 2015. We used mixed-effect models adjusted for cohort, wave, baseline age, sex, education, race, familiarity, and follow-up years, as well as survey designs, to describe and compare the intercepts and slopes in cognitive functions of the two NHATS cohorts. We included Cohort 1 (N=7,325) respondents (2011-2015), and Cohort 2 (N=7,330) respondents (2015-2019). Compared to Cohort 1, Cohort 2 has a significantly higher intercept and a slower decline for episodic memory, and a significantly higher intercept but a significantly faster decline for global cognition, orientation function, and executive function. Consistently, older age, poorer educational attainment, and minority races/ethnicity are associated with worse cognitive performances. Our results provide a comprehensive image of cohort declines for Americans aged 65 years and older. Our findings are consistent with the Flynn Effect in that the general levels of cognition of later cohorts improved. Furthermore, we found support for the Flynn Effect in a short term. We also found significant effects of older age, poorer educational attainment, and minority race/ethnicity on cognitive function.