bluuebunny/crossref_metadata_2025 huggingface dataset:
OLDER ADULT PERSPECTIVES ABOUT ONLINE EXERCISE CLASSES DURING THE COVID-19 PANDEMIC AT MULTIPLE TIME POINTS
Authors: Porter Michelle , Murphy Dallas , Dunn Nicole , Barclay Ruth , Cornish Stephen , Ripat Jacquie , Sibley Kathryn , Webber Sandra
Published: December 2022

Engaging in physical activity can bring health benefits for older adults. However, during the pandemic the availability of in-person exercise classes has been sporadic. As such, online exercise programs have become more common. This research had the goal of exploring the uptake of online exercise programs by older adults in Manitoba, Canada in the first few months in the pandemic and then more than 1.5 years into the pandemic. Older adults (65 years and older) were recruited via emails from a variety of community organizations. Participants completed anonymous online surveys in summer 2020 (n=678) and fall 2021 (n=570). Less than 50% of respondents reported participating in online exercise classes during the pandemic in both surveys. For both surveys, pre-recorded classes were the most common, however, this decreased from 80% in the first survey, to 57% in the second survey. Conversely, live classes where the instructor could see the participants increased from 17% in the 2020 survey, to 47% in the 2021 survey. Additionally, platform use shifted from YouTube as the most popular in the first survey, to Zoom in the second survey. Most of the online classes originated from their local communities. Of those who participated in online exercise early and later in the pandemic, about two thirds reported that they would continue online exercise classes outside of the pandemic. A major reason for not participating was because they enjoy the social aspect of in-person classes. The perspectives of the study participants will be valuable for policymakers, programmers, and instructors.
COMPARING DATA-DRIVEN AND THEORY-DRIVEN APPROACHES TO CLASSIFY SOCIAL RELATIONSHIPS ACROSS THE LIFE COURSE
Authors: Friedman Elliot , Teas Elizabeth , Marceau Kristine
Published: December 2022

A life course perspective on social relationships highlights the salience of specific relationships at specific times in life, but analyses that account for life course trajectories in social relationships are rare. The present study explores the properties of two analytic approaches to classifying life course relationships: 1) a priori, or theoretical, classification strategies, and 2) latent profile analysis (LPA). Including multiple dimensions of social relationships at different time points across the life course, we determined whether theoretical or LPA profiles better predict later-life functional limitations, given that functional impairment is prevalent among middle-aged and older adults. We also assessed whether the two approaches are differentially associated with a broad set of covariates. Data were from three waves of the Midlife in the United States (MIDUS) study (n = 6,909). Relationship variables (parental affection, parental discipline, social support, social strain, and positive relations with others) were from wave 1. Functional limitations were measured at wave 3. Both the LPA and theoretical approach resulted in 4 profiles (although there were qualitative differences), and both approaches differentiated covariate values in similar ways. Loglikelihood comparisons in Mplus showed that the LPA, compared to the theoretical approach, was more sensitive to detecting differences in functional limitations. Overall, the data-driven profiles differed from theory-based profiles, which may be substantively meaningful for understanding associations between life-course relationships and health. Practical implications include development of a measure for future research to apply these novel life-course social relationship groups, particularly with smaller samples not suitable for LPA.
OLDER AMERICANS LIVING ALONE: AN INTERSECTIONAL ANALYSIS OF SOCIAL ISOLATION RISKS DURING THE COVID-19 PANDEMIC
Authors: Bokun Anna , Flood Sarah , Moen Phyllis
Published: December 2022

More Americans aged 50-75 are living alone than ever before (about a third of adults over 60 live alone today–see Ausubel 2020; Esteve 2020), placing older adults at risk of social isolation, and especially so during COVID-19. Not only do demographers’ project the rate of older adults living alone will continue to rise, but they also predict increasing racial disparities due to differential population aging rates (Verdery and Margolis 2017). We pinpoint two mediators of social isolation: employment status and living arrangements, drawing on panel data from the Current Population Survey, from January 2018 through August 2021 (N = 83,232), to investigate whether the pandemic increased disparities in vulnerabilities to social isolation across different subgroups. We use an intersectional lens to consider the experiences of population groups defined by gender, age, race/ethnicity and social class. We know that employment has important protective health benefits (Berkman, et al. 2000; Kelly, et al. 2017). Living arrangements condition social isolation, especially in terms of living alone (Cudjoe, et al. 2020). The aim of our study is twofold. First, we aim to show how the dynamics of living alone and employment participation for older adults change between the immediate pre-Covid period and Covid period, using COVID-19 as a natural experiment in precipitating change. Second, we show how demographic characteristics intersect to structure vulnerability to social isolation during the same period. Our results demonstrate the risks of social isolation are not evenly distributed, suggesting the need for policies and practices promoting social inclusion.
INTERFACE OF INFORMAL AND FORMAL SUPPORT IN THE LINKAGE BETWEEN COGNITIVE DECLINE AND LONELINESS
Authors: Park Soobin , Park Sojung , Amano Takashi , Kim BoRin
Published: December 2022

Older adults with cognitive impairment are at risk of higher loneliness due to increasing challenges to retain essential social skills and decreasing social networks. This study explores ways to reduce the relationship between cognitive function and loneliness. Drawing on the cognitive discrepancy theory of loneliness, we hypothesized loneliness may be reduced by improving an individual’s actual level of social interaction, creating opportunities for social relationships. This study examined complex relationships among informal (frequency of social contact with family members and friends) and formal support (use of home- and community-bound services, HCBS), and loneliness, among older adults with different levels of cognitive impairment. Data came from the Health and Retirement Study (2012) (N=651) with the sample included respondents 51+ years who completed a modified Telephone Interview for Cognitive Status. Results from hierarchical regression showed older people with a lower level of cognitive function were less likely to experience loneliness (b=-.15, p<.01). Although frequent social contact with family and friends reduces loneliness (b=-.24, p<.001), it did not moderate the relationship between cognitive function and loneliness. Interestingly, the use of HSBC also turned out to be not a significant protective factor. Our findings suggest merely increasing social interaction levels with family and friends may not necessarily curb loneliness for older adults with cognitive impairment. Given the current characteristics and nature of HCBS primarily focus on providing basic physical needs of older adults, prioritizing the development of emotional comfort and recreational activities that alleviate their psychological loneliness is essential, especially amidst the pandemic.
BEYOND HOUSING
Authors: Raimondo Marianne
Published: December 2022

Social isolation and loneliness in older adults are a public health challenge that has been exacerbated during the COVID pandemic. While quarantining although it was necessary to protect individuals from the virus, older adults lost their usual social supports, connectedness, and relationships. Research has shown that loneliness and social isolation have many negative effects on a person’s physical and mental health. This presentation will describe an initiative of Age Friendly RI which addressed the problem of social isolation among older adults living in a congregate housing community who struggled with stress, anxiety, depression, and exacerbation of mental illness. Through a partnership between a state college and a community based mental health center, and supported with grant funding, behavioral health services and supports were embedded in the housing community. The project was multi-faceted involving community health workers and a community support professional who provided outreach and emotional support, the use of technology to help residents connect with medical providers or loved ones or enjoy music, games, movies, and students who provided outreach and taught older adults how to use technology. A social isolation scale was administered to identify residents at high risk of social isolation and targeted intervention. The evaluation of the program will be discussed in terms of the interventions implemented and the outcomes realized, including resident well-being and satisfaction. Finally, it will suggest a pathway for sustaining the integration of behavioral health services in housing to better meet the behavioral health needs of older residents beyond the pandemic.
SOCIAL RELATIONSHIPS AND COGNITIVE IMPAIRMENT IN LATER LIFE
Authors: Thomas Patricia , Sauerteig-Rolston Madison , Bauldry Shawn , Nemeth Samuel , Ferraro Kenneth
Published: December 2022

With population aging and the growing population at-risk of cognitive impairment, Alzheimer’s disease, and related dementias, there is a need for a better understanding of how social factors may affect cognitive impairment. Drawing from stress process theory and social integration theory, we examine the impact of positive and negative dimensions of relationship quality with friends and family on cognitive impairment in later life. We analyze Cox proportional hazards models using nationally representative panel data from the Health and Retirement Study (2006-2016, N=10,626) to examine how the quality of family and friend relationships in adulthood may influence risk of cognitive impairment. Strain with family members and with friends was significantly related to higher risk of cognitive impairment (Hazard Ratio: 1.15 [95% CI: 1.08, 1.21] and 1.20 [95% CI: 1.13, 1.28], respectively). Support from family members was beneficial, related to lower risk of cognitive impairment (HR: 0.93, CI: .89, .99); however, support from friends was related to higher risk of cognitive impairment (HR: 1.10, CI: 1.05, 1.14). Findings reveal the implications of social support and strain in different types of relationships for cognitive health.
THE STRUCTURAL AND COGNITIVE SOCIAL CAPITAL OF KOREAN OLDER ADULTS AND THEIR DEPRESSION TRAJECTORIES
Authors: Kim Jinhyun , Um Sun-Bi , Shi Xiang , Park Hyunjung
Published: December 2022

Despite the rapid increase of older population in South Korea, we do not understand the patterns of their social capital and relationships with depression trajectories in depth. This study aims to identify the patterns of social capital of Korean older adults aged 65 years and older based on latent class analyses and their depression trajectories by latent classes. For data analyses, 3,606 Korean older adults from the Korean welfare panel study data were selected. Latent class analyses were conducted by using various components of structural social capital such as number of contacts with family, friends, and neighbors and cognitive social capital such as trust, reciprocity, and satisfaction from social relationships. Results showed that three latent classes were found. We named the first class as a strong structural and cognitive group because it showed the highest levels of number of social contacts, trust and reciprocity. The second class was called as a weak structural and strong cognitive group because it showed lower levels of social contacts but higher levels of satisfaction from social relationships. The third class was called a weak structural and cognitive group because it showed the lowest levels of social contacts, trust, reciprocity, and satisfaction from social relationships. Results from latent growth curve modeling, the second class showed the lowest depressive symptoms but the third class showed the highest depressive symptoms at baseline. Only the third class showed significant rate of changes in depression. Differences in depression trajectories by three latent classes need to be further discussed.
DO I GET BY WITH A LITTLE HELP FROM MY FRIENDS? FINDINGS FROM THE IOWA UNMARRIED SURVIVORS STUDY
Authors: Hensley Robert , Bishop Alex , Martin Peter
Published: December 2022

The purpose of this study was to analyze the role that selected personality variables (Neuroticism, Agreeableness, Conscientiousness, Extroversion, and Openness), social support, and coping played in loneliness of 227 (M = 78.2, SD = 8.1) participants in the Iowa Unmarried Survivors Study. This study is a sample of never married, divorced, and widowed participants. Blocked multiple regression analyses were used in this study. In the first block, age, gender, ethnicity, past schooling, current marital status, total illnesses, and childhood poverty were included. The second block contained the aforementioned personality variables, and the third block included both social support and coping. Results indicated that both Neuroticism and Extraversion were significant predictors of loneliness, β = .266, p < .00, β = -.294, p < .05, and β = .27, p < .00, respectively. In short, the greater the neuroticism, the higher the score in loneliness. Moreover, the lower the level of extraversion, the higher the score in loneliness. In addition, social support served as a significant predictor of loneliness, β = -.412, p < .00. The more social support in the participants’ lives, the lower level of loneliness. Finally, coping predicted loneliness. In essence, the more loneliness in their lives, the greater the use of coping mechanisms utilized. This model explained 58% of the variance in loneliness scores. Navigating through late adulthood as an unmarried survivor presents a host of challenges, and these results add to our understanding of the link between personality, social support, coping, and loneliness in late life.
UNRAVELING THE AMBIGUITY BETWEEN COGNITION AND DEPRESSION: A LONGITUDINAL ANALYSIS OF OLDER ADULTS
Authors: Roessler Meghann , Manchella Mohit , Singh Anmoldeep , Coleman Max , Francis Heather , Saykin Andrew , Risacher Shannon , Apostolova Liana
Published: December 2022

Research on directionality of the relationship between cognitive functioning and depression is ambiguous, especially when considering implications for patients with mild cognitive impairment or Alzheimer disease (AD). Previous research suggests that depression in late life could be a pre-clinical manifestation of AD before other cognitive symptoms are detectable. Some research supports the hypothesis that level of depression can independently predict level of cognition. Other research suggests that depression is a risk factor for developing dementia or AD late in life. Further research on the impact of subjective cognitive decline versus objective cognitive performance in association with depressive symptoms is a critical area to explore. Using data from the Social Networks in Alzheimer Disease (SNAD) study and the Indiana Alzheimer Disease Research Center (IADRC), we conducted a preliminary longitudinal analysis of 196 focal subjects (Mage = 71.6 years, Pfemale = 63%). Interviews conducted one year apart were leveraged to elucidate the bidirectional relationship between depressive symptomology and cognition. Using a lagged dependent variable approach controlling for age, sex, race, and education, the results indicate that only executive function predicts depression at timepoint 2 (-0.31 SD, p< 0.001). However, depression predicts focal Cognitive Change Index (CCI) (0.06 SD, p< 0.05), processing speed (-0.04 SD, p< 0.05), and episodic memory (-0.04 SD, p< 0.05). Other cognitive domains examined, including attention, language, visual/spatial skills, MoCA score, and informant-rated CCI, were not significant as predictors or as outcomes. These results suggest that depression may be a more robust predictor of cognition than cognition is of depression.
DEPRESSION, DEPRESSIVE COGNITIONS, AND DEPRESSIVE SYMPTOMS IN CAREGIVING GRANDMOTHERS: A GROWTH CURVE MODEL
Authors: Burant Christopher , Musil Carol , Zausniewski Jaclene , Jeanblanc Alexandra
Published: December 2022

Grandmothers caring for grandchildren have elevated levels of depressive symptoms compared to grandmothers who do not provide care. Depressive symptoms are state-like in nature and describe recent depressive symptoms. The Depressive Cognition Scale© captures changes in negative thinking patterns that often precede depressive symptoms. Depressive cognitions, according to Beck’s theory of depression, are the first depressive symptoms to appear and typically lead to more serious symptoms of depression. Specifically, depressive cognitions reflect negative thinking patterns. Previously diagnosed depression may contribute to current levels of depressive cognitions and depressive symptoms. Data were collected on 342 participants in a longitudinal nationwide online research study of caregiving grandmothers. A latent growth curve model was used to track the trajectory of depressive symptoms at four time points (baseline, 2 weeks, 12 weeks, and 24 weeks). This latent growth curve model was tested to gain an understanding of how diagnosed depression and depressive cognitions impact the trajectory of depressive symptoms over time. The model fit the data well (Chi Square=24.301.; df=12; p=.019; TLI=.977; CFI=.987; RMSEA=.055). Baseline depressive cognitions strongly impacted the intercept (Standardized Beta=.65, p<.001) and the slope of depressive symptoms (Standardized Beta=-.65, p<.001), diagnosed depression predicted depressive cognitions (Standardized Beta =.32, p<.001) and the intercept of depressive symptoms (Standardized Beta=.36, p<.001). The continued impact of diagnosed depression and depressive cognitions over 24 weeks indicates the need for potential interventions to further address diagnosed depression and depressive cognitions as a way to decrease depressive symptoms in grandmother caregivers.
THE MULTIDISCIPLINARY HISTORIES OF ACTIVE AGING IN POLAND
Authors: Robbins-Panko Jessica
Published: December 2022

In contemporary Poland, Universities of the Third Age are the most visible institutional forms of active aging. These lifelong-learning institutions that are specifically for retirees often cultivate ideals of independence through workshops and classes that teach new, and potentially transformative, skills and hobbies (Kobylarek, 2018). Universities of the Third Age in Poland emerged out of the fields of andragogy, pedagogy, and social work, fields that have regional intellectual roots in the late 19th/early 20th-century presocialist era, and are based on radically different ideals of personhood, relationality, and care than those of the contemporary postsocialist neoliberal era (Robbins, 2021). This paper analyzes 1) historical data from institutional archives of two Universities of the Third Age in Poland, and 2) secondary sources on histories of andragogy, pedagogy, and social work, to create a locally grounded intellectual history of active aging in central and eastern Europe. The Polish case offers an opportunity to think across divergent political-economic eras, in which assumptions about the value of a person to society have shifted. By tracing how the fields of andragogy, pedagogy, and social work have shaped active aging in Poland, this paper finds that 1) dichotomies of East/West, socialist/capitalist, and individual/collective are insufficient to explain the history of contemporary practices of active aging, and 2) intellectual history can reveal complex relations between political-economic change, and ideals and practices of aging. These findings have implications for advancing gerontological theories of 1) active aging in cross-cultural contexts, and 2) how active aging relates to sociopolitical change.
CHALLENGES AND REWARDS EXPERIENCED IN THE VERY OLD PARENT-CHILD RELATIONSHIP: RELATIONSHIP QUALITY MATTERS
Authors: Boerner Kathrin , Kim Kyungmin , Kim Yijung , Gallagher Elizabeth , Jopp Daniela
Published: December 2022

Very old parents and their “old” children are a growing group in industrialized countries worldwide. However, little is known about the nature and implications of this relationship constellation, especially the challenges and/or rewards experienced within the relationship. We therefore examined factors associated with perceptions of challenge and reward among very old parents and their children. Using data from 114 very old parent-child dyads in the Boston Aging Together Study, we estimated Actor-Partner Interdependence Models to predict challenge, reward, and challenge/reward ratio outcomes of dyad members as a function of relationship quality, support exchanges, family norms, and personality. Relationship quality emerged as the most influential predictor, albeit more consistently for children than for parents. When children experienced the parent-child relationship as more positive, both children and parents experienced fewer challenges and more rewards (i.e., both actor and partner effect). Parents’ experience of relationship quality was only associated with their own challenge perceptions (i.e., actor effect only). The roles of support exchanges, family norms, and personality were relatively minor, with few significant effects if at all. Given the importance of relationship quality for challenge and reward perceptions, support services or interventions targeting relationship quality could be a key pathway to minimizing challenges and maximizing rewards among very old parents and their children. Focusing on relationship perceptions of the child may be particularly critical in improving the experiences of both parent and child.
CROSS-NATIONAL COMPARISONS OF STRESS AND WELL-BEING IN THE INTERNATIONAL FAMILY OF HEALTH AND RETIREMENT STUDIES
Authors: Park Yoobin , Crosswell Alexandra , Phillips Drystan
Published: December 2022

Strong evidence demonstrates the long-term influence of stress and well-being on psychological, social, and physical health outcomes across the lifespan. Because of this, stress and well-being measures have been added to nearly all of the International Family of Health and Retirement Studies. However, this newly available data has not been compared cross-nationally or within-country to unpack how culture influences these important predictors of healthy aging. Using the Gateway to Global Aging Data, which provides harmonized data from the Health and Retirement Study and its sibling nationally representative studies, levels of self-reported stress (e.g. job stress, discrimination, loneliness) and well-being (e.g. quality of life, life satisfaction) are compared across 30 countries. Data come from the following studies: HRS, ELSA, SHARE, TILDA, CHARLS, KLoSA, MHAS, and JSTAR. We used data from the latest study wave for which the relevant survey was implemented. Average age of participants across studies is 67 and 55% are women. Initial analyses show stressor specific findings such as participants in Korea reported greater work stress than participants in Japan, England, the United States, and across Europe, and the United States reported higher loneliness than China and England, but not higher than Ireland. Reporting cross-national and within-country variation in these measures will be generative in pointing to new research directions for understanding how culture influences health and aging trajectories.
ORALLY ACTIVE, CLINICALLY TRANSLATABLE SENOLYTICS RESTORE Α-KLOTHO IN MICE AND HUMANS
Authors: Zhu Yi , Prata Larissa Langhi , Gerdes Erin Wissler , Netto Jair , Pirtskhalava Tamar , Giorgadze Nino , Tripathi Utkarsh , Inman Christina
Published: December 2022

Decreased α-Klotho, a geroprotective factor, and increased senescent cell burden are both associated with early onset of physical disability, cognitive impairment, and premature all-cause mortality. It has been demonstrated that eliminating senescent cells can enhance physical function, cognition, and survival in mice, as does overexpressing α-Klotho. Mice with low α-Klotho exhibit accelerated senescent cell accumulation, recombinant α-Klotho decreases senescent cell burden and restores lifespan in these mice, and senescent epidermal cells are reduced in mice overexpressing α-Klotho. Here, we tested the hypothesis that senescent cells cause decreased α-Klotho and hence that reducing senescent cells can increase α-Klotho. Senescent cell conditioned medium (CM) reduced α-Klotho in cultured non-senescent human umbilical vein endothelial cells (HUVECs), renal tubular endothelial cells, and astrocytes. These effects of senescent CM were partially attenuated by neutralizing antibodies against the senescence-associated secretory phenotype (SASP) factors, activin A and IL-1α. Transplanting senescent cells into younger mice caused decreased urine and brain α-Klotho. Genetically reducing highly p16Ink4a-expressing cells in old INK-ATTAC mice or administering the senolytics, Dasatinib plus Quercetin (D+Q) or Fisetin (F), to young mice transplanted with senescent cells, young diet-induced obese (DIO) mice, or naturally-aged mice increased urine, kidney, and/or brain α-Klotho. Treating patients with idiopathic pulmonary fibrosis (IPF), a cellular senescence-related disease, with D+Q led to increased urinary α-Klotho. Thus, targeting senescent cells causes increases in the geroprotective factor α-Klotho, potentially amplifying the beneficial effects of senolytic drugs.
INTERMITTENT KETOGENIC DIETS EXTEND LIFESPAN AND ATTENUATE INFLAMMAGING IN MALE MICE
Authors: Zhou Zeyu , Kim Kyoungmi , Ramsey Jon , Rutkowsky Jennifer
Published: December 2022

A ketogenic diet (KD) has been shown to increase functional lifespan in male mice when fed isocalorically to a control diet (CD). However, it is not clear if intermittent ketogenic diets (IKD) that induce brief and recurring periods of ketosis would be as effective at prolonging lifespan. In the present study, 12-month-old C57BL/6JN male mice were fed an intermittent single day KD (KD fed on Mon, Wed and Fri each week, IK1) or 2-day KD (KD fed on 2 consecutive days each week, IK2). These two IKD regimes were selected to mimic the widely used alternate-day or 5:2 intermittent fasting approaches, without the caloric deficit. Our results showed that lifespan was significantly increased in both IK1 and IK2 groups, with IK1 showing a 13.6% and IK2 showing a 7.9% increase in median lifespan compared to the CD (p < 0.01). At 27 months of age, levels of circulating proinflammatory cytokines were significantly decreased in IK1 and IK2 mice compared to control mice. Also, levels of proinflammatory cytokines were significantly elevated in 27-month-old control mice compared to 12-month-old mice, while levels in IK1 and IK2 mice were not significantly altered with aging, and these effects were still persistent during days the animals were fed the CD. Unlike the continuous KD, health span measures were not altered in IK1 or IK2 mice at 26 months of age. In summary, IKDs that produce shorts episodes of ketosis can be effective at extending longevity in mice, possibly by attenuating systemic inflammation with aging.
TESTING A DYADIC SLEEP INTERVENTION FOR PERSONS LIVING WITH COGNITIVE IMPAIRMENT AND THEIR CARE PARTNERS
Authors: Brewster Glenna
Published: December 2022

Sleep disturbance is prevalent among persons living with cognitive impairment (PLWCI) and their care partners, suggesting that dyadic sleep disturbance is an interdependent phenomenon. There is also interdependence in the dyadic sleep disturbance. Despite the pervasiveness of shared sleep disturbance among these dyads and its negative impact on dyadic health outcomes, there are remarkably few interventions for sleep disturbance in which both members of the dyad participate. This study examines sleep outcomes of PLWCI-care partner dyads with insomnia symptoms. Dyads were simultaneously participating in a cognitive behavioral therapy for insomnia intervention. The Epworth Sleepiness Scale and the Insomnia Severity Index assessed daytime sleepiness and insomnia, respectively, at baseline and immediately post-intervention. We compared pre- and post-intervention ESS and ISI scores. For the 14 participants (n=7 dyads), care partners were spouses, on average 71.6 years, female (100%) and highly educated (18.85 years). The PLWCI were on average 73.85 years with 18.28 years of education. Daytime sleepiness improved for four and worsened for two care partners. It improved for three and worsened for three PLwCI. Insomnia improved for five care partners and four PLwCI. Two dyads experienced congruent improvement of daytime sleepiness. Four dyads reported congruent improvement of insomnia symptoms. A behavioral sleep intervention simultaneously engaging both the PLWCI and the care partners resulted in a reduction in insomnia and daytime sleepiness symptoms for most of the participants. This study provides preliminary evidence that PLwCI-care partner dyads with sleep disturbance can work together to improve their sleep outcomes.
SUPPORT AND UTILIZATION OF ADVANCED PRACTICE NURSES IN LONG-TERM CARE TO MAXIMIZE OUTCOMES AND EMERGENCY RESPONSE
Authors: Johnson Alisha , Harrison Tracie
Published: December 2022

Incorporation of Advanced Practice Registered Nurses (APRNs) into Long-Term Care (LTC) results in sustained positive outcomes and has potential to help guide LTC facilities in times of emergency such as the COVID-19 pandemic. To optimally utilize the role of an APRN in the care of older adults and people with disabilities requires understanding the needs of LTC while balancing the personal characteristics of APRNs transitioning into practice (TTP). Findings from an ethnographic dataset (participant observations, interviews, field notes) of a cohort of 9 APRNs embedded full-time into 5 LTC settings over their first year of practice (overlapping with the first 3 ½ months of the COVID-19 pandemic) were integrated to glean lessons about LTC and APRN characteristics associated with successful APRN transition and utilization during stable and emergent care. Guided by a complexity science sensitizing framework focused on emergent and holistic systems, findings lead to multiple conclusions. The ability to influence positive outcomes in routine and emergent situations must be modeled. APRNs require meaningful mentoring relationships and acceptance by administrators and practitioners to develop successful TTP. Successful TTP included their embrace of role as resident caretaker, their participation in facility quality improvement, and their positive impact in an emergency response. Utilization and transition were enabled by facilities with organized characteristics versus inhibited by chaotic ones, which was exacerbated by the pandemic. Personal role fulfillment drove many APRNs to push through adversity. Administrators must address and honor concerns and attempts at self-care during times of doubt.
PERCEPTIONS OF OLDER ADULTS AND CAREGIVERS OF AN AUTOMATED ROBOT TO FACILITATE AGING IN PLACE
Authors: Case Donna , Velazquez Nathan , Savich Tatjana
Published: December 2022

This study explored the perceptions of forty older adults 55+ and caregivers of the usefulness of the Labrador Retriever (https://labradorsystems.com/) in facilitating aging in place. Participants consisted of older adults who are enrolled in a PACE program or reside at The Village of Oakland Woods in southeastern Michigan as well as providers and board members of organizations that provide support to these older adults. Participants viewed an in-person demonstration of the Labrador Retriever before verbally completing a thirteen question survey with answers input by research team members. The questions were a combination of multiple choice questions such as ”Having seen the Labrador demonstration, do you think the Labrador Retriever System could help you in your setting?” followed by open ended questions such as “Having seen the Labrador Retriever, how might this system help you in your setting?”. A total of 9 qualitative themes related to the potential uses of the Labrador Retriever System were identified as: Medications, Aging in Place, Safety and Fall Prevention, Carrying Items (i.e. laundry, food, cleaning supplies), Hydration, Independence, Reducing Caregiver Burden, Nutrition, and Cognitive Issues. These themes are consistent with the barriers to aging in place identified in the literature.
THE EFFECT OF OBESITY ON COVID-19 OUTCOMES AMONG HOSPITALIZED OLDER ADULTS
Authors: Parianos Mary , Zadeh Ali Vaeli , Carrero Ricardo Criado , Marcano Claudia , Crawford Andrew , Collado Elias , Larned Joshua
Published: December 2022

Background

According to the CDC, approximately 30% of hospitalizations for COVID-19 infection between the onset of the pandemic and November 2020 were attributed to obesity. However, there is limited data on how obesity affects the overall outcome of COVID-19 in hospitalized older adults.

Methods

A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD-10 codes, a cohort of patients aged 65–75 and Elixhauser Comorbidity Index (ECI) >4 with a history of obesity admitted for COVID-19 was identified. This cohort was matched with a group of patients with no history of obesity, considering age, gender, and ECI. Records from both groups were reviewed for multiple outcomes over 30 days following admission. Pearson’s chi-squared was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant.

Results

There were 151,429 members in each group. Obese individuals had a higher risk of 30-day all-cause readmission (RR=1.10, CI95% 1.07–1.11, p < 0.0001), ICU admission (RR=1.11, CI95% 1.08–1.15, p < 0.0001), acute thromboembolic events (RR=1.14, CI95% 1.07–1.2, p < 0.001), and deep venous thrombosis (RR=1.21, CI95% 1.12–1.32, p < 0.00001). There was no difference in length of hospitalization.

Conclusion

Obesity is a modifiable risk factor that negatively affects COVID-19 outcomes in the older population. Given the prevalence of obesity in our population, primary and secondary obesity prevention is more important than ever.
THE RELATIONSHIP BETWEEN CHILDHOOD ADVERSITY AND MENTAL HEALTH IN OLDER ADULTS
Authors: Lian James , Anstey Kaarin , Kiely Kim
Published: December 2022

Background

There is a need to understand how early adversity is linked with mental health in older adults. The aim of this study was to 1) explore the optimal way to operationalise a scale of adverse childhood experiences (ACEs) and 2) examine the association between ACEs with depression and anxiety in older adulthood.

Methods

Data were from Wave 1 of the Personality and Total Health (PATH) Through Life Project (N = 7485, 51% women). Older adults aged 60–65 reported their childhood experiences of domestic adversity on a 17-item scale (e.g., physical abuse, neglect, poverty). Depression and anxiety were assessed using four validated screening instruments (GDS, GAS, MCS-12, PHQ-9). Three approaches to scoring the ACE scale were compared: i) cumulative risk, ii) factor analysis, and iii) latent class analysis (LCA). Confirmatory factor analysis (CFA) of the dimensional model of adversity and psychopathology was examined. Linear regression models estimated associations between ACEs and mental health, adjusting for age, race, education, and gender.

Results

Childhood adversity was associated with late life depression and anxiety using the cumulative risk approach. CFA examined latent factors of threat and deprivation in our dataset, which were highly correlated, leading to problems with multicollinearity when estimating associations. Finally, LCA revealed six classes of ACEs: high adversity, low adversity, low affection, authoritarian upbringing, high parental dysfunction, and moderate parental dysfunction. High adversity and high parental dysfunction were associated with higher levels of depression and anxiety symptoms compared to other latent classes.
INTERGENERATIONAL CONNECTIONS: TURNING POINTS IN COLLEGE STUDENT ATTITUDES ABOUT OLDER ADULTS AND AGING
Authors: Watson Wendy , Faulkner Sandra , Pollino Madison , Shatterly Jaclyn , Stelle Charlie
Published: December 2022

Intergenerational Connections was a semester-long community-based engagement project in which thirty-four undergraduate students enrolled in a relational communication course met via Zoom with older adults in a long-term care facility for four dialogues about close relationships. The project used a Critical Interpersonal and Family Communication Pedagogy approach to have students critically engage with stereotypes and expectations about older adults through class readings, discussion, and interaction. The students wrote reflections after each dialogue and a final reflection expressing their expectations and experiences of interacting with an older adult. We analyzed the reflections using a turning point analysis and found two turning points related to Perceptions of Aging and Developmental Changes and Understanding and Expectations of Relationships. Students recognized stereotypes they held about older adults and aging and how engaging with an older adult dispelled many of those assumptions. Students were surprised by how much they had in common with their older adult partner. They learned about relationships through their dialogues with their partner and found many “words of wisdom” they wanted to incorporate into their relationships. In their final papers, students reflected on being advocates for older adults and how this project helped them understand that they can have conversations with older adults and not be afraid that they will not be able to connect. This paper will discuss how this community engagement project served to reframe aging for these young adults, and students’ recognition of the role that older adults play and the value that their involvement brings to society.
AFRICAN-AMERICAN ALZHEIMER’S CAREGIVER TRAINING AND SUPPORT PROJECT 2 PILOT STUDY: OUTCOMES ANALYSIS
Authors: Glueckauf Robert , Lampe Nik , Kazmer Michelle , Nowakowski Alexandra , Wang Yuxia , Thelusma Naomi , Williams Dominique , McGill-Scarlett Cordy
Published: December 2022

The purpose of this study was to conduct an initial evaluation of the quantitative and qualitative outcomes of the African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS2). Quantitative objectives focused on assessing changes in caregiver depression and health status, as well as the severity of caregiving and self-care problems from pre- to post-intervention. Secondary quantitative analyses examined post-treatment changes in social support and caregiver burden. Qualitative objectives included examining caregivers’ perceptions of the effectiveness of in-session training activities, quality of relationships among participants and their facilitator, and appraisals of spiritual elements of the program. Nine African American family caregivers of older adults with dementia completed the ACTS2 lay pastoral care facilitator-led, telephone cognitive-behavioral intervention. The twelve-week training program included 7 skills-building groups and 5 individual problem-solving sessions. Significant improvements were found on the majority of dependent measures, including caregiver depression, health status, problem severity, and social support. Qualitative analysis highlighted the value caregivers placed on relationships with their co-participants and group facilitators, the role of spirituality within the program, and the importance of goal setting in improving caregiver distress and self-care. Convergence was found between quantitative and qualitative findings, particularly improvements in the domains of caregiver distress, health status, and social support. Overall, the findings of the pilot study were promising. Replication using a randomized controlled design with a larger sample size is needed to test the reliability of the findings. Benefits of tailoring intervention to caregivers’ sociocultural preferences and spiritual values are also addressed.
DEVELOPMENT AND APPLICATION THE QUESTIONNAIRE FOR MEDICAL CHECKUP OF OLD-OLD (QMCOO) - TAIWAN VERSION
Authors: Hung Jui-Ying
Published: December 2022

In 2022, population over the age of 65 is currently about 3.8 million (accounting for about 16% of the total population) as an “aged society” in Taiwan. According to the report about the frailty of the elderly increases with age, especially 75 - 79 years old, are the most obvious functional decline (The Ministry of Health and Welfare, 2022). This trend that also happened in 2005, the interim report of the 3rd national health promotion measures showed an increased prevalence of diabetes mellitus and obesity in Japan. In response to this, Dr. Satake and Dr. Arai (2020) develop the questionnaire for Medical Checkup of Old-Old (QMCOO) suited measure frailty to people aged ≧75 years better and composed of 15 questions regarding the following 10 domains: health condition, mental health, eating behavior, oral function, body weight loss, physical function and falls, cognition function, smoking, social participation and social support implemented in April 2020. This study authorized by Dr. Satake et, al in August 2022, aims to translate the QMCOO in Chinese version and through expert discussions to confirm that there are no difference between the original version in Japanese/English, and the apply query specification for QMCOO in Taiwan. This study recruited 300 older adults in Taichung city to answer all the questions in QMCOO and analysis the diagnostic frailty distributed status compared to the data measure in the Kihon Checklist in the same time. This finding the cutoff scores 2/3 for the QMCOO might be effective in diagnosing frailty in Taiwan.
VALIDATION OF GLIM CRITERIA ON MALNUTRITION IN CHINESE OLDER INPATIENTS
Authors: Ji Tong , Li Yun , Liu Pan , Zhang Yaxin , Song Yu , Ma Lina
Published: December 2022

Backgrounds

Malnutrition is a nutritional disorder that has a high incidence and can lead to multiple poor prognoses, such as frailty. Early identification and correct evaluation of malnutrition are essential for improving clinical outcomes. Objective: Therefore, we aimed to explore the applicability and effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criterion for identifying undernutrition in older inpatients.

Methods

In total, 223 participants aged ≥60 years were involved. Nutrition was evaluateded employing MNA-FF and GLIM criteria, which adopts a two-step procedure. The first step was to use three different methods for nutritional risk screening: NRS-2002, MNA-SF, and MUST. The second step is to diagnose undernutrition. The Clinical Frailty Scale was used to assess frailty. Sensitivity, specificity, Youden index, kappa values, and positive and negative predictive values were measured to test the validity of the GLIM criteria. Logistic regression models were used to assess whether there was a correlation between malnutrition and frailty.

Results

We found that 32.3–49.8% of inpatients were at risk of malnutrition based on the GLIM diagnosis using the three different screening tools, 19.3–27.8% of patients were malnourished. The GLIM criteria with MNA-SF as the diagnostic validation and MNA-FF as a reference showed high consistency (k = 0.629; p < 0.001), sensitivity (90.5%), and specificity (86.4%). Logistic regression analysis showed that malnutrition, using MNA-SF with the GLIM criteria, was relevant to higher likelihood of frailty (OR=1.887; 95% CI: 1.184–2.589). Conclusions: The GLIM criteria with the MNA-SF may be a more reliable malnutrition assessment process in elderly inpatients.
REVISITING ELECTRONIC FRAILTY INDEX BY ADDING A LAB-BASED MARKER OF NUTRITION: A HEART FAILURE COHORT
Authors: Kim Seulgi , Orkaby Ariela , Park Catherine , Horstman Molly , Virani Salim , Intrator Orna , Naik Aanand , Razjouyan Javad
Published: December 2022

Malnutrition is associated with worse prognosis and increased risk for adverse outcomes in patients hospitalized with heart failure (HF). The objective is to assess the utility of adding the Prognostic Nutritional Index (PNI), a validated measure of nutritional status, to the Veterans Health Administration frailty index (VA-FI) in predicting time to death in patients hospitalized with HF. We conducted a retrospective cohort study of veterans age ≥50 years hospitalized with HF as their primary diagnosis. PNI was calculated using lab values in the year prior to hospitalization with the following equation: 10 x serum albumin (g/dL)+0.005 x total lymphocyte count (mm3). VA-FI identified five groups: robust (≤0.1), prefrail (0.1–0.2), frail (0.2–0.3), moderately frail (0.3–0.4), and severely frail (>0.4). PNI was added to VA-FI (VA-FI-Nutrition) using the same cutoffs. We identified changes in frailty status using VA-FI versus VA-FI-Nutrition by summarizing the count by each class and reported the hazard ratio (HR) for all-cause mortality in each VA-FI category based on the new VA-FI-Nutrition groups. VA-FI-Nutrition identified patients within each VA-FI class that belong to the next frailty strata: robust (20.2%), prefrail (18.3%), frail (16.7%) and moderately frail (16.7%). We observed higher mortality rates among those whose frailty class changed based on VA-FI-Nutrition compared to VA-FI: robust (HR, 1.65, 95%CI:1.38, 1.97), prefrail (HR, 1.52, 95%CI: 1.41, 1.65), frail (HR, 1.42, 95%CI: 1.33, 1.52), and moderately frail (HR, 1.33, 95%CI: 1.24, 1.43). Adding PNI to VA-FI provides a more accurate mortality assessment and may be utilized to triage high-risk patients.
THE QUALITY IN QUALITATIVE: AN EXAMINATION OF RETIREMENT INTERVIEWS
Authors: Silver Michelle
Published: December 2022

Qualitative interviews are a dynamic and complex way to understand life experiences. Retirement is an ever-evolving, dynamic, and complex social construct we associate with the end of one’s career. Exploring what retirement means to different people in the context of critical gerontological theories of successful aging can contribute to a better understanding of the implications of this important transition at the individual and societal level. However, sifting through participants stories is not always a straightforward endeavor, particularly in the case when participants have complex and dynamic stories. This paper examines the value of qualitative research methods in unpacking complex personal narratives. As the landscape surrounding mature workers’ experiences continues to change, this paper extends policy debates about retirement, as well as scholarly conversations about the richness and complexity of qualitative research.