bluuebunny/crossref_metadata_2025 huggingface dataset:
MOBILE-BASED MULTIDOMAIN LIFESTYLE INTERVENTION AND HEALTH PROMOTION IN OLDER KOREAN AMERICANS
Authors: Kim Junhyoung
Published: December 2022

Prior studies have suggested that the nature-based virtual reality (VR) program serves as a therapeutic tool to increase health and wellbeing among older adults. While much research on virtual reality indicates their health benefits among older adults, there are research gaps in the current literature on the nature-based VR experiences of older Korean Americans. The objective of this study was to gather preliminary information on the health outcomes of the program as well as challenges to participation. Based on in-depth interviews with five participants, three main salient themes as positive outcomes emerged: (a) enjoyment, (b) stress reduction, and (c) cognitive function. On the other hand, there were three main challenges that participants experienced: (a) challenges in the immersion experience itself, (b) difficulties with the controllers, and (c) cybersickness. This finding suggests that the nature-based virtual reality program can serve older immigrant population as a therapeutic tool to increase their mental and cognitive health.
USING REAL-WORLD EVIDENCE TO SUPPORT THE FDA REGULATORY APPROVAL: METHODOLOGICAL CONSIDERATIONS
Authors: Lu Kevin , Slattum Patricia
Published: December 2022

Evidence from clinical trials has traditionally been used to support regulatory drug approval, whereas real-world evidence (RWE) has been used for post-marketing surveillance studies. With the enaction of the 21st Century Cures Act, the Food and Drug Administration (FDA) is evaluating the potential use of RWE to support new indications for an approved product or to satisfy post-approval study requirements. Yet the substantial evidence standard remains unchanged for FDA approval. To date, the FDA has issued guidelines or frameworks for using RWE for regulatory decisions. However, many methodological challenges remain unanswered when using RWE in gerontology research. This Pharmaceutical Care and Outcomes Research Interest Group-sponsored symposium consists of leading experts in the country to address these problems. The four papers in this symposium will address methodological challenges that are unique in gerontology research. Specifically, The first paper will introduce the FDA drug evaluation process, focusing on the key considerations for evaluating RWE in regulatory decision making; the second paper will discuss possible challenges related to data sources from which RWE are generated in aging research; the third paper will provide a case example of some of the challenges in using RWD sources to generate RWE in the Alzheimer’s Disease setting; and the fourth paper will provide recommendations for improving gerontology research based on RWE going forward.
CELL SENESCENCE IS A FEATURE AND MODULATOR OF THE AGED INFLAMMATORY BRAIN CELL LANDSCAPE
Authors: Schafer Marissa , Zhang Xu , Carver Chase , Pearsall Vesselina , Atkinson Elizabeth , Clarkson Benjamin , Grund Ethan , LeBrasseur Nathan
Published: December 2022

New strategies to preserve cognitive function could broadly benefit the aging population. Cellular senescence is a hypothesized mediator of inflammation-related tissue dysfunction in aging. Using single-cell RNA-sequencing, we discovered an age-related brain myeloid population exhibiting overlapping senescent and disease-associated activation signatures, including upregulation of chemoattractant factors. We confirmed senescent brain myeloid cells promote peripheral immune cell chemotaxis in vitro. Through mass cytometry, we demonstrate age- and sex-dependent increases in activated resident and infiltrating brain immune cells are reduced through systemic targeting of p16-positive senescent cells, which is associated with improvements in executive function and spatial learning tasks. Our high-dimensional results reveal dynamic remodeling of the age-dependent brain immune cell landscape and implicate senescent cell targeting as a strategy to counter inflammatory changes and cognitive decline.
AGE-ASSOCIATED GRANZYME K-EXPRESSING CD8+ T-CELLS ENHANCE ATHEROSCLEROSIS IN MICE
Authors: Tyrrell Daniel , Goldstein Daniel
Published: December 2022

A novel population of age-associated Granzyme K (GZMK)-expressing CD8 T cells was found in mice and humans. These cells enhance local tissue senescence and inflammation and are distinct from central memory and conventional Granzyme B- or Interferon γ-producing effector memory CD8 T cells. It is unknown whether these cells drive chronic disease; thus, we induced atherosclerosis in young (3-mo) and aged (18-mo) wild-type mice via the PCSK9-AAV model and used scRNAseq to demonstrate that this GZMK-CD8 T cell population homes to atherosclerotic lesions exclusively in aged mice. Neutralizing CD8 T cells demonstrates that GZMK-CD8 cells drive age-enhance atherosclerosis. Finally, we transferred GZMK-CD8 cells from different aged donors into young CD8-/- hosts and demonstrate that GZMK-CD8 cells from aged but not young donors drive atherosclerosis. In conclusion, we identified a novel role for this recently described population of aging-specific GZMK-expressing CD8+ T cells as a critical driver of chronic disease.
HOW TO GET AN NIA GRANT
Authors: Santora Kenneth
Published: December 2022

Dr. Santora will provide an overview of the NIA application process and will share information on relevant policy changes.
IMPLEMENTATION SCIENCE IN DEMENTIA CARE: METHODOLOGICAL, CULTURAL, AND SOCIODEMOGRAPHIC CONSIDERATIONS
Authors: Gaugler Joseph , Gitlin Laura , Prusaczyk Beth
Published: December 2022

The gap between aging science and practice persists. Getting the best possible evidence into the real world is a particular challenge in gerontology because of the complex needs of older persons, the family caregiving experience, the workforce shortage, and underlying structural concerns with how services for older people are regulated, paid for, and valued. The purpose of this symposium is to consider contextual dimensions to facilitate implementation, methodological considerations, strategies to inform cultural adaptation of evidence-based innovations, and how creativity and innovation in low- and middle-income countries can better inform implementation practices in resource rich countries and vice-versa. Specifically, Dr. Marie Boltz and colleagues will examine the conceptual and theoretical underpinnings of organizational readiness for implementation and the operationalization of the construct. Dr. Joseph Gaugler and co-authors will provide case examples of three “hybrid effectiveness” trials in dementia care in different care settings including community-based and residential long-term care settings, each of which incorporate implementation methods alongside traditional evaluations of effectiveness. Dr. Lauren Parker and her team will demonstrate how cultural adaptation strategies were applied to facilitate the implementation of a community-based, evidence-based dementia care intervention. Dr. Baker and colleagues consider implementation issues and innovations in low- and middle-income countries. Dr. Beth Prusaczyk, an implementation expert, will serve as Discussant and highlight future implementation issues to advance best practices that facilitate and expedite the translation of aging science.
CULTURAL ADAPTATION OF THE ADULT DAY SERVICE PLUS PROGRAM FOR HISPANIC/LATINO DEMENTIA CAREGIVERS
Authors: Parker Lauren , Marx Katherine , Knimbeng Manka , Johnson Elma , Koeuth Sokha , Gaugler Joseph , Gitlin Laura
Published: December 2022

Although Hispanic/Latinos are at disproportionate and increased risk for Alzheimer’s disease and related dementias, few evidence-based supportive care interventions have been specifically developed for or adapted for this population. Adapting a supportive care intervention requires more than Spanish language translation and necessitates an understanding of cultural nuances and care preferences of Hispanic/Latino families and staff who implement the intervention. This paper reports on the cultural adaptation of the Adult Day Service Plus (ADS Plus) intervention for delivery by staff to Hispanic/Latino caregivers which was guided by the Cultural Adaptation Process Model. Also, using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME),we discuss: 1) when modifications were made, 2) who determined modifications needed, 3) what aspects of the intervention were modified, 4) the relationship to fidelity and how fidelity was maintained, and 5) reasons for modifications. Modifications to the delivery and content were changed to reflect values and norms of both the Hispanic/Latino staff and the caregivers they serve. As supportive interventions for dementia caregivers are developed and implemented into real world settings, inclusion of cultural elements may enhance research participation from Hispanic/Latino provider sites and caregivers. We suggest in this paper that cultural adaptation is an essential consideration in developing an intervention as well as adapting evidence-based previously tested interventions, and in implementation science. Cultural adaptation offers an important lens by which to identify contextual factors impacting intervention adoption interventions and needed adaptations to assure equity in the reach of evidence-based programs.
DEPRESSION AND PAIN PERSEVERANCE THROUGH EMPOWERED RECOVERY (DAPPER) PILOT PROGRAM: A CASE STUDY ON TECHNOLOGY
Authors: Clair Catherine , Melvin Tonisha , Szanton Sarah , Saylor Martha Abshire , Thorpe, Jr. Roland J , Taylor Janiece
Published: December 2022

There is a paucity of work focusing on the engagement of older African American women with technology. The aim of the pilot study was to test the Depression and Pain Perseverance through Empowered Recovery (DAPPER) program in a sample of older African American women living with pain and low mood (N=19). The research team hypothesized that most of the women would prefer virtual visits, thus both in-person and virtual options were available for program delivery. So far, of 11 participants, five women have opted to do in-person visits. When asked why, one participant said that having the nurse come to her house was “rewarding, [especially] when you live alone.” Another participant commented that she did not have a computer in her home. These findings demonstrate that older adults exist on a spectrum of comfort with and access to technology.
CHALLENGES AND SOLUTIONS FOR MOBILE HEALTH INTERVENTION RESEARCH IN OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS
Authors: Lukkahatai Nada , Junxin Li
Published: December 2022

Advances in smart phone technologies resulted in exponential growth in the use of mobile technology in health care. The mobile health or mHealth became a tool in engaging patients in self-care, monitor symptoms and provider-patients communication. Older adults living with Multiple Chronic Conditions (MCCs) are required to self-manage their complex conditions. These health demands are greater in low-income older adults. The mHealth can be beneficial in supporting health and increase access to care for this population. Our study examined a feasibility of combination of the mHealth and tailored exercise program for low SES older adults. We found that age-related physical and cognitive decline, acceptance of technology, complexity of user interface, and financial burden hinder the benefit and accessibility of the mHealth. The research team purpose solutions include improve user interface, create training session and technical support, provide incentives and technology and involve caregivers for these challenges.
RECRUITMENT OF SOMMA PARTICIPANTS: TECHNIQUES TO ENROLL OLDER ADULTS IN A COMPLEX STUDY
Authors: Newman Anne , Cawthon Peggy , Mau Theresa , Kritchevsky Stephen , Hepple Russell T , Coen Paul , Goodpaster Bret , Cummings Steven
Published: December 2022

We screened approximately 4200 individuals to enroll 881 including 41% men and 59% women with a mean age =73.4 ± 5SD years; 13% were Black, 85% White and 2% of other race and ethnic groups. We will add 80 individuals aged 30-69 years. Exclusions included unstable medical conditions and inability to walk 400 meters(m). The median baseline 400m gait speed at usual pace was 1.05 ± 0.18SD m/s. Techniques to recruit and enroll a diverse population for this complex project included the use of in-person and video-conference information sessions to explain the complicated study to interested adults and to screen potential participants as needed The COVID pandemic created numerous challenges; while SOMMA was able to meet its recruitment goals, the enrollment period lasted 33 months (instead of the originally planned 18 months). Attendance at follow-up in-person and phone-based assessments is excellent.
JOSEPH T. FREEMAN AWARD AND EXCELLENCE IN REHABILITATION OF AGING PERSONS AWARD PRESENTATIONS AND LECTURES
Authors: Brown Cynthia
Published: December 2022

The Joseph T. Freeman Award lecture will feature an address by the 2022 Freeman Award recipient Neil M. Resnick, MD, FGSA, of the University of Pittsburgh. The Joseph T. Freeman Award is a lectureship in geriatrics awarded to a prominent clinician in the field of aging, both in research and practice. The award was established in 1977 through a bequest from a patient's estate as a tribute to Dr. Joseph T. Freeman. The Excellence in Rehabilitation of Aging Persons Award lecture will feature an address by the 2022 Excellence in Rehabilitation Award recipient Patricia C. Heyn, PhD, FGSA, FACRM, of Marymount University. The Excellence in Rehabilitation of Aging Persons Award is designed to acknowledge outstanding contributions in the field of the rehabilitation of aging individuals.
REFLECTION AND INTENTION: END-OF-LIFE PLANNING IN FORMER CAREGIVERS OF PARENTS LIVING WITH DEMENTIA
Authors: Mroz Emily , Matta Tara , Ali Talha , Piechota Amanda , Abboud Anissa , Sharma Shubam , Monin Joan , Fried Terri
Published: December 2022

Family caregivers for parents living with Alzheimer’s Disease or Related Dementias (ADRD) provide support through health decline, care planning, and death. Guided by the Consensual Qualitative Research method and grounded in a life story framework, this study examines recalled caregiving experiences and descriptions of personal end-of-life planning in 32 midlife former caregivers of parents with ADRD (range: 40-65; 44% male). Former caregivers often expressed appreciation for end-of-life planning but varied in their engagement in planning since their loss. Descriptions of hesitation with planning were rooted in salient challenges from caregiving experiences and reflected relational concerns (e.g., about burdening others with care needs), planning complexity (e.g., perceiving too many factors to account for), or mortality denial (e.g., aversion to thinking more about death). These caregiving experiences may clarify the value of end-of-life planning while, in some cases, impeding decision-making, leading to gaps between former caregivers’ planning intentions and engagement.
REIMAGINING ADVANCE CARE PLANNING: FORMER CAREGIVERS OF AFRICAN AMERICANS WITH DEMENTIA PERSPECTIVES
Authors: Miller Emika , Moss Karen , Wright Kathy , Wilson-Lawson Kimberly , Happ Mary Beth , Rose Karen , Monroe Todd , Wills Celia
Published: December 2022

Advance care planning disparities persist among lower socioeconomic status African American older adults living with dementia despite multiple decades of research. The perspectives of former family caregivers are rarely used in developing effective interventions. This study aims to characterize the advance care planning and other health-related decision-making perspectives of former family caregivers of African Americans who lived with dementia. This qualitative study is part of an ongoing mixed-methods study to co-create a culturally tailored advance care planning intervention. Former caregivers (n=11) participated in semi-structured interviews and identified the following needs: Caregiver education, caregiver recognition by healthcare providers, and removal of caregiving obstacles. Participants also acknowledged their need to restore identity following the death of their care recipient and a desire to assist other caregivers through research participation. This study fills a critical gap by including former caregivers’ perspectives in co-creating a culturally tailored advance care planning intervention.
MIDLIFE CREATIVITY AMONG COMPOSERS AND NOVELISTS
Authors: O'Neill Desmond
Published: December 2022

Although the study of midlife has increased in recent years, it still lags behind study of life at the extremes of age. As a key threshold stage in the lifespan, our understanding can be enhanced by exploration of novelists and composers whose most substantive work began to be produced in midlife. This presentation will draw off the works of midlife works of composers who also composed into later life - Giussepe Verdi, Richard Strauss and Johannes Brahms - from the concert proposed by the Indianapolis Symphony during GSA 2022, as well as reflecting on the works of Anita Brookner as representative of other novelists and poets whose work and careers came to prominence in midlife.
SOCIAL STRESSORS ASSOCIATED WITH AGE-RELATED T LYMPHOCYTE PERCENTAGES IN OLDER US ADULTS: EVIDENCE FROM THE HRS
Authors: Klopack Eric , Crimmins Eileen , Cole Steve , Seeman Teresa , Carroll Judith
Published: December 2022

Exposure to stress is a risk factor for poor health and accelerated aging. Immune aging, including declines in naïve and increases in late memory and terminally differentiated T cells, plays a role in immune health and tissue specific aging, and may contribute to elevated risk for poor health among those who experience high psychosocial stress. Past data have been limited in estimating the contribution of life stress to the development of accelerated immune aging and investigating mediators such as lifestyle and CMV infection. This study utilizes a national sample of 5744 US adults over age 50 to assess the relationship of social stress (viz., everyday discrimination, stressful life events, lifetime discrimination, life trauma, and chronic stress) with flow cytometric estimates of immune aging, including naïve and terminally differentiated T cell percentages and the ratio of CD4+ to CD8+ cells. Experiencing life trauma and chronic stress was related to a lower percentage of CD4+ naïve cells. Discrimination and chronic stress were each associated with a greater percentage of terminally differentiated CD4+ cells. Stressful life events, high lifetime discrimination, and life trauma were related to a lower percentage of CD8+ naïve cells. Stressful life events, high lifetime discrimination and chronic stress were associated with a higher percentage terminally differentiated CD8+ cells. High lifetime discrimination and chronic stress was related to a lower CD4+:CD8+ ratio. Lifestyle factors and CMV seropositivity partially reduced these effects. Results identify psychosocial stress as a contributor to accelerating immune aging by decreasing naïve and increasing senescent T cells.
ADAPTING THE ECHO MODEL TO MEET THE NEEDS OF RURAL DEMENTIA CAREGIVERS
Authors: Schenck Sabine , Carrico Catherine , Carling Stacy
Published: December 2022

Caring for an individual with dementia may result in caregiver stress and burden (Cassie & Sanders, 2008), which can lead to detrimental health outcomes if not managed with effective coping skills and support (Shulz & Martire, 2004). Access to support and psychoeducation is limited in rural and frontier communities, and solutions are needed to reach caregivers across sparsely populated regions. Project ECHO (Extension for Community Health Outcomes) is an evidence-based model designed to improve patient outcomes through healthcare provider education. The Wyoming Dementia Together Caregiver Network is the first of its kind to adapt the ECHO model for family caregivers of persons with dementia. This presentation details evaluation results of 24 session across 52 weeks (n=162). Results suggest that adaptation of Project ECHO for family caregivers is feasible and palatable. In addition, the adapted program shows promise for improving caregiver outcomes such as depressive symptoms and caregiver burden.
CONNECTING THE DOTS: CHRONIC CARE MANAGEMENT PROGRAM IMPLEMENTATION IN RURAL PRACTICES
Authors: Jones Faith , Franke Kevin , Woods Tonja , Bjore Emma , Punke Elizabeth
Published: December 2022

As the focus of healthcare changes from a “sick” care model to a population health model, primary care and specialty clinic practices have new opportunities supported through Medicare reimbursement. The incorporation of team-based care coordination programs into clinic practices is an important step towards value-based care and achieving the Triple Aim: better health for the population, better care for individuals, and lower costs through improvements. Since 2019, six rural Wyoming primary care practices have completed training to implement and expand care coordination programs. HealthTechS3 provides participating clinics with team-based training in the implementation of the Chronic Care Management Program, Behavioral Health Integration, and other billable care coordination services. To date, 301 patients have enrolled in care coordination services. These practices have generated $350,000 in revenue. Using a consolidated implementation framework as a guide, critical components of successful rural care coordination program implementation are discussed.
REIMAGINING AGING: LESSONS ON HEALTHY AGING FROM AARP
Authors: Keenan Teresa , Lampkin Cheryl
Published: December 2022

This presentation will include insights on healthy aging based on data obtained from multiple recent AARP surveys fielded among nationally representative samples of midlife and older adults. Samples were weighted to reflect population estimates (i.e., gender, ethnicity, etc.). Studies also included oversamples of Black/African American and Hispanic/Latino respondents when possible, enabling enhanced analyses. This multi-analysis presentation will provide valuable insights on healthy aging in general, the impact the COVID-19 pandemic has had on the older populations’ ability to maintain healthy habits, and how our “new normal” suggests the need to reimagine healthy aging. This presentation will showcase exciting new findings from AARP Research on diet, exercise, resiliency, and mental health, among others. Augmented with qualitative data, this presentation will also allow participants to hear the voices of older adults on these issues. Additionally, new data collected in late fall 2022 will provide a preview of up-to-the-minute insights.
RACIAL/ETHNIC DIFFERENCES IN SUBJECTIVE COGNITIVE DECLINE AMONG US ADULTS AGED ≥45 YEARS, 2015–2020
Authors: Olivari Benjamin , Wooten Karen , Jackson Eva , McGuire Lisa , Croft Janet
Published: December 2022

Recent studies report that older minorities have a higher prevalence of subjective cognitive decline (SCD), the self-reported experience of worsening or more frequent memory loss or confusion, than older non-Hispanic Whites. This study describes the prevalence of SCD by race/ethnicity and select demographic and social characteristics among U.S. adults aged ≥45 years and whether those reporting symptoms of SCD talked with a health care professional about them. Data collected from 215,406 respondents by the Behavioral Risk Factor Surveillance System (BRFSS) in 2015-2020 were used in the analyses. Statistical comparisons were made using chi-square tests and p value of < 0.05. SCD was reported by nearly 10% of the study population. Asian/Pacific Islanders (5.0%) were least likely to report experiences of SCD and American Indian/Alaska Natives (16.7%) were most likely to report the experience compared to other racial/ethnic groups. Among adults with SCD, Asian/Pacific Islander (34.5%) and Hispanic (40.5%) adults were less likely to talk with a health care professional about their SCD symptoms compared to non-Hispanic White (48.5), non-Hispanic Black (49.5%), and American Indian/Alaska Native (50.5%) adults. Early detection of SCD symptoms can be important to identify early signs of dementia or other potentially treatable conditions and establish a care plan to help people remain as healthy and independent for as long as possible. Health care professionals, especially those working with groups with increased prevalence of SCD, could consider initiating discussions with adults as young as 45 years of age to identify early signs of dementia-like symptoms.
THE IMPACT OF IMPLEMENTING THE PREFERENCES FOR EVERYDAY LIVING INVENTORY (PELI) ON SURVEY DEFICIENCY OUTCOMES
Authors: Abbott Katherine , Bowblis John , Straker Jane , Van Haitsma Kimberly
Published: December 2022

The Ohio Department of Medicaid added the PELI as one of five quality incentive points used to determine Medicaid per diem reimbursement rates with the goal of improving person-centered care among Ohio’s nursing homes (NHs). The purpose of this study was to explore if the degree of PELI implementation had an impact on quality as defined by deficiencies and star rating. Multinomial logistic regression of 1,300 NH-year observations was used to understand the relationships between survey star ratings/deficiency scores on PELI implementation controlling for organizational characteristics of the NH. We find complete PELI implementation statistically significantly increased the probability of being a 4- or 5-star survey-rated facility. Complete PELI implementation is associated with small improvements each year that add up. Organizational change takes commitment and persistent effort over time to see changes in quality as reflected by star ratings and deficiencies. Recommendations for practice and policy will be discussed.
PROJECT ECHO FOR NURSING HOMES: A PATIENT-CENTERED, RCT TO IMPLEMENT INFECTION CONTROL BEST PRACTICES IN NHS
Authors: Heilbrunn Emily , Calo William , Francis Erica , Kong Lan , Hogentogler Ellie , Fisher Abbey , Hood Nancy , Kraschnewski Jennifer
Published: December 2022

Nursing homes (NHs) have been devastated by COVID-19. Only 3% of designated infection preventionists in NHs have taken a basic infection control course. Little is known about the implementation of effective infection control practices in NHs. This study utilizes Project ECHO (Extension for Community Health Outcomes), an evidence-based tele-mentoring model, to connect subject matter experts with NH staff to proactively support evidence-based infection control guideline implementation. This study will determine how guidelines can be implemented effectively in NHs, including reducing COVID-19 diagnoses and improving other key patient-centered outcomes (e.g., quality of life) NHs (N=136) were recruited and assigned to ECHO or ECHO Plus using a randomized design. A multi-pronged approach to improving infection control and emergency preparedness in NHs is important. The ECHO model has significant strengths allowing for remote learning delivered by a multi-disciplinary team and utilizes case discussions that match the context and capacity of NHs.
DEVELOPMENT OF DEMENTIA FRIENDS FOR INCARCERATED SETTINGS CURRICULUM
Authors: Burman Bonnie , Kinzig Elizabeth
Published: December 2022

This presentation describes the working relationships and steps that were taken to develop Dementia Friends for Incarcerated Settings. This included identifying population needs, approval processes, curriculum development specific to this population, learner coordination, implementation, measurement and reporting. Dementia Friends, a one-hour session to help everyone in a community understand five key messages about dementia, was used as the framework for an educational program targeting staff at correctional facilities. Dementia Friends is a standardized program that can be modified depending on the target audience or sector. Our sector-specific program was piloted in all 27 Ohio prisons to ensure that all staff are knowledgeable about ways to make a difference in the lives of those living with dementia.
INNOVATIONS IN TECHNOLOGY FOR SOCIAL ENGAGEMENT AMONG OLDER ADULTS AND TO IMPROVE CAREGIVER COMMUNICATION AND TRAINING
Authors: Meng Hongdao , Barbeau Sean , Li Mingyang , Doyle Cassidy , Wiechart Kelly , Hammond Robert , Kearns William
Published: December 2022

Music-based interventions (MBIs) have been shown to benefit persons with dementia. To develop new MBIs and build the evidence base for motor, cognitive, emotional, and behavioral outcomes, accurate measures of music exposure (e.g., content, dose, and duration) are critically important. However, most commercial music services require internet access and/or subscription fees without providing convenient ways for researchers to access music exposure data. Our research team developed the open-source MUsic to Support Engagement and Resilience (MUSER) Android application with an associated data processing engine. Caregivers can use MUSER to deliver individualized music selections via smartphones/tablets, with music exposure data being generated for research use. We used the Kotlin programming language for application development and Java/Python/Microsoft BI for data processing and analytics instrumentation. The MUSER application was tested for music exposure measurement feasibility with 16 users (ten research team members and six family caregivers of persons with dementia) for two weeks between July and November of 2021. Semi-structured interviews were conducted pre-post application testing to gather qualitative and quantitative data to enrich the understanding of user experiences. Family caregivers had a mean age of 57.8 (SD=26.2; range 20-77). The average number of listening days was 6 (SD=2.5), and the average music listening duration was 203 minutes (SD=123.2). Caregivers played an average of 52 (SD=36.9) songs from 10 (SD=4.2) albums involving 34 (SD=36.3) artists. Given the ease of deployment and integrated data collection and reporting capabilities, this application supports collaborative software development among researchers to advance MBI research.
NOT HAVING THE FAMILY, INSURANCE, AND MONEY AND EXPERIENCING LOTS OF PAIN: FEARS ABOUT CANCER AMONG OLDER LATINO MEN
Authors: Carrion Iraida , Neelamegam Malinee
Published: December 2022

Cancer is the second leading cause of death among Latino men. A total of 44.1% of Latino males 60-years or older have a lifetime probability of developing invasive cancer with lower survival rates, even when accounting for age and stage distribution. Given the population growth is essential to examine older Latinos’ understanding of a cancer diagnosis. The study consisted of 200 surveys that included a qualitative component consisting of open-ended questions in Spanish. We separately analyzed the responses of the 57 immigrant Latino men to understand their perspective regarding cancer, prevention, diagnosis, and treatment. The median age is 68 years and the length of stay in the US is 27 years. Utilizing a grounded theory approach and thematic analysis, codes were developed based on five priori interview themes: leaving people behind, worry and stress about payment, emotions of sadness and fear of uncertainty, struggle with acceptance, and faith as comfort.
THE ROOM WHERE IT HAPPENS: ENGAGING EQUITABLY TO OPTIMIZE CANCER SURVIVORSHIP CARE
Authors: Seaman Aaron , Pagedar Nitin
Published: December 2022

Cancer survivorship care programs, services, and research would benefit from including people living with a cancer history who have ceased their survivorship care in their engagement efforts. Our prior research with head and neck cancer survivors has shown that a considerable number of patients discontinue their post-treatment survivorship care despite still having care needs. Those patients who continue their care are also the ones most often engaged in research and community partnership; as the ones who are “in the room where it happens,” they consequently have the most influential voices in shaping survivorship care. In this paper, we underscore the necessity of including those who discontinue survivorship care in research and community engagement efforts. We use our work with head and neck cancer survivors as a model for strategizing ways to inclusively and respectfully do so.
A GOOD END OF LIFE WITH DEMENTIA ACROSS CULTURES
Authors: van der Steen Jenny
Published: December 2022

Conceptualizations of a good end of life with dementia vary across cultures and understanding differences and similarities can help develop care planning tools and help understand validity of measuring it in the context of cross-cultural comparisons. We have analysed (2019-2020) 14 cross-cultural studies covering qualitative data of 121 people with dementia and 292 family caregivers. Nine cross-culturally common themes emerged, ranging from basic care needs addressed to satisfaction with life and spiritual well-being. Good relationships were essential in all themes, but an emphasis on “care for caregivers” differed the most across cultures. Based on this work, we expanded an existing dementia care goals model by refining palliative care goals beyond comfort and functioning, and in an ongoing Delphi study (2021-2022) it was evaluated by experts of over 30 countries. This session will report on these studies, focusing on relevant cross-cultural differences, and connecting it to available measures of comfort and end-of-life care.
DEATH AND DYING IN GREEN CARE FARMS
Authors: Meijers Judith , Smit Kirsten , de Boer Bram , Verbeek Hilde , Bolt Sascha
Published: December 2022

Green care farms form an alternative to traditional nursing homes for people with dementia and combine agriculture production with health-related, social and educational services. Twenty-four-hour care green care farms offer end-of-life care. The aim of the study was to explore the experiences of healthcare workers and family caregivers with end-of-life care for people with dementia who died on a green care farm in the Netherlands. Semi-structured, in-depth interviews were conducted to explore their experiences with end-of-life care, including topics such as advance care planning, bereavement support and the influence of COVID-19. The study showed that most experiences were characterized by personal attention for the resident and family caregivers, and tailored holistic care. The duration of the dying phase was typically short, and most residents remained active until their final days. Despite the COVID-19 measures, healthcare workers and family caregivers still experienced adequate end-of-life care.
DUAL SENSORY LOSS AND DEPRESSIVE SYMPTOMS: FINDINGS FROM THE LONGITUDINAL AGING STUDY IN INDIA (LASI)
Authors: Wang Ethan , Morales Emmanuel Garcia , Lin Frank , Reed Nicholas , Deal Jennifer
Published: December 2022

Prior work suggests that vision and hearing loss may be risk factors for depressive symptoms in older adults. However, few studies have focused on the relationship of both vision and hearing loss (dual sensory loss, DSL) and depressive symptoms. Using the first nationally representative population study from LASI in India conducted from 2017-2019, Poisson models tested the association of DSL with depressive symptoms. Self-reported vision and hearing loss were associated with increased depressive symptoms (PR 1.29; 95%CI, 1.25-1.33 and 1.15; 95%CI, 1.09-1.22) after adjusting for age, sex, education, economic status, marital status, urbanicity, region, diabetes, heart disease, hypertension, stroke, and smoking. DSL had a 46% higher risk (95% CI, 1.37-1.56) of depressive symptoms. Poor vision and/or hearing loss may be a risk factor for depressive symptoms in adults in India aged ≥45 years. The risk of depressive symptoms in those with sensory loss should be investigated in further studies.
AGING AND THE SOCIAL BRAIN: THE ROLE OF SOCIAL NETWORKS IN ALZHEIMER'S DISEASE AND RELATED DEMENTIAS
Authors: Perry Brea
Published: December 2022

Research suggests social connectedness reduces dementia risk and helps older adults with neuropathology maintain cognitive functionality and quality of life. However, little is known about the specific underlying social and biological mechanisms. This presentation provides an overview of three promising pathways through social bridging (i.e., cognitive enrichment through expansive social networks), social bonding (i.e., neuroendocrine benefits of integration in cohesive social networks), and social stress (i.e., HPA axis dysregulation resulting from social losses, role exits, and dysfunction or strain in relationships). It discusses how personal social network methodology combined with tests of general and social cognitive function and/or biomarkers can identify specific etiological mechanisms. These insights can be leveraged to develop policies and programs that support brain health and cognitive function in older adults. This presentation sets the stage for the remainder of the symposium, which presents empirical findings examining these mechanisms from a social network perspective.
NEUROLOGICAL CORRELATES OF SOCIAL BONDING AND BRIDGING
Authors: Manchella Mohit , Logan Paige , Perry Brea , Peng Siyun , Hamilton Lucas , Risacher Shannon , Saykin Andrew , Apostolova Liana
Published: December 2022

Social connectedness has been linked to decreased rates of cognitive decline in later life. However, recent work suggests that particular social network characteristics (i.e., bonding and bridging) may buffer against age-related degeneration. The present study analyzes social network and structural MRI data of 176 older adults from the Social Networks and Alzheimer’s Disease (SNAD) study. Results indicate that increased social bridging is associated with greater grey matter (GM) volume in several limbic structures. Increased social bonding is associated with greater GM volumes in several cerebral cortex structures as well as greater volumes in some components of the limbic system. Most notably, the effects of bridging are primarily lateralized in the left hemisphere while the effects of bonding are observed mostly in the right hemisphere. These results suggest that the neurocognitive benefits of social connectedness depend on the preponderance of bridging and/or bonding ties in older adults’ social networks.
FUNCTIONAL AGING TRAJECTORIES AND DRUG INTERACTIONS
Authors: Deliveira Thais Lopes , Hägg Sara
Published: December 2022

Markers of functional aging can be used to track biological aging longitudinally and how it changes in response to the environment, e.g., drugs. We aimed to investigate how different drug classes may alter functional aging trajectories using data from the National E-infrastructure of Aging Research (NEAR) in Sweden. Data were harmonized across several longitudinal cohorts of aging for general cognitive performance, grip strength, walking speed, sensory ability (visual and hearing), lung function and assessment of frailty using the accumulation deficit model known as the frailty index. Selected drug classes were lipid lowering, glucose lowering and blood pressure lowering medications that are commonly used in old adults. Preliminary analysis using data from one longitudinal cohort shows that using glucose lowering drugs was associated with lower frailty. Additional analyses are ongoing to increase sample sizes. We anticipate that several drug classes may be important for changing functional aging trajectories in late life.
AGE-RELATED HEARING LOSS, LATE-LIFE DEPRESSION, AND RISK FOR INCIDENT DEMENTIA IN OLDER ADULTS
Authors: Golub Justin , Brewster Katharine , Hu Mei-Chen , Zilcha-Mano Sigal , Brown Patrick , Wall Melanie , Roose Steven , Rutherford Bret
Published: December 2022

The interrelationships between hearing loss (HL), depression, and dementia remain poorly understood. 8529 participants ≥60 years without cognitive impairment were analyzed from the National Alzheimer’s Coordinating Center uniform dataset. Participants had no HL, untreated HL, or treated HL. Outcomes included depression (15-item GDS≥5) and dementia conversion. A longitudinal logistic model examined the association between HL and changes in depressive symptoms. Cox proportional hazards models examined HL and incident dementia. Treated HL (vs no HL) had increased risk for depression (OR=1.26, 95%CI=1.04-1.54) and dementia conversion (HR=1.29; 1.03-1.62). Baseline depression was a strong independent predictor for dementia conversion (HR=2.32, 1.77-3.05). Development/persistence of depression was also associated with dementia (HR=1.89, 1.47-2.42), but only accounted for 6% of the direct hearing-dementia relationship suggesting no significant mediation of depression. In conclusion, both HL and depression are independent risk factors for dementia conversion. Understanding the mechanisms linking these later-life disorders may identify targets for early interventions.
PHOTO DOCUMENTATION: USING NEW METHODS IN COLLABORATION WITH ART
Authors: Heinz Melinda , Gleissner Laura , Benton Nathan
Published: December 2022

Narrative analysis has been used extensively in qualitative research, but photo analysis is relatively new. In the present study, older adults took photographs and wrote narratives for 15 days about something that brought meaning and purpose to their lives. This presentation explains how both methods were paired together and the challenges of seeking Institutional Review Board (IRB) when new and “unproven” approaches are used. In our case, IRB reviewers were particularly concerned with identifying information in photographs and recommended that personal information (e.g., medication bottle) should be blurred when sharing photographs. Discussion of how using diverse qualitative methods can create opportunities for new dissemination methods and partnerships with other disciplines will also be noted. In our study, several pop-up art exhibits of participant photos and narratives were hung in public community spaces to promote greater discussion and reflection on purpose and meaning in later life.
COVID-19 INTENSIFIED HOME CARE WORKFORCE CHALLENGES
Authors: Hunter Melissa , Tyler Denise , Porter Kristie , Dey Judith , Squillace Marie , Haltermann William , Oliveira Iara
Published: December 2022

The COVID-19 pandemic affected home care workers in several important ways. The purpose of this study was to detail the challenges faced and the state and federal policy responses implemented to address those challenges. We conducted scans of federal and state policies enacted during the pandemic, home care agency practices described in media reports and the literature, and interviews with 25 stakeholders. Some challenges encountered were entirely new and resulted directly from the pandemic, such as limited access to personal protective equipment due to workers not being recognized as “essential.” In other cases, the pandemic worsened long-standing challenges, such as recruitment and retention. State policy responses included Medicaid rate increases, hazard pay, and changes to staff training requirements. Federal policy responses included disaster relief funding as well as allowing non-physician practitioners to order services. Stakeholders suggested additional policy changes will be needed to address ongoing challenges experienced by this workforce.
Fear and Violence, Loyalty and Treason: Settlement of Status in Syria
Authors: Sosnowski Marika
Published: December 2022

This article examines the arbitrary and oftentimes violent nature of loyalty and belonging in the case of Syria but with applicability to other authoritarian or high-surveillance contexts. It shows how the new “settlement of status” process is an extension of the governmentality of violence used by the Syrian regime to delineate loyal citizens from traitors. However, the article argues that this process is Janus-faced and actually serves to undermine the regime in the long run by destabilizing its surety around who is considered loyal and who is a potential threat. This uncertainty has the potential to sow the seeds for greater dissent and with it, act as one possible catalyst for the regime's eventual collapse. The Syrian case offers broader insights into the various social and political permutations of a citizen's relationship to the state and how that relationship can be impacted over time by the state's use of fear and violence as mechanisms for social control.
SCAT uncovers ATLAS’s first tidal disruption event ATLAS18mlw: a faint and fast TDE in a quiescent Balmer strong Galaxy
Authors: Hinkle Jason T , Tucker Michael A , Shappee Benjamin J , Holoien Thomas W-S , Vallely Patrick J , de Jaeger Thomas , Auchettl Katie , Aldering Greg , Ashall Chris , Desai Dhvanil D , Do Aaron , Payne Anna V , Tonry John L
Published: December 2022

We present the discovery that ATLAS18mlw was a tidal disruption event (TDE) in the galaxy WISEA J073544.83+663717.3, at a luminosity distance of 334 Mpc. Initially discovered by the Asteroid Terrestrial Impact Last Alert System (ATLAS) on 2018 March 17.3, the TDE nature of the transient was uncovered only recently with the re-reduction of a SuperNova Integral Field Spectrograph (SNIFS) spectrum. This spectrum, taken by the Spectral Classification of Astronomical Transients (SCAT) survey, shows a strong blue continuum and a broad H α emission line. Here, we present roughly 6 yr of optical survey photometry beginning before the TDE to constrain active galactic nucleus activity, optical spectroscopy of the transient, and a detailed study of the host galaxy properties through analysis of archival photometry and a host spectrum. ATLAS18mlw was detected in ground-based light curves for roughly 2 months. From a blackbody fit to the transient spectrum and bolometric correction of the optical light curve, we conclude that ATLAS18mlw is best explained by a low-luminosity TDE with a peak luminosity of log(L [erg s−1]) = 43.5 ± 0.2. The TDE classification is further supported by the quiescent Balmer strong nature of the host galaxy. We also calculated the TDE decline rate from the bolometric light curve and find ΔL40 = −0.7 ± 0.2 dex, making ATLAS18mlw a member of the growing class of ‘faint and fast’ TDEs with low peak luminosities and fast decline rates.
Modelling multiphase gases in cosmological simulations using compressible multifluid hydrodynamics
Authors: Weinberger R , Hernquist L
Published: December 2022

The diffuse medium in and around galaxies can exist in a multiphase state: small, cold gas clouds contributing significantly to the total mass embedded in pressure equilibrium with a hotter, more diffuse volume-filling component. Modelling this multiphase state in cosmological simulations poses a significant challenge due to the requirements to spatially resolve the clouds and consequently the interactions between the phases. In this paper, we present a novel method to model this gas state in cosmological hydrodynamical simulations. We solve the compressible two-fluid hydrodynamic equations using a moving-mesh finite-volume method and define mass, momentum, and energy exchange terms between the phases as operator-split source terms. Using a stratified flow model, our implementation is able to maintain volume fraction discontinuities in pressure equilibrium to machine precision, allowing for the treatment of both resolved and unresolved multiphase fluids. The solver remains second order accurate on smooth hydrodynamics problems. We use the source and sink terms of an existing two-phase model for the interstellar medium to demonstrate the value of this type of approach in simulations of galaxy formation, compare it to its effective equation of state implementation, and discuss its advantages in future large-scale simulations of galaxy formation.