bluuebunny/crossref_metadata_2025 huggingface dataset:
SITTING PATTERNS, PHYSICAL ACTIVITY, AND PHYSICAL FUNCTIONING IN OLDER ADULTS
Authors: Rosenberg Dori E , Greenwood-Hickman Mikael Anne , walker Rod , Richmire KatieRose , Crane Paul , Larson Eric , LaCroix Andrea
Published: November 2019

We examined cross-sectional associations between physical function and device-based (activPAL) sedentary patterns and physical activity. Physical function tasks included time to complete 5 chair stands and walk a 10-foot gait speed course. We estimated associations using linear regression models adjusting for age and sex; coefficients represent estimated change in mean activPAL measures associated with each second increase in gait/chair stands time. Longer gait speed times were associated with more total sitting time (b=0.19, p < 0.01), fewer steps (b=-788.0, p<0.001), fewer sitting breaks (b=-1.7, p<0.01), and more prolonged sitting bouts (b=0.19, p<0.01). Longer chair stand times were associated with more total sitting time (b=0.06, p<0.001), less standing time (b=-0.04, p<0.01), fewer steps (b=-176.8, p<0.001), fewer sitting breaks (b=-0.45, p<0.01), and more prolonged sitting bouts (b=0.07, p<0.001). Prolonged patterns of sitting time and higher total sitting time, in addition to lower physical activity, were consistently associated with worse physical function.
ASSOCIATION OF 10-YEAR WALKING TRAJECTORIES WITH COGNITIVE FUNCTION IN OLDER ADULTS: ADULT CHANGES IN THOUGHT STUDY
Authors: Gardiner Paul , Jefferis Barbara J , Richmere KatieRose , LaCroix Andrea Z , Crane Paul K , Larson Eric B , Rosenberg Dori E
Published: November 2019

We identified trajectories of older adults’ walking and their associations with cognitive function. Data on walking (days/week) were collected at baseline of the Adult Changes in Thought study and every two years for 10 years. Cognitive function was assessed by the Cognitive Abilities Screening Instrument (CASI) at year 12. Group-based trajectory analyses identified trajectories among 763 participants (baseline age 70±5 years, 60% female). Regression models, adjusted for baseline sociodemographic and health factors, examined associations with cognitive function. Five walking trajectories were identified: consistently inactive (18.1%), medium active (21.9%), early decline (15.8%), late decline (18.4%), and consistently active (25.8%). Mean CASI score was 92.0 (SD 6.9). CASI scores were lower in early b = -1.66 (95%CI: -2.97, -0.35) and late decline b = -1.89 (-3.26, -0.51) groups, with no difference in consistently active and inactive groups, compared to the medium active trajectory group. Ten-year walking trajectories may determine late-life cognitive function.
ASSOCIATIONS BETWEEN NEIGHBORHOOD CHARACTERISTICS AND SITTING PATTERNS IN OLDER ADULTS
Authors: Greenwood-Hickman Mikael Anne , Walker Rod L , Richmire KatieRose , LaCroix Andrea , Larson Eric B , Crane Paul K , Rosenberg Dori E
Published: November 2019

Neighborhood characteristics are associated with self-reported sedentary behavior (SB) in older adults. However, self-report measures are not able to accurately assess total sitting time nor detailed patterns of SB. This analysis explores the relationship between device-based SB variables from activPAL and neighborhood characteristics (demographics) in the ACT cohort. Neighborhood characteristics were assessed with the modified Physical Activity Neighborhood Environment Scale (PANES; scored 1.0-4.0, higher score, higher walkability). Data were analyzed using linear regression models adjusted for demographic factors. Higher PANES score was associated with higher daily steps (+1180 daily steps/point on PANES, p<0.001) and sit-to-stand transitions (+2.7 daily transitions/point on PANES, p=0.004). Confirming other studies, neighborhood walkability promotes physical activity. A novel finding was that sitting interruptions, which can only be assessed with devices, were also associated with higher neighborhood walkability, while total sitting time was not.
STUDIES ON ADJUSTMENT TO RETIREMENT: HOW OLDER EUROPEANS NAVIGATE THE RETIREMENT TRANSITION
Authors: Solinge van , Grunwald Olga
Published: November 2019

Retirement is a significant life transition in late adult life that often brings about great changes in individuals’ patterns of everyday activity, social networks as well as one’s economic resources, requiring adjustment for both the retiree and other members of the household. Retirement is a process that starts with a preparatory stage, followed by the actual act of retirement and a post-retirement stage where retirees have to get used to the changing aspects of life that result from the work-retirement transition, and seek to achieve psychological comfort with their retirement life. This symposium brings together empirical research on the various stages of the retirement process, from different national backgrounds. The guiding question is how work and the loss of work affect well-being. Hence, the symposium will give insights into the circumstances under which retirement risks well-being and psychological comfort of older adults. Anna Wanka discusses under which conditions retirement feels right for German retirees, and how this feeling shifts and changes throughout the retirement process. Sarah Dury follows with the post-retirement stage by demonstrating a qualitative perspective of recently retired Belgians about their adjustment, role and activities they exert during post-retirement. Isabelle Hansson examines the role of personality for retirement adjustment in a Swedish sample of older adults. Hanna van Solinge explores the impact of agency in the work-retirement transition on adjustment to a longer working life /retirement and life satisfaction in a Dutch panel study.
THE ROLE OF PERSONALITY IN RETIREMENT ADJUSTMENT: LONGITUDINAL EFFECTS ON LIFE SATISFACTION
Authors: Hansson Isabelle , Henning Georg , Buratti Sandra , Lindwall Magnus , Kivi Marie , Johansson Boo , Berg Anne Ingeborg
Published: November 2019

Research on the retirement transition suggests that personality can influence the adjustment process, but the mechanisms involved remain still largely unknown. In the present study we investigate direct and indirect associations between the Big Five personality traits and life satisfaction over the retirement transition. Indirect effects were evaluated through the role of personality for self-esteem, autonomy, social support, perceived physical and cognitive health, and financial satisfaction. The sample included 796 older adults and four annual measurement waves in the Swedish longitudinal HEARTS study. Results from multivariate latent growth curve models showed multiple indirect effects of personality. Extraversion was positively related to life satisfaction through increased self-esteem, autonomy, and social support. Neuroticism was negatively associated with life satisfaction through decreased self-esteem, autonomy, social support, and perceived cognitive ability. Our findings suggest that retirees with higher neuroticism are more likely to experience adjustment problems resulting from negative changes in key resources.
SMART LIFE, FITNESS, WELLNESS, AND THE PROMISE OF DIGITAL HEALTH TECHNOLOGIES FOR OLDER PEOPLE
Authors: Katz Stephen
Published: November 2019

Based on the author’s ethnographic observation and collection of product media kits, videos, and photographs from the Consumer Electronics Show 2019, this paper critiques the ways in which positive lifestyle concepts such as ‘smart life’, ‘fitness’ and ‘wellness’ are designed within products aimed at senior marketing to shape the older consumers as composites of health problems open to technological intervention. However helpful sensor clothing, home surveillance cameras, self-tracking appliances, robotic companions, or digital mobility devices may be, they are also opportunities to capitalize on shared personal data and subscription-based monitoring services. Discussion links these concepts to wider concerns about algorithimic standardization of health risks for older people, healthcare austerity programs, and social inequalities based on technical markers of successful aging and privileged life-course trajectories
THE IMPORTANCE OF TRANSPARENCY AND OPEN SCIENCE IN GERONTOLOGY: PERSPECTIVES FROM EARLY-CAREER RESEARCHERS
Authors: Lodi-Smith Jennifer , Graham Eileen K
Published: November 2019

The past decade has seen rapid growth in conversations around and progress towards fostering a more transparent, open, and cumulative science. Best practices are being codified and established across fields relevant to gerontology from cancer science to psychological science. Many of the areas currently under development are of particular relevance to gerontologists such as best practices in balancing open science with participant confidentiality or best practices for preregistering archival, longitudinal data analysis. The present panel showcases one of the particular strengths of the open science movement - the contribution that early career researchers are making to these ongoing conversations on best practices. Early career researchers have the opportunity to blend their expertise with technology, their knowledge of their disciplines, and their vision for the future in shaping these conversations. In this panel, three early career researchers share their insights. Pfund presents an introduction to preregistration and the value of preregistration from the perspective of “growing up” within the open science movement. Seaman discusses efforts in and tool for transparency and reproducibility in neuroimaging of aging research. Ludwig introduces the idea of registered reports as a particularly useful form of publication for researchers who use longitudinal methods, and/or those who work with hard-to-access samples. The symposium will include time for the audience to engage the panel in questions and discussion about current efforts in and future directions for transparent, open, and cumulative science efforts in gerontology.
TRANSPARENCY AND REPRODUCIBILITY IN THE NEUROIMAGING OF AGING
Authors: Seaman Kendra L
Published: November 2019

In concert with broader efforts to increase the reliability of social science research, there are several efforts to increase transparency and reproducibility in neuroimaging. The large-scale nature of neuroimaging data and constantly evolving analysis tools can make transparency challenging. I will describe emerging tools used to document, organize, and share behavioral and neuroimaging data. These tools include: (1) the preregistration of neuroimaging data sets which increases openness and protects researchers from suspicions of p-hacking, (2) the conversion of neuroimaging data into a standardized format (Brain Imaging Data Structure: BIDS) that enables standardized scripts to process and share neuroimaging data, and (3) the sharing of final neuroimaging results on Neurovault which allows the community to do rapid meta-analysis. Using these tools improves workflows within labs, improves the overall quality of our science and provides a potential model for other disciplines using large-scale data.
REGISTERED REPORTS FOR ECRS: ENABLING SLOW SCIENCE ON TIGHT TIMELINES
Authors: Ludwig Rita
Published: November 2019

Early career researchers (ECRs) may experience tension between the ideal and actual amounts of time they have to complete a scientific project. Sometimes, a timeline is truncated because a citable product is required for applications or fellowship deadlines. This scenario is especially common for researchers who use longitudinal methods, and/or those who work with hard-to-access samples. Registered reports, an open science initiative, offer one resolution to this tension. In registered reports, the steps of analysis planning, manuscript writing, and peer review occur earlier than the traditional journal article publication process. If an in principle acceptance is earned, ECRs are afforded citable, peer-reviewed acknowledgement of their scientific thinking prior to the conclusion of a research project. This talk will serve as a primer on the registered report process. I will also discuss resources for writing registered reports, and provide a list of relevant participating journals in the field of gerontology.
THE ROLE OF WORK AND RETIREMENT IN COGNITIVE AND BRAIN AGING
Authors: Hueluer Gizem , Rebok George W
Published: November 2019

According to the “use it or lose it” hypothesis of cognitive aging, cognitive enrichment and cognitively engaging activities are associated with the maintenance of high levels of cognitive functioning in old age. Similar ideas have been brought forward with respect to characteristics of individuals’ work environment, with more cognitively enriching work demands providing an optimal environment for cognitive development and maintenance. The goal of this research group is to showcase new developments in research on work, retirement and cognitive aging. Hülür et al. examine the role of perceived work environment for cohort differences in trajectories of cognitive change based on 56-year longitudinal data from the Seattle Longitudinal Study. Andel et al. use data from the Swedish Adoption/Twin Study of Aging to examine trajectories of cognitive aging before vs. after retirement with two-slope growth curve models. Zulka et al. conduct a systematic literature review on the association between retirement and cognition and examine the role of factors such as occupational experiences and the cognitive domain studied. Burzynska et al. investigate the relationship between stressful and stimulating occupational exposures and structural brain health and cognition in older age. The discussion by George Rebok will focus on how these findings contribute to our understanding of the role of occupational experiences for cognitive and brain aging and how they can be utilized to promote maintenance of cognitive functioning in old age.
REVIEW ON THE COMPLEX RELATION BETWEEN RETIREMENT AND COGNITION: UNRAVELING THE MIXED EVIDENCE
Authors: Zulka Linn Elena , Hansson Isabelle , Hassing Linda B
Published: November 2019

A systematic review from 2017 revealed a great research gap concerning the question if retirement affects cognitive function. Since then, several longitudinal studies have been published, calling for an updated review. The aim of this review is to provide an update with a focus on different retirement operationalization, different cognitive outcomes, and potential mediators like occupational experiences. Twenty peer-reviewed studies with longitudinal designs were included. The results revealed no clear pattern regarding the association between retirement and the cognitive outcomes. Study results varied in relation to factors like occupational experiences, differences in study quality, and cognitive domains. To get an insight into mechanisms behind the relation between retirement and cognitive functioning, more complex study designs are needed that take into account the impact of pre-retirement factors, different retirement related aspects, and the varying effects depending on cognitive domain.
CAN NEIGHBORHOOD AND LOCAL ENVIRONMENTS MODIFY COGNITIVE DECLINE? FINDINGS FROM THE REGARDS STUDY
Authors: Clarke Philippa J , Finlay Jessica M
Published: November 2019

Environmental factors may significantly increase the risk of, or buffer against, age-related cognitive decline, yet policies and practices to improve cognitive health outcomes to date largely overlook the role of neighborhoods and socio-physical environmental contexts. Residence in socioeconomically advantaged neighborhoods may promote cognitive function through greater density of physical and social resources (e.g., libraries, parks, coffee shops, air conditioning, community centers) that promote physical activity, facilitate mental stimulation, and encourage social engagement. This symposium will identify natural, built, and social environmental factors linked to changes in cognitive function over time (assessed by animal naming and world list learning tests) based on secondary data analyses of a national, racially diverse (42% Black), population-based sample of over 30,000 Americans aged 45+ in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study followed annually since 2003. The first two papers investigate the roles of racial residential segregation and education on cognitive function disparities at the neighborhood and city scale. The third paper explores fast-food restaurants as socially interactive community spaces for older adults that may help buffer against cognitive decline. The fourth paper investigates effects of local air temperature on cognitive testing performance, and discusses how regional differences and seasonality may buffer or exacerbate temperature-cognition associations. Altogether, the symposium elucidates how cognitive health is impacted by a complex interplay of individual and geographic factors. The papers inform policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the well-being of older adults aging in place.
EVALUATING THE ASSOCIATION BETWEEN SLEEP AND MEMORY IN OLDER VETERANS WITH PTSD
Authors: Hall Katherine S , Morey Miriam C , Bosworth Hayden , Beckham Jean , Pebole Michelle
Published: November 2019

Sleep disturbances are core symptoms of posttraumatic stress disorder (PTSD), and recent studies also suggest a link between PTSD and cognitive impairment. There is some evidence of an association between sleep disturbances and cognitive abilities, such as memory, though few studies have focused on older adults and fewer still among those with mental health conditions. This study examined the association between subjective memory complaints and sleep (quality and quantity) in older veterans with PTSD. Fifty-four veterans with PTSD (M age=67.4, 85.2% African American, 90.7% men) participated in the study. Sleep was assessed using the Pittsburgh Sleep Quality Inventory (PSQI) and the PSQI Addendum for PTSD (PSQI-A). Memory was assessed using the Frequency of Forgetting Scale (FOF) derived from the Memory Functioning Questionnaire. The relationship between sleep quality parameters and FOF were examined using bivariate correlations and independent samples t test. Over 60% of participants met military-specific criteria for poor sleep (PSQI≥10; PSQI-A>5). Overall sleep quality on the PSQI-A was significantly associated with worse memory (r=-0.38, p<.01). Among specific sleep parameters (e.g., sleep latency, sleep duration), greater daytime dysfunction due to sleepiness was significantly associated with worse memory (r=-0.44, p<.01). Between-group analyses comparing memory complaints across participants classified as ‘poor’ versus ‘good’ sleepers on the PSQI-A approached significance (t(52)=1.93, p=.06). This study suggests that poor sleep may be a correlate of memory complaints among older adults with PTSD. Future studies are needed to determine whether poor sleep is an underlying factor in the link between PTSD and cognitive impairment.
MIND-BASED AND MOVEMENT-BASED MIND-BODY INTERVENTION FOR CHINESE OLDER PEOPLE WITH DEPRESSION
Authors: Chan Sunny H W , Lo Herman H M , Yu Chong Ho
Published: November 2019

Mind-body intervention has been well established as an alternative psychosocial intervention for managing depression. Mindfulness-based intervention (MBI) and health qigong (HQ) are two common forms of mind-body intervention which share the common focus on breathing. However, they may represent two distinct approaches with different mechanisms. MBI focuses more on mind-based practices whereas HQ may focus predominantly on body-based movement practices. Thus, a large research gap in comparing the unique therapeutic effects of mind-based and movement-based health practices on alleviating depression among older people is worthy of further investigation. A total of 45 community-dwelling Chinese older adults aged 60 or above with symptoms of clinical depression were recruited. They were randomly assigned to three different groups, including an MBI group, a HQ group, and a waitlist control (WLC) group. Comparisons were made before and after 8-week interventions. Regarding the primary outcome, the effect sizes between the MBI and WLC groups, as well as between the HQ and WLC groups, were reasonably large (Hedges’ g = 1.338 and 0.725, respectively), yet the effect size between the MBI and HQ groups was moderate (Hedges’ g = 0.325). Specifically, participants in the MBI group showed more improvements on perceived stress, self-efficacy, and mental health, whereas participants in the HQ group showed relatively better performance regarding interoception and physical mobility. Findings from this research demonstrate the unique therapeutic effects of mind-based and movement-based interventions on alleviating depression among older people. The application of two distinct forms of mind-body intervention in a Chinese context is discussed.
ELDER MISTREATMENT AND ANXIETY SYMPTOMS AMONG U.S. CHINESE OLDER ADULTS
Authors: Chao Ying-Yu , Chang Yu-Ping , Dong XinQi
Published: November 2019

Purpose: Elder mistreatment is a critical public health issue across all cultural backgrounds. However, we have limited understanding of the mental health outcomes of elder mistreatment among older Chinese Americans. This study aimed to examine the association between different types of elder mistreatment and anxiety symptoms among U.S. Chinese older adults. Methods: Data were from the Population Study of Chinese Elderly in Chicago (PINE), a community-based participatory research study of 3,157 Chinese older adults in the Greater Chicago area. Elder abuse was assessed with the overall abuse screening test and Modified Conflict Tactic Scale. Anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS-A). Multivariate logistic regression analyses were performed. Results: Participants had a mean age of 72.8 ± 8.3 years old (range 60-105). After controlling for potential covariates, participants with overall abuse (OR = 1.76, 95% CI: 1.57-1.98, p < .001), psychological abuse (OR = 1.76, 95% CI: 1.53-2.02, p < .001), physical abuse (OR = 1.56, 95% CI: 1.03-2.36, p < .05), and financial exploitation (OR = 1.24, 95% CI: 1.06 – 1.44, p < .001) were more likely to have anxiety symptoms. However, sexual abuse was not significantly associated with anxiety symptoms (p = 0.83). Conclusion & Implications: Our findings indicate that elder mistreatment may result in anxiety symptoms among Chinese older adults. Further studies can examine whether Chinese cultural traits (e.g., face, harmony) influence the relationships between elder mistreatment and anxiety symptoms.
AGING WITH SCHIZOPHRENIA: RACIAL DISPARITIES IN COGNITIVE IMPAIRMENT
Authors: Dobbins Sarah , Hubbard Erin , Leutwyler Heather C
Published: November 2019

Introduction: Cognitive impairment (CI) is a core feature of schizophrenia (SCZ). Comorbidities such as substances/smoking, metabolic syndrome, and medications contribute to CI. There are racial disparities in CI in the general US population. No study has evaluated CI racial disparities among people with schizophrenia (PWSCZ). The aims of this study were to describe the clinical/psychosocial correlates and racial disparities in CI. Methods: Cognitive performance in PWSCZ over 55 years old was measured using MATRICS Consensus Cognitive Battery (N=66). We calculated age- and gender-corrected scores for global cognitive performance, which represent number of standard deviations away from the mean of the MCCB normative sample. Clinical and sociodemographic data were collected. A counterfactual approach was used to explore mediation of CI through education. Results: Our “all-comer” convenience sample represented 57.6% white, 25.8% black, and 16.6% other non-white groups. There was a black/non-black disparity in cognitive score (-2.33 v.s. -1.68, t=2.843, p<.01). This difference remained significant in a regression model adjusted for age, substance use, smoking, education, antipsychotic medication, and positive/negative symptoms (-.6611, [95%CI:-1.12,-.20], overall F8, 57=3.690, p=.0016). In the mediation analysis, education accounted for 19% of the disparity in CI. In the counterfactual scenario in which education was distributed equally, education accounted for 48% of the disparity. Conclusion: There are significant racial disparities in cognitive performance among older PWSCZ, and educational attainment may account for a sizable portion of the disparity.
FORMAL TRAINING IN TELEHEALTH UNIQUELY PREPARES AN INTERDISCIPLINARY WORKFORCE IN GERIATRICS AND GERONTOLOGY
Authors: Nearing Kathryn A , Lum Hillary D , Hardland Janna , Church Skotti , Hartz Stephanie
Published: November 2019

Geriatric Research Education and Clinical Centers (GRECCs) are centers of excellence funded by the Veterans Administration for the advancement and integration of research, education and clinical activities in geriatrics and gerontology to improve the health, and health care of, older Veterans. The GRECC Connect program expands access to care for rural-residing older Veterans and caregivers. Eastern Colorado GRECC Connect integrates Associated Health Trainees (Audiology, Psychology, Social Work, Pharmacy) and Geriatric Medicine Fellows into interdisciplinary tele-geriatric and tele-palliative care consultations provided to outlying community-based outpatient clinics. The formal telehealth training includes: (1) an initial didactic orientation to introduce skills, common challenges, and important tips when working with older patients and caregivers via telehealth; (2) direct observation and modeling by preceptors, followed by a structured opportunity to debrief what the trainee observed and address questions; and (3) opportunities to provide Geriatric telehealth services, supported by the interprofessional team and feedback and reflection. A formal competency assessment, standardized observation protocol and debriefing guide support the development and assessment of telehealth competencies. During exit interviews, trainees indicated that these experiences offered unique opportunities to develop their clinical skills, particularly related to active listening and communication. They identified their involvement with GRECC Connect as a highly valued aspect of their Geriatrics training. Rigorous training in telehealth is an essential aspect of workforce development in Geriatrics and Gerontology given the concentration of older adults in rural areas. During this session, we will highlight the value of telehealth training for workforce development in Geriatrics and Gerontology.
THE LAST MONTH OF LIFE: AN EXPLORATORY REVIEW OF THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Latimer Abigail , Montemuro-Rode Lauren , Garrison Brianna , Gibson Allison
Published: November 2019

Approximately 80% of Americans prefer to die at home. Hospice and palliative care services are associated with improved pain and symptom management, increasing capacity to meet preferences for end-of-life care at home. However, according to the NHPCO (2018) only 48% of Medicare beneficiaries were enrolled in hospice at the time of death. This poster presents trends in the last month of life for adult Medicare beneficiaries age 65 or older examining the influential factors contributing to the quality of end-of-life experiences. A cross-sectional survey design was utilized with the National Health and Aging Trends Study (NHATS). Descriptive and inferential statistics were generated to describe a sample of persons (n= 241) who died in 2017. The sample demographics are predominately white (77.6%) females (61.4%) over 90 years old (42.4%). 29.5% of individuals died at home, 29.5% at the hospital, and 27% at a nursing home. Only 32.2% had hospice care in the last month, with many experiencing pain (71.1%), shortness of breath (54.7%), and anxiety/sadness (56.9%). There were 33.6% of participants who lived alone at death and 70% did not receive hospice care. The majority of these individuals were widowed (70.4%) and 33.3% died in the hospital. The other 28.4% died at their home or someone else’s and 25.9% died in a nursing home. Many older adults face multiple barriers to experiencing a quality end-of-life experience. Future research should examine the challenges facing those living alone at time of death.
REGIONAL VARIATIONS IN ENGAGEMENT IN ADVANCE CARE PLANNING AMONG RACIALLY AND ETHNICALLY DIVERSE OLDER ADULTS
Authors: Kim Kyeongmo , Hong Michin , Kim Giyeon
Published: November 2019

Advance care planning (ACP) has positive effects on the quality of end-of-life of older adults. Given the influence of environmental factors on health and behavioral health behaviors among older adults, geographic variations may exist in engagement in ACP. This study examined whether 1) there was a regional variation in engagement in ACP and 2) there was a racial/ethnic difference in ACP across regions (Northeast, Midwest, South, and West). Drawn from the 2012 National Health and Aging Trends Study, 2,015 Medicare beneficiaries in the U.S. were included in analyses. Results from logistic regression analysis showed that older adults living in the West (OR=1.66, p=0.003) and the Midwest (OR=1.39, p=0.032) were more likely to be engaged in ACP compared to those living in the South. African Americans (OR=0.31, p<0.001), Hispanics (OR=0.30, p<0.001), and other races (OR=0.49, p=0.04) were less likely than their white counterparts to be engaged in ACP. We also conducted four separate logistic regression analyses by regions. In the Northeast, Midwest, and South, African Americans were less likely to be engaged in ACP compared to whites. In the West, Hispanics were less likely to be engaged in ACP compared to whites. Findings from this study provide a clear picture of racial/ethnic disparities in ACP across different regions in the U.S., suggesting where to target for future interventions to improve engagement in ACP among racial/ethnic minorities. Future research should be conducted at lower levels of geographic areas to find modifiable geographic factors to improve engagement in ACP among older adults.
VARIATION IN ADVANCE DIRECTIVES TIMING BETWEEN END-STAGE RENAL DISEASE PATIENTS AND CANCER PATIENTS
Authors: Wang Yu-Hsuan , Enguidanos Susan
Published: November 2019

The United States has the third highest prevalence and the second highest incidence of End-Stage Renal Disease (ESRD). ESRD is associated with high mortality and lower quality of end-of-life experiences. Having an advance directive (AD) is associated with better care at the end of life. Although past ACP completion rates in ESRD patients has been studied, little is known about its timing differences between ESRD and cancer patients. This study investigates the timing difference of AD completion between ESRD and cancer patients We conducted logistic regression to analyze data from the Health and Retirement Study, a nationally representative longitudinal survey of older adults. The analytic sample included exit interviews from 2012 to 2016 among 971 proxies of deceased with ESRD or cancer. Among the sample, 47% of decedents completed an AD; 44% of cancer patients and 48% of ESRD patients. Being a racial minority (OR=0.38, p<0.001), and lower education (OR= 0.63, p=0.001) were associated with lower AD completion rates. No significant differences in AD completion rates were found between cancer patients and ESRD patients. Compared to cancer patients, ESRD patients were more likely to complete ADs more than one year before death (OR=3.15, p=0.001). However, there were no significant difference between cancer patients and ESRD patients in AD completion rates in the three months before death. Although both samples had comparable rates of AD completion, compared to cancer patients, ESRD patients tend to document care preferences earlier. Further studies are needed to investigate factors related to early documentation of ADs.
THE INTERACTIVE ASSOCIATION OF EDUCATION AND NEIGHBORHOOD ENVIRONMENTS ON COGNITIVE DECLINE
Authors: Esposito Michael H , Clarke Philippa , Sol Ketlyne , Finlay Jessica , Hicken Margaret , Judd Suzanne , Wadley Virginia
Published: November 2019

Education’s ambiguous association with cognitive decline may be due to unmeasured effect heterogeneity, including variation across environmental contexts. In areas with more social and physical resources, education may play less of a role in shaping cognitive trajectories. In areas with fewer resources, educational capital may be more important for slowing cognitive decline. Using multilevel models, this paper examines whether education’s impact on cognitive trajectories varies among neighborhoods defined by differential densities of social and physical resources. Findings suggest that education plays a consistent role in shaping cognition across contexts. Lower education is associated with lower cognitive function (High school vs College: b=-2.97; sd=0.16) and marginal differences in rates of decline (College vs High School: b=0.04; sd=0.03). However, these patterns are invariant across neighborhoods. Findings reiterate the importance of education for cognitive function in late life, and stimulate further research on other contextual factors that may affect rates of cognitive decline.
CHILDHOOD CONDITIONS AND ARTHRITIS AMONG MIDDLE-AGED AND OLDER ADULTS IN CHINA: THE MODERATING ROLES OF GENDER
Authors: Lu Nan , Wu Bei , Jiang Nan , Dong Tingyue
Published: November 2019

This study examined the moderating effect of gender on the relationship between childhood conditions and arthritis among middle-aged and older adults in China. The data were derived from the 2015 wave and the life history module of the China Health and Retirement Longitudinal study. The sample included 19800 respondents age 45 and over. Multiple imputation was used to handle the missing data. A multilevel logistic regression was used to test the proposed models. Childhood socioeconomic status, mother’s education, subjective health, access to health care and medical catastrophic event were found to be significant factors associated with arthritis in later life, after controlling for adulthood and older age conditions. Furthermore, the effects of childhood socioeconomic status on arthritis were found to be higher among men than women. The findings highlight the important role of childhood conditions that affect the onset of arthritis in later life. Policy and intervention implications are discussed.
DEATH NARRATIVE IN 19TH-CENTURY CHINA: HOW DID NEWSPAPERS FRAME DEATH AND DYING?
Authors: Lou Yifan
Published: November 2019

This study explored the death narrative in the late Qin dynasty as expressed in Chinese newspapers in the 19th century. Using textual analysis to analyze the 646 pieces of news containing death-related topics, this study revealed the discourse regarding death and dying during this period can be understood at three levels: (a) euphemism of death: the language of death and its relationship with power and social hierarchy; (b)definition of “good death”: including preferences for location, cause, and experiences of death and dying; and (c) Western influence on the death narrative: missionaries’ efforts to incorporate Catholic and Chinese traditions to attract more believers. This paper argues that the current Chinese people’s perception of death is inherited and evolved from those historical roots, which has practical implications for the systematic development of hospice care in China. Suggestions include changing the language used in the hospice policy, emphasizing the importance of confidentiality in home-based hospice programs, and building a hospice system based on public perceptions of so-called “good death” while advocating for individualized definitions of this concept.
FLOURISHCARE: HELPING OLDER ADULTS FLOURISH IN RURAL COMMUNITIES
Authors: Faul Anna , D’Ambrosio Joe , Yankeelov Pamela , Cotton Samantha G , Austin Megan , Huff Mona , Handy Darla
Published: November 2019

Flourishing represents living within an optimal range of human functioning. To foster older adults flourishing, our FlourishCare model of care coordination was developed as part of a HRSA Geriatric Workforce Enhancement Program (GWEP) to transform PC sites by delivering coordinated services in 6 rural KY counties. FlourishCare is unique in its integration of academic teams, community health teams and mental health specialists within age-friendly primary care health systems.FlourishCare recognizes that many of the largest drivers of health care costs fall outside the clinical care environment. One of the major components of Flourish is the involvement of community health navigators (CHNs), community education coordinators (CECs) and community coalitions working with the health teams to respond to the social determinants of health. For each patient that is referred and agrees to participation in the program, the CHN performs Flourish clinical and home assessments and obtains medical records. A repeated measure designed was used to assess the 60 patients who have baseline assessments results along with at least a 6-month assessment and in some cases a 12-month assessment (n= 20). Patients have demonstrated a significant increase in their flourishing across all determinants of health. There was also a significant improvement the total FI from pre to post-test at 6-month. These outcomes illustrate that it is important to operationalize the outcomes for older adults by evaluating the success as the ability of the older adult to flourish when they can maintain current functioning, access to resources have sufficient support systems in place.
NEIGHBORHOOD CONDITIONS AND SELF-NEGLECT IN LATER LIFE: LONGITUDINAL EVIDENCE FROM THE NSHAP
Authors: Upenieks Laura , Iveniuk James , Schafer Markus H
Published: November 2019

Self-neglect includes persistent inattention to personal hygiene and the conditions of one’s immediate living environment and is known to be associated with an increased risk of mortality among older adults. Although previous studies have shown that many individual factors predict self-neglect, neighborhood characteristics have received much less attention. Extant research has yet to consider connections between the conditions of one’s neighborhood and self care over time. Using nationally representative longitudinal data from the National Social Life, Health, and Aging Project (NSHAP), we consider several features of neighborhood context in later life, including self-reported perceptions of neighborhood cohesion and neighborhood danger, neighborhood disorder (measured by interviewer ratings), and concentrated neighborhood disadvantage (using census data). Adjusting for individual-level factors (including social connection, physical and cognitive health, and demographics), results from both lagged dependent variable and cross-lagged panel models find higher levels of neighborhood disorder to be associated with higher self-neglect scores (measured by interviewer ratings) over time. Social cohesion, perceived neighborhood danger, and collective efficacy were not associated with self-neglect when controlling for neighborhood disorder. These findings suggest that improving neighborhood disorder may be an effective approach for self-neglect prevention in later life
JOINING AND REMAINING: FACTORS THAT CONTRIBUTE TO MEMBERSHIP IN A VILLAGE
Authors: Dunkle Ruth E , Harlow-Rosentraub Karen , Pace Garrett T , Coppard Larry
Published: November 2019

Many older people want to age in place with one popular model of care being the Village Model. Understanding why people join and why they continue as members are important considerations for a Village to survive. Utilizing open-ended data from a representative sample of current members of a Village (N=100), we examined the reasons for people becoming members as well as continuing their membership. Twenty six percent of the sample were men, age ranged from 50-95, 30% lived alone and 58% believed that their health was very good. Data were coded by three researchers with discrepancies resolved by discussion to refine the codes. Three categories were identified: instrumental, social, and altruistic. The most frequent reason for joining was instrumental (35%) where the member wanted the services provided by the Village. It was also the most frequent reason for continuing membership (57%). An analysis was also conducted to examine predictors of reasons for joining and continuing membership in the Village. These included, age, gender, health, and living alone. Results indicate that men were less likely to join or continue their membership for instrumental reason compared to women, and members who live alone were more likely to become a member for social reasons. When age at entrance into the Village was examined, each increasing year of age was associated a .01 increase in the probability of continuing as a member for instrumental reasons. Findings provide guidance in issues related to sustaining membership in a Village.
EFFECTS OF AGE ON CONNECTION TO NATURE AND POSITIVE AFFECT
Authors: Carney Amy Knepple , Patrick Julie
Published: November 2019

Socioemotional selectivity theory positis that when we feel our time as limited, when a person ages, emotion based goals become a priority (Carstensen, Isaacowitz, & Charles, 1999). Although previous studies have shown that all age groups benefit from a connection to nature (CN; Bisceglia, Perlman, Schaack, & Jenkins, 2009; Han, 2008; Mayer et al., 2009), there have been no studies conducted to determine if there are age differences in CN and how that relation contributes to positive affect. Analyses were conducted with a sample size of 152 participants with an average age of 37.55 years (SD = 15.64; Range 18 -89). Age was significantly positively associated with CN, r(151)=.16, p<.05. Additionally, an ANOVA showed that middle-aged to older adults reporting significantly higher CN than younger adults. The relation of positive affect to age and CN was then examined. In the analysis examining the effects of age and CN on positive affect, the model was significant, F(3, 146)=8.48, p<.05, R2 = .15. Both, CN, and age, uniquely contributed to the variance accounted for on positive affect, although, the interaction of CN and age did not uniquely contribute to the variance. These results may be indicative of socioemotional selectively theory, in that older adults were choosing connection to nature because it fulfilled more emotional activities/goals than the younger adults in the study. Because previous research has all but ignored the association of CN and age and their relation to positive affect, it should be considered in future research.
FAST-FOOD RESTAURANTS: A NEIGHBORHOOD RESOURCE FOR COGNITIVE FUNCTION AMONG AGING AMERICANS?
Authors: Finlay Jessica M , Clarke Philippa , Esposito Mike , Gomez-Lopez Iris , Judd Suzanne , Wadley Virginia
Published: November 2019

In this exploratory mixed-methods sequential design study, interviews with 125 adults aged 55-92 (mean age 71) living in the Minneapolis (Minnesota) metropolitan area suggest that large-chain fast-food restaurants such as McDonald’s may serve as reservoirs of cognitive function. Thematic analysis revealed perceived benefits of fast-food settings for older adults including familiarity and comfort; affordability; sociability with friends, family, staff, and customers; and entertainment (e.g., newspapers, crosswords). To further test these observations, we analyzed data from urban and suburban REGARDS participants. Preliminary multilevel regression models found that participants residing within 5 kilometers of a McDonald’s restaurant exhibited higher cognitive function than similar individuals who live further from said organizations (b=0.31; se=0.12). The results complicate understanding of fast-food settings and prompt further research that tests whether restaurants can serve as community spaces for older adults to help buffer against cognitive decline by fostering social interaction and mental stimulation.
DISASTER PERCEPTIONS AND PREPAREDNESS BEHAVIORS AMONG U.S. OLDER ADULTS
Authors: Krook Melissa , Vitaliano Peter
Published: November 2019

U.S. economic loss from natural disasters hit an all-time high in 2017 with 16 climate events totaling $306 billion. However, disasters’ costliest effects may result from emotional and psychosocial health. Research suggests those who are: seniors, distressed, and/or experience early-life vulnerabilities have increased risk for negative health responses. This study addresses the need to reduce vulnerability/increase preparedness by evaluating how older adults (OA) perceive/prepare for disasters, including influential psychological factors. Literature review results indicate OA are: (1) among our most vulnerable populations for disasters, (2) underprepared, though resources are available, and (3) preparing friends/family before themselves. The Socioemotional Selectivity Theory (SST) posits: alongside aging, time perceptions become constrained, motivations shift, and we prefer positive over negative information. Therefore, I asked: (1) if OA are intuitively resistant to negative information, like impending disasters, how might we reframe it to align with their desire for positive information? (2) If we approach OA through positive experiences, will they be motivated to prepare? I employed a model: preparedness behavior (PB) is a function of vulnerability (V) and resilience (R). A survey was developed to assess how factors of V and R would interact/influence PB. I will pilot test this survey through evaluating community-living OA. PB is expected to be negatively related to V, positively related to R. This study extends disaster research by using psychological variables to predict preparedness and evaluating preparedness motivation using SST as a guiding framework. Results should increase knowledge about OA’s disaster preparedness perceptions and factors to mitigate increased preparedness.
THE ROLE OF SENSE OF COMMUNITY IN CHANGING THE HEALTH-PROMOTING EFFECT OF BUILT ENVIRONMENT: A COMMUNITY SURVEY
Authors: Tang Jennifer Y M , Chui Cheryl , Chiu Tuen Yi , Chiu Rebecca , Lou Vivian W , Tse Michael , Leung Angela Y M , Lum Terry
Published: November 2019

Previous research that studies the impact of built environment on health often attribute the enabling effects of environment on physical activity participation and opportunities for social interaction. Few studies have explored how the role of subjective feeling, such as the feeling of connectedness with the community, affects the association between built environment and physical and mental health. We conducted a cross-sectional survey with 2,247 residents aged 50 years or above in five districts in Hong Kong. We tested the mediation effect of sense of community in the relationship between physical environment and health using the path analysis. We administered a questionnaire to assess the residents’ perceived age-friendliness of outdoor spaces and buildings in the district. We used the Brief Sense of Community Scale and the 12-item Short-form Health Survey to measure sense of community and physical and mental health. We found that age-friendliness of outdoor spaces was modestly correlated with mental health (r = 0.10, P < 0.001) but not with physical health (r = 0.02, P = 0.4), whereas age-friendliness of buildings correlated with both (r = 0.05, P = 0.01; r = 0.06, P = 0.004). Sense of community mediated 25.9% of the total effect between outdoor space and physical health, 20.4% between outdoor space and mental health, and 42.5% between service and building on physical health. To conclude, sense of community was a partial mediator of the environment-health relationship. Future design of built environment should take into consideration its potential influence on sense of community and health.