bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicians’ Knowledge and Attitudes About Delirium Detection and Management
Authors: Shrestha Priyanka , Husser Erica , Berish Diane , Ngo Long , Boltz Marie , Inouye Sharon , Marcantonio Edward , Fick Donna
Published: December 2020

Delirium is a serious and potentially life-threatening problem, but it remains clinically under-recognized. Various factors contribute to this under-recognition, including limited understanding of delirium, insufficient training and application of delirium assessments, potential stigma for the patient and increased workload for the clinician. As a part of an NIH funded study testing a rapid two-step delirium identification protocol at two hospitals in the U.S. (one urban and one rural), clinicians completed a 12-item survey to assess their knowledge and attitudes about delirium and their confidence in preventing and managing delirium. Survey response options followed a 5-point rating scale (strongly disagree, disagree, undecided, agree, strongly agree). The sample for this analysis included 399 clinicians (MDs=53; RNs=235; CNAs=111). Chi-square was used to test for group differences between clinician types. Less than half of the clinicians reported agreeing with the statement, “delirium is largely preventable” (MDs: 47%; RN: 44%; CNA: 41%, p-value=0.021). MDs and RNs indicated a high level of confidence in recognizing delirium while CNAs endorsed lower levels of confidence (MDs: 87%; RN: 81%; CNA: 65%, p-value=0.001). All types of clinicians reported lower confidence in managing delirium (MDs: 29%; RN: 36%; CNA: 44%, p-value=0.117). 47% of CNAs and 37% of RNs agreed there is a need for additional training in caring for persons with delirium while only 21% of MDs agreed (p = 0.031). Understanding how different types of clinicians think and feel about delirium will inform training and communication initiatives, clinical implementation, and research on best practices for delirium identification and management.
Maze Test Score Adjustments When Using Non-Dominant Hand in Fitness-To-Drive Assessments
Authors: Unsworth Carolyn , Hext Gemma , Baker Anne , Browne Matthew
Published: December 2020

Older drivers with health impairments may be required to undertake fitness-to-drive assessments. Scores on the Occupational Therapy-Drive Home Maze Test (OT-DHMT) can contribute to fitness-to-drive recommendations. The OT-DHMT is a short, timed maze test that has been shown to be valid and reliable, and norms are available for completion with a driver’s dominant hand. However, the validity of a person’s score when using their non-dominant hand to complete the test, for example following stroke, is unknown. This study aimed to determine if a person’s OT-DHMT score time (in seconds) requires adjustment when completed with a non-dominant hand. The OT-DHMT was administered with a normative sample of 150 participants, aged 21-81 years (mean=48.6,SD=19.38). Overall, OT-DHMT score times were significantly faster when using a dominant (M=15.73) compared with non-dominant (M=17.64) hand, d=1.91 (CI 1.13, 2.69), t= 4.84,p< .01. Employing a generalised weighted least squares regression model indicated that multiplying a driver’s non-dominant hand time by .833 seconds for drivers aged ≤60, and by .929 seconds for drivers aged 61+ can approximate dominant hand completion times. Adjusted scores can then be compared against normed scores to aid fitness-to-drive recommendations. The adjustment required for people aged ≤60 is larger than for older people, reinforcing previous findings that younger people have faster OT-DHMT completion times. These findings support the clinical utility and vaildity of using the OT-DHMT with older people undergoing fitness-to-drive assessment who may be required to use their non-dominant hand due to conditions such as stroke, arthritis or amputation.
Reduction of Elevated Proton Leak Rejuvenates Mitochondria in the Aged Cardiomyocyte
Authors: Zhang Huiliang , Alder Nathan , Wang Wang , Szeto Hazel , Marcinek David , Rabinovitch Peter
Published: December 2020

Rational: Aging-associated diseases, including cardiac dysfunction, are increasingly common in the population. However, the mechanisms of physiologic aging in general, and cardiac aging in particular, remain poorly understood. While effective medical interventions are available for some kinds of heart failure, one age-related impairment, diastolic dysfunction in Heart Failure with Preserved Ejection Fraction (HFpEF) is lacking a clinically effective treatment. Methods and Results: Using the pH indicator cpYFP in the model of naturally aging mice and rats, we show direct evidence of increased mitochondrial proton leak in aged heart mitochondria following a pH gradient stress. Furthermore, we identified Adenine Nucleotide Translocator 1 (ANT1) as mediating the increased proton permeability of old cardiomyocytes. Most importantly, acute (2 hours) in vitro treatment with the tetra-peptide drug SS-31 (elamipretide) reverses age-related excess proton entry, decreases the mitochondrial flash activity and mitochondrial permeability transition pore (mPTP) opening and rejuvenates mitochondrial function. Moreover, we show that SS-31 benefits the old mitochondria by direct association with ANT1 and stabilization of the mitochondrial ATP synthasome, leading to substantial reversal of diastolic dysfunction. Conclusion: Our results uncover excessive mitochondrial proton leak as a novel mechanism of age-related cardiac dysfunction and elucidate how SS-31 is able to reverse this clinically important complication of cardiac aging.
Physical Robustness and Resilience Among Long-Lived Female Siblings: A Comparison With Sporadic Long-Livers
Authors: Galvin Angéline , Ukraintseva Svetlana , Arbeev Konstantin , Feitosa Mary , Christensen Kaare
Published: December 2020

Background: Long-lived individuals are central in studies of determinants of healthy longevity. However, few pro-longevity factors have been identified, presumably because of “phenocopies”, i.e. individuals that live long by chance. Familial longevity cases may include less phenocopies than sporadic cases and provide better insights into longevity mechanisms. Here we examined whether long-lived female siblings have a better ability to avoid common diseases at ages 65+ (proxy for “robustness”) and/or survive to extreme ages (proxy for “resilience”) compared to sporadic long-livers. Methods: 1,156 long-lived female siblings were selected from three nationwide Danish studies (DOS, GeHA, LLFS) and age-matched with sporadic long-lived female control from the Danish population. Outcomes included cumulative incidence of common health disorders from age 65, and overall survival from 2006 onwards. Logistic and Cox models were used to evaluate incidence and survival respectively. Results: Long-lived female siblings had significantly lower risks of hypertensive (OR=0.84; 95%CI=0.71-0.99) and cerebrovascular (OR=0.73; 95%CI=0.55-0.96) diseases and depression (OR=0.74; 95%CI=0.62-0.88) at ages 65+, and better survival to extreme ages (HR=0.71; 95%CI= 0.63-0.81) compared to sporadic long-livers. After adjusting for diseases above, the association with mortality changed only marginally (HR=0.73 (0.64-0.83)). Conclusion: Familial longevity cases could be more informative for studying mechanisms of healthy longevity than sporadic cases. Long-lived female siblings demonstrate better physical robustness and resilience than their age-peers from general population, which might be attributed to a genetic component in familial longevity.
Pain Interference: A Barrier for Daily Living Activities in Older Adults with Multisite Musculoskeletal Pain
Authors: Koren Yael , Leveille Suzanne
Published: December 2020

Almost half of older adults experience multisite musculoskeletal pain (MMP) contributing to difficulty in daily activities but little is known about specific domains by which pain interferes in daily living. This study aims to determine domains of pain interference (PI) related to MMP in a cohort of older adults living in the community. The MOBILIZE Boston Study (MBS) is a cohort study of 749 adults aged ≥70y. Musculoskeletal (MSK) pain was assessed using the joint pain questionnaire and grouped as: no pain, single site, and multisite pain. The Brief Pain Inventory PI sub-scale assessed level of interference (0-10 rating) in 7 categories in the previous week including general activity, mood, walking, work, relationships with people, sleep, and enjoyment of life. Interference items were grouped as: none (0 rating), mild (>0, ≤2), moderate ( ≥2, ≤5), and severe (≥5) PI. There was a strong gradient of PI according to pain groups with severe walking interference in 36.5% of those with MMP compared to 3.8% of those with no MSK pain. The least PI was in relationships with others (9.1% of MMP vs 1.1% of no MSK pain). Reports of interference in other domains were intermediate (20-26% of MMP vs 3-4% of no MSK pain). Women and those with Less education reported the most PI in every domain but no differences were observed by age. Greater attention to specific domains of pain interference such as walking could have substantial benefits for reducing the overall impact of MMP among older adults.
Successes and Challenges of Fostering Age-Friendly Health Systems Through a Long-Term Services and Supports ECHO
Authors: Brunker Cherie , Butler Jorie , Telonidis Jacqueline , Chiu Yin-Shun
Published: December 2020

Launched in June 2016, the Utah Geriatric Education Consortium (UGEC) inter-professional Learning Community was developed by faculty in collaboration with primary care and community partners with a focus on Long Term Care. In 2019, UGEC expanded to include Assisted Living, Home Care and Hospice -5 primary care and 6 community long-term services and supports (LTSS) partners in rural and urban Utah with a primary objective of developing and training existing LTSS healthcare providers and direct care workers on the elements of age-friendly health systems (“4Ms”: mentation, medication, mobility, and what matters) to enhance care and improve outcomes for older adults across the continuum of LTSS. Attendance in the monthly distance learning sessions averages 27.5. Sessions are rated highly and engage nurses, behavioral health workers, administrators, physicians, nursing assistants, occupational and physical therapists. The process, challenges, successes of transitioning to a LTSS ECHO (Extension for Community HealthCare Outcomes) will be discussed.
Engaging the University’s Retired Community
Authors: Elfenbein Pamela
Published: December 2020

In support of our older adult community and in alignment with Age Friendly University principles, the University of North Georgia Center for Healthy Aging promotes wellness and disease prevention through active research and intervention, promotes leadership through mentorship and partnerships, fosters an environment of healthy aging through interdisciplinary service and research with community partners, and supports healthy aging through innovative interprofessional collaboration and research. This presentation offers insight into the ways we have engaged retired faculty and staff, with particular focus on a collaboration with The Wisdom Project, a community organization of adults 55+ interested in using their skills and talents to benefit their community through action and advocacy projects. While aligned with Principle 9, this presentation also offers insight regarding how the university supports additional AFU Principles.
AGHE Program of Merit for Gerontology Programs
Authors: Elfenbein Pamela
Published: December 2020

The POM designation provides gerontology programs with an AGHE “stamp of approval,” which can be used to verify program quality to administrators, to lobby for additional resources to maintain a quality program, to market the program, and to recruit prospective students into the program. This worldwide process of evaluation for both Gerontology programs verifies for students that the program is consistent with globally vetted criteria in gerontology endorsed and recognized by AGHE; assures the public of the quality of programs and their graduates; clarifies for employers the knowledge and skills imparted to students who graduate from POM designated gerontology programs; informs campus administrators of global guidelines, expectations, and practice in gerontology education programs; and indicates to interested students that the program is of high quality. Those interested in the Gerontology Program of Merit will be able to ask questions, understand the application process, and ask for technical assistance.
Important Considerations in Developing and Evaluating Intergenerational Service-Learning Programs
Authors: Donorfio Laura
Published: December 2020

Very often, intergenerational programs measure their success by collecting feedback primarily from the students participating in the program. Critical stakeholders such as the adults/older adults, administrators, and service-learning personnel can be overlooked, as well as the impact of the various classroom activities and tools used. Each fall semester over a five-year period, an undergraduate adulthood and aging intergenerational service-learning course was offered, measuring and building on the successes and challenges from the previous year. No matter how much thought goes into planning a class, unexpected variables naturally unfold over time. This presentation will highlight a best practices model developed over a five-year period with feedback collected from key constituents. Engaging different generations in a purposeful service-learning experience is complex and intended outcomes are not guaranteed. Understanding the key variables and the needs of all those involved through feedback and measurement, can help ensure a more meaningful educational experience. Part of a symposium sponsored by Intergenerational Learning, Research, and Community Engagement Interest Group.
Why Engagement Matters to Gerontological Student Learning
Authors: Fruhauf Christine , Brothers Allyson , Ehrhart Nicole , Naughton Blake , Schneider Sue
Published: December 2020

Learning opportunities beyond the classroom create lasting and positive effects on students’ academic and professional growth. When faculty members participate in engaged scholarship in their local communities, out-of-classroom learning opportunities for students likewise expand. In the context of aging, the array of opportunities for students to engage with community partners is vast, from interactive course assignments to research opportunities, clinical experience, local policy efforts, and more. This paper builds on previous theoretical and empirical work from scholars (including AGHE and GSA Fellows) in the science of engagement, and integrates case examples of campus-community relationships from our collective years in the academy. Examples will showcase how engaged teaching, engaged research, and engaged service collectively informs and enriches our students’ experiences. In the spirit of the 2020 conference theme, we will discuss opportunities for university-community engagement as a way to strengthen and inspire current and future gerontological pedagogy.
A State University Perspective on Becoming an Age-Friendly University
Authors: Charness Neil
Published: December 2020

I describe the process of FSU becoming an Age-Friendly University (AFU). After hearing a presentation on AFU at the Age Directors meeting at GSA by Joann Montepare in November 2016, I judged that many of the ten principles of an AFU were already in operation at FSU. So, I decided to confer in December with VP for Faculty Development and Advancement, Janet Kistner, about how to move the AFU application process forward. I generated a draft document and circulated it to major units dealing with aging on campus: the Institute for Successful Longevity, the Pepper Institute on Aging and Public Policy, and the Pepper Center. Eventually, a one-page version of the longer document was introduced at an FSU Cabinet meeting and approved in April 2017. I detail some of the critical discussion points, the concerns of upper administration, and the timeline for completion of the process at FSU. Part of a symposium sponsored by Directors of Aging Centers Interest Group.
The AGESW Pre-Dissertation Fellows Program: Participants’ Perceptions of Mentorship and Training for Academia
Authors: Fields Noelle , Gibson Allison , Wladkowski Stephanie , Wallace Cara , Latimer Abigail
Published: December 2020

Good mentoring is key for doctoral student success. In 2010, AGESW began offering the Pre-Dissertation Fellows Program (PDFP) to enhance social work doctoral students’ professional development and skillset for academia. The purpose of this study was to examine student participants’ perceptions of the PDFP in its role to providing mentorship and training for an academic position. This qualitative study examined eight cohorts (2010-2018) of the AGESW PDFP (N=85). Using thematic analysis, responses identified a number of aspects of professional development gained, gratitude for the training, an appreciation for candid advice received, and areas of professional development they felt they were lacking within their doctoral training. Findings bolster support for structured programs and professional development that supplement doctoral education in a student’s first two years. Implications for doctoral education, mentorship training, and avenues to enhance the AGESW pre-dissertation program will be discussed
Advancing the Study of Subjective Age: More Seriously Considering Gender
Authors: Turner Shelbie , Hooker Karen , Calasanti Toni
Published: December 2020

Socially-cued age expectations inform people’s subjective age - that is, how old they feel relative to their chronological age. Age-graded expectations are widely considered to be gendered, yet gender has not often been empirically examined as the scholarship on subjective age has developed. Because subjective age shapes the experiences a person has becoming and being an older adult, and is an important correlate of later life health, more seriously considering gender’s influence on subjective age is crucial to better understanding gender differences in older adults’ well-being. In our symposium we bring gender to the center of subjective age scholarship. Barrett, Michael, & Noblitt begin by establishing that subjective age research should portray gender as a social-level, rather than individual-level, characteristic. As a complement, Turner, Settersten, and Hooker illustrate how gender has or has not been included in the four theoretical domains of subjective age (self-perceptions of aging, old age stereotypes, age identity, and awareness of age related change), and offer insights into how gender might be included in future studies on each domain. We then shift to two papers presenting new empirical analyses on the role gender plays in subjective age. Kornadt shares how men and women’s commitment to certain social roles differentially informs their subjective age, while Settersten, Day, and Hagestad turn attention to a double standard of aging for women and men with evidence across Europe. Discussant Toni Calasanti closes by offering thoughts on the future of subjective age and gender scholarship, including considering gender beyond the binary.
Go&Grow: A Social Exergame to Promote Well-Being Among Dementia Caregivers
Authors: Lin Xin Yao , Saksono Herman , Stowell Elizabeth , Lachman Margie , Castaneda-Sceppa Carmen , Parker Andrea
Published: December 2020

Dementia caregivers are at risk for poor health outcomes due to high stress and little time for health-promoting behaviors. The current study examined whether Go&Grow, an exergame (digital game in which play involved real-world physical activity), could increase caregivers’ physical activity and social contact and reduce their stress. Go&Grow allows participants to grow flowers virtually as they increase their physical activity. Participants can also interact with others on Go&Grow. Go&Grow was piloted with 18 dementia caregivers (ages 22-70) over a six-week period. Multilevel modeling results showed that weeks with more Go&Grow usage were associated with more steps and more social contact. Days with more social contacts on Go&Grow were associated with more physical activity. Participants reported they were able to manage their distress better at posttest compared to the pretest. The discussion will highlight study limitations as well as implications for technology-based game and intervention design for caregiver well-being. Part of a symposium sponsored by Technology and Aging Interest Group.
Adverse Employment Histories and Later Health Functioning: European Findings Based on Life Histories From SHARE and ELSA
Authors: Deindl Christian , Wahrendorf Morten
Published: December 2020

We investigate associations between adverse employment histories over time and health functioning in later life, and explore moderation by national labor market policies. Harmonized life history data come from two studies, SHARE and ELSA, with health beyond age 50 (men= 11,621; women= 10,999). Adverse employment histories consist of precarious, discontinued and disadvantaged careers between age 25 and 50, and we use depressive symptoms, grip strength and verbal memory as outcomes. Adverse employment histories are associated with poor health functioning later in life, especially repeated periods of unemployment, involuntary job losses, weak labor market ties and disadvantaged occupational positions. We find no variations of the associations by national labor market policies. Our study highlights the need to improve working conditions at early career stages. Despite the importance in shaping employment histories, the role of national policies in modifying the impact of employment on health is less clear.
Aging in Context: The Importance of Comparative Studies for Understanding the Lives of Older Adults
Authors: Glicksman Allen , Ring Lauren , Keating Norah
Published: December 2020

Access and use patterns of both formal and informal services for older migrants are often examined in a dyadic framework where one group of older persons (or their caregivers) is studied in relation to their use of a program or service. A comparative approach, that might also examine the reasons that some persons may (or may not) use a service, may yield important findings that place the dyadic studies within a larger social and policy context. By using a comparative approach, we can also consider influences of the culture of origin for older adults and their caregivers, as well as the policies and programs offered in the destination country. The four papers on this panel explore these issues. The first paper will frame the discussion, and the remaining three will focus on informal care, formal care, and the point of contact between aging services professionals and older immigrants. The first paper (Torres) takes a broad look at social exclusion mechanisms that bar access to services due to racism in the host societies. The second presentation (Diederich, et. al.) examines how place of origin can influence caregiving behavior. The third paper, (Thiamwong) examines a single program that is used to serve multiple ethnic minority/immigrant groups. Finally, (Ring et. al.,) will examine trust or its absence in the attitudes of older migrants toward use of formal aging services in two migrant populations. The four papers also demonstrate how different research methods (qualitative, quantitative, scoping review) can be used to illuminate these issues. International Aging and Migration Interest Group Sponsored Symposium.
Use of Photo Elicitation Within Phenomenology: Depicting Lived Experience of Older Learners in an AFU
Authors: Zakrajsek Andrea
Published: December 2020

While the use of photographs is an emerging data generation method within phenomenology (Plunkett, Leipert & Ray, 2013; Shulze, 2007), research that incorporates photo elicitation to inform the understanding of the lived experience is limited. This presentation will describe the use of photo elicitation within a phenomenological approach to explore the lived experience of older learners in higher education. After an initial interview, six participants aged 50 years and older shared photographs that that they chose to depict experiences of being student at a regional comprehensive university in the Midwest. Photographs served as mode for participant reflection of their experiences and guided a second interview. Interpretative Phenomenological Analysis (Smith et al., 2009) with photographs and verbatim transcripts ensued and resulting findings included: complicated sense of belonging and community development and access. Implications for use and analysis of photographs within qualitative research will be discussed.
Bayesian Modeling of Cognitive Impairment in the Presence of Retest Effects
Authors: Oravecz Zita , Roque Nelson , Sliwinski Martin
Published: December 2020

Diagnosing the early onset of neuropathologies, such as mild cognitive impairment (MCI), requires repeated evaluation of cognitive skills several times per year -- a measurement design known as a “burst design.” Detecting the often subtle cognitive decline in the presence of retest effects requires careful statistical modeling. The double exponential model offers a modeling framework to account for retest gains across measurement bursts, as well as warm-up effects within a burst, while quantifying change across bursts in peak performance. This talk highlights how a Bayesian multilevel implementation of the double exponential model allows for flexible extensions of this framework in terms of accommodating different timescales (nesting) and person-level predictors and drawing intuitive inferences on cognitive change with Bayesian posterior probabilities. We will use reaction time data to show how individual differences in asymptotic performance and change can be related to predictors such as age and MCI status. Part of a symposium sponsored by the Measurement, Statistics, and Research Design Interest Group.
Validation of the Ambivalent Ageism Scale in China
Authors: Zhang Xin
Published: December 2020

Two studies were conducted to validate the Ambivalent Ageism Scale in China. In the first study, 474 Chinese adults (18-58) were asked to take the Chinese version of the AAS. EFA exhibited a similar factor solution as the original study, with high internal consistency and construct validity. Moreover, in a second study, 372 Chinese adults (18-85) took the AAS and provided their estimations of the similarities between their current and their past/future self via the SIC. Results indicated that all three factors of the SIC positively related to hostile ageism, whereas succession and identity positively related to benevolent ageism and consumption negatively related to it. Additionally, past self-continuity was positively associated with hostile ageism, and future self-continuity was negatively associated with it, but neither form was associated with benevolent ageism. These results further validate the AAS in China and also provide evidence for the uniqueness of benevolent ageism.
We Treat Them Better Than the Family They Have: Negotiating Aide-Family Relationships in the Home Care Setting
Authors: Franzosa Emily , Tsui Emma
Published: December 2020

Unpaid and paid care in the home are closely intertwined, but a lack of outside supervision and support often forces family and non-family caregivers to negotiate care tasks and boundaries alone, leading to role conflict and role ambiguity. This analysis drew on two qualitative studies of home health aides (S1 n = 27, S2 n =26) to explore 1) aides’ perception of their caretaking role; 2) aides’ experiences co-producing care with family members; and 3) factors affecting these relationships. Data were analyzed through grounded theory and discourse analysis. We identified three relationship dynamics between aides and family members: independent, where aides and families provided care separately; competitive, where aides and families struggled over control of care tasks; and carative, where aides considered family part of the unit of care. We propose strategies for employer agencies to better support paid and unpaid caregivers in negotiating boundaries and co-producing care.
Personality and Insomnia Symptoms in Older Adults: The Baltimore Longitudinal Study of Aging
Authors: Rojo-Wissar Darlynn , Wanigatunga Amal , Simonsick Eleanor , Terracciano Antonio , Schrack Jennifer , Hossain Sharmin , Costa Paul , Spira Adam
Published: December 2020

Personality and disturbed sleep are tied to medical morbidity in older adults. We examined associations of personality dimensions and facets from the five-factor model with reports of insomnia symptoms in 1,069 well-functioning older adults 60-97 (SD=8.64) years (51% women) from the Baltimore Longitudinal Study of Aging. Personality was assessed by the Revised NEO Personality Inventory, and insomnia symptoms measured by the Women’s Health Initiative Insomnia Rating Scale. Adjusting for demographics and depressive symptoms, higher neuroticism (B=0.05, SE=-0.01, p<.001) and lower conscientiousness (B=-0.03, SE=-0.01, p<.05) were associated with greater insomnia severity. Although openness, extraversion and agreeableness were not associated with insomnia, a facet of each was. Higher scores on the “positive emotions” facet of extraversion (B =-0.03, SE=-0.01, p<.05) “ideas” facet of openness (B=-0.03, SE=-0.01, p<.05) and altruism facet of agreeableness (B=-0.03, SE=-0.01, p<.05) were associated with lower insomnia severity. Sleep disturbances may partially mediate personality’s influence on health. Part of a symposium sponsored by the Sleep, Circadian Rhythms and Aging Interest Group.
Schaalman Senior Voices: Transitioning From “What’s the Matter?” to “What Matters?”
Authors: Rodriguez-Morales Grisel , Emery-Tiburcio Erin , Golden Robyn , Fenton Marc , Chandy Jasmine
Published: December 2020

The 4Ms of an Age-Friendly Health System start with What Matters to the older adult. A unique method for asking that question is through film. Schaalman Senior Voices (SSV) films older adults talking about What Matters to them, and uses the films to stimulate discussion about later life with older adults in the community (n=264), with health care professions students learning to listen to older adults (n=1250), and health system executives considering implementation of the Age-Friendly Health Systems (AFHS) initiative (n=100). SSV has completed longer professional films interviewing 12 older adults. Using a mobile platform, SSV has filmed 50 older adults in the community and at health events. Outcomes of film discussions will be presented, including inspiration for older adults having conversations with family and physicians about What Matters, health care students effectively using skills in asking What Matters to enhance the care they provide, and executives considering AFHS implementation.
Are Different Diseases in Old Age Connected With Different Attitudes Toward Own Aging and Subjective Age?
Authors: Schönstein Anton , Wahl Hans-Werner , Denkinger Michael , Dallmeier Dhayana , Rothenbacher Dietrich , Klenk Jochen , Bahrmann Anke
Published: December 2020

Subjective views on aging (VoA; e.g., subjective age, attitude toward own aging “ATOA”) are regarded as important biopsychosocial markers of aging but their antecedents are not entirely clear. Besides general risk factors (depression, cognition, activities of daily living), we compared multiple disease groups to establish connections between specific morbidities and risk for negative VoA. Data was drawn from the ActiFE-Ulm study for which a representative sample of community-dwelling older people (65-90 years) was recruited. Follow-ups were conducted 7.7 years (median) after recruitment (T2; N=526). Self-reported depression at T1 was the strongest general risk-factor for negative VoA at follow-up (both subjective age and ATOA). Back pain predicted negative ATOA, whereas rheumatism was associated to both negative ATOA and older subjective age. We conclude that diseases are differentially associated with VoA. Further, mental health problems such as depression seem to be of higher importance for VoA as compared to other factors.
Attitudes Toward Sexual Behaviors in Long-Term Care: Development of an Assessment Tool
Authors: Spalding Rachael , Katz Emma , Edelstein Barry
Published: December 2020

Most older adults living in long-term care settings (LTCs) indicate that expressing their sexuality is important to them (Doll, 2013). Little is known about the general public’s attitudes towards sexual behaviors in LTCs. Attitudes of LTC residents’ family members are particularly important, as family members are most likely to visit residents and to care about their quality of life. Family members’ attitudes could in turn inform facility policies and management. We will present preliminary data from a series of qualitative interviews with community-dwelling adults regarding their attitudes. We will discuss how these data are being used to inform current work on a measure of attitudes toward sexual behavior in LTCs.
Kinlessness, Loneliness, and End of Life: A Cross-National Comparison of 20 Countries
Authors: Calvo Esteban , Mair Christine , Ornstein Katherine , Donoso Rosario , Medina José
Published: December 2020

Countries across the globe are experiencing declining rates of fertility and marriage, which present a distinct challenge for older adults’ social integration, well-being, and end-of-life care. However, older adults who are “alone” (e.g., no partner, no child) may not be lonely, and end-of-life risks faced by “kinless” older adults likely vary significantly by country context. Using harmonized, cross-national data from 20 countries (United States (HRS), England (ELSA), and European Union (SHARE)), we examine associations between family structure, loneliness, and end-of-life outcomes. Although “kinless” family structures are associated with greater loneliness in the pooled sample, the percent of “kinless” who report no signs of loneliness ranges from 7% (Greece) to 56% (Denmark). Family structure is associated with various end-of-life outcomes, and these associations vary by country—likely reflecting differences in healthcare structure. We discuss distinctions between “being alone,” “being lonely,” and “being without care” in light of cross-national variation.
Patterns and Predictors of ADRD Among Racial and Ethnic Minority Groups
Authors: Zahodne Laura , Elliott Cerise
Published: December 2020

This symposium addresses issues surrounding Alzheimer’s disease and related dementia (ADRD) across multiple racial/ethnic minority groups, including African Americans, Latinos, and Arab Americans. Using US national data, Kindratt and colleagues challenge the universality of the healthy migrant effect by comparing patterns of cognitive disability across US- and foreign-born Arab Americans. Arab Americans represent an increasingly visible ethnic minority group whose unique history has the potential to clarify knowledge about sociocultural influences on ADRD. Also using US national data, Garcia and colleagues examine within-group heterogeneity among Latinos. They conclude that the number of years and proportion of life spent with and without subjective cognitive impairment differ as a function of ancestry and nativity. Using data from two local communities, Diminich and colleagues investigate mechanisms underlying ADRD risk among Latinos by considering both stress responding and plasma-based AD biomarkers as predictors of Latino cognitive health. Lee and colleagues focus on social relationships and cognitive aging in a diverse, national cohort. They suggest that the quality of social support from social network members may uniquely affect the cognitive functioning of African Americans older adults. Finally, Cerise Elliott from the National Institute on Aging (NIA) will offer perspectives on how racial/ethnic minority group focused research can advance NIA’s goals related to understanding and eliminating ADRD inequalities. In total, this symposium highlights the need to disaggregate racial/ethnic groups, as well as the importance of incorporating both individual and contextual factors in order to fully understand patterns of ADRD risk and resilience.
The Longitudinal Associations of Self-Perceptions of Aging and the Age Composition of Social Networks
Authors: Cohn-Schwartz Ella , Schafer Markus , Ayalon Liat
Published: December 2020

Relying on the age segregation theory (limited contact between the generations), this study examined the temporal associations between the age composition of one’s social ties and one’s self-perceptions of aging (SPA). Data came from the 2014 and 2017 waves of the German Ageing Survey (DEAS). Age composition of the network was assessed as the number of kin and non-kin in the social network who are either five years older or five years younger than the respondent. A latent change score model assessed the bidirectional associations. Adults who had younger social network members, both kin and non-kin, had better SPA three years later. A positive SPA at baseline also predicted a higher number of younger non-kin relationships over time. These results stress the role of SPA in adults’ social network as well as the role of the age of social network members in shaping adults’ SPA.
The HOPE Project (Helping Older People Engage): Relevance to Upstream Suicide Prevention
Authors: Van Orden Kim , Conwell Yeates , Chapman Ben , Williams Geoff , Sörensen Siilvia , Rowe Jody
Published: December 2020

The HOPE Project is an ongoing RCT testing whether Senior Corps volunteering for lonely older adults (age 60+) leads to reduced loneliness and improved quality of life—outcomes associated with suicide in later life. We have randomly assigned 130 participants to 12-months of volunteering or active control. We will describe the trial as well as baseline characteristics of participants that may predict non-compliance with volunteering/control. We found no difference between conditions nor demographic characteristics (age, gender) on non-compliance. Participants demonstrated wide variability in depression at baseline (PROMIS t-score range 38.9 to 71.4) and 18% reported suicide ideation; neither were associated with compliance (p>.20). These preliminary findings indicate that those with more severe mental health symptoms were equally willing/able to engage in volunteering as those without depression and suicide ideation. Volunteering is a highly scalable intervention (given nationwide Senior Corps infrastructure) that may function as upstream suicide prevention.
Natural, Everyday Language Use Provides a Window into the Integrity of Older Adults’ Cognitive Functioning
Authors: Polsinelli Angelina , Moseley Suzanne , Grilli Matthew , Glisky Elizabeth , Mehl Matthias
Published: December 2020

Language use during structured clinical tasks predicts pathological cognitive aging. However, structured tasks reflect only a narrow band of potential communication contexts, which limits the ability to capture cognitive processes manifested in language use under more natural conditions (i.e., minimal constraints). The Electronically Activated Recorder (EAR) makes it possible to sample language from the full ecology of individuals’ interactions. As interactions are cognitively complex, language use in everyday life might be especially sensitive to the integrity of higher-order cognitive processes, including executive functions (EF). Using the EAR and a standard EF battery, we show that EF, particularly working memory, is reflected in analytic (e.g. articles and prepositions), complex (e.g. longer words), and specific (e.g. more numbers) language. The EAR provides first evidence that the words used in daily life reflect the integrity of EF and that reliance on less complex language could reflect WM variability among cognitively healthy adults.
Exploring Community Leaders’ Understanding and Attitudes Toward Depression Among Older Korean Americans
Authors: Kim Eunhye
Published: December 2020

This study explores community leaders’ understanding and attitudes toward depression among older Korean Americans. The community leaders who provide services for older adults play a significant role because these leaders typically engage with the target population by providing services. A qualitative method was applied for this study. A total of 12 community leaders were interviewed for 60 minutes using the semi-structured interview guide. The constant comparative approach was employed to analyze data using NVivo software. The findings indicated that the community leaders were aware of the severity of the issues, but lacked knowledge regarding depression and had stereotypes against depression. Those leaders identified negative personality issues of people with depression and desired to avoid discussing depression with older adults. The results suggest that interventions are essential to support community leaders and empower them to take actions to provide services to promote understanding of depression in older adults.
Veteran Status and Old Age Depression: A Life Course Epidemiology Study
Authors: Frochen Stephen , Sheehan Connor , Ailshire Jennifer
Published: December 2020

Military service and exposure to war may influence the development of depression, leading to disparities in the condition among veterans and non-veterans. This study included 10,512 older men from the 1996 to 2014 waves of the Health and Retirement Study (HRS). We estimated Center for Epidemiology Depression (CESD) score trajectories among veterans and non-veterans and veterans of different war cohorts in growth curve models, controlling for early, mid, and late life characteristics. CESD score trajectories were lower among veterans and war veterans than non-veterans and non-war veterans, respectively. The highest levels of depression were among war veterans who served in more than one war. Veterans demonstrated lower levels of depression than non-veterans, calling into question the health advantage of veterans and selection mechanisms into the military and out of HRS. Multiple war veterans showed the highest levels of depression, representing the greatest mental health threat to veterans in the study. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.
When the Day Goes Awry: Families Caring for Persons With Dementia
Authors: Roberto Karen , Savla Jyoti , Zarit Steven
Published: December 2020

The daily lives of family caregivers of persons with dementia (PwD) often require that they manage multiple competing demands in a context of unpredictability. Memory and behavior changes associated with dementia can cause PwD to act in random and irrational ways that create stress and influence all aspects of caregivers’ everyday life. Supportive others, including informal helpers and formal service professionals, should provide relief to primary caregivers; however, help may not alleviate caregiver stress and can sometimes compound the burden of care. This symposium draws on daily diary surveys and face-to-face interviews to focus on four aspects of managing everyday care of PwD among family caregivers in rural areas. Brandy Renee McCann explores how caregivers’ vigilance on behalf of PwD care quality interacts with service use. Karen Roberto examines the ways in which caregivers manage PwD resistance to help, including their use of forceful care strategies. Rosemary Blieszner focuses on competing caregiver roles and demands that may contribute to or alleviate caregiver stress. Tina Savla addresses the unexpected, and often hidden, challenges involved in using formal services. Collectively, the four presentations provide in-depth insight into the complicated daily lives of families coping with dementia and the ways in which they meet the demands of full-time caregiving under often difficult and challenging circumstances. Discussant Steve Zarit considers the efficacy of these management strategies for various aspects of everyday care and offers suggestions for future research and person-centered programs and interventions to reduce health disparities among caregivers in rural areas.
Area-Level Disadvantage and Changes in Disability-Free Life Expectancy for Older Australians
Authors: Tawiah Richard , Anstey Kaarin , Jagger Carol , Kiely Kim
Published: December 2020

We report the first analysis of inequalities in Disability-Free Life Expectancy (DFLE) trends for Australia, based on two cohorts of the nationally representative Household Income and Labour Dynamics in Australia survey. Each cohort was aged 45+ at baseline with 7-years of annual follow-up (Older cohort: 2001-2007, n=6363; Younger cohort: 2011-2017, n=8197). Disability was defined by a Global Activity Limitation Indicator, and socioeconomic position (SEP) by an area-level index of disadvantage. Compared to men in high advantage areas, men residing in low advantage areas experienced smaller gains in life expectancy (3.0 vs 4.6 years at age 65), DFLE (0.6 vs 1.8 years) and years with disability (2.4 vs 2.8 years). In contrast, for women in low advantage areas all years gained in life expectancy (2.6 years) were years with disability, whereas women in high advantage areas experienced gains in DFLE (1.7 years) and even more years with disability (2.7 years).
Socioeconomic Position Across the Life Course and Trends in Disability-Free Life Expectancy in Australia
Authors: Kiely Kim , Tawiah Richard , Jagger Carol , Anstey Kaarin
Published: December 2020

There has been little investigation of how life-course social mobility is linked to Disability-Free Life Expectancy (DFLE). We report novel analysis of the HILDA survey examining how DFLE trends differs by three markers of socio-economic position (SEP): early-life (educational attainment), midlife (occupational level), and late-life (area-disadvantage). All women, irrespective of their educational level, gained years with disability (Age 65: Low education=1.5 and High education=2.5 years). Similar results were obtained by level of occupation, but women with low occupation showed small declines in LE (-0.8 years), all being losses in DFLE. Only women in the most advantaged areas gained DFLE. For men, higher levels of any marker of SEP were associated with DFLE gains that were larger than, or comparable to, gains in years lived with disability, although lower education was associated only with gains in years lived with disability. DFLE trends differ by SEP marker more in women than men.
Why Creativity Matters to Aging and Health
Authors: Hanna Gay , Saunders Pamela , Bernard Marie
Published: December 2020

As GSA turns 75, it is an appropriate time to review the history of the creative aging movement. This symposium explores the research, policy and practice of creative aging - past and present, starting in the 1970’s through the efforts of pioneering leaders in the aging, humanities and arts in conjunction with growing support from the newly established National Endowment for the Arts and related aging and health service systems. The foundational research by Gene Cohen, MD PHD and others at the turn of the 21st Century will be described in terms of its building the science to utilize the humanities and arts to scaffold policy and practices that promote the potential of aging through creative expression rather than the pervasive view of aging as a time of loss. Moving towards strength-based approaches to further the development of overall health including brain reserve, physical fitness and social networks, creative aging collaborations will be highlighted as the future of this initiative. Case studies of joint research projects between state departments of both aging and arts in partnership with Universities will demonstration contemporary practices to address major aging issues around isolation, loneliness and caring for the care giver.