bluuebunny/crossref_metadata_2025 huggingface dataset:
Valsartan and Sacubitril Combination Treatment Enhances Collagen Production in Older Adult Human Skin Cells
Authors: Marin Sela , godet Ines , Nidadavolu Lolita S , Walston Jeremy , Gilkes Daniele , Abadir Peter M
Published: December 2021

Collagen is a major component of the skin’s support system, allowing for firmness, elasticity, and mechanical strength. In older adults, skin collagen production decreases significantly, and is associated with increased sagging, wrinkling, and thinning. The Renin Angiotensin System (RAS) is a key hormonal system that changes with age and affects multiple organ systems. While primary health benefits of Angiotensin (Ang) receptor type1 (AT1 R) blockers (ARBs) are believed to arise from systemic effects on blood pressure. There exists a skin-specific Renin Angiotensin System (RAS), but the impact of ARBs on older skin is unknown. Human skin fibroblasts from individuals aged 2 (young individual) and 57 (older individual) were treated with drugs that alter RAS: Valsartan (an ARB) and neprilysin inhibitor Sacubitril. Fibroblast proliferation and collagen production was quantified in response to the drug treatment using fluorescence microscopy. Fibroblasts from 57-year-old individuals were slower to proliferate and had less collagen content as compared to fibroblasts from young individual. Valsartan alone treatment had no effect on collagen production from young or old fibroblasts. In contrast, Sacubitril treatment increased collagen production by approximately three-fold in young (2.87 ± 0.27 RFU, P<.0001), and older (2.93 ± 0.53 RFU, P<.0001) fibroblasts. Concomitant treatment with Valsartan and Sacubitril increased collagen production by five-fold increase (5.36 ± 1.08 RFU, P<.0001) in young fibroblasts, and four-fold (4.18 ± 0.96 RFU, P=.003) in older cells. This study demonstrates a novel use for the widely prescribed drug combination, Sacubitril and Valsartan, which significantly improves collagen production in older adult fibroblasts.
A Study of C2C12 Myoblast Bioenergetics in Response to the CCG-1423 Rho A Inhibitor
Authors: Nguyen Bachkhoa , Ameer Fathima , Crane Jasmine , Azhar Gohar , Zhang Xiaomin , Wei Jeanne
Published: December 2021

CCG-1423 is a Rho A pathway inhibitor which has been reported to inhibit Rho/SRF-mediated transcriptional regulation. SRF and SRF cofactors, which include ternary complex factors (TCFs) and myocardin-related transcription factor (MRTF), regulate various cellular functions. The Rho/SRF signaling pathway also regulates the sirtuin 2 (SIRT2) gene that contains a classic serum response element (SRE) sequence. Current research on CCG-1423 focuses on gene expression levels of SRF in response to CCG-1423 and how SRF levels affect the cells; the studies are focused on cell morphology, migration, viability/reproduction, and overall function. The pathways of this inhibitor have yet to be fully elucidated, but several have been suggested with good evidence. Our goal is to study the effect of CCG-1423 on mitochondrial function and gene expression of cells. In this work C2C12 myoblast cells have been used as an in-vitro model to study cellular bioenergetics and variations in gene expressions induced by CCG-1423. The effect of CCG-1423 on mitochondrial function was determined by measuring the mitochondrial oxygen consumption rate and glycolysis rate after treating C2C12 cells with varying concentrations of CCG-1423 overnight. In C2C12 myoblast cells, CCG-1423 treatment significantly reduced mitochondrial oxygen consumption rate (OCR) in a dose-dependent manner. However, treatment of C2C12 cells with CCG-1423 overnight increased the extracellular acidification rate (ECAR) in a dose-dependent manner. By indicating that CCG-1423 represses mitochondrial respiration via the Rho-SRF signaling pathway, the results of this study may enable a better understanding of the bioenergetics of the cell in the aging body.
The Evaluation of Smart Speaker Skills for Chronic Disease Management of Older Adults
Authors: Pighin Melissa , Choi Yong Kyung
Published: December 2021

A voice-activated smart speaker is an emerging technology that presents unique opportunities to support the chronic disease management of older adults. We identified the available health-related smart speaker skills in Amazon Alexa platform that support chronic disease management and assessed their functionalities to inform the development of a home-based lifestyle intervention program for older adults with cardiovascular disease and type 2 diabetes. From January to March 2021, we searched Alexa Skills using keywords related to diabetes, medication, blood pressure and nutrition management. Our search produced total 156 potentially relevant skills (63 diabetes, 57 medication, 11 blood pressure and 25 nutrition related), of which 22 skills met inclusion criteria. Apps were excluded if it was only informational, not relevant to the topic, had zero user rating, available in language other than English, and required an external device or a subscription to a specific health plan or service. 22 skills (4 diabetes, 8 medication, 3 blood pressure and 7 nutrition) were evaluated with Echo Show 8 device. The skills were evaluated using the modified version of IMS Institute for Healthcare Informatics app functionality scores and the score (0 to 11) was calculated accordingly. The median number of functionalities was 3.5 and 68% of skills (15/22) had 4 or fewer functions. The highest rated skill was a medication management app named myNurseBot having 6 out of 11 functionalities. The poor functionality score highlights a need for a more robust and comprehensive smart speaker skill to support the health management of older adults.
Civic Engagement in Retirement and the Socioemotional Experience of Pandemic Time
Authors: Bo Boroka
Published: December 2021

This research integrates literature from the sociology of the life course, sociology of emotions and the sociology of time to examine how Socioeconomic Status (SES) influenced retiree civic engagement during the COVID-19 pandemic. I find that SES framed both the social experience of time and the prevalent emotions experienced by retirees while physically distancing during the early days of the pandemic. These individual-level experiences translated to markedly different blueprints for civic engagement. High-SES retirees were more likely to ‘go global’, organizing to advocate for their interests. Conversely, low-SES retirees were more likely to ‘turn in’, minimizing their civic engagement. My findings reveal how existing sociopolitical inequalities may become further entrenched in public health crises. Policies aimed at combating inequalities in later life also need to consider socioemotional and sociotemporal factors.
Daily Cognitive Difficulties and Social Experiences Among Older Adults
Authors: Zhaoyang Ruixue , Mogle Jacqueline , Harrington Karra , Sliwinski Martin
Published: December 2021

Self-reported cognitive difficulties are common in older adults and may be an early indicator of future cognitive decline or dementia. In past retrospective reports, cognitive difficulties have been linked with differences in social engagement or social relationships among older adults. However, little is known about how self-reported cognitive difficulties in daily life, such as memory lapses, relate to older adults’ daily social experiences. This study examined how self-reported cognitive difficulties were related to older adults’ daily social interactions and loneliness. Data were drawn from 312 community-dwelling older adults (aged 70 to 90 years) who reported their social interactions and loneliness throughout the day (five times) as well as cognitive difficulties (e.g., memory lapses, problems with attention) at the end of each day for 14 days. Multilevel models revealed that participants reported fewer memory lapses on days when they reported more frequent interactions with family members (p=.041). Higher levels of disruptions to daily activities caused by cognitive difficulties, in turn, predicted higher levels of loneliness the next day (p=.006), but not changes in social interactions the next day. At the between-person level, more memory lapses in daily life were associated with less frequent social interactions with friends, but more frequent unpleasant social interactions and higher levels of loneliness on average. These results suggest that older adults’ self-reported cognitive difficulties were dynamically associated with their social interactions and loneliness at the daily level and played an important role in older adults’ social life and well-being.
Development and Evaluation of Treatment Adherence Interventions for Older Adults With MCI Using IoT Devices
Authors: Shin Jinhee , Cho Eunhee , Kim Gwang Suk , Kim Heejung , Ye Byoung Seok , Pack Chang-Gi
Published: December 2021

For older adults with mild cognitive impairment (MCI), treatment adherence is essential to prevent and delay dementia. Older adults with MCI should maintain treatment for chronic diseases, exercise regularly, and adhere to treatment to maintain health status. There is a lack of comprehensive interventions to promote treatment adherence (medication adherence and physical activity) for older adults with MCI. The purpose of this study was to develop an internet of things (IoT)-based real-time treatment adherence for old adults with MCI and examine the effectiveness of the program. This study was a randomized controlled trial. The patients were enrolled from the neurology outpatient department clinic at a hospital in Korea. The subjects were 18 in the experimental group and 20 in the control group. This study intervention was IoT-based medication adherence device and real-time monitoring sever plus wrist wearable device. The study consists of a 10-week intervention period. The intervention program was provided for only the experimental group and the control group with a wearable device and usual care. Assessments were conducted at baseline, 6 weeks, and 10-weeks. A mixed-effects model was used in the analysis to evaluate the program. The IoT-based treatment adherence intervention was effective in improving medication adherence over time (β =11.465, p<.001), physical activity (K-PASE) (β =27.376, p<.001) and average the number of steps per week (β=3202.53, p<.001). Health care providers can use this program to improve treatment adherence for chronic disease management and dementia prevention of older adults with cognitive impairment.
Interactions Between Plasma Amyloid and Aging Markers to Determine Clinically Meaningful Cognitive Decline
Authors: Lu Wan-Hsuan , Giudici Kelly , Vellas Bruno , de Barreto Philipe Souto
Published: December 2021

Background: Brain amyloidosis is a well-known pathological hallmark of Alzheimer’s disease (AD) and can be early identified by measuring plasma amyloid-β (Aβ) status. Growing evidence implicates the biological mechanisms of aging, including chronic inflammation, mitochondrial dysfunction and neurodegeneration, in AD pathogenesis. This study aims to investigate the interactions between plasma Aβ status and aging markers on clinically meaningful cognitive decline. Methods: This secondary analysis from Multidomain Alzheimer Preventive Trial (MAPT) enrolled 401 community-dwelling older adults (mean age ± SD: 76.7 ± 4.6 years) who had clinical dementia rating (CDR) scale as 0 or 0.5, and who had their plasma biomarkers measured: amyloidosis: Aβ42/40 ratio; inflammatory: tumor necrosis factor receptor type 1 (TNFR-1), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), C-reactive protein (CRP); mitochondrial dysfunction: growth differentiation factor 15 (GDF-15); neurodegeneration: neurofilament light chain (NfL). Cognitive decline was determined by diagnosed dementia and worsening CDR status. Cox regression and moderation modeling were applied to examine the interrelationships between biomarkers and risk of cognitive decline. Results: Among 401 participants, 43.9% were cognitive normal (CDR=0) and 56.1% were mild cognitive impairment (CDR=0.5) initially. After 3.3 ± 1.1 years of follow-up, 7.0% of population evolved dementia and 34.2% had worsening CDR status. GDF-15 and NfL presented prospective associations with incident dementia. However, risk of dementia associated with plasma Aβ did not change after considering the serum level of GDF-15 and NfL. Conclusion: The markers of mitochondrial dysfunction and neurodegeneration did not partially explain the associations between plasma Aβ status and cognitive decline in older adults.
Long-Term Visit-To-Visit Blood Pressure Variability and Cognition: A Systematic Review of Observational Studies
Authors: Yoneda Tomiko , Knight Jamie , Zhang Amelia , Muniz-Terrera Graciela , Piccinin Andrea
Published: December 2021

Existing literature suggests that in comparison to a single blood pressure (BP) measurement, or the mean of multiple recordings, BP variability (BPV) may reflect dysfunction in cardiovascular regulatory mechanisms, leading to compromised cognitive health. No systematic review has yet synthesized observational reports examining the association between cognition and long-term visit-to-visit BPV. In response, a comprehensive literature search was executed in December, 2019, and updated in December, 2020. Methodological approach was pre-registered (https://osf.io/vmnuq/). Of 1385 reports, 27 met eligibility criteria. Most executed secondary analyses using existing longitudinal datasets of older adults (N=21). Intervals between measurement occasions ranged from 30 days to four years, and follow-up ranged from 0.5-25 years. Most studies computed more than one index of BPV (range=1-6), and all included at least three BP recordings (range=3-12). Given extensive between-study variability in analytic approach (e.g., BPV and cognition treated as continuous and/or categorical variables; number of covariates ranged 0-18), our team determined that meta-analyzing the results would be inappropriate. Despite heterogeneity in study characteristics, the majority (85.2%) reported that systolic BPV (sBPV) was negatively associated with cognition; specifically, higher sBPV was associated with cognitive impairment (N=9), cognitive decline (N=6), and/or risk of dementia (N=5). Four studies also revealed higher sBPV in individuals with dementia compared to controls. Three studies reported no association, while one reported a positive significant association between BPV and cognition. Results were similar for diastolic BPV. Despite considerable heterogeneity in study characteristics, greater variability in visit-to-visit BP appears to be consistently associated with adverse cognitive outcomes.
The Association Between Leisure Games and Cognitive Functioning Among Older Adults
Authors: Terada Tyran , Lee Yeonjung
Published: December 2021

Stimulating leisure games have been shown to offer cognitive stimulation among older adults. This cross-sectional study examined the association between word games (crossword puzzles and scrabble) / cards and games (games such as chess) and cognitive functioning among adults aged 65 years and older (n=3271). All data were collected from the Health and Retirement Study (2016). Results from the hierarchical regression models suggest that higher levels of participation in word games (p<.01) and cards and games (p<.01) predicted higher levels of cognitive functioning. In the final model, after controlling for age, gender, ethnicity, marital status, education, and income, a total variance of 31 percent was explained. All covariates were statistically significant except marital status. Word games (β=.117, p<01) and cards and games (β=.054, p<.01) had a significantly positive association with cognitive functioning. These findings suggest that participation in word games and cards and games are associated with cognitive functioning among older adults.
The Effects of Mild Cognitive Impairment on Fall Severity in Older Adults
Authors: Jones Megan , Paulson Sally , Gills Joshua , Campitelli Anthony , Glenn Jordan , Madero Erica , Myers Jennifer , Gray Michelle
Published: December 2021

Falls affect more than 30% of older adults and are one of the leading causes of injury, hospitalization, and mortality in this populations. Mild cognitive impairment (MCI) is one of the risk factors for falls in older adults. The purpose of this study is to determine if older adults with MCI have increased fall severity than older adults without MCI. Participants (n: 81: age: 79 ± 6) completed a Montreal Cognitive Assessment (MoCA) and a Hopkins Falls Grading Scale, a tool used to grade the severity of falls on a scale of 1-4 (1 = loss of balance without fall; 4 = fall requiring hospital admission). Participants were categorized as having MCI (score <26: N: 44: age: 81 ± 6.4) or non-MCI (score ≥26: n: 37: age: 77 ± 6). Groups were analyzed using a one-way ANOVA in SPSS to compare the severity of falls within the previous 12 months. There were no differences between groups for fall grade 1 (p =.22) or fall grade 2 (p =.45). There was a significant difference between groups for fall grade 3 (p =.04) and fall grade 4 (p =.05) with the MCI group having more of these falls compared to the non-MCI group. Older adults with MCI had a higher number of falls requiring medical attention than older adults without MCI. Although falls are a risk in all older adults, those with MCI may be at higher risk of more injurious falls than older adults without MCI.
Maintaining Integrity of Worldwide FINGER Clinical Trials During the COVID-19 Pandemic
Authors: Roehr Susanne
Published: December 2021

The COVID-19 pandemic presents challenges to the conduct of randomized clinical trials of lifestyle interventions. World-Wide FINGERS international network convened a forum for researchers to discuss statistical design and analysis issues they faced during the pandemic. We report experiences of three trials that, at various stages of conduct, altered designs and analysis plans to navigate these issues. We provide recommendations for future trials to consider as they develop and launch behavioral intervention trials. The pandemic led researchers to change recruitment plans, interrupt timelines for assessments and intervention delivery, and move to remote intervention and assessments protocols. The necessity of these changes add emphasis to the importance, in study design and analysis, of intention to treat approaches, flexibility, within site stratification, interim power projections, and sensitivity analyses. Robust approaches to study design and analysis are critical to negotiate issues related to the intervention.
Involvement in Decision-Making for Daily Care and Cognitive Decline among Older Adults Who Need Care in Japan
Authors: Komatsu Ayane , Nakagawa Takeshi , Noguchi Taiji , Saito Tami
Published: December 2021

Effective decision-making regarding daily care for older adults with needs could reduce the risk of dementia by preventing loss of motivation and improving care quality. However, empirical studies are scarce, particularly in non-Western countries with different socio-cultural backgrounds. By using 2-year longitudinal data of older Japanese adults aged 65 years and above who were receiving care at home, as well as of their family caregivers, we examined the association of involvement in decision-making with the onset of cognitive decline among older Japanese adults requiring care. The analysis included 219 cases of individuals with normal cognition and no missing variables at baseline and responded to the follow-up survey. An MMSE score of 23 or lower at follow-up was defined as the onset of cognitive decline. The level of involvement in decision-making was assessed by one item and dichotomized (not involved/involved). The covariates were age, gender, education, MMSE score, eligibility level for long-term care, and others at baseline. At baseline, 67.1% were 75 years or older, 58.9% were female, and 91.8% responded being “involved” in the decision-making. The incidence of cognitive decline at follow-up was 30.6%. The multivariable logistic regression analysis showed that involvement in decision-making (OR=0.298 [95% CI: 0.10-0.88], p=0.029) was negatively and significantly associated with the onset of cognitive decline. Our findings show the importance of involvement in the decision-making for daily care to reduce the risk of subsequent cognitive decline in older adults requiring care, even in a culture of familism.
Depressive Symptoms Moderate the Association Between Lifetime Discrimination and Inhibition Among Older Adults
Authors: Wright Regina , Bygrave Desiree
Published: December 2021

Discrimination has been identified as a potentially modifiable environmental stressor that reduces cognitive function. As the burden of discrimination can extend from early to late life, understanding its role in cognition in late life is critical. Further, understanding the potential moderating influence of depressive symptoms, which are common among older adults, on the linkage between discrimination and cognition, may provide further insight into the potential patterns of psychosocial stress and negative affect that may promote cognitive decline and dementia. Thus, we sought to examine whether depressive symptoms moderate linear relations of lifetime discrimination to cognitive function in the domains of visuospatial, verbal, and working memory, executive function, and psychomotor ability, adjusting for age, sex, race, and education. Participants were 165 older adults (34% male) with a mean age of 68.43y. Participants completed a health screening, a battery of cognitive tests, a psychosocial assessment, and cardiovascular testing relevant to the larger study. Linear regression results showed a significant interaction between lifetime discrimination and depressive symptoms (p<.05) related to the Stroop interference score, a measure of inhibition. A probe of the interaction showed that greater lifetime discrimination was associated with better inhibition among participants with fewer depressive symptoms. This paradoxical finding is consistent with scant research that shows exposure to discrimination may heighten performance, and is more common among individuals that have achieved more, both educationally and vocationally. Greater depressive symptomatology may reduce this paradoxical association. Future research should explore this question both longitudinally and in a larger sample.
Perceptual Versus Conceptual Value-Directed Strategic Processing in Younger and Older Adults
Authors: Nguyen Lydia , Lydon Elizabeth , Mudar Raksha
Published: December 2021

Value-directed strategic processing involves selectively attending to and processing information deemed more important while ignoring or inhibiting less important information. What we selectively attend to can be driven by the value we ascribe to the information, often based on stimulus factors such as perceptual features that make the information stand out, or conceptual features that make it easy to group information. The current study investigated whether behavioral measures of value-directed strategic processing are differentially affected when value is defined by perceptual versus conceptual features, and how normal cognitive aging impacts processing. Cognitively normal younger (N = 16; mean age: 22.1 ± 2.9 years) and older adults (N = 16; mean age: 66.9 ± 7.3 years) completed two value-directed strategic processing tasks, where value was defined by either perceptual (i.e., uppercase and lowercase letters; Letter Case task) or conceptual (i.e., animals and household items; Categories task) features. Both groups had higher recall on the Categories task compared to the Letter Case task, and higher recall for high- than low-value words. However, older adults recalled fewer total words than younger adults, but the groups did not differ across task types. These findings indicate that manipulating perceptual and/or conceptual features to define value can be used to study value-directed strategic processing in younger and older adults. Furthermore, grouping information based on conceptual features may be more effective for promoting subsequent recall in both younger and older adults.
Gender Differences in Mental and Physical Health: Implications for Aging With a Traumatic Brain Injury
Authors: Swinford Emma
Published: December 2021

Traumatic Brain Injury (TBI) is a major cause of disability and death in the U.S., and survivors often experience temporary or life-long health effects as a result of their injury. While risks and outcomes of fall-related TBI in older adults have been well-documented, the intersection of TBI-related health challenges and the experience of aging with a TBI is less well understood. This project explores gender differences in health outcomes among TBI survivors. A Needs Assessment survey was conducted in early 2020 with adult TBI survivors in Missouri (n=150). The mean age of respondents was 46 and 58% identified as male. Bivariate analyses reveal gender differences in health conditions among TBI survivors before and after injury. Significantly more males than females reported substance use disorder for alcohol (20.7% and 7.9%, p < .05) prior to injury, whereas twice as many females reported developing chronic pain after injury than males (68.3% and 31.0%, p < .001). Further, while about 21% of both male and female respondents reported experiencing other mental health conditions, such as anxiety, prior to injury, over 35% of males and almost 58% of females experienced mental health concerns after injury. Additionally, balance/mobility issues, sleep disorders, sensory issues, and cognitive challenges were frequently identified post-injury conditions. Co-morbidities impact our experiences, capabilities, and quality of life as we age. Policies and programs to support TBI survivors and their families may better address the co-occurring health conditions among TBI survivors by considering gender differences in the experience of aging with a TBI.
Lessons for Humanities and Arts in Gerontology and Geriatrics Curricula From the Medical and Health Humanities
Authors: O'Neill Desmond
Published: December 2021

The role of Humanities, Arts and Cultural Gerontology in gerontology and geriatrics curricula finds a metaphor in the rapidly evolving field of medical and health humanities, with which this author has been involved for three decades. Behind the call for increasing humanities and arts scholarship in the pedagogy of both fields lies the challenge of establishing an interdisciplinary nexus of scholarship that avoids the challenges of dilettantism and gestures such as providing lists of novels and movies. This presentation draws on the presenter's bibliometric research in the medical and health humanities which indicates authorship in the majority to be either solely from the humanities or from healthcare, with little indication of joint working in either authorship or acknowledgements (the scholar's courtesy), and explores the background issues of academic culture with a view to proposing solutions to elevate the inclusion of humanities and arts as a significant element of gerontology education.
Challenges in caring for people with dementia during COVID-19: Findings from long-term care facilities across Japan
Authors: Ikeuchi Tomoko , Suzuki Mizue , Kikuchi Kazunori , Kan Akiko , Shimada Chiho
Published: December 2021

Long-term care facilities for older adults have been profoundly affected by the coronavirus disease 2019 (COVID-19) pandemic in Japan. This study investigated the challenges that care staff members faced by the height of the first wave (i.e., April 2020) and the height of the second wave (i.e., October 2020) of the pandemic at long-term care facilities in Japan. We mailed questionnaires in October 2020 to 5,895 care facilities throughout Japan. A total of 22.7% of the questionnaires were returned. Of those, 87.4% had at least one resident with dementia. Based on the results, 65.2% reported having restricted all visitors during the first wave. Although 42.8% reported continuing to restrict all visitors during the second wave, more than 54% allowed visitors while limiting the number of visitors or the time of each visit. Nearly 76% reported that restrictions on visitations may have exacerbated the behavioral and psychological symptoms of dementia (BPSD) among residents. In place of visitations, over 50% used video calls or phone calls to communicate with the family members, and 45.7% reported that the virtual visits were efficacious in alleviating the BPSD. However, more than 70% reported not having adequate Internet services and computer equipment at their facilities, and nearly 90% reported insufficient staffing. Our findings suggest that the pandemic may have pressed for a change of direction for dementia care with the introduction of virtual visitations and other initiatives. Nevertheless, facilities may face difficulties with implementing such changes due to inadequacies in the availability of resources.
The Effect of Vaccines on Older African Americans Emotional Experiences During the COVID-19 Pandemic
Authors: Hanna Sophie , Bass Dwana , Shair Sarah , DiCerbo Loraine , Giordani Bruno , Kavcic Voyko
Published: December 2021

The COVID-19 pandemic is an unprecedented health emergency that has forced a change in the daily life of all individuals across the nation for over a year. As vaccinations have begun in Detroit, we examined their effect on older African Americans’ emotional experiences and intent to get vaccinated during the pandemic to help understand how persons make decisions to accept vaccinations. For this study, 194 community-dwelling older African Americans (mean age = 75, age range = 64-94) were recruited from the Wayne State Institute of Gerontology Healthier Black Elders Center and general Detroit area. A telephone survey was administered to assess pandemic experience including demographics, emotional responses (e.g., gratitude, happiness, anger, fear), everyday stressors (e.g., economic problems, reduced privacy), and vaccination attitude (e.g., concern over safety, intent to vaccinate). Of the 194 participants, 149 completed the survey before the first vaccination occurred in the United States on December 15, 2020, and 45 completed the survey after. Participants had not yet been vaccinated, but 67% said they would as soon as available. Participants in the post-vaccination group, as compared to pre-vaccination group, showed increases in stress-related locus of control (p=.03) and reported being more likely to get vaccinated (p=.02). They showed decreased worry about availability of health and safety supplies (p=.01), reduced perceived stress (p=.02), and a decrease in fears of COVID-19 (p=.05) and vaccination safety (p<.001). The current study highlights the effect of vaccinations on the attitudes and emotions experienced by an older minority population living in an urban area.
The Relationship Between Covid-19 Anxiety and Well-Being Outcomes in Older Veterans
Authors: Kintzle Sara , Castro Carl
Published: December 2021

Understanding the impacts of the COVID-19 pandemic on the well-being of vulnerable populations is essential in planning for care post pandemic and preparing for future pandemics. One such population often overlooked during the COVID-19 pandemic is older veterans, whose military service often results in physical and psychological effects that creates vulnerability to the impacts of COVID-19 beyond their age risks. The purpose of this research was to examine the relationship between COVID-19 anxiety and well-being in older veterans. Survey data was collected from the end of June 2020 through August 2020 and examined the well-being of veterans during the COVID-19 pandemic. This research looked at the 122 veterans in the sample who were aged 65 and older. Age ranged from 65 to 94 years (M=73, SD = 5.0). The sample was predominately Male (90%), White (83%), educated (65%) and married (69%). Moderate to high COVID-19 anxiety was reported in 38 percent of the sample. Older veterans who reported moderate to high COVID-19 anxiety were 5 times more likely to report loneliness, 11 times more likely to meet the diagnostic cut off for anxiety, 3 times for depression, 2 times for PTSD, and 3 times for moderate to severe insomnia. Results revealed a clear association between COVID-19 anxiety and the well-being of older veterans. Findings have implications for ensuring well-being outcomes are restored in older veterans as cause for pandemic anxiety is reduced. Results also demonstrate older veterans should be recognized as a vulnerable population in preparation for care future pandemics.
Impact of COVID-19 on Older Adults: Changes in Health Access, Health, Socialization and Adaptive Coping Activities
Authors: Scott Judith , Yun Stacy , Qualls Sara
Published: December 2021

Indirect effects of stay-at-home guidelines may negatively affect mental health by reducing health self-care behaviors and engagement in social participation. This study reports on the impact of the COVID-19 pandemic on community-dwelling older adults’ perceived physical and mental health and everyday health behaviors. 126 older adults participated in a county-wide telephone survey during June-July of 2020, asking about changes in mental and physical health, and adaptations in health behaviors. We investigated the effects of three negative everyday health behavior changes during the pandemic (changes in health services access, perceived changes in health, and increased social isolation) as well as two positive everyday health behaviors (adherence to stay-at-home guidelines to reduce risk, and adaptive coping activities) on mental health and COVID-related distress. Examples of active coping strategies were stockpiling resources, spiritual practices, or outreach to others. Descriptive statistics, bivariate correlations, and multiple regressions characterized the impact of COVID-19 on perceived mental health. Descriptive data included changes in health service access, changes in mental and physical health, reduced social engagement, increased adherence to guidelines, and increased adaptive coping activities. Significant predictors of mental health impact of the pandemic were changes in health service access (β = .18, p < .05), health changes (β = .25, p < .01), and adaptive coping activities (β = .21, p < .05). Findings suggest COVID-19 distress may be alleviated with improved health care access and increased social contact. Mental health challenges may also benefit from increased engagement in adaptive coping activities.
Adaptability of Older Adults at the Onset of the COVID-19 Pandemic
Authors: Blackman Laurie , Wang Donna , Krase Kathryn , Roberson-Steele Joyce , Clarke-Jones Annette , Attis Latoya
Published: December 2021

It is important to understand the unique experiences and perspectives of older adults who were required to incorporate critical adjustments to behavior during the onset of the COVID-19 pandemic. An anonymous, cross sectional survey was administered online through Qualtrics Survey Software in June 2020. The results of this study found that older adults utilized different sources of information than younger adults; they were more likely to read the newspaper or listen to the radio, and less likely to rely on social media for information. Older respondents in this study reported coping with the COVID-19 outbreak better than younger respondents, were less likely to report that they were personally affected by the virus, and less likely to feel overwhelmed by the amount of information about COVID-19. The findings of this study highlight resilience in older adults not found in younger adults, and provide an important step in identifying policy and practice suggestions to reduce negative repercussions for older adults experiencing the current crisis, as well as future generations of older adults who might experience similar events.
Spatial Distribution of COVID-19 and Comorbidities in New England
Authors: Lee Chae Man , Jansen Taylor , Xu Shu , Karakida Maki , Porell Frank , Silverstein Nina , Dugan Elizabeth
Published: December 2021

At the onset of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) identified chronic conditions which elevated the risk of COVID-19 complications: chronic obstructive pulmonary disease (COPD), diabetes, heart disease, kidney disease, and obesity. The aim of this study is to visualize the spatial distribution of confirmed cases of COVID-19 and local rates of comorbidities in CT, MA, NH, and RI and to identify the spatial clustering of hot spot between COVID-19 cases and rates of a summary measure of comorbidities across communities. This study collected data from state’s departments of public health in 4 New England states of confirmed COVID-19 cases as of February 25th, 2021 and extracted community-level rates of comorbidities among adults age 65+ from recent Healthy Aging Data Report (www.healthyagingdatareports.org). Results showed that the cities Bridgeport, CT (n=14,637), Boston, MA (n=57,912), Manchester, NH (n=9,658), and Providence, RI (n=26,792) had the highest rates of COVID-19 and the highest population density. The GIS based map illustrated that the largest cities with the highest population densities had both relatively high incidences of COVID-19 and heavy burdens of comorbidities. This study found that the hot spot areas of COVID-19 were observed in communities with the highest chronic disease burdens. These hot spots of COVID-19 and comorbidities are areas where resources (testing, masks, vaccines) should be surged to protect the community. The identification of hot spots may motivate residents to take every mitigation step to prevent and control COVID-19.
A Remote Music-Based Service-Learning Project to Support Isolated Older Adults in Long-Term Care
Authors: King Emma , Reschke-Hernandez Alaine
Published: December 2021

Growth of the aging population warrants a commitment to teaching students to work effectively with older adults. In an online university course focused on inclusive music practices, students engaged in an extensive service-learning project to enhance course learning objectives and increase sensitivity to disability, social justice, and inclusion issues across the lifespan. Based on community needs, one student aimed to reduce isolation among older adults living in a long-term care facility. The student selected this target and population because of the detrimental effects of isolation on psychosocial, cognitive, and physical well-being; and reduced access to interactive programs and services among older adults living in residential facilities during the COVID-19 pandemic. Components of the project included a service-learning proposal, an annotated bibliography, an interview with the community partner, three activity designs, and a reflective essay. Based on existing research regarding interventions used to reduce isolation among older adults, the three activities the student designed were music bingo, interactive singing, and stretches to music. Throughout the service-learning process, the student consulted the community partner to ensure relevance of the activities. Principles of Universal Design for Learning (UDL), such as providing multiple visual and auditory means to engage with materials, enhanced accessibility of the activities. In this presentation, the student and course instructor will reflect on this case experience and the value of service-learning to foster professional skill development, engaged citizenship in working effectively with older adults, and an appreciation of the need for justice, equity, and fairness for all community members.
Assessing Needs, Well-being, and Telehealth Access of Older Adults with Limited Resources during COVID-19 Pandemic
Authors: Damier Sashah , Twahir Assma , Tewary Sweta , Pandya Naushira , Cook Nicole
Published: December 2021

The COVID-19 pandemic created new barriers and challenges to accessing primary care services, particularly among older adults who already faced barriers related to access to care, including transportation, health literacy, and self-management support. Nova Southeastern University South Florida Geriatric Workforce Enhancement Program (NSU SFGWEP) partnered with primary care clinics to conduct wellness calls to older adult patients identified through clinic EHR. The wellness calls’ objectives were to 1) discuss COVID-19 protective measures; 2) assess wellness needs and access to care barriers; and 3) screen for telehealth support. From September 2020 to February 2021, the team (including medical students, public health students, and SFGWEP staff) contacted 200 patients via telephone and conducted a comprehensive wellness survey developed by the study team, informed by validated surveys. Among the 200 patients called, 60% (n=34) were very concerned about the Covid-19 pandemic, 33% (n=34) reported often feeling isolated from others, and 20% (n=34) expressed difficulty getting medical care. A smaller subset of patients reported concern about limited COVID-19 testing (n=1), lack of knowledge about seeing their provider via telehealth (n=7), lack of face masks (n=1), and challenges with obtaining medication refills (n=1). Following wellness calls, the NSU SFGWEP team provided education, referred to clinical resources, and, for low-income patients with access to care challenges, provided Samsung Tablets (n=50) with peer training to enable telehealth.
Regional Microstructural Integrity in Relation to Gait Speed: The Atherosclerosis Risk in Communities Study
Authors: Sullivan Kevin , Blackshear Chad , Hughes Timothy , Gottesman Rebecca , Vemuri Prashanthi , Mosley Thomas , Griswold Michael , Windham B Gwen
Published: December 2021

Brain imaging-based biomarkers of neuropathology are associated with mobility in older adults, but the relation of regional microstructural integrity to gait speed in the context of a broader neuropathological profile is less understood. We examined cross-sectional associations of microstructural integrity with 4-meter usual-pace gait speed (cm/s) in a subsample of ARIC study participants who completed 3T MRI brain scans with diffusion tensor imaging(2011-13; n=1785; mean age=76.2±5.3, 60% Female, 28% Black). We considered total brain and six regional averages of fractional anisotropy (FA; lower=worse microstructural integrity) and mean diffusivity (MD; higher=worse microstructural integrity): frontal, temporal, parietal, occipital, anterior and posterior corpus callosum. Associations were tested in multivariable linear regression models adjusted for demographics, cardiovascular risk factors, and with and without additional neuropathological indices: total brain volume, white matter hyperintensities, infarcts, and microhemorrhages. When modeled separately, all neuropathology indices were associated with slower gait speed. Every standard deviation(SD) higher total brain FA was associated with +2.56 cm/s gait speed (95%CI: 1.64,3.48) and every SD higher MD was associated with -4.27 cm/s gait speed (-5.34,-3.20). All regional estimates were comparable. When adjusted for all other neuropathology indices, only posterior corpus callosum FA (β=1.72; 0.67,2.77), total MD (β=-1.63; -3.02,-0.25), frontal lobe MD (β=-1.76; -3.03,-0.48), and temporal lobe MD (β=-1.40; -2.78,-0.02) remained significantly associated with gait speed. Microstructural integrity is an informative measure of brain pathology in relation to mobility, with regional measures tied to executive, memory, and somatosensory function being more informative when a broader neuropathological profile is considered.
Exploring Well-Being Outcomes Among Persons Living with Dementia: Self-Reports Versus Caregiver Proxy Reports
Authors: Minyo Morgan , Powers Sara , Ciancibello Alyssa , Schaffer Rachel , Bass David
Published: December 2021

A vast amount of research has focused on the development of dementia caregiving evidence-based programs (EBPs) in order to mitigate the well-known negative impacts of providing care for persons living with dementia (PLWD). In order to support efficacious results, many programs utilize a variety of both objective and subjective outcomes as typically reported by the caregiver or collected via medical history and clinical assessments. However, more recent research has attempted to understand the subjective illness experience of PLWD through self-report measures. Using data obtained from an online database (i.e., Best Practice Caregiving), that currently provides in-depth information on 44 dementia caregiving EBPs, the current study aimed to examine the number of EBPs that incorporated PLWD self-report measures on a variety of well-being outcomes. Results indicate that out of the 44 EBPs included for analysis: 1) Four out of 19 programs evaluating PLWD symptom severity/difficulty/distress used a PLWD self-report measure; 2) Eight out of 10 programs evaluating PLWD symptoms of depression used a PLWD self-report measure; 3) Five out of 10 programs evaluating PLWD quality of life/care utilized a PLWD self-report measure; and 4) One out of 9 programs evaluating ADL/IADL dependencies utilized a PLWD self-report measure. Discussion will focus on potential gaps and limitations of primarily using caregiver proxy reports to collect personal well-being outcomes for PLWD and ways in which researchers can integrate more self-report measures into intervention and programmatic evaluations.
FIRST: Enhancing Agency Dementia Capability through Dementia-Specific Interventions and Supportive Services
Authors: Wellbrock Elizabeth , Hutchinson Joanna
Published: December 2021

Through the First Identify and Refer then Serve and Track (FIRST) Project, individuals and caregivers have critical connections to community organizations and resources to learn ways to handle living with memory problems. The FIRST project integrated new practices into existing programs to address gaps in service and piloted a new dementia-specific case management program. The initial intervention is a system-level change within the County of San Diego’s Aging & Independence Services (AIS) department to identify, pilot, and implement a brief Alzheimer’s Disease and Related Dementias (ADRD) screening tool. The tool was used by non-clinical personnel to identify potential ADRD cases. Individuals who screened positive for possible ADRD were referred to their physicians for an accurate diagnosis. The second intervention consisted of two components: a behavioral symptom management intervention for social workers to use in the home with caregivers and a dementia-specific case management program (including respite care) to improve quality of life and future planning for those with ADRD living alone or with a family caregiver. As of January 2021, 536 clients across several AIS programs have been screened for ADRD, of which, 60% screened positive. FIRST case management has served 196 clients, 70 who lived alone and 126 who lived with their caregiver. Respite was provided to 98 clients totaling to 3,666 hours. This poster evaluates the effectiveness of the program components in increasing dementia capability of an agency, and where applicable, its effect on caregiver burden and self-efficacy.