bluuebunny/crossref_metadata_2025 huggingface dataset:
BALANCING WORK AND HEALTH IN AGING: EMPLOYMENT AND ARTHRITIS DEVELOPMENT AMONG MIDLIFE AND OLDER WOMEN
Authors: Tan Micah , Straughan Paulin
Published: January 2025

With population aging, many countries have opted to delay mandatory retirement ages and to encourage workers to continue working into mid- and late-life. However, the implications of such policies for the health of older workers are still understudied. Existing research has demonstrated that women tend to experience greater negative effects on their physical health from working due to having to also shoulder a greater responsibility for household chores and caregiving. Yet, there is a paucity of research examining if such effects are present for older workers, as well as in East-Asian contexts where additional responsibilities at home are greater for women. As such, utilizing two waves of data from the Singapore Life Panel collected in January 2018 and January 2023, the current research aims to understand the physical health effects of work among middle-aged and older-adult women relative to men in Singapore. With a final sample size of 4225 respondents (mean age at baseline = 60.38 years) that had not yet been diagnosed with arthritis at baseline and in fully-adjusted models controlling for marital status, having children, and levels of social support available, we find that women who were working at baseline had a greater likelihood of being diagnosed with arthritis at follow-up relative to women who were not working. In comparison, working at baseline is not found to have any effect on the likelihood of being diagnosed with arthritis among men in the sample. The implications of these findings for health and labor policies in aging populations are discussed.
RELATIONSHIP BETWEEN JOB STRESS AND SELF-CARE ON MIDDLE-AGED AND OLDER ADULT EMPLOYEE WELL-BEING
Authors: Mertz Laurel , Smith Jennifer
Published: January 2025

Given that workplace stress and burnout are related to numerous adverse well-being outcomes, identifying strategies to decrease workplace stress or mitigate its effects is vital. Self-care may be a resource to protect against the negative impact of job stress on employees’ health and well-being, but self-care research is limited in non-healthcare fields. Additionally, as the number of older adults in the workforce rises, there is an increasing need to understand and enhance older adult employees’ well-being. The purpose of this study was to assess whether members of the middle-age and older adult workforce are able to engage in as much self-care as they need, and to determine whether the ability to engage in enough self-care attenuates the relationship between job stress and well-being outcomes. A total of 2,112 full-time employees, ages 43 to 77, were recruited via an online research panel (mean age = 54.0 years, 59.0% male, 64.2% White). Participants completed a survey that assessed job stress, ability to engage in self-care, and well-being (i.e. life satisfaction, job satisfaction, mental and physical health). Multiple regression analyses indicated that engaging in enough self-care attenuated the negative relationship between job stress and satisfaction with one’s life and job, but not health. These results provide evidence that self-care may be effective in protecting against the negative impact of workplace stress in the middle-age to older adult workforce. Further research is needed to examine the effectiveness of formal workplace self-care interventions, as formal interventions may supplement employees’ personal levels of self-care.
INCLUSIVE CROSS-CULTURAL LEARNING: END-OF-LIFE CRITICAL CARE ACROSS KOREAN AND AMERICAN LITERATURE
Authors: Kim Soo Hyun , Wright Rebecca
Published: January 2025

Background

Korean Americans are the fastest growing racial-ethnic population in the US, however, demographic reporting often groups by race, prohibiting exploration of ethnic and cultural needs. This represents a challenge for clinicians tailoring end-of-life care in critical care environments.

Objectives

Report the state of the science from a scoping review of Korean and American end-of-life critical care literature.

Methods

A comprehensive scoping review of the literature was performed in 2024 following the Joanna Briggs methodology, across seven databases: PubMed, CINAHL, EMBASE, Web of Science, KCI, Global Index Medicus, and KoreanMed. Articles were included in English and Korean with no time limit.

Results

Exploration of end-of-life critical care was limited: all studies were descriptive. Korean articles (N=23) highlighted minimal advanced care planning, physician-led care, and an absence of direct patient perspectives. US (N=26) literature revealed a gap in critical care content but included older adult’s hypothetical perspectives of palliative care. Differences were noted in preferences for end-of-life interventions between Korean Americans and other racial-ethnic groups. Some contradictions were noted in Korean American perspectives where life-sustaining treatments were viewed positively but not wanted, yet with an expectation that all treatment options should be pursued out of filial piety.

Conclusion

There is substantial need for research into end-of-life care needs in critical care environments to improve inclusion and equity for Korean Americans. Korean literature provides some insights into cultural norms the US could draw from. However, Korean Americans may have different needs to Koreans, requiring further exploration and intervention development.
NAVIGATING COMMUNITY-BASED HOSPICE TRANSITIONS: PALLIATIVE CARE TEAM PROCESSES TO SUPPORT PATIENT-CENTERED CARE
Authors: Mann Catherine , Masella Norine , Sullivan Suzanne
Published: January 2025

Palliative care systems provide a bridge to hospice as goals of care change during chronic, progressive, serious illness management. However, research is lacking on the role of palliative care teams in promoting care transitions outside of the hospital. The aim of this study is to understand the process palliative care teams use to support care transitions in the community to improve earlier acceptance and admission to hospice care by patients and families. Using a Straussian grounded theory approach, we explored processes palliative care teams use to support patient and caregiver transitions in homecare settings. Data were collected through eight recorded and transcribed interviews of palliative care team members (nurses and social workers, n=28) using the constant comparative method. Participants were recruited from three hospice and palliative care agencies serving three counties in New York state. A theory grounded in a process of building trust (e.g., creating safe spaces, listening and learning, building a rapport, meeting patients where they are at), watching and waiting (e.g., deciding if hospice criteria is met, determining readiness for transition, advance care planning), maximizing facilitators (e.g., personalizing care, involving the interdisciplinary team and caregivers, accessing resources), minimizing barriers (e.g., advocating for patient, addressing social determinants of health, navigating regulatory limitations), and getting them over the hill (e.g., educating to reduce stigma, normalizing hospice, reaching the tipping point) was developed. The process identified in the study reveals important mechanistic targets for the development of interventions that promote patient-centered hospice care transitions in the home.
USING LIFE REVIEW TO EXPLORE DEATH EXPERIENCES AND SELF-MANAGEMENT AMONG HEALTHY OLDER ADULTS IN TAIWAN
Authors: Tsou Hsin-Ying , Ten Pan Yu- , Kuo Tsuann
Published: January 2025

Background

Discussing death is considered a culturally sensitive topic in Eastern societies, as it may evoke concerns related to inheritance, filial piety, and mortality. Avoiding conversation about death can result in family members guessing the wishes of the deceased and may cause disputes and conflicts within the family. Purpose This study aims to explore the changing process of understanding death and self-arrangement among 11 healthy older adults in Taiwan through the use of life review program.

Method

This paper examines participation, dialogue, changes, and reflection in ten life review group sessions with 11 healthy older adults through participant observations and document text analysis. The sessions took place weekly for two hours between April to June in 2023.

Result & discussion

The process to reflect deaths and their self-management included four stages. 1) The “resistance” stage: participants expressed uncertainty by stating “I don’t know how to talk about it”. 2) In “promotion” stage: participants were encouraged to share their experiences in managing funeral arrangements for family members, leading them to realize that “there is no standard answer for funerals, only respect for the deceased”. 3) During the “change” stage: participants were willing to make arrangements regarding properties, medical decisions, funeral arrangements of their own. 4) In the “sharing” stage: an act was performed to summarize the course and to recognize that everyone was unique.

Conclusion

The life review group can effectively guide older adults to discuss their death experience and self-arrangement.
ASSOCIATION BETWEEN MULTIMORBIDITY AND KIDNEY FUNCTION DECLINE IN OLD AGE: A SWEDISH POPULATION-BASED COHORT STUDY
Authors: Beridze Giorgi , Dai Lu , Carrero Juan-Jesús , Marengoni Alessandra , Vetrano Davide Liborio , Calderón-Larrañaga Amaia
Published: January 2025

We aimed to study the associations between multimorbidity (the presence of ≥2 conditions) and multimorbidity patterns, and the risk of kidney function decline in older adults. 3094 individuals from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were followed between 2001 and 2016. Multimorbidity was operationalised as the number of chronic conditions and multimorbidity patterns identified using latent class analysis. Joint models and Cox regression models were used to explore the associations between multimorbidity, and absolute and relative (≥25% decline from baseline) changes, respectively, in the estimated glomerular filtration rate (eGFR) calculated using the creatinine-based Berlin Initiative Study equation. Mean age of the sample was 73.9 and 87% had multimorbidity. There was a dose-response relationship between the number of chronic conditions, and absolute (β [95% CI] = -0.05 [-0.07;-0.03]) and relative (HR [95% CI] = 1.23 [1.17;1.29]) declines in eGFR. Five patterns of multimorbidity were identified. The Unspecific, low burden pattern had the lowest morbidity burden and was used as the reference category. The Unspecific, high burden and Cardiometabolic patterns showed accelerated absolute (β [95% CI] = -0.15 [-0.26;-0.05] and -0.77 [-0.98;-0.55], respectively) and relative (HR [95% CI] = 1.45 [1.09;1.92] and 3.45 [2.27;5.23], respectively) declines. Additionally, the Cognitive and Sensory pattern showed accelerated relative decline (HR [95% CI] = 1.53 [1.02;2.31]). No associations were found for the Psychiatric and Respiratory pattern. Multimorbidity is strongly associated with accelerated kidney function decline in older age. Individuals with cardiometabolic multimorbidity exhibit a particularly increased risk.
DETERMINANTS AND TRAJECTORIES OF HEALTHY AGING IN OLDER AMERICANS
Authors: Sahab Lujain
Published: January 2025

Background

As the proportion of ageing individuals in the population increases, there is an increase in the burden of age-related chronic conditions. Therefore, it is essential to identify determinants of healthy ageing through extensive research and implement strategies to address challenges in society.

Methods

This analysis included an average of 8,340 participants, aged 50+ years, who participated in 6 waves (2006-2016) of the Health and Retirement Study. Healthy ageing measurement included freedom from cognitive impairment, freedom from disability, and high physical functioning. The study examined socioeconomic and ethnic inequality in healthy ageing over 10 years. Multilevel analysis was used to assess education, wealth, income and ethnic inequality in health ageing while accounting for demographic and behavioural factors.

Results

The analysis found that Females had lower odds for healthy ageing (OR: 0.64, 95% CI: 0.61–0.67). Black individuals had statistically significant lower odds of ageing healthily (OR: 0.87, 95% CI: 0.81–0.93) while hispanics had higher odds. The higher the educational degree the more likely you are to age healthily. Former smokers have a higher chance of healthy ageing (OR: 0.84, 95% CI: 0.80–0.88). The higher an individual’s wealth and income the more likely they are to age healthily. People who reported their health as poor were more likely to age negatively (OR: 0.22, 95% CI: 0.20–0.23).

Conclusion

This study showed that Being male, white, wealthy, with a high income were associated with a higher chance of achieving healthy ageing.
SELF-RATED HEATH PREDICTS INCIDENT MODERATE/SEVERE DISABILITY IN AGING MEN: THE MANITOBA FOLLOW-UP STUDY
Authors: John Phil St , Nowicki Scott , Tate Robert
Published: January 2025

Background

There is evidence that Self-Rated Health (SRH) predicts death, but less evidence that SRH predicts new disability. Objective: To determine if SRH predicts moderate/severe disability in a prospective cohort study of aging men.

Methods

We conducted an analysis of a prospective cohort study of men who qualified for air crew training in the Royal Canadian Air Force, which began in 1948. Since 2004, an annual survey is sent out which measures age-reference SRH, functional status, and the Short-Form-36 (SF-36). In 2004, 796 men were alive, responded to the questionnaire and did not have disability. Functional status has been measured with an annual questionnaire which includes items on Basic Activities of Daily Living (BADLs) and Instrumental ADLs (IADLs). We considered impairment to be two or more BADLs impaired (of five considered) or three or more impaired IADLs (of seven). We calculated the median time to disability, and compared groups with a log rank test. We then constructed a proportional hazards model for the outcome of new disability.

Results

SRH was associated with incident disability: Compared to those with Excellent SRH, the Hazard Ratio (95% confidence interval) was 1.79 (1.19, 2.68) for those with Very Good SRH; 2.87 (1.91, 4.30) for those with Good SRH; and 2.40 (2.04, 5.65) for those with Fair/Poor/Bad SRH. This association persisted after adjusting for age, the SF-36 and chronic diseases. Conclusions: SRH predicts new disability.
TWENTY-FOUR-HOUR ACTIVITY COMPOSITION ASSOCIATIONS WITH MUSCLE POWER AND STRENGTH IN OLDER MEN AND WOMEN
Authors: Roe Lauren , Strotmeyer Elsa , Glynn Nancy , Cawthon Peggy , Ma Yan , Hetherington-Rauth Megan , Kritchevsky Stephen , Cauley Jane
Published: January 2025

Physical activity (PA) and sedentary (SED) behavior have opposing associations with skeletal muscle function and are often studied separately, but are codependent. We evaluated associations of 24-hr movement behaviors [moderate-to-vigorous intensity (MVPA), light intensity (LPA), SED, and sleep] with muscle power and strength in 714 community-dwelling older adults (58% women, 76±5 years) from the Study of Muscle, Mobility and Aging (SOMMA). Compositional data analysis applied to 24-hr accelerometry (wrist-worn) determined proportions of time spent in each behavior relative to the remaining behaviors. Multiple linear regression evaluated associations between 24-hr composition with peak stair climb ascend power and leg press power (W), and maximum leg press strength and grip strength (kg). Compositional isotemporal substitution methods determined theoretical changes in the outcome if 10-60 minutes of one behavior was displaced by another in 10-minute increments. Higher proportions of MVPA vs. other behaviors were associated with higher leg press power in men (β: 67.5, 95% CI: 19.9, 115.1) and women (β: 29.1, 95% CI: 8.1, 50.2), and higher stair climb power in women (β: 25.0, 95% CI: 16.5, 33.4). Higher proportions of LPA vs. remaining behaviors were associated with lower leg press power in men (β: -117.9, 95% CI: -193.7, -42.1) and women (β: -39.0, 95% CI: -73.5, -4.6), and lower stair climb power in women (β: -31.6, 95% CI: -45.5, -17.8). No significant associations were found for strength. The most effective time-use substitution to improve muscle power may be through displacing SED or LPA with MVPA in older men and women.
WHAT COMES FIRST? SENTINEL CHRONIC AND SUBSEQUENT MULTIMORBIDITY AMONG OLDER ADULTS
Authors: Zuo Dongmei , Cunningham Solveig
Published: January 2025

The majority of the U.S. adult population is affected by at least one chronic condition. To develop clinical practice guidelines and early prevention interventions, it is necessary to understand the progression of multimorbidity. We investigated the first chronic condition, or sentinel condition, developed by individuals using 15 waves of longitudinal data from the Health and Retirement Study, 1992-2020. Hypertension, arthritis, and heart diseases emerged as the most frequent sentinel conditions. Employing weighted multinomial logistic regression models, we assessed the association of onset age, sex, and race/ethnicity with the likelihood of these conditions relative to a combined category of cancer, diabetes, lung diseases, or stroke as the first onset disease, adjusting for education, marital status, and household income. We find that, compared to having cancer, diabetes, lung, or stroke diseases as the sole first onset condition, each additional year of age decreases the odds of having hypertension and heart disease as the first onset disease by 1.9% and 2.2%, respectively, and decreases the odds of arthritis by 1.8%. Being Hispanic and non-Hispanic Black increases the odds of hypertension as the first onset disease by 64% and 19%, respectively. Being female increases the odds of arthritis by 60%, while being Hispanic increases the odds by 16%, and being non-Hispanic Black decreases the odds by 44%. For multimorbidity, being female and non-Hispanic Black decreases the odds by 12% and 36%, respectively, while being Hispanic increases the odds by 55%, relative to cancer, diabetes, lung diseases, or stroke as the first onset disease.
LONG-DISTANCE FAMILY CAREGIVERS’ APPRAISAL OF BURDEN AND STRAIN SCALES: FINDINGS FROM THE LDCARE INTERVENTION
Authors: Chunga Richard , Cimarolli Verena , Boerner Kathrin , Czaja Sara
Published: January 2025

Although there is a significant and growing number of long-distance family caregivers (LDCs) of older adults with dementia, most evidence-based interventions have been designed and evaluated for caregivers living geographically close to their care recipients. Commonly used scales were designed for proximate caregivers to assess their levels of burden and strain and used to measure outcomes of caregiver interventions. However, LDCs face unique challenges that such scales may not adequately capture. As part of the feasibility testing of a new, remotely delivered, psychoeducational intervention for LDCs, called LDCare, several commonly used burden and strain scales were administered to 40 participating LDCs. During the pre-intervention assessment, the Zarit Burden Interview-12, Pearlin’s Family Conflict Scale, Job-Caregiving Conflict, and Role Captivity Scale were administered to the LDCs. After each scale, open-ended questions were included to provide an opportunity for the participants to evaluate the scales’ relevance to their experience as LDCs. Across scales, most participants stated that the questions described their thoughts and feelings well in general, however, comments regarding some questions’ irrelevance to long-distance caregiving were most common for the Zarit Burden Interview-12 and the Role Captivity Scale. Participants remarked that lower everyday caregiving engagement and geographic distance rendered some questions difficult to answer. Concerns among some LDCs regarding the scales’ relevance to their situation indicate that further research is needed to better understand how questions may be tailored to their unique experiences.
HYPERTENSION CONTROL PROGRAM IN A LARGE HEALTH CARE SYSTEM SERVING HISPANIC MEDICARE BENEFICIARIES IN SOUTH FLORIDA
Authors: Chaves Paulo , Desoria Maureen , Roque Leslye , Mas Rafael
Published: January 2025

Healthcare systems play a key role in hypertension control and health equity promotion in large populations. This study assessed the impact of a multifaceted hypertension control program in a large healthcare system serving Medicare and dual eligible (DE) Beneficiaries primarily of Hispanic origin in South Florida, an understudied population. Leon Medical Centers, a major integrated healthcare services provider to Medicare and DE patients in Miami-Dade, FL, implemented a hypertension control program in 2011. Electronic health records (2008-2018) from patients aged 65-89 years with hypertension were analyzed. Controlled BP definition was annual average systolic BP< 140 mmHg and diastolic BP< 90 mmHg. Age- and diabetes-standardized annual BP control rates were calculated. Random effects modeling compared BP control levels after vs. before program implementation. From 2008 (n=4,710) to 2018 (n=21,540), mean age±SD increased (73.4±5.3 to 77.1±6.1). Proportion of Hispanics remained constant (>98%). Overall age-adjusted odds of BP control were 5.8 (95% confidence interval [CI]: 5.6-6.1) times higher after program implementation. BP control rates increased similarly in both sexes. In women, standardized control rates increased from 68.9-73.3% (2008-2010) to 88.8-92.3% (2013-2018). Standardized control rates tended to be lower in DE than in Medicare patients at baseline – e.g., 2008: 67.2% (65.9-69.3%) vs. 72.2% (70.4-73.8%), but similar after program implementation – e.g., 2018: 89.9% (89.3-90.5%) vs. 90.2% (89.4-91.0%). Implementation of a primary care-based, multicomponent, culturally congruent hypertension control program was associated with meaningful increases in BP control levels in both men and women, and Medicare and DE patients in a large healthcare system in South Florida.
IMPACTS OF PAYMENT REFORM AND COVID-19 ON POSTACUTE CARE ACCESS FOR OLDER ADULTS WITH DISABILITIES
Authors: Prusynski Rachel , Leland Natalie , Humbert Andrew , Dahal Arati , Brown Cait , Amaravadi Harsha , Mroz Tracy
Published: January 2025

Recent Medicare payment reforms, the Patient-Driven Payment Model (PDPM) for skilled nursing facilities (SNFs) and the Patient-Driven Groupings Model (PDGM) for home health agencies (HHAs), aim to improve access to post-acute care for patients with complex care needs by focusing reimbursement on diagnosis and medical complexity. Caring for complex patients, such as those with disabilities, under previous systems may have been less profitable for providers, discouraging admissions. We examined whether these policies improved access to SNF and HHAs for beneficiaries with disabilities. We conducted an interrupted time series analysis of Medicare hospitalizations from 2018-2021 to identify changes in access to SNFs or HHAs. This period included reform implementation and the COVID-19 pandemic, which emerged shortly after reforms. We identified 7,734,908 hospitalizations for beneficiaries with a disability as the original reason for Medicare entitlement. Before reforms, 11.1% of beneficiaries with disabilities were discharged to SNFs and 13.1% to HHAs. PDPM was associated with no difference in HHA discharges but a 0.43-percentage point (pp) decline for SNF. PDGM was associated with increases in HHA (1.91pp) and SNF (0.37pp) discharges until the COVID-19 pandemic, when HHA discharges again increased, remaining high at an average of 18.4% after vaccination efforts. SNF discharges declined at the onset of the pandemic but increased to 14.3% of all hospital discharges after vaccination efforts. Results suggest PDPM worsened access to SNF for beneficiaries with disabilities, but SNF access rebounded after COVID-19 vaccinations. Alternatively, PDGM improved access to HHAs for beneficiaries with disabilities, which remained high during the pandemic.
APPLYING THE TDF FRAMEWORK TO VACCINATION DECISION-MAKING AMONG DIVERSE OLDER ADULTS
Authors: Patskanick Taylor , Ashebir Sophia , Balmuth Alexa , D’Ambrosio Lisa , Coughlin Joseph
Published: January 2025

Annual immunization rates among U.S. adults remain low relative to younger age groups and vary further by vaccine target. Gaps in research understanding the factors influencing older adults’ uptake of vaccines typically indicated for those aged 50+ such as pneumococcal, flu, tetanus, diphtheria and pertussis, shingles, and coronavirus 2019 as persist. Older adults represent a spectrum in the degree to which they may be up-to-date on these recommended vaccines and the facilitators or barriers to this uptake may further vary across vaccine targets. This paper presents findings from the qualitative portion of a cross-sectional study conducted from 2021 to 2022 in which 25 virtual focus groups and interviews of adults aged 65+ (N=112) and who identified as Black or African-American, Latine, Asian or Asian-American, or White were convened to discuss vaccination decision-making. Groups were stratified by racial/ethnic identity and degree to which participants were up to date on the aforementioned vaccinations. In this paper, data were analyzed in MAXQDA2024 using the Theoretical Domains Framework to identify and map the framework’s constructs across vaccine targets among the partially or fully vaccinated. Findings compare and contrast the prevalence of domains (e.g., social influence, emotion, knowledge) across targets among the vaccinated in our sample. Implications of this work for healthcare professionals who seek to influence health behavior change and future research focused on the implementation of interventions to improve vaccination uptake among older adults will be discussed.
INFLUENZA VACCINATION AND OLFACTION IN OLDER ADULTS: FINDINGS FROM HEALTH ABC
Authors: Yuan Yaqun , Chamberlin Keran , Li Chenxi , Luo Zhehui , Tian Teresa , Simonsick Eleanor , Chen Honglei
Published: January 2025

Olfactory impairment is common in older adults and is likely associated with multiple adverse health outcomes. However, few risk or protective factors for olfactory impairment in older adults have been identified. We examined the cross-sectional association between flu vaccination and olfaction among 2507 participants of the Health, Aging and Body Composition study (aged 71-82 years, 51.7% women, and 37.4% Blacks). Olfaction was tested at the clinic visit Year 3 in 1999-2000, using the Brief Smell Identification Test. Olfaction was defined as good (test score 11-12), moderate (9-10), or poor (0-8). Participants were asked about receiving flu vaccines in the past year at each clinic visit from Years 1 to 3. We used multinomial logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CI) of flu vaccine reported at each clinic visit and olfaction tested at Year 3, adjusting for demographics, lifestyle, general health status, and flu occurrence within the past three months. At Year 3, compared with those not vaccinated, participants with flu vaccination were less likely to have moderate olfaction (OR=0.66, 95%CI, 0.51-0.85) and potentially fewer poor olfaction (OR=0.79, 95%CI, 0.60-1.02). The association appeared more evident in men and white participants. Similar findings, albeit slightly attenuated, were found in analyzing flu vaccination data reported at Year-1 and Year-2 clinical visits. Our study provides preliminary evidence that flu vaccination may be protective against olfactory loss in older adults, especially for men and the white race.
METHODOLOGICAL CHALLENGES WITH VOLATILE OLDER PARTICIPANTS: LESSONS FROM A VACCINE HESITANCY SURVEY
Authors: Van Vleet Bryce , Fuller Heather , Huseth-Zosel Andrea
Published: January 2025

Vaccine hesitancy is a critical health risk to older adults who may refuse vaccination for common, preventable, and life-threatening diseases like shingles, pneumonia, COVID-19, and influenza. Despite the importance of understanding vaccine hesitancy among older adults, mistrust in science and hostility towards researchers has been previously documented but it is unclear how these processes impact the research process. Thus, we sought to examine the characteristics and response patterns of volatile survey participants. Data were drawn from a mixed-methods survey about vaccination perceptions and behaviors conducted with 901 community dwelling older adults (65+). Volatile participants (n=59) were identified through their expression of excessive anger (e.g., explicit language, criticism, etc.) or mistrust (e.g., paranoia, accusations, etc.) in open-ended responses. First, linear regression was conducted to identify possible demographic predictors of volatile responses (R2=.063, p<.001). Volatile respondents were significantly more likely to be younger, highly religious, and conservative. Next, chi-square and post-hoc analyses were used to examine differential missingness in volatile participant responses. Volatile participants were more likely to answer questions they likely considered controversial, such as questions about COVID-19 and influenza vaccines. Volatile participants were also less likely to fully complete certain items of vaccine hesitancy and vaccine barrier scales. However, intra-individual response variability analysis did not detect outright deception from volatile participants. Overall, this study highlights methodological challenges in researching vaccine hesitancy among older adults and suggests recommendations to future researchers on conducting studies on politicized topics with skeptical, or even hostile, participants.
ORAL CARE IS A NECESSITY NOT A LUXURY: POLICIES THAT HELP OR HINDER ORAL CARE FOR OLDER ADULTS
Authors: Gallant Kayla , Reid Katrina , Ilardo Joan , Zell Angela
Published: January 2025

We interviewed fifteen stakeholders including state-level policy officials, medical practitioners, dental advocacy organizations, and educators to identify factors influencing oral care provision for older adults in residential settings. The interviews were conducted by two second-year medical students under the supervision of a Ph.D. social worker and a Doctor of Public Health. Analysis of interview transcripts followed grounded theory methodology. Our findings revealed several key themes limiting the provision of dental care to older adults in residential settings. These themes included financial constraints (e.g., Medicare and Medicaid coverage and reimbursement could be unpredictable state by state and year by year), inadequate training (e.g., few specialized dental training programs addressing geriatric oral care needs), limited resources for care provision within nursing facilities, and a systemic insufficient awareness of the dental needs of older adults in residential settings. This study’s results illustrate the means of overcoming the limitations plaguing oral care for older adults in residential settings and ultimately advancing geriatric oral health outcomes in skilled nursing facility (SNF) settings. Next steps are to introduce a “train-the-trainer” model at a SNF. Registered and student dental hygienists will train certified nursing assistants to provide basic oral care for older residents in the SNF to improve geriatric oral health, ensure access to basic oral care, and strengthen the SNF’s ability to provide dental services.
EARLY PALLIATIVE CARE UTILIZATION AMONG OLDER ADULTS WITH METASTATIC CANCER IN A MEDICARE COHORT
Authors: Nowels Molly , Kozlov Elissa , Crystal Stephen , Duberstein Paul
Published: January 2025

Meta-analytic data have found early palliative care (EPC) to be associated with better outcomes among older adults with cancers. EPC is now recommended for all people with advanced cancers. Ideally, the resources required to appropriately treat referred patients would reflect the needs of the patient population. We are aware of no prior attempts to characterize patients receiving EPC. To address this gap, we used a 20% random sample of fee-for-service Medicare enrollees from 2008-2016 to identify predictors of EPC use within 8 weeks of a new diagnosis of metastatic cancer. Logistic regression modeling adjusted for demographics, cancer site, indicators for a variety of physical and behavioral health diagnoses, the Elixhauser comorbidity index, and several indicators for past-year health service use. 525,936 individuals were included, with 4.9% (25,982) receiving EPC. Several behavioral health diagnoses were associated with increased odds of EPC, including both active and remitted alcohol use disorder; active drug use disorder; major depression; and schizophrenia. These findings suggest that the caseloads of palliative care clinicians may disproportionately include persons with histories of significant psychiatric disorders and behavioral health disorders. Though palliative care clinicians may effectively manage some psychological symptoms, such interventions fail to consistently do so. Moreover, few palliative care teams include psychologists or psychiatrists, potentially leading to significant gaps in clinical expertise. Models of palliative care should integrate specialty mental health clinicians to meet the demand for EPC services and manage the spectrum of needs among older adults with advanced cancers.
EXPLORING THE RELATIONSHIP BETWEEN HOME TIME AND SERIOUS ILLNESS AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Butler Rachel , Degenholtz Howard
Published: January 2025

Population-based measures like Healthy Days at Home (HDAH) are increasingly used as quality of life or health system performance metrics. These measures are just beginning to be studied in the context of older adults living with serious illness (SI). We explored factors associated with the duration of home time among community-dwelling Medicare beneficiaries with SI. Using 2016 data from the National Health and Aging Trends Study (NHATS) linked to Medicare claims, we calculated home time for sampled community-dwelling older adults using the HDAH measure. We operationally defined SI as having a diagnosis code in Medicare claims for at least one of nine severe chronic conditions identified by the Dartmouth Atlas. We conducted multivariate analyses to explore how a SI diagnosis (independent variable) is associated with home time (dependent variable). Covariates included gender, age, household composition, census division, and health and well-being (including self-reported health, number of chronic conditions, psychological symptoms, and subjective well-being). In unadjusted analyses, we found the overall community-dwelling sample population had a mean of 361.9 HDAH, while those with SI had a mean of 353.6 HDAH. A Poisson regression showed that community-dwelling older adults with SI had statistically significant fewer HDAH compared to those without SI (β=-0.03 fewer HDAH; CI:-0.03, -0.02). None of the covariate effects were statistically significant. This work furthers our understanding of opportunities to enhance service delivery systems for community-dwelling older adults with SI, a population not necessarily at the end-of-life but one that is vulnerable to frequent, intensive, high-cost health system encounters.
HOSPICE NURSES’ PERSPECTIVES AND CHALLENGES ON HOLISTIC CARE IN MULTIPLE INSTITUTIONS
Authors: Li Ying-Chun , Shiu Chian-Huei , Juang Wang-Chuan , Cheng Yu-Qi
Published: January 2025

Holistic care is a comprehensive care model, including the body, mind, spirit, and society. Palliative care is part of holistic care to improve patient’s quality of life and reduce medical care overuse. Nurses are the primary group providing holistic care. With the increasing care burden of older adults and non-communicable diseases, the demand for palliative care has grown significantly. Taiwan has a growing emphasis on palliative care, and international studies have shown that nurses’ understanding and implementation of holistic care are relatively deficient. Therefore, this study aims to understand hospice nurses’ perceptions and behaviors of holistic care and the challenges or difficulties encountered in its implementation. The study was divided into questionnaires and qualitative interviews based on the knowledge, attitude, and behavior theory. The study samples were from a southern medical center and its collaborative multi-institutions. The questionnaire results indicated that knowledge, attitude, and behavior mutually influence each other, with attitude acting as a complete mediator. Additionally, receiving educational training has a significantly positive impact on both attitude and behavior (p< 0.01). Interview results showed the respondents’ perspectives and behaviors were quite similar to each other. Furthermore, the foremost challenge identified was related to dealing with the patient’s family members. In conclusion, through research to understand hospice nurses’ perceptions and behaviors on holistic care, find out the difficulties and challenges encountered in implementation, and establish appropriate education training and management systems accordingly, which will encourage nurses to provide better holistic care and improve the quality of care.
RELATIONSHIP BETWEEN PERSONALITY TRAITS AND PREFERENCE FOR COPING STYLES IN OLDER ADULTS
Authors: Kakuta Momoho , Gondo Yasuyuki , Nakagawa Takeshi , Masui Yukie , Kamide Kei , Ikebe Kazunori , Ishizaki Tatsuro , Arai Yasumichi
Published: January 2025

Coping styles comprise various coping strategies roughly divided between primary and secondary control by active and passive attitudes. Personality traits are known to influence coping strategies. However, little is known about whether differential patterns of associations with personality traits emerge between primary and secondary control. This study aimed to clarify the relationship between personality traits and preference for coping styles in the octogenarian when the influence of personality would be maximized due to functional declines. Data were collected from 913 community-dwelling people (47.2% male) aged 78 to 82 years who participated in the Japanese longitudinal cohort study of Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians (SONIC). We analyzed the big five personality traits, SOC as the primary control, and positivity effect as the secondary control. We examined the correlation between personality traits and the two coping strategies and compared their independent correlation coefficients of the coping strategies for each personality trait. Only neuroticism was negatively correlated, and the others were positively correlated with both controls. There was no difference in the correlation coefficients of coping strategies on neuroticism and openness (n.s.), whereas extraversion (p =.000) and agreeableness (p =.048) had a significantly stronger correlation with the secondary control, and consciousness (p =.003) had a significantly stronger correlation with the primary control. The analysis indicated that the preference for coping styles differs by personality traits. We emphasized that higher neuroticism avoids using coping strategies, and higher consciousness and extraversion accelerate primary and secondary control, respectively.
ADVERSE CHILDHOOD EXPERIENCES AND SLEEP DEPRIVATION IN OLDER ADULTS: THE MEDIATING ROLE OF SOCIAL ISOLATION
Authors: Jesmin Syeda , Amin Iftekhar
Published: January 2025

Background

Between 40% and 70% of older adults have chronic sleep issues that can negatively affect their physical and mental health. While research shows that exposure to adverse childhood Experiences (ACEs) can be related to later life sleep quality, it is not clear how social isolation in later life can mediate this relationship. Method: We used the Behavioral Risk Factor Surveillance System (BRFSS) 2022 data. The dependent variable sleep deprivation was measured as sleep less than seven hours per night. Multiple logistic regression models were used to examine the associations between the ACE scores and individual reports of sleep deprivation after controlling for potential confounders. A mediation analysis was estimated for the eight ACE variables, social isolation, and sleep deprivation.

Results

After controlling for gender, race/ethnicity, education, marital status, and self-reported health status, the odds of experiencing sleep deprivation were significantly higher among those who reported four or more ACEs compared to their counterpart who reported three or fewer ACEs (OR = 1.76, 95% CI: 0.171–1.82). Among non-Hispanic Blacks, ACEs were associated with significantly greater odds of reporting sleep deprivation. Social isolation acted as a mediator in the ACE and sleep relationship. An inverse dose-response (P < 0.05) was observed between the sleep duration and experience of ACE.

Conclusion

This study identifies subgroups of older adults who are at greater risk of experiencing sleep deprivation as a result of social isolation and ACEs. Screening for ACEs and improving social participation could help address sleep deprivation in older adults.
DIVERSE VOICES OF MENOPAUSE: STUDY RESULTS OF US WOMEN AGES 35 AND OLDER
Authors: Sauer Jennifer , Cozad Aisha
Published: January 2025

AARP conducted a bimodal study gauging the impact of menopause symptoms on women and their treatment preferences. The focus groups included 36 women ages 40 and older from a mix of race/ethnicity, education level, and income. The survey of 1,510 U.S. women ages 35 and older included racial/ethnic oversamples of Black/African American (B/AA), Hispanic/Latino (H/L), and Asian American, Native Hawaiian, Pacific Islander women (AANHPI). Three unique multicultural perspectives emerged: 1) symptoms varied by race/ethnicity. For instance, more Black/African American women than other racial/ethnic groups, experience hot flashes (B/AA: 71%; White: 63%; AANHPI: 61%; H/L: 60%); more Hispanic/Latino women than Black/African American or Asian American, Native Hawaiian, Pacific Islander women report mood/emotional swings (H/L: 55%; B/AA: 44%; AANHPI: 36%; White: 49%;); 2) half (49%) all women say symptoms have a negative impact on day-to-day life with more Hispanic/Latino women feeling this way than White or Black/African American women (negative: 63%, 54%, 51%, respectively); 3) more White women than other racial/ethnic groups take psychotropic medications (White: 30%; B/AA: 24%; H/L: 21%; AANHPI: 14%) and more Black/African American, Hispanic/Latino, and Asian American, Native Hawaiian, Pacific Islander women than White women, take vitamins and supplements (B/AA: 57%; H/L: 57%; AANHPI: 57%; White: 47%). HRT use is consistent across racial/ethnic groups. Focus group verbatims, aligned with survey results, provide meaningful insights of the impact of menopause on women.
MULTISECTOR COLLABORATION TO PROMOTE HEALTHY AGING: A PRACTICAL GUIDE FOR PUBLIC HEALTH
Authors: O’Leary Meghan , Fromknecht Catharine , Lin Yen , Costello Kathryn
Published: January 2025

In collaboration with the HHS Office of Disease Prevention and Health Promotion, NORC at the University of Chicago developed a Quick Start Guide designed for public health officials to start or enhance partnerships with state officials who work with the older adult population. As the proportion of Americans over the age of 65 continues to increase, multisector partnerships will be critical to address the needs of this population and ensure that older adults live healthy, happy lives. The Quick Start Guide includes a set of recommendations for public health departments to use as a starting place for engaging with their counterparts in state and local agencies that are focused on healthy aging. The Quick Start Guide was developed based on interviews with state health department staff and is designed to be used by public health departments at any stage in the process of collaboration, either just beginning or building on existing collaboration. This session will summarize the recommendations in the Quick Start Guide and share examples of how state health departments have successfully partnered with their counterparts at state aging agencies.
A SYSTEMATIC REVIEW OF THE LITERATURE ON ACADEMIC RETIREMENT
Authors: Silver Michelle
Published: January 2025

Objectives

The number of academics reaching traditional retirement age has been increasing thus motivating the need to better understand retirement experiences among higher education faculty. This review paper aims to: (i) identify the types of studies and traits being measured in studies of academic retirement, (ii) understand the determinants of retirement, including pathways and obstacles, among academics being measured in the literature, (iii) map the most prevalent types of studies and findings regarding academic retirement, and (iv) appraise the current state of the literature.

Methods

We conducted a systematic review of the literature to address our research objectives. Studies were identified from multiple database using search terms regarding retirement among academic faculty. Included studies examined determinants of academic retirement, perspectives, and/or retirement experiences among academics. Four reviewers screened the studies for inclusion and completed the data extraction.

Results

A total of 102 papers met the inclusion criteria. Most studies were based on cross-sectional survey data, followed by qualitative interviews; quantitative, qualitative, and mixed-methods research were included. Commonly measured determinants included age and spousal retirement timing. A mapping of the literature indicates a focus on geographical and/or subfield areas. Conclusions: Insights regarding academic’s retirement experiences provide insights about varying retirement pathways and can help elucidate retirement pathways that enhance transitions particularly for those in professions with generally high autonomy. Future research ought to focus on supports to help retain mature workers within academia and overall determinants of satisfaction with retirement among academics.
COUPLE COMMUNICATION AFTER RETIREMENT AND WELL-BEING IN ARAB SOCIETY: AN APIM ANALYSIS
Authors: Nashef-Hamuda Reem
Published: January 2025

This study examined the influence of perceived marital responsiveness on life satisfaction and depression among 106 retired married couples from the Arab society in Israel (mean male age = 70.3, female age = 65.1) with an average of 43.3 years of marriage and 3-5 children. Utilizing the Actor-Partner Interdependence Model (APIM), findings highlighted a positive impact of individual (actor) responsiveness on Satisfaction with Life Scale (SWLS) scores and a negative impact on depression levels. Furthermore, partner responsiveness significantly affected both life satisfaction and depression, underscoring the importance of mutual perceptiveness in marital dynamics. The analysis revealed no significant relationship between marital control and either SWLS or depression, nor were there significant gender differences in the effects, indicating that the benefits of perceived responsiveness are consistent across genders. These results emphasize that life satisfaction and depression in retirement are influenced by both one’s own and one’s partner’s responsiveness, reinforcing the value of mutual support in marital relationships.