bluuebunny/crossref_metadata_2025 huggingface dataset:
THE CLARK TIBBITTS AWARD AND HIRAM J. FRIEDSAM AWARD LECTURES AND PRESENTATIONS
Authors: Bradley Dana
Published: December 2023

The Clark Tibbitts Award Lecture will feature an address by the 2023 award recipient Edward Schneider, MD of the University of Southern California. AGHE’s Clark Tibbitts Award was established in 1980 and named for an architect of the field of gerontological education. The award is given each year to an individual or organization that has made an outstanding contribution to the advancement of gerontology and geriatrics education. The Hiram J. Friedsam Award Lecture will feature an address by the 2023 award recipient Harvey Sterms, PhD, FGSA of the University of Akron. Hiram J. Friedsam was the professor, co-founder, and director of the Center for Studies in Aging and dean of the School of Community Service at the University of Northern Texas. Dr. Friedsam was an outstanding teacher, researcher, colleague, and mentor to students, faculty, and administrators, as well as a past president of AGHE. The purpose of this award is to recognize those who emulate Dr. Friedsam’s excellence in mentorship.
USING NATIONAL CORE INDICATORS—AGING AND DISABILITIES—FOR QUALITY, POLICY, AND SYSTEM TRANSFORMATION
Authors: Giordano Stephanie
Published: December 2023

National Core Indicators Aging and Disabilities (NCI-AD™), uses survey data to support State Medicaid, aging, and disability agencies to conduct surveys with individuals receiving publicly-funded long-term services and supports and measure and track their own outcomes and performance using reliable data collection methods and tools. Established in 2015, NCI-AD is now in use by 22 states nationwide. The NCI-AD portfolio includes the flagship survey – the Adult Consumer Survey (ACS) and the State of the Workforce—Aging and Disabilities (SotW-AD) survey. The ACS collects data directly from older adults and people with physical disabilities to assess the outcomes of services provided to individuals. Indicators address key areas of concern including service planning, rights, community inclusion, choice, health and care coordination, safety and relationships. In 2022, NCI-AD piloted the SotW-AD survey with five participating states. A first of its kind for the aging and disabilities field, this new effort collects and aggregates statewide information about wages, benefits, and turnover of the direct service workforce—as reported by the agencies that employ them. The SotW-AD will launch to all AD states in summer 2023. This session will provide an overview of the NCI-AD program, the type of data collected from each survey, and how state-level and research partners have utilized the data sets.
CHALLENGING IDEAS OF CONSTANT CONNECTION AND DIGITAL INCLUSION
Authors: Cotten Shelia , Schuster Amy
Published: December 2023

1We live in a world where we are constantly connected to devices. This constant digital connection is where many individuals communicate and exchange social support with social ties. For most, this results in being online and connected to devices multiple times each day. Older adults have been slower to adopt and use emerging technologies. This presentation challenges the concept of digital inclusion by focusing on older adults and their technology use. We provide an overview of technology usage by different age groups using existing national level data. Next, we utilize life course and aging theoretical perspectives to help articulate that while a constant connection to devices may be normative for younger age groups, this may not, and perhaps should not, be the case for older adults. We conclude with a discussion of the social construction of digital inclusion and emphasize the significant variation that exists in this construct.
TARGETING AND APPROACHING LEGISLATURES TO SUPPORT FAMILY CAREGIVING: LESSONS LEARNED
Authors: Fields Beth
Published: December 2023

The Caregiver Advise, Record, and Enable (CARE) Act has passed in 45 states and requires hospitals to ask patients if they have a family caregiver, notify that family caregiver about the patients upcoming discharge, and educate family caregivers how to provide the care the patient will need after discharge. Early research demonstrates that this Act has favorably influenced hospital and patient outcomes such as quality indicators and family caregiver confidence. Despite this research and widespread support, this Act has yet to be passed in Wisconsin. This presentation will report on lessons learned from a systematic method for targeting and approaching Wisconsin state legislatures within the Assembly Committee on Health, Aging, and Long-term Care. Interviews, fieldnotes, in-person visits, and telephone and email correspondences with legislatures were conducted to learn their perspectives on advancing family caregiving policy. Lessons learned from this systematic method for targeting and approaching legislatures included the timing of interactions matter, the use of concise language maximizes understanding, the mode of delivery impacts response rate, and the transformation of family caregiving research to infographics increases uptake. Findings from this work can be used to elevate family caregiving support by bridging the evidence to policy gap.
NIA DIVISION OF AGING BIOLOGY
Authors: Kohanski Ronald
Published: December 2023

Dr. Kohanski will discuss research priorities for the NIA Division of Aging Biology. Dr. Kohanski will also be available for small group discussion.
THE AGING NETWORK AND CLIMATE RESILIENCE
Authors: Dabelko-Schoeny Holly , Rao Smitha , Sheldon Marisa , Katie White
Published: December 2023

Originally established to support planning and services related to community-based supports, Area Agencies on Aging (AAA) are well-positioned to lead cutting edge innovations driven by local community needs and changing socio-environmental contexts. This presentation illustrates a partnership between the Central Ohio Area Agency on Aging (COAAA) and the Age-Friendly Innovation Center at The Ohio State University focused on advancing research-informed practice in response to the realities of aging in a warmer world. This project included three main phases. First, safety and emergency preparedness data were collected from individuals aged 50 and older living in central Ohio through a random sample survey (N=1417), revealing 25% of non-white residents (compared to 21% white) did not have or know they have 3-day emergency supplies, food, and medicine, and 84% of residents in urban areas did not have access to an alternative source of power in event of outages. Second, a community conversation identifying priorities and needs related to the rising number of extreme weather events was held with COAAA leadership, community organizations, and residents. Third, targeting locations of high density of older adults at highest risk, the last phase of this work focused on the development of a tool to reduce harm for older adults living in affordable housing in partnership with COAAA embedded Service Coordinators. This project illustrates how AAAs can partner with applied researchers to innovate and strengthen services within communities and build evidence to address emerging community needs across the aging network.
BRIDGE JOBS AS PATHS TO WORKING LONGER: DO GENDER AND RETIREMENT IDENTITIES MATTER?
Authors: Oh Yun taek , Moen Phyllis
Published: December 2023

Leaving a full-time career job happens not only by completely exiting the labor force but also by having bridge jobs. When choosing to have bridge jobs, some workers perceive themselves as partially or completely retired while others are not. This study first categorizes bridge jobs into three types: switching occupations, leaving employers, and reducing work hours to part-time. Then, this study uses the Health and Retirement Study to investigate how the self-perceived retirement status in bridge jobs affects the timing of complete withdrawal from the labor force by using two-way fixed-effects event study regression. The results show that a significant proportion of older workers consider themselves partially or completely retired when leaving employers or reducing work hours but do not when switching occupations. The results also show the effects of bridge jobs on the complete withdrawal are different by the self-perceived retirement status and gender. Switching occupations reduces the probability of retirement for male workers who do not consider it as retirement while it increases the probability of retirement for female workers who consider it as retirement. Leaving the employer reduces the probability of retirement for male workers who consider these bride jobs as retirement while it does not for female workers. These findings imply the importance of self-perception of retirement in labor force participation and how it differs by the types of bridge jobs.
CONSTRUCT VALIDITY OF FRABONI SCALE OF AGEISM IN A CHINESE-MAJORITY SAMPLE FROM SINGAPORE
Authors: Cao Yuanyuan , Lim Jie Xin , Ho Ringo , Theng Yin-Leng
Published: December 2023

The 29-item Fraboni Scale of Ageism (FSA; Fraboni et al., 1990) was constructed to measure three dimensions of ageism (Antilocution, Discrimination, and Avoidance) using samples from Canada. The factor structure of the FSA has been challenged in recent studies using US samples (Rupp et al., 2000) and Chinese samples (Fan et al., 2020), resulting in alternative factor structures. The current study aimed to test the different factor structures proposed in these past studies with a sample from Singapore, a Chinese-majority multicultural country. Data from 311 individuals, aged between 21- and 55-year-old were collected. They completed the 29-item FSA using a six-point agreement scale. Confirmatory factor analysis was used to test the goodness-of-fit of the aforementioned factor structures. The results indicated that none of three models provided a good fit to the data. A follow-up exploratory factor analysis with parallel analysis suggested a 3-factor structure. Thirteen out of the 29 items were found to have at least one salient cross-loading after Geomin rotation. These findings suggest that the samples likely interpreted and responded to the items differently resulting in different item-factor configurations, implying the impact of regional culture on the construct validity of FSA. Researchers aiming to quantify ageism in their population using FSA are advised to examine the FSA factor structure prior to using it.
FINANCIAL EXPLOITATION IN OLDER AGE: A REVISIONARY MODEL
Authors: Han Duke
Published: December 2023

Financial exploitation can have a devastating impact on the independence and wellbeing of older adults, yet the reasons why some older adults experience financial exploitation remain elusive. Recent work informed by the fields of neuropsychology, neuroscience, behavioral economics, and epidemiology has increasingly demonstrated links between financial vulnerability in older age and serious health outcomes such as cognitive decline and incident Alzheimer’s Disease. Because of this, research on financial exploitation in older age has progressively been made a public health priority, and this has led to a substantial expansion in knowledge on the topic. Despite this beneficial growth in understanding, gaps in knowledge, misconceptions, and ageist viewpoints continue to persist. To address these, this presentation will (1) discuss the potential role of age-associated cognitive changes in financial exploitation, (2) review neuroimaging findings from our group and others relevant to understanding possible brain changes involved, and (3) highlight cross-cultural, interpersonal, and other considerations that need prioritization in future research endeavors. In conclusion, we will present a revisionary model of financial exploitation in older age which considers not only the potential vulnerabilities of the older adult, but also the persons committing the financial exploitation and the contextual factors that may contribute to poorer outcomes. This revisionary model can more effectively inform interventions for the prevention and mitigation of financial exploitation in older age.
PLANNED CESSATION OF POTENTIALLY INAPPROPRIATE MEDICATIONS: TRAINEE EXPERIENCES FROM LONG-TERM CARE PROGRAMS
Authors: Dickerson Kimberly , Quellhorst Jennifer
Published: December 2023

Polypharmacy is a global concern. There is no universal consensus on definition. VIONE is an innovative, end user friendly, portable, simple methodology that is easy to teach, adapt, customize across the continuum of care, in any clinical setting, for any medication. Trainees demonstrate immense eagerness, ability and potential to benefit from exposure to medication optimization through both safe prescribing and safe deprescribing practices. Given the good fortune of long term care settings, trainees follow the patients and directly engage in implementing methodical safe deintensification of potentially inappropriate medications through shared decision making. Trainees address prescription cascades and health literacy issues. Trainees also track outcomes to deprescribing, are made aware of the data and intervene as needed. Overall - this has been a very professionally rewarding and personally enriching experience. We have case reports with specific timelines, medications, doses, duration, rationale, responses and data analytics that illustrate the merits of engaging trainees early on in their careers to safe medication optimization and deprescribing practices. Data tracked includes number of patients impacted, number of medications deprescribed, dose decreased, safer alternatives prescribed, number of users, cost savings, location, medications deprescribed etc. that are updated daily with VIONE score cards and dashboards utilizing medical informatics and corporate data warehouse data - thus proving the rich granularity, transparency and data integrity.
OUT-OF-HOME MOBILITY, DAILY WORKING MEMORY, AND NEIGHBORHOOD WALKABILITY IN HEALTHY OLDER ADULTS
Authors: Luo Minxia , Kim Eun-Kyeong , Weibel Robert , Martin Mike , Roecke Christina
Published: December 2023

Out-of-home mobility could enhance cognitive performance, but environmental contexts — such as neighborhood walkability — may influence the associations. This study examined daily out-of-home mobility in relation to daily cognitive performance in healthy older adults and the moderator effects of neighborhood walkability therein. Participants wore a custom-built mobile GPS sensor („uTrail“) and completed smartphone-based working memory assessments for 15 days, and responded to the baseline Neighborhood Environment Walkability Scale. Analyses included 947 days’ data from 109 Swiss older adults aged 65 to 89 years. Out-of-home mobility (i.e., out-of-home time, maximum distance from home) were extracted from the GPS data. Multilevel models showed that daily out-of-home time and daily maximum distance from home were not associated with daily working memory performance across the study sample, but the associations were moderated by neighborhood walkability. Out-of-home time and maximum distance from home were positively (vs. negatively) associated with working memory performance in participants who lived in neighborhood with higher (vs. lower) street connectivity and more (vs. less) access to places for walking and cycling. Additionally, maximum distance from home were positively (vs. negatively) associated with working memory performance in participants in neighborhood with lower (vs. higher) mixture of land use. To conclude, spending more time out of home and travelling longer distance away from home could be beneficial for daily cognitive performance of older adults who lived in well-connected and higher-walkable and -bikeable neighborhood. Travelling longer distance could also benefit those who lived in a neighborhood with a lower mixture of land use.
THE LINK BETWEEN VIOLENCE EXPOSURE AND BIOLOGICAL AGING IN MID-LIFE MUSLIMS IN ISRAEL
Authors: Iktilat Khalil , Agmon Maayan
Published: December 2023

Trauma and accumulated chronic stress throughout life are associated with negative health outcomes; more specifically, exposure to violence has been linked to an accelerated aging state. In Israel’s Arab sector, rates of violence have been steadily rising for the past several years. Homicide rates, relative to population size, are seven times higher among Arabs. We aimed to determine the effects of exposure to violence on estimation of biological age as a measure of rate of aging within the ethnic minority of Muslims in Israel. We have conducted a cross-sectional study that included 375 participants age 50.5±6.9 years, of which 61% women. Biological age was estimated using the Klemera-Doubal method and physiological biomarkers; exposure to violence was measured using the Screen for Adolescent Violence Exposure questionnaire followed by a principal component analysis. The average total score of violence exposure was 1.83±0.36 (range 1-5, 1 corresponds with lower exposure). We found a positive and significant relationship among biological age, the “direct evidence of violence” component, and the “evidence of severe violence in the immediate environment” component (r = 0.119, p<0.05; r = 0.111, p<0.05, respectively). These results demonstrate that exposure to violence negatively affects health and accelerates aging within Israel’s Muslim minority. Comprehensive, culturally- and gender-adapted programs are required to reduce violence and address its contribution to the negative aging trajectory in this population.
HEALTH PROFILE OF PORTUGUESE CENTENARIANS FROM 2011 TO 2021: AN UPDATE BASED ON NATIONAL CENSUS
Authors: Ribeiro Oscar , Araujo Lia , Paul Constanca , Teixeira Laetitia
Published: December 2023

According to the Portuguese National Census, the number of centenarians increased from 1526 (82.1% women) in 2011 to 2801 (82.0% women) in 2021. Along with a description of main sociodemographic characteristics, this paper provides an updated health profile of this population based on their perceived difficulties in six functional domains of basic actions (seeing, hearing, walking, cognition, self-care, and communication) as assessed by a set of questions developed by the Washington Group on Disability Statistics that is consistent with the International Classification of Functioning, Disability, and Health (ICF). Sex differences are also presented, as well as comparisons between data from Census 2011 and Census 2021. Most centenarians show major constraints in their mobility and personal care (76.3% cannot/have great difficulties in walking/climbing stairs, and 72.8% cannot/have great difficulties in bathing/dressing), and a better outcome is reported in communication (64.2% report no/reduced difficulty for understanding/being understood). This profile globally follows the pattern observed in 2011, but with fewer centenarians reporting such level of difficulties. The percentage of centenarians reporting no/reduced difficulties in seeing and hearing increased from 32.6% and 27.7% in 2011, to 54.4% and 44.8% in 2021, respectively. In both censuses, women presented a higher percentage of difficulties in all health-related variables. Globally, this comparative perspective shows improvements in the perceived health profile of the later born cohort of Portuguese centenarians and features the continued need for addressing gender-specific and gender-sensitive interventions that acknowledge older women’s care needs.
POSITIVE EVENT DIVERSITY AND AGE: TESTING CURVILINEAR ASSOCIATIONS
Authors: Klaiber Patrick , Hill Patrick , Almeida David , DeLongis Anita , Sin Nancy
Published: December 2023

Prior research has found that older adults report more frequent positive events compared to younger and middle-aged adults. It remains unknown, however, to what extent age is related to experiencing positive events spread across different positive event types (i.e., positive event diversity, PED). We therefore examined age differences in PED and its affective well-being correlates across three large daily diary datasets: wave 2 (N = 1919) and the Refresher sample (N = 744) of the National Studies of Daily Experiences, and the Coping with the COVID-19 Outbreak Study (N = 1392). We used Shannon’s Entropy to quantify PED. There was a curvilinear association between PED and age, indicating that PED was higher among middle-aged compared to younger and older adults. On a zero-order basis, PED was correlated with higher positive affect and uncorrelated with negative affect. However, the pattern of results changed when considering positive event frequency as a moderator. Among people with high positive event frequency, PED was linked to higher negative and lower positive affect, but not associated with either positive or negative affect at low levels of positive event frequency. These relationships did not differ by age. This study suggests that middle-aged adults experience the widest range of positive event types, perhaps reflecting the diverse set of social roles that middle-aged adults often fulfill (e.g., worker, parent, partner). In addition, there might be negative consequences to experiencing a lot of positive events across very different contexts which may indicate social role strain.
INTERVENTION DEVELOPMENT USING PALLIATIVE CARE CLINICAL PRACTICE GUIDELINES CONCERNING SPIRITUALITY
Authors: Beck Monica , Gallagher Amelia
Published: December 2023

Nurses may be reticent to engage older adult cancer patients in spiritual histories despite evidence of improved health outcomes citing lack of education, skills, and time as barriers. Few interventional studies target these barriers using the Clinical Practice Guidelines for Quality Palliative Care as a framework for providing spiritual care excellence. Lift the Spirit, an enhanced educational communication intervention, integrated the guidelines for assessing and respecting patient and family spiritual beliefs, provider self-reflection, and spiritual screening and assessment using a validated instrument. The mixed-methods pilot study aimed to assess the feasibility and acceptability of Lift the Spirit. A purposive sample of nurses (n = 17) viewed an educational module, role-played conducting spiritual histories using the Faith, Importance, Community, Address (FICA) © instrument, and completed debriefing interviews. Pre/post outcome measures of Spiritual History Knowledge and Spiritual History Self-Efficacy were analyzed using a Wilcoxon paired signed-rank test. Debriefing interview data were content analyzed. The Theoretical Framework of Acceptability was used to content code and identify acceptability-related content. There were significant differences between pre and post knowledge and self-efficacy scores, respectively (Wilcoxon Signed-Ranks: Z = -3.18, p = 0.002; and Z = -3.20, p = 0.001). Qualitative findings supported the feasibility and acceptability of Lift the Spirit; participants found the FICA© instrument and role-playing especially helpful. Preliminary findings suggested Lift the Spirit was feasible, acceptable, and positively impacted knowledge, skills, and self-efficacy. The utility of an intervention like Lift the Spirit to improve older adult cancer patient outcomes was demonstrated.
HOW IMPORTANT IS IT TO PRAY AND MEDITATE FOR BRAZILIAN OLDER ADULTS? SOCIODEMOGRAPHIC AND CLINICAL CHARACTERISTICS
Authors: Salecker Mariana , de Souza Yolanda , Bós Angelo José
Published: December 2023

Praying and meditating are considered spiritual expressions, but little is known about this importance among older adults. Therefore, this abstract aim to understand the frequency and the sociodemographic and clinical characteristics related to the importance given by the Brazilian older adults to praying and meditating. This is a secondary analysis of the transversal data of the Older Adults Health Longitudinal Study, made by Fiocruz in 2015. The dependent variable is: “How much daily praying and meditating is important to you?” Independent variables included: sex, age, educational level, marital status, race, and self-perception of health. The relation between the variables were tested by Chi-Square, considering p<0.05 significant. Praying and meditating everyday were important in 87.6% of the participants. Higher percentages were noticed between the ages of 60 to 69 years old (88.8%) and the ages 80 to 89 years old (88.1%, p<0.001), women (91.6%, p<0.001), widows (90.8%, p<0.001), indigenous (89.1%, p<0.001), with primary school complete (90.5%, p<0.001) and with regular auto perception health (88.4%, p=0.051). We conclude that there is higher than expected frequency of Brazilian older adults who consider important praying and meditating. They are more likely to be women, widow, indigenous, younger, less educated and have regular self-perception of health.
ADAPTING TO THE HEALTH RESEARCH MENTORING LANDSCAPE: THE ENHANCING RESEARCH FOR ONLINE LEARNERS (ENROLL) PROGRAM
Authors: Peterson Matthew
Published: December 2023

Engaging students in mentored research has contemporary challenges, including virtual environments and student disengagement. This provides an opportunity to develop novel methods to attract and support students in health research, with the goal of encouraging a career in the health sciences. The overarching objective of EnROLL is to attract, support, and engage on-line and on-campus learners in faculty-led, interdisciplinary health science research. The specific aims of EnROLL are, 1) to develop a focused program and curriculum in faculty-led research to engage online graduate and underserved undergraduate students in health research, 2) to develop and implement an effective model of research mentor training for dissemination, and 3) to assess the value in the program as a model to disseminate for engaging students in faculty-led health research. Now in the second year of funding, attracting students into the mentoring structure has been the biggest challenge. To address this challenge, novel strategies for student recruitment and engagement have been implemented. A stipend-supported scholars program and novel intergenerational events are two examples. Engaging external institutional partners has also yielded differing perspectives and collaborations. This program’s recruitment challenges have yielded new programmatic strategies and unforeseen opportunities. The need for creative and adaptable programming will be highlighted and discussed.
INTERNATIONAL PUBLISHING OPPORTUNITIES AT THE JOURNAL OF AGING & SOCIAL POLICY
Authors: Miller Edward , Simpson Elizabeth , Gusmano Michael , Nadash Pamela
Published: December 2023

Policymakers, practitioners, and researchers need a balanced, thoughtful, and analytical resource to meet the challenge of global aging at a rate that’s historically unprecedented. The Journal of Aging & Social Policy (JASP), which was founded in 1989, serves this role by drawing contributions from an international panel of policy analysts and scholars who assume an interdisciplinary perspective in examining and analyzing critical phenomena that affect aging and the development and implementation of programs for older adults from a global perspective. Study settings extend beyond the United States to include Europe, the Middle East, Australia, Latin America, Asia, and the Asia-Pacific rim. This presentation will document the scope, content, and focus of JASP, including the rise of international submissions, which now account for approximately half of articles published. Opportunities for publishing in JASP will be discussed; so too will strategies for navigating the peer-review process successfully.
PERCEIVED STRAIN ON THE SPOUSAL RELATIONSHIP AMONG MARRIED CUSTODIAL GRANDPARENTS WITHIN THE PARENTING ROLE
Authors: Kim Eunbea , Lee Jeong Eun , Smith Gregory
Published: December 2023

Providing primary care for grandchildren is known to have a significant impact on custodial grandparents’ well-being. For married custodial grandparents, although their caregiving burden may spill over to marriage which can lead to negative psychological outcomes, it has rarely been examined. We examined how custodial grandparents couples’ perceived stress in the spousal relationship due to parenting (PSSR) is associated with their psychological outcomes mutually using Actor Partner Interdependent Model. We further tested the moderating effect of coping strategies on the association between PSSR and psychological outcomes. Participants are grandparents couples providing full-time care to their grandchild in the absence of the grandchildren’s biological parents (N_dyad = 193). We found that one’s PSSR was associated with one’s higher depressive symptoms for both grandmothers and grandfathers. Regarding anxiety symptoms, only grandmothers’ PSSR was positively related to both their own and their spouses’ anxiety level.In terms of coping strategies, we found that a higher level of problem-focused coping was related to higher levels of anxiety for both grandmothers and grandfathers when grandmothers experienced higher PSSR. A higher level of emotional coping was related to higher level of depressive symptoms in both grandfathers and grandmothers when they experienced a higher level of PSSR. A higher level of emotional coping was related to both grandfathers and grandmothers’ higher level of anxiety when grandmother’s PSSR was higher. Our research adds to the existing body of literature by emphasizing how emotional and problem-focused coping can moderate the connection between increased PSSR and psychological outcomes among custodial grandparents.
ASSESSING CAREGIVING SUPPORT NETWORKS FOR PERSONS WITH DEMENTIA IN A LONG-TERM CARE CONTEXT IN CHINA AND THE US
Authors: Xu Hanzhang , Dupre Matthew , Lynch Scott , Østbye Truls , Wu Bei
Published: December 2023

Informal caregivers are vital to the provision of care for persons living with dementia (PLWD). Although PLWD often receive care from multiple sources, little is known about the broad caregiving support networks that PLWD have. Furthermore, the structure of caregiving support networks is likely influenced by the availability, accessibility, and affordability of LTC services. Therefore, caregiving support networks in China and in the U.S. are likely to differ. In this study, we identified the major types of caregiving support networks that PLWD have using the Health and Retirement Study and China Health and Retirement Longitudinal Study. Results from latent class analysis show that both countries have three major types of caregiving networks, but they differ in the proportion of each country’s population that follow each type. Unlike conventional secondary data studies that often only focus on existing data, we are working with WE-THRIVE Consortium to further gain a comprehensive understanding of the dementia care context in China and in the U.S. Through an expert panel survey, we will assess the scope, services, needs, funding, and ownerships of LTC in each country. We will then link the data from expert survey to the two national aging studies to contextualize the caregiving support networks in persons with dementia. This new way of linking existing individual-level with country-level data is directly responsive to the priority research areas identified by the National Academy of Medicine and will shed light on which caregiving support networks need more external formal support to promote person-centered dementia care.
PRACTICAL STRATEGIES FOR RETAINING DIRECT CARE WORKERS
Authors: Janssen Leah
Published: December 2023

Direct care workers (DCWs), such as state-tested nurse aides, personal care aides, and home care aides are a critical component of the long-term services system. While there is consensus in both the research and practice community on the challenges faced, the plan for a long-term solution continues to be developed. The final paper of this symposium is based on a review of state and national initiatives and interviews with high-performing long-term services and support providers, and culminates into a tip sheet of practical strategies for providers who are seeking to recruit and retain DCWs. The tip sheet is organized in relation to the symposium theme of work culture, which includes elements of creating a welcoming and respectful work environment, employing a participative leadership model, and opportunities for DCWs to anonymously assess work culture. It also discusses staffing ratios that are critical to recruiting and retaining workers, as well as an examination of career ladders, mentorship opportunities, and strengthening training standards. DCW economic well-being (e.g., financial incentives such as wages, bonuses and benefits) and community impact are also explored. The priority of this section is to help providers gain insights on establishing a work culture that is more receptive to DCWs’ needs.
PROVIDERS AND DIRECT CARE WORKERS’ PERCEPTIONS OF RETENTION
Authors: Karmacharya Isha , Janssen Leah , Brekke Bailee
Published: December 2023

Direct care worker (DCW) retention remains a persistent challenge for long-term services and supports (LTSS). Multiple studies have identified key factors for worker retention, including worker training and empowerment, career advancement opportunities, compensation, and communication. However, few studies include multiple perspectives on understanding work culture from both providers and DCWs, which is essential for developing effective retention strategies that address the needs and concerns of different stakeholders. This qualitative study explores elements of work culture through semi-structured in-depth interviews with 21 providers and 16 DCWs from 12 high-performing LTSS facilities and agencies across Ohio. The facilities/agencies were selected based on state-level family satisfaction and staff retention data. Three major elements of work culture emerged as important for DCW retention: 1) a family-like approach, 2) working conditions, and 3) worker empowerment. DCWs value a family-like approach in the workplace, which included relationships with clients and their supervisors. Favorable working conditions comprised freedom of choice, participative leadership, and effective communication that promoted retention. DCWs experienced empowerment through recognition and appreciation, coupled with financial incentives and career advancement opportunities. These findings suggest simple modifiable changes to work culture that improve worker retention in LTSS. This study urges policymakers to consider these implications for addressing the ongoing challenge of DCW retention.
AGE DIFFERENCES IN AFFECT DYNAMICS: APPLYING A FORMALIZED THEORETICAL APPROACH
Authors: Wirth Maria , Voss Andreas , Rothermund Klaus
Published: December 2023

Emotional aging research is dominated by the idea of age-related improvements that result from shifts in motivation. Socioemotional selectivity theory (SST) proposes that as individuals age, they increasingly favor emotion-related goals and savor positive but avoid negative emotions. Previous age-comparative studies on everyday emotional experience typically were descriptive or studied the processes underlying emotional experience in isolation. We aimed at a more holistic approach to test hypotheses derived from SST regarding age-related differences in general emotional dispositions (i.e., anchoring), emotional reactivity, and emotion regulation by using a comprehensive computational approach. We applied our Model of Intraindividual Variability in Affect (MIVA) to data on everyday emotional experiences in an age-diverse sample (N = 378, age range 14 – 86 years). Parameter estimations were carried out within a Bayesian framework. Our results provide partial support for predictions derived from SST. Consistent with SST, affect elicited by pleasant events was down-regulated less by older adults and affect elicited by unpleasant events was down-regulated more by older compared to younger adults. Inconsistent with SST, anchoring showed a negative age-related trend, indicating a more positive general affect disposition in younger, not older adults. Reactions to pleasant events showed no age-related differences. Reactivity to unpleasant events was highest in midlife and lower for younger and older adults. We discuss the broader implications of our approach for understanding emotional development across the lifespan.
THE CHALLENGES OF LARGE QUALITATIVE DATASETS AND MEETING THE EXPECTATIONS OF INDIGENOUS COMMUNITIES AND FUNDERS
Authors: Lewis Jordan
Published: December 2023

Literature on Alaska Native Elders and how they subjectively define a successful older age is limited. The lack of a culturally specific definition often results in the use of a generic definition that portrays Alaska Native Elders as aging less successfully than their White or non-Native counterparts. However, there is very little understanding of the diverse array of successful aging experiences and how this data will translate to other racial and ethnic minority populations, as well as advance the field of successful aging. This decade long study research the concept of successful aging from an Alaska Native perspective, or what it means to age well in Alaska Native communities and the lessons Elders. Qualitative, in-depth, interviews have been conducted with 154 Elders representing 20 participating communities to explore the concept of successful aging and the role of their community in the aging process. This study highlights the four (6) elements of successful aging, or “Eldership:” emotional wellbeing, spirituality, community engagement, Native ways of life, generativity, and physical health. These elements serve as the foundation of how communities define who is an Elder and what is important when considering who has aged successfully or not. This presentation will discuss challenges of analyzing large datasets to inform future studies, the development of a theory and measure of successful aging, as well as how to balance the needs of Indigenous community partners and the funders.
MENTAL HEALTH FIRST AID TRAINING: EVIDENCE OF ITS EFFECTIVENESS FOR MENTAL HEALTH PROMOTION AMONG OLDER ADULTS
Authors: Amin Iftekhar
Published: December 2023

Background

About 15% of adults aged 60 and over have a mental health disorder. However, stigma and lack of knowledge of mental health resources act as barriers for them to seek professional help. Mental Health First Aid (MHFA) is an evidence-based program that teaches participants how to identify, understand and respond to signs of mental illnesses and substance use disorders. The Older Adults version of this training focuses on the unique experiences and needs of older adults. This study evaluated the effectiveness of a Substance Abuse and Mental Health Services Administration (SAMHSA) funded MHFA training program among older adults. Method: Data were collected from MHFA training sessions delivered to 27 staff and 36 residents at two assisted living facilities from January to March 2023. A quasi-experimental, pre-post design was used. Two outcomes mental health literacy and stigma were measured at the pretest, posttest, and 4 months after the the training. A paired sample t-test was performed to test the differences between the pre- and post-test.

Results

Statistically significant improvements in self-confidence in promoting help-seeking and reduction in stigmatizing attitudes were observed among participants in post-tests and 4-month tests. Participants reported increased knowledge in how to provide initial support to someone who may be mental health crisis and help connect them to the appropriate care.

Conclusion

Results indicate MHFA is likely to improve mental health awareness and reduce stigma among older adults. This study adds new evidence to the literature on the MHFA program’s effectiveness among older adults and their caregivers.
GENOMIC ARCHITECTURE OF FEMALE REPRODUCTIVE AGING
Authors: Murray Anna
Published: December 2023

Female reproductive lifespan is characterised by declining ovarian reserve, but the underlying mechanism is poorly understood. Reproductive ageing is a multifactorial trait with both genetic and environmental modifiers. Our research uses genome-wide analyses to identify the genes and biological processes that govern female reproductive ageing. We have identified 290 genetic loci with relatively common variants (>0.1%) that are associated with timing of natural menopause, in a meta-analysis of >200,000 women in the ReproGen consortium. In combination these common variants explain around 12% of the variation in menopause timing. Women in the top 1% combined genetic risk centile for earlier menopause are approximately 5x more likely to have menopause before 40 years. A high genetic risk for earlier menopause in mothers, but not fathers, is also associated with increased de novo mutation rate in offspring. We assessed the role of rare (MAF<0.1%) protein-coding variants on ovarian function in data from 104,733 females in the UK Biobank using gene burden association tests. We identified nine genes with associations that passed our multiple testing threshold. Protein-truncating variants in ZNF518A were associated with earlier menopause (effect size 5.61 years, P=1.2x10-10), with an effect larger than for any previously reported gene or variant. Deleterious variants in SAMHD1 were associated with >1 year later menopause and were also a germline risk factor for cancer predisposition in males and females. Understanding the genetics of reproductive ageing is not only important for fertility, but also has implications for broader age-related health outcomes, such as cancer, diabetes and osteoporosis.
RACIAL–ETHNIC DISPARITIES IN STRESS EXPOSURE AND THE ONSET OF LATER-LIFE LIMITATIONS IN ACTIVITIES OF DAILY LIVING
Authors: Sauerteig-Rolston Madison , Ferraro Kenneth
Published: December 2023

This study investigates the relationship between stress exposure – including cumulative stress burden and domain-specific stressors – and the onset of activities of daily living (ADL) limitations in later life and examines whether there are racial-ethnic and nativity differences in this relationship. Examining data from the Health and Retirement study (HRS), we apply logistic regression and Weibull accelerated failure-time models to examine associations between stress and baseline ADL limitations as well as stress exposure and age of onset of ADL limitations over a decade. Interaction tests between stress and race-ethnicity and nativity were employed to understand how stress exposure uniquely influences ADL limitations among White, Black, US-born Hispanic, and foreign-born Hispanic older adults. Black, US-born Hispanic, and foreign-born Hispanic adults were more likely to develop an ADL limitation at a younger age compared to White adults (β = -0.06; β = -0.07; β = -0.09; respectively). Cumulative stress burden, childhood traumatic events, adult financial strain, everyday discrimination, and major lifetime discrimination were associated with an earlier onset of ADL limitation among White, Black, US-born Hispanic and foreign-born Hispanic adults. Further, US-born Hispanic adults that experienced the same amount of childhood traumatic events as White adults experienced an earlier transition to ADL limitation by a factor of 0.65 or in about 35% of the time. Reducing racial-ethnic and nativity disparities in ADL limitations in later-life will require efforts to adjudicate the long lasting historical and structural disadvantages that contribute to differential stress exposure across the life course.
SOCIOECONOMIC DISPARITIES IN THE MEDICARE HOSPICE CARE INDEX (HCI) INDICATORS
Authors: Plotzke Michael , Christian Thomas
Published: December 2023

The Centers for Medicare & Medicaid Services’ Hospice Care Index (HCI) measures quality using ten claims-based indicators characterizing hospice service provision. We examine socioeconomic disparities amongst those indicators for hospice users using Medicare claims data from Federal Fiscal Years 2020-2021. We estimate ten ordinary least squares regression models where the dependent variables are each of the ten indicators and the independent variables are provider- and beneficiary-level characteristics. To examine socioeconomic disparities, we also include indicators for beneficiary race/ethnicity, dual eligibility for Medicaid status, urban/rural status, and an area deprivation index. The model with all control variables showed the smallest difference between the socioeconomic variables. For example, the average probability of a Black beneficiary having a least an eight-day gap between nursing visits is 60.3% versus 58.9% (p-value < 0.01) for a white beneficiary. If we only control for socioeconomic variables and no hospice or provider-level controls, we find larger differences, with the average probability of a Black beneficiary having a least an eight-day gap between nursing visits equal to 62.4% versus 58.7% (p-value < 0.01) for a white beneficiary. The results varied by the HCI indicator as well as the socioeconomic variable being examined. These findings suggest that two otherwise similar beneficiaries from different socioeconomic groups are, on average, treated equally by the same hospice. Instead, socioeconomic disparities for some indicators result from how beneficiaries sort into hospices, where the lowest quality hospices are more likely to treat the most disadvantaged.
FEASIBILITY AND ACCEPTABILITY OF A DEPRESSION AND PAIN INTERVENTION WITH OLDER AFRICAN AMERICAN WOMEN
Authors: Taylor Janiece , Clair Catherine , Gitlin Laura , Bandeen-Roche Karen , Hladek Melissa deCardi , Riser Tiffany , Thorpe Roland , Szanton Sarah L
Published: December 2023

Older African American women experience social determinants of health that put them at risk for experiencing comorbid pain and depressive symptoms. The purpose of our study was to tailor a preexisting evidence-based depression intervention to include pain and test it in older African American women. We conducted a randomized waitlist control study with 21 frail or pre-frail, African American women, 50 years of age and older with pain and depressive symptoms. The average age of the participants was 64.8 (SD: 10.5), average pain intensity was 7.0 (SD: 1.9) out of 10, and average PHQ-9 depressive symptoms score was11.9 (SD: 4.0). Effect sizes at 12 weeks post intervention were -1.05 for depressive symptoms indicating a substantial decrease in depressive symptoms. We did not see a significant change in pain intensity but identified changes in pain behavior scores. The women described the intervention as beneficial and provided suggestions for future iterations.
HAVING A SENSE OF PURPOSE IN LIFE AS A PROTECTIVE FACTOR FOR COGNITIVE DECLINE IN LATER ADULTHOOD
Authors: Kim Giyeon
Published: December 2023

The purpose of this symposium presentation is to discuss the role of having a sense of purpose in life in protecting against cognitive decline in later adulthood. The speaker presents recent findings on purpose in life as a protective factor for cognitive decline from a nationally representative sample of older adults. First, the speaker presents evidence that older adults with a purpose in life showed slower trajectories of cognitive decline during the 6-year period and that purpose in life was a significant moderator of age- and race/ethnicity-cognitive decline associations in later adulthood. Second, the speaker presents evidence that a significant moderating role of purpose in life in the relation of widowhood to total cognition and fluid intelligence, but not in the widowhood-crystallized intelligence relation and that the significant moderating role of purpose in life was found only for those who were female, White, and more educated. Lastly, the speaker discusses implications for research and practice, as well as directions for future research on educational programs to improve purpose in life among older adults from diverse backgrounds.