bluuebunny/crossref_metadata_2025 huggingface dataset:
HEALTHCARE AIDE-FOCUSED INTERVENTIONS TO IMPROVE PAIN MANAGEMENT IN LONG-TERM CARE
Authors: Knopp-Sihota Jennifer , Nuspl Megan , MacGregor Tara , Reeves Jennifer , Saleem Ahsan
Published: December 2022

Pain is endemic for residents of long-term care homes, with many residents experiencing pain daily. Given that healthcare aides provide most daily care for residents, they are ideally situated to deliver timely assessment and non-drug interventions for managing resident pain. In this Cochrane-style systematic review, we searched 7 databases to identify intervention studies that included long-term care residents aged ≥60 years who received interventions to reduce chronic pain. Interventions were either delivered by healthcare aides at the resident level or were directed at healthcare aides to improve their pain management practices. We screened 400 titles/abstracts and 152 full-text articles. Nine studies met inclusion criteria and were included in a narrative review. Due to the limited number of studies and variety of study designs, data were insufficient to perform meta-analyses or thematic analysis. Three studies described pain interventions delivered by healthcare aides at the resident level reporting significant improvement of pain. Six studies described pain interventions delivered to healthcare aides. Results of these interventions were inconsistent; 2 reported significant improvements in pain-related outcomes (e.g., resident pain, monitoring of pain), 3 reported insignificant changes, and 1 reported a positive correlation between measured pain and pain medication use. We concluded that despite the paucity of research in this area, this systematic review provides preliminary support for pain interventions by healthcare aides for long-term care residents. Future research exploring interventions for healthcare aides to take greater roles in pain management could unlock further improvements in resident care.
CHARACTERIZING GENERATIONAL CAREGIVING USING DATA FROM THE BRFSS
Authors: Olivari Benjamin , Reed Nia , Bouldin Erin , Jackson Eva , Omura John , McGuire Lisa , Croft Janet
Published: December 2022

As the proportion of family and friends in the U.S. providing informal care increases, it is important to understand how this may impact certain demographic groups. Millennials and older adults are two generational segments of caregivers of interest given the complexities associated with these groups. Millennials can be sandwiched between a growing older population of parents or grandparents while also raising young children, often providing care for both. Similarly, older adults frequently balance caring for spouses, themselves, and grandchildren. We characterized these two groups of caregivers using 2015-2019 Behavioral Risk Factor Surveillance System (BRFSS) data from the Caregiver Optional Module administered in 44 states, D.C., and Puerto Rico. Among 246,223 Module respondents, 21.3% reported providing care for a family member or friend. Among caregivers, 12.4% were identified as Millennials (aged 18-38 years), and 19.7% were older adults (aged≥65 years). About one-in-three Millennial caregivers reported providing care to a parent and half to another relative, such as a child or grandparent. While less than 4% of Millennial caregivers reported providing care for a spouse, nearly one-in-five older adult caregivers did. Although their care recipients may differ, both groups reported high intensity of care, with 30% of caregivers in each group providing 20 hours of care or more weekly. Caregiving among older adults can be further complicated by their own health difficulties, with over half of older adult caregivers reporting having two or more chronic conditions and one-third reporting a disability. BRFSS data may inform planning efforts pertaining to these caregiving groups.
ASSOCIATION OF CARDIOVASCULAR DISEASE WITH RACE/ETHNICITY IN FAMILY CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Baik Dawon , McNair Bryan , Centi Sophia
Published: December 2022

Family caregivers of persons with dementia (dementia FCGs) experience high caregiving burden, and caregiving-related stressors have been linked to cardiovascular disease (CVD). Racially and ethnically diverse FCGs face additional challenges in managing their own health; however, racial/ethnic disparities in caregiving-associated cardiovascular health are understudied and poorly understood. To fill the gap, we evaluated racial/ethnic differences in CVD risk and CVD conditions among dementia FCGs in the U.S. Using 2015-2020 Behavioral Risk Factor Surveillance System data (N = 6,132), we compared CVD risk and CVD conditions in racial/ethnic dementia FCG minorities to non-Hispanic White dementia FCGs. Logistic regression models were used to estimate unadjusted (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI) for association of race/ethnicity with CVD risk and CVD conditions, adjusting for potential confounders. Compared to non-Hispanic White FCGs, non-Hispanic Black FCGs (AOR 0.33, 95% CI 0.2-0.53) and non-Hispanic Asian FCGs (AOR 0.16, 95% CI 0.05-0.51) were less likely to have depressive symptoms. Hispanic FCGs (OR 0.69, 95% CI 0.5-0.95), non-Hispanic Black FCGs (AOR 0.6, 95% CI 0.41-0.86), and non-Hispanic Asian FCGs (AOR 0.51, 95% CI 0.28-0.94) were less likely to smoke. Non-Hispanic Black FCGs were less likely to exercise (OR 0.69, 95% CI 0.52-0.91) and more likely to be obese (AOR 1.64, 95% CI 1.14-2.36). The findings confirm racial/ethnic disparities in psychological, behavioral, and metabolic risk factors for CVD among dementia FCGs. Future studies should investigate how dementia FCGs’ caregiving-related conditions affect CVD and how racial/ethnic considerations can inform culturally appropriate prevention-care strategies.
HEALTH COACHING FOR DEMENTIA CAREGIVERS: LESSONS LEARNED FROM THE ICARE4ME STUDY
Authors: Fisher Lauren , Massimo Lauren , Hirschman Karen
Published: December 2022

Frontotemporal dementia (FTD) is a common cause of young-onset neurodegenerative disease that causes progressive changes in behavior and personality. FTD is often diagnosed around age 60, creating complex care needs that result in caregivers of persons with FTD experiencing high rates of depression, burden, and poor self-care. The iCare4Me for FTD study (NCT04686266) randomized 15 caregivers to receive a virtual health coaching intervention over 6 months (10 sessions) and 15 caregivers to the control group. To better understand the caregivers’ experience with the health coach intervention, two focus groups with intervention group caregivers (n=5) were held. Focus groups were recorded, transcribed and coded using content analysis. Caregivers reported the most valuable aspect was the relationship that was developed with their health coach. Caregivers particularly valued having someone to talk to who was outside their immediate social and support networks. It was noted the structured self-care curriculum served as a good backbone for discussions, but more specific coping conversations related to loss of patient empathy, prognostic uncertainty, and anticipatory grief are needed. One caregiver described being, “… awash in grief and it's affected my memory” while another described “grief is a big issue and I don't really find too many people understand it, because my husband is alive, but so many parts of him are gone”. These findings will be used to inform future studies utilizing health coaches for caregivers of persons with FTD. Implications for evidence-based virtual health coaching interventions with caregivers of persons living with FTD will be described.
QUALITY OF LIFE AND SOCIAL DETERMINANTS PREDICT HOSPICE IN DEMENTIA CAREGIVING DYADS: A MACHINE LEARNING APPROACH
Authors: Sullivan Suzanne , Bo Wei , Li Chin-Shang , Xu Wenyao , Chang Yu-Ping
Published: December 2022

Hospice care is available to assist people with serious illness and their caregivers who wish to age in place, avoid unnecessary hospitalizations, and remain at home through the end-of-life. However, hospice care is under-utilized nationally despite the disproportionate prevalence of end-of-life dementia caregiving burdens among disadvantaged groups. The reasons are unclear, but emerging research suggests that systemic barriers may contribute to underutilization. Commonly used quality-of-life frameworks have long included social determinant of health (SDH) factors such as social, environmental, financial, and healthcare access needs. Investigating the link between quality-of-life and SDH concerns of persons with dementia (PWD) and their caregivers may help identify when a PWD might benefit from hospice care. This study uses machine learning techniques to longitudinally analyze caregiver/care-recipient dyads in the National Health and Aging and Trends Study (NHATS) linked to the National Study of Caregiving (NSOC) (2015-2018) to identify quality-of-life and SDH predictors of hospice use among 117 PWD and their primary caregivers. Results indicate that distinguishing features selected by Information Gain Ratio [IGR] predict that memory rating, receiving food stamps, whether health prevents enjoying life, having trouble chewing or swallowing, diabetes, a regular doctor, and nobody to talk to can predict hospice use well (accuracy=0.6848; sensitivity=0.8244; specificity=0.5371; AUC=0.7425). Quality-of-life/SDH factors are important longitudinal predictors of hospice that can be detected up to three years prior to death. Our study uses inductive, machine learning approaches to provide testable hypotheses for future research to improve the quality of end-of-life care through hospice for PWD and their caregivers.
SHORT-TERM COUPLED ASSOCIATION BETWEEN BLOOD PRESSURE AND COGNITIVE FUNCTIONING
Authors: Yoneda Tomiko , Piccinin Andrea , Rush Jonathan , Lewis Nathan , Knight Jamie , Vendittelli Rebecca , Hofer Scott
Published: December 2022

An extensive body of research has investigated the association between cognition and blood pressure (BP). Limited research, however, has examined the association at the daily within-person level. No study has yet applied an intensive measurement design utilizing the convenience and objectivity of mobile devices for cognitive assessments and automated BP monitors. To address this gap in the literature, we recruited community-residing healthy adults (N=64; Mage=70.6, SD=3.5; 76.6% female), who recorded their BP and completed a battery of brief cognitive tasks twice daily for 14 days. Multi-level models estimated associations between systolic/diastolic BP (sBP/dBP) and cognitive functioning, adjusting for time-varying self-reported effort, stressors, and physical activity, as well as time-invariant variables (age, sex, education, and anti-hypertensive medication). At the interindividual level, results suggest that individuals with higher overall sBP and dBP relative to others performed worse on delayed-reproduction and visual short-term memory tasks. At the intraindividual level, on occasions when individuals had higher sBP compared to their personal average, they performed relatively worse on delayed-reproduction tasks. Mean sBP was also significant within these models, suggesting that this coupled relationship is stronger for individuals with higher sBP on average. Analyses did not indicate significant associations for working memory, reaction time, or cognitive interference assessments, which may have been due to relatively limited power for between-person analyses. Use of such digital health technology is critical for detecting the complex nature of and interplay between physiological and cognitive processes. Further, research based on intraindividual associations may contribute to strategies aiming to promote lifestyle modifications.
CROSS-VALIDATION OF THE LICHTENBERG FINANCIAL DECISION RATING SCALE
Authors: Flores Emily , Lichtenberg Peter
Published: December 2022

This study examines the cross-validation of the long form of the Lichtenberg Financial Decision Rating Scale in relation to decision making abilities and suspected financial exploitation.Ninety-five older adult community participants underwent an assessment session which included the LFDRS, cognitive tests and the Independent Living Scale financial management subtest. The LFDRS has four subscales including an intellectual factor that measures choice, understanding, appreciation, and the rationale of decisions. Demographic information was also collected.The concurrent validity of the subscales and LFDRS were examined by Pearson correlations in order to be able to examine the relationship between cognitive test scores, ILS money management scores and LFDRS risk scores. Hierarchical regression analysis was conducted to determine whether cognitive and financial management tests were contributed to the prediction or risk scores greater than demographic variables. LFDRS total was significantly related to executive functioning and female gender. The Financial Situational Awareness subscale showed significant correlations with Trailmaking B but was unrelated to demographics. The relationship of executive functioning to vulnerability to exploitation was largely driven by the Financial Situational Awareness subscale. This finding is consistent with previous studies of the LFDRS and adds to the evidence supporting the concurrent validity of the LFDRS with cognitive functioning.
FACTORS ASSOCIATED WITH COGNITIVE FUNCTION AMONG OLDER ADULTS IN VIETNAM
Authors: Saito Yasuhiko , Chei Choy Lye , Vu Nguyen , Dong Linh
Published: December 2022

While Viet Nam is aging rapidly, there are few studies on cognitive function of older adults. We aimed to study status of cognitive function among older adults in Viet Nam and examine factors associated with cognitive function. The baseline data of the Longitudinal study of Ageing and Health in Viet Nam conducted in 2018/2019 was used for the study. LSAHV was a nationally representative survey of those aged 60 and above and computer-assisted personal interview (CAPI) using a tablet was conducted for data collection. The number of older person included in the study was 5,530. Cognitive function was measured by Short Portable Mental Status Questionnaire (SPMSQ). Factors such as demographic, socioeconomic, health behavior and daily activities such as reading newspaper were examined for their association with cognitive function by linear regression analyses. We found that better cognitive function was associated with engaging in physical activity in both male and female, listening to radio and receiving material support from children in male, and reading in female. Poorer cognitive function was associated with IADL limitation and financial support in both male and female, obesity in male, and hypertension and hearing loss in female. Our study provides an understanding of the associated factors with cognitive function of older people in Viet Nam. Some of the factors examined are modifiable and can be improved to prevent cognitive decline. It is also important to consider sex differences in planning and implementation of interventions and programs to prevent cognitive decline in Viet Nam.
DOES PERCEIVED EFFICACY OF COGNITIVE TRAINING BIAS OUTCOMES?
Authors: Zhang Shenghao , Gray Nicholas , Charness Neil , Boot Walter
Published: December 2022

Cognitive training has the potential to help older adults maintain or improve their cognitive abilities, but there has been debate regarding how susceptible cognitive outcomes in these studies are to placebo effects. Some previous research has found that expectations can shape performance on study outcomes, although this is not always a consistent finding. The degree to which perceived intervention efficacy can lead to changes in the performance of objective outcome measures typically assessed in these studies is unclear. The aim of the current study is to explore the effects of perceived effectiveness of cognitive training on actual improvements in a large sample of older adults. The current study utilized data from the Intervention Comparative Effectiveness for Adult Cognitive Training (ICE-ACT, NCT03141281) Trial. Two hundred and thirty older adults (Mean age = 72) were randomized into one of four training conditions: (1) a web-based brain game suite, Brain HQ, (2) a strategy video game, Rise of Nations, (3) Instrumental Activities of Daily Living (IADL) training, or (4) an active control condition of puzzle solving. Reasoning, memory, processing speed, and IADL performance were measured before and after the intervention. Perceived efficacy of training in those outcome domains were also measured. Bayesian ANOVA analysis showed strong evidence of group differences in perceived efficacy within all outcome domains across the training conditions whereas Bayesian regression showed moderate to strong evidence against influences of perceived efficacy on changes in performance. Discussion will focus on implications of those results on behavioral and cognitive intervention designs.
AGING, COGNITION, AND COMMUNITY EXPERIENCE: CARE CONTINUA AND RISK RATIOS OF DAILY LIFE WITH MCI
Authors: Shank Kendra Heatwole
Published: December 2022

Mild cognitive impairment (MCI) affects an estimated 15-30% of the population (Sachdev et al., 2015; Ward et al., 2012). Cognitive changes directly impact participation in instrumental activities of daily living that support the ability to age in place (Thoma-Lurken et al., 2018; Riley et al., 2014). To date, little is known about these initial challenges beyond self- and caregiver report. The purpose of this research was to understand the nature of out-of-home participation for individuals with cognitive change. Community-dwelling older adults with MCI and their care partners (n=10) were recruited in a suburban region. Data were collected utilizing the “go-along” interview method (Carpiano, 2009) in combination with geospatial mapping and photography. Results included three factors that influenced ongoing community participation related to cognitive changes, including the importance of familiarity of spaces developed over time, strategies related to roadways and parking, and the use of routine to create structure and to increase the support offered by others. In addition, the go-along methodology revealed additional insights about the experiential continuum of providing and receiving care, and how enacting a ‘relative’ risk and risk perceptions impacted participation. Results of this research offer a unique view into daily life of people with MCI and suggest ways that individuals and caregivers can be advised, and their wellbeing enhanced through continued out-of-home participation. There are also multiple applications for increasing the accessibility of community spaces for cognition inclusion. Theoretical implications are also addressed, via re-framing the selection, optimization, and compensation model for considering cognitive change.
IMPROVEMENT OF CAREGIVER MASTERY IS RELATED TO DECREASED ANXIETY AMONG PEOPLE LIVING WITH COGNITIVE IMPAIRMENT
Authors: Hwang Yeji , McPhillips Miranda , Huang Liming , Perez G Adriana , Hodgson Nancy
Published: December 2022

Anxiety is common and distressing in people living with cognitive impairment. High caregiver mastery, a positive view of one’s ability to provide care, is known to be protective against anxiety in people whom they are caring for. However, the longitudinal relationship between caregiver mastery and anxiety is unknown. Our objective was to examine whether improvement in caregiver mastery was related to decrease in anxiety in people living with cognitive impairment. This was a secondary data analyses using Healthy Patterns Clinical Trial (NCT03682185), an RCT of a home-based activity intervention designed to improve circadian rhythm disorders in people living with cognitive impairment. A total of 158 participants with cognitive impairment who provided data at both pretest (T1) and posttest (T2) were analyzed. Measures included Caregiver Mastery Scale and Neuropsychiatric Inventory. We used linear regression analyses to examine the relationship between changes in caregiver mastery and changes in anxiety. The sample was primarily female (66.7%), Black (63.1%), with mean age 73.3±8.4. The mean change of anxiety frequency (T2-T1) was -0.2±1.0; anxiety frequency decreased over time. The mean change of caregiver mastery (T2-T1) was 0.4± 3.0; caregiver mastery improved over time. After controlling for age, cognition, changes in sleep impairments, changes in depression, and intervention group assignment, improvement of caregiver mastery over time (B=-0.087, SE=0.035, t=-2.51, p=0.013) was related to decreased anxiety frequency over time (R2= 0.112, F=2.31, p= 0.039). Interventions to improve caregiver mastery may alleviate anxiety symptoms in people living with cognitive impairment. Additional research and practice implications will be discussed.
PREPARING THE NURSING WORKFORCE TO CARE FOR OLDER ADULTS IN THE 21ST CENTURY
Authors: Brabham Deborah
Published: December 2022

Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults’ health outcomes. This study aimed to determine differences in senior nursing students’ knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate’s degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula. Albert Bandura’s social cognitive, triadic reciprocal determinism model provided the theoretical framework to underpin this research study. A non-experimental, descriptive survey design included a convenience sample of students enrolled in a BSN, ASN, and PN program. A total of 178 students participated in the study. Palmore Facts on Aging Quiz 2, Kogan’s Attitudes Toward Old People Scale, and the Hartford Geriatric Nurse Competency tool was used to collect data. From the results, it is clear that students enrolled in BSN, ADN, and PN programs demonstrated limited knowledge about facts on aging. Students’ attitudes toward older adults were positive, and a correlation was found between knowledge and attitudes. Students perceived competency about older adults was high but purely subjective. Students’ preference to work with older adults post-graduation in the PN group was higher than students in the BSN and ADN groups. These findings underscore the need to systematically design an evidence-based curriculum inclusive of geriatric content across (BSN, ADN, and PN) programs to prepare the nursing workforce to care for older adults.
PSYCHIATRIC HISTORY AND LATER-LIFE COGNITIVE CHANGE: EFFECT MODIFICATION BY SEX, RACE, AND ETHNICITY
Authors: Brown Maria , Mutambudzi Miriam
Published: December 2022

Objective

To better understand life course influences affecting cognitive function and decline in later life, we explored sex and race/ethnicity differentials in the relationship between a history of psychiatric, emotional, or nervous problems and cognitive functioning in later life, while accounting for early life disadvantage and relevant covariates.

Methods

Multi-level growth curve models examined associations between psychiatric history and cognitive functioning, and differences by sex and race/ethnicity (SRE), in 20,155 Health and Retirement Study (1995-2014) participants aged 65 or older, by estimating cognition scores and plotting trajectories of change with age by SRE.

Results

A history of psychiatric, emotional, or nervous problems was significantly related to cognition scores and rates of decline. Hispanic and Black participants had significantly lower cognition scores at age 75 and steeper rates of decline than White females, and Black race and the Hispanic race-sex interaction erased the protective effects of being female.

Conclusions

Our findings indicate that members of minority groups with a history of psychiatric problems evidence lower cognitive function in later life, and as a result, have a greater need for community-based long-term care than their peers without this history. Future research should include longitudinal analyses of different components of cognitive function, specific psychiatric diagnoses, and life history data that capture socioeconomic and psychosocial experiences throughout the life course. Population level findings as reported here, along with aggregate findings from similar studies, can inform interventions and policies regarding support for populations that are vulnerable to mental illness and to subsequent cognitive decline.
VARIATIONS IN COGNITIVE STATUS IN OLDER ADULTS WITH MEMORY DIFFICULTIES: THE ROLE OF PERSONALITY AND RESILIENCE
Authors: Barbour Elizabeth , van Antwerp Kodi , Lind Majse , Morgan Amanda , Bluck Susan
Published: December 2022

By approximately 70-years-old, two out of three Americans experience some cognitive impairment (Hale et al., 2020). Cognitive abilities that often decline with age include working and short-term memory (Cohen, 2019), both important for encoding and retaining information (Alloway & Copello, 2013). Depending on severity, affected individuals may face difficulties performing daily tasks. Beyond biological mechanisms, Self-Life Acceptance (Resilience; Wagnild & Young, 1993) and personality (i.e., Neuroticism, Openness; BFI-2-XS; John & Soto, 2017) may relate to variations in cognitive status. We collected measures of Self-Life Acceptance, Neuroticism, and Openness to investigate their relations to older adults’ cognitive status (i.e., working and short-term memory; TICS; Brandt et al., 1988). The sample was comprised of older adults clearly experiencing memory difficulties (N = 49, Mage = 76.12). In a hierarchical regression, the interaction between Self-Life Acceptance and Neuroticism predicted higher cognitive status. Deconstructing this effect, for older people with low-to-moderate Neuroticism, having worse cognitive status was related to greater feelings of Self-Life Acceptance. These individuals show resilience; when cognitive status is worse, acceptance of oneself and life appears to ‘kick in’ allowing individuals to maintain well-being in the face of memory difficulties. Self-Life Acceptance, however, is not present for those high in Neuroticism. In a second regression, less Self-Life Acceptance and higher Openness were also related to better cognitive status. Our findings show psychosocial factors can predict variations in cognitive status. This work provides a window into how older individuals with different personality traits and varying capacity for resilience cope with memory loss.
THE ROLE OF THIRD PLACES IN REDUCING LONELINESS AMONG CAREGIVING SPOUSES
Authors: Choi Yeon Jin , Ailshire Jennifer
Published: December 2022

Loneliness is a public health concern that is associated with poor mental and physical health. Caregiving spouses of community-dwelling older adults often have high levels of caregiving burden, which make them more vulnerable to social isolation and loneliness. There has been a growing interest in third places as mediums for social interaction. Research on third places shows a positive association of greater access to third places with social networks and social health. However, this has not been tested in the context of caregiving. In this paper, we examined the role of various types of third places in reducing loneliness among caregiving spouses. We used the 2006-2016 Health and Retirement Study and the National Neighborhood Data Archive to examine the relationship between the availability of third places per square mile and loneliness. Third places include food outlets (e.g. grocery stores), eating and drinking places (e.g., restaurants, coffee shops), commercial establishments (e.g., department stores), entertainment organizations (e.g., museum), exercise facilities (e.g., fitness), religious organizations (e.g., churches), civic and social organizations (e.g., social clubs), personal care services (e.g., barbershops, beauty salons), and social services for older adults (e.g., senior centers). We found that caregiving spouses living in neighborhoods with greater availability of third places had lower levels of loneliness. We also found gender differences in the association. For instance, greater availability of eating and drinking places was associated with loneliness only among females. Increasing access to places that provide opportunities for social interactions may prevent social isolation and reduce loneliness among caregiving spouses.
ALIGN-CARE: IMPLEMENTATION AND FEASIBILITY OF NEW GERIATRIC SURGERY CO-MANAGEMENT MODEL FOR PHYSICAL AND SOCIAL FRAILTY
Authors: Ko Fred , Chow Stephanie , Baim-Lance Abigail , Park Amy , Schiller Gabrielle , Kim Minji , Sreevalsan Kavya , Hung William
Published: December 2022

Pre-operative geriatric evaluation in frail older patients that addresses both medical and psychosocial needs is often not completed prior to surgery, leaving frail older adults ill prepared for surgery. The ALIGN-CARE interprofessional co-management model uniquely serves to standardize care and coordination amongst the surgeon, geriatrician and social worker in ambulatory settings to allow a greater window of time to intervene for surgical optimization. Program elements include assessment of preoperative medications, functional status, cognition, nutrition, What Matters Most, advance care planning (ACP), and social determinants of health. Recommendations and action items from the geriatric-social work team are presented to surgeon and primary care physicians for follow-up and optimization. Program and process elements recorded in a REDCap database facilitate longitudinal evaluation of ALIGN-CARE model implementation feasibility. Initial data of 9 frail surgical oncology patients indicate increases in meaningful ACP discussions, patient-oriented decisions regarding surgery candidacy, and surgeon referrals for inpatient geriatric consultation post-operatively as a result of ALIGN-CARE. Current analyses to assess feasibility and quality of the program include thematic coding of program documents, semi-structured interviews of key stakeholders (surgeons, geriatricians, social workers, patients), and quantitative analysis of program outcomes, including uptake of program elements and process measures. Planned areas of analytic focus include workflow, cross-specialty coordination, and patient and primary care engagement and activation. We anticipate identifying specific barriers and facilitators of ALIGN-CARE implementation in our evaluation to aid the dissemination and upscaling of interprofessional co-management programs aimed to improve outcomes and quality of life for frail, older surgical patients.
DEPRESSIVE SYMPTOMS MEDIATE THE ASSOCIATION OF FRAILTY PHENOTYPE SYMPTOMS AND COGNITION FOR FEMALES BUT NOT MALES
Authors: Resciniti Nicholas , Merchant Anwar , Lohman Matthew
Published: December 2022

We aimed to evaluate whether depressive symptoms mediated the relationship between frailty phenotype and cognitive function by sex. Frailty phenotype symptoms, cognitive function scores, and depressive symptoms were measured in 3,705 community-dwelling US adults from the Health and Retirement Study (HRS) from 20012-2016. Fried’s frailty phenotype criteria (weakness, slowness, physical inactivity, low weight, and exhaustion) were used as a continuous score for frailty symptoms (0-5). Global cognition was measured by the Telephone Interview for Cognitive Status (range: 0-35). The Centers for Epidemiologic Studies-Depression Scale (CES-D) was used as a continuous measure to assess depressive symptoms (0-8). We used mediation analysis to estimate the direct and indirect effects of frailty symptoms on cognitive scores to evaluate the role of depressive symptoms as a potential mediator. Males had a larger total effect (β= -0.43; 95% CI: -0.66, -0.02; p< 0.001) for lower cognitive score for each increase in frailty symptom compared to females (β= -0.28; 95% CI: -0.47, -0.08; p=0.02), suggesting all five frailty symptoms was associated with 2.15 lower cognitive scores for males and 1.50 for females. A significant indirect effect from frailty phenotype to cognition was found through depressive symptoms for females (β= -0.03; 95% CI: -0.06, -0.00; p=0.02) but not males (β= -0.04; 95% CI: -0.08, 0.00; p=0.07). These results highlight the importance of identifying individuals with frailty and depressive symptoms to monitor and provide interventions to preserve cognitive function
FRAILTY AND OSTEOARTHRITIS IN OLDER CHILEANS
Authors: Albala Cecilia , Marquez Carlos , Angel Barbara , Saguez Rodrigo , Lera Lydia
Published: December 2022

The adverse consequences on health of frailty, make it early diagnostic very important. The coexistence of frailty with osteoarthritis, a frequent condition especially in older women, has been less studied Objective. to study the association between frailty and self-reported osteoarthritis.

Methods: Cross-sectional study in994 people65 years and older (72.1%women, mean age72y±6.7) from the Alexandros cohort, designed to study disability associated with obesity in community-dwelling people60y and older living in Santiago/Chile. The frailty phenotype was defined as having ≥3 from the5 following criteria: weak handgrip dynamometry, unintentional weight loss, fatigue/exhaustion, five chair-stands/slow walking speed and low physical activity. Self-reported osteoarthritis was registered.We found a prevalence of osteoarthritis was much higher in women than in men (49.4% vs22.9%, p<0.01) Osteoarthritis was present in46.5% of frail people and30% of the robust ones (p=0.01). Frailty was present in53.3% of women with OA in and11.8% of men with OA. The crude OR for the association of frailty with Osteoarthritis was significant only for women (OR=1.43;95% CI:1.06-1.93). After sex and age adjusted logistic regression for frailty in Ostroarthritis, the OR for frailty was OR=1,39;95%IC (1,04-1,85), p=0,025, but in women with osteoarthritis the adjusted OR for frailty increase to OR=11.98 (5.637-13.23)Considering the severe consequences of frailty over health, the high burden of Osteoarthritis, its high frequency in women, and the strength of the association between both conditions, the screening for frailty is highly recommended In older women with Osteoarthritis.
CHANGES IN LIFE-SPACE WITH LOSS OF RELATIVES AND FRIENDS AMONG OLDER ADULTS: RESULTS FROM THE UAB STUDY OF AGING
Authors: Driggers Amelia , Kennedy Richard , Buys David
Published: December 2022

Increasing age brings greater risk of the death of friends and family (hereafter referred to as loss). Loss may impact individuals’ life-space mobility (LSM); however, no research has explored relationships between loss and LSM trajectories. Using the UAB Study of Aging, we examined differences in LSM trajectories of 1000 community-dwelling older Alabamians (65+years) with and without loss during the study period. We assessed LSM using the UAB Life-Space Assessment (LSA), a validated instrument measuring individuals’ ability to move through zones ranging from their bedroom to out of town. We assessed loss every 6 months using a standard bereavement questionnaire capturing spousal, other relative, or friend loss. We used piecewise linear mixed effects models to compare LSA trajectories. Those who do not experience loss had a baseline mean LSA score of 49.5 and show a decline of 0.08 points per year (p < 0.001). Those that do experience loss had a baseline LSA score of 60 and decline by 1.0 point per year before the loss (p < 0.001), accelerating to 1.8 points per year after the loss (p < 0.001). Those with loss do not experience acute decline post loss but do have an acceleration of the pre-existing decline. More research is needed on this topic to better understand the impact of loss on LSM trajectories; but this finding suggests that more public health and clinical interventions may be needed for those who experience loss. Specifically, bereaved individuals may benefit from social, mental, or healthcare services for loss-related challenges.
HELP-SEEKING FOR SUICIDE RISK AMONG MIDDLE- TO OLD-AGE ADULTS
Authors: Wang Xiaochuan , Beltran Susanny , Gryglewicz Kim
Published: December 2022

Suicide is a major public health concern. Suicide rates have increased steadily in the U.S. and are highest among middle-aged (ages 45-64) and older (age 75+) adults. Help-seeking represents an important coping behavior that can mitigate suicide risk. However, research on this topic is sparse, especially among older adults. To address this gap, a systematic review of the existing literature describing help-seeking for suicide risk among middle- to old-age adults was conducted. Using PRISMA guidelines, we searched electronic databases (e.g., ProQuest, EBSCOhost, PsycINFO, PubMed, Medline) and key journals with suicide and/or gerontology focuses for peer-reviewed publications in English between 2010-2020. The search yielded 4,732 unduplicated publications. After screening articles for relevance based on titles and abstracts, 52 articles were reviewed in full text. A total of 24 articles met inclusion criteria and were included in this review. The articles reviewed included a range of topics, including prevalence of service utilization, service use prior to suicide-related behaviors, and correlates of help-seeking. Overall, prevalence of service utilization was generally low and varied by suicidal history (e.g., greater prevalence among those with a history of suicide attempt, as compared to those with suicide ideation but no attempts). The systematic review also identified key service use facilitators (e.g., higher suicide literacy, previous or current suicidality) and barriers (e.g., stigma). Results of this systematic review highlight the need for future research and tailored services to improve suicide prevention and intervention strategies for middle-aged and older adults.
PROTECTING RETAIL CUSTOMERS FROM GIFT CARD PAYMENT SCAMS
Authors: Bailey Dionne , DeLiema Marti
Published: December 2022

Older adults are frequently targeted by scams and fraud, a persistent and growing problem in the U.S. According to the Federal Trade Commission, gift cards were the most common method of payment requested by fraud criminals in 2021. The purpose of this AARP-sponsored study is to investigate gift card payment scams by analyzing the retail sector for current interventions and opportunities to protect customers from fraud. Through secret shopping at 23 retail locations in a large U.S. city, we documented the existing status of merchant controls designed to prevent suspicious gift card purchases, as well as how these measures work in practice. At each location, the "secret shopper" attempted to purchase between $400-$1000 in gift cards from a sales clerk, while another researcher stood in line nearby to observe the interaction. ​​Nearly 80% of retail stores had signs warning customers about gift card frauds. Fewer than 50% imposed limits on the purchase amount; more than 40% required manager approval, and five of the transactions resulted in manager involvement. Current retail measures would only limit purchases in around 22% of gift card frauds and would completely halt about 9% of transactions. Results indicate that despite warnings, retailers are not doing enough to protect customers from fraud. New policies are needed to advocate for reduced gift card purchase limits, increase public awareness, educate retail employees on the red flags, and enforce anti-money laundering rules to limit fraud.
EVALUATING THE STAFFING METHODOLOGY MODEL IN THE VETERANS HEALTH ADMINISTRATION’S COMMUNITY LIVING CENTERS
Authors: Brown Lana , Lensing Shelly , Sullivan Sheila Cox , Odom Teresa , Moore Jade , Billings Pamela , Minor Lisa
Published: December 2022

The project purpose was to describe nursing hours per patient day (NHPPD) within the Veterans Health Administration (VHA) and to evaluate Staffing Methodology in the VHA Community Living Centers (CLCs) by comparing Staffing Methodology targeted NHPPD with actual NHPPD. Data were compiled retrospectively for each CLC unit over a one-year timeframe for calendar year 2019. VHA had 134 CLCs including 390 nursing units. Nursing units without 6 months of actual NHPPD data were excluded from the data set. For descriptive analyses, actual NHPPD were averaged across months for each unit. The percent of target was calculated as this average divided by the NHPPD target times 100. The percentage of months each unit met the targeted NHPPD was calculated. After data exclusions, the final data set included 322 nursing units from 133 CLCs. The mean for actual hours as a percent of target was 121.6% (95% CI, 118.5 to 124.7%) indicating that the units’ average hours across 2019 were 21.6% significantly higher than target. Also, half of units met their targets 91.7% of months as reflected by the median. The actual NHPPD significantly differed across months (p< 0.001) with the 2019 months of January and October having the highest NHPPD. Similar results were seen for NHPPD as a percent of target. Veteran safety is a VHA priority and appropriate nurse staffing is key to providing care that improves Veteran outcomes and reduces adverse events. Further exploration is needed on how nurse staffing in the CLCs impacts Veteran outcomes, safety, and satisfaction.
IMPACT OF COGNITIVE RESERVE IN OBJECTIVE AND SUBJECTIVE SUCCESSFUL AGING
Authors: Mendoza Ruvalcaba Neyda Ma , Arias-Merino Elva Dolores , Flores-Villavicencio Maria Elena , Rodríguez Díaz Melina
Published: December 2022

Cognitive reserve (CR) refers to the capacity of the brain to withstand changes due to age or disease-related pathology, showing how flexibly and efficiently the individual makes use of available brain resources. This study aims to explore the contributions of the CR to understanding successful aging (SA).(Project-Conacyt-256589)Population based, random sample included n=656 community-dwelling older adults 60-years and older (mean age=72.8, SD=7.6 years, 58% women). CR was measured by their main indicators: education, life-long learning, being bilingual, participation, use of information and communications technology. Objective SA was operationalized as no important disease, no disability, physical functioning, cognitive functioning, and being actively engaged. Subjective was an appreciation if they considered themselves as successful agers. Sociodemographic and health data were also asked. Pearson′s correlation test and MANOVAs were performed.In total 11.2% met the criteria for SA, although 76% considered themselves as successful agers. CR was significantly related to subjective and objective criteria of SA(p<.000), except to no-important diseases. CR explains in general 20% of the variance in objective SA, specifically explains 28% of variance in the criteria of high cognitive function, 18% of the variance in disability, 11.3% of life engagement, 8% of physical functioning, and 2% of disease-free criteria. Also, CR explains 10% of the variance in subjective SA. This study has shown that CR the is related to SA, this set possible targets for cognitive interventions to promote resiliency of the brain not only for preventing cognitive pathologies, but also for encouraging successful and healthy aging in older adults.
SWISS CENTENARIANS: PRELIMINARY FINDINGS FROM THE SWISS100 PHONE STUDY
Authors: Jopp Daniela , Cavalli Stefano , von Gunten Armin , Herrmann Francois , Martin Mike , Uittenhove Kim
Published: December 2022

Increase in very old individuals is observed in all developed countries around the world. The number of centenarians has also been rising, requiring the investigation of the characteristics of these exceptionally long-lived individuals as well as their experience of life at age 100. In the present study, we present findings from the first nation-wide Swiss centenarian study SWISS100. Given the ongoing COVID-19 pandemic, we conducted a telephone study with centenarians and a family member as proxy informant, using a mixed-methods approach to investigate specific characteristics, their life circumstances and their experience during the pandemic. Recruitment was conducted with the help of the national address registry. A total of 64 centenarians and 62 family members participated, leading to data for 119 centenarians. Centenarians were on average 102 years old, with a range of 100 to 108 years. In line with higher survival rates in females, 76% were women and 24% were men. Most centenarians had received basic education and had completed an apprenticeship. Concerning their residence, 43% lived in private homes and 57% lived in institutions. Of those living in private, half lived alone, one fourth lived with their spouse and one fourth lived with a child. The majority was widowed. Over 80% had children. Although over 70% of the centenarians reported health restrictions, 60% reported good to excellent subjective health. Over 90% of the sample were aware of COVID-19. Despite substantial COVID-19-related restrictions, life-satisfaction was high. Overall, Swiss centenarians show health-related vulnerability but also psychological resilience.
PREDICTORS OF MHEALTH MINDFULNESS USE IN OLDER ADULT CAREGIVER POPULATION
Authors: Llaneza Danielle , Kozlov Elissa
Published: December 2022

Caregivers of older adults with MCI have multiple competing demands that limit their ability to seek mental health care, despite being at high risk for stress, anxiety, burnout, and depression. MHealth mindfulness interventions have preliminary efficacy to reduce distress for caregivers, but it is unknown which caregivers are most likely to use and benefit from mHealth mental health interventions. Understanding older adult caregiver mHealth use is an important step in providing personalized mental health care. This study investigated caregiver characteristics that predicted mHealth mindfulness mobile application use in a sample of n=58 caregivers of older adults with MCI. Using linear regression models, it was determined that years spent caregiving, having someone to help with caregiving tasks and education level were all significant predictors of the total amount of minutes spent using the mindfulness application. Our results contribute to the growing body of literature on mHealth strategies to address caregiver distress. Future work should address the expansion of mHealth innovations for older adults and their care persons.
IMPLEMENTATION OF LIFE STORY TECHNOLOGY IN RESIDENTIAL CARE SETTINGS: BENEFITS AND BARRIERS
Authors: Wilk Christa , Cordell Ashlee , Orsulic-Jeras Silvia , Powers Sara , Ejaz Farida , Sanders Beth
Published: December 2022

Life story work is a promising intervention in residential care settings to engage persons with dementia (PWD) in meaningful conversation and promote person-centered care. Utilizing technology to streamline the life story collection process brought gerontologists and tech developers together to create LifeBio Memory™: an app which utilizes machine-learning and artificial-intelligence to collect life story data more efficiently than collection by hand. This presentation highlights focus group findings related to the benefits and barriers of this adaptation. Two waves (Time 1 and Time 2) of 60–90-minute (mean=80 SD=14.31) focus groups were conducted via Zoom nine months apart to evaluate the acceptability and feasibility of LifeBio Memory™. In Time 1 (n=35), community-dwelling PWD, residential care staff, and current/former LifeBio program users were asked to provide feedback on 1) their experience with the original version of LifeBio and 2) a prototype of the app. A thematic analysis yielded a list of recommended changes utilized to develop the app. In Time 2 (n=28), participants were asked to provide feedback on 1) training, 2) experience using the app, 3) implementation feasibility, 4) impact on person-centered care. A second thematic analysis was conducted. Across time 1 and 2, participants reported high levels of acceptability and feasibility for the LifeBio Memory™ concept and provided valuable feedback to the tech developers related to future implementation barriers of such technology. This presentation will discuss focus group findings related to 1) benefits of the adaptation, 2) barriers to using the tablet app, 3) implementation of the adaptation.