bluuebunny/crossref_metadata_2025 huggingface dataset:
PROFILES OF OLDER INCARCERATED PERSONS WHO ATTEMPT SUICIDE FOLLOWING RELEASE
Authors: Barry Lisa , Li Yixia , Byers Amy
Published: December 2023

Release from incarceration is a strong risk factor for suicide. Yet little is known regarding factors associated with suicide attempt among older adults who reentered the community following incarceration. Leveraging a national cohort of U.S. veterans age ≥50 released from incarceration between FY2007 and FY2018 (N=30,584), we conducted a 1:3 matched case-control study and compared demographic and comorbidity factors between those who attempted suicide (cases, N=643) and those with no suicide attempt (controls, N=1,929) up to 13 years post-release. Comorbidity profiles were determined using latent class analysis. As compared with controls, cases had higher proportions of chronic illnesses (e.g., chronic lung disease [35.2% vs. 19.6%], diabetes [32.2% vs. 19.4%], Hepatitis C [24.9% vs. 9.6%]); depression (75% vs. 28.7%); substance use disorders (SUDS) (83.0% vs. 39.4%); and other serious mental illnesses (SMI) (e.g., schizophrenia [34.2% vs. 13.2%], psychotic illness [39.5% vs. 12.5%]). We found four distinct latent clusters among cases (entropy statistic = 0.80): (1) “Minimal Comorbidity” (18%); (2) “PTSD/SUD” (35%); (3) “High Psychiatric/SMI” (32%); and (4) “High Medical/Psychiatric Comorbidity” (15%), and four clusters among controls (entropy statistic = 0.84): (1) “Minimal Comorbidity” (50%); (2) “SMI” (8%); (3) “Tobacco dependence/SUD” (33%); and (4) “High Medical/Psychiatric Comorbidity” (9%). Compared with controls, fewer cases were likely to have the “Minimal Comorbidity” profile (18% vs. 50%), whereas more were likely to have profiles with SMI (32% vs. 8%). Establishing comorbidity profiles of older persons reentering the community after incarceration may help determine who is more likely to die by suicide, thus informing prevention efforts.
BIOLOGICAL MARKERS OF FALLS IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT
Authors: Pieruccini-Faria Frederico , Okuyan Canan , Sarquis-Adamson Yanina , Son Surim , Sultana Munira , Montero-Odasso Manuel
Published: December 2023

Mild Cognitive Impairment (MCI) nearly doubles the risk of falls in older adults. While the association between cognition and falls risk is relatively well understood, no study has explored how biological markers of organic integrity contribute to falls risk in MCI. This study aimed to identify biological markers that could be associated with an increased rate of incidental falls in MCI. A total of 142 participants with MCI (aged 74.3 ± 6.1 years;75% women) with blood tests performed at baseline in Gait and Brain Cohort Study were analyzed. Participants were followed up to 7 years (mean of 28 ± 22.1 months), and falls were reported during the follow-up period(70% fell). Eighteen biological markers extracted from blood serum were dichotomized into low and moderate-to-high levels based on tertile cut-offs. Negative binomial regression model was used to estimate the incident rate ratio (IRR) of falls for biological markers, adjusted for age, sex, global cognition, gait speed, total follow-up duration, and history of falls in the past 12 months at baseline. Results showed that low Parathyroid Hormone (PTH) level (IRR=1.73; 95%CI=1.07, 2.79; p=0.02) and moderate-to-high Interleukine-8 (IL-8) level (IRR= 1.81; 95%CI 1.05-3.14; p=0.03) were associated with an increased rate of falls during the follow-up. Moderate-to-high IL-8 level was also associated with an increased rate of falls with injuries (IRR=2.07; 95%CI=1.05, 4.08; p=0.03). This suggests that in addition to cognitive deficits, impaired calcium metabolism caused by low PTH level and inflammatory processes affecting internal organs may increase falls risk in older adults with MCI.
RETINAL AGING IN COMPANION DOGS
Authors: Mowat Freya , Salzman Michele , Merten Natascha , Rogers Callie
Published: December 2023

Companion dogs cohabit with humans in approximately 45% of US households. They experience similar environmental exposures and lifestyles to their human companions, and have shown sensory, cognitive, and neurological decline with aging. The relationship between age and retinal neurologic function in dogs has not been described. The aim of this study was to determine associations between age and retinal full-field electroretinographic measures in companion dogs, an important translational model species for human neurologic aging. Healthy adult companion dogs with no ophthalmic abnormalities were included (n=54, 18 male, 36 female, median weight 25.7kg, median age 89 months). Unilateral full-field light-adapted and dark-adapted electroretinography (ERG) was performed using a handheld device, with mydriasis and topical anesthesia. Standard least squares effect leverage models were used with log transformed data to determine the cross-sectional effect of age, sex, and bodyweight on ERG amplitudes and peak times. Age and sex were significantly associated with ERG outcome variables, more consistently with ERG amplitude than peak time; age had the largest and most significant effect leverage on outcomes (significantly affecting 3/9 peak time and 8/10 amplitude outcome variables). Younger and female dogs had higher ERG amplitudes. Body weight had no significant effect on any outcome. Our finding that aged companion dogs have reduced ERG amplitudes and prolonged peak times mirror ERG findings in aging humans. Because dogs have a shorter lifespan compared with humans, they may act as a sentinel species to monitor for emerging risk factors for age-related neurologic decline.
TRAJECTORIES OF C-REACTIVE PROTEIN OVER THE MENOPAUSE TRANSITION: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION
Authors: El Khoudary Samar , Qi Meiyuzhen , Chen Xirun , Greendale Gail , Karlamangla Arun , Matthews Karen
Published: December 2023

Inflammation is a mechanistic pillar of aging contributing to the pathogenesis of several common medical conditions. Numerous in-vitro and animal experiments support a link between estrogen decline over the menopause transition (MT) and inflammation. Whether the MT per-se is associated with increased inflammatory load is not obvious. Using longitudinal data from 1,459 (11,373 observations) women (at baseline: 42-52 years old; underweight/normal 39.6%, overweight 28%, obese 32.4%; White 44.5%, Black 27.8%, Chinese 10.7%, Japanese 12.1%, Hispanic 4.9%) with a known final-menstrual-period (FMP) date and at least 3-measures of high sensitivity C-reactive protein (hs-CRP) spanning between 10 years before to 14 years after FMP, we characterized trajectories of hs-CRP and their associations with premenopausal obesity and race/ethnicity. Observations indicating acute inflammation were deleted and data were censored at first use of hormone therapy. Group-based trajectory modeling adjusted for time-varying smoking-status and steroids/statin use was utilized to identify trajectories. LOESS plots and piecewise linear mixed-effects models were used to determine if trajectories were linear or had inflection points around FMP. Three distinct hs-CRP trajectories were identified: low-rise (low-level significantly increased 2.5Yrs after FMP; 26.6%), medium-stable (remained stable across MT; 41.7%), and high-decline (high-level significantly declined at FMP; 31.7%). White women were more likely to show the medium-stable trajectory, Black and Hispanic the high-decline, and Chinese and Japanese the low-rise trajectory. Premenopausal obesity predicted the high-decline trajectory, underweight/normal predicted the low-rise, while overweight predicted the medium-stable trajectory. Heterogeneous patterns of hs-CRP over the MT exist and are related to women’s race/ethnicity and premenopausal obesity.
WOMEN SUPPORTING WOMEN: PEER SUPPORT GROUP FOR OLDER WOMEN WITH METASTATIC BREAST CANCER IN NIGERIA
Authors: Chidebe Runcie , Agha Agha A , Nwakanma-Akanno Onyedikachi , akwiwu Chika Okem , Nwakasi Candidus , Aruah Simeon , Esiaka Darlingtina , Cummins Phyllis
Published: December 2023

Metastatic breast cancer (mBC) is incurable and devastating to all cancer patients. In Nigeria, the proportion of patients with stage III or IV/metastatic breast cancer at diagnosis is 98%. Although many younger mBC patients live for years, older mBC patients have poorer prognosis, more physical symptoms, poorer access to palliative care, and experience higher social isolation. Also, most older Nigerian women diagnosed with mBC experience psychological challenges during and after their treatment, with higher possibility of abscondment from treatment. While peer support groups (PSG) have become increasingly beneficial for improving the quality of life (QoL) of these older women, there is paucity of literature exploring the benefit of these groups and how they provide support to cancer patients in Nigeria. Using a qualitative research approach and interpretative phenomenological analysis, we explored the experiences of older Nigerian women (n=8) living with mBC who belong to a PSG. Our finding shows that for older women living with mBC, seeing peers with similar lived experiences inspire them to keep living, being hopeful, and experience a reduction in death anxiety. PSG provides a culture of love, peer support, socialization and strengthened connections. In addition to pain and inability to walk (mBC linked disabilities) being recurring physiological challenges for many older women with mBC, forced retirement/inability to work, death anxiety, financial burden, and limited access to cancer care are some of the socio-psychological challenges they face. Therefore, the establishment of PSG in cancer treatment centers in Nigeria would improve QoL and reduce abscondment from treatment.
CARE JUSTICE FOR UNPAID AND UNDERPAID CARE WORKERS
Authors: Hooyman Nancy
Published: December 2023

Scholarship on older women, family caregiving, feminist gerontology, community-based services and policy change intersected throughout my career. As a social worker, care of older adults has always been a matter of social justice. My focus now is on care justice for those who perform the critical work of long-term services and supports: unpaid family caregivers and underpaid home care workers. This lecture will examine the interrelationships among both types of care laborers, who often face structural constraints on their decision to care and whose work is devalued, marginalized and invisible. Inequities for care workers by race, immigrant status, and sexual orientation are rooted in systemic racism, sexism, xenophobia, and homophobia. This lecture presents the components of a care justice framework, informed by feminism, intersectionality, and care theory, of fundamental structural changes to value collectively the essential work of care, ensure meaningful choice to care, and reduce inequities in care labor.
UNIVERSITY KENAN DISTINGUISHED PROFESSOR AND CO-DIRECTOR, PROGRAM ON AGING, DISABILITY, AND LONG-TERM CARE
Authors: Zimmerman Sheryl
Published: December 2023

The concept of person-centeredness -- simply stated, knowing the person in a holistic perspective and meeting the individual’s needs and preferences -- has become so ubiquitous in health and supportive care that it borders on being a cliché. More so, it is often not reflected in national surveys and databases; considered in relation to the capacity of varying systems of care; forward-thinking in terms of emerging realities; or dissected in reference to some of the nuanced and implicit issues responsible for bringing it to the forefront of national attention. This Kleemeier Award lecture will reconstruct the concept of person-centeredness based on literature review, questionnaires, interviews, forums, and think tank meetings with diverse experts. It is supported by National Institute of Aging through a grant to the Alzheimer’s Association’s LINC-AD.
STATE GENEROSITY IN HOME- AND COMMUNITY-BASED SERVICES (HCBS): VARIATIONS AND IMPACT ON DEMENTIA OUTCOMES
Authors: Cheng Zijing (Flora) , Li Yue
Published: December 2023

To meet the needs of community-living older adults and reduce overall medical spending, home- and community-based services (HCBS) provide assistance and care for persons with significant physical and cognitive limitations. Together, Medicaid long-term services and supports (LTSS) coverage and the Title III program under the Older Americans Act (OAA) of 1965 support the majority of the HCBS for older adults living in the U.S. with low-income and/or disabilities. We evaluated state variations in generosity of supporting HCBS in recent years and how these variations affect the healthcare outcomes of community-living older adults and socio-economic and racial disparities in dementia outcomes. State HCBS generosity from the perspectives of program participation and intensity of services was defined by the exploratory and the confirmatory factor analysis with data from multiple sources, including state reports from the National Association of State Budget Officers. State data was linked to a nationally representative sample of older adults who enrolled in the Health and Retirement Study in 2020. Analyses revealed that overall state supports for HCBS increased over time in recent years while state Medicaid expenditures for institutional long-term care remained largely stable. State supports through both Medicaid and the OAA programs for HCBS varied substantially and persisted in recent years. Discussion will focus on instrumental variable analyses that determine the causal impact of state variations in HCBS generosity on health outcomes (i.e., unmet need; hospitalization) for persons living with dementia persons.
ASSOCIATIONS BETWEEN NEIGHBORHOOD SOCIAL DESTINATIONS AND GPS-DERIVED COMMUNITY MOBILITY OF OLDER ADULTS
Authors: Moored Kyle , Crane Breanna , Dunlap Pamela , Carlson Michelle , Rosso Andrea
Published: December 2023

Neighborhood social destinations may encourage greater out-of-home travel (i.e., community mobility) and support independent functioning in later life. We examined associations between quantity of destinations that promote social interactions (e.g., arts/recreation, restaurants, stores, civic/religious institutions) and objective, GPS-derived community mobility. Participants were 146 adults ≥65 years old (Mean=77.0±6.5 years, 68% women) at baseline of a randomized trial to improve walking coordination. Participants carried a GPS device that passively collected real-time location data for 5-7 days. Spatial extent of community mobility was quantified using median standard deviational ellipse area (SDEa, km2) and maximum distance from home (mDOH, km). Duration of community mobility was characterized using percentage of time spent out-of-home (pTOH). Community mobility measures were stratified into tertiles due to positive skew. We used National Establishment Time Series (NETS) classifications to derive a total social destination count at the Census tract-level (Mean=48.9±35.7 social destinations per tract). Ordinal logistic regressions were adjusted for demographics (age, gender, race, education), device, season, and number of comorbidities and were clustered on Census tract. Each 1-SD greater destination count was associated with 46% greater odds of being in a higher tertile of pTOH (OR=1.46, 95% CI: 1.08-1.97, p=.014). Number of social destinations was not associated with SDEa or mDOH (all p’s>.05). Nearby social destinations may encourage greater duration, but not necessarily spatial extent, of community travel. Future work utilizing GPS can objectively measure activity in community social spaces to assess its benefits for cognitive and mental health in later life.
ROLE CAPTIVITY, DAILY SOCIAL ISOLATION, AND THE MENTAL HEALTH OF DEMENTIA CAREGIVERS
Authors: Puga Frank , Wang Danny , Bibriescas Natashia , Poe Abigail , Alvarez Loreli , Jablonski Rita , Vance David
Published: December 2023

Family members providing informal care to individuals living with Alzheimer’s disease and related dementias (ADRDs) have an increased risk of poor mental and cognitive health. Social connection has been proposed as an intervention target to support the health and well-being of ADRD caregivers; however, little is known about daily variation in social connection, contextual factors that impact social connection, and its association with caregiver mental health experiences. Thus, the purpose of this study was to examine the relationship between role captivity and daily social isolation (i.e., lack of social connection) among dementia caregivers, as well as associations between social isolation and depression and anxiety-related symptoms. A sample of community-dwelling ADRD caregivers (N=30) completed a baseline survey followed by 14 days of daily diaries (n=323 data points). Participants were asked about role captivity, social isolation, and daily depression and anxiety-related symptoms. Data were analyzed using mixed-level modeling. Role captivity reported at baseline was significantly associated with daily social isolation (B=0.82, 95% CI [0.68, 0.96], p <0.001). Further, daily social isolation was significantly associated with both depression (B=0.69, 95% CI [0.61, 0.77], p <0.001) and anxiety (B=0.55, 95% CI [0.48, 0.62], p <0.001) related symptoms reported on a given day. The findings from this study contribute knowledge on ecologically valid interventions that target daily experiences of social isolation and support the mental health of dementia caregivers. Such interventions are critically important given the proposed links between mental health, social isolation, and cognitive health in later life.
PUBLIC SECTOR INVOLVEMENT IN AGE-FRIENDLY CITIES AND COMMUNITIES: A SCOPING REVIEW
Authors: Greenfield Emily , Pope Natalie , Keyes Laura , Russell Elizabeth
Published: December 2023

The global age-friendly cities and communities (AFCC) movement has long centered the involvement of the public sector, calling on high-ranking authorities to commit to improving the built, social, and service environments of their localities. However, there is little understanding of how the public sector is involved in actual practice. To address this gap, we conducted a scoping review of peer-reviewed articles published since 2010, with a focus on studies in Canada and the United States, to synthesize the evidence on the ways in which the public sector has been involved with AFCC work. Our review identified four primary themes. The first theme describes the variety across studies in descriptions of the overall positioning of the public sector in AFCC efforts, with public sector actors ranging from leaders to partners to targets for advocacy. The second theme addresses activities that are initiated by a public administration that targets age-friendly improvements for that administration. The third theme encompasses activities that help to connect a public administration with, as well as influence, outside actors, primarily the private sector and government administrations at other systems levels. The final theme elucidates the various ways in which the public sector is involved with AFCC assessment, evaluation, and research. We discuss the implications of our findings for practice, policy, and continued empirical research. We also discuss theoretical implications for AFCC efforts in terms of distinguishing “whole of government” from “whole of society,” grassroots, and planning-specific approaches.
ADVANCING AGING EQUITY AMONG OLDER BOSTONIANS
Authors: Hernandez Adriana , Coyle Caitlin
Published: December 2023

More than five years after the City of Boston started its journey towards becoming an Age and Dementia Friendly community, the initiative and its collaborators have been working to ensure that the initiative and its many contributions are equally realized by all Bostonians. Drawing on the concept of aging equity--that all older adults, despite their life course histories, have equitable access to programs and services that help them age well. To achieve this means removing obstacles to accessing community features that support healthy aging, establishing social and civic engagement opportunities, ensuring safe environments, establishing access to healthcare, and disseminating knowledge of available supports and services. This presentation will describe the research and community engagement that led to the development of an aging equity conceptual framework and examples of how it is being operationalized in the City of Boston. For example, we will share the ways in which outreach and communication strategies have been altered to more equitable practices including efforts to build trust, engage in cultural translation of programs and services, and consider new channels of information sharing.
EAST MEETS WEST: INTERVENTIONS, PRACTICE MODELS, AND POLICIES TO SUPPORT FAMILY CAREGIVERS IN DIVERSE CULTURES
Authors: Sun Fei , Sun Juanjuan , Lu Jiehua , Harrison Tracie
Published: December 2023

This East Meets West symposium consists of six studies that examined innovative interventions, practice models and policies designed to support family caregivers of older adults in the U.S., Taiwan, and mainland China. The first two papers both used case management interventions to assist family caregivers with a focus on caregiver depression. The paper from the U.S. found that more difficulties of performing caregiving tasks and less caregiver preparation contributed to higher levels of depression, and the paper from Taiwan found that caregivers who received the case management service reduced depression at four-month and six-month follow-up assessments. The third paper discussed a “time travel” paradigm developed to guide service design and delivery for persons with dementia at different stages. The fourth paper used the state of Michigan as a case to examine service gaps in the current aging service network, and identifies an urgent need for statewide policy renovations to support family caregivers. The fifth and sixth papers both used large secondary data analyses to examine the effects of piloted policy and practice efforts on family caregiver outcomes. One study found that the long-term care insurance programs have resulted in positive caregiver outcomes including reduced caregiving financial cost, time, and physical and psychological burden. The other study found the use of home-based care services reduced adult children caregiver burden and did not affect the relationship between older adults and adult children caregivers. After individual presentations are done, two discussants will summarize shared themes in these papers and provide critical feedback.
A CRITICAL EXAMINATION OF AAA SERVICES AND SUPPORTS FOR CAREGIVERS IN MICHIGAN: POLICY AND PRACTICE IMPLICATIONS
Authors: Ilardo Joan , Zell Angela
Published: December 2023

To identify the service gaps for family caregivers in Michigan, this study examined the perceptions of stakeholders from the 16 area agencies on aging (AAA). An online questionnaire was administered to assess a point-in-time picture of current caregiver assessments and services in 2020. Fifteen AAAs responded to see definitely or probably an increase in the number of caregivers in their catchment areas. Fifteen AAAs currently purchase or contract for respite care services. Fourteen provide some type of direct caregiving resources. Twelve utilize staff to develop and monitor care plans. While some provided caregiver training, none directly provided supportive services. AAAs anticipated rapidly increasing needs for caregiver supports and services. While each provided a different array of services, they anticipated that demand would continue to increase given a rising aging population in Michigan. Results were used to craft a proposal to establish a network of regional caregiver resource centers. Recommendations in the study include creating a task force of stakeholders to identify standardized service definitions, measures and reporting requirements; create a no-wrong-door, multi-prong approach for caregivers to access programs; provide respite care through contracts and referrals to community-based organizations; create a network of trainers to disseminate evidence-based best practices to AAAs and contractors; use untapped resources such as AARP and Alzheimer’s Association; explore forming local healthcare systems and provider collaborations to identify caregivers and triage them. Next steps are to pursue funding from the legislature and other sources to create regional caregiver resource centers across the state.
PARTNERING TO IMPROVE CARE: STRENGTHENING THE FAMILY CAREGIVER AND HOME CARE WORKER RELATIONSHIP
Authors: Scales Kezia , King Jessica , Dieppa Emily
Published: December 2023

Family caregivers and home care workers provide essential daily care for millions of older adults and individuals with disabilities across the United States—and together they constitute the backbone of home and community-based services (HCBS). In many cases, these unpaid and paid caregivers work closely together and share common knowledge, skills, experiences, and challenges. Yet the overlap and relationship between them remains relatively understudied. This session will describe the importance of strengthening the family caregiver/home care worker dyad and discuss promising developments in research, policy, and practice. We will then highlight a pilot training intervention designed to improve the shared knowledge and interpersonal competencies of family caregivers and home care workers. The intervention— Partnering to Improve Care: Direct Care Workers and Families—was developed by PHI (a national nonprofit research, public education, and consulting organization) in partnership with the Florida Pioneer Network, Home Instead, and Florida State University through the North and Central Florida Geriatrics Workforce Enhancement Partnership (GWEP). Informed by the PHI Coaching Approach®, the intervention consists of five parallel online training modules for family caregivers and for home care workers that utilize adult learner-centered teaching methods and reflect input from home care stakeholders. The modules portray common scenarios that family caregivers and home care workers face and aim to build communication and relationship skills that facilitate collaborative problem-solving and the provision of person-centered care. We will present key findings on the feasibility and acceptability of this intervention, discuss next steps in this research, and highlight broader policy and practice recommendations.
PRAGMATIC IMPLEMENTATION OF AN ADVANCE CARE PLANNING INTERVENTION: FINDINGS FROM SHARING CHOICES
Authors: Scerpella Daniel , Wolff Jennifer , Gaugler Joseph
Published: December 2023

Advance care planning (ACP) is defined as a key task in ambulatory care for patients to share values, goals, and preferences for future medical care. Ideally ACP is revisited throughout the course of serious illness and engages family in discussions with clinicians. Most interventions, however, have not targeted primary care as a setting for ACP but have instead targeted a specific illness, conversation or setting such as the inpatient hospital or nursing home. Additionally, family is often not included in ACP discussions. This symposium will discuss critical components of the SHARING Choices cluster-randomized pragmatic trial, including the setup, monitoring, and analysis of this intervention within two primary care health systems located in the Baltimore-Washington DC metropolitan corridor. Each presenter will discuss key efforts conducted during the trial that highlight challenges, lessons learned, and novel approaches of embedding an evidence-based intervention within usual care settings targeting older adults 65 years of age and older. Preliminary analyses indicate that the ACP intervention was highly effective for increasing the likelihood of having advance directives in the patients’ electronic health records within 1-year of intervention initiation (odds ratio = 2.88, p < 0.001). Attendees of this symposium will take away relevant insights for implementing effective ACP and communication interventions within primary care settings as well as supporting outcome data. Our discussant will provide thoughts on the implications of these results for current primary care organizations and in the field of ACP and communication for older adults including those with dementia.
PERCEIVED WORKPLACE AGEISM AND OLDER WORKERS’ LABOR FORCE TRANSITIONS DURING THE GREAT RECESSION
Authors: Sahin Duygu Basaran
Published: December 2023

Previous research suggests that workplace ageism increased during the Great Recession (GR). During the GR, despite having lower unemployment rates compared to younger workers, older workers took considerably longer to find jobs once they were unemployed. Yet, no study has investigated the potential role of workplace ageism in older workers’ labor force outcomes. This study examines the role of perceived workplace ageism in older workers’ labor force transitions during the GR using longitudinal data from the Health and Retirement study. I conduct a multi-period analysis and compare how the association of perceived workplace ageism with labor force transitions changed during the GR compared to pre and post-recession periods. Results from multivariate logistic regressions show that only in the GR period, both measures of perceived workplace ageism – pressure to retire before age 65 and preference for young in promotions – were associated with a higher likelihood of employment instability (b= 0.336 p< 0.05 and b= 0.340 p< 0.05), net of demographic, socioeconomic, financial, job-related and health-related factors. Moreover, older workers perceiving workplace were less likely to retire and thereby more likely to be unemployed (b= -0.667 p< 0.05). In contrast, perceived workplace ageism had no association with reducing or increasing the hours worked per week. In sum, this study provided the first individual-level evidence on the impact of perceived workplace ageism on older adults’ labor force transitions during the GR. Findings can be used to motivate additional studies on older workers’ experience during the Covid19 crisis.
THE SYNERGISTIC EFFECT OF STRESSORS AND UPLIFTS FOR DAILY SUBJECTIVE AGING IN THE US
Authors: Neupert Shevaun
Published: December 2023

Exposure to daily stressors is consistently associated with reduced health and well-being, including feeling subjectively older. Experiencing uplifts, however, are typically associated with increased health and well-being, but have not yet been examined with respect to subjective aging. The current study tested daily stressors and uplifts as unique as well as interactive effects for daily subjective age and daily ageist attitudes. A sample of 440 U.S. adults aged 50-85 participated in a 14-day daily diary study, reporting on their subjective age, ageist attitudes, daily stressors, and daily uplifts each day. All variables demonstrated significant within-person variability, with ICCs ranging from .68 (uplifts) to .75 (subjective age). Daily stressors and daily uplifts were each uniquely predictive of daily ageist attitudes, where daily stressors were positively associated and daily uplifts were negatively associated with daily ageist attitudes. For daily subjective age, there was a synergistic effect of daily stressors and daily uplifts. On days with no stressors, daily uplifts were not associated with daily subjective age. However, on days with stressors, increases in daily uplifts were associated with significant decreases in subjective age. These findings underscore the multidimensionality of subjective age constructs and will be situated within cross-cultural comparisons.
DOES STRESS MAKE YOU FEEL OLDER? A DAILY DIARY STUDY OF SUBJECTIVE AGING, STRESS, AND UPLIFTS IN TURKIYE
Authors: Can Reyyan , Neupert Shevaun
Published: December 2023

Subjective aging, how one perceives their age, is associated with psychological, emotional, and social well-being. Adults’ subjective perceptions of their age are malleable and can fluctuate on a daily basis, influenced by various life events such as experiencing stress or uplifts. We conducted a 14-day daily diary study to assess how subjective age and ageist attitudes are predicted by daily stressful events and uplifts in Turkey/Turkiye. 68 Turkish participants aged 50 to 90 years (M= 57) responded to subjective age, ageist attitudes, stress, and uplifts questionnaires every day. Multilevel model analyses indicated that individuals perceived themselves as emotionally and physically older on days when they encountered more stressors and fewer uplifting events. Additionally, on those days, participants reported that they looked and behaved older than their chronological ages. Uplifts corresponded negatively to ageist attitudes; individuals who experienced more uplifting events during the day had fewer negative judgments of aging. Taking age as a subjective construct, these results suggest that having fewer stressors in daily life changes people’s feelings about their aging process. In addition, involvement in uplifts can buffer ageist attitudes on a daily basis.
DAILY EXPERIENCES OF UPLIFTS, STRESSORS, AND SUBJECTIVE VIEWS ON AGING IN GERMANY
Authors: Kornadt Anna E
Published: December 2023

People’s subjective experience of aging can vary from day to day and is related to other experiences in people’s daily lives. While stressors have been previously investigated as predictors of subjective aging, less research has taken the role of positive events into account. We were thus interested in the relationship of daily stressors and uplifts on different indicators of daily subjective aging in later life. In a preliminary sample of N = 42 German adults aged 52 - 75 years, participants completed up to 14 daily-diary questionnaires on subjective age (single item and multidimensional) and ageist attitudes, daily stressors and uplifts. All variables showed significant within-person variability, with ICCs ranging from .24 (stressors) to .87 (ageist attitudes). Uplifts were related to daily subjective age: On days with more uplifts, people felt younger. Stressors were not related to subjective age and no relation was found with ageist attitudes for uplifts and stressors. Findings will be contextualized in a cross-cultural sample.
FEELING YOUNGER TODAY? THE ROLE OF MEANINGFUL AND FLOW-CONDUCIVE ACTIVITIES
Authors: Tse Dwight
Published: December 2023

Given the conceptualization of subjective age being a construct that varies daily, one question naturally follows is whether doing particular activities may be associated with daily subjective age. Specifically, extrapolating from flow and vital engagement theory, we hypothesize that activities that are personally meaningful or flow-conducive (activities that are conducive to flow experience, a psychological state of simultaneously intense concentration and enjoyment) may be associated with older adults’ feeling younger on the day. In a 14-day diary study, participants residing in the United Kingdom reported their subjective age at the end of the day. They also identified the activity on which they spent most time during the day and reported their flow experience and perceived meaningfulness in the activity. With the initial data from a sample of N = 69 adults (age range: 50 to 83) who completed at least 7 daily surveys, we found that higher-than-usual (i.e., within-person) levels of both activity meaningfulness and flow experience were associated with feeling younger. These effects were robust even after controlling for daily stressors and uplifts. Interestingly, there was an interaction between within-person activity meaningfulness and flow experience, such that the effect of flow experience was stronger in activities with lower (vs. higher) levels of meaningfulness. Our findings provide preliminary support that doing personally meaningful and flow-conducive activities may be associated with feeling younger on the day, underscoring the possibility of activity-level behavioral change that influences subjective age.
WITHIN- AND BETWEEN-COUNTRY DIFFERENCES IN DAILY ASSOCIATION OF VIEWS OF AGING AND NEGATIVE AFFECT
Authors: Shrira Amit , Palgi Yuval , Neupert Shevaun
Published: December 2023

Few studies found cultural differences, both across and within countries, in the association between subjective views of aging (VoA) and psychological concomitants. However, a question remains whether such cultural differences exist on a daily level. We therefore examined cultural differences in daily covariation of VoA and negative affect (NA) within an Israeli sample (comparing Israeli Jews to Arabs) and between countries (comparing the Israeli sample to an American sample). The Israeli sample included 75 participants (age ranged 50 to 88, 36% Arabs). The American sample included 77 participants (age ranged 50 to 82). Participants reported subjective age, subjective accelerated aging, ageist attitudes, and NA across 14 days. Within-person variability ranged from 28% (ageist attitudes) to 52% (NA) of the total variance in the Israeli sample, and 26% (subjective age) to 38% (subjective accelerated aging) in the American sample. On days respondents felt younger, felt to be aging slower, or had less ageist attitudes, they also reported lower NA. Cross-level interactions showed that the associations of subjective age and subjective accelerated aging with NA were significantly stronger among Israeli Arabs (versus Israeli Jews) and significantly stronger in the Israeli sample (versus the American sample). The daily covariance between ageist attitudes and NA remained similar across cultural groups. These findings attest to the importance of taking a cultural perspective on daily relationships between VoA and psychological concomitants. Our talk will discuss potential explanations for the abovementioned cultural differences and similarities and will point to future directions in our Subjective AGES project.
AGING AND NUMERACY: A META-ANALYSIS
Authors: Best Ryan , Sadeqi Farima
Published: December 2023

Numeracy, the ability to competently make use of numbers and numerical information, is a unique cognitive ability associated with diverse positive outcomes across the lifespan. Often included as a covariate in studies of cognitive aging, there is some scattered evidence of lower numeracy in older adults when compared to younger adults. Importantly, one longitudinal study found evidence of a quadratic decline in numeracy starting in later middle-age. The current study systematically reviews the literature on aging and numeracy as measured by one of three frequently implemented objective measures: the Lipkus numeracy scale (Lipkus et al., 2001), Weller et al.’s Rasch-based numeracy scale (2013), and the Berlin Numeracy Test (Cokely et al., 2012). Effect sizes were calculated from two types of studies: those including age as a categorical extreme group comparison variable or as a continuous variable from adult lifespan samples. Hedge’s g was computed as the effect size in the former studies and Pearson’s r was calculated as the effect size for the latter. For comparison across studies in a single random-effects model, Pearson’s r effect sizes were mathematically transformed into Hedge’s g’s. Type of sample (extreme group vs. adult lifespan) and age range were included in a second mixed-effects model to account for heterogeneity in effect sizes. Initial results show lower numeracy in older adults, but reduced effect size estimates in lifespan samples compared to those using extreme group comparisons. The implications for using linear estimates of effect size for the quadratic relationship between age and numeracy are discussed.
PERSPECTIVE-TAKING DECLINE IN OLDER ADULTS WITH AND WITHOUT SUBJECTIVE COGNITIVE DECLINE
Authors: Yow W Quin , Ye Nina , Li Xiaoqian
Published: December 2023

Subjective cognitive decline (SCD), a self-reported decline in cognitive function without objective cognitive decline, is an early risk marker of pathological aging (Jessen et al., 2020). Healthy older adults with SCD(+) were found to have lower objective cognition and increased rates of cognitive decline compared to those without SCD(-) (Morrison & Oliver, 2023). Cognitively-healthy older adults (OA) had shown a decline in perspective-taking abilities compared to younger adults (YA). However, little research has examined whether self-report SCD plays a role in such age-related declines. We examined age-related changes in perspective-taking abilities in OA with and without SCD vis-à-vis YA. Participants were 25 YA (Mage=22.44, range=20-27), 27 SCD- (Mage=68.67, range=60-77), and 20 SCD+ (Mage=66.55, range=60-72). OA were categorized as SCD-/SCD+ based on SCD-Questionnaire (Rami, 2014). SCD- and SCD+ groups were comparable in general cognition (Montreal Cognitive Assessment; p=.91). Participants completed the “owl” task assessing visual perspective-taking (VPT) and the “director” task assessing cognitive perspective-taking (CPT). Kruskal-Wallis tests revealed that YA outperformed OA (Zs>3.52, ps<.001) in VPT, with no significant difference between SCD- and SCD+ (Z=1.27, p=.21). Surprisingly, both YA and SCD+ were better than SCD- in CPT (Zs>2.34, ps<.04), and SCD+ did not differ significantly from YA (Z=0.02, p=.99). Our results suggest that while visual perspective-taking may decline with age regardless of SCD, cognitive perspective-taking may be preserved in older adults with SCD. SCD(+) may signal a hyperawareness of cognitive states in self and others, which in turn stimulate better cognitive perspective-taking. Implications of SCD on social cognition will be discussed.
THE CURRENT AND RETROSPECTIVE COGNITIVE RESERVE (2CR) SURVEY AND ITS RELATIONSHIP WITH COGNITIVE AND MOOD MEASURES
Authors: Aichele Stephen , Borella Erika , Ghisletta Paolo , Carbone Elena
Published: December 2023

Cognitive reserve (CR) is often assessed with surveys spanning demographic, lifestyle, and socio-behavioral variables. The role of both past and current life experiences on CR has, however, rarely been examined. We developed the Current and Retrospective Cognitive Reserve (2CR) survey to assess classical CR proxies (socio-economic status, engagement in leisure and social activities) and other dimensions of potential importance (family engagement, religious/spiritual activity) both currently (CRc; in later adulthood) and retrospectively (CRr; as recalled from younger adulthood). We administered the 2CR, measures of general cognitive functioning, working memory (WM), vocabulary, fluid reasoning, and depressive symptoms (DS) to 235 community-dwelling Italian adults (ages 55-90 years). We used exploratory and confirmatory factor analyses to examine the 2CR latent structure, and we estimated correlations of its dimensions with cognitive abilities and DS. Analyses confirmed a three-level factor structure with two global CR factors (CRc and CRr) at the top level, dimensional CR factors (socio-economic status, family engagement, leisure activity, social engagement, and religious/spiritual activity) at mid-level, and observed items at the lowest level. Item-factor representations partially differed across CRc and CRr. Both CRc and CRr were positively correlated with measures of intelligence, WM, and DS. Associations with measures of intelligence were comparatively stronger for CRr, whereas associations of WM and DS were slightly stronger for CRc. The 2CR can be considered a reliable survey for assessing CR proxies within a multidimensional, “life stage-dependent” framework insofar as CRc are CRr closely related but also differently associated with intelligence, WM, and DS.
REVISITING THE TEACHING NURSING HOME: PRAGMATIC EVALUATION IN A REAL-WORLD SETTING
Authors: Degenholtz Howard
Published: December 2023

Revisiting the Teaching Nursing Home (RTNH) is a renewal of the Teaching Nursing Home model pioneered in the 1980s, which found that creating partnerships between schools of nursing (SONs) and nursing homes (NHs) improved clinical outcomes. In its first two years, the RTNH initiative has fostered partnerships between three SONs and four NHs in Pennsylvania, and is planning to expand. The program is implementing the Institute for HealthCare Improvement Age-Friendly Health System “4Ms” quality improvement framework through an online learning network. The 4M quality improvement framework focuses on four evidence-based elements: Mobility, Mentation, Medication, and What Matters. In addition, the participating SONs are incorporating the 4Ms into curricula and clinical rotations. The evaluation will examine both implementation and outcomes for SONs and NHs. Measures include student competency, staff satisfaction and burnout, clinical process of care and resident outcomes. While some resident level measures can be extracted from the Minimum Data Set (MDS), others (deprescribing, rehabilitation goals, preference sensitive care) require access to the electronic medical record (EMR). The goal of this presentation is to describe the methodology for measuring the wide range of outcomes and to examine the performance of a synthetic comparison group to study overall quality using CASPAR data. We selected 1,764 similarly sized, non-profit NHs and conducted bivariate, and propensity score analysis to determine if the participating NHs were different on any observable characteristics. The findings suggest that the participating NHs were not statistically significantly different in terms of overall quality rating, staffing, or inspections.
DISPARITIES IN ELECTION, ACCESS, AND OUTCOMES IN MEDICARE END-OF-LIFE CARE: A NATIONAL STUDY
Authors: Christian Thomas , Plotzke Michael , Cancel Mariana Sarango , Hersey Catherine , Harrison Zinnia
Published: December 2023

We examined whether end-of-life care racial disparities persist even within groups with similar geographic access and health care options. We reviewed calendar year (CY)2021 fee-for-service Medicare claims to determine if a beneficiary ever: elected hospice, had an end-of-life care conversation with their physician, and/or received advanced care planning services. We obtained beneficiary characteristics from Medicare administrative records and used Consumer Assessment of Health Providers and Systems Hospice star ratings to identify poorer quality hospices (one- or two-stars out of five). As a measure of the quality-of-care processes beneficiaries received, we calculated Hospice Visits in the Last Days of Life (HVLDL). Using logistic regression, we calculated Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (CIs) to characterize the association between race/ethnicity and end-of-life services utilization. Relative to white decedents, beneficiaries were less likely to elect hospice if they were black [AOR 0.67 95% CI 0.65-0.69], Asian [AOR 0.62 95% CI 0.59-0.66] or Hispanic [AOR 0.76 95% CI 0.72-0.81]. Additionally, non-white beneficiaries more often received care from poorer quality hospices than the white beneficiaries residing in their same zip code (black AOR 1.26 95% CI 1.21-1.31, Asian AOR 1.21 95% CI 1.14-1.29, Hispanic AOR 1.16 95% CI 1.09-1.24). In such poorer quality hospices, non-white beneficiaries have lower HVLDL rates (white 48.5%, black 40.3%, Asian 42.6%, Hispanic 45.8%). We found no substantial racial/ethnic disparities in recorded advance care plans or end-of-life conversations. CMS should continue to monitor trends in hospice utilization and ensure all beneficiaries receive equal and adequate care.