bluuebunny/crossref_metadata_2025 huggingface dataset:
SHORT-TERM DIESEL EXHAUST PARTICLE NEUROTOXICITY MEDIATED BY TLR4 ACROSS AGE AND SEX
Authors: Shkirkova Kristina , Zhang Hongqiao , Diaz Arnold , Mack Wendy , Sioutas Constantinos , Finch Caleb , Pike Christian , Mack William
Published: December 2022

Experimental animal exposures show neurotoxic effects of diesel in young mice even after short-term exposures. We hypothesize that neuroinflammatory effects of diesel exhaust particles (DEP) are mediated by toll-like receptor 4 (TLR4) activation in brain microglia. We studied both sexes of young (2 months) and middle-aged (18 months) TLR4 flx/flx (CX3CR1CreER +/-) mice, in which macrophage-specific TLR4 deletion is induced by tamoxifen. DEP from National Institute of Science and Technology (NIST 2975) was suspended in pure water and re-aerosolized for 5 hr exposure at 100 µg/m3 concentration. Experimental groups were Filtered Air+Corn Oil, DEP+Corn Oil, Filtered Air+Tamoxifen, DEP+Tamoxifen. We studied markers of inflammation, oxidative stress, and microglia activation in the white matter of corpus callosum. At baseline, middle-aged mice showed higher levels of microglia activation (Iba-1), complement activation (C5, C5a), and oxidative stress (8-OHdG, 4HNE). DEP significantly increased microglial activation, inflammation, and oxidative stress. TLR4 knockdown showed a rescue effect in DEP group for Iba-1 and 8-OHdG in young but not in middle-aged mice. Both C5a and 4HNE were rescued by TLR4 knockdown in young and middle-aged mice, possibly with less robust effects in older mice. No significant sex effects were observed. Middle-aged mice have higher levels of baseline white matter inflammation and oxidative stress. DEP exposure caused robust neuroinflammatory and oxidative responses in white matter across ages. TLR4 knockdown attenuated DEP caused neuroinflammatory and oxidative responses, suggesting that microglia play an important role in DEP neurotoxicity.
THE UNIQUE IMPACT OF THE COVID PANDEMIC ON PREDOCTORAL GEROPSYCHOLOGY TRAINING: RECOMMENDATIONS FROM THE FIELD
Authors: Reel Candice , Bashian Hannah , Boyle Julia , Jacobs Mary , Mlinac Michelle
Published: December 2022

The COVID-19 pandemic impacted predoctoral psychology training at the graduate, practicum, and internship levels including a greater reliance on telehealth and evolving learning needs. However its unique impact on geropsychology training has not been explored. The Building Bridges workgroup for predoctoral training faculty levels, we describe opportunities and barriers to address evolving geropsychology training needs during the pandemic as determined through working group discussion. Negative impacts to training identified include: decreased opportunities for 1) face-to-face patient care and 2) telehealth care due to disparities in telehealth access and utilization in older adults. Other impacts on the geropsychology pipeline include declining opportunities to see older adults at practicum sites. Conversely, increased media attention to the impact of COVID on older adults’ physical and mental health may lead to graduate students’ having greater interest in geriatric mental health and reinforcing a geropsychology career. Recommendations for training programs to address the long-term ramifications of the pandemic will be offered.
PAY RATES AND EMOTIONAL LABOR: CONTENT ANALYSIS OF JOB ADVERTISEMENTS FOR HOME HEALTH AIDES
Authors: Pond Brittney
Published: December 2022

In the United States, over 3.5 million home health aides provide care and assistance to older adults and people with disabilities living in the community (Almeida, Cohen, Stone, & Weller, 2021). These providers are often tasked with emotionally and physically demanding work and are poorly compensated for their labor. In this poster I discuss the connection between the emotional demands of home health care jobs and their compensation through a quantitative content analysis of online job advertisements for home health aide positions (n=312). This research addresses two primary research questions: 1) what are the prevailing pay rates for home health aides and how do they compare to living wages? 2) what is the relationship between emotion work requirements and pay rates in home health aide job advertisements? In about 57% of the job advertisements hourly wages were not sufficient to meet the living wage level according to the MIT Living Wage Calculator. Using linear probability models, I found that there is no statistically significant difference between pay rates listed by home health agencies requiring emotional labor and home health agencies not requiring emotional labor while holding education, experience, and licensure requirements constant. Stratifying the data by home health agency/company size (1,000 employees or less and 5,000 employees or more) yielded no statistically significant results. These findings support and expand upon existing literature that home health aides are undercompensated for their work regardless of agency size, and provide evidence for the need for fair compensation and support.
PET OWNERSHIP AND MAINTENANCE OF EXECUTIVE FUNCTION IN OLDER ADULTS– EVIDENCE FROM THE BLSA
Authors: Friedmann Erika , Gee Nancy , Simonsick Eleanor , Kitner-Triolo Melissa , Barr Erik , Resnick Barbara , Adesanya Ikmat , Gurlu Merve
Published: December 2022

Pet ownership (PO) or human-animal interaction (HAI) has been associated with better physical and mental health in individuals with existing disease or disability. In experimental studies, HAI improves some aspects of cognitive function. No research addresses HAI and longitudinal changes in cognitive function in older adults. We examined the relationship of PO to maintaining executive function (EF) within generally healthy community-dwelling older adults in the Baltimore Longitudinal Study of Aging (BLSA). We hypothesized less EF deterioration among pet owners than non-owners; and less deterioration among dog-walkers than owners who don’t walk their dogs. 637 women (55.9%) and men aged 50–100 years (M=68.3, SD=9.6) completed a PO questionnaire which ascertained ownership history and comprehensive examination every 1–4 years over 1–13 years (M=7.5, SD=3.6). Linear mixed models with time varying PO examined changes in EF according to PO. Pet owners (n=185) were younger (p < 0.001) and healthier (p=0.030) than non-owners; thus, age and comorbidities were included as covariates in the longitudinal analyses. EF, assessed using the Trail-Making Test (TMT), deteriorated with age (p’s < 0.001). Deterioration was less severe among pet owners than non-owners (TMT A: p < 0.001; B: p < 0.001; difference: p=0.042) and dog owners than non-owners (TMT A: p=0.025; B: p=0.009; difference: p=0.076), but not among cat owners than non-owners. Among dog owners (n=73), dog walkers experienced less deterioration than non-walkers (TMT A: p=0.156; B: p=0.001; difference: p < 0.001). This study provides the first longitudinal evidence that PO may contribute to maintaining EF among community-dwelling generally healthy older adults as they age.
INTERNALIZED HOMOPHOBIA MEDIATING THE RELATIONSHIP OF SELF-CONCEALMENT ON DEPRESSION IN LGB OLDER ADULTS
Authors: Calzada Christopher , Goar Carl St , Hollander Matthew , Mo Vennisia , Kiefer Jamie , Hougaard Ben , Carre Nicole , Gomez Rowena
Published: December 2022

Previous research has demonstrated that self-concealment of sexual orientation may negatively affect the wellbeing of lesbian, gay, and bisexual (LGB) adults (Hu, Wang, & Wu, 2013). Additionally, studies have indicated that internalized homophobia significantly predicts depressive symptoms in LGB older adults (Sharma & Subramanyam, 2020). The present study examined how internalized homophobia may mediate the predictive relationship between self-concealment on depression symptoms in LGB older adults. As part of a larger study, participants (Nf301) responded to several questions and measures including the Sexual Orientation Self-Concealment Scale, The Internalized Homophobia Scale, and the Center for Epidemiological Studies Depression Scale. Using the Baron and Kenny’s Method for Mediation (1986), the data analysis indicated that internalized homophobia fully mediates the relationship between self-concealment and depression severity (ps < .05). These results suggest that older adults who self-conceal their sexual orientation may experience an increase in depressive symptoms because of internalized homophobias. These findings may help clinicians better understand the mechanisms contributing to the high rates of depressive symptoms within the older LGB population. Furthermore, the findings suggest that cognitive restructuring of thoughts related to internalized homophobia and self-concealment may improve depressive severity in older LGB adults.
RISKS FOR LATER-LIFE COGNITIVE IMPAIRMENT: DISENTANGLING CHILDHOOD AND EARLY FAMILY-LIFE PREDICTORS
Authors: Mundy Lindsey , Johnson Kimson , Smith Jacqui
Published: December 2022

Observing later-life health outcomes using a life-course model uncovers critical periods of influence. We investigated the relationship between five multi-component measures of childhood disadvantage (determined by Morton et al., 2022) and risk of cognitive impairment (determined by the Langa-Weir Classification) in later life. Data from the Health and Retirement Study (n= 9,509) were used. We conducted a multivariable parametric survival analysis to examine the relationships between the early life predictors of low socioeconomic status (SES), childhood impairments, risky adolescent behaviors, risky parental behaviors, and childhood chronic illness and the risk of developing later-life cognitive impairment between 2006 and 2016. We found that each additional indicator of low SES, risky adolescent behavior, and impairment in childhood increased the risk of developing cognitive impairment over the 10 years studied (HR=1.14, p < .05; HR=1.15, p < .05; HR=1.19, p < .05). Additional indicators of risky parental behaviors, however, were related to a smaller risk of developing cognitive impairment over time (HR=0.96, p < .05). Childhood chronic illness was not significantly associated with the risk of developing cognitive impairment. These results show that early-life factors might have long-term implications for the development of cognitive impairment in later life and display differential relationships with risk when parsed into competing categories. Measures of disadvantage indicating smaller risk may point to the resilience and plasticity of the brain in early life and highlight the need for the study of multiple life stages in order to track predictors of cognitive impairment throughout the life course.
RISK OF HEART FAILURE AFTER CATHETER ABLATION VS. MEDICAL THERAPY FOR ATRIAL FIBRILLATION IN OLDER ADULTS
Authors: Carrero Ricardo Criado , Crawford Andrew , Zadeh Ali Vaeli , Wong Alan , Fleischhacker Alexander , Collado Elias , Larned Joshua
Published: December 2022

Background

Age increases the risk of atrial fibrillation (AF). Catheter ablation (CA) proved being safer and superior to anti-arrhythmic drugs (AADs) in maintaining sinus rhythm and preventing readmissions. However, data on the risk of developing heart failure (HF) following each treatment in older adults is limited.

Methods

A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD 9 and 10 codes, a cohort of patients without a history of HF, aged 65 to 75, with an Elixhauser Comorbidity Index (ECI) of >4 and new-onset AF (index event) was identified. The cohort was then divided into two groups based on treatment received following the index event and matched considering age, gender, ECI, and other cardiovascular diseases. Records from both groups were reviewed for the first episode of HF over 12 months following the initiation of treatment. Pearson’s chi-squared test was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant.

Results

6,446 were included in each group. The mean age, gender and ECI were indifferent. 958 (15%) of patients treated with AADs and 987 (15.3%) of patients treated with CA had a first episode of HF over a year after the treatment which was not significantly different between groups (RR=1.03, CI95% = 0.95- 1.11, p=0.49).

Conclusion

The modality of treatment after the first episode of AF in older population doesn’t significantly affect the risk of HF over the first year.
IMPACT OF OACS ON OUTCOMES OF COVID-19 INFECTION IN OLDER ADULTS WITH HISTORY OF ATRIAL FIBRILLATION
Authors: Carrero Ricardo Criado , Crawford Andrew Carl , Vaeli Zadeh Ali , Wong Alan , De Ana , Diaz Diego , Collado Elias , Larned Joshua
Published: December 2022

Background

Age, atrial fibrillation (AF), and COVID-19 infection predispose patients to hypercoagulability and poor outcomes. It is unclear if older adults with AF and COVID-19 infection would benefit from oral anticoagulants (OACs).

Methods

A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD-10 codes, adults aged 65–75 and Elixhauser Comorbidity index(ECI) >4 with a history of AF admitted for COVID-19 were identified. The use of OACs for 6 months before the index event was used to split the cohort into two propensity score-matched groups considering age, gender, and ECI. Records from both groups were reviewed for multiple outcomes during the same admission. Pearson’s chi-squared test was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant.

Results

We compared 16,967 individuals in both anticoagulated and non-anticoagulated groups. Anticoagulated patients had a lower risk of mortality (RR=0.11, p=0.026), and a higher risk of 30-day all-cause readmission(RR=1.12, p < 0.0001). However, there were no differences in ICU admission, gastrointestinal bleeding, intracranial hemorrhage, thromboembolic events, or length of hospitalization.

Conclusion

Compared to non-anticoagulated patients, older adults with a history AF on chronic oral anticoagulants had a lower risk of all-cause mortality, and higher risk of 30-day all-cause readmission. This information would help clinicians decide whether to prescribe OACs to this population of patients.
RESEARCH ON AGING: THE INTERNATIONAL VIEW FROM THE EDITORS' DESKS
Authors: Burr Jeffrey , Peng Chagmin , Kim Kyungmin
Published: December 2022

We review the scope, content, and focus of the peer-reviewed journal, Research on Aging (SAGE), publishing its 45th volume this year. We will discuss how scholarship produced from researchers around the globe has changed over the years. Data on submissions, acceptance rates, and the important role of an international editorial board will be presented. The review process will be described, along with suggestions on how to increase chances of success when submitting original research. Although Research on Aging is sometimes considered to focus primarily on social gerontology, the scope in recent years has widened considerably, with manuscripts in aging studies published from such fields as economics, psychology, demography, public health, and public policy, as well as from sociology, and social work, among others. One of several special issues forthcoming in the journal will be described to demonstrate the possibilities for international impact.
SHORT- AND LONG-TERM OUTCOMES AFTER HIP SURGERY IN OLDER ADULTS WITH AND WITHOUT HEART FAILURE
Authors: Wei Sijia , Pan Wei , Xue Tingzhong (Michelle) , Tsumura Hideyo , Lee Chiyoung , McConnell Eleanor
Published: December 2022

Older adults with heart failure (HF) have a higher risk for adverse outcomes after hip fracture surgery than those without. Propensity score matching (PSM) reduces selection bias and makes a direct group comparison (older adults with and without HF) possible. Thus, this study aimed to assess the impact of HF on short-and long-term outcomes after hip fracture surgery in older adults living with and without HF. Electronic health records data of older adults (n = 1171) hospitalized for hip fracture surgery between October 2015 and December 2018 were extracted. Comparison groups (with and without HF) were identified using 1:1 ratio PSM to control for observed differences in baseline characteristics. Regression models were used to compare group differences in outcomes. Although in analyses without PSM, older adults with HF were more likely to have higher 90-day readmission, and 30-, 90-, and 365-day mortality, this association was not significant after controlling for selection bias. However, the associations between having HF with 30-day readmission and longer length of stay were significant before and after PSM. Additionally, if patients did not receive hip fracture surgery procedures within two days of admission, they had a 3.6-day longer inpatient stay (P-value < 0.0001) and were 47.8 times more likely to die during hospitalization (95%CI 4.9–482.0, P-value < 0.001). Being non-white was significantly associated with higher 90- and 365-day mortality. Future research should consider PSM approach on national representative datasets to rigorously evaluate the effects of HF on mortality and readmission following hip fracture surgery in older adults.
IMPACT OF A DRIVING DECISION AID ON DECISIONAL CONFLICT AMONG OLDER ADULT DRIVERS AND THEIR STUDY PARTNERS
Authors: Fowler Nicole , Johnson Rachel , Peterson Ryan , Schroeder Matthew , DiGuiseppi Carolyn , Han Duke , Hill Linda , Betz Marian
Published: December 2022

Forty-four million US licensed drivers are ≥65 years old and at higher crash risk. Decision-making about stopping or continuing driving is difficult and often involves family and friends. This study examines if decision conflict about changing driving habits is associated between older adult drivers and their study partners (SPs) (i.e., family member or friend). Data were from a multi-site trial assessing a driving decision aid. Decision conflict about stopping or continuing driving for drivers and their SPs were measured with the Decision Conflict Scale (DCS). Dyadic associations between drivers’ and SPs’ DCS scores pre- and post-decision aid implementation were analyzed using an actor-partner interdependence model. Among 228 driver-SP dyads, driver mean (SD) age was 77.1 (5.1) years; 50.0% female; 98.7% non-Hispanic; 94.7% white; and 97.8% urban-dwelling. SPs mean age was 66.1 years (13.9); 65.8% female; 95.6% non-Hispanic; 92.1% white; and commonly the driver’s spouse (54.6%) or adult child (21.1%). Most drivers (71.7%) and SPs (63.3%) had baseline DCS scores < 25 (drivers mean 18.5 (SD 12.3); SPs 20.5 (16.8)), suggesting low decision conflict. DCS was correlated within dyads at baseline (r=0.18, p < 0.01), and baseline DCS was associated with post-decision aid DCS (p < 0.001 for SPs [β=0.73] and drivers [β=0.73]). While SPs’ baseline DCS was not associated with drivers’ post-decision aid DCS, drivers’ baseline DCS and SPs’ post-decision DCS were (β=0.10; p=0.036). Higher decision conflict about driving felt by older drivers is frequently shared by their SPs, in whom decision conflict may persist even after a driving decision aid intervention.
PERCEIVED FINANCIAL VULNERABILITY, WEALTH, AND WEALTH CHANGE: THE HEALTH AND RETIREMENT STUDY
Authors: Maynard Madison , Flores Emily , Paulson Daniel , Lichtenberg Peter
Published: December 2022

Financial vulnerability among older adults is an escalating social concern given all too frequent financial exploitation of this population. The 6-item Perceived Financial Vulnerability (PFV) was derived from the 56-item Lichtenberg Financial Decision Rating Scale to examine awareness and psychological vulnerability regarding finances. It was included as an experimental module in the Health and Retirement Study (HRS) in 2018. Prior findings have identified significant associations of PFV with wealth, demographics, and health status. The goals of the current study were to examine the relationship between wealth, changes in wealth, and perceived financial vulnerability. The sample included 1156 respondents to the HRS. Respondents were 57.5% female and 77.2% Caucasian. Average age was 68.28 (SD = 10.74) and average years of education was 13.11 (SD = 2.88). The PFV demonstrated adequate internal consistency (α = .60). Total assets at baseline (2016) and change in total assets over two waves (2016 to 2018) were independently stratified into deciles and used as primary predictors of perceived financial vulnerability in 2018. A multiple linear regression model was conducted to examine these relationships. Consistent with previous findings, demographics (R2=0.04, F(5,1150)=10.07, p < .001) and baseline wealth (B= -0.20, SE=0.02, p < .001) predicted PFV scores. Subsequent addition of wealth change (B=-0.06, SE=0.02, p=.002) significantly contributed to overall variance accounted for (p < .01). Negative wealth change over two years and low baseline wealth related to higher PFV. These findings support the construct and the PFV measure as valid and informative.
TECHNOLOGY-DRIVEN INTERGENERATIONAL PROGRAM IN THE PANDEMIC
Authors: Groden Sheryl , Carpenter Matthew , Blackwood Jennifer , Goldberg Allon
Published: December 2022

Intergenerational programs increase interaction among groups allowing both generations to share their beliefs, talents, knowledge, and wisdom. The Senior Programming Intergenerational College Experience (SPICE) Project was designed to deliver an 11-week long intergenerational program with college-aged and older adult participants and was provided virtually during the pandemic. The purpose of this study was to describe the participation characteristics and attitudes towards aging and technology of older adults who completed the SPICE program. Older adult recruitment occurred through paper fliers posted at senior centers/housing, libraries, faith-based organizations in Genesee County, Michigan and through a large state-wide electronic study recruitment portal. Older adult participants were English speaking; aged 55+ years; able to participate in live Zoom sessions once/week; and were committed to complete >75% of the SPICE program. Online surveys were completed before/after SPICE to evaluate attitudes towards aging and technophilia. Results from 15 older adults who completed >75% of SPICE sessions indicated that they were able to cope with life as they got older (60%), viewed aging as a positive experience (85.7%), were not afraid to use new technology (68.6%) and believed technology was useful/fun (88.6%). Older adults were divided on willingness to try new technology and their ability to keep up with technological progress. These data indicate that for higher education institutions focused on designing age-inclusive online opportunities, older adults who possess a positive attitude toward aging and technology may be more likely to complete intergenerational programs.
AFRICAN-AMERICAN DEMENTIA CAREGIVER STRATEGIES INVENTORY (DCSI-A): INITIAL PSYCHOMETRIC EVALUATION
Authors: Lampe Nik , Glueckauf Robert , Behers Benjamin , Wang Yuxia , Jean-Pierre Sarai
Published: December 2022

Recent studies have found promising evidence of the benefits of cognitive-behavioral interventions (CBIs) in improving depression and health status of African-American dementia caregivers (CGs). However, limited information exists about the specific CB strategies used in these investigations and which CB strategies were most effective in reducing caregiver distress and distress-related health problems. To address these shortcomings, Glueckauf and colleagues developed the African-American Dementia Caregiver Strategies Inventory (DCSI-A) using data from two CBI interventions (Nf129). The primary objectives of the current study were: (a) to identify the most frequently used categories of CBI strategies deployed by African-American CGs and (b) to conduct an initial evaluation of the psychometric properties of the DCSI-A. Descriptive statistics were calculated to assess strategy category frequency and percent of total responses. The two most frequently used strategies were: (1) CG Health-Related Intervention Strategies with 19 endorsements, 16.10% of total strategies and (2) Strategies for CG Social, Recreational, Personal Enhancement and Other Community Activities with 18 endorsements, 15.25% of total responses. These findings suggested that health-related and social, recreational, and personal enhancement strategies were the most commonly used by African-American CBI participants. Intercoder agreement was assessed across two one-month coding intervals, each of which contained 5 coding sessions. Mean percent of agreement and Kappa were .94 and .93, respectively. Both reliability measures fell within the highly acceptable range. Coder drift was minimal across the two time intervals. Future research will evaluate the psychometric properties of the DCSI-A with a larger sample of African-American CGs undergoing CBI.
SLEEP CHARACTERISTIC OF AN OLDER END OF LIFE (EOL) CAREGIVER: A SINGLE CASE STUDY
Authors: Park Hyeyoung , Lee Sunghoon , Bailey Amelia , Liu Yunda , Jacelon Cynthia
Published: December 2022

Background

Extensive caregiving work, psychological distress, and caregiving burdens put end of life (EOL) caregivers at great risk of sleep disturbances.

Methods

A single case mixed method design was used to explore older EOL caregivers’ sleep characteristics. Multi-dimensional data was collected through a series of methods including questionnaires (caregiver and care recipient demographics, care recipient symptom severity, caregiver caregiving strain, depressive symptoms, and sleep quality), 14 days of National Sleep Foundation (NSF) sleep diary, 28 days of daily sleep and activity measured by wearable personal sleep monitoring devices (Garmin vivofit 4), and a semi-structured interview. Data was analyzed using thematic content analysis. Findings: A 60 year old female taking care of her 85 years old mother with dementia, kidney cancer, and several other illnesses was recruited for this case study. She showed overall poor sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI, total score: 8), and she slept 6.73 (±1.27) hours per day on average with 52.96% of deep sleep, 41.63% of light sleep, and 5.41% awake times. The caregiver reported that her daily sleep quality depended on her care recipient’s health condition each night. She also described others supporting for her caregiving work as a “double-edged sword,” because she needed to trade some privacy for the additional help.

Conclusion

Further study is needed for EOL caregivers’ poor sleep quality considering external factors and sleep intervention for EOL caregivers should be developed considering these external caregiving contexts.
URBAN ENVIRONMENT AND AFFECTIVE STATES IN REAL TIME: AN ECOLOGICAL MOMENTARY ASSESSMENT STUDY OF OLDER ADULTS
Authors: Liang Peichao , Guo Yingqi , Chan On Fung , Chui Cheryl Hiu-Kwan , Liu Yuqi , Lu Shiyu , Lum Terry
Published: December 2022

Older adults are more dependent on their surrounding environment. Extensive research has demonstrated beneficial effects of both nature and built environment on mental health of older people. However, most previous research used cross-sectional designs failed to test the intraindividual variability between environment, behavior, and mental wellness in daily life. We used ecological momentary assessment (EMA), activity sensors, and GPS tracking to examine the association between real-time environment, mobility and activity, and momentary affect among older adults in Hong Kong. Data collection and data processing was conducted from December 2021 to May 2022. 168 older adults aged 65 to 84 received seven EMA prompts per day during a fifteen-day period, and completed a total of 17,345 momentary assessments of affective states, mobility, and activities. A set of GPS-derived indicators were used to measure the real-time environment. To disaggregate the between- and within-person effects, we used multilevel models to estimate three dimensions of affect, i.e., valence, calmness, and energetic arousal, in EMA observations, nested within individual participants. Preliminary results indicate significant concurrent associations between environmental attributes and momentary affect at the within-person level, while the between-person differences appear to be either null or modest. Being out of home is associated with higher valence ratings (b=0.04, p=0.0427), while exposure to green is associated with a lower level of energetic arousal (b=-0.03, p=0.0163). Greater walkability is consistently associated with higher momentary affect ratings in three dimensions, but these associations are not statistically significant. Implications of these findings for promoting healthy aging will be discussed.
THE RECIPROCAL RELATIONSHIP OF SELF-RATED HEALTH AND INSTRUMENTAL HELP FROM CHILDREN: EVIDENCE FROM GERMANY
Authors: Jessee Lisa
Published: December 2022

Prior research suggests that receiving support from children may promote health among ageing parents. Poor health, however, often precedes the need for support. Yet, research linking instrumental support and self-rated health (SRH) has been deficient in two regards: First, little research has addressed the relationship between instrumental support and SRH simultaneously using longitudinal data. Second, only few studies, have accounted for unobserved confounders (e.g. within-person effects) and potential reverse causality. Recently developed dynamic panel models with fixed effects provide an opportunity to address these methodological issues. Using four waves of the German Ageing Survey (DEAS) among 4,496 adults aged 40 years and older, the current study investigates the potential bidirectional relationship between instrumental support and SRH. I find that prior receipt of instrumental support from children is not a significant predictor of future reported poor SRH. Similarly, previous poor SRH does not significantly predict the likelihood of receiving instrumental support from children at follow-up. Independent of older adults’ SRH, however, prior receipt of instrumental support is a statistically significant predictor of receiving support at follow-up. Regardless of receiving children’s instrumental support, poor SRH in the past predicts poor SRH in the future. The results shed new light on prior bidirectional associations between SRH and instrumental support in the German context. Previous results may be partly explained by a lack of controls for unobserved individual characteristics. The findings suggest that policy interventions may not exclusively rely on older adults’ receipt of support from children in the event of health declines.
A LATENT CLASS ANALYSIS OF STRESSORS AND RESOURCES AMONG SPOUSAL CAREGIVERS TO OLDER ADULTS IN THE UNITED STATES
Authors: Liu Ruotong , Chi Iris , Wu Shinyi
Published: December 2022

Spousal caregivers to older adults experience differing intensities of co-occurring caregiving stressors and resources. Analyzing their heterogeneous profiles can improve recognition of spousal caregivers needing support and caregiving impact on their health. This study aims to identify latent classes among spousal caregivers to older adults and to explore the associated background characteristics and health outcomes. Using pooled data from Round 5 and Round 7 of National Study of Caregiving and the linked National Health and Aging Trends Study, eight indicators for stressors and three indicators for resources are included for latent class analysis to identify distinguishable spousal caregiver subgroups. ANOVA test or Chi-square test are used to understand the different characteristics across spousal caregiver classes. Multivariate regression is conducted to examine associations between class membership and health outcomes. Three latent classes are identified among the 793 included spousal caregivers: low-stress low-support class (39%), medium-stress high-support class (36%), and high-stress medium-support class (25%). Compared to the other two classes, high-stress medium-support class includes more female than male, medium-stress high-support class has greater portions of non-Hispanic Black individuals, and caregivers in low-stress low-support class have fewer comorbidities. In addition, compared to low-stress low-support class, spousal caregivers in high-stress medium-support class reported lower (0.42 unit) level of self-rated health and higher (1.87 unit) level of depressive symptoms. These results confirmed the heterogeneity among spousal caregivers, and highlighted the elevated needs to address the physical and mental health needs among spousal caregivers whose levels of resources could not offset the caregiving stress they experience.
PREDICTING CARE-RECIPIENTS’ WELLBEING BASED ON SPOUSAL CAREGIVERS’ CO-OCCURRING STRESSORS AND RESOURCES
Authors: Liu Ruotong , Chi Iris , Wu Shinyi
Published: December 2022

Besides caregivers, care-recipients’ health outcomes can be impacted by caregiving as well. The aim of the current study is to explore whether care-recipients’ longitudinal health outcomes differ by caregivers’ profiles characterized by the co-occurring and relative intensities of caregiving stressors and resources. Data from Round 5 and Round 7 of National Study of Caregiving and Round 5 to Round 8 of the linked National Health and Aging Trends Study are utilized. After multiple imputation, sample characteristics are described and compared among the 639 unique care-recipients by caregivers’ latent classes. Generalized estimating equations (GEE) with first-order autoregressive covariance are estimated to examine the differences in care recipients’ health outcomes at baseline and rates of change across groups. The average self-rated health at baseline is 2.73 (SD=1.02), and the average baseline depressive symptoms are 2.65 (SD=2.76). GEE results indicate that compared to care-recipients cared by low-stress low-support spousal caregivers, those cared by medium-stress high-support and high-stress medium-support partners score 0.20 and 0.35 unit lower in self-rated health at baseline, respectively, and those cared by high-stress medium-support caregivers on average score 1.21 unit higher in depressive symptoms at baseline. No statistical differences in rate of change are detected for both self-rated health and depressive symptoms across groups. Despite different levels of health at baseline, our research does not find care-recipients’ rates of change in health different across groups over one-year. Future studies are needed to further explore the longer-term differences in rates of change and to better understand the caregiving dyads.
FACTORS ASSOCIATED WITH VOLUNTEERING AMONG FAMILY CAREGIVERS OF OLDER ADULTS
Authors: Baik Sol , Coleman Rachel , Crittenden Jennifer
Published: December 2022

Family caregiving has been linked to an increased risk of poor mental health, poor physical health, and higher rates of perceived social isolation among caregivers. Despite the connection between caregiving and negative outcomes, or perhaps because of this connection, caregivers seek out and enjoy other life roles and activities including formal volunteerism. To explore the connection between informal caregiving and volunteering and establish the representative prevalence of formal volunteering among caregivers, descriptive and multivariate logistic regression analyses were carried out with data from 1,745 caregivers in the National Study of Caregiving (NSOC) (2017). Utilizing social capital theory four models were constructed with salient demographic characteristics associated with volunteering (model 1), caregiving context (model 2), caregiver physical and mental health (model 3), along with participation in informal and formal social networks (model 4). About a quarter of the sample participated in volunteering (26%). The average age was 60.5 years (SD = 14.3) and more than half consisted of female caregivers (67.11%). Non-Hispanic Whites (62.9%) were the majority of the sample, followed by non-Hispanic Blacks (28%), Hispanic (6.5%), and caregivers in other racial/ethic groups (2.6%). Gender, educational achievement, caregiving for a spouse, coresiding with care recipient, caregiving for multiple care recipients, quality of relationship with care recipient, caregiver psychological well-being, having emotional/physical support, attending religious services, and group activity participation were all significant indicators for caregiver volunteerism. Findings support the importance of both human and social capital in volunteering among caregivers.
GIDDY UP! LESSONS LEARNED FROM INTRODUCING AN ONLINE, NATURE-BASED INTERVENTION TO ASSISTED LIVING
Authors: Westmore Megan , Anderson Keith , Mauldin Rebecca
Published: December 2022

The processes involved with developing, funding, and conducting intervention studies in long-term care present a unique set of challenges for researchers. In this presentation, we explore the experiences of researchers evaluating an online nature-based intervention in assisted living. The first challenge lies in creating or finding a novel intervention specific to the setting and population. In this case, the researchers found and tailored an existing online, interactive program that focused on ranch life in rural Montana – Days at Dunrovin. In partnership with the developer of Days at Dunrovin, a group intervention was developed specifically for long-term care settings. The second challenge is finding a facility that has the desire, environment, and staffing to support the intervention. In this case, the researchers were able to partner with an assisted living facility that had an owner who was interested in research, an environment that matched the experimental design of the study, and a staff that was eager to find new ways for residents to engage with the world, particularly during the COVID-19 pandemic. The final challenge involves selecting a funding mechanism that best fits the needs of the study. In this case, the researchers targeted a private foundation that provided ample funding along with the latitude and flexibility that allowed the study to evolve and pivot as necessary. This presentation concludes with recommendations for both budding and seasoned researchers who seek to introduce creative interventions into long-term care settings.
HOW TO ENGAGE SENIORS AS VOLUNTEERS IN SOCIAL CARE SECTORS: A CASE STUDY OF A TIMEBANK IN HONG KONG
Authors: Lu Shiyu
Published: December 2022

Objective

Exploring the roles of older adults as volunteers in social care settings has attracted wide attention to facilitate healthy aging. However, knowledge of engaging older adults as volunteers in social care sectors remains scant. This study explores theoretical mechanisms for promoting volunteer engagement among older adults in the social care sector.

Method

This study used a time bank program called Good Hands in Hong Kong as a case study. Good Hands was established in 2018 and engaged almost 200 older adult volunteers to provide buddying and accompany (e.g., home visits and medical escort services) to over 390 frail peers in the community. This study adopted a qualitative method. Three semi-structured focus group interviews with 18 participants, including senior volunteers and the timebank staff, were conducted in January – August 2021. The thematic analysis. Stakeholder checks were conducted in July 2022 to enhance the credibility of the findings.

Results

Three emergent themes were identified as critical components to facilitate engagement among senior volunteers: (1) strong cross-sector collaboration, (2) meaningfulness in voluntary work comprising four subthemes, including capacity optimization, care capacity enhancement, belonging cultivation, and value recognition, and (3) a co-producing environment. In addition, this study also identified the challenges related to the sustainability of the timebank program.

Conclusion

This study is the first to explore mechanisms for promoting volunteer engagement among older adults in the social care sector. The findings provide theoretical and practical implications for the roles of older adults in social welfare production for our society.
IMPACT OF AN ONLINE COURSE ON GERIATRICS AND QUALITY IMPROVEMENT SKILLS FOR NURSES IN LONG-TERM SERVICES AND SUPPORTS
Authors: Telonidis Jacqueline , Savage Kirstie , McLeskey Nanci , Edelman Linda
Published: December 2022

Nurses working in long-term services and supports (LTSS) settings need training in geriatrics and quality improvement (QI). Our Geriatric Workforce Enhancement Program (GWEP) created an online Nurse Residency Program for nurses from other LTSS settings. Nurses (n=7) who completed the program showed statistically significant improvements in confidence in performing geriatrics skills (t = -3.12, df = 6, p = 0.01), attitudes about community-centeredness (t = -2.14, df = 6, p = 0.04), self-efficacy to engage in the treatment and assessment of depression (t = -3.06, df = 6, p = 0.01), and dementia (t = -2.04, df = 6, p = 0.04). Open-ended, satisfaction responses revealed improved self-efficacy with conducting a QI project. Empowering nurses in LTSS settings may improve quality of care, and decrease burnout and turnover. Future revisions will make the course both asynchronous and applicable to other professions in order to build stronger interprofessional LTSS teams.
AMPLIFYING COMMUNITY ENGAGEMENT TO INCREASE REPRESENTATION AND APPLICABILITY OF CAREGIVING RESEARCH
Authors: Williams Ishan , Jones Randy , Brown-Hughes Travonia
Published: December 2022

Alzheimer’s disease and related diseases (ADRD) disproportionately affect persons of African American ethnicity, yet persons who identify as Black/African American are consistently and markedly underrepresented in Alzheimer’s research. Prior research suggests that a complex array of factors, from mistrust in medical research to non-inclusive recruitment approaches, have led to the disparity. With the growing rates of ADRD among racial/ethnic groups in the US, it is imperative that research scientists develop interventions and clinical research that are culturally informed and meaningful to the lives of diverse caregivers. The goal of our research is to demonstrate the importance of community engagement and culturally informed interventions, and to offer best practices to advance the science of caregiver recruitment, which may ultimately improve overall representation across racial/ethnic caregiver groups. Research findings will highlight the variety of recruitment strategies used to build trust and more sustainable relationships with diverse communities often underrepresented in research.
ASSOCIATION OF MID UPPER ARM CIRCUMFERENCE AND COGNITION: A POPULATION-BASED COHORT STUDY
Authors: Lynch David , Howard Annie Green , Tien Hsiao-Chuan , Du Shufa , Zhang Bing , Wang Huijun , Gordon-Larsen Penny , Batsis John
Published: December 2022

Introduction

Evidence suggests a positive association between muscle mass and cognitive impairment exists. Mid-upper arm muscle circumference (MUMC) is a simple measure that may provide prognostic information on cognitive status.

Methods

We included adults aged ≥55 years from the China Health and Nutrition Survey 1997-2018 with MUAC and triceps skinfold (TSF) measurements at each visit. Cognition was estimated based on a subset of the modified Telephone Interview for Cognitive Status (TICS, 0─27). Sex-stratified linear mixed-effects models accounting for within-individual and within-community correlation assessed the association between MUAC and the ratio of MUAC:TSF with TICS across age. We tested whether the rate of cognitive decline by age differed by quartiles of MUAC and MUAC:TSF in separate models. In cases of no statistical differences in cognitive declines by age, we tested whether overall cognitive function was associated with quartiles of MUAC and MUAC:TSF across all ages.

Results

Of 5,964 adults (53% female, age 62.4±6.4), mean MUAC was 26.6±3.74 and 26.2±3.9 cm, mean MUAC:TSF ratio was 2.9±1.6 and 1.94±1.1, and baseline TICS was 15.4±6.1 and 13.2±6.4 for men and women, respectively. MUAC was not associated with the rate of cognitive decline. Lower MUAC was associated with higher overall cognitive function scores for men (p=0.01) and women (p=0.05). For men and women there was no association between MUAC:TSF ratio and either cognitive decline or overall function.

Conclusion

MUMC can be a marker to predict overall cognitive function across this period in the lifecycle, suggesting that declining MUAC may help predict lower overall cognitive function
SWISS NURSING HOMES’ ENGAGEMENT IN QUALITY IMPROVEMENT: A MULTICENTER CROSS-SECTIONAL STUDY
Authors: Favez Lauriane , Simon Michael , Serdaly Christine , Zúñiga Franziska
Published: December 2022

Many publications have focused on quality improvement interventions in nursing homes but the self-initiated daily involvement of nursing homes in quality improvement activities has rarely been investigated (e.g., conducting surveys, using data to set quality aims and track quality of care over time, conducting quality improvement projects). Such activities can be carried out by nurses in expanded roles with competences beyond those of regular registered nurses (e.g., advanced studies, Bachelor/Master’s degree), but evidence is lacking. We aimed to described the involvement of nursing homes and of nurses working in expanded roles in quality improvement activities in Swiss nursing homes. A cross-sectional multi-center study (2018-2019) using survey data from a convenience sample of 115 Swiss nursing homes and 104 nurses in expanded roles was used and descriptive statistics applied. Most nursing homes reported carrying several quality improvement activities (median = 8 activities out of 10 surveyed). The group of nursing homes working with a nurse in an expanded role (n = 83) were more engaged in quality improvement than the other group (median = 8 versus 6.5) Higher-educated nurses participated more in a majority of quality improvement activities than lower-educated nurses (Bachelor/Master-educated nurses: median of 13 out of 17 activities surveyed, versus diploma-educated nurses: 10), except for clinical teaching. This study provides insights into nursing homes’ involvement in daily quality improvement and suggests that, depending on the targeted quality improvement needs, nursing homes use different profiles and education levels of nurses in expanded roles.
NATIONWIDE ALIVIADO CHAMPION TRAINING: KNOWLEDGE IMPROVEMENT, CHAMPION TURNOVER, AND LESSONS LEARNED
Authors: Sadarangani Tina , Durga Aditi , Ford Ariel , McCabe Donna , Jones Tessa , Convery Kimberly , Lin Shih-Yin
Published: December 2022

Aliviado Champions are hospice employees selected by their agency to lead the local implementation of the Aliviado program. Accordingly, training and retention of champions are critical to hospices’ success (or failure) of program implementation. As of February 2022, we have trained 308 champions across 19 agencies; 94% of the champions agreed all learning objectives were met. A total of 144 champions (97 nurses, 27 social workers, 16 chaplains, and 5 providers) completed pre- and post-training dementia knowledge surveys, demonstrating significant improvements in dementia knowledge, attitudes, and confidences in 7 out of 10 domains post training (p<0.005). The champion turnover rate during COVID-19 (March 2020-Feb 2022) was 11%. In addition, we share our experience adapting the originally 2 full-day, in-person Aliviado Champion Training into a Zoom-based format in response to COVID-19 including strategies to prevent Zoom fatigue. We also discuss strategies to address turnover and rapidly onboard new champions during COVID-19.