bluuebunny/crossref_metadata_2025 huggingface dataset:
SUBJECTIVE COGNITIVE DECLINE IN CAREGIVERS: 21 STATES, PUERTO RICO, AND DC, 2015-2017
Authors: Taylor Christopher A , Edwards Valerie J , Knapp Kenneth A , Bouldin Erin D , McGuire Lisa C
Published: November 2019

Informal caregivers can provide assistance that can help family members and friends live in the community longer but can place caregivers at increased risk for poorer health outcomes. Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss. The objective of this study is to describe SCD in caregivers. Data were analyzed from 21 states, Puerto Rico, and District of Columbia who administered both the Caregiver and Cognitive Decline modules of the Behavioral Risk Factor Surveillance System in the same year for 2015–2017. A higher proportion of caregivers reported SCD (13.4%) compared to non-caregivers (10.2%). Of those who did need assistance with daily activities due to SCD, 1 in 8 non-caregivers were unable to the necessary assistance compared to 1 in 4 caregivers. SCD among caregivers is of particular concern because it affects both the caregiver and care recipient.
EVERYDAY DISCRIMINATION AND KIDNEY FUNCTION AMONG OLDER ADULTS: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: Cobb Ryon J , Thorpe Roland J , Norris Keith C
Published: November 2019

Background: The current study examines the cross-sectional association between everyday discrimination and kidney function among older adults. Methods: We use cross-sectional data from a nationally representative sample of older adults to examine this relationship. Our measure of kidney function derives from the estimated glomerular filtration rate (eGFR) obtained by the Chronic Kidney Disease Epidemiology Collaboration equation, while our indicator of everyday discrimination is drawn from self-reports. Results: Results from our ordinary least squared regression models reveals that, after adjusting for demographic characteristics, everyday discrimination was associated with lower mean eGFR (β=-.79; S.E.: .34). The relationship between everyday discrimination and kidney function was not explained by cardiovascular, metabolic, or economic factors. Conclusions: Findings suggest this study suggest that everyday discrimination may be a unique risk factor for poorer kidney function among older adults. Because these findings are cross-sectional, additional research is needed to determine whether the observed associations persist over time.
THE JOURNAL OF GERONTOLOGY: SOCIAL SCIENCES: GLOBAL SCHOLARSHIP CHALLENGES AND OPPORTUNITIES
Authors: Carr Deborah
Published: November 2019

Journal of Gerontology: Social Sciences aims to publish the highest quality social scientific research on aging and the life course in the U.S. and worldwide. The disciplinary scope is broad, encompassing scholarship from demography, economics, psychology, public health, and sociology. A key substantive focus is identifying the social, economic, and cultural contexts that shape aging experiences worldwide. In the coming decade, social gerontology research is poised to present many opportunities for cross-national and cross-cultural scholarship – driven in part by the proliferation of large parallel data sets from many nations in Europe, Latin America, and Asia. I will discuss the role that peer-reviewed cross-national scholarship can play in disseminating knowledge that informs gerontological research, policy, and practice internationally. I will also identify under-researched areas that will be of great interest to scholars in the coming decade, including LGBT older adults, aging in the Global South, reconfigured families, and centenarians.
HEALTH AND WELL-BEING AFTER DISPLACEMENT IN LATE LIFE AMONG ASIANS
Authors: Li Wenjun , Glicksman Allen , Balaswamy Shantha
Published: November 2019

Displacement in late life may cause social and health issues. Displaced older adults may experience language and cultural barriers, loss of social networks, difficulties in navigation in new physical and social environments, limited options in transportation and mobility, delayed access to health care, and thus sudden or gradual loss of their autonomy, and increasing dependence on their adult children. These issues are known but not well understood, and effective interventions are yet to do developed. This symposium brings together four studies that address several critical social and health issues among late-life Asian immigrants. Dr. Inoue discusses use of person-centered care to reduce social isolation and loneliness among old and ill Asian immigrants in long term care settings. Ms. Ring examines racial differences in navigation and access to long term aging services and social supports (LTSS), and evaluates the use of Social Interaction Modeling to help connect limited English-speaking minorities in need to the formal LTSS system. Dr. Torres from Sweden provides a systematic review of research into racial/ethnic differences in health and social care, and from an international perspective, advocates a research agenda that is both diversity-astute and injustice-aware. In settings where self-report data are likely unreliable, Dr. Li demonstrates an innovative method for objectively measuring spatiotemporal patterns of physical and social activities and use of neighborhood resources among non-English speaking late-life immigrants. Together these studies demonstrate that existing methods can be adapted and new methods can be created to answer important health and social issues among late-life Asian immigrants.
MEASURING SPACE AND TIME USE, PHYSICAL AND SOCIAL ACTIVITIES AMONG NON-ENGLISH SPEAKING LATE-LIFE ASIAN IMMIGRANTS
Authors: Li Wenjun , Churchill Linda , Cheng Jie , Siden Rachel , Aguirre Annabella , Kane Kevin
Published: November 2019

Little is known about the health and health care needs of non-English Speaking late-life Asian immigrants. Due to language barriers and memory issues, self-report data are unreliable for investigating activity patterns in this population. In the ongoing NIA-funded Healthy Aging and Neighborhood Study, we developed a novel method to objectively measure space and time use, location- and time-specific physical and social activities using accelerometer (ACC) and Global Positioning System (GPS) devices. The study has recruited over 150 Caucasians and 150 minorities including 50 non-English speaking late-life Asian immigrants. The participants answered surveys in their preferred language (English, Spanish, traditional or simplified Chinese) and wore ACC/GPS devices for 7 to 10 full days. Activity levels and geographic locations are recorded every 30 seconds. Using the combined ACC/GPS data, time- and location-specific activity amounts, time use and mobility patterns are objectively measured. Baseline findings will be reported at the GSA conference.
COMMUNITY BELONGING THROUGH THEATER: CREATIVE ARTS INTERVENTION FOR LOW-INCOME OLDER ADULTS
Authors: Dunkle Ruth E , Sutherland Laura , Pace Garrett T , Kennedy Ariel , Baldwin Patricia
Published: November 2019

Creative arts can promote social contact and possibly reduce isolation. A professionally run theater group comprised of low-income older adults met for 12 weeks to learn basic skills and perform a play. Using a pre-post questionnaire, data were gathered from the treatment group (n=14) who participated in the class and a non-participating comparison group (n=5) to identify potential program effects on measures of social isolation, community belonging, and social exclusion. Participants were African American living in low-income housing in an urban area. The average age of the sample was 65 years, 21% were men, 83% had at least high school degree, 71% reported good to excellent health, and 58% reported at least one ADL. Regression analyses showed that a sense of community belonging was significantly greater for the treatment group than the comparison group at time 2.This was not the case when considering social isolation or social exclusion. When controls were added (age, health, and previous theater experience), the significant difference remained with higher age predicting a sense of community belonging. The greater number of class sessions attended was also associated with a greater sense of community belonging for the treatment group. Through the shared experience of theater, participants can gain a sense of community, but this activity does not seem to be related to social isolation or social exclusion. It could be that theater participation fosters a sense of belonging due to group dynamics but is not a significant enough activity to reduce a sense of isolation or exclusion.
PHYSICAL ACTIVITY INTERVENTION IN HOME CARE: COMPARING FAMILY AND NON-FAMILY CAREGIVING DYADS
Authors: Muramatsu Naoko , Yin Lijuan
Published: November 2019

An increasing number of states pay family members who care for older adults in Medicaid-funded home care. Previous research documented pros and cons of hiring family members as home care providers. However, little is known about whether family and non-family caregiving dyads function differently when they participate in health promotion interventions in home care. Using data collected in a pilot study of a gentle physical activity program delivered by home care workers in a Medicare home care program, this study compared 18 family and 32 non-family caregiving dyads in client outcomes (self-reported and performance-based function) and process outcomes (exercise-related social support provided by home care aides) before and after the intervention. Linear mixed models indicated that client outcomes improved after the 4-month intervention (p<0.05), controlling for clients’ age, gender, and number of chronic conditions. Compared to family caregiving dyads, greater improvement in exercise-related support was observed in non-family caregiving dyads (p<0.05), where care providers offered less exercise-related support at baseline. The intervention program was received well by both family and non-family dyads, as expressed by one of the caregivers: “It makes my client feel good about herself. I also feel good for my client.” Results suggest that empowering caregivers with health promotion skills is a promising strategy, especially in non-family caregiving dyads. Further research is warranted to produce evidence-based health promotion programs for family and non-family caregiving dyads in home care.
COGNITIVE DECLINE AMONG OLDER ADULTS IN RURAL CHINA: THE PROTECTIVE ROLE OF FORMAL SCHOOLING
Authors: Pei Yaolin , Wu Bei , Cong Zhen , Hu Mengyao
Published: November 2019

Evidence shows that education is strongly associated with cognitive functioning; however, few studies have examined the effect of education on cognitive decline among older adults with very limited education. Our study analyzed six waves of panel data (2001, 2003 2006, 2009, 2012 and 2015) from the Longitudinal Study of Older Adults in Anhui Province, China. We estimated two-level multilevel models of cognitive functioning for older adults age 60+, sampled using probability sampling strategy. We found that having formal schooling was positively associated with better cognitive functioning. Older adults with formal schooling had slower decline in cognition and the gap in cognition between the literate and illiterate widened with age. These findings highlight the role of early life experience in affecting cognitive function in later life and suggest that disadvantages in cognitive functioning accumulate throughout the life course for persons with no formal education.
SYSTEMS BIOLOGY OF AGING
Authors: Labunskyy Vyacheslav
Published: November 2019

The biology of aging is an immensely complex process that impacts function at the sub-cellular, cellular, tissue, organ, and whole organism levels. New technologies and systems-level approaches provide an opportunity to greatly enhance our understanding of this complexity.
SYSTEMS LEVEL UNDERSTANDING OF AGING
Authors: Labunskyy Vyacheslav
Published: November 2019

Aging is a complex trait is controlled by multiple genetic and environmental factors. Genome-wide screens in invertebrate organisms have led to the identification of hundreds of genes, whose deletion or knockdown can dramatically increase lifespan. Many of these genes represent conserved signaling pathways and biological processes suggesting that they might be involved in the regulation of mammalian aging. Nevertheless, the mechanistic basis by which the majority of these long-lived gene deletions extend lifespan remains poorly understood. Using yeast Saccharomyces cerevisiae as a model system, we employ systems biology network analysis of transcriptomic and protein expression data to build a detailed translational regulatory network of aging in yeast and identify genetic interactions among various aging pathways. Through these studies we expect to gain understanding how the regulatory networks are perturbed with aging, which could provide important insights into human disorders associated with the old age.
WADDINGTON’S LANDSCAPE OF CELL AGING
Authors: Hao Nan , Li Yang , Jiang Yanfei , Paxman Julie , O’Laughlin Richard , Pillus Lorraine , Tsimring Lev , Hasty Jeff
Published: November 2019

Cellular aging is a complex process that involves many interwoven molecular processes. Studies in model organisms have identified many individual genes and factors that have profound effects on lifespan. However, how these genes and factors interact and function collectively to drive the aging process remains unclear. We investigated single-cell aging dynamics throughout the replicative lifespans of S. cerevisiae, and found that isogenic cells diverge towards two aging paths, with distinct phenotypic changes and death forms. We further identified specific molecular pathways driving each aging fate and revealed that these pathways interact and operate dynamically to enable an early-life switch that governs the aging fate decision and the progression towards death. Our work uncovers the interconnected molecular pathways that drives the aging process and opens up the possibility of designing interventions that simultaneously target multiple network nodes, instead of single genes, to more effectively extend the healthspan.
GENOME-WIDE ASSOCIATION STUDY OF EXTREME HUMAN LONGEVITY DISCOVERS UNCOMMON LONGEVITY VARIANTS
Authors: Gurinovich Anastasia , Gurinovich Anastasia , Song Zeyuan , Andersen Stacy L , Perls Thomas T , Sebastiani Paola
Published: November 2019

The strong heritability of extreme human longevity supports the hypothesis that this is a genetically-regulated trait. However, association studies focused on common genetic variants have discovered a limited number of longevity-associated genes. We conducted a genome-wide association study of 4,216 individuals including 1317 centenarians from the New England Centenarian Study (median age = 104 years) using >9M genetic variants imputed to the HRC panel of ~65,000 haplotypes. The set included approximately 5M uncommon variants. The associations were tested using a mixed effect logistic regression model with genotype-based kinship covariance of the random effects to adjust for cryptic relations using the package GENESIS. The analysis discovered 45 genome-wide significant SNPs (p< 5E-08) including 8 new loci in chromosomes 3, 6, 7, 9, 10, 14 and 15 in addition to the APOE locus. The list includes new pQTLs in serum that suggest a new biological mechanism involved in extreme human longevity.
MULTI-OMIC BIOLOGICAL AGE ESTIMATION, CORRELATION WITH WELLNESS, DISEASE PHENOTYPES: LONGITUDINAL SAMPLE OF 3558
Authors: Price Nathan , Price Nathan , Earls John , Rappaport Noa , Heath Laura , Wilmanski Tomasz , Lovejoy Jennifer , Hood Leroy
Published: November 2019

Biological age (BA) has been shown to be a better predictor of mortality and disease than chronological age (CA). Aging’s diverse effects are visible across many data types. We investigated BA from deep phenotyping of 3558 wellness program participants and controls. The Klemera-Doubal BA estimation algorithm was applied to genetic and longitudinal clinical laboratory, metabolomic, and proteomic assay data. BA trajectories were calculated using Generalized Estimating Equations. BA of individuals with Type-2 Diabetes averaged 6+ years greater than CA. Wellness program participation decreased individuals’ rate of aging (coefficient: -0.16, 95% CI: -0.45, 0.19), with effects dependent on sex, initial BA, and CA. Measures of metabolic health, inflammation, and toxin bioaccumulation were strong predictors across data types and sex. Deep phenotyping enabled calculation of a BA measure and a wellness program improved BA, either in absolute terms or relative to CA, showing it is modifiable.
UNDERSTANDING AND ADDRESSING IMMUNOSENESCENCE
Authors: Van Der Most Robbert
Published: November 2019

Aging comes with an increased impact of infectious disease in terms of hospitalization, morbidity and mortality. This increased susceptibility to infection appears to be linked to age-related changes in the immune system and its capacity to respond to infection and vaccination. Importantly, this phenomenon occurs despite existence of pre-existing immune memory. The age-related weakening of the immune response is referred to as “immunosenescence”. Immunosenescence operates at several levels of the immune system and is multifactorial. Recent advances in systems immunology have shed new light on the immunological processes that may drive the age-related changes in immune response to infection and vaccination. However, gaps in our understanding still exist at basic and translational research levels. One approach to counteract this is the development and implementation of innovative vaccines against the pathogens with particular risks for older adults. The use of innovative immune adjuvants holds promise for the development of such vaccines.
IMPLICATIONS OF RELATIONSHIPS WITH FAMILY, FRIENDS, AND NEIGHBORS FOR WOMEN'S WELL-BEING IN LATE LIFE
Authors: Fuller Heather , Fuller Heather , Toyama Masahiro
Published: November 2019

Social support is well documented as promoting women’s well-being across the lifespan, yet implications vary depending on the source and type of support. The present study examined whether relationships with family, friends, and neighbors (both satisfaction with and number in social network) affected well-being over two years. Midwestern women (N=188, mean age = 80) were sampled from two waves of the Social Integration and Aging Study (2013, 2015). Hierarchical regression models indicated that satisfaction with friends predicted better life satisfaction, but satisfaction with family and neighbors did not predict well-being. In contrast, number of neighbors in social network predicted lower life satisfaction and greater stress, while number of family and friends were not associated with well-being. Moreover, differential effects emerged between older and younger women. Findings highlight unique facets of older women’s social relationships and suggest that future research and interventions addressing age and the source of support are warranted.
THE HEALTH OF MALE VETERANS IN LATER LIFE
Authors: Wilmoth Janet M , Landes Scott D , London Andrew S
Published: November 2019

Veterans have the opportunity to accrue health-promoting “military capital,” but they are also at risk of experiencing a “military hazard” effect that undermines later-life health and mortality outcomes. Given these possibly competing effects, there is substantial heterogeneity in physical and mental health among older male veterans. The health and mortality outcomes of older veterans who were not substantially harmed during military service appear to be just as good as, if not better than, those of nonveterans. However, older veterans who served in-theater, were exposed to combat or hazardous chemicals, and/or were physically or psychologically harmed during service tend to have worse health and higher mortality than non¬veterans. Some older veterans with these experiences struggle with life-long or late-onset PTSD, while others exhibit resilience and posttraumatic growth. Additional population-level, life-course research is needed on specific war-era cohorts to identify the mechanisms that shape veteran status differences in late-life health and mortality.
FACTORS INFLUENCING SELF-REPORTED COGNITION OVER TIME
Authors: Hill Nikki , Katz Mindy
Published: November 2019

Self-reported cognitive problems among cognitively intact older adults are often associated with an increased risk of future cognitive decline and Alzheimer’s disease (AD). However, cross-sectional evidence suggests that self-reported cognition may be more influenced by factors such as personality or affective symptoms than concurrent objective cognitive performance. Furthermore, self-reported cognition is measured using a variety of items that assess different constructs (e.g., current memory performance, perceived decline over time), which may be differentially influenced by individual characteristics or item interpretation. The purpose of this symposium is to present findings from multiple analyses that examined the influence of individual characteristics (i.e., personality, perceived stress, and family history of dementia) on self-reported cognitive problems, and to further describe how item type influences older adults’ responses to questions about their memory. First, we present the results of an investigation that examined the influence of personality on three types self-reported memory, with a specific focus on how these associations may differ in Black and White older adults. Second, we extend this discussion with results of an examination of associations among personality, family history of AD, and memory self-report. Our third presentation explores bidirectional associations between perceived stress and memory complaints over time. And finally, we present the results of a factor analysis of self-reported cognition items that distinguishes those that tend to travel together over time from those that are better at discriminating between individuals.
POTENTIAL BENEFITS FROM LIVING IN A CCRC
Authors: Wyatt-Brown Anne
Published: November 2019

Unlike many people who hope to postpone moving until late in life, my husband and I had to move quickly because he could no longer manage the stairs in our condo. We chose a nearby CCRC where my parents had lived in the 1980s. My husband loved our choice, and gradually I adjusted to life in an institution. When he died in 2012, I had to start over again as a single woman. Fortunately, people were very kind to me, which made adjusting much easier. Other residents were equally supportive when I had breast cancer, which involved chemo and radiation. I realized recently that co-residents have taught me to make supportive comments when people tell me that they can’t remember names. Acknowledging that we all have declines to deal with makes it easier for us all to accept aging’s inevitable changes while using our housing community for support.
DO WHAT I SAY, NOT WHAT I DO? CHALLENGING CONTEMPORARY WISDOM ABOUT RESIDENCE IN OLD AGE
Authors: Rowles Graham D
Published: November 2019

An environmental gerontologist teaching about “aging and environment” for 30 years, I had it all figured out. Downsize and divest, stair free environment, universal design, environmental centralization, location close to services. At 60, I was consulting with an architect to design an age friendly home and searching for a level plot. But then, serendipitously, we found our current home, a residence defying all of these principles. An irresponsible denial of aging and pending frailty? Thirteen years later, I’m not so sure. In this presentation, I explain why, focusing on processes of “making and remaking home” and “being in place” that have been central themes in my research career. I explore ways in which as my wife and I grow older, harnessing modern technologies, newly emergent living arrangements and contemporary communication, we anticipate being able to age in place far longer than has been possible for previous generations.
LEVERAGING COMMUNITIES AS NETWORKS TO REDUCE MALNUTRITION IN OLDER ADULTS
Authors: Sadarangani Tina , Beasley Jeannette , Jarrott Shannon E
Published: November 2019

Malnutrition in older adults, while ubiquitous, remains largely underrecognized and undertreated. In community-dwelling older adults, 25% of those at risk of over or under nutrition do not receive any dietary interventions; routine screenings for malnutrition are not typically required in community-based settings. In this interdisciplinary symposium, we explore issues focused on the delivery of evidence-based nutrition interventions to meet the needs of community-dwelling older adults. Using national survey data, we begin by underscoring the importance of treating the complex needs of adults at risk of malnutrition by examining health sequelae, specifically hospitalizations, in community-dwelling adults receiving home-delivered meals. We subsequently examine approaches to malnutrition screening in community-based settings, focusing on the utility of the DETERMINE checklist. We explore barriers and facilitators of providing person-centered nutrition to ethnically diverse Asian American older adults in the adult day healthcare setting. Finally, we shift our focus to overnutrition, discussing the dissemination of a telehealth diabetes prevention program, BRInging the Diabetes prevention program to GEriatric populations (BRIDGE) among older adult meal program recipients. Older adults in community-based health settings are at risk of malnutrition, and among them, those who are prone to social isolation, are at highest risk for adverse outcomes. While congregate settings can facilitate social interaction, honoring food preferences and facilitating choice to address undernutrition, is challenging. Conversely, telehealth interventions may present a feasible approach for addressing overnutrition. We conclude by discussing how current and future research can inform innovative person-centered community-based approaches to identify and treat malnutrition.
EXPLORING HOW CARE PROVIDERS TALK ABOUT COMMUNICATION DIFFICULTIES WITH ETHNIC MINORITY PATIENTS
Authors: Ågård Pernilla
Published: November 2019

Previous research into cross-cultural interactions in health care settings shows that care providers experience communicating with elderly ethnic minority patients as problematic. According to the social constructionist framework upon which this presentation draws, people negotiate the characteristics they ascribe to the world around them through talk. It is against this backdrop that the presentation – which is based on a focus group study with end-of-life care providers (n=60) – sets out to explore how care providers talk about communication difficulties with elderly ethnic minority patients. The presentation demonstrates how the study of communication difficulties can illustrative the challenges of cross-cultural interaction in end-of-life care settings. Through the attention on how communication difficulties are discussed, this presentation shifts the focus from the elderly ethnic minority patients and the reasons for why they are experienced as problematic when it comes to communication, to the actual process where these problems are negotiated.
MANDATORY MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS IN PENNSYLVANIA: EVALUATING POLICY CHANGE
Authors: Degenholtz Howard
Published: November 2019

The Commonwealth of Pennsylvania is implementing a mandatory Medicaid managed Long-Term Services and Supports (LTSS) program that covers people age 21 and older who are fully eligibly for both Medicare and Medicaid, living in a nursing facility paid for by Medicaid, or in an aged or physical disability home and community based services (HCBS) waiver. The overall program goals are to: Enhance Opportunities for Community Living; Improve Service Coordination; Enhance Quality and Accountability; Advance Program and Innovation; and Increase Efficiency. The program will be administered by 3 managed care organizations (MCOs) that are obligated to coordinate with Medicare Advantage and D-SNP plans. This major policy change affects the traditional roles and responsibilities of the aging network by shifting the locus of control to insurance companies. This presentation will describe the policy change, the implications for the aging network, and the multi-method evaluation designed to assess the implementation and outcomes.
FAMILY CAREGIVING AND THE OLDER AMERICANS ACT
Authors: Whiting C Grace
Published: November 2019

This session will focus on the challenges faced by millions of family caregivers and the innovative approaches that the OAA and other programs are using to be supportive of caregivers.
ROLE OF COPING STYLES AND NEGATIVE LIFE EVENTS ON HIGHER PERCEIVED MENTAL FATIGABILITY IN OLDER ADULTS
Authors: Gmelin Theresa , Andersen Stacy L , Boudreau Robert M , Christensen Kaare , Wojczynski Mary K , Cosentino Stephanie , Glynn Nancy W
Published: November 2019

Older adults are vulnerable to negative recent life events (RLE) which deplete attentional resources and leads to cognitive exhaustion. Adaptive coping styles reduce perceived stress severity but their role on cognitive tiredness is unknown. We examined RLE and coping styles on perceived mental fatigability (Pittsburgh Fatigability Scale (PFS), 0-50pts, higher=greater fatigability) in the Long Life Family Study (N=1464, age=74.7±12.6, female=57.7%, 43.9% ≥1 major RLE past 6 months, 27.8% higher mental fatigability≥13). All analyses adjusted for family structure, field center, age, and sex. PFS mental scores correlated with all NEO-FFI (60-item, 5-domain) personality traits representing maladaptive (neuroticism r=0.25 p<.0001) and adaptive (conscientiousness r=-0.18, extraversion r=-0.24, p<.00001) coping. Having ≥1RLE was associated with higher mental fatigability (OR=1.4, 95% CI:1.2,1.8, p=.0004); adjustment for neuroticism (OR=1.3, 95% CI:0.9,1.7, p=.06) attenuated the association. Education on adaptive coping may be a modifiable skill that allows older adults to maintain lower perceived mental fatigability despite stressful events.
PRESIDENTIAL SYMPOSIUM: EXPANDING THE GEROSCIENCE NETWORK
Authors: Kaeberlein Matt
Published: November 2019

In keeping with the 2019 GSA Annual Meeting theme of “Strength in Age—Harnessing the Power of Networks”, the Biological Sciences Presidential Symposium focuses on cutting edge approaches to understand the biology of aging using network and systems approaches.
STRESS-BUFFERING EFFECTS OF VOLUNTEERING ON DAILY WELL-BEING: RESULTS FROM THE NATIONAL STUDY OF DAILY EXPERIENCES
Authors: Han Saehwang , Kim Kyungmin , Burr Jeffrey
Published: November 2019

Based on theory and empirical evidence linking volunteering and health, we investigated the associations between daily engagements in formal volunteering, stressors, and negative affective well-being, focusing on the stress-buffering effect of volunteering. Using eight days of daily diary data from the second wave of the National Study of Daily Experiences (participants, N = 1,320; participant-day observations, N = 8,277), we estimated a series of multilevel models to assess the within-person associations between daily volunteering, stressors, and affect. Results indicated there were no direct associations between daily volunteering and negative affect. However, we found the association between daily stressors and negative affect (but not positive affect) was weaker on days when volunteering was performed compared to days volunteering was not performed. Taken together, our findings suggested that short-term health benefits associated with daily volunteering were largely based on the stress-buffering effects of helping others, rather than through a direct effect.
PAIN, PAIN MANAGEMENT, AND CONSEQUENCES OF PAIN AMONG AL RESIDENTS
Authors: Resnick Barbara
Published: November 2019

The purpose of this study was to describe the incidence, management and impact of pain on function, agitation, and resistance to care. This was a descriptive study using baseline data from 260 residents in the second cohort of the FFC-AL-EIT study. The majority of the sample was female (71%) and white (96%) with a mean age of 87 (SD=7). Fifty-two residents (20%) reported pain based on objective (PAINAD) or subjective (verbal descriptive scale, VDS) pain assessments. A total of 75 residents (29%) received pain medication and 22 (42%) individuals reporting pain were not getting pain medication. Controlling for age, gender and cognition, PAINAD was significantly associated with agitation, function, and resistance to care and the VDS was only associated with function. Pain assessments should include objective and subjective measures and management of pain should be considered as it may help to optimize function and decrease behavioral symptoms among AL residents.
THE EXAMINATION OF DETERMINANTS AND BARRIERS TO END-OF-LIFE DECISION MAKING AND PLANNING
Authors: Gaines Brittany E , Dobbs Debra J
Published: November 2019

As individuals are living longer, in many cases with chronic diseases, there is an increased focus on end-of-life (EOL) planning and decision making. This includes a broad spectrum of choices including advance care planning (ACP) and turning to palliative care or hospice care. Although there has been an increase in palliative and hospice care enrollment and ACP engagement over the past decade, participation remains low for certain subgroups of the population. The purpose of this symposium is to offer insight into reasons for these varying rates of engagement by exploring determinants and barriers to EOL decision making and planning and by examining caregiver knowledge of EOL decision making and planning from the service provider perspective. The first three studies examine various types of influences in EOL decision making and planning. Inoue and colleagues explore factors associated with the length of hospice stay, and Gaines and colleagues examine the impact of environmental characteristics in ACP. Ornstein and colleagues use Denmark registry data to assess the role of kinlessness at the time of death in EOL decision making and healthcare utilization. The final presentation by Noh and colleagues examines how service providers in rural areas perceive community residents’ knowledge of ACP and palliative care. The discussion following these presentations will compare findings across different forms of EOL decision making and planning, consider the impact of the varying methodological approaches used, and highlight implications of these works for potential interventions and policies related to EOL decision making and planning.
A PRACTICE FRAMEWORK FOR CONSIDERATION OF GENDER IN ETHICAL DECISION-MAKING
Authors: Bowland Sharon , Halaas Beth
Published: November 2019

Gender role stereotypes, social norms and social policies negatively influence health and well-being for marginalized groups. These inequalities are embedded in the fabric of our society and are often unquestioned and hidden. Practitioners frequently use an ethical lens that does not consider the influence of gender on life course decision-making. We developed the Practice Framework for Older Persons (PFOP) to assess past and current realities that take gendered experiences into consideration. By contextualizing means and opportunities, a more complete picture can be drawn about a person’s unique gender experiences. Subsequently, we can better understand their decision-making processes, wants, needs, and desires. This type of assessment may be particularly beneficial for women and transgender persons given ethical demands for practice paradigms which consider gender fluidity and development of a sense of personal agency.
INTEREST GROUP SESSION—COMMUNITY COLLEGE: THE ROLE OF COMMUNITY COLLEGES IN WORKFORCE DEVELOPMENT AND TRANSFER WITHIN GERONTOLOGY
Authors: Abushakrah Jan , Faber Michael A
Published: November 2019

This symposium will highlight how innovative and often non-traditional Community College Gerontology students are motivated to seek career shifts and intentional training and comprehensive education. Understanding and applying this approach allows students to build on their prior skills, especially caregiving experience, to advance to more professional roles in the field of Gerontology. During this symposium we will focus on the Applied Gerontology aspect of Community College programs, including short-term certificates and other approaches related to and informed by the rapidly evolving workforce development in the field of aging. Selected Community College and University representatives, who understand and are leaders in the field of Applied Gerontology, will highlight models of existing Community College and University partnerships/collaboration that work, as well as provide models of other applied approaches. In addition, there will be an opportunity for robust dialog between Community Colleges and four-year Colleges and Universities – both on developing other effective Applied Gerontology approaches, and on creating even better partnerships and collaboration. This symposium will appeal to professionals working in both two and four-year systems of higher education. Colleges and Universities desiring to develop or enhance relationships with area Community Colleges will find this session especially helpful.
FACILITATORS OF DEPENDENCY IN THE VERY OLD: RESULTS FROM THE NEWCASTLE 85+ STUDY
Authors: Kingston A , Robinson Louise A , Duncan Rachel , Jagger Carol
Published: November 2019

In order for governments to plan health and social care strategies to help people maintain independence, evidence is required to show how risk factors are associated with progression in dependency. We use a transparent measure of dependency, based on help needed with activities of daily living, incontinence and cognitive impairment, categorised as: high (24-hour care); medium (daily care); low (less than daily) and independent, then characterise changes over ten years (age 85-95) using the Newcastle 85+ Study while exploring how eight disease groups, multimorbidity and impairments interact to increase care needs. Stroke and diabetes confer an increased risk of low-level dependency. Complex multimorbidity, or three or more falls engendered the greatest risk of transitions to substantial dependency. There should be a focus on prevention of, and appropriate and efficient service provision for those with complex multimorbidity with emphasis on stroke, diabetes and falls, to maintain the independence of older people
RELATIONSHIP BETWEEN CARE HOME STAFFING AND QUALITY OF CARE: A MIXED-METHODS APPROACH
Authors: Spilsbury Karen , Charlwood Andy , Valizade Danat , Haunch Kirsty
Published: November 2019

Beyond broad recognition that ‘staff influence quality’, little is known about the care home workforce and its relationship to quality. Our study examines this relationship for the first time in the UK. Quality is a complex, contested and dynamic concept: we have operationalised this concept using data collected at national and organisational levels to measure quality, as well as considering the views of quality of different stakeholders. We will present interim findings from this study’s work packages (due to complete in July 2020), including: (1) our review which has developed theoretical explanations of how, why and in what circumstances staffing promotes quality for residents and relatives; and (2) our observational study using routine administrative data sets at national and provider level. Key findings include the importance of experience and stability of care hoe staff, as well as how care is delivered (individual commitment, team reciprocity and organisational mandate).
USING ACCESSIBLE TECHNOLOGY TO SUPPORT CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Maslow Katie , Trudeau Scott A , Czaja Sara J
Published: November 2019

There is widespread enthusiasm about the potential of technology in general to support persons living with dementia and their families and other caregivers. At the same time, recommendations from the 2017 National Research Summit on Care, Services, and Supports for Persons with Dementia and their Caregivers emphasize the need for research to develop, evaluate, and disseminate specific technologies that can achieve meaningful benefits for well-defined subgroups of persons living with dementia and their caregivers, including individuals from diverse populations and individuals who live and receive care in various settings. This symposium focuses on specific home-based technologies to help family caregivers of community-living persons with dementia. Our three speakers will talk about research results for three different technology-related interventions, including: use of home video telehealth visits to help family caregivers provide effective dementia care and provide medical management; use of home video assessments by occupational therapists to help family caregivers increase home safety for community-living persons with dementia; and approaches for making a self-paced Home Safety Toolkit available to family caregivers of community-living veterans with dementia. Each speaker will report both positive outcomes, including family caregiver satisfaction, and barriers encountered in delivering the interventions. Such barriers include difficulties with the technologies as well as caregiver reluctance to change and costs that were not covered by health care insurance or health systems. Our discussant will respond to the presentations and solicit audience questions and discussion.
CAREGIVER EXPERIENCE OF TELEHEALTH-DELIVERED HOME SAFETY EVALUATIONS
Authors: Gately Megan
Published: November 2019

People with dementia are living in the community, necessitating in-home supports for their day-to-day needs. Given geriatrics work force shortages, innovative strategies that increase the reach of extant providers while maintaining quality are needed. Home-based video telehealth may increase access to specialty care such as a dementia-focused home safety evaluation by an occupational therapist; however, little is known about the technological demands and caregiver experience of a home safety evaluation delivered by telehealth. Our study employed video telehealth to deliver a dementia-focused home safety evaluation compared to in-person evaluation for caregivers (n=10) of veterans with dementia. Most video visits encountered technological problems. Caregiver experience between the video and in-person evaluations differed. Our findings reflect the highly dynamic, complex nature of in-home video telehealth which requires maximal collaboration with caregivers. By explicating the resource demands and potential burden of video telehealth for caregivers, development of effective in-home telehealth evaluation is enhanced
CORRELATES OF BREAST CANCER SCREENING BEHAVIORS AMONG INDIGENOUS WOMEN
Authors: Roh Soonhee , Lee Yeon-Shim , Lee Kyoung Hag , Jun Jung Sim
Published: November 2019

Cervical cancer remains a significant cause of morbidity and mortality among women globally; yet cancer burden is unevenly distributed among racial/ethnic groups. With 12,820 new cases in 2017 in the U.S., cervical cancer is the top cause of death among Indigenous women. Indeed, cervical cancer mortality rates among AI women in South Dakota are five times the national average and 79% higher compared to Whites in that region. This study examined predictive models of utilization of mammograms among Indigenous women adapting Andersen’s behavioral model. Using a sample of 285 Indigenous women residing in South Dakota, nested logistic regression analyses were conducted to assess predisposing (age and marital status), need (personal and family cancer history), and enabling factors (education, monthly household income, mammogram screening awareness, breast cancer knowledge, self-rated health, and cultural practice to breast cancer screening). Results indicated that only 55.5% of participants reported having had a breast cancer screening within the past 2 years, whereas 21.0% never had a mammogram test. After controlling for predisposing and need factors, higher education, greater awareness of mammogram, and higher utilization of traditional Native American approaches were significant predictors of mammogram uptake. The results provide important implications for intervention strategies aimed at improving breast cancer screening and service use among Indigenous women. Educating health professionals and Indigenous community members about the importance of breast cancer screening is highly needed. It is critical to assess a woman’s level of traditional beliefs and practices and its possible influence on screening participation and future screening intention.
META-SYNTHESIS: OLDER ADULT SURVIVORS’ RESILIENCE
Authors: Greene Roberta R , Cohen Harriet , Greene Nancy A , Hantman Shira
Published: November 2019

This paper presents the results of a meta synthesis of 8 qualitative studies that examined resilience among 270 older adult survivors following potentially traumatic adverse events (Bonanno, 2004). The primary data involved information about survivors’ critical events during the Holocaust , the Cambodian genocide, and the discriminatory practices of the Jim Crow U.S. South. A narrative approach to gerontology was used to collect and analyze the original data. known as a constant comparison data analysis ( Glaser & Strauss, 2009; Miles & Huberman, 1994). This allowed for the understanding of risks such as such as discrimination, imprisonment, genocide, and possible loss of life and the development of themes of resilience at the personal, interpersonal, sociocultural, and societal levels (Kenyon & Randall, 2001) The meta synthesis of secondary data involved coding the original findings, grouping them into descriptive themes, and generating new overarching analytical themes (Thomas & Harden, 2008). The most prevailing theme at the personal-level (internal feelings) was overcoming the grief of losing a loved one. Interpersonal-level themes (relationships between people) were related to staying connected to family. Sociocultural-level themes (the beliefs and mores of the time) centered on making meaning of a critical event within its historical context Societal themes (government and institutions) themes were indicative of being able to contribute or influence one’s current community. Implications for clinical practice and policy formation are provided.
LIFE SPACE MOBILITY AND NEIGHBORHOODS: HOW HOME MODIFICATIONS IMPACT AGING IN PLACE
Authors: DeLaTorre Alan , García Ivis , Reno Julianne , Kim Ja Young , Moore Keith Diaz
Published: November 2019

This presentation details a mixed methods study funded by the National Institute for Transportation and Communities that was conducted with 50 older adults aged 65 and older who lived in Portland, Oregon (n=25) and Salt Lake County, Utah (n=25). The purpose of the study was to improve understanding of how home modifications affect older adults’ mobility in different life-spaces (e.g., one’s bedroom, neighborhood), their understanding of aging in place and neighborhood, and their ability to age in place. During each home visit, a series of research protocols (i.e., surveys, interviews, mapping exercises) were carried out with each participant. The study found that home modifications (e.g., grab bars, replacing showers with bathtubs, and adding raised toilets) were reported to increase in-home mobility and, for some, their independence; however, for certain participants, those same modifications were less useful, especially to those with the need for caregiver supports. Life-space mobility outside the home was impacted by home modification such as ramps and railings on stairs; for some, those modifications bolstered social connections and access to services. Overall, home modification were seen as enabling both mobility and aging in place. Furthermore, respondents’ understanding and description of their neighborhoods varied greatly and were influenced by mobility barriers (e.g., presence of sidewalks and crosswalks) and available amenities.