bluuebunny/crossref_metadata_2025 huggingface dataset:
Research Participant Interest in Alzheimer’s Disease Biomarker Disclosure
Authors: Erickson Claire , Chin Nathaniel , Gleason Carey , Johnson Sterling , Clark Lindsay
Published: December 2020

Researchers can characterize the pathophysiological progression of Alzheimer’s disease (AD) even in the absence of symptoms. As we better understand the role of biomarker accumulation in the clinical manifestation of AD, disclosing personal biomarker information will become increasingly relevant. Yet, interest and preferences for AD biomarker disclosure are not well understood. We developed a 30-minute phone survey to gather information from Black and white participants on likelihood to enroll in biomarker disclosure studies, reasons for enrolling, and potential outcomes following a hypothetical positive result. Data were collected from cognitively healthy participants (n=334, mean age=64.8±7.7, 45% Black) enrolled in the Wisconsin Alzheimer’s Disease Research Center or Wisconsin Registry for Alzheimer’s Prevention. 49.7% of participants were very or extremely likely to enroll in an AD biomarker disclosure study. This result varied by biomarker method, with about half the sample very or extremely likely to enroll in PET scan disclosure (45.5%), fewer likely to enroll in cerebrospinal fluid disclosure (32.2%), and a majority likely to enroll in blood-based biomarker disclosure (86.2%). The most important reasons for learning biomarker results included informing lifestyle changes to help prevent dementia (82.9% responded very or extremely important) and knowing more about personal AD risk (69.1% responded very or extremely important). These results suggest that as biomarker collection method burden decreases, willingness to participate in a biomarker disclosure study increases. Further, personal dementia prevention and risk are a strong motivator for learning biomarker results. Moving forward, these results may inform AD biomarker protocol development.
Testing Cellular Proliferation Responses to Oxidative, Glucocorticoid and Metabolic Challenges in the Baboon
Authors: Adekunbi Daniel , Li Cun , Nathanielsz Peter , Salmon Adam
Published: December 2020

Aging is associated with progressive loss of cellular homeostasis which results from intrinsic and extrinsic challenges. Testing how such challenges relate to the aging process is often limited by the available model systems. We use primary cells (fibroblasts) isolated from baboons as a non-human primate cellular model to address how stressful challenges affect resilience. Using a real-time live-cell imaging system, we characterized a protocol for testing the effects of pro-oxidant compounds (e.g hydrogen peroxide (H2O2), paraquat and thapsigargin), dexamethasone and low glucose environment on cellular proliferation in fibroblasts derived from baboons across the life-course. The inhibitory effect of H2O2 (50 and 100µM), an oxidative stress, on cell proliferation was dose-dependent, with a higher impact in old males (age 14.52-14.80 years; average life span 21 years) compared to young males (6.35-6.39 years). Exposure to a different oxidative stress, paraquat (100 and 200µM) tended to reduce cell proliferation rate with age in males but not females. Inhibitory effects of thapsigargin, an endoplasmic reticulum stress inducer, on cell proliferation were dependent on challenge duration (2 vs 24h), concentration (0.1 and 1µM) and donor age, with greater resilience in young males than young females (4.33-6.70 years). Dexamethasone (100 and 500µM), a glucocorticoid, reduced cell proliferation dose-dependently, with older males exhibiting more resilience than females. In response to low glucose (1mM), cell proliferation reduced with age. Donor’s chronological age and sex are important variables in cellular response to challenge compounds faced during aging, which will guide our on-going studies on the cellular transcriptome and proteome.
The Association between Environmental Factors, Race, and Cognitive Status
Authors: Cheung Ethan Siu Leung , Mui Ada
Published: December 2020

Based on the data from National Social Life, Health and Aging Project, Wave 3, this study examined two research questions: what is the role of race in predicting cognitive status? and what are predictors of cognitive status between white and black older adults? Cognitive status was assessed using the 18-item survey-adapted Montreal Cognitive Assessment. Using the ecological framework, correlates of cognitive status were conceptualized in three levels of environments: micro- (personal health), meso- (social relationship), and macro-environments (community characteristics). Hierarchical regressions analyses were employed. Findings indicated that 83% of the sample (n= 2,829) were whites and the mean age was 72.95. Bivariate analyses suggested significant racial differences in cognitive status, marital status, income, education, health, social relationship, and community characteristics. Additive and interactive models showed that race had an independent effect as well as joint effects with the three levels of environments in explaining cognitive status. Parallel regression analyses for each racial group were undertaken and models were significant (P < .0001). In two separate models, common predictors for better cognition included being younger, more educated, fewer IADL impairments, and less depression. For older whites, unique correlates for better cognition were being female, higher income, sense of control in life, safer community, and neighbor relations. The only unique correlate for older blacks to have better cognition was community cohesion. Results provided insights on racial differences in cognition experienced among community-dwelling older Americans, and emphasized the need for social programs that promote race-sensitive, age-friendly communities to protect against cognitive decline.
The Effect of Midlife Cardiovascular Risk Factors on Cognitive Function Nearly Half a Decade Later
Authors: Warren Teresa , Pahlen Shandell , Xian Hong , De Anda Jennifer , Kremen William , Franz Carol
Published: December 2020

Several cardiovascular risk factors (CVRFs) have been associated with poor cognitive function. However, few studies have examined these factors longitudinally during midlife. We hypothesized that more midlife CVRFs would predict worse cognitive function approximately six years later. Participants were 886 men who participated in waves 2 and 3 of the Vietnam Era Twin Study of Aging. The American Heart Association’s “Life’s Simple 7” index was used to measure CVRFs. CVRFs were assessed at mean age 61 (range 55-66) and included smoking, physical activity, diet, body mass index, cholesterol, glucose, and blood pressure. Each factor was coded on a 3-point scale (0-2), ranging from poor to ideal status. These scores were then used to create a composite CVRF index (0-14). We examined several cognitive domains assessed at mean age 67 (range 61-73): abstract reasoning, episodic memory, processing speed, executive function, working memory, general verbal fluency, and semantic fluency. Analyses were adjusted for ethnicity, and education, and mean age 61. In the generalized estimating equation models, there were significant main effects indicating that the CVRF index at mean age 61 significantly predicted cognitive function at mean age 67 in episodic memory, 95% CI [.01, .08], p = .01, processing speed, 95% CI [.02, .09], p = .01, and executive function, 95% CI [.00, .06] ], p = .03. The CVRF index did not predict cognitive function in the other cognitive domains. These results suggest that poor cardiovascular health in late midlife may exacerbate cognitive decline.
An Assessment of Attendee Experiences With a Workshop to Reframe Aging-Related Communications
Authors: Chesser Stephanie , Porter Michelle
Published: December 2020

The Centre on Aging at the University of Manitoba adapted the FrameWorks Institute’s Gaining Momentum toolkit into an interactive workshop that was delivered to aging-related stakeholders (e.g., health professionals, educators, researchers, advocates, older persons) across the province of Manitoba, Canada. The purpose of this study was to complete a qualitative assessment of attendee experiences with the workshop and its impact, if any, on their aging-related communication behaviors. Study participants recruited from four communities (two urban, two rural) completed two telephone interviews—one approximately two weeks and one approximately three months post-workshop—about their experiences, motivations for attending, and short and long-term communication goal setting. Through the interviews, most participants expressed positive experiences with the workshop content, as well as an enjoyment of its interactive elements (e.g., self-introduction activity, reframing short and long form aging-related communications, group feedback). Several also shared specific examples of how workshop content was influencing their short/long-term aging communication strategies. Some participants, however, also identified ways that local culture could impact the interpretation of and, thus, potential success of workshop language and/or framing recommendations in specific communities. Overall, the findings from this study suggest that the Gaining Momentum workshop was a valuable experience for attendees that inspired critical assessment of, and changes to, the ways they communicated about aging in their professional and personal lives. Future research is warranted to explore the ways its content could be adapted to better meet the unique communication considerations within the province of Manitoba (e.g., cultural, geographic, and language-related implications).
Spatial Analysis of Healthcare Offer and Request for Older People Aged 65 Years and Over in Quebec
Authors: Duc Juliette , Barbat-Artigas Sébastien , Bosson-Rieutort Delphine
Published: December 2020

With years, the health-needs of an individual become numerous and more complex, resulting in the requirement of an even more appropriate offer of health services. However, it is known that different factors make the services and the request of the population to health care unequally, especially the interregional variations. These are represented by a gap between the offer of healthcare and the need of the populations. The aim of this study was 1) to map the relationship between the location of the healthcare services in Quebec and population aged 65 years and over, and 2) to identify the characteristics related to the geographic variations in access to healthcare. We used data from “statcan.gc.ca”, “donneesquebec.ca” and “msss.gouv.qc.ca” regarding the facilities, their capacity, their services, and the populations’ characteristics. Analyses were performed on QGIS and R software. As expected, our results showed that there is a gap between the healthcare needs and the services: older people need a large amount of diverse services which are not always provided by secluded areas. Moreover, it also appeared that the deprivation index is related to the offer of health care. As this project takes part in a global project studying the health care trajectories of older people in Quebec using their administrative health databases, those findings will help better understand the impact of the geographic factors for the interregional variations of healthcare.
Impact of Age on Community Diabetes Prevention Program Attendance and Weight Loss Goals
Authors: Napoleone Jenna , Strotmeyer Elsa , Miller Rachel , Devaraj Susan , Rockette-Wagner Bonny , Arena Vincent , Venditti Elizabeth , Kriska Andrea
Published: December 2020

The Diabetes Prevention Program (DPP) lifestyle intervention demonstrated that meeting the weight loss (WL) and activity goals prevents/delays type 2 diabetes. Older DPP participants, 60-85 years, reduced the risk of developing diabetes by 71% versus 58% in those <60 years. Currently, community translated DPP-based lifestyle interventions including Group Lifestyle Balance (DPP-GLB), are reimbursed by Medicare for overweight/obese older adults with prediabetes. This effort examined the impact of age group (60-65: reference, 66-70, ≥71 years) on both DPP-GLB maintenance session attendance (months 7-12) and achieving the 5% WL goals at 6- and 12-months. Data were combined from two identical 12-month DPP-GLB intervention trials involving overweight/obese adults with prediabetes and/or metabolic syndrome. Participants ≥60 years attending ≥4 sessions (months 0-6), with complete data on session attendance and WL were included (n=145; age=68.7 + 5.8 years, range 60-88; 79% women). Participants aged 66-70 years (N=46) were more likely to meet the 6-month 5% WL goal (67.4%) vs. 60-65 years (N=51; 45.1%; p=0.03). Participants aged 66-70 (69.6%) and ≥71 years (N=48; 60.4%) were more likely to meet the 12-month WL goal vs. 60-65 years (35.3%; 66-70: p=0.0007; ≥71: p=0.01). Maintenance attendance did not vary by age group with approximately 30% of each group attending ≥4 of 6 maintenance sessions (p=0.55). In conclusion, adults 66+ vs. 60-65 years more successfully met the clinically meaningful 5% WL goals at 6 and 12 months. With nationwide implementation of community-based “real-world” DPP-GLB lifestyle interventions, better understanding of program success across older adult age groups will enhance program reach and effectiveness.
Moderating Effect of Race and Ethnicity Between Technology Use and Social Isolation
Authors: Cho Sunghwan , Buckley Tommy , Kim Kyeongmo
Published: December 2020

Social isolation among older adults has brought about poor outcomes of their health and well-being. Information and Communication technology (ICT) is known to alleviate social isolation of older adults. However, it is unknown how ICT access and use are associated with social isolation by race. This study examined the association of ICT and social isolation from the National Health and Aging Trends Study (NHATS), estimating moderating effects of race and ethnicity. The sample for this study was community dwelling Medicare beneficiaries aged 65+ (n=5,567). An index for ICT was formed from five domains: social network websites, email and texting, working cellphone, tablet devices and online computer use (range 1-5, mean=3.96, SD=0.927), and social isolation was derived from responses to five areas: living arrangement, attending religious activities, numbers of important people to talk with, attending other activities such as club participation and volunteer work (range=0-2, mean=1.74, SD=0.927). Race and ethnicity included White (69.6%), African-American (20.7%), Hispanic (5.5%) and Asian/Pacific Islander (2.5%). Multiple linear regression was used using a moderating effect of race/ethnicity, including relevant covariates. Findings revealed increased ICT use was associated with lower social isolation (b=0.05, p<0.05), and race/ethnicity was a significant moderator in the association between ICT and social isolation for African-Americans (b=0.08, p<0.05) and Hispanics (b=0.15, p<0.05) compared to White older adults. The findings indicate that racial differences should be considered when applying technology use to reduce older adults’ social isolation. Practitioners can provide racially competent ICT services for older adults interested in tech-based communication.
Adding Life to Years: Adopting Age-Friendly Public Health in Washington State
Authors: Ham Carolyn , Getz Marci , Bardi Janna
Published: December 2020

Age-Friendly Public Health is an emerging concept and practice aiming to equip the public health infrastructure to more readily address aging issues. In 2019, the Washington State Department of Health (WA DOH), began operationalizing Age-Friendly Public Health within the agency. Work entailed bringing together a cross-agency workgroup on healthy aging and drawing on expertise from agency programs including environmental health, immunizations, falls prevention, emergency preparedness, chronic disease and many others. The workgroup conducted an internal assessment of ‘touch points’ regarding aging work within WA DOH. The Life Course Perspective was used as a theoretical framework to categorize current efforts, and existing research on social determinants of health in aging were used to identify potential areas for future impact. In addition, the Healthy Brain Initiative (HBI) Road Map for public health was used to identify current and potential approaches to addressing Alzheimer’s Disease and Related Dementias. This workgroup inventoried WA DOH’s current efforts that align with the HBI agenda, and identified 88 opportunities to promote healthy aging and brain health. This work contributes to the emerging field of Age-Friendly Public Health by demonstrating strengths and challenges of advancing healthy aging through state public health agencies.
Bringing Older Adults to the Table: Opportunities for Consumer Engagement in Planning and Policy Making
Authors: Prendergast Alice , Fuller Kristi
Published: December 2020

Efforts to include community voice in health policy and service planning are gaining recognition and support in the United States. Findings suggest community involvement can contribute to a better understanding of systems and factors that impact health, and, subsequently, more effective and sustainable policy and program design. Additionally, engagement can increase community buy-in, and community members can gain a greater awareness of services; increased confidence navigating systems; feelings of social connectedness; and capacity to advocate around issues through participation. Despite these findings, the extent to which community members are engaged in planning and decision-making varies considerably. Researchers from Georgia State University conducted a review of state plans on aging using the Person-Centered Outcomes Research Initiative (PCORI) Engagement Principles and the Health Research & Educational Trust’s Community and Patient Engagement Spectrum as frameworks to assess evidence of community engagement. The frameworks recognize engagement throughout the planning process, including design, data collection and interpretation, and dissemination. The review revealed that few planning processes described significant engagement, but rather met the minimal requirements established by federal policy. Federal guidance on community-informed planning practices is sparse, as are resources to support states in adopting these processes. To address this gap, the research team drew on the frameworks and other promising practices to design two community engagement projects, both in partnership with Georgia’s Division of Aging Services. Methods for participant engagement, data collection, interpretation and application of results, and lessons learned through both projects will be discussed, as well as potential implications.
Economics Risks of and Growth of the High Deductible Health Plan Among Patients With Cognitive Impairment
Authors: Lu Kevin , Li Sam , Yuan Jing , Li Minghui
Published: December 2020

OBJECTIVES: High Deductible Health Plan (HDHP) is characterized by higher deductibles and lower monthly premiums. Nevertheless, health economists are concerned that HDHPs may reduce or delay needed care, which will ultimately lead to poorer access to care for chronically affected participants. The objectives of this research are 1) to investigate the HDHP enrollment trend over the past decade; and, 2) to determine the effects of HDHP on risks of financial access risks among adults with cognitive impairment (CI). METHODS: Data were obtained between 2010-2018 from National Health Interview Survey (NHIS). Financial access to healthcare was assessed based on 6 survey questions by CDC. For data analysis, simple T tests and Chisq tests were used where appropriate, with multi-variable logistic regressions implemented to evaluate the effects of HDHP on risks of financial access. RESULTS: Of the 103,649 enrollments, 1,148 were with cognitive impairment and 102,501 were without CI diagnosis. A 55% increase in HDHP registers with cognitive impairment was observed from 2010 (30.50%) to 2018 (47.24%). After controlling for confounding variables, patients with HDPHs were more likely to have risks of financial access compared to those without HDHP (OR= 1.313, 95% CI, 1.002-1.719, p=0.0483). CONCLUSIONS: HDHPs are intended to support effective care options and reduce health care costs. Our research among CI patients with HDHP experienced more financial access risks than those without HDHP, indicating that HDHPs might have unintended consequences of healthcare usage. Employers and health care decision-makers may need to consider providing compensation to those HDHP enrollers with CI.
Social Characteristics, Health and Mortality among Male Centenarians using Veterans Affairs (VA) Healthcare
Authors: Gagnon Lien Quach David , Dugan Elizabeth , Cho Kelly , Gaziano Michael , Spiro Avron , Ward Rachel , Driver Jane
Published: December 2020

Studying health and mortality among centenarian Veterans is critical to understanding the limit of the male human life span and Veterans’ extraordinary model of successful aging. The majority of VA users are male, but little is known about social characteristics and health among male centenarians in general. We investigated the annual mortality rate of male centenarian Veterans seeking care from the VA and identified social characteristics and health conditions that influenced the risk of mortality. This longitudinal study used VA Electronic Health Record (EHR) data from 1997 – 2012 (n=1858). Dates of death were obtained from the EHR, aggregated by the Corporate Data Warehouse from multiple sources. Independent variables included age, race, marital status, and periods of military service. Health conditions consisted of cancer, congestive heart failure (CHF), diabetes, chronic renal disease, chronic pulmonary disease, peripheral vascular disease, dementia, myocardial infarction, liver diseases. The mean age was 100.4 (range: 100-115), 76% were white and 49% married. The average annual mortality rate was 32 per 100 person-years. The annual mortality rate was stable and not affected by race, but did differ by marital status. Divorced or separated centenarians had a 21% higher rate of death than married centenarians [Hazard Ratio (HR):1.21, 95% CI 1.07 - 1.36]. A diagnosis of dementia increased the mortality risk by 37% (HR: 1.37, 95% CI: 1.04 - 1.81) and CHF by 37% (HR: 1.37; 95% CI: 1.13 - 1.66). Providers should consider prevalent health conditions, as well as marital status, in managing care of centenarian veterans.
Money Follows the Person and Informal Caregivers: Insights Into a New Stage of the Caregiving Career
Authors: Robison Julie , Shugrue Noreen , Fabius Chanee , Fortinsky Richard , Porter Martha , Baker Kristin
Published: December 2020

The Money Follows the Person (MFP) program transitions people to the community after extended institutional stays. This study examines effects of this transition on informal caregivers in this new caregiving career stage. Analyses explore whether and how MFP affects caregivers according to caregiver race/ethnicity, and care recipient age and disability type. Data come from surveys with 686 caregivers of persons in Connecticut’s MFP from November 2014-November 2018. Using Pearlin’s Caregiver Stress Process Model, bivariate and multivariate analyses examine predictors of multiple caregiver well-being indicators. Care recipients: older adults (50%), and younger persons with physical (35%), mental health (8%) or developmental (7%) disabilities. Caregivers: non-Hispanic White (62%), non-Hispanic Black (24%), and Hispanic (14%). Caregivers’ average assistance is 5 days/week, 6 hours/day, with 3 activities of daily living and 5 instrumental activities; 11% are paid for caregiving. Compared to other community-based samples, they report low mean levels of burden (4.7 of 16), anxiety (2.2 of 18) and depressive symptoms (31%), and high positive feelings about caregiving (9.5 of 12). A majority feel less stressed (60%) or no change in stress (20%) compared to before and during the institutional stay. Caregivers across the four care recipient groups don’t differ on most outcomes, although more caregivers of people with developmental disabilities (82% vs. 55-61%) report less stress once the person transitions. Black and Hispanic caregivers report more intensive caregiving, but White caregivers report more burden and subjective stress. Findings illustrate the benefits of programmatic support during a newly defined post-institutionalization caregiving career stage.
Patterns of Court Monitoring of Guardianship Practice in Iowa
Authors: Swenson Tami
Published: December 2020

Guardianship, as a best practice, should provide persons with medical incapacity support for better medical care decision making, but the examination of health outcomes for those under guardianship has a dearth of evidence in practice and within the research literature. This study addresses this gap by using the publicly-available Iowa Courts online database to collect data elements useful for the investigation of the process of guardianship practice. A systematic random sample using the 99 counties within Iowa as strata was extracted for all open guardianship cases. Most of the sampled cases (96%) had private appointed guardians. Approximately 28% had case histories over 10 years, 26% 5 to 10 years, 12% 3 to 5 years, 22% 1 to 2 years, and 12% were open cases for fewer than 12 months. Court monitoring of medical conditions varied with annual, biannual, triennial, or 5 year requirements. Delinquencies in filing required medical condition documentation was common and over half of all cases had at least one delinquency in their case history and 33% had a filing delinquency within the past 2 years. Local judicial courts vary in the amount of supervision they provide guardians, and the findings from this research provide needed research to inform guardianship practices as demand increases for these services with the demographic imperative of an aging population and increasing prevalence of dementia-related health conditions.
Changes in Physical Activity during COVID-19 Pandemic in Urban and Rural Older Veterans and their Cohabitants
Authors: Wu Chao-Yi , Wall Rachel , Beattie Zachary , Mattek Nora , Kaye Jeffrey , Dodge Hiroko , Silbert Lisa
Published: December 2020

Background: The COVID-19 pandemic has changed the health security of older adults. Few have examined how older US veterans have reacted and coped with the COVID-19 pandemic. We aimed to identify changes in physical health and their differential impact by rurality of older veterans. Method: Participants were veterans (aged ≥ 62 years) and their cohabitants, living in the Pacific Northwest, enrolled in the Collaborative Aging Research using Technology (CART) initiative. Daily step counts via actigraphy were collected from January 1st to July 8th, 2020. COVID-19 time periods were determined by stay-at-home orders issued on March 13th, 2020. Generalized estimating equation models were used to examine changes in physical activities associated with COVID-19 time periods and rurality indicated by the rural-urban commuting area score. Results: A total of 102 participants were included in the analysis (mean age = 71.0 years, 56% male, 32 living in urban areas). Daily average step counts were 2318 and 3012 before and after COVID-19 stay-at-home orders (t=4.85, p<.001). After controlling for covariates, participants living in large rural (β=.26, p=.03) and small/isolated areas (β=.23, p=.02) walked more than those living in urban areas after COVID-19 stay-at-home orders. Conclusion: Older adults cope differently during the COVID-19 pandemic based on rurality, with those living in large rural and small/isolated rural areas have an increased physical activity. Reasons for increased step counts (e.g., mood, visitors, size of the house) require further investigation. This result demonstrates the potential utility of real-world monitoring to objectively inform interventions for COVID-related secondary health changes.
COVID-19 Worries and Behavior Changes in Older and Younger Men and Women
Authors: Barber Sarah , Kim Hyunji
Published: December 2020

The case fatality rate of COVID-19 is higher among older than younger adults, and is also higher among men than women. However, worry, which is a key motivator of behavioral health changes, occurs less frequently for older than younger adults, and less frequently for men than women. Building on this, we tested whether older adults – and particularly older men -- would report the least amount of COVID-19 worry and also fewer COVID-19 behavior changes. To do so, from March 23-31, 2020, we administered an online questionnaire assessing COVID-19 perceptions, worries, and behavior changes. Participants were a convenience sample of United States residents, who were community-dwelling younger adults (18-35) or older adults (65 to 81). Analyses included 146 younger adults (68 men, 78 women) and 156 older adults (82 men, 74 women). Participants was predominately White, living in suburban/urban areas, and had completed some college. Our results showed that during the early phase of the outbreak in the United States, older adults perceived the risks of COVID-19 to be higher than did younger adults (e.g., thought COVID-19 was different than the flu). Despite this, older men were comparatively less worried about COVID-19 than their younger counterparts. Compared to the other participants, older men had also implemented the fewest behavior changes, such as wearing a mask. These tesults suggest that interventions are needed to increase COVID-19 behavior changes in older men. These results also highlight the importance of understanding emotional-responses to COVID-19, as these are predictive of their behavioral responses.
COVID-19-Related Free Telephone Consultations by Public Health Nurses
Authors: Sumikawa Yuka , Honda Chikako , Yoshioka-Maeda Kyoko , Iwasaki-Motegi Riho , Yamamoto-Mitani Noriko
Published: December 2020

Public health centers are located in each municipality in Japan and are responsible for infectious disease control including COVID-19. Public health nurses (PHNs) are stationed at the centers and work at the forefront, covering a variety of services from individual consultations to hospital escort for those tested positive. Starting January, PHNs at A city (population approx. 210,000) established a free telephone consultation hotline for COVID-19. This study aims to review the PHNs’ telephone consultations during the first wave of COVID-19. The number of calls were aggregated weekly and their time-trend was examined. The study was approved by the University of Tokyo Ethics Review Board. During the first wave between January and May, there were 3,242 calls, with the highest number of calls (n=491/week) in the second week of April. At this point the regular PHNs were not enough to meet the hightened needs of consultations and PHNs from other departments were temporalily transferred for support. The number of consultation calls fluctuated weekly. The increase of calls seemed to preceed the increase of positive cases by one week. We consider that the call may be an initial action of those who suspected possible infection, and the consultation by the PHN might have led them to proper clinic visits and PCR testing. Telephone consultation is an easy tool to use for general public, especially older persons. Having health professionals respond directly to calls may have had the advantage of providing appropriate guidance for infection control and PCR testing and mental support.
Evaluating Service-Learning with Older Adults on Undergraduate College Students During the COVID-19 Pandemic
Authors: Merkin Sharon
Published: December 2020

Introduction: Students in the Frontiers in Human Aging course at UCLA participate in service-learning (SL) with older adults. In 2020, completion of SL coincided with the outbreak of the novel coronavirus disease (COVID-19) pandemic. We evaluated the impact of SL on student attitudes on aging and community service in the context of the pandemic. Methods: Students were assigned to senior residential and daycare programs for 18-20 hours of SL. A retrospective pretest-posttest survey asked about attitudes and interests before and after SL and how the COVID-19 pandemic affected these perceptions; 73 (of 103) students responded. Mean differences before and after SL were tested and differences were assessed within groups reporting COVID-19 effects. Results: SL improved students’ attitudes and ability to engage with older adults, knowledge about aging concepts, interest in future work with older adults, attitudes on community service, social well-being and feelings of usefulness (p<0.001). There was no significant change in overall anxiety about aging (p=0.1), however, students showed increased anxiety about losing independence and finances when older (p<0.05). At least 50% of students reported that the COVID-19 pandemic increased their awareness of needs of older adults (81.9%) and decreased connection to their peers (50.7%); the impact of SL remained unchanged by these effects. Conclusion: Despite the overall benefits of SL, increased anxiety about aspects of aging suggests the need to address these concerns. While the COVID-19 pandemic did not seem to affect the impact of SL, this event did seem to influence perceptions about aging and social integration.
Examining the Impact of the COVID-19 Pandemic on Psychosocial Outcomes across Age: A Stress and Coping Framework
Authors: Minahan Jillian , Falzarano Francesca , Yazdani Neshat , Siedlecki Karen
Published: December 2020

The emergence of COVID-19 and the measures implemented to curb its spread are anticipated to have long-term implications for mental health. Older adults may be at increased risk for adverse mental health outcomes as opportunities to remain socially connected have diminished. Further research is needed to better understand the impact of pandemic-related stress on mental health. Utilizing the stress and coping framework, the purpose of this study is three-fold: 1) to examine the influences of COVID-19-related stress on depression, anxiety, and loneliness, 2) to assess the mediating role of coping style and social support, and 3) to investigate whether these relationships vary across age. Participants (N = 1,318) between the ages of 18-92 years completed an online survey, assessing pandemic-related stress, mental health, social support, coping, and their experiences with social distancing, during the initial implementation of social distancing measures in the United States. Stress, social support, and coping style were related to psychosocial outcomes. Results suggested that avoidant coping mediated the relationship between pandemic-related stress and psychosocial outcomes, particularly depression. Avoidant coping more strongly mediated the relationship between stress and depression in younger adults compared to older adults. Results were consistent with the stress and coping framework and recent work highlighting the older adults’ resilience during the COVID-19 pandemic. Findings highlight the associations between positive coping behaviors and psychosocial well-being and indicate that older adults may use unique adaptive mechanisms to preserve well-being during the COVID-19 pandemic.
Trends in Mortality in Puerto Rico Between 1979 and 2018: An Analysis of the Puerto Rico Healthcare Reform
Authors: Santos Alexis
Published: December 2020

Between 1993 and 2000, the Government of Puerto Rico decided to transform the role of the government from a provider of healthcare to an insurer. Despite claims about the success of the reform, no study has assessed whether it improved the health of the population or reduced mortality. The aim of this study is to assess whether the implementation of the Puerto Rico Healthcare Reform of 1993 reduced mortality and infant mortality in Puerto Rico in a significant way. I calculated crude death rates (CDR), age-standardized death rates, infant mortality rates, total deaths and life expectancy between 1980 and 2018. I used a quasi-experimental design to study the effect of the implementation of the Puerto Rico Healthcare Reform on these indicators. The primary objective was to estimate changes in trends after 2000. The Age-Specific Mortality Rates have reduced since 1980. The least pronounced change for 2018, in comparison to 1980, was for young adults (20-24 years, 25-29 years, and 30-34 years). The CDR was affected based on the implementation of the reform, but the Infant Mortality Rates was not. The Standardized Death Rate and deaths indicate that there was a small reduction in these indicators. I also found that the gains in life expectancy were concentrated in older adults (aged 65 and older). Analysis of all-cause mortality indicators allows for the evaluation of this healthcare reform. The reduction in mortality in the post-2000 period was not entirely due to the trend that existed before the healthcare reform was implemented.
How Age Affects Personal and Social Reactions to COVID-19: Results from the National Understanding America Survey
Authors: Kim Jung Ki , Crimmins Eileen
Published: December 2020

The pandemic of COVID-19 has had tremendous impact on Americans’ lives including their personal and social behaviors. While everyone is affected in some way by the pandemic, older persons have been far more likely to suffer the most severe health consequences. For this reason, how people have responded to the COVID-19 outbreak may differ by age. Using a nationally representative sample from the Understanding America Study (UAS), we examined differentials in behavioral responses to COVID-19 by age and how they change over time. At the beginning of the pandemic (March, 2020), older people were less likely than younger ones to engage in preventive behaviors. As the pandemic progressed, however, older people have adopted healthy behavioral changes more than younger people, such that about two months after the pandemic started, older people were more likely to comply with suggested and regulated behaviors including practicing better hygiene, quarantining, and social distancing. Even when considering other potential influences on behavioral responses, older age was significantly related to performing more preventive behaviors, and gender, racial/ethnic minority status, perceived risk for infection and dying and political orientation were also found to be related to people’s behavioral responses.
Living Alone During COVID-19: Social Contact and Emotional Well-Being among Older Adults
Authors: Ng Yee To , Fingerman Karen , Zhang Shiyang , Britt Katherine , Colera Gianna , Birditt Kira , Charles Susan
Published: December 2020

The COVID-19 outbreak and the associated physical distancing measures dramatically altered the social world for most older adults, but people who live alone may have been disproportionately affected. The current study examined how living alone was related to social contact and emotional well-being among older adults during the pandemic. Adults (N = 226) aged 69+ completed a brief survey assessing their living situation, social contact with different social partners (in person, by phone, electronically), and emotions during the morning, afternoon and evening the prior day. Older adults who live alone were less likely to see others in person or to receive or provide help, and reported less positive emotion the prior day than those who lived with others. Living alone was associated with more positive emotions concurrent with in-person contact. In contrast, phone contact was related to higher levels of negate affect among those living alone, but not among those who live with others. Findings suggest older adults who live alone may be more reactive to social contact during the COVID 19 outbreak than older adults who reside with others. In-person contact appears to confer distinct benefits not available via telephone contact, suggesting that possible interventions during the pandemic may work best with safe forms of in-person contact.
Recombinant SARS-CoV-2 Spike Protein Mediates Glycolytic and Inflammatory Activation in Human Monocytes
Authors: Pence Brandt
Published: December 2020

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) in part through cytokine storm. Metabolic reprogramming in immune cells mediates inflammation, and recent evidence suggests SARS-CoV-2 activates glycolysis in monocytes to facilitate cytokine production. In this study I investigated the ability of the spike protein (subunit 1) from SARS-CoV-2 to cause glycolytic reprogramming and inflammatory activation in isolated human monocytes. Primary human monocytes were isolated from healthy young donors (N=4) by immunomagnetic negative selection and stimulated with recombinant SARS-CoV-2 spike protein subunit 1 (rS1) for 6 hr. Glycolysis was monitored by assessing extracellular acidification using a Seahorse assay. Supernatants and cell lysates were subsequently processed for gene and protein expression assays by qPCR and ELISA respectively. Treatment of monocytes with rS1 at 10 nM and 30 nM led to significant upregulation of glycolysis, as well as a substantial increase in gene and protein expression of interleukin-6. Mouse bone marrow-derived macrophages did not display enhanced glycolysis when stimulated with rS1, suggesting a specific interaction of the protein with the ACE2 receptor, rather than a general inflammatory response caused by contamination with endotoxin or similar. Glycolytic activation in monocytes in response to rS1 suggests that immunometabolic modulators, including common geroprotectors such as rapamycin and metformin, may have efficacy in treating COVID-19.
Health Access and Outcome Differentials Among Older Adults Age 50 Years or Above in Ghana
Authors: Yale Kodwo-Nyameazea , Amponsah Nana Akua
Published: December 2020

Health outcomes are substantially influenced by demographic and socioeconomic indicators. Their presence or absence can act to boost or curtail health opportunities and outcomes. These health indicators are often not evenly distributed across geographic regions. The focus of this study is to explore how Ghana’s north-south regional divide manifests in the health outcomes of its people. The study was based on a data from the Research on Early Life and Aging Trends and Effects (RELATE), a harmonized cross-sectional dataset with 147,278 respondents from 14 countries including Ghana. This study pooled 4724 respondents from Ghana aged 50 years or above. The study found that several demographic and socioeconomic indicators had significant associations with optimal health. However, most of the associations were attenuated after other variables in the model were controlled. Specifically, the study found that being a male gender and doing rigorous work were risk factors for living below optimal health in both the North and South regions. However, using healthcare services and being single or unmarried were protective factors but only in the South region. The results of the study also showed that indicators for good health generally favored the South region but the North region reported higher self-rated health score, smaller proportions of overweight and obese residents, fewer numbers of chronic health conditions, and a smaller proportion of resident living below optimal health. This finding demonstrates that the link between positive health indicators and healthiness has subtle nuances that could be attributed to how people conceptualize health and healthiness.
Predictors of Breast Cancer Screening Behaviors Among American Indian Women in the Northern Plains
Authors: Roh Soonhee , Lee Yeon-Shim , Moon Heehyul
Published: December 2020

Purpose: This study examined predictive models of the utilization of mammograms among American Indian women adapting Andersen’s behavioral model. Using a sample of 143 American Indian women residing in the Northern Plains. Methods: Data were collected using a self-administered survey completed by 143American Indian women over the age of 45 in the Midwest. 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: Nested logistic regression analyses 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. Conclusions: The findings highlight important implications for intervention strategies aimed at improving breast cancer screening and service use among American Indian women. Educating health professionals and American Indian 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. Given the findings, prevention and intervention strategies, including public awareness and education about breast cancer screening are promising avenues to reduce screening disparities among American Indian women.
Older Adult Cohousing Communities: The Lived Experience
Authors: Cummings Sherry , Kropf Nancy
Published: December 2020

“We’re on the leading edge of the baby boomers so we don’t do anything like anybody has ever done before and that includes aging.” (Tammy, SS). This quote embodies the perspective of older adults engaged in a new housing phenomenon – older adult cohousing communities (OACCs). OACCs are designed, managed, governed and maintained by the older residents themselves. Seventeen such communities currently exist, and more are being developed by active baby boomers who are searching for more meaningful, relational and eco-friendly options for aging-in-place. The older adult cohousing movement in the U.S., which began in 2005, is small but growing quickly. However, a dearth of literature exists on this phenomenon. This qualitative study examined older adult cohousers’ lived experiences. The study employed an existential-phenomenological research method. Maximum variation purposive sampling was employed. Twelve communities were identified that represented the full range of geographic environments, structures, missions, cost and size. Interviews were conducted individually or in focus groups. In all, 73 older adult cohousers participated in the study. The Gerotranscendence Theory of Aging was used to guide the development of the structured interview questions and to organize data analysis and interpretation. Digital recordings were transcribed, and an inductive method was used to allow codes and themes to arise from the data itself. Patton’s (1990) criteria for judging themes was employed. This poster will clarify the nature, principles and structure of OACCs. Themes that emerged from the study - benefits, challenges, aging-in-place, interpersonal relationships and personal growth - will be described .