bluuebunny/crossref_metadata_2025 huggingface dataset:
THE LONGITUDINAL RELATIONSHIPS BETWEEN SOCIAL ISOLATION AND HEALTH OUTCOMES: THE ROLE OF PHYSICAL FRAILTY
Authors: Mehrabi Fereshteh , Béland François
Published: December 2022

Social isolation is a public health issue that is linked to poor health outcomes. However, the mechanisms underlying this association remain unclear. The main objective of this study was to explore whether changes in frailty moderated the relationship between changes in social isolation and changes in health outcomes over two years. We examined the mediating role of changes in frailty when the moderation hypothesis was not supported. A series of latent growth models (LGMs) were used to test our objectives using data from three waves of the FRéLE study among 1643 Canadian community-dwelling older adults aged 65 years and over. Missing data were handled by pattern mixture models with the assumption of missing not at random. We measured social isolation through social participation, social networks, and social support from different sources of social ties. We assessed frailty using the Fried frailty phenotype. Our moderation results revealed that high levels of changes in social participation, support from friends, nuclear, and extended family members, and social contacts with friends were associated with greater changes in cognitive and mental health among frail older adults with diminished physiological reserves compared to robust older adults. Additionally, changes in frailty mediated the effects of changes in social participation and social contacts and support from friends on changes in chronic conditions. This longitudinal study suggests that frailty moderated the relationships between social isolation and mental and cognitive health but not physical health. Overall, social support and strong friendship ties are key determinants of frail older adults’ health.
THE EFFECT OF COMMUNITY HEALTHCHOICES ON USE OF HOME AND COMMUNITY-BASED SERVICES
Authors: Kastner Keri
Published: December 2022

Medicaid claims data for the years 2013 to 2020 were analyzed to examine use of common categories of home and community-based services (HCBS) as well as the proportion of people living in nursing homes as opposed to receiving long-term services and supports in the community. There was a long-term trend prior to Community HealthChoices of a shift the locus of LTSS away from nursing homes. The implementation of managed care to deliver LTSS continued, but did not appear to accelerate this trend. However, MLTSS did appear to control to growth in hours of personal care per person both in the aggregate and longitudinally within the same individuals over time. There were decreases in the use of adult day services and home delivered meals. However, the decline in home delivered meals was more than offset by an increase in uptake of the supplementary nutritional assistance program (SNAP).
THE IMPACT OF COMMUNITY HEALTHCHOICES ON PERSON-CENTERED SERVICE PLANNING
Authors: Yauch John
Published: December 2022

Person-centered service planning (PCSP) is a required component of home and community-based services programs that operate under Medicaid waivers. CMS requires that states have processes in place to assure that participants and their family members (as desired and appropriate) are involved in decisions about their care. This mixed-method study combines interviews with participants and qualitative service coordinators regarding the PCSP process. Participant interviews using the Consumer Assessment of Health Providers Survey – Home and Community Based Services version found that the measure of “choice over services” improved slightly however, the “planning your care” measure was unchanged. Interviews with service coordinators found that the introduction of managed care had led to a system that was overly bureaucratic and focused on medical rather than social needs. This led to a perception that the service plans neglect aspects of daily living that are important for a good quality of life.
IMPLEMENTATION SCIENCE FOR THE SCALE-UP, SPREAD, AND SUSTAINABILITY OF ASSISTIVE TECHNOLOGIES FOR HEALTHY AGING
Authors: Freeman Shannon , Carroll Simon
Published: December 2022

In this symposium we present papers from four key stakeholders on a Michael Smith Foundation for Health Research (MSFHR) Implementation Science Team (IST) that is investigating the application of an emerging approach, the non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework (Greenhalgh et al., 2017, 2018), to help predict and evaluate the success of technology-supported health and social care programs in British Columbia (BC). Specifically, our team’s intention is to apply the NASSS framework to answer the following research questions: 1) Can the NASSS framework be used to enhance the effectiveness and impact of innovative ATs through improving the equitable scale-up, spread, and sustainability of these technologies for older adults? 2) What are the most important factors in the technology development and implementation process that contribute to equitable scale-up, spread, and sustainability of ATs for older adults? And 3) How can we improve transdisciplinary and intersectoral collaborations to enhance and improve the equitable implementation of ATs for older adults? Based on discussions from team, advisory, and expert panel meetings, a Rapid Realist Review (RRR) of the literature, and an analysis of data collected to date, the speakers will respond to these questions.
AGE DIFFERENCES EMOTION GLOBALIZING: AN EXAMINATION OF BOUNDARY CONDITIONS
Authors: Barlow Meaghan , Willroth Emily , Wrosch Carsten , John Oliver , Mauss Iris
Published: December 2022

Emotion globalizing is an individual difference variable referring to the extent to which daily variations in an individual’s current emotions spillover into their evaluations of life satisfaction. The present research sought to: 1) extend the conception of emotion globalizing to stressor-related emotions, 2) examine age differences in these processes, and 3) differentiate associations with evaluations of life satisfaction and day satisfaction. To do so, we used daily diary data from two adult lifespan community samples [Study 1: N = 133 females, age range = 23-78; Study 2: N = 137, age range = 18-95]. Multilevel models revealed older (compared to younger) adults exhibited less negative (but not positive) emotion globalizing and stressor-related emotion globalizing. No age differences were revealed in the association between stressor-related emotions and day satisfaction. These findings support and extend assumptions underlying the mechanisms of emotion globalizing and inform theories of emotional aging.
MID-LIFE JOB STRESS AND SUPPORT PREDICT SLEEP HEALTH TRAJECTORIES THROUGHOUT ADULTHOOD
Authors: Lee Soomi , Smith Claire , Allen Tammy , Wallace Meredith , Almeida David , Buxton Orfeu , Patel Sanjay , Andel Ross
Published: December 2022

Good sleep is necessary for healthy aging, but it may be threatened by work stress. This study connected midlife job characteristics to trajectories of sleep health profiles (within-person configurations of key self-reported facets: duration, regularity, sleep onset latency or SOL, insomnia symptoms, feeling unrested, and napping) over one decade. A working adult sample (N=847, Mage=45) of the Midlife in the United States study provided data on sleep and job characteristics in 2004-2006 (T1) and 2013-2016 (T2). Four sleep profiles were consistently identified at both time points: (1) good sleepers, (2) irregular but sufficient, (3) short sleepers, and (4) long SOL/insomnia. Higher job demands at T1 predicted a transition from good or irregular/sufficient sleep at T1 to long SOL/insomnia at T2. Higher workplace social support at T1 predicted maintenance of good or irregular/sufficient sleep over time. Attention to job demands and workplace social support may help promote sleep health.
UNDERSTANDING RACIAL AND ETHNIC DISPARITIES IN NURSING HOME CARE IN COOK COUNTY, IL
Authors: Caldera Selena
Published: December 2022

Nursing facility data from the Illinois Department of Public Health reveals significant racial disparities in access to high quality nursing homes (NH) for older Black and Latino Illinoisans. While half of all Illinois NH residents live in a 1- or 2- star rated nursing home, 68% of Black NH residents live in such facilities. This study seeks to understand racial and ethnic disparities in access to, quality of, and experiences with care in Cook County, Illinois NHs and develop community-identified solutions to close quality, access, and equity gaps. We employ key informant interviews in a two-stage process that begins by developing a current state analysis of the experience with care through interviews with community stakeholders, including advocacy groups, policy and community leaders and public agencies. Those findings then guide interviews with older Black, Latino, and Chinese NH residents and their caregivers where we identify community-grounded solutions to closing equity gaps.
PHYSICAL AND MENTAL HEALTH OUTCOMES AMONG OLDER MILITARY VETERANS
Authors: Landes Scott , Wilmoth Janet
Published: December 2022

Older veterans are a unique health population, with physical and mental health outcomes impacted by the positive health aspects of military social capital as well as the negative aspects of military-related hazards. This symposium focuses on physical and mental health outcomes among older military veterans both before COVID-19, and during the COVID-19 pandemic. Three studies address veteran health outcomes pre-pandemic. Two of the pre-pandemic studies focus on veteran-only samples in order to determine whether aspects of marital quality predicted levels of loneliness, and risk factors for trauma re-engagement among those with medical illness. The third pre-pandemic study examines whether the increased mortality risk observed among older veterans compared to nonveterans varies by combat status. Two studies address veteran health outcomes during the COVID-19 pandemic. The first uses a sample of older veterans with PTSD who were surveyed pre-pandemic and during the pandemic in order to ascertain the mental and physical health impact of the pandemic. The second COVID-19 study uses data from a study of Veterans Affairs’ Home Based Primary Care (HBPC) providers to learn about the best practices discovered to ensure COVID-19 vaccination uptake by some of the most vulnerable older veterans. Results from each of these studies will shed light on policies and practices needed to ensure the best physical and mental health outcomes for older military veterans.
EXPLORING MULTIDIMENSIONAL RESILIENCE IN OLDER VETERANS WITH PTSD DURING THE PANDEMIC
Authors: Hall Katherine
Published: December 2022

The COVID-19 pandemic and restrictions for physical and social distancing has affected all older adults, but one segment that has unique needs and experiences is older veterans with PTSD. This presentation will explore how PTSD symptomology, and psychosocial functioning in this population have changed compared to pre-pandemic findings. The impact of the pandemic on daily life activities and functional impairment will also be explored. Participants recruited to a wellness clinical trial for older veterans with PTSD at two different timepoints (pre-pandemic, n=54; post-pandemic, n=28) completed PTSD and mental health assessments, and a physical performance battery testing strength, mobility, balance, and aerobic endurance. PTSD symptoms, specifically avoidance and hypervigilance were markedly lower in the post-pandemic sample. Higher levels of physical impairment were observed in the post-pandemic sample, suggesting a need for targeted outreach and health promotion programs among older adults with PTSD symptoms during the pandemic.
HEALTH LITERACY AMONG OLDER ADULTS IN SWITZERLAND: CROSS-SECTIONAL EVIDENCE
Authors: Meier Clément , Vilpert Sarah , Borrat-Besson Carmen , Borasio Gian Domenico , Jox Ralf J , Maurer Jürgen
Published: December 2022

Despite being widely regarded as a major cause of health inequalities, little is known regarding levels of health literacy among older adults in Switzerland. To fill this gap, this study assesses health literacy and its associations with individuals’ social, regional, and health characteristics in a nationally representative sample of adults aged 58 years and older in Switzerland. We use data of 1’625 respondents from a paper-and-pencil self-completion questionnaire that was administered as part of wave 8 (2019/2020) of SHARE in Switzerland. Health literacy is measured using the short version of the European Health Literacy Survey questionnaire (HLS-EU-Q16). We use multivariable regressions to explore how respondents' sociodemographic characteristics are independently associated with health literacy. Overall, 6,8% of the respondents had inadequate health literacy, 24,6% problematic health literacy, and 68,6% sufficient health literacy. There were significant associations between health literacy and individuals' gender, education, economic situation, and self-rated health. Women had higher levels of health literacy than men (p < 0,001). Moreover, a higher education level (p < 0,001), fewer financial difficulties (p< 0.01), and higher self-rated health (p < 0,001) were positively correlated with adequate/higher levels of health literacy. One-third of older citizens have difficulties managing health-related issues in Switzerland. These findings call for targeted interventions, such as using simplified health or eHealth information tools, improved patient-provider communication, and shared decision-making, promoting lifelong learnings activities and health literacy screening for older patients to increase low health literacy and mitigate its consequences, thereby alleviating remaining social health inequalities in the Swiss population.
LIFE LESSONS: THE EXPERIENCES OF OLDER ADULTS LIVING IN PUERTO RICO DURING COVID-19
Authors: Fabelo Humberto , Morgan Matthew , Vazquez Julia , Becker Todd
Published: December 2022

What life lessons emerge from a group of older Puerto Ricans concerning their experiences with COVID-19. We will review study participants’ reports of how they spent their time during the pandemic, what they found most difficult to cope with, and life lessons they learned as a result. We will use Erickson’s life course theory of psychosocial development to frame their responses to these questions, including the crises (and strengths) of generativity versus stagnation (care) and ego integrity versus despair (wisdom). We will report evidence of care and wisdom as core ego strengths resulting from their lived experience. We will also review how isolation, sense of community, and key mental and physical health factors seemed to influence how their responses suggest coping strengths. We will discuss our findings in the context of social and cultural norms of current cohorts of older Puerto Ricans, highlighting the salience of community and family relations. (150 words)
THE PHYSICAL AND MENTAL HEALTH OF HOME HEALTHCARE WORKERS: WHAT DO WE KNOW AND WHAT CAN WE DO ABOUT IT?
Authors: Sterling Madeline
Published: December 2022

This presentation will use data from the 2014-2018 CDC's Behavioral Risk Factor Surveillance Survey to characterize the physical and mental health of home health care workers compared to other similar frontline, low-wage worker groups, before the COVID-19 pandemic. Next, using primary survey data collected in partnership with the 1199SEIU Training and Employment Fund, the health of the workforce during the COVID-19 pandemic will be presented, as well as the workforces' needs. The survey includes data from over 250 home health care workers employed in New York, NY who provided care during the pandemic. Finally, data from a pilot feasibility study of an intervention aimed at improving home care workers' well-being will be presented.
CARING FOR HOMEBOUND VETERANS DURING COVID-19 IN THE US DEPARTMENT OF VETERANS AFFAIRS MEDICAL FOSTER HOME PROGRAM
Authors: Manheim Chelsea , Katz Maya , Haverhals Leah
Published: December 2022

The COVID-19 pandemic made older, homebound adults with multiple chronic conditions increasingly vulnerable to contracting the virus. The United States (US) Department of Veterans Affairs (VA) Medical Foster Home (MFH) program cares for such Veterans residing in private homes of non-VA caregivers. In this qualitative study, we assessed adaptations to delivering safe and effective healthcare during the early stages of the pandemic for Veterans living in rural MFHs, interviewing (n=37) VA MFH care providers at 19 MFH programs across the US. We identified themes reflecting adaptations to care provision, including care providers increasing communication and education to caregivers who prioritized Veteran safety. Caregivers coordinated increasing telehealth visits, applied creative strategies to mitigate social isolation of Veterans and themselves, and Veterans were prioritized for in-home COVID-19 vaccinations. Study findings illustrate the importance of clear, regular communication and intentional care coordination to ensure high quality care for vulnerable, homebound populations during crises.
FEELING YOUNG TODAY, FEELING GOOD TOMORROW? MICROLONGITUDINAL DYNAMICS IN SUBJECTIVE AGE
Authors: Rupprecht Fiona , Schmidt Laura , Sieverding Monika , Nikitin Jana , Wahl Hans-Werner
Published: December 2022

Insights into the short-term dynamics and micro-longitudinal consequences of subjective age can drive our understanding of its long-term mechanisms across adulthood. Using data from 80 newly retired individuals (aged 59 to 76 years; 59% women) collected on 21 days, we made use of a recent methodological advance—multilevel dynamic structural equation modeling. As possible same-day correlates and micro-longitudinal consequences of subjective age, we investigated physical activity, step number, sleep quality, affect, and stress, which were either assessed via wearables (FitBit Charge HR) or daily diaries. Analyses suggest a weak autoregression of subjective age, indicating that how old one feels is determined via daily rather than lasting experiences. Indeed, there were significant same-day relations to all suggested correlates. The one effect lasting across several days was from an older subjective age on subsequent negative affect—a potential short-term mechanism contributing to the detrimental long-term influence of an older subjective age.
DYADIC EFFECTS ON DEPRESSIVE SYMPTOMS OF SPOUSE CAREGIVERS AND THEIR CARE RECIPIENTS: EVIDENCE FROM CHINA
Authors: Liu Jinyu , Lou Yifan , Li Lydia , Xu Hongwei , Zhang Zhenmei
Published: December 2022

Objectives

The likelihood of providing care to a spouse in middle and older ages has increased as life expectancy increases, but knowledge about how the caregiver and care recipient influence each other’s mental health is limited. This study examined whether a partner’s physical, cognitive, and mental health in a spousal caregiving dyad are associated with the other partner’s depressive symptoms in China and whether the dyadic effects vary by gender.

Methods

This study used data from Wave 3 (2015) and Wave 4 (2018) follow-up surveys of the China Health and Retirement Longitudinal Study (CHARLS). The analytic sample featured 1,245 dyads of care recipients aged 45 or older and their spouse caregivers. The Actor-Partner Interdependence Model was used to test the dyadic effects among all couples in the analytic sample, couples with wife caregivers and couples with husband caregivers, respectively.

Results

We found that caregiver’s depressive symptoms at Wave 3 were significantly associated with care recipient’s depressive symptoms at Wave 4 in the full sample. Regardless of caregiver or care recipient roles, wives’ mental health was impacted by their husbands’ depressive symptoms, but not vice versa. Wife recipient’s cognitive impairment was associated with husband caregiver’s lower depressive symptoms. Discussion: This study sheds light on the mental health of couples in the context of caregiving in China. The findings indicate that interventions to support couples in a caregiving dyad need to consider the influence they have on each other, and the gender and health conditions of each in the dyad.
THE IMPACT OF CHILDHOOD ADVERSITY ON CAREGIVERS' HEALTH
Authors: Avent Elizabeth , Yonashiro-Cho Jeanine , Gassoumis Zach
Published: December 2022

Caregivers tend to report fair or poor health compared to non-caregivers. Adverse childhood experiences (ACEs), which are traumatic events experienced before age 18, have been associated with several health conditions and overall poor health in adulthood. The additive effect of early-life stressors and caregiving stressors may have a compounded impact on the health of caregivers, contributing additional stress and burden to their caregiving situation. Data from the 2019 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) were used to analyze self-rated health (SRH) in the context of caregiving and ACEs, based on responses from Florida, Georgia, Tennessee, Virginia, and Utah (N= 41,334). Of the 8,368 caregivers, nearly 23% reported 4 or more ACEs, compared with 13% of non-caregivers. Nested regression models showed that caregivers have lower SRH (b=-0.04, p=0.0002); however, after including the combination of ACEs and being a caregiver, there was no significant impact of being a caregiver alone on SRH. The effect of ACEs alone on SRH persisted, with the strongest effect for individuals with 4 or more ACEs (b=-0.41, p< 0001). The finding that caregivers’ childhood adversity accounts for SRH moreso than their caregiver status highlights the importance of a lifespan approach when considering caregiver health and, potentially, burden. This has implications for practice, suggesting that screening caregivers on their history of ACEs may be a valuable tool to identify caregivers at higher risk for poor health outcomes who may benefit from additional resources to support their health and well-being.
CHILDHOOD SES IS ASSOCIATED WITH FASTER WORSENING METABOLIC SYNDROME SEVERITY FOR BLACK RELATIVE TO WHITE WOMEN
Authors: Surachman Agus , Adler Nancy , Laraia Barbara , Epel Elissa
Published: December 2022

This analysis examined whether early life SES was associated with longitudinal changes in metabolic syndrome (MetS) severity among Black and white women. Data were from 531 women (non-Hispanic Black=263; non-Hispanic white=268, Mage=39) in the National Growth and Health Study (NGHS). Information about parental education was collected during the baseline survey when participants were 9. Information regarding MetS severity were collected during year-7 (Mage=16), year-10 (Mage=19), and year-30 (Mage = 39) follow-up studies. Controlling for baseline body mass index, smoking status, and marital status, Black participants showed a faster increase in MetS severity across two decades. Early life SES (b=.03, SE=.01, p<.05), independent of current SES, was associated with faster worsening MetS severity among Black relative to white women. The socioeconomic context of early rearing is an important factor for racial disparities in accelerated aging among these early midlife Black and white women.
BRIDGING SILOS: EVALUATION OF AN INNOVATIVE REGIONAL SENIOR TRANSPORTATION SERVICE
Authors: Jansen Taylor , Silverstein Nina , Dugan Beth , Lee Chae Man , Xu Shu , Su YanJhu
Published: December 2022

A pilot study was conducted for a regional transit authority (RTA) to evaluate the implementation of a customized software to increase ridership, trips, destinations and coordination of rides among four Councils on Aging (COA) using RTA vans to serve rural communities in north central Massachusetts. Baseline and follow up ride data were collected from each COA from Fall 2019 (N= 178 riders; N= 4,230 trips) and Fall 2021 (N= 131 riders; N= 2,020 trips) and from 59 stakeholder interviews with riders, drivers, dispatchers, and staff from the COAs, RTA, and software company. The evaluation found after 6 months that while the goals of the pilot were not yet achieved, due in part to external factors such as the COVID-19 pandemic and driver shortage, valuable lessons were learned including the importance of balancing provider goals of efficiency and reporting with rider needs of driver hands-on assistance and friendly scheduling support.
GERONTOLOGIC BIOSTATISTICS: MERGING WITH DATA SCIENCE AND TOWARD PERSONALIZED MEDICINE
Authors: Shardell Michelle , Murphy Terrence , Allore Heather
Published: December 2022

The sub-discipline of gerontologic biostatistics (GBS) was introduced in 2010 to emphasize the special challenges encountered in the design and analysis of research studies of older persons. These challenges center on the multifactorial nature of human aging, characterized by the parallel and progressive deterioration of diverse organ and cellular systems that eventually results in death. Ten years after the introduction of GBS, which initially focused on important aspects of design and analysis that ensure their statistical validity, we update how GBS has been enriched by evolving practices. We present individual sessions on three seminal developments in the practice of GBS: integration of data science and multiple streams of data, including those automated and or multidisciplinary in nature; enhanced methods of addressing the heterogeneity of treatment effects from health-related interventions for older patients; and how interactive visualization can help specific patients locate themselves along the continuum of individualized treatment effects. We conclude our presentation with a session that reviews three prominent trends in the validation of the heterogeneity inherent to the assessment of health among older adults. Reflecting this era of big gerontological data, we discuss several established modeling approaches for validation, the proliferation of signal intensive behavior phenotypes, and the deep characterization of phenotypes through OMICS studies and multimodal approaches. All talks discuss pitfalls and areas of future development and draw from published studies. We are submitting as an interest group collaborative panel submission between two interest groups: Epidemiology of Aging and Measurement, Statistics and Design.
PREDICTORS OF DEPRESSION AMONG MIDDLE-AGED AND OLDER MEN AND WOMEN IN EUROPE: A MACHINE LEARNING APPROACH
Authors: Aichele Stephen , Handing Elizabeth , Strobl Carolin , Jiao Yuqin , Feliciano Leilani
Published: December 2022

The high prevalence of depression in a growing aging population represents a critical public health issue. It is unclear how social, health, cognitive, and functional variables rank as risk/protective factors for depression among older adults and whether there are conspicuous differences among men and women. We utilized random forest analysis (RFA), a machine learning method, to compare 56 risk/protective factors for depression in a large representative sample of European older adults (N = 67,603; ages 45-105y; 56.1% women; 18 countries represented) from the Survey of Health, Ageing and Retirement in Europe (SHARE Wave 6). Self-rated social isolation and self-rated poor health were the most salient risk factors, jointly accounting for 22.0% (in men) and 22.3% (in women) of variability in depression. Difficulties in mobility (in both sexes), difficulties in instrumental activities of daily living (in men), and higher self-rated family burden (in women) accounted for an additional but small percentage of variance in depression risk (2.2% in men, 1.5% in women). To our knowledge, this is the first large, multi-country study to use machine learning to compare a broad range of social, health, functional, and cognitive variables as concurrent risk/protective factors for depression in middle-aged and older adults—and with analyses conducted independently for women and men. The results point to the importance of screening for depression risk within this age demographic during routine medical visits (i.e., when assessing general health status) and further indicate that such screening may be improved by inclusion of measures of perceived social isolation.
INNOVATIONS IN AGING: CREATING A TRANSDISCIPLINARY RESEARCH COLLABORATIVE GRADUATE FELLOWSHIP PROGRAM
Authors: Martin Diane , Latimer Nia , Bowers Katherine
Published: December 2022

Social isolation impacts nearly one-quarter of community dwelling adults aged 65+ in the United States. It is associated with poor physical and mental health, cognitive decline, higher healthcare costs, and early mortality. Older adults are at greater risk because they are more likely to live alone, experience a shrinking social network from loss of family and friends, and encounter limitations with driving and mobility resulting from chronic health conditions and sensory impairments. Social isolation in later life is not new; however, the COVID-19 pandemic brought to light the increased risk for negative outcomes. Reducing social isolation is a priority area for our state’s Department of Aging (DoA), and the updated State Plan on Aging highlights the need for innovative approaches to develop and strengthen initiatives addressing social isolation among older adults. The DoA is advancing multiple projects, including a partnership with our public university to create a transdisciplinary graduate fellowship program. The program brought together professional students from medicine, nursing, pharmacy, and social work and resulted in a community of practice in which fellows engaged with DoA and university faculty to share best practices and receive training in transdisciplinary research. In this session, the first presentation will focus on development of the fellowship program and highlight the success of the inaugural year; the second session will focus on the future goals of the fellowship program, and the third presentation will share how we plan to expand the partnership between our public university and our state’s Department of Aging.
YEAR ONE AND BEYOND: SUSTAINING A COLLABORATIVE AGING FELLOWSHIP PROGRAM
Authors: Martin Diane
Published: December 2022

A graduate aging fellowship experience can provide participants with unique opportunities for professional development in interdisciplinary and transdisciplinary research, community engagement, and team science. Program success is contingent on multiple factors beyond participant recruitment and customizable curriculum to meet the educational goals of individual participants. Stakeholder buy-in, strategic planning, and identification of funding streams are all necessary to support an internal program beyond its first year. In this session, we will offer guidance in planning, building, and sustaining a fellowship program for current graduate students with a professional interest in supporting older adults.
"WHAT'S YOURS IS MINE": A DYADIC STUDY OF EVERYDAY EMOTIONAL EXPERIENCES AND CORTISOL IN OLDER COUPLES
Authors: Pauly Theresa , Kolodziejczak Karolina , Drewelies Johanna , Ashe Maureen , Madden Kenneth , Ram Nilam , Gerstorf Denis , Hoppmann Christiane
Published: December 2022

Older partners’ health is linked; individuals’ physiological arousal can be shaped by their own and their partner’s emotional experiences. This study examines those associations using repeated daily life assessments (7 days) of physiological arousal (cortisol), positive affect (PA), and negative affect (NA) obtained from 321 older couples. Results from multi-level models revealed, at the between-person level, that individuals with higher average cortisol had partners with higher overall NA; and, at the within-person (momentary) level, that cortisol was lower in moments when the partner’s PA was higher than usual and when one’s own PA was higher and NA was lower than usual. On a day level, cortisol output was lower on days with lower own NA and with higher partner PA, particularly when relationship satisfaction was high, but unrelated to own PA. The findings emphasize the importance of considering how members of a dyad influence each other’s health in old age.
UNDERSTANDING THE PALLIATIVE CARE INFORMATION CIRCULATING ON TWITTER DURING THE CORONAVIRUS PANDEMIC
Authors: Inoue Megumi , Hashemi Mahdi , Li Meng-Hao , Kulkarni Rajendra , Koizumi Naoru
Published: December 2022

Palliative care is a growing medical specialty. While its value has become particularly evident during the pandemic, it faces various challenges including misconceptions among the general public, a lack of awareness of its benefits, and limited/sporadic access and coverage by Medicare. Given the increasing number of people sharing their health information and seeking healthcare information on social media where misinformation is widely spread, this study examined types of information on palliative care circulated on Twitter. A total of 26,495 English Tweets were collected 01/01/2020 – 12/30/2021 using the keywords “Palliative” and “Covid” or “Corona”. We manually developed a framework for coding/classifying the first 6,000 Tweets. Of those, 5,308 were unrelated Tweets (e.g., advertising palliative care seminars/conferences). Among the remaining Tweets, persistent myths were observed (e.g., palliative care is only for dying people) and were labeled accordingly. In addition, while some people mentioned negative impact of the pandemic on palliative care (e.g., shortage of beds), others found value in palliative care and reported positive changes due to the pandemic (e.g., telehealth in palliative care). Consequently, the following categories were defined for Tweets: i) Recognized benefits (203 Tweets); ii) Positive impact of the pandemic on palliative care (120 Tweets); iii) Negative impact of the pandemic on palliative care (333 Tweets); iv) Myth (63 Tweets). We will use these manually classified Tweets to train machine-learning algorithms to automatically classify the remaining tweets, aiming to obtain a comprehensive understanding of palliative care information circulating on Twitter and seek ways to promote palliative care use.
THE CORONAVIRUS JOB RETENTION SCHEME AND MENTAL HEALTH AMONG OLDER WORKERS: EVIDENCE FROM ENGLAND
Authors: Gessa Giorgio Di , Zaninotto Paola
Published: December 2022

The COVID-19 pandemic has led to major economic disruptions. In March 2020, the UK implemented the Coronavirus Job Retention Scheme –known as furlough –to minimize the impact of job losses. So far, little is known on the mental health impact of this scheme on older workers, and on whether this varies by job characteristics. Exploiting longitudinal data from Wave 9 (2018/19) and two COVID-19 sub-studies (June/July 2020; November/December 2020) of the English Longitudinal Study of Ageing we use logistic and linear regression models to investigate associations between changes of employment and mental health during the pandemic. About 10% of respondents aged 52-67 were furloughed in the initial phase of the pandemic. Overall, employment disruption was associated with changes in mental health, although results suggest differences by pre-pandemic job characteristics (i.e. hours worked, physical effort, social class, and stress measured by the effort-reward imbalance model).
CHILDHOOD AND MIDLIFE CULTURAL ENGAGEMENT AMONG KOREAN MARRIED COUPLES
Authors: Kim Kyungmin , Burr Jeffrey , Han Gyounghae , Kim Bon
Published: December 2022

Cultural reproduction theory posits that cultural resources transmit to the next generation, suggesting a lingering effect of parental influences on cultural experiences in adulthood. Further, middle-aged adults’ cultural engagement may not only be influenced by their own childhood experiences but also their spouses’ experiences. This study extends our understanding of childhood and midlife cultural engagement of married couples, using a sample of 1,271 couples (age 49–66) from the 2012 Korean Baby Boomer Panel Study and Korean Forgotten Generation Study. Results from Actor Partner Interdependence Models showed that beyond one’s own childhood cultural engagement, spouse’s childhood cultural engagement was associated with levels of perceived cultural engagement at midlife (for both husbands and wives) and number of arts and cultural activities at midlife (only for husbands). Given the cross-spousal associations in cultural engagement among Korean middle-aged couples, both spouses’ cultural resources need to be considered for policy implications.
SOCIAL DETERMINANTS OF HEALTH AND WILLINGNESS FOR END-OF-LIFE DISCUSSION AMONG KOREAN AMERICAN IMMIGRANTS
Authors: Noh Hyunjin , Choi Eunyoung , Lee Lewis , Lee Hee
Published: December 2022

This study aimed to examine social determinants of health (SDH) associated with Korean American (KA) immigrants’ willingness for end-of-life discussions with family and doctors. A self-administered, cross-sectional survey was conducted with 259 KAs in Alabama. Demographic, health, acculturation, and SDH information were collected. Binary logistic regression analyses were conducted to examine associations between SDH and willingness for end-of-life discussion. Most participants were willing to discuss with family (94%) and doctors (82%). Those aware of hospice care were more likely to have willingness for discussion with family and doctors. Those who could not see a doctor because of cost and who had higher threats to interpersonal safety were less likely to have willingness for discussion with family. Those with more chronic conditions and higher social isolation were less likely to have willingness for discussion with doctors. Interventions aimed to promote KAs' end-of-life discussions should consider the SDH identified in this study.
CHALLENGES RELATED TO DATA SOURCES FOR RWE IN AGING RESEARCH
Authors: Lu Kevin
Published: December 2022

Numerous challenges remain in research to generate RWE for FDA approvals and other health care decision-makers or stakeholders. This is particularly true for research to evaluate the effectiveness of pharmaceutical care and patient outcomes in older populations. For example, data sources available for RWE in the older populations are limited and data access can be daunting; identifying appropriate data sources for FDAapprovals remain challenging. Most of the FDA approvals are based on RWE rely on multiple data sources instead of a single database. In addition, pharmacoepidemiologic studies in older adults using RWD are often limited in capturing important clinical information and prognostic factors that are useful for decision-makers. Polypharmacy, frailty, and patient outcomes measures are often inconsistent depending on specific databases and thus produce controversial results. We will discuss different data sources appropriate for pharmacoepidemiology research and make comparisons and contrasts of different research approaches using different databases.
USE RWE TO IMPROVE DRUG INFORMATION FOR GERIATRIC PATIENTS
Authors: Li Minghui , Watts Chelsea
Published: December 2022

Older adults are the main users of medications. However, they are usually excluded from clinical trials due to comorbidity and polypharmacy. Older adults, especially those 75 years and older, are underrepresented in clinical trials. This creates a unique opportunity to use RWE to improve the quantity and quality of drug information for geriatric patients. The quality of RWD is critical to have information on patient population, comparator, measurement, and endpoints. Data linkage is encouraged if key variables are not included in one data source. In addition, external controls based on RWE can be used when clinical trials are unethical or impractical. They can be applied for older adults, rare diseases, and under-represented minorities. For conditions common in older adults (e.g. Alzheimer's disease, lung cancer, and osteoporosis), RWE is greatly needed for all geriatric age groups. The entire spectrum of geriatric populations could identify age differences in efficacy and safety outcomes.
CARE NETWORKS OF RURAL APPALACHIAN FAMILY CAREGIVERS AND PERSONS LIVING WITH DEMENTIA
Authors: Savla Jyoti , Roberto Karen , Blieszner Rosemary
Published: December 2022

Dementia care research typically focuses on primary family caregivers with limited consideration of their engagement with a broader care network and the geographic area in which they reside. Using a mixed-methods approach, we analyzed care networks of 163 primary caregivers and their relative living with dementia in rural Virginia. Six distinct care network types emerged based on the primary caregiver's gender, relationship to the person living with dementia, and presence of other informal caregivers. Networks differed by the caregiver’s emotional connectivity with family/friends and feelings of caregiver strain, role overload, and loneliness. Caregivers’ service use attitudes and support service utilization varied across network types and across divergent economic resources of the rural counties in which families resided. Findings establish a framework for understanding the types and influences of care networks and tailoring services to support dementia family caregivers in diverse rural areas.
CHANGES IN RURAL AND URBAN FAMILY CAREGIVING NETWORKS IN THE MIDWEST DURING THE COVID-19 PANDEMIC
Authors: Ashida Sato , Cho Hyunkeun , Thompson Lena , Williams Kristine , Koehly Laura , Schneider Haley , Donohoe Maria , Hossain Lubna
Published: December 2022

This study elucidates the changes in family caregiving networks during the COVID-19 pandemic and its implications on caregiver well-being. Eighty-two caregivers of individuals diagnosed with dementia within the past 2 years participated in this study to test a post-diagnosis intervention that provides a community care planning service that connects caregivers directly to community-based services. Caregivers completed telephone surveys at baseline and 3- and 6-month follow-up. The number of network members engaging in malfeasant (negative) social interactions increased by 0.798 every 3 months (p=0.002). Members engaging in uplifting interactions decreased, especially among intervention participants, by 1.93 every 3 months (p=0.047); urban caregivers reported greater decrease than rural (p=0.006). Participants in intervention group showed a trend for greater decrease in COVID-19 related distress (10-point scale) over time compared to control group (p=0.059); those with more members engaging in uplifting interactions reported lower distress (p=0.017) regardless of intervention status, network size, and rurality.
CONTEXT MATTERS IN DECISION-MAKING: CAREGIVING NETWORKS OF AFRICAN AMERICAN DEMENTIA DYADS
Authors: Johnson Kalisha Bonds , Epps Fayron , Song MinKyoung , Lyons Karen , Hepburn Kenneth , Driessnack Martha
Published: December 2022

Limited research explores the contextual and cultural nuances within African American dementia dyads within the United States and how these factors influence decision-making processes. Through a secondary data analysis of semi-structured interviews, we examined decision-making processes in five African American dementia dyads related to how they navigated decisions for the person living with Alzheimer’s disease and related dementias (ADRD) across five unique contexts (e.g., mother with multiple daughters, mother with son and daughter where the son was the “primary” caregiver). Analysis revealed that within dyads, persons living with ADRD were involved in the decision-making processes, but the level of the involvement in decision making by the caregiving networks varied across dyads. Understanding the context in which decisions are made (i.e., within the dyad, across multiple family members in a caregiving network) has important implications in clinical practice and research. Interventions should be tailored to reflect these contextual and cultural nuances.
SENESCENCE-DERIVED PROTEIN BIOMARKERS DURING AGING AND OSTEOARTHRITIS
Authors: Schilling Birgit , Patel Sandip , Rose Jacob , Campisi Judith , Bons Joanna , King Christina , Schurman Charles
Published: December 2022

Aging is a complex biological process associated with progressive loss of physiological function and susceptibility to several diseases, such as cancer and neurodegeneration. As senescence burden increases with aging and becomes a risk factor for many age-related diseases we are specifically interested in senescence-derived aging signatures. We use cutting-edge proteomic workflows to investigate both the senescence-associated secretory phenotype (SASP) in tissue cultures. We are subsequently examining exosome proteins as well as lipid cargo in plasma from human young (20–26 yrs) and old cohorts and old (60–66 yrs) individuals. We will also present current work assessing senescence markers in cartilage and bone targeting underlying mechanisms and options for intervention for osteoarthritis. Overall, our focus is specifically directed towards senescence-derived biomarkers of aging.
AN AGE-RELATED POSITIVITY EFFECT IN HUMOR: AN ASIAN CONTEXT
Authors: Ng Zoe Ziyi , Yow W Quin
Published: December 2022

Humor plays a pivotal role in our interaction with people. According to the age-related positivity effect, older adults (OA) demonstrate more positive emotions and are better able to modulate negative emotions than younger adults (YA), suggesting an increase in humor appreciation with age. However, given the heterogeneity and complexity of humor, it is unknown if this effect holds across various types of humor in a culture with ambivalent attitudes toward humor (Yue, 2016). We explored age-related effects in the perception of four types of humor with Asian adults: incongruity-resolution/benign humor, aggressive humor, local-slang humor, and self-vs.-other-deprecating humor. Fifty-six Singaporean-Chinese OA (n=26;M=64.33) and YA (n=30;M=22.48) watched four short videos depicting the four types of humor in a randomized order. Participants rated how funny each video was (from a scale of 1-not funny-at-all to 5-very-funny), ranked them in the order of most-to-least-entertaining and answered questions on Future-Time-Perspective-scale and self-rated humor.Repeated-measures ANOVA found significant main effects of age, F(1,59)=6.60, p=.013, where OA gave higher ratings than YA (M=3.00 vs. 2.47), and humor-type, F(3,177)=26.87, p<.001. There was a significant linear contrast in humor-type where aggressive and benign humor had the lowest ratings while self-vs.-others-deprecating humor had the highest ratings. Ranking analyses revealed that OA preferred local-slang and others-deprecating humor while YA preferred other-deprecating humor significantly above chance. Interestingly, there was no relationship between self-rated humor and future time perspective with age. Overall, OA displayed a greater appreciation of humor than YA, supporting an age-related positivity effect in an Asian context, despite preference differences. We would like to thank Prof Suzanne Flynn, Department of Linguistics and Philosophy, MIT, for her guidance, and the MOE Tier 2 Academic Research Fund Tier 2 (T2MOE2005) and SUTD Growth Plan Grant for Healthcare (SGPHCRS1902) awarded to the last author.