bluuebunny/crossref_metadata_2025 huggingface dataset:
No Historical Change in Views on Aging and Their Correlates: Emerging Evidence From Germany and the United States
Authors: Wahl Hans-Werner , Drewelies Johanna , Duezel Sandra , Lachman Margie , Smith Jacqui , Ram Nilam , Lindenberger Ulman , Gerstorf Denis
Published: December 2021

To examine historical changes in views on aging, we compared matched cohorts of older adults within two independent studies that assessed differences across a two-decade interval, the Berlin Aging Studies (BASE, 1990/93 vs. 2017/18, each n = 256, Mage = 77) and the Midlife in the United States Study (MIDUS, 1995/96 vs. 2013/14, each n = 848, Mage = 67). Consistent across four different dimensions of individuals’ subjective views on aging (age felt, age appeared, desired age, attitudes towards own aging) in the Berlin Aging Studies and corroborated with subjective age felt in the MIDUS, there was no evidence whatsoever that older adults of today have more favorable views on how they age than older adults did two decades ago. We discuss reasons for our findings, including the possibility that individual age views may have become increasingly decoupled from societal age views.
Where's the Bar? Alcohol and Meaningful Engagement Among Assisted Living Residents With Dementia
Authors: Bender Alexis , Kemp Candace , Burgess Elisabeth
Published: December 2021

Alcohol use across the life course provides some physical and psychological benefits when used in moderation. As a social model of care, assisted living (AL) communities emphasize autonomy; yet, we do not know how this philosophy extends to drinking. Using ethnographic and interview data from a larger 5-year NIA-funded study in four diverse AL communities designed to identify best practices for the meaningful engagement of AL residents with dementia, we examine how residents, families, and staff interpret residents’ rights about alcohol use and how staff and families facilitate or limit alcohol use of residents with dementia. Findings indicate staff and families frequently rely on a narrative of “watchful oversight” to limit or restrict alcohol consumption while simultaneously affirming the social connection of drinking (e.g., alcohol-free socials). We discuss the implications of our findings for research and practice aimed at promoting meaningful engagement and quality of life among persons with dementia.
Psychological Resilience, Stress, and Pain: The Moderating Role of Positive Affect and Well-Being
Authors: Morais Calia , Robinson Michael , Fillingim Roger , Bartley Emily
Published: December 2021

Chronic low back pain is the leading cause of disability among older adults. The impact of psychological factors, including high levels of stress, are associated with increased risk for pain. Despite the growing evidence suggesting that psychological well-being is associated with better health outcomes, limited research has examined positive psychological factors in the context of pain among older adults. In this secondary data analyses of we examined the association of perceived stress on pain and physical functioning, and the moderating role of positive affect and well-being (PAW) on these relationships. A total of 60 adults over the age of 60 completed completed questionnaires assessing perceived stress (Perceived Stress Scale) and positive affect and well-being (Neuro-QOL PAW). The Back Performance Scale measured back-related physical functioning and movement-evoked pain. We hypothesized that PAW would be inversely associated with pain outcomes and would moderate the relationship between perceived stress and pain. Bivariate correlations assessed the association between study variables, while the interaction of PAW and perceived stress was examined via linear regression. Age (r=.30), income (r=.28), and being married (r=.32) were associated with higher PAW scores, while there was an inverse association with movement-evoked pain (r=-.28). After controlling for demographic covariates, moderation analysis revealed that higher levels of perceived stress were associated with poorer physical functioning, but only among those with lower positive affect and well-being (b=0.14). As seen, examining the influence of positive psychological functioning on pain-related outcomes has important clinical implications that may promote positive pain adaptation in this population.
Leveraging Disruptions to Create an Equitable, Age-Friendly, Learning Health System
Authors: Prusaczyk Beth , Lenze Eric , Carpenter Brian , Morrow-Howell Nancy
Published: December 2021

In a learning health system, the system’s own data and the experiences of its workforce are integrated with external evidence to provide better care. In an age-friendly health system, core principles of age-friendly care are integrated into every point in the system. Disruptions caused by the COVID-19 pandemic, and the innovations that addressed them, present an opportunity to discuss how these two frameworks may be combined and leveraged to transform care for older adults. We will present examples of pandemic-related disruptions, including rapid changes in how patients and providers move within and between facilities and the significant toll on healthcare workers’ mental health. We will also highlight innovative solutions to these disruptions that could transform healthcare systems. Critical to these points is a discussion of how these disruptions have disproportionately impacted healthcare workers and patients of color and how the innovations must be implemented using an anti-racist, health equity lens.
Lessons From Disruption: A New Normal for Families and Care Partners
Authors: Fields Beth
Published: December 2021

COVID-19 has forced community-dwelling older adults to rely on family members and care partners more than ever before for support. Often at the expense of their own health and well-being, family members and care partners help older adults manage physical and psychosocial needs, navigate a complex, ever-changing healthcare system, and follow public health guidelines. Given the increasing demands and poor outcomes, there is no better time than now to develop policies and practices that better recognize and support family members and care partners of older adults. To inform policy and practice development, this symposium will present findings from a literature review of peer-reviewed studies published from 2019 through 2021 that identifies and addresses challenges and opportunities related to caregiving for an older adult in a pandemic. The experiences of the past year demonstrate that the new normal needs to recognize and support family members and care partners.
Re-Envisioning Aging in the Right Place to Disrupt Homelessness for Older People
Authors: Weldrick Rachel , Canham Sarah , Weil Joyce
Published: December 2021

Recent developments in the aging-in-place literature have recognized the significance of aging-in-the-right-place. That is, aging in a place that supports an individual’s unique values, vulnerabilities, and lifestyles. This symposium will build upon existing research by critically examining the potential for older persons with experiences of homelessness (OPEH) and/or housing insecurity to age-in-the-right-place. Presenters will include interdisciplinary researchers with a diversity of perspectives stemming from gerontology, social work, and environmental design. The symposium will begin with Weldrick and Canham presenting a conceptual framework for aging-in-the-right-place that has been developed to outline indicators relevant to OPEH and housing-insecure older people. Elkes and Mahmood will then discuss findings from a study of service providers working with OPEH to consider the relative benefits and challenges of temporary housing programs. Following, Brais and colleagues will present findings from an environmental audit, developed as a novel assessment tool to evaluate the accessibility and physical design of housing programs for OPEH. A final presentation by Kaushik and Walsh will highlight findings from a photovoice study on perspectives of aging-in-the-right place among OPEH during the Covid-19 pandemic. Joyce Weil, an expert in measurement of person-place fit and life course inequalities, will discuss the implications of these papers and reflect on the potential for the aging-in-the-right-place framework to address the diverse needs of the growing population of OPEH through policy and practice. Together, the participants of the symposium will advance this emerging scholarship using a wide range of methods and perspectives.
Aging in the Right Place: A Conceptual Framework for Housing Insecure Older People
Authors: Weldrick Rachel , Canham Sarah , Mahmood Atiya , Sussman Tamara , Walsh Christine
Published: December 2021

Emerging research has highlighted the significance of aging in the right place (AIRP) by recognizing that secure and optimal housing should support an individual’s unique vulnerabilities and lifestyles. Existing literature, however, has yet to consider what it means for older people experiencing homelessness and/or housing insecurity to age-in-the-right-place. In order to address this knowledge gap, a review of person-environment fit models for older people and other relevant literature was conducted to determine critical identifiers of AIRP for housing insecure older people. Findings from this literature review were then refined in collaboration with interdisciplinary scholars and community partners to establish a conceptual framework. This paper presents the resulting conceptual framework and outlines the key indicators of AIRP relevant to housing insecure older people. The proposed framework provides a practical and meaningful contribution to the literature which can be used to promote housing security among individuals often excluded from existing aging-in-place models.
Trends in Leisure-Time Activity Participation Among Young-Old Adults in China
Authors: Zhang Wei , Feng Qiushi , Chen Huashuai
Published: December 2021

Engagement of leisure activities is highly associated with health and wellbeing in later life. In this study, we examined the trends of leisure activity engagement in young-old adults aged 65–74 in China for a 16-year period. Panel data for a nationally representative sample of young-old adults were obtained from the 2002–2018 Chinese Longitudinal Healthy Longevity Survey. Findings revealed that, compared with 2002, young-old adults in subsequent years were less likely to engage in any form of social leisure activity. The odds of participating in social events, regular exercise, and outdoor activities decreased most prominently over time, while downward trends in tourism and joining outdoor activities showed signs of reversal post-2014. In contrast, trends for engaging in home-bound and solitary leisure activities generally increased. The future elderly in China have generally tended towards solitary leisure activities over time and public health interventions are required to reverse such trends.
Social Participation Patterns and Well-Being Among Older Adults: Findings From the United States, the UK, and China
Authors: Tan Chenxin , Zhou Yun , Wu Bei
Published: December 2021

This study used Latent Class Analysis to examine patterns of social participation among older adults in the US, the UK, and China, from the three nationally representative surveys conducted in 2018-2019: The Health and Retirement Study, the English Longitudinal Study of Ageing, and the China Health and Retirement Longitudinal Study. Although the profiles of social participation were distinctively different, several common patterns were found: Comprehensive Participants, Occasional Participants, and Deficient Participants. It was estimated that less than 10% of older adults from these countries were extensively engaged in social participation. Seventy-seven percent of Chinese older adults were shown being “Deficient Participants”, and the percentages were 29% and 20% in the US and the UK, respectively. The findings showed positive associations of levels of participation with socioeconomic status and health. The magnitudes of these associations varied across the nations. Actions are needed to promote levels of participation for Chinese older adults.
Social Isolation, Resilience, and Psychological Well-Being in Older Chinese Americans
Authors: Qi Xiang , Zhang Wei , Wang Katherine , Pei Yaolin , Wu Bei
Published: December 2021

Using data collected in 2018 on 398 older Chinese Americans aged 55+ residing in Hawaii, we examined the associations of social isolation with psychological well-being and the mediating role of resilience. Social isolation was measured by their marital status, living arrangement, contact with children/family/friends, and participation in social activities. Psychological well-being was measured by psychological distress, life satisfaction, and happiness. Results from multivariate linear regressions and ordered logistic regressions showed social isolation was positively associated with psychological distress (β=0.017, p<0.05), and negatively associated with life satisfaction (β=-0.220, p<0.001) and happiness (β=-0.086, p<0.05) . By contrast, resilience was associated with lower psychological distress and higher life satisfaction and happiness. Moreover, mediation analysis showed that resilience contributed to 32% of the association between social isolation and psychological distress, 24.9% of the association between social isolation and life satisfaction, and 16.3% of the association between social isolation and happiness.
Recruitment Challenges and Strategies for Multimodal Intervention Trials
Authors: Bartley Jenna
Published: December 2021

Determining ways to improve hip fracture recovery in older adults is important, however recruitment of this target population into clinical trials is challenging. Multimodal interventions that target multiple mechanisms of recovery may improve outcomes, but each component presents unique recruitment barriers. While exercise interventions have been shown to be beneficial for hip fracture recovery, offering exercise following completion of conventional physical therapy can be viewed as a burdensome time commitment. Hormone replacement therapy may hold promise for overcoming anabolic resistance, but concern about adverse side effects can also deter participation. STEP-HI is a multisite trial testing whether exercise and testosterone can improve hip fracture recovery in older women. In this talk, recruitment barriers experienced in STEP-HI and strategies employed to overcome these barriers will be discussed. Strategies include: partnering with hospitals, skilled nursing facilities and orthopedic surgeons. providing talks and education materials; and featuring past participant testimonials in recruitment materials.
How Does Testosterone Augment the Anabolic Response to Exercise in Frail Older Adults?
Authors: Bhasin Shalendar
Published: December 2021

Testosterone treatment increases muscle mass, strength, and leg power in menopausal women, hypogonadal men, older men with mobility limitation, COPD and ESRD. Testosterone's effects on muscle mass and strength are augmented by exercise training and growth hormone. Testosterone treatment improves some measures of physical performance, such as stair climbing power and aerobic capacity; the improvements in gait speed have been modest. Testosterone increases muscle mass by inducing the hypertrophy of type 1 and 2 muscle fibers, and by increasing satellite cell number. Testosterone promotes the differentiation of mesenchymal progenitor cells into myogenic lineage and inhibits their differentiation into adipogenic lineage by activating Wnt-target genes, including follistatin that plays an important role in mediating testosterone's effects on the muscle. Testosterone also increases polyamine synthesis in the muscle. Combined administration of testosterone plus multi-component exercise intervention that includes functional training may be needed to improve function and mobility in older adults.
Interpersonal Associations Between Affect and Depressive Symptoms in Persons With Early Dementia and Their Spouses
Authors: Monin Joan , Piechota Amanda , Syed Sumaiyah
Published: December 2021

Positive and negative affect have independent effects on health and occur frequently in close relationships. No research to our knowledge has examined self-reported affective experiences of persons with dementia (PWD) and their spouses and interpersonal associations with their psychological health. Secondary analysis of baseline interviews from a randomized clinical trial testing a stress reduction intervention in 45 couples (n=90) examined whether individuals’ positive and negative affect were associated with their own depressive symptoms (actor effects) as well as their partner’s depressive symptoms (partner effects) and whether these associations differed for PWD and spouses. Actor partner interdependence model results showed that for PWDs and spouses, one’s own positive affect was related to one’s own lower depressive symptoms (B=-3.10, SE=.59, df=58.70, p<.001), and one’s own negative affect was associated with one’s own greater depressive symptoms (B=6.62, SE=.60, df=65.67, p<.001). These effects were independent from each other. Partner effects were not significant.
Presidential Symposium: Physiological vs. Molecular Clocks, Studies From Mice to Humans
Authors: Rogina Blanka
Published: December 2021

Aging is associated with a functional decline in metabolic, physiological, proliferative, and tissue homeostasis leading to deterioration at the organismal level, and an increased risk for disease and death. Genetic, pharmacological and nutritional interventions have been successfully used to preserve metabolic health, which leads to preserved healthspan and extended longevity. However, the rate at which animals in a population become impaired by age-related frailty and disease is highly variable and several aging clocks that measure different age-modulated processes in the organism are being use as potential markers of the rate of aging. These molecular clocks allow to a more accurate quantification of the biological age of animals. Nevertheless, there is still room for further discussion in terms of the strengths and weaknesses of these biomarkers, in order to probe their biological significance, cellular mechanisms, and epidemiological potential to further explore their long-term benefit of increasing healthspan. This symposium will discuss new approaches to delineate physiological versus molecular clocks based on studies in mice and humans. We will also discuss species-specific metabolic mechanisms based on longitudinal studies in mice, monkeys and humans.
The Growing Global Healthy Longevity Ecosystem
Authors: Seoh Thomas
Published: December 2021

The geroscience field has started to grow exponentially in recent decades. This in turn has led to a rapidly emerging global ecosystem of players and nodes that has radiated out into fields from clinical investigation to medical practice to capital markets and startup activity to consumer-facing goods and services, regulations, laws and policies and the general wellness-conscious public. These are still early days, and there is uncertainty and a lack of awareness about the shape and activities of this rapidly growing and evolving community. This presentation will attempt a high-level survey of the current landscape in the hope of promoting awareness and collaborations among diverse, multiple initiatives that can accelerate the field.
The Ties That Bind: How Online and Offline Interactions Affect Social Support and Quality of Life for Older Adults
Authors: Cotten Shelia
Published: December 2021

Though a digital divide still exists, older adults are increasingly using a range of information and communication technologies (ICTs) – smartphones, apps, tablets, and computers – to communicate and engage with social ties. This symposium focuses on modalities of interaction – whether online or offline – that older adults use to interact with social ties. The research projects detailed examine the frequency of different interaction modalities, as well as impacts of these interaction modalities on older adults’ perceptions of social support and quality of life. Kadylak and colleagues focus on social robots and how older adults may engage with this evolving technology to improve social engagement and aging in place. Kim and Fingerman investigate whether daily social media use is associated with same-day negative or positive mood in later life. Xie and colleagues examine older adults’ patterns of both online and offline social interaction during COVID-19, and how older adults perceive these interactions. Schuster and Cotten, using a national sample of individuals aged 65 and older, examine whether social media use may be related to a range of quality of life indicators. Each of these studies provides additional insights into the ways through which older adults interact and communicate with social ties, and potential impacts of the different ways through which they interact, which may provide insights into groups seeking to increase social engagement among older adults in general and during times when social isolation may be exacerbated due to societal stressors, such as pandemics.
Older Adults' Online and Offline Social Interactions During the COVID-19 Pandemic
Authors: Xie Bo , Shiroma Kristina , De Main Atami , Davis Nathan
Published: December 2021

During the COVID-19 pandemic, much of our social interaction has transitioned from in-person to online. This study examined older adults’ social interaction during COVID-19, online and offline. Participants were recruited from community-dwelling older adults in Central Texas. Data collection took place via the telephone during June-August 2020 (N = 200; age range: 65-92 years; Mean: 73.6; SD: 6.33). Participants used a variety of communication modes, including phone or texting (used by 99% of the participants); email (44%); in person (35%); video chat (31%); social media (24%); and postal mail (4%). Most participants (77%) used more than one communication mode. Participants discussed their preferences for and challenges of technology (i.e., smart phones) and its applications (i.e., video chat, telehealth, and social media). Participants’ self-reported experiences ranged from positive (50%), mixed (35%), to negative (15%). These findings will inform policy and community interventions to promote older adults’ social interactions during the pandemic.
Daily Social Media Use, Social Ties, and Emotional Well-Being in Later Life
Authors: Kim Yijung , Fingerman Karen
Published: December 2021

Research has seldom explored older adults’ daily social media use and its interface with ‘offline’ social ties. Using data from the Daily Experiences and Well-being Study (N = 310; Mage = 73.96), we investigated whether more daily social media use was associated with the same-day negative or positive mood in later life, and how these associations varied with older adults’ daily social encounters and social network structure. More daily social media use was associated with less same-day negative mood. Additionally, more daily social media use was associated with less negative mood on days with more in-person encounters, compared to the days with fewer in-person encounters. More daily social media use was also associated with more positive mood for individuals with a relatively small social network, but not for their counterparts. Post-hoc analyses supported a compensatory function of social media for those older adults lacking social connections in their daily lives.
The Impact of Volunteering Motivation for Older Korean Adults on Social Integration and Role Identity
Authors: Kim Meeryoung
Published: December 2021

As life expectancy increases, older Korean adults need more activities for the next 20 to 30 years after their retirement. Rowe and Kahn indicate active social participation as an area of successful aging. After retirement, older adults uphold a desire to be part of society. This study examines the motivation effects for volunteering on social integration, role identity and volunteer satisfaction. Subjects for this study are 303 older volunteers belonging to the Korean Senior Citizens’ Association throughout South Korea. According to the results, the skills obtained through volunteering had a significant effect on social integration, role identity, and volunteer satisfaction. Value motivation also had a significant effect on social integration, and reinforcement motivation significantly affected role identity. Implications of this study were found to have various effects according to the motivation for volunteering. Therefore, it will be important to understand the older adults’ motives so that they can volunteer accordingly.
Training in Interdisciplinary, Practice-Oriented Minority Aging Research: Honoring the Work of Dr. James Jackson
Authors: Mezuk Briana , Taylor Robert , Thorpe Roland
Published: December 2021

Few scientists had the breadth and depth of scholarship, the keen interest in interdisciplinary scientific collaboration, and the commitment to mentoring the next generation of scientists as Dr. James Jackson. His passing remains a tremendous loss for the field. This symposium, organized by members of the Michigan Center for Urban African American Aging Research (MCUAAAR), which was founded by James over 20 years ago, reflects on the impact of transdisciplinary team science, of the importance of research networks and resource sharing, of the need to center research within practice and community, and of the scientific innovation that comes from integrating conceptual models, data sources, and methodological approaches from seemingly disparate fields. The session is co-chaired by Dr. Robert Taylor, longtime faculty member and current PI of MCUAAAR. The talk by session chair Dr. Briana Mezuk will discuss the ways in which the training approach of Analysis Core has inspired new training programs on integrative methods focused on minority health and disparities. The talk by Dr. Tam Perry will describe the innovations of the Community Liaison and Recruitment Core, including how COVID-19 impacted the activities of the Healthier Black Elder Center. The third talk by Dr. Rodlescia Sneed, a MCUAAAR early-career scientist, provides an example of how this Center supports interdisciplinary minority aging research through her project focused on older adults who have a history of incarceration. Finally, Discussant Dr. Roland Thorpe, a member of the MCUAAAR Advisory Board, will reflect on Dr. Jackson’s legacy of mentorship and collaboration.
Aging Across the Lifespan: Rethinking the David Barker Hypothesis
Authors: Ferrucci Luigi
Published: December 2021

For many years, the scope of geriatric medicine has been the care of older persons affected by multiple disease with the aim of improving their functional status and optimize quality of life. As our knowledge of the mechanisms of aging grows rapidly, it is becoming clear that accomplishing this scope requires taking a life-course perspective. Research have failed to establish a clear-cut distinction between normal aging and pathology leading to the hypothesis that aging is at the root of chronic diseases, and difference in health can be ascribed to different aging rates. Research in model organisms, suggest that aging can be modified with consequent changes on healthspan and longevity. Interventions that modulate aging may ultimately prevent most-age-associated diseases and their consequences. From this perspective, geriatric medicine is the leading and most promising branch of biomedical science. Challenges remain: first, demonstrating that certain interventions slow down the aging rate requires the valid measure of aging, and while many tools were developed, “epigenetic clocks” being the most promising, the underline mechanism that drive their changes with aging and validity in clinical applications are unclear. We do not know whether variability in the rate of biological aging assessed in old age are already detectable in younger individuals and person-specific rates remain constant during life. In 1986, David Barker stated the hypothesis that the period of gestation, characterized by a strong epigenetic imprinting, affects health and wellbeing across life, perhaps by setting the aging rate. Perhaps pediatric and geriatric medicine are more connected than previously believed.
Caregiver Services: Needs, Benefits, and Best Practices
Authors: Reinhard Susan
Published: December 2021

Just under 1 in 5 Americans (19.2%) are caregivers for adults with chronic illnesses. Caregiving is the great equalizer as caregiving remains an activity that occurs among all generations, racial/ethnic groups, income or educational levels, family types, gender identities, and sexual orientations. This presentation will provide a snapshot of the current status of caregiving in the United States. It will explore why caregiver services are needed and will highlight the impacts many caregivers face as a result of their stepping up to help family and friends. In addition, this presentation will discuss what is considered best practice in caregiver services and how the public and private sectors can work together to develop solutions to support family caregivers and those under their care.
Overview of NIA Research and Priorities
Authors: Hodes Richard
Published: December 2021

Dr. Hodes will provide an overview of NIA's structure and mission, in addition to discussing research foci from across the Institute's scientific divisions.
But How Will We Measure It? Co-Creating Assessments of Outcomes in Age-Friendly Care, PA
Authors: Berish Diane
Published: December 2021

Moving from concept to quantitative measurement can be complex. There were several challenges in co-designing measures to assess the impact of Age-Friendly Care, PA, a geriatric workforce enhancement program. First as a FQHC, our clinical partner had not captured the metrics of interest. Second, the co-developed operational definitions for our metrics should be feasible, relevant, and useful for all project members. Third, funder reporting requirements must also be addressed. Working within this context, we co-created 11 outcome indicators structured around the 4Ms (IHI) now with 9 months of data. EMR changes to make data reportable included measuring opioid misuse mitigation, high-risk medication elimination, cognitive assessment and dementia care management, advanced care planning, care partner presence, annual wellness visit completion, pneumonia vaccination rates, colorectal screening rates, mobility goal tracking, and presence of a caregiver. Work continues around formulating themes to create a reportable mechanism for assessing What Matters.
Environmental Gerontology During COVID-19: Aging in Place Since the Pandemic Onset
Authors: Cannon Melissa , Finlay Jessica , Rowles Graham
Published: December 2021

The COVID-19 pandemic is fundamentally changing neighborhood landscapes as we shelter in place and adjust our lifestyles. To age-in-place is to live in one’s home and/or community “safely, independently, and comfortably.” The ability to age-in-place is a public health priority for all, regardless of income or health status, and requires a variety of community resources to be sustainable. Since the pandemic onset, access to neighborhood resources was limited to reduce transmission risks. Changes to economic arrangements and socio-spatial norms have profoundly impacted daily life, though how these influence health and well-being is largely unknown. It is likely that these effects may vary in different communities and contexts; for example, neighborhoods that are able to self-organize to safely provide social support and resources may fare better. This symposium brings together cutting-edge studies in urban and rural U.S. places to explicate how the pandemic is transforming aging-in-place experiences and perspectives. The first presentation shows how rapidly community-based services have adjusted operations to meet the needs of their communities. The second presentation explores strategies to provide social support in rural communities. The third presentation highlights the social health needs of a subset of older adults who had not formed friendships with their neighbors. Together, these studies suggest that close examinations of aging-in-place conditions and mechanisms from organizational, socio-spatial, and social network perspectives are evermore important amid a pandemic. We discuss the implications of these empirical findings in relation to emerging theories within environmental gerontology.
ESPO and Behavioral and Social Sciences Section Symposium: Addressing the Needs of Black, Indigenous, and People of Color (BIPOC) Communities Throughout the Stage Model
Authors: Sprague Briana , Meyer Kylie , Mingo Chivon
Published: December 2021

Behavioral interventions have been successfully deployed to prevent and manage chronic conditions among older persons, improve mental health, and support caregivers’ ability to cope with care stressors. However, intervention effects may not be equally distributed among populations, nor equally acceptable or accessible among Black, Indigenous, and People of Color (BIPOC) communities. In this symposium, we will discuss how behavioral interventions can better meet the needs of BIPOC older adults and caregivers, who may not equally benefit from advancements in behavioral interventions due to issues such as a reliance on non-diverse study samples and lack of cultural tailoring. This symposium will be structured in accordance with the National Institutes of Health Stage Model of Behavioral, and will feature researchers whose work address BIPOC needs across the trajectory of intervention development. Representing Stage 1 research, Fayron Epps, PhD, RN, will describe her use of a community advisory council to develop a faith-based toolkit to support African Americans living with dementia and their caregivers. Next, Laura Gitlin, PhD, MA, will describe her experiences testing a Stage 3 intervention to lower depression among African Americans, including challenges advancing the culturally-tailored program to Stage 4. Lastly, Shanae Rhodes, BSN, RN will describe her Stage 2 evaluation of a conversation group created and attended by women of color to socially connect in response to COVID-19. Although speakers will describe research projects that represent specific research Stages, this symposium will have a large discussion-based component and will cover all parts of the Stage Model of Behavioral Intervention.
Changes in Grandparenting During the Pandemic and Effects on Mental Health: Evidence From England
Authors: Gessa Giorgio Di , Bordone Valeria , Arpino Bruno
Published: December 2021

Policies aiming at reducing rates of hospitalisation and death from Covid-19 encouraged older people to reduce their physical contacts. For grandparents in England, this meant that provision of care for grandchildren was allowed only under very limited circumstances. To date, evidence on changes in grandparenting during the pandemic is scarce and little is known about whether and to what extent reduction in grandchild care provision impacted grandparents’ mental health. Using pre-pandemic data from Wave 9 (2018/19) and the second Covid-19 sub-study (November/December 2020) of the English Longitudinal Study of Ageing, we first described changes in grandparenting since the start of the pandemic. Then, using regression models, we investigated associations between changes in grandparenting and mental health (depression, quality of life, life satisfaction, and anxiety) during the pandemic, while controlling for pre-pandemic levels of the outcome variables. Almost a third of grandparents reported that the amount of grandchild care during the pandemic reduced or stopped altogether, whereas 10% provided as much or more care compared to pre-pandemic levels, mostly to help parents while working. Compared to grandparents who provided grandchild care at some point during the pandemic, those who stopped altogether were more likely to report poorer mental health, even taking into account pre-pandemic health. A reduction in grandparenting was only marginally associated with higher depression. Although policies to limit physical contacts and shield older people reduced their risks of getting ill from Covid-19, our study shows the consequences of stopping childcare provision in terms of poorer mental health among grandparents.
Intergenerational Exchanges In Aging South Asian Muslim Families: An Intersectional Lifecourse Perspective
Authors: Khan Mushira , Kobayashi Karen , Smith Andre
Published: December 2021

International migration flows are increasing at a rapid pace and are often accompanied by emergent global realities, (re)negotiation of identities and familial bonds, anticipated challenges, and unforeseen exigencies. Concomitantly, advances in public health have resulted in longer lives with an increasing proportion of the global population now 65 years and older. While these demographic shifts have received considerable research attention, little is known about aging South Asian Muslim families in the US and the ways in which they adjust and adapt to shifting social realities. To address this gap, this qualitative study explores the intersections of faith, culture, gender, age, and immigrant status, and how these seminal life course events shape intergenerational care and support exchanges in South Asian Muslim families. Building on findings from 30 in-depth narrative interviews with three generations of immigrant South Asian Muslim women, and using an intersectional lifecourse perspective, this study explores the (re)negotiation of familial bonds and the enactment of religious beliefs and practices such as those around filial expectations in a transnational Islamic context. It shows how, for the grandmothers, daughters, and granddaughters in the study, their Islamic faith was a part of both the public sphere and a collective ideology, as well as a deeply personal and intimate attachment that provided structure and continuity in their everyday lives. Finally, the implications of these findings in the broader context of Islamophobia and salient structural barriers to accessing available health and social support services for aging South Asian Muslim families are discussed.
Psychometric Testing of the BRI Unmet Need Instrument: A Comprehensive Measure of Dementia Caregivers' Needs
Authors: Minyo Morgan , Bass David , McCarthy Kate , Judge Katherine
Published: December 2021

Compared to non-dementia caregivers, family/friend caregivers of individuals with dementia experience more negative caregiving consequences. One reason is the myriad of negatively impacted life domains including: managing symptoms; family communication; financial and legal matters; and finding and coordinating services. Few psychometrically tested measures exist for assessing the range of potential unmet needs of dementia caregivers. Such a measure would describe the frequency and correlates of unmet needs and provide a key outcome for intervention research. This study tested the psychometric properties of a comprehensive measure of unmet needs, the BRI Unmet Need Instrument. Data from 192 family/friend dementia caregivers was used to test reliability and four validity types. Results showed total unmet needs, as well as its nine subscales, had good reliability (Cronbach’s alpha .70 - .95). Discriminant validity was confirmed through factor analyses of the 45 unmet needs and items in measures of depression and care-related strain. Unmet need items loaded on separate factors that were deemed acceptable (.72-.38). Predictive validity was assessed by the association with depression, which was significant and an acceptable range (r = .22, p < .01). Convergent validity was confirmed by significant associations with three caregiver strain measures, mastery (r = .40, p <.01), emotional strain (r = .19, p < .01), and relationship strain (r = .15, p <.05). Good structural validity for nine predetermined unmet needs subscales was found using principal component analysis (loadings = .82-.39). Results suggest the BRI Unmet Needs Instrument is a ready-to-use, reliable and valid comprehensive measure.
Geriatric Comanagement Reduces Hospital-Acquired Geriatric Syndromes in Older Vascular Surgery Inpatients
Authors: Thillainadesan Janani , Aitken Sarah , Monaro Sue , Cullen John , Kerdic Richard , Hilmer Sarah , Naganathan Vasi
Published: December 2021

Aims Based on our meta-analysis, surveys and qualitative studies of geriatricians in Australia and New Zealand, we designed and implemented a novel inpatient model to co-manage older vascular surgical inpatients at a tertiary academic hospital in Sydney. This model, called Geriatrics co-management of older vascular surgery patients (Gerico-V), embedded a geriatrician into the vascular surgery unit who introduced a range of interventions targeting older people. Here we evaluated this model of care. Methods We undertook a prospective before-and-after study of consecutive patients aged ≥65 years admitted under vascular surgery. One hundred and fifty-two GeriCO-V patients were compared with 150 patients in the pre- GeriCO-V group. The primary outcomes were hospital-acquired geriatric syndromes, delirium, and length of stay. Results The GeriCO-V group had more frail (43% vs 30%), urgently admitted (47% vs 37%), and non-operative patients (34% vs 22%). These differences were attributed to COVID-19. GeriCO-V patients had fewer hospital-acquired geriatric syndromes (49% vs 65%; P =.005) and incident delirium (3% vs 10%; P = .02), in unadjusted and adjusted analyses. Cardiac (5% vs 20%; P <.001) and infective complications (3% vs 8%]; P = .04) were fewer in the GeriCO-V group. LOS was unchanged. Frail patients in the GeriCO-V group experienced significantly less geriatric syndromes and delirium. Conclusions The Gerico-V model of care led to reductions in hospital-acquired geriatric syndromes, delirium, and cardiac and infective complications. These benefits were seen in frail patients. The intervention requires close collaboration between surgeons and geriatricians, and may be translated to other surgical specialties.
Intergenerational Learning: An Opportunity to Transform Nursing Students’ Perspectives of Older Adults
Authors: Thornton Marleen , Burns Kathryn , Street Lara
Published: December 2021

The purpose of this pilot project was to explore the experience of an intergenerational learning environment focused on healthy aging for nursing students and older adults. Intergenerational learning experiences provide opportunities for individuals from different age groups to communicate and participate in learning activities together. The growing population of older adults calls for increased geriatric nursing expertise. Nursing students’ attitudes toward older adults are often negative though, and result in decreased interest in geriatric nursing. The opportunity to transform nursing students’ perspectives on older adults has the potential to improve nursing care for older adults, and the number of nurses focused on geriatric nursing care. This qualitative inquiry used a convenience sample of 10 participants from a cross-listed university course on healthy aging for baccalaureate nursing students and older adult members of a lifelong learning institute. Semi- structured focus group interviews were conducted. Narrative transcripts were analyzed using an inductive approach. Analysis illustrated improved nursing students’ perspectives of older adults and aging. A similar theme was noted for older adults’ perspectives of younger adults. The importance of social interaction within an intergenerational learning environment and the need for opportunities to challenge ageist perspectives was illustrated. Increased exposure to healthy older adults, personally and professionally, may increase nursing students’ interest in geriatric nursing and improve nursing care for older adults. Future research should examine more specifically how intergenerational learning experiences can decrease ageism, improve nursing students’ and nurses’ perspectives on older adults, and improve nursing practice for older adults.
Inequities in Access to High-Quality Home Health Agencies Among Racial and Ethnic Minorities With and Without Dementia
Authors: Ma Chenjuan , Wu Bei , Brody Abraham
Published: December 2021

There are rising concerns of inequities in access to high-quality home health agencies (HHA). Using multiple national data sources that included 574,682 individuals from 8,634 HHA, we examined access to high-quality HHA care among racial and ethnic minorities with and without dementia. Approximately 9.9% of the individuals were Black, 6.2% Hispanic, and 3.3% other race/ethnicity. Over one-third (36.3%) had been diagnosed with dementia. Black and Hispanic individuals were 5.5 percentage points (95% CI, 5.2% - 5.9%) and 7.4 percentage points (95% CI, 7.0% - 7.8%) respectively more likely to receive care from agencies defined as having low-quality compared to White counterparts. Persons living with dementia were 1.3% less likely to receive care from high-quality agencies. Having dementia increased the inequity in accessing high-quality HHA between Black and White individuals. Racial and ethnic minorities, particularly those with dementia were at a disadvantaged position to receive care from high-quality HHA.
Understanding the Link Between Discrete Negative Emotions and Empathic Accuracy
Authors: Wieck Cornelia , Gerstorf Denis , Schilling Oliver , Katzorreck Martin , Lücke Anna , Kunzmann Ute
Published: December 2021

Extant theories have suggested that negative emotions generally harm cognitive processes. However, adopting a discrete emotion perspective, in this study, we predicted that only anger and fear but not sadness should be negatively associated with empathic accuracy, a process that has been shown to be cognitively highly demanding. Over 100 participants (Mage = 66.66 years, SDage = 1.00) reported their emotional reactions in response to a negative film in the laboratory, documented their everyday momentary emotions six times a day over seven consecutive days, and completed a film-based empathic accuracy test. Initial findings suggest that only fear but not anger or sadness was related to empathic accuracy. More specifically, high levels of fear both in the laboratory and in everyday life predicted low empathic accuracy. This pattern of findings will be discussed in the context of discrete emotions theories.
Nursing Facility and Health Care Service Use and Costs Under the CMS Financial Alignment Initiative
Authors: Palmer Lauren , Toth Matt , Wang Joyce , Schneider Emily , Dorneo Allison , Chiri Giuseppina , Walsh Edith
Published: December 2021

The Centers for Medicare & Medicaid Services created the Financial Alignment Initiative (FAI) to test the impact of integrated care and financing models for dually eligible Medicare-Medicaid beneficiaries. Using Medicare claims, the Minimum Data Set 3.0, and state-provided enrollment files, we evaluated demonstration impacts on long-stay nursing facility (NF) use, other health care service utilization, and costs for the overall eligible population in two FAI demonstration States with managed fee-for-service models, Colorado and Washington. We used quasi-experimental, difference-in-differences regression models for the impact analyses. In Colorado, there was a 7.2 percent decrease (p<0.001) in long-stay NF use, relative to the comparison group. Otherwise, the demonstration showed unfavorable service utilization results—increases in preventable emergency department (ED) visits and declines in 30-day follow-up after mental health discharge (MHFU)—and no impact on Medicare costs. In Washington, there was also a decrease in long-stay NF use (12.4 percent, p<0.001) and skilled NF admissions (21.7 percent, p<0.001). However, the demonstration resulted in decreases in physician visits and 30-day MHFU. There was a favorable decrease in Medicare costs. The impact of the FAI demonstrations on NF use was favorable for both States, while the impact on service utilization and Medicare costs was mixed and more favorable in Washington. Washington’s care coordination model was intensive and targeted to high-cost individuals while Colorado provided minimal care coordination. Coordinated care and integrated long-term services and support may help postpone NF institutionalization, but there is no evidence these activities reduced preventable hospitalizations or ED visits.