bluuebunny/crossref_metadata_2025 huggingface dataset:
HOW CAN WE SOLVE THE LONELINESS PROBLEMS WITH INTERGENERATIONAL DIGITAL DIVIDE?
Authors: Lee Yeseul , Song Si Young , Joo Susanna , Kim Hyoun Kyoung
Published: December 2023

As Korean society is rapidly digitalizing and aging, ’the intergenerational digital divide’ due to a large gap in digital skills between the younger and older generations is rising social issues. Lack of digital skills among older adults is likely to make them feel isolated with limited opportunities for social integration in a highly digitalized society. This study examined the extent to which digital skills and intergenerational integration were differently associated with loneliness in Korea between the younger and older generations with the aim of informing efforts to reduce loneliness. The data was collected through an online survey from December 2021 through January 2022. The sample consisted of 315 Korean older adults aged 65 or above and 322 young adults in their 20s. The loneliness with 11 items from Loneliness Scale, digital skills with 4 items from Digital Citizenship Scale, Intergenerational Integration Scale with 30 items and a binary generation variable (young adults=0, older adults=1) were measured. Results from a serial mediation analysis showed that, compared to younger adults, older adults had lower levels of digital skills, which led to low intergenerational integration, which in turn affected loneliness. Findings from two simple mediation paths showed that only digital skills had a significant single mediating role in the association between generation and loneliness but intergenerational integration did not. This study suggests that enhancing digital skills with providing opportunities for online intergenerational interaction can decrease loneliness and associated issues, especially for older adults.
PUBLIC BATH USE AT A JAPANESE SENIOR APARTMENT ASSOCIATED WITH NEIGHBORHOOD RELATIONSHIPS AND SOCIAL SUPPORT
Authors: Takase Mai , Nakamoto Isuzu , Murayama Hiroshi
Published: December 2023

The number of older adults who choose to move into senior apartments is increasing in Japan. The development of quality relationships within the senior apartment is important for the healthy aging of the residents. A “public bath” is a unique facility in Japanese senior apartment where residents can interact with each other. Historically, Japan has had a culture of bathing with family and friends in public baths, and the use of this facility is expected to lead to socialization. This study aimed to examine the association between the frequency of public bath use, and neighborhood relationship and social support within a senior apartment. A cross-sectional survey was conducted in a senior apartment in February 2022 (Saitama Prefecture, Japan) towards the entire residents (n=185). Frequency of public bath use (once a week or more vs. less than once a week) was used as the independent variable. Neighborhood relationship (can support or talk to each other vs. only light greetings or no relationship) and social support (have vs. do not have social support) within the senior apartment were used as dependent variable. A binary regression analysis (n=117, female=60.7%) revealed that a higher frequency of public bath use associated with deep neighborhood relationship (OR: 7.14, 95% CI: 1.39-36.63) and social support (OR: 3.44, 95% CI: 1.19-9.99). These results suggest the importance of having a public bath in Japanese senior apartment setting. Furthermore, integrating facilities that possess cultural significance at senior apartments could be important for fostering social relationships.
SOCIAL ISOLATION AND COGNITIVE IMPAIRMENT IN OLDER ADULTS WITH DIABETES
Authors: Kim Bohyun , Hu Jie
Published: December 2023

Social isolation is a notable influencing factor contributing to cognitive impairment in older adults with diabetes, leading to an increased risk of dementia. As the specific mechanisms by which social isolation affect cognitive health have not been fully understood, it is important to identify the underlying mechanisms. This study aims to examine the pathways between social isolation and the psychological mediators of cognitive impairment in older adults with type 2 diabetes. A secondary data analysis was conducted using the National Social Life, Health, and Aging Project Wave 3 Database (2015-2016) of 725 older adults with diabetes aged 60 and over. The Social Disconnectedness Scale, Perceived Isolation Scale, Center for Epidemiological Studies Depression Scale, Hospital Anxiety and Depression Scale, and Perceived Stress Scale were used. Structural equation modeling was employed to investigate the complex interplay of social isolation and psychological mediators with cognitive impairment. Bootstrapping procedures were used to assess significance of indirect effects through psychological mediators. The hypothesized model was supported with adequate fit to the data (CFI=0.90; RMSEA=0.05; SRMR=0.08). Social disconnectedness had an indirect effect on cognitive health through perceived isolation and perceived stress (γ= -0.122, p< 0.01). However, there was no significant indirect effect through anxiety and depressive symptoms. The model provides a framework for developing interventions to reduce cognitive impairment in socially isolated older adults with diabetes. Understanding the pathways between social isolation and cognitive impairment will provide a foundation for controlling modifiable factors to prevent the progression of dementia in older adults with diabetes.
WELL-BEING IN MIDDLE-AGED ADULTS: THE MEDIATING ROLE OF SOCIAL MEDIA USE
Authors: wu jingchuan , Lin Xin Yao , Lin Tian , Almeida David
Published: December 2023

As individuals age, social connection becomes increasingly important, and social media has the potential to facilitate social connections. This study aimed to investigate the relationship between age and well-being, focusing on the mediating role of social media use. While previous research has found social connection to be an important predictor of well-being, the specific implications of social media use for social connection on various aspects of well-being remain unclear. To explore this relationship, the study used publicly available data from the Midlife in the United States (MIDUS) study wave 3 and refresher 1, with a sample of 6871 participants (M = 56.80 yrs, SD = 14.58 yrs). Results showed that social media use played a significant mediating role in well-being, specifically in loneliness (b = 0.001, p=0.003), positive affect (b = -0.002, p< 0.001), and eudaimonic well-being (b = -0.020, p< 0.001). However, the indirect pathway from age to well-being through social media use was negative. That is, as individuals aged, they tended to use social media less frequently, which in turn was associated with worse well-being outcomes. These findings add to the expanding body of research on the complicated relationship between social media use and well-being, emphasizing the significance of focused interventions to encourage social media use for social connection in middle-aged adult populations. The study has implications for health professionals working with middle-aged adults, underlining the importance of considering social media use as a potential method of enhancing well-being.
DIFFERENCES IN COGNITIVE DECLINE DUE TO ALZHEIMER’S DISEASE, NEURODEGENERATIVE DISORDERS, AND TRAUMA
Authors: Tupler Larry , Yashkin Arseniy , Hoque Masudul , Yashin Anatoliy , Akushevich Igor , Stallard Eric
Published: December 2023

Alzheimer’s disease (AD) is a form of progressive dementia associated with significant personal, social, and economic burdens, making targeted interventions aimed at mitigating the effects of this condition on cognitive decline highly desirable. However, AD is but one of a range Neurodegenerative Disorders (ND) classified as dementias of aging. Furthermore, neither AD/ ND nor cognitive decline itself are monolithic: each individual disorder degrades specific aspects of cognition at differing rates. Isolating the most vulnerable facet of good cognitive health associated with each condition can lead the way to more personalized health interventions and an overall reduction of the burdens posed by AD /ND. In this paper we assess how the presence of AD and/or other ND degrade immediate (IR) and delayed (DR) recall over an extended period of time vs. the effect of non-degenerative brain trauma and AD/ND-free aging. Using Medicare-linked data from the Health and Retirement Study we found that, when compared to AD/ND-free aging, the onset of AD accelerates the decrease of IR by an overage of 0.30-0.37 points bi-annually, with similar effects on DR. Vascular dementia was associated with a 0.24-point loss of IR, but only for individuals with initially low recall capacity (≤5); those with high initial recall capacity (6+) did not experience loss of IR but lost 1.01 points of DR bi-annually. For comparison, traumatic brain injury was associated with 0.12-0.23 points decline in IR and 0.15 in DR bi-annually.
EVALUATING POPULATION ATTRIBUTABLE FRACTIONS ASSOCIATED WITH ALZHEIMER’S DISEASE RISK FACTORS
Authors: Akushevich Igor , Yashkin Arseniy , Ukraintseva Svetlana , Yashin Anatoliy , Kravchenko Julia
Published: December 2023

Although many risk factors for Alzheimer’s disease (AD) and related dementias (ADRD) have been identified, there is no consensus about their joint role in risk of these disorders. The extent to which joint variation in the effects of behavior, socioeconomic status, comorbidities and genetic variants may affect risk of AD/ADRD is underexplored. In this study, we used Health and Retirement Study (HRS) data linked to Medicare diagnoses and genetic data to evaluate and compare the effects of three groups of AD/ADRD risk factors: i) Medicare diagnoses for AD risk-related diseases, ii) survey-based self-reported health, behavior, physical function, education, and socioeconomic status, and iii) individual SNPs and polygenic risk scores incorporating genetic risk factors for AD/ADRD. We applied univariable and multivariable Cox models for estimating AD and ADRD risks, identified most powerful predictors, evaluated their population attributable fractions, and constructed predictive multivariable models for AD/ADRD risks. The results showed that Medicare-based diagnoses are superior in terms of predictive power of AD/ADRD risk than their self-reported counterparts. Cerebrovascular and heart diseases, depression, and brain injury had the largest effect on AD/ADRD risk. Depression and arterial hypertension were the largest contributors to AD risk in population. These two factors and APOE4 proxy SNP rs769449, together explained approximately half of the population attributable fraction of AD risk. The effect of PRS on AD/ADRD was significant for genes involved in inflammatory pathway. Our study demonstrated that AD/ADRD risk is multifactorial in nature and its variation is tied to multiple demographic, socioeconomic and health-related risk factors.
OLDER ADULTS WHO SCREEN POSITIVE FOR COGNITIVE IMPAIRMENT: PREDICTORS OF FOLLOW-UP
Authors: Cohen Matthew , Lanzi Alyssa , Saylor Anna , Boulton Aaron , Rittereiser Jennifer , Ritona Michelle , Ellison James
Published: December 2023

Interventions for cognitive decline are most likely to be effective when they are initiated as early as possible. Here, we present data from a community-based program for older adults that provides brain wellness education and cognitive screening. Individuals who screen positive are given the option to have results sent to their primary care provider (PCP). We have compared the characteristics of those who do with those who do not elect to send positive results to identify meaningful differences that might suggest program enhancements. 812 community-dwelling older adults (mean age = 73, SD = 10.7) were screened with the Mini-Cog and AD8 either in person (n = 534; 66%) or by Zoom (n = 278, 34 %). 367 (45.2%) participants screened positive. Of these, 279 (76%) elected to send their results while 82 (23%) declined. A logistic regression revealed that the decision to send results was not systematically related to age, sex, race, ethnicity, Mini-Cog score or AD8 score. It was, however, associated with the participant’s number of medical conditions (e.g., high blood pressure): OR = 1.293, p=.005. This indicates that people with greater awareness of their medical status, or those more actively engaged with a PCP are more comfortable communicating with their provider. Future research should investigate these and additional factors that might contribute to older adults’ decision to act on positive screening results. For example, participants may be more willing to share results if the screener emphasizes that (like blood pressure) some causes of cognitive impairment are modifiable.
PREVALENCE AND PAYMENTS PER CAPITA OF ADRD IN PUERTO RICO AND THE US: ESTIMATES FROM MEDICARE DATA
Authors: Carrion-Baralt Jose
Published: December 2023

Puerto Rico is one of the oldest US jurisdictions (22.7% aged 65 and over – 65+), where over 40% of the 65+ population lives under federal poverty levels. However, very little epidemiological and health economics research on Alzheimer’s Disease and Related Dementias (ADRD) has been conducted on this population. This work compares prevalence of ADRD and several of its risk factors, as well as Medicare Payments-Per-Capita (PpC) between the Puerto Rico (PR) and US National populations aged 65+, and between males and females 65+ in PR. We compared prevalence and PpC data for PR and US for ADRD and Diabetes, Hypertension, Hyperlipidemia and Depression from the publicly available CMS Multiple Chronic Conditions Data Warehouse 2018 file. All fee-for-service beneficiaries were included. Prevalence of ADRD in PR was 33% higher than in the US, while Medicare PpC were 146% higher in the US. Prevalence of Diabetes in PR was 77% higher than in the US, while Medicare PpC were 80% higher in the US. Prevalences of hypertension and hyperlipidemia were not significantly different, but PpC were almost double in the US. Prevalence of depression was 30% lower in PR. Prevalences of ADRD and all other conditions were higher among PR women than among PR men. Significant health disparities exist between PR and the US (and between PR males and females), both in terms of prevalence and PpC of ADRD and several associated risk factors. These findings are important evidence for the formulation of public policies that can help eliminate these disparities.
SLEEP DISTURBANCES SHOW FEASIBILITY TO MONITOR DISABILITY PROGRESSION IN EARLY ALZHEIMER’S DISEASE
Authors: Chang Jun Ha , Wu Ruiqian , Zhang Ying , Rizzo Matthew , Merickel Jennifer
Published: December 2023

Our objective is to assess the utility of real-world sleep to discriminate activities of daily living (ADL) decline in Alzheimer’s disease (AD). ADL decline warns of dementia and disability. Improved understanding of how sleep indexes ADL decline provides a platform for early monitoring and intervention to slow AD disability and progression. Fifty-seven impaired (mean age =76.7 years; mild cognitive impairment [MCI]: N=50, AD: N=7) and 30 unimpaired (mean age = 73.6 years) subjects participated. Demographics and the Dependence Scale (DS) were collected. The DS evaluated ADL decline from partner (e.g., spouse) report. The subject’s sleep was monitored for 3-months (N = 6,336 total days) using wrist-worn actigraphy and validated with sleep diaries. Sleep dysfunction was estimated using means and standard deviations (SD) of total sleep time, sleep latency, sleep efficiency, wakefulness after sleep onset (WASO), and awakening count. Logistic regression––adjusting for age, gender, and education––ranked the utility of sleep dysfunctions to discriminate ADL decline. Forty-six subjects (impaired: N=38, unimpaired: N=8) showed ADL decline (DS > 0). WASO variability (SD; b = 1.66, p < 0.001) and mean awakening count (b = -0.98, p = 0.003) best discriminated ADL decline. Sleep duration did not discriminate ADL decline. In line with prior literature, results underscore the role of sleep disturbances over duration in ADL decline and AD progression. Nightly awakenings show key clinical importance for real-world monitoring of AD-related disability risk. Further research may investigate the specificity and longitudinal reliability of sleep dysfunction to discriminate individual AD progression profiles.
THE VIRGINIA MEMORY PROJECT: AN INNOVATIVE SERVICE AND EPIDEMIOLOGICAL BRAIN HEALTH REGISTRY
Authors: Rhodes Ann , Coney Rachel , Miller Melicent
Published: December 2023

The Virginia Memory Project (VMP) is a statewide memory loss and caregiving needs registry in Virginia, United States. The VMP was launched in June of 2022 and supports statewide surveillance efforts via expanding the BRFSS (Behavioral Risk Factor Surveillance System) memory loss and caregiving modules via a digitized, mobile-capable online survey. In addition to collecting BRFSS data, the VMP partners with regional community brain health organizations to support respondents in getting connected to brain health and caregiving services. The VMP model is innovative because it combines a service and epidemiological registry to support improved resource allocation and decision-making in Statewide dementia care planning. It also provides a pathway for caregiving and memory loss services. In the pilot period of the VMP, there were 138 respondents, with a median age of 61, mean=58, range=18-100, and most respondents identified as White 65% (n=99), with smaller proportions of Black/AA, 16.7% (n=22), and Asian 5.3% (n=7). 96.2% of respondents were non-Hispanic. Most respondents were married (n=66, 50.4%) with no children in the home (77.9%), and 26.7% (n=35) provided contact information for potential brain health or caregiving services. For respondents who completed the memory loss module, 33% (n=26) reported memory loss or confusion worsening over the last year, but only 60% (n=15) had discussed symptoms with a healthcare professional. 33.3% (n=24) reported having caregiving responsibilities. The VMP increases brain health surveillance capacity in Virginia and represents an innovative pathway between a state department of health, a university data registry, and a community service provider.
TRAJECTORIES OF MOTORIC COGNITIVE RISK SYNDROME AND INCIDENT DEMENTIA IN SCOTLAND
Authors: Mullin Donncha , Gadd Danni , Luciano Michelle , Russ Tom , Muniz-Terrera Graciela
Published: December 2023

Background

Motoric cognitive risk syndrome (MCR) - objective slow gait and subjective cognitive complaints - is quick and easy to measure, making it a potentially useful clinical tool for identifying those at high risk of developing dementia. This is the first exploration of MCR syndrome’s predictive ability for incident dementia in a Scottish cohort (Lothian Birth Cohort 1936) and the first examination of the various trajectories of MCR. Method: We classified a total of 680 community-dwelling participants (mean [SD] age 76.3 [0.8] years) free from dementia into non-MCR or MCR groups. We used cox proportional hazard methods to evaluate the risk of developing all-cause dementia in the years following MCR diagnosis, adjusting for age, sex, comorbidity index, apolipoprotein E status, physical activity level, and years of education. We analysed the trajectories for everyone with MCR by tracking their outcomes over 9 years. Result: The prevalence of MCR at baseline was 5.6% (n=38/680). After 9 years of follow-up, 11.6% (n=79/680) of the total cohort developed dementia. The presence of MCR increased the risk of dementia (adjusted hazard ratio 2.37 [95%CI 1.06-5.32; p=0.0359]). The trajectories of those with MCR at baseline were: i) reverted to healthy (n=6/38), ii) ongoing MCR (n=13/38), iii) progressed to dementia (n=9/38), or iv) died (n=10/38).

Conclusion

MCR could identify a target group for early interventions of modifiable risk factors to prevent incident dementia. Individuals with MCR follow similar trajectories to the related predementia syndrome, Mild Cognitive Impairment.
USABILITY OF A TABLET-BASED HOME MEMORY TEST IN OLDER ADULTS WITH AND WITHOUT COGNITIVE IMPAIRMENT
Authors: Liu Yanchen , Sanders Lisbeth , Vishnepolskiy Igor , Williams Rebecca , Sanders Jeff , Serpico Anthony , Gravenstein Stefan , Bayer Thomas
Published: December 2023

Increasing Alzheimer’s and related disorders prevalence, highlights the need for accurate and reliable cognitive screening and diagnostic tools. We studied usability of LifeBio Brain, a prototype cognitive testing mobile application. We established baseline cognitive performance in volunteers from Brown University’s Geriatric Clinic using the Saint Louis University Mental Status (SLUMS). We asked volunteers to use the LifeBio Brain app at home on an iPad twice daily for 10 times, for about 15 minutes each time, followed by completion of a 10-question System Usability Scale on satisfaction that assesses the app and its ease of use. The LifeBio Brain app contains a mix of adapted cognitive tests such as clock draw and Trails A, and game-like experiences, presented in a randomized order. We analyzed a white non-hispanic sample (n=51) with a balanced distribution of age [79.6 (7.2) years, range 66-95] and sex (58.82% women). The median SLUMS score of 25, indicates cognitive impairment in most participants. Similarly, the median usability score on the 50-point System Usability Scale was 41. We found that 80% of participants had a usability score of 35 or greater, with a 95% CI of 31-38, and 67% had a usability score of 40 or greater. SLUMS score ≤14 correctly predicted study completion in 90% of participants. Most volunteers from an outpatient geriatrics clinic found LifeBio Brain usable. Volunteers leaving the study early tended to have lower SLUMS Scores. The LifeBio Brain app may have utility for measuring memory and thinking abilities in a white outpatient geriatrics population.
ALLOSTATIC LOAD AND STATUS IN MID LIFE AND BEYOND
Authors: Bailey-Arafah Micah
Published: December 2023

Objective

This study explores how status and processes of cumulative dis/advantage shape allostatic load across the life course.

Methods

Data from these analyses are from a national sample of adults from the Biomarker Substudy of the Study of Midlife in the US (MIDUS), a longitudinal study of health and well-being in the United States (N=1186) aged 35-86 years old. Education level, multiple indicators of financial stability, and demographic data were used to construct a measure of status. Those in the Biomarker substudy completed a physiological assessment that included blood, urine, and saliva assays to assess functioning of the sympathetic and parasympathetic nervous systems, hypothalamic-pituitary-adrenal axis, cardiovascular, inflammatory immune activity, glucose metabolic system, and lipid metabolic system. These data were used to create an allostatic load index. An alternate allostatic load index was developed using reported medication to affect three of seven biological systems: cardiovascular and the glucose and lipid metabolic systems. Nested regression models were estimated to explain differences in allostatic load.

Results

Reported financial instability across the life course was associated with higher levels of allostatic load, and higher levels of education were associated with lower levels of allostatic load, both with and without reported medication usage.

Conclusion

These findings demonstrate that structural forces impact allostatic load, both with and without reported medication usage, and expand previous work on allostatic load and social status.
FRAILTY TRAJECTORY AMONG VETERANS WITH HEART FAILURE AGED 50+: 20-YEAR LONGITUDINAL STUDY
Authors: Razjouyan Javad , Naik Aanand
Published: December 2023

A few studies used large longitudinal cohort of heart failure (HF) patients to report the shape of frailty trajectory (FT) and its importance in predicting death. We assessed the additive predictive power of FT to the cross-sectional frailty index (FI). A retrospective cohort of veterans aged 50+ by 10/2022 were constructed. We included patients admitted with HF for the first time as the principal diagnosis; had two primary care physician visits in for each year in past three years; admitted after 2001 and had reported ejection fraction at the time of admission. FI constructed based on the previously validated FI for veterans. The three FIs for each year before admission were used to fit a linear line model. The slope and the intercept were used to characterize the FT. We used logistic regression to compare the predictivity of FI versus FT by reporting area under the curve (AUC) for 30-day mortality and all-cause mortality. 111,426 included with median follow-up of 3.0 (IQR,1.4,5.3) years. 82% died within the first 5 years (age,72±10;BMI,31±8; EF≤40%,48%). On average 1.8 per year deficits accumulated annually and 78% of patients had FI≥0.2 at the time of admission versus 60% in a year prior to admission. FT improve the AUC of 30-day and all-cause mortality by 6% compared to FI. FT is a better predictor of mortality than cross-sectional FI for HF population. FT provided additional information beyond the cross-sectional FI by enhancing mortality prediction, identifying individuals who are at high risk of mortality with low FI.
BASIC SCREENING SURVEY IN DETROIT SENIOR CENTERS
Authors: Koternamski April , Byrappagari Divesh , Jones Judith
Published: December 2023

The objective of the Senior Oral Health Equity Project (SOHEP) Basic Screening Survey (BSS) was to determine the oral health status of seniors 55yrs and older in Detroit senior centers. The ASTDD BSS tool was used to collect the data. The screenings were conducted in two local senior centers to determine the prevalence of dental disease as well as dental care needs. The data were collected using Qualtrics© and analyzed using SPSS©. Majority of the seniors (n=67) screened were African American (88.9%), female (79.1%) and between the ages of 65 and 85 yrs. (89.6%). Results showed that there is a high prevalence of tooth loss (6 or more teeth – 59.6%), untreated decay (38.8%), need for periodontal care (52.2%) and need for dental care (43.3%). The results suggest that the senior center participants have limited access to dental care. There is a need to develop preventive dental programs for seniors where they congregate and live.
PERSONALITY, SOCIAL ISOLATION, AND LONELINESS: CROSS-SECTIONAL DATA FROM THE CANADIAN LONGITUDINAL STUDY ON AGING
Authors: Bethell Jennifer , Andrew Melissa , Morgan Debra , O’Connell Megan , Phillips Natalie A , Wittich Walter , McGilton Katherine
Published: December 2023

Good social connection is associated with better health. However, the relationships between distinct aspects of objective and subjective social connection, and how personality traits may impact these relationships, are not well-understood. For example, in predicting loneliness, personality could moderate the impact of objective social connection by influencing the way social relationships are evaluated. We used cross-sectional Canadian Longitudinal Study on Aging data (n=27,765), collected between 2015 and 2018, to explore the potential confounding or modifying effects of personality traits on the associations between social isolation and loneliness score among 46-90 year-olds. We estimated associations using ordered logistic regression models, whereby the outcome was the loneliness score and exposures were social isolation and each of five personality traits (extraversion, agreeableness, conscientiousness, emotional stability, and openness). We produced three sets of models (social isolation only; personality trait only; and social isolation, personality trait and their interaction) and conducted all analyses stratified by sex and adjusting for potential confounders. We found that, for both males and females, social isolation and each of the five personality traits were associated with loneliness scores (p< 0.001), however, with only one exception (openness among females), there was no statistical evidence that personality modified the association between social isolation and loneliness. Our findings have potential implications for research assessing the health effects of social connection and personality as well as intervention studies that target social isolation as means of addressing loneliness.
RECENT DEVELOPMENTS IN FRAILTY IDENTIFICATION, TREATMENT, AND PREVENTION IN OLDER ADULTS: A REVIEW
Authors: Hoogendijk Emiel , Dent Elsa
Published: December 2023

Frailty is a clinical condition characterized by an increased susceptibility to stressors and an elevated risk of adverse outcomes such as mortality. In the light of global population aging, the prevalence of frailty is expected to soar in coming decades. The current study provides a review of novel developments and emerging practices in frailty research regarding prevention, identification, and management of the condition in older adults. We searched geriatric journals in the top two quartiles (based on 2021 Impact Factors from Clarivate Journal Citation Reports) for articles published between January 2018 and December 2022. We screened 1519 articles for eligibility and assessed the full text of 278 articles. Popular research trends included the study of frailty transitions and trajectories, analyses of life-course risk factors for frailty, identifying frailty using biomarkers (and biomarker panels), and investigating the altered response to medications by older adults with frailty. Other areas with novel developments included: artificial intelligence (machine learning) for frailty identification; exercise and physical activity for the management of frailty; medication management, gerontechnology; education of healthcare professionals; integrated care; person-centered care; guidelines; cost-effectiveness of management strategies; and COVID-19. This review identified a strong need for the implementation and evaluation of cost-effective and community-based interventions to prevent and manage frailty. Our findings highlight the need to strengthen healthcare systems to better support older adults with frailty and involve those with frailty in shared decision-making regarding their care.
USING HOSPITAL ELECTRONIC HEALTH RECORDS TO DETERMINE FRAILTY WITH THE PICTORIAL FIT-FRAIL SCALE
Authors: Bohnsack Alanna , Faig Karla , Cook Allyson , MacLellan Cameron , Benjamin Susan , Shanks Josh , Gionet Sherry , Jarrett Pamela
Published: December 2023

Hip fractures are common in older adults, particularly those that are frail. There is no “gold standard” tool to measure frailty retrospectively from hospital Electronic Health Records (EHRs). The aim of this research was to explore the utility of the Pictorial Fit-Frail Scale (PFFS) in determining frailty retrospectively in older adults admitted to hospital with a hip fracture. A random sample of 200 patients who had a hip fracture was extracted from a larger sample of 682 hip fractures that occurred in older adults (65 years and older) admitted to a Level 1 Trauma Center (April 2015-March 2019). Each EHR was reviewed to determine the availability of data and the score for each of the 14 PFFS domains. The majority, 189 (94.5%) of the EHRs, had data to complete 11-14 of the domains. Patient information was often unavailable to complete the domains of daytime tiredness and pain. The average age was 83.2 (SD 8.2), and 73.0% were female. The mean Raw PFFS score prior to admission was 9.7 (SD 6.6), and 45.5% of patients were classified as moderately or severely frail. Using the Standardized PFFS score (adjusted for up to three missing domains), the mean score was 11.8 (SD 7.9), and 58.2% of patients were classified as moderately or severely frail. The hospital EHR can be used to complete the PFFS. This finding provides researchers and healthcare professionals with a way to stratify older hospitalized patients by frailty, which may be a useful tool for evaluating health outcomes.
FACTOR STRUCTURE OF THE BRIEF PAIN INVENTORY–SHORT FORM IN AFRICAN AMERICAN OLDER ADULTS WITH OSTEOARTHRITIS
Authors: Wu Jianli , Horgas Ann , Booker Staja
Published: December 2023

The Brief Pain Inventory-Short Form (BPI-SF) is a widely used questionnaire designed to assess aspects of cancer pain, such as pain intensity and pain interference. Psychometric properties have rarely been evaluated in other pain conditions such as osteoarthritis. Osteoarthritis is a major contributor to pain and physical disability in African Americans (AA) older adults. Thus, it is important to evaluate the psychometric properties of BPI-SF in this health disparity population. Participants were AA aged 50-94 years with self-reported osteoarthritis. The final convenience sample (N=110) completed surveys including a demographics questionnaire and the validated BPI-SF. Confirmatory Factor Analysis (CFA) was used to evaluate the factor structure. Measurement invariance across two age groups [i.e., young-old (50-69); old-old (70-94)] was examined. CFA revealed that a three-factor model (i.e., pain intensity, activity interference, and affective interference) demonstrated the best fit (χ2/df=1.595, CFI=0.949, RMSEA=0.074) to the data. AAs reported pain intensity (M=4.58, SD=2.01), affective interference (M=3.03, SD=2.54), and activity interference (M=4.19, SD=3.25). The change of CFI between configural and metric invariance is below the cutoff point of .01, supporting the full metric (i.e., factor loadings) invariance across two age groups. However, the full scalar (i.e., items intercepts) invariance was not established. The results support a three-factor structure of BPI-SF that is invariance across two age groups at the full metric level. This suggests that the BPI-SF is an appropriate measure to characterize chronic pain intensity, affective interference, and activity interference for older AAs with osteoarthritis.
COMPARISON OF SENSOR BASED CONTINUOUS ADL ASSESSMENTS TO CARE-GIVER ADCS-ADL SURVEY RESULTS
Authors: Fitch John , Williams Rachel , Myers Dennis , Devin Michael
Published: December 2023

This paper presents analysis results between the Birkeland Current (BC) Sovrin IoT in-home sensing system and monthly ADCS-ADL survey data for Care Recipient/Caregiver (CR/CG) pairs (N=117) as part of a Phase II NIA SBIR study (R44AG065118) conducted from 2021 to 2023. The analysis provides correlation analysis between overall BC ADL Scores and ADCS-ADL scores as well as comparisons to IADL/BADL scores. The CR population was screened to represent mild to mid-level cognitive decline and was continuously monitored in home and assisted living environments for up to 18 months. The BC system demonstrates significant correlation with the ADCS-ADL score at the level of sensitivity of the ADCS survey and subfactor results. The BC system is able to demonstrate sensitivity to a single point change in the two-factor BADL score as well as a single point change in the two-factor IADL score. Discussion of limitations of comparison to retroactive surveys is described. Novel ADL measurement dimensions are discussed for further study.
FEASIBILITY OF USING SMARTPHONES AS A TOOL TO PROMOTE PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Elumeze Josephine , Sarmiento Erika Ortiz , Chu Winnie , Friel Ciaran , Swartz Ann , Myers Alyson K , Nouryan Christian , Burns Edith
Published: December 2023

Smartphones have potential to allow asynchronous education, individualized feedback and coaching around physical activity (PA) though it’s unclear if older adults make use of these capabilities. We conducted anonymous, semi-structured interviews/surveys on current PA levels, and experience with mobile technology and PA programs with a convenience sample of older adults, and family members/caregivers receiving care at a large geriatrics academic practice over a 3-month period. Data included demographics, experience with smartphone and PA applications. Current levels of PA were measured with the International Physical Activity Questionnaire (IPAQ). Comparisons of PA levels based on mild vs moderate vs vigorous activity. 25 completed surveys, most of whom were female (67%) and identified as non-White (68%), with a mean age of 80.8 years, range 67-96. The majority (84%) reported owning smartphones, 8% reported using PA apps, and 8% used wearable activity trackers (WATs). 44% walked at least 10 minutes per day, but only 32% reported attaining moderate PA, and 12% vigorous PA. Average time/day walking 1.1-hour, average time/day moderate activity 0.74 hours. Both younger (age≤80 years) and older (age>80 years) adults were similar in owning Smartphones (85% vs. 83%) and using WATs (8% vs. 8%). Only the younger group used PA apps (15% vs. 0%). The ubiquity of Smartphones especially among such a demographically heterogeneous group suggests this may be a viable tool for increasing PA among a wide range of older adults. Next steps should address low rates of PA app use, intergenerational differences, and the possibility of incorporating socialization with technology.
THE RELATIONSHIP BETWEEN SELF-REPORTED QUALITY OF LIFE AND SMARTPHONE GPS DATA
Authors: Lee Kyungmi , Azuero Andres , Kumar Sidharth , Puga Frank , Demiris George , Ritchie Christine , Wright Alexi A , Dionne-Odom J Nicholas
Published: December 2023

Patients with advanced cancer and their family caregivers often experience poor quality of life. Self-reported measures are commonly used to quantify quality of life of family caregivers but may have limitations such as recall and social desirability bias. Variables derived from passively obtained smartphone GPS data are a novel approach to measuring quality of life that may overcome these limitations, and enable detection of early signs of deteriorating mental and physical health. The purpose of this study was to examine the temporal directionality of the correlations between self-reported quality of life (i.e., PROMIS Global 10: physical and mental health domains) at 3 timepoints and passively acquired smartphone GPS data among 7 family caregivers and 4 advanced cancer patients over a 12-week period. We extracted variables (i.e., total distance, time spent at home, transition time, and number of significant locations) with algorithms applied to the raw GPS sensor data. Uncertainty measures for the correlation estimates were computed as uncorrected 95% Bootstrap confidence intervals. We found a medium-to-large correlation between quality of life and the daily smartphone GPS data averaged by week in certain time periods (e.g., temporal correlations between physical health and transition time for 0–6 weeks; r’s ranging from 0.30 to 0.53). Additionally, we found a medium-to-large correlation between quality of life and within-person variability (standard deviation) in daily smartphone GPS data. Our findings indicate that variation in within- and between-person behavior patterns captured by GPS data may signal potential changes in individuals’ physical and mental health outcomes.
INCLUDING PEOPLE WITH COGNITIVE IMPAIRMENT IN HEALTH SERVICES RESEARCH: PROMISING PRACTICES AND LESSONS LEARNED
Authors: Boughrum Alice Prendergast , Fuller Kristi
Published: December 2023

Engaging impacted populations, including consumers, in the design of health policies and services is increasingly recognized and prioritized in the United States. However, people with dementia and other forms of cognitive impairment are underrepresented and have often been excluded from health services research. As the number of people worldwide who are living with some form of cognitive impairment is expected to rise dramatically in the coming years, it is critical that researchers across all areas of health services research consider including this population in their work and ensure decisions for exclusion are fully justified. That said, individuals with cognitive impairment constitute a vulnerable population and additional precautions and safeguards are warranted to ensure they are protected throughout and beyond their participation in research studies. The inclusion of people with cognitive impairment also adds complexity to studies, and appropriate research protocols are often challenging to design and implement. This poster will describe two studies conducted by researchers at Georgia State University that included populations with cognitive impairment. The content will cover background about the study populations, which varied in diagnosis and disease progression; methods for recruitment, screening, and consent; and helpful communication strategies to employ throughout the research process. The poster will also share lessons learned and promising practices identified for both studies.
PPA TELE-SAVVY: RESULTS OF AN ONLINE PILOT INTERVENTION WITH CAREGIVERS OF PERSONS WITH PRIMARY PROGRESSIVE APHASIA
Authors: Morhardt Darby , Maley Kathryn , Dowden Lauren , O’Neil Kaitlyn , Dyslin-Kman Deborah , Roberts Angela , Lindauer Allison , Gefen Tamar
Published: December 2023

Primary Progressive Aphasia (PPA) results from a neurodegenerative disease such as frontotemporal lobar degeneration or Alzheimer’s disease and is characterized by a progressive loss of specific language functions eventually progressing to widespread cognitive decline consistent with generalized dementia. Most interventions available to dementia caregivers do not match PPA caregiving families’ needs for tailored psychosocial support. This pilot study is an adaptation of Tele-Savvy, an evidence-based online psychoeducation caregiver program. Goals: (1) address communication and other cognitive and behavioral challenges facing informal caregivers of those living with PPA throughout disease progression, and (2) help caregivers achieve competence in their role. Nine spousal caregivers were recruited to a pilot mixed methods study, which included seven 90-minute weekly videoconference sessions, mindfulness exercises and homework assignments. Participants provided feedback throughout the intervention. Pre-post effects were assessed on PPA knowledge, mood, caregiver burden, perceived stress, competence, quality of life and dyadic relationship. A focus group was held 4 weeks post-intervention. Pre-post results revealed a post-intervention trend toward decreased depression and reported relationship strain. Thematic analysis of recorded videos and transcribed weekly sessions, in addition to an evaluation focus group revealed four themes: a) Increasing knowledge of PPA; b) Learning communication and connection strategies; c) Initiating care planning; d) Integrating intellectual and emotional aspects of PPA caregiving. Participants were provided findings for their feedback. This study demonstrated the feasibility of offering an adaptation of the Tele-Savvy intervention for caregivers of persons with PPA. An informed second pilot study will be held in Spring 2023.
PERCEIVED WORK ENVIRONMENT AND OUTCOMES AMONG CARE STAFF IN LONG-TERM CARE SETTINGS DURING COVID-19
Authors: Cho Eunhee , Kim Min Jung , Lee Kyung Hee , Kang Bada , Jang Jiyoon , Shin Jinhee , Eltaybani Sameh , Yamamoto-Mitani Noriko
Published: December 2023

Coronavirus disease (COVID-19) has severely affected residents in long-term care (LTC) facilities. However, how care staff in LTC facilities perceive their work environment during the pandemic and its potential impact on their work outcome are less understood. This study examined the associations between perceived work environment, staffing levels, and educational status of care staff and their general and COVID-19 specific work outcomes during the pandemic in LTC facilities. The study employed a cross-sectional, observational, correlational design. A total of 207 care staff were conveniently recruited from 30 LTC facilities in South Korea. The perceived work environment, staffing levels, educational status of care staff, and their work outcomes were collected using questionnaires. Multivariable binary logistic regressions were conducted, controlling for the characteristics of care staff and facilities included. Approximately 45% of the participants were either nurse aids or care workers, and 38% were registered nurses. Nearly half reported that their work environment was poor. Care staff who perceived their work environment to be poor were more likely to be dissatisfied with their work (odds ratio [OR] 15.40), experience high burnout (OR6.93), intend to leave the facility within a year (OR7.83), and experience increased overtime work due to COVID-19 (OR4.03). They were also less likely to perceive an immediate response to COVID-19 from their facility (OR0.45). The LTC work environment should be improved from its current state and government-led initiatives for infection control should be implemented to enable a better response to future public health crises in LTC settings.
RACIAL AND ETHNIC DIFFERENCES HOSPITAL DISCHARGE DISPOSITIONS FOR OLDER ADULTS: A PUBLIC POLICY PERSPECTIVE
Authors: Kang Sunny
Published: December 2023

This paper presents two empirical studies regarding racial disparities in older individuals’ hospital discharge. The first study targeting factors associated with older Black patients’ readmission to ambulatory care, examined 7,619 older patients from the 2016 National Ambulatory Medical Care Survey; the second study focused on race and mental disorders’ impact on older patients’ nursing home (NH) admissions upon hospital discharge, analyzing 186,646 older patients from 2007 to 2010 National Hospital Discharge Survey. We mainly used Binary Logistic Regression Analyses (1) to examine the impact of racial disparities in ER readmission within one week to two months’ discharge and (2) to study the racial disparities in NH admissions upon hospital discharge. Based on the studies, policy efforts are called upon to address the specific needs of racial minorities using Medicaid as a primary payment method; as well as for individuals residing in facilities with higher concentrations of Medicaid beneficiaries. Discharge diagnoses such as lower-limb fractures, chronic ulcers, and mental health conditions, especially among Black individuals with mental health conditions increased the odds of NH admission. Other factors such as the Medicare as the primary payer for the hospitalization, being unmarried, and prior residence in a skilled nursing facility are also important predictors for NH admissions. Black individuals appear to increasingly be disproportionately represented in the NH population. This may relate in part to the greater morbidity they experience related to chronic conditions such as diabetes and heart disease, which warrants further investigation as to the reasons for their high presence.
SMART MUSIC INTERVENTION: PROTOCOL DEVELOPMENT OF A WEARABLE DEVICE FOR COLLECTION OF PHYSIOLOGICAL DATA
Authors: Ihara Emily , Pathak Parth , Inoue Megumi , Tompkins Catherine , Hong Y Alicia
Published: December 2023

This study tested a protocol of collecting physiological data through sensors on a wearable device in response to favorite music from late adolescence/early adulthood. The benefits of personalized music for individuals living with dementia have been demonstrated in various studies, showing decreases in agitation, anxiety, depression, and other behavioral and psychological symptoms of dementia and improvement in mood, memory, and well-being. Most studies have relied on observational data, standardized clinical scales, and self- or caregiver-reported perceptions of the effects of personalized music. Passively-collected physiological data may minimize researcher bias during data interpretation. We tested the protocol on 15 participants, triangulating the physiological, observational, and self-reported effects of personalized music on stress. Physiological measures were captured by a wearable wristband Empatica E4 and included heart rate, electrodermal activity, and temperature. Self-reported measures included the Perceived Stress Scale, level of stress on a 0-10 scale, and reactions to each song (happy, energized, calm, relaxed, nostalgic, sad, excited). Prior to music listening, we induced stress through three iterations of the Trier Mental Challenge Test, which involves three minutes of math exercises. Participants reported their level of stress after the Trier Test and after each song. Researchers observed participant reactions during each song. Preliminary analysis shows that nine minutes of a stress-inducing activity was enough to capture stress reactions and demonstrated a feasible protocol for collecting physiological, observational, and self-report data. These results inform the development of a novel protocol that responds to a person’s stress levels through a personalized music listening intervention.