bluuebunny/crossref_metadata_2025 huggingface dataset:
CHILDHOOD SEXUAL TRAUMA, SUBSTANCE USE, AND ART ADHERENCE AMONG OLDER ADULTS LIVING WITH HIV
Authors: Brown Monique
Published: December 2022

Childhood sexual abuse (CSA) is associated with lower ART adherence among people living with HIV and is linked to substance use (SU) in adulthood. However, studies examining the mediating role of SU in the association between CSA and ART adherence are lacking. Therefore, the aim of this study was to examine SU as a mediator in the association between CSA and ART adherence among older adults living with HIV (OALH). Data were obtained from 91 OALH. Adjusted path models were used to determine the mediating role of SU. After controlling for sociodemographic characteristics and depression, CSA had a direct association with ART adherence (β=-3.20; p<0.001) and with SU (β=-2.46; p=0.023). The association between SU and ART adherence was not statistically significant (β=0.071; p=0.444). Therefore, the indirect effect between CSA, SU, and ART adherence was not statistically significant (β=0.175; p=0.468). Future research should examine alternative pathways between CSA and ART adherence.
SUPPORT NEEDS AND RESOURCES OF OLDER WOMAN LIVING WITH HIV
Authors: Manalel Jasmine , Kaufman Jennifer , Brennan-Ing Mark
Published: December 2022

People living with HIV are at increased risk for social isolation and sparse support networks, making it difficult to navigate complex caregiving needs as they age. This study aimed to identify the support needs and resources of older women living with HIV, an understudied population in this field, and their association with well-being. Participants included 217 heterosexual women aged 50 to 77 (Mage=59) from the ROAH 2.0 Study. Almost half of the sample (47.7%) had never required assistance because of HIV or other illness or disability, whereas the remainder required current or past assistance. Preliminary findings controlling for sociodemographics indicated that availability of emotional support, but not practical support (i.e., having someone to count on for activities of daily living), was associated with lower depressive symptomology. Identifying sources and types of support will help older women leverage existing social ties or form new ones to promote successful aging with HIV.
MISEXPRESSION OF GENES LACKING CPG ISLANDS IS A SHARED TRAIT OF MAMMALIAN AGING
Authors: Beck Samuel
Published: December 2022

Changes in the 3-D architecture of chromatin are observed in various diseases and are also a hallmark of aging. Disruption of the nuclear lamina and associated heterochromatin are commonly observed in various aging contexts, including premature aging diseases, cellular senescence, and normative aging. Although these conserved structural changes have been reported for over two decades, their impacts on transcription and contribution to age-related degenerative changes remain unknown. By performing a large-scale computational analysis and experimental validation, here we show that genes lacking CpG islands (CGI- genes), which form heterochromatin when transcriptionally silent, are globally misexpressed in aged nuclei with disrupted chromatin architectures. We demonstrate that CGI- gene misexpression is a common feature of mammalian aging and explains the molecular basis of various age-associated defects, ranging from loss of cellular identity and increased transcriptional noise to age-associated chronic inflammation. Our findings reveal that CGI- gene misexpression is directly associated with age-related physiological deterioration, thus providing a novel biomarker of aging.
A SIMPLE ANIMAL MODEL OF EXERCISE REVEALS A MOLECULAR DETERMINANT OF LONG TERM HEALTH MAINTENANCE
Authors: Driscoll Monica
Published: December 2022

At all stages of life, both dynamic gene expression changes and events that “lock in” particular programs that promote health and maintenance are critical factors in aging trajectories. We have a long-term interest in the fundamental biology of healthy maintenance, a topic that has led us to consider multiple facets of healthspan. A powerful whole-organism intervention with maintenance-promoting, anti-disease, anti-aging impact is exercise. The molecular and cellular mechanisms that mediate long-term system-wide exercise benefits, however, remain poorly understood, especially as applies to “off target” tissues that do not participate directly in training activity. We are investigating the basic biology of exercise benefits using the simple 959-celled model C. elegans. We found that multiple daily swim sessions are essential for exercise adaptation, leading to enhanced expression of muscle structural genes and improved locomotory performance. Importantly, swim exercise training enhances whole-animal health parameters such as mitochondrial respiration and mid-life survival, increases functional healthspan of pharynx and intestine, and enhances nervous system health by increasing learning ability of adults and protecting against neurodegeneration in models of tauopathy, Alzheimer’s disease, and Huntington’s disease. Remarkably, swim training only during early adulthood induces long-lasting systemic benefits that in several cases are still detectable well into mid-life. Our investigation of the molecular requirements for long-term maintenance (“legacy effects”) revealed that deletion of the sole C. elegans extracellular superoxide dismutase gene SOD-4 changes this pattern. sod-4 mutants are able to swim train to gain measurable benefits, but do not maintain the healthspan improvements that wild type animals do, defining extracellular SOD-4 as a powerful mid-life maintenance factor associated with exercise experience. Our talk will discuss transcriptomic analysis of exercise and SOD-4, as well as our current understanding of the molecular mechanisms operative. Notably, mammalian extracellular SOD ecSOD has been shown to promote exercise associated health and protection against oxidative stress insults (PMID: 32220789 Yan, Spaulding 2020), implicating ecSOD in a conserved role for health maintenance and underscoring potential for therapeutic translation.
FACTORS ASSOCIATED WITH MEALTIME LANGUAGE CHARACTERISTICS IN NURSING HOME STAFF AND RESIDENTS WITH DEMENTIA
Authors: Liu Wen , Jao Ying-Ling , Yoon Si On
Published: December 2022

Interactive staff-resident communication is crucial for nursing home residents with dementia requiring mealtime assistance. Effective communication may facilitate food intake and promote function and nutrition. However, understanding of staff and resident language characteristics in mealtime interactions is limited. This study examined language characteristics and associated factors in mealtime interactions. This was a secondary analysis using data from videotaped mealtime observations (N=160) involving 36 staff and 27 residents with moderate-to-severe dementia (53 staff-resident dyads) in 9 nursing homes. The dependent measures were 1) the number of words produced in each utterance (expression length), and 2) whether staff named the resident in each utterance (naming the resident). Mixed-effects models examined the effect of utterance quality (positive vs. negative utterances), intervention (pre- vs. post-communication training), and subject speaking (staff vs. resident), adjusting resident comorbidities and dementia stage. Staff (mean=4.30, SD=2.98) produced significantly longer utterances than residents (mean=2.64, SD=2.27). Expression length was modulated by utterance quality and intervention. Staff’s negative utterances were shorter than their positive utterances, while residents’ negative utterances were longer than their positive utterances. Staff’s negative utterances became longer after the intervention while the length of positive utterances remained similar pre- and post-intervention. Staff named the resident in 16.72% of their utterances and was more likely to name residents with severe dementia. Findings emphasize the potential benefit of communication training on mealtime interactions. Findings also highlight the need to further examine the impact of language characteristics on food intake, which may guide intervention development to promote nutrition for residents with dementia.
FIFTEEN-YEAR TRENDS IN THE PATTERNS OF MEAL TIMING AND EATING FREQUENCY AMONG US ADULTS
Authors: Farsijani Samaneh , Mao Ziling , Newman Anne
Published: December 2022

Understanding patterns of eating behavior may provide insights into contributors to obesity and metabolic diseases. To characterize trends in meal timing and frequency in US population age >19 years, we performed a serial cross-sectional analysis of 8 National Health and Nutrition Examination Survey (NHANES) cycles (2003-2018) on 34,470 adults (52.5% women and 21% black). Time of food and beverage intake was extracted from two 24-hour food recalls. The following meal timing measures were defined: 1) The time of the last and first calorie intake either from food or drink, 2) Eating window: The time elapsed between the first and last food intake, 3) Calorie midpoint time: The time when half of the calories for the day were consumed, 4) Late night eating: Consumption of ≥33% of total daily energy between 5:00pm and midnight, and 5) Eating frequency: Frequency of food or beverage consumption >0 kcal which were >15 minutes apart. From 2003 to 2018, survey-weighted mean (±SE) of eating window decreased from 12.21±0.06 to 12.02±0.05 hours/d (Ptrend=0.002). Time of the last calorie intake significantly decreased from 20.31±0.04 to 20.09±0.03 hours/d, while the time of first calorie intake and eating frequency remained unchanged. More than two-third of participants consumed ≥33% of total daily energy after 5:00pm. Over the 15-year span, composition of diet has also changed, including a decline in total calorie intake and percentage of energy from carbohydrate intake, while percentage of energy from dietary fats increased, Ptrend< 0.05. Patterns of eating behavior have changed in American adults over time.
MEASURING PROFESSIONAL KNOWLEDGE OF LATER LIFE DEPRESSION
Authors: Laine Abby , Steffen Ann
Published: December 2022

Research linking behavioral health providers’ knowledge of later life depression to their clinical practices and patient outcomes is restricted by outdated measures. A multi-stage study was conducted to ameliorate this gap. Qualitative interviews with geropsychology content experts (N = 5) generated 49 true/false items capturing relevant concepts in later life depression, including brain health concerns. Additional content experts (N = 10) completed the questionnaire and a card sort task placing items into categories (Psychopathology, Assessment/Diagnosis, Treatment, Other) to understand measurement structure. This resulted in retention of 42 items. A random pool of licensed social workers (N=900) were mailed the survey packet with option to complete via return mail or online. This presentation will review scale psychometrics, reliability, and construct validity among MSWs from diverse clinical backgrounds. Associations between participant characteristics and knowledge of cognitive and other depressive symptoms will also be highlighted.
CLINICAL TOOLS TO ADDRESS BRAIN HEALTH CONCERNS IN THE CONTEXT OF LATER-LIFE DEPRESSION
Authors: Bergstrom Kelly
Published: December 2022

GSA’s revised KAER Toolkit for Primary Care Teams (Fall, 2021) is an important resource, yet the complexities of depressive and cognitive symptoms in aging individuals create particular challenges for generalist behavioral health providers. Mental health practitioners and their patients can benefit from evidence-based clinical intervention materials that address the intersection of depression and brain health concerns. This presentation highlights treatment strategies and clinical tools from the new Brain Health module of the revised 2021 client workbook Treating Later-Life Depression: A Cognitive Behavioral Therapy Approach from Oxford University Press. Examples will be presented of large print within-session “Learn pages” that inform both providers and patients about normative cognitive aging and ways in which cognitive functioning can be affected by depression. Between-session “Practice forms” will also be demonstrated that address lifestyle factors to promote brain health, consideration of whether to complete a cognitive evaluation, and strategies to manage brain health changes.
SELF-REPORTED DENTAL CONDITIONS AND MEMORY DECLINE: THE MEDIATION ROLE OF STROKE
Authors: Tan Chenxin , Luo Huabin , Qi Xiang , Wu Bei
Published: December 2022

The relationship between oral health and cognitive function has been studied extensively; however, little research has examined the underlying pathways. Using a cohort of 6,403 adults aged 51+ from the 2006-2010 English Longitudinal Study of Ageing, we analyzed the effect of changes in self-rated dental conditions on memory function (ranges 0-20) and the mediation effect of stroke using a causal mediation analysis framework. Controlling for socio-demographics, lifestyle, and health status, we found that compared with participants whose dental conditions remained the same, those who reported deterioration of dental conditions in 2006-2010 (N=1,755) experienced a steeper decline in memory function, with an average total effect of -0.22 (95% CI=-0.36, -0.07). The stroke incident had an average mediation effect of -0.007 (95% CI=-0.014, -0.001), representing 3% of the average total effect. The findings accentuate the importance of dental care access for older adults with exacerbated oral health problems.
A VISION FOR THE FUTURE OF ASSISTED LIVING RESEARCH: LEVERAGING ADMINISTRATIVE DATA TO STUDY QUALITY
Authors: Thomas Kali , Carder Paula , Smith Lindsey , Zimmerman Sheryl
Published: December 2022

Because the assisted living industry is neither federally regulated nor federally licensed, methodologies to study the quality of long-term care used in other settings (e.g., annual inspection reports, resident assessment data) do not exist for the large and growing number of assisted living communities and their residents. The objective of this presentation is to present a vision for the future of assisted living research to inform quality using large, national datasets. To do this, the presenter will discuss existing approaches to identify and characterize assisted living communities and their residents using administrative data. A specific focus will be to highlight the opportunities and challenges associated with each approach. The presenter will offer suggestions for possible enhancements in existing approaches and next steps in the study of assisted living aimed at understanding and improving the quality of care delivered in these settings.
ELDER MALTREATMENT IN INDIA: EXAMINING THE SENIOR CITIZENS ACT OF 2007 AND ITS IMPLEMENTATION
Authors: Ejaz Farida
Published: December 2022

Although cultural traditions place a high regard for older adults, elder maltreatment is on the rise in India. Prevalence rates vary widely. A recent national survey demonstrated a prevalence rate as low as 5% (LASI, 2020) while another report (HelpAge, 2015) found that 50% of older adults felt emotionally abused by family members. This presentation focuses on an important legislation, ‘The Maintenance and Welfare of Parents and Senior Citizens Act’ of 2007, amended in 2013 and 2018. It makes it obligatory for adult children and heirs to care for their parents/stepparents, address their needs, provide a monthly allowance and protect their property. As part of the implementation of this Act, tribunals have been set up to prosecute perpetrators. Police stations also have a helpline for Senior Citizens to address complaints amicably. Through two case studies, we will discuss how the Act is implemented in India, bringing critical nuances to light.
EXPERIENCING PAIN TOGETHER: CARE PARTNERS REFLECT ON A DYADIC INTERVENTION FOR PAIN SELF-MANAGEMENT
Authors: Fox Aimee , Schmid Arlene , Portz Jennifer Dickman , Van Puymbroeck Marieke , Leach Heather , Sharp Julia , Fruhauf Christine
Published: December 2022

When caregivers and care receivers (caregiving dyad) both experience persistent pain, there is increased risk for shared adverse health outcomes, including social isolation and decreased relationship satisfaction. Yet, there are few non-pharmacological pain interventions for the caregiving dyad. The purpose of this study was to understand changes in the caregiving dyad after participating in a dyadic, multi-modal intervention for pain self-management. Fifteen caregiving dyads with pain (N=30) participated in the Merging Yoga and self-management to develop Skills (MY-Skills) intervention. Open-ended questions were included in the post-intervention evaluation tool to discuss changes in the dyadic relationship. Qualitative methods were used to analyze data, develop a coding scheme, and identify themes. Findings suggest the intervention strengthened relationships by improving communication, enhancing emotional connection, and increasing physical activity. This study demonstrates the importance of dyadic approaches to interventions for care partners with pain.
STRATEGIES TO CREATE CAREGIVER-FRIENDLY WORKPLACES
Authors: Tell Eileen , Nadash Pamela , Ruggeri Siena
Published: December 2022

An estimated one in six employees is juggling work and being a family caregiver. Research suggests working caregivers neglect their own health and experience higher levels of stress and poor mental health. Their employers also experience negative outcomes, most typically in terms of increased absenteeism, lost productivity, difficulty recruiting and retaining workers, and higher health care claim costs. A wide range of strategies have emerged for employers to better support working caregivers and, hopefully, thereby reducing the financial impact both for the company and the caregiver. In this session, we discuss recommendations that emerged from research with both public and private sector stakeholders to identify best practice models and action steps for a national strategy supporting working family caregivers. Recommendations range from employer education, voluntary recognition programs, tax credits for employer-paid caregiver support programs, expanded PFMLA, and even federal LTSS financing reform.
EFFECT OF ACA MEDICAID EXPANSION ON THE LABOR SUPPLY OF DIRECT CARE WORKERS
Authors: Xu Lili , Sharma Hari
Published: December 2022

Direct care workers (DCWs) such as personal care aides, home health aides, and nursing assistants provide critical care to patients and residents in different settings including at home, nursing homes, and hospitals but DCWs earn low wages with limited benefits. The Affordable Care Act Medicaid expansion increased health insurance access among low-income individuals but there are concerns that public insurance may disincentivize labor supply. In this study, we examine whether Medicaid expansion affected the labor supply of low-educated DCWs at both extensive and intensive margin overall, and by different healthcare settings. Using annual American Community Survey data from 2010 to 2019 retrieved via Integrated Public Use Microdata Series, we identify 100,676 adult DCWs (age: 19-64) with a high school or less degree from 50 states and DC. We examine the potentially causal effect of Medicaid expansion on labor supply of DCWs using difference-in-differences and event-study regressions We find that Medicaid expansion is associated with a 2.9 percentage-point (p< 0.01) increase in full-time employment (>=35 hours) and a 1.9 percentage point (p< 0.05) decrease in part-time employment (20-34 hours). We also find that unemployment decreased by 0.8 percentage points (p< 0.1) among DCWs mainly driven by those working in the long-term care industry. Our study suggests that Medicaid expansion does not have a negative impact on labor supply among low-educated DCWs. States that have not expanded Medicaid can consider policies to increase insurance coverage for DCWs as a strategy to strengthen this workforce.
HOME HEALTHCARE WORKFORCE AND NEIGHBORHOOD CHARACTERISTICS
Authors: Ma Chenjuan
Published: December 2022

Despite the rapid increase in the needs for home- and community-based services (HCBS), including home health care which is the most commonly used HCBS, workforce shortage has become a critical challenge to home health agencies in providing quality care to meet the needs of millions of homebound Americans. This study aimed to examine the availability of home health care workforce and its variations by neighborhood characteristics. We linked several national datasets from 2019 and included information from 11,005 HHC agencies in 1,849 counties. The unit for analysis is county. We found that on average county had fulltime equivalent (FTE) 83 (SD=351) home health care nurses, 120 (SD=411) FTE skilled home health providers (e.g., nurses, physical/occupational therapists) and 37 (SD=411) FTE aides. For every 1,000 persons, on average counties had 0.7 (SD=4.6) FTE nurses, 0.9 (SD=4.7) FTE skilled providers, and 0.2 (SD=0.8)) FTE aides. For every 1,000 older adults (>=65), on average counties had 3.6 (SD=23.9)) FTE nurses, 4.8 (SD=24.6) FTE skilled providers and 1.2 (SD=4.4) FTE aides. We also found that counties with moderate (2nd tertile) proportion of Black and Hispanic Americans; counties with highest (3rd title) proportion of Black and Hispanic Americans had the lowest number of FTE home health care aides per every 1,000 persons. Our findings highlight the staff shortage facing home health care and suggest the existence of disparities in availability of home health care workforce.
PANDEMIC POLICIES MOVING FORWARD: WHAT HAVE WE LEARNED
Authors: Lindberg Brian
Published: December 2022

Leading aging and health policy advocates will present their findings and viewpoints regarding pandemic and post-pandemic policy and programmatic changes and innovations. Issues will include elder justice, home and community-based services, Medicaid, nursing home care, and social isolation. The group will discuss what has changed and how will programs and services be different in the future.
ALL HANDS ON DECK: CONCEPTUALIZING AND OPERATIONALIZING COLLABORATION WITHIN CARE NETWORKS
Authors: Koumoutzis Athena , Ellis Katrina , Lewis Jordan , Lin Zhiyong , Zhou Yuanjin , Chopik William , Gonzalez Richard
Published: December 2022

Care recipients often report multiple caregivers that provide assistance. Yet, consideration of conceptual and methodological issues of caregiving networks has yet to be fully explored. This paper proposes a care collaboration index for each care network that predicts variation in collaboration among multiple networks. The association between network size, race/ethnicity, and dementia status with collaboration was also examined. Data came from the 2015 waves of NHATS and NSOC. Operationalization of collaboration was derived from 1,298 caregivers within 552 care networks. Care recipients were older adults (Mage = 83.69, SD = 7.73), most were women (71.6%), 47.9% had possible/probable dementia, and 38.9% identified as persons of color. The collaboration index considered shared care tasks and scope of assistance while controlling for the size of the immediate and broader care networks. This measure also considered task overlap among care networks as a collaboration process. A series of regression models were run to analyze whether care collaboration differed for older adults by key predictors and if the association between care collaboration and predictors varied across care tasks. Care networks with more caregivers garnered greater collaboration overall, both in general and across most types of tasks. Greater collaboration was observed among Black, Hispanic, and Other (non-White) care recipients and those with possible/probable dementia. This index provides a way to examine care network behaviors and highlights the importance of collaboration-informed approaches. Implications regarding the relationship between care collaboration and outcomes for caregivers and recipients will be discussed.
INSIDE THE REVIEW MEETING
Authors: Gabor Helena
Published: December 2022

What happens to applications on meeting day? What do study section members discuss? Review of applications are evaluated for their scientific and technical merit, and this is reflected in the reviewers’ written assessment of the project’s overall impact. In addition, reviewers score five core criteria and additional review criteria as defined in the funding opportunity announcement. The panel’s initial assessment determines which applications will be discussed in full at the meeting. For each that is discussed, reviewers briefly present the strengths and weaknesses of the application and discuss the factors that inform their overall assessment. At the end of the discussion, a final impact score is given by all eligible members of the panel, which is reported on the summary statement. Every application undergoes a similar process that ensures that fair and consistent consideration is applied to all applications. At the end of the presentation, attendees will learn how the foundation and pillars of the NIH peer review process are put into practice through scoring, discussion, and potential impact on the field.
ALTRUISTIC AGING: ON THE MORALITY OF “AGING WELL”
Authors: Barrett Anne , Vecchione Katia
Published: December 2022

A dominant aging narrative emphasizes what individuals should do to age well, namely remain active and productive. Underlying these promotional messages, however, are others about what should be avoided. At their core is a proscription against becoming dependent, thus “burdensome.” To critically examine this aging narrative, we develop the concept of “altruistic aging,” which captures a cultural expectation that older adults adopt a selfless concern for the well-being of others. We use data from interviews with 28 Italians aged 65 and older to illustrate how the goal of altruistic aging shapes older adults’ behaviors in the present and their framing of care options in the future. It motivates physical and social activity, as well as healthy eating – all aimed, in part, at extending the duration of one’s self-sufficient years. Altruistic aging also involves expunging the idea of ever living with one’s children and emphasizing the benefits of nursing homes. This observation suggests that altruistic aging may be constructed as a familial duty, particularly in nations like Italy with family-centered models of care. Our analyses reveal that taken-for-granted, and culturally celebrated, orientations toward aging may mask an internalization of ageism that devalues the self to the point of selflessness.
DETERMINING EVIDENCE FOR EFFECTIVE FAMILY CAREGIVER COMMUNICATION: STRATEGIES LEADING TO BREAKDOWN AND REPAIR
Authors: Coleman Carissa , Hu Jinxiang , Williams Kristine
Published: December 2022

Communication is fundamental for dementia care and identifying evidence for strategies that facilitate or impede communication is needed. We analyzed 221 videos from a randomized controlled trial of a family caregiver telehealth intervention (FamTechCare) using Noldus second-by-second behavioral coding of communication behaviors and breakdowns in interactions between 53 caregiver-person with dementia dyads. Coded data from 3,642 30-second observations were first analyzed using penalized regression for feature selection (least absolute shrinkage and selection operator; LASSO) to identify strategies most important for predicting prevention and successful repair of communication breakdown. Bayesian mixed modeling was then used to identify communication strategies associated with successful versus unsuccessful prevention and repair of communication breakdown taking into account of the dyadic structure of our data. Results showed that given our data, communication breakdown was associated with caregivers changing topic (Mdn=11.23, 95% CrI [4.39, 24.43]), ignoring (Mdn=11.47, 95% CrI [4.75, 24.17]), making commands (Mdn=10.55, 95% CrI [3.41, 23.22]) and taking over the task (Mdn=4.04, 95% CrI [1.69, 7.23]). Successful repair of breakdown was associated with caregivers verbalizing understanding (Mdn=-0.47, 95% CrI [-0.88, -0.09]), tag questions, (Mdn=-2.44, 95% CrI [-5.35, -0.33), and silence (Mdn=-0.78, 95% Crl [-1.18, -0.40) while ignoring and changing topic were associated with unsuccessful repair (Mdn=3.63, 95% Crl [-2.56, 4.78; and 2.51 [1.39, 3.74]). These results provide evidence for development and testing of evidence-based communication strategy training for family caregivers of persons with dementia. Future analyses will identify effects of dementia stage, diagnosis, and dyad characteristics on associations.
EFFECTIVENESS OF SMOKING CESSATION INTERVENTIONS WITH LDCT LUNG CANCER SCREENING AMONG AFRICAN AMERICAN SMOKERS
Authors: Tseng Tung-Sung , Kao Yu Hsiang , Li Mirandy
Published: December 2022

Low dose computed tomography (LDCT) screening can detect lung cancer early and decrease lung cancer-specific mortality for current smokers but remains under-utilized among these populations. Although African-American smokers tend to smoke less and have lower smoking pack-year histories, they have lower quit rates, higher rates of mortality from lung cancer than other racial/ethnic groups. This study examined the effectiveness of a smoking cessation intervention integrating LDCT screening among African-American smokers. This study recruited 60 African-American daily smokers over the age of 55 who qualified for LDCT screening. Participants were randomly and equally assigned into two groups (intervention and control). Overall, the mean age was 61.0 years old (standard deviation, 5.5), 61.7% of the participants were female and, 91.7% had lower incomes (<$20,000). Descriptive statistics were used to summarize demographics, smoking status, knowledge, attitudes, and stage of change for smoking cessation. The findings showed that participants in the intervention group had a lower number of daily cigarettes smoked (9.5 vs. 11.0) and a higher reduction in the number of daily cigarettes smoked (-2.3 vs. -0.9) than those in the control group. Participants in the intervention group were more likely to be in the preparation stage of the stages of change model (50.0% vs. 40.0%), progress in the stage of change (36.7% vs. 16.7%), or report already having had quit smoking (10.0% vs. 3.3%) than those in the control group. LDCT screening represents a potential "teachable moment" for African-American smokers, which may encourage them to consider these strategies for smoking cessation.
VIDEO CALLING REDUCES LONELINESS FOR HEARING IMPAIRED OLDER US ADULTS DURING THE COVID-19 PANDEMIC
Authors: Zhang Amanda , Wroblewski Kristen , McClintock Martha , Hawkley Louise , Pinto Jayant
Published: December 2022

Older adults with hearing impairment (HI) experience communication challenges that may result in increased loneliness exacerbated by social distancing during COVID-19. Video-calling may mitigate isolation-related loneliness. We addressed this hypothesis in the National Social Life, Health, and Aging Project (NSHAP), a longitudinal, nationally representative study of home-dwelling older US adults. Hearing ability was determined by interviewer-rating and loneliness/video-calling use by self-report. Fewer older adults (≥55 years) with HI (n=221) reported regular use of video-calling during the pandemic vs. those without HI (n=2337) (14% vs. 30%, p<0.001). Older adults with HI reported greater loneliness during COVID-19 (p=0.031), with video calls mitigating this relationship through a dose-dependent effect in adjusted analyses (interaction p=0.001). Video-calling decreases HI-related loneliness, despite potential barriers those with sensory impairment face using this technology. Promoting greater adoption of video-calling could be a strategy to protect against HI-related loneliness in aging.
FINANCIAL FRAUD EXPERIENCES AT AGE 85+: AN EXPLORATORY STUDY WITH THE MIT AGELAB 85+ LIFESTYLE LEADERS PANEL
Authors: Patskanick Taylor , Ashebir Sophia , Miller Julie , D'Ambrosio Lisa , Coughlin Joseph
Published: December 2022

Financial exploitation of older adults has emerged as one of the most common and costly forms of elder abuse. While prior research has examined the risk and protective factors that contribute to older adults’ experiences of being defrauded, less has specifically explored the prevalence of these factors among the 85+ age demographic. This not only includes hearing from the 85+ directly about the factors that have contributed to successful financial exploitation, but also the factors that contributed to their experiences of unsuccessful and ‘near miss’ exploitation. This paper shares findings from a mixed methods study with the MIT AgeLab 85+ Lifestyle Leaders, a U.S.-based panel of octogenarians and nonagenarians. Leveraging an online survey (n=32) and virtual focus groups (n=18) conducted in September 2021, findings distinguish among three categories of experiences with financial fraud – those had been, almost were, or have never been a victim of financial fraud within the past five years. In particular, ‘almost victims’ frequently scored in between ‘have been’ and ‘have never been’ victims with regard to several questionnaire variables. Six perceived risk factors for financial fraud victimization emerged from both data sources, including being older, cognitive decline, misplaced trust and a lack of knowledge, loneliness, technology use, and stereotypes of older adults. The majority of Lifestyle Leaders identified protective factors including, knowledge about protecting oneself from financial scams, a lifetime of experience and one’s social network. These findings will be discussed in further detail along with their implications for multidisciplinary professionals working with older adults.
IMPACT OF NON-NATIVE ENGLISH SPEAKING ON MEDICATION PROBLEMS AND ER VISITS AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Zhu Yujun , Enguidanos Susan
Published: December 2022

Older adults have higher risk of experiencing medication related problems (MRPs), leading to increased morbidity, healthcare utilization, and mortality. Few studies have examined the relationship between non-native English speaking (NNES) and MRPs and their association with health service use. This study aimed to explore language disparities in MRPs and their relationship to emergency room (ER) visits among community-dwelling older adults. We used secondary enrollment data from a community medication program for older adults (N=180). We conducted linear regression to examine the relationship between NNES and MRPs, and logistic regression to explore the association between MRPs and ER visits. Generalized structural equation modeling (GSEM) with bootstrapping was used to test the indirect effect between NNES through MRPs to ER visits. The sample was diverse with 40% White, 30% Hispanic, 22% African American, and 8% of other races; 18% were non-native English speakers. Analysis showed NNES was associated with having 2.7 more MRPs than native English-speaking participants, while race was not significant, after controlling for covariates. Each additional MRP was associated with a 9% increased probability of having an ER visit. The GSEM results found a significant indirect effect between NNES through MRPs to ER visits (β, 0.27; 95% CI, 0.07 to 0.61). Although NNES was not directly related to ER visits, it may have inhibited the ability of Hispanics to read important medication instructions, contributing to their elevated risk of experiencing MRPs, thus indirectly increasing potential risks leading to ER visits. Further research is needed to better understand this relationship.
STAIR CLIMB TIME AND FUNCTIONAL POWER ASSOCIATIONS TO MUSCLE FUNCTION AND PHYSICAL PERFORMANCE
Authors: Strotmeyer Elsa , Lui Li-Yung , Glynn Nancy W , Santanasto Adam , Kritchevsky Stephen , Cawthon Peggy , Newman Anne , Cauley Jane
Published: December 2022

Repeated stair climbing assesses sustained performance and neuromuscular components of movement, including functional muscle power (force*velocity). However, repeated stair climb associations to standard muscle and physical function measures are not established in older adults. We hypothesized that stair climb time (sec), and ascend power (peak and average; Watts=W) over 3 stair climb laps were associated with standard muscle function, physical function and risk factors in the Study of Muscle, Mobility and Aging (SOMMA; preliminary baseline N=455; 76.9+/-5.3 years; 58.0% women; 85.7% White). Adjusting for age, sex, race, and BMI using multivariate linear regression, stair climb time, peak power and average power were significantly associated with all standard muscle (Keiser leg press 1-RM strength and power; grip strength) and physical function (400m walk speed, SPPB and components) measures. Women had worse stair climb performance vs. men (all p< 0.01) including: longer total time (29.6+/-8.1 vs. 27.4+/-6.7 sec), lower peak power (121.9+/-34.5 vs. 161.4+/-39.0 W), and lower average power (94.9+/-24.3 vs. 124.1+/-28.4 W). Adjusting for age, sex, race, BMI, CHAMPS total physical activity/week, CES-D depressive symptoms, and comorbidity count using multivariate linear regression, older age was related to slower stair climb time and lower peak/average power. Other known risk factors were also associated with worse stair climb performance: non-White race (average power only), lower physical activity (peak/average power only), BMI, depressive symptoms, and higher comorbidity (time only). Repeated stair climb time and power may capture unique aspects of functional decline with aging and are associated with standard muscle and physical function measures.
REBUILDING THE NURSING HOME WORKFORCE: A TIME FOR CHANGE
Authors: Holaday Louisa , Travers Jasmine
Published: December 2022

The COVID-19 pandemic magnified several long-standing problems in nursing homes, including issues within the nursing home workforce. Issues include staffing shortages, high turnover, low pay, inadequate training, poor treatment and limited access to resources. Research suggests that workforce issues of these kinds have the potential to significantly threaten and further increase disparities in the quality of care for nursing home residents. Thus, solutions are needed that ensures the nursing home workforce receives adequate investment so that these critical personnel are able to more effectively do the work that they do. In this presentation, workforce issues salient within the nursing home setting will be elaborated and potential solutions to mitigating these issues will be discussed.
ELDER ABUSE IN SPECIAL POPULATIONS IN THE US: AMERICAN INDIANS AND ALASKA NATIVES AND THOSE LIVING IN THE RURAL SOUTH
Authors: Teaster Pamela B Teaster
Published: December 2022

The number of older adults who experience abuse, neglect, and exploitation as well as the complexities of the cases continue to increase, despite advances in prevention and intervention of the problem. At once a multifaceted problem that involves intertwining individual, relational, community, and societal contexts, issues related to elder abuse become even more complicated among special populations, which require a nuanced understanding and approach to prevention, detection, and intervention. This presentation is a compilation of the findings from studies of the mistreatment of older American Indians and Alaska Natives (AIANs) and adults living in the rural south, all populations that are understudied. Both research and practical policy and practice solutions that have the potential to resolve disparities in these populations will be discussed.
PERSONALITY PROFILES OF CENTENARIANS AND NEAR-CENTENARIANS IN THE HEALTH AND RETIREMENT STUDY
Authors: Ryou Yeon Ji
Published: December 2022

Centenarians are typically considered exceptional survivors who maintain their general health. The current study aims to track the change of personality over time and examine the differences between centenarians (defined as 98+ years; n = 516) and a group of non-survivors (died before 98; n = 6,771) using data from the Health and Retirement Study. Findings demonstrated that extraversion, agreeableness, conscientiousness, and openness decreased in 2012 and climbed again in 2014. Conversely, however, neuroticism increased in 2012 and then decreased in 2014. Interestingly, a pattern similar to that of 2012 appeared in 2020. Significant differences between centenarians and non-survivals were found in 2006 and 2010. Centenarians were more extraverted, agreeable, conscientious, and open-minded than non-survivors in 2006. Similarly, centenarians were more extraverted, agreeable, and open-minded than their counterpart in 2010. These findings provide a cornerstone for future research investigating the change of personality and its role in longevity among centenarians.
RECRUITMENT FOR A MULTISITE PRAGMATIC TRIAL OF DEMENTIA CARE STRATEGIES: BARRIERS AND SUCCESS DURING COVID-19
Authors: Reuben David , Maslow Katie
Published: December 2022

With 2176 participants recruited, D-CARE is the largest pragmatic clinical trial of dementia care strategies, to date. At four clinical trial sites (CTS), D-CARE will compare the effectiveness of three dementia care strategies over 18 months: 1) by nurse practitioners or physician assistants within a health care system, 2) by social workers or nurses at community-based service organizations (CBO), or 3) usual care. Primary outcomes include person with dementia (PWD) behavioral symptoms and caregiver strain. Other outcomes include the PWD quality of life and ability to reach personal goals, and caregiver self-efficacy, distress, and depressive symptoms. Recruitment began in June 2019 with a basic protocol in which participating providers reviewed lists generated from the electronic health records (EHR) of patients who had a diagnosis of dementia, allowing the removal of patients who should not be contacted and giving an opportunity to provide information about the family caregiver. Some practices gave “blanket” referral allowing research staff to recruit participants directly. Other practices provided direct referrals via EHR communications to the research team. Self-referrals triggered by public postings in clinics and CBOs, social media, and media coverage were also accepted if a dementia diagnosis was confirmed in the EHR. By March 16, 2020, all in-person recruitment visits were suspended due to COVID-19. In response, informed consent was switched to telephone with verbal consent as permitted by State and Institutional regulations. This symposium describes the creative approaches employed by CTS’ to respond to these challenges and reach the recruitment goal in January 2022.
ELECTRONIC HEALTH RECORD SCREENING FOR PERSONS LIVING WITH DEMENTIA IN D-CARE
Authors: Yang Mia , Lenoir Kristin , McCurry Darcy , Currie Katherine , Pajewski Nicholas , Williamson Jeff
Published: December 2022

Pragmatically identifying persons living with dementia (PLWD) for research is a persistent challenge, reflecting limitations in data elements. As part of the D-CARE study, the recruitment coordinator and analyst collaborated to create a screening algorithm to identify potentially eligible patients. A combination SAS/R script was applied on a monthly basis (Oct 2020-Dec 2021) to a clinical data warehouse, identifying living patients 50 years or older with ICD-10 codes for dementia or related conditions within the past two years, and an encounter within the past year. This process identified 6,478 unique patients, leading to the recruitment of 837 PLWD into the study (22% Black or Hispanic). Algorithmic components that enhanced recruitment efforts included the incorporation of data elements necessary to contact and enroll patients, formatting data consistent with reporting requirements, and tracking information on primary care provider, diagnosis dates with the set of providers that agreed to recruit for the trial.
MOBILE INTERVENTION FOR FAMILY DEMENTIA CAREGIVERS: FROM FOCUS GROUPS TO SMARTPHONE PLATFORM
Authors: Jain Felipe , Madarasmi Saira , Ursal D J , Gutierrez-Ramirez Paulina , Sikder Abu , Banerjee Sreya , Gomez Liliana Ramirez
Published: December 2022

There is growing recognition that in-person delivery of caregiver interventions limits scalability due to distance from locations where interventions are available, and costs associated with locating substitute care for the person living with dementia. Internet-based interventions are often not optimized for smartphones, which are more accessible than desktops to minoritized populations and those of lower socioeconomic status. In this study, focus groups were conducted with 17 English language and 12 Spanish language family dementia caregivers regarding needs for smartphone-based technological intervention. We employed an inductive and deductive driven mixed method analytic approach. Identified needs included psychoeducation regarding dementia, provision of caregiver skills information, activities for the person living with dementia, and relaxation techniques. Similarities and differences among preferences between the two populations were identified. Family dementia caregivers endorsed several needs for mobile intervention. The development of a new mobile application platform to meet these needs will be described.
FAIR SHARING OF THE BLSA DATA ECOSYSTEM
Authors: Griswold Michael , Henegan James , Blackshear Chad , Moore Ann , Smith Thomas , McGowan Deric , Simonsick Eleanor , Ferrucci Luigi
Published: December 2022

The BLSA is an invaluable resource for the study of human aging with uniquely rich measures taken longitudinally on a continuous replenishment cohort since 1958. Tremendous interest has been expressed by the United States and international research communities in expanded access to and use of BLSA data to address emerging scientific questions. Here, we will describe recent study leadership initiatives into: (1) making the BLSA data more FAIR (Findable, Accessible, Interoperable, and Reusable), (2) growing a BLSA data ecosystem that enables scalable sharing, and (3) leveraging and developing platforms for accessing the ecosystem. Lastly, we will demonstrate current platform functions that empower researchers to find and access BLSA data, metadata, protocols, code and supporting materials to make new discoveries.
DEVELOPING A FITNESS AGE-NORMALIZED PERCENTILE-BASED APPROACH TO DEFINE EXCEPTIONAL AGING
Authors: Simonsick Eleanor , Moore Ann , Tanaka Toshiko , Tian Qu , Ferrucci Luigi
Published: December 2022

An operational definition of ‘well-aged’ is integral to research identifying biological, psychological and behavioral parameters that predict and/or support healthy aging but remarkably few measures exist. A major challenge is incorporating age-related physiologic decline – a normal feature of healthy aging. We defined well-aged using fast 400m walk performance, a measure of cardiovascular fitness and hallmark of healthy aging. We determined the sex-specific, age-normalized 75th percentile using 4000+ observations collected over 15 years from BLSA participants aged 50-96y (51% women). In 1257 BLSA participants mean age 68.9y (52% women) we compared well-aged to average-aged (25th-75th percentile) adjusting for age, sex and race, and found more favorable WBC, triglycerides, CRP, depressive symptoms, waist/height ratio, eGFR and FEV1 z-score distinguished concurrent well-aged status (all p<.003). Waist/height ratio and pulse-wave velocity (both p<.001) predicted retained well-aged status 2-plus years later. Future work aims to identify physiologic and behavioral facilitators of healthy aging.