bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived Appreciation for Care Associates with Higher Quality Caregiving Day-to-Day
Authors: Meyer Kylie , Chinea Arielle , Masoud Sara , Hamilton Kevin , Glassner Ashlie , Wang Jing , White Carole
Published: December 2021

Family members are critical to dementia care and the U.S. long-term services system. Yet, little is known about how to support the quality of care provided by family members, who often receive little training. We hypothesize that on days when caregivers feel more appreciated, they report providing a higher quality of care. To test this hypothesis, we asked spousal dementia caregivers (N=21) to complete 14 daily surveys that asked about their daily caregiving experiences. Our measure for “quality of care” was based on the Exemplary Caregiving Scale, and included 3-items pertaining to provision of care (e.g., “You considered your spouse's wishes and opinions when providing assistance”). Response options included “Most of the time,” “Some of the time,” and “Never”; scores were summed (range 0 to 6). Caregivers were also asked to what extent their spouse appreciated the care provided (“Not at all,” “Some,” or “A lot”). We applied multi-level mixed models to the data, and controlled for age, gender, Hispanic ethnicity, number of behavioral symptoms of dementia each day and months since diagnosis. In adjusted models, we found that on days when caregivers believed care recipients appreciated care provided “Some” or “A lot,” they reported providing higher quality care (B=0.52, p=0.010 and B=0.79, p<0.001, respectively) compared with days when caregivers believed care recipients appreciated care provided “Not at all”. Preliminary results may inform programs to support caregivers’ ability to provide high quality care (e.g., by helping caregivers to perceive rewards) and to identify caregivers at risk of providing low-quality care.
Aging immigrant family caregivers health, social engagement, and health literacy
Authors: Ramos Mary Dioise
Published: December 2021

Family caregiving is evolving in multiple ways. There is an increasing recognition of the role of informal or unpaid family caregivers. Extensive body of research shows that family members who provide care to individuals with chronic or disabling conditions are themselves at risk. However, most evidence on family caregiving gear towards Caucasian middle-class populations. There is limited research that exists about aging immigrant family caregivers who are ill-prepared for their role and provide care with little or no support. The specific aim of this study was to assess and determine the association of health status, social engagement, and health literacy among aging immigrant family caregivers. This study utilized a non-experimental, cross-sectional, correlational design. Most of the participants are female married Asian women, who are retired, living with their spouses, and taking care of their family members more than 4 hours a day with Alzheimer’s, Parkinson’s, and cardiovascular disorder. Most participants have existing medical condition such as hypertension, diabetes, high cholesterol, and heart disease. Most participants experienced problem with sleep and difficulty falling asleep. While some participants experienced fatigue and having trouble doing regular leisure activities with others. There is an association between sleep disturbance and ability to participate in social roles and activities among aging immigrant family caregivers. Inclusion of people from different ethnicities, backgrounds, and socioeconomic position in caregiver research is vitally important. There is a need for a greater understanding of the contextual factors of family caregiving and recognizing the prevalence and characteristics of aging immigrant family caregivers.
Family Advocacy for Residents in Nursing Homes During the COVID-19 Pandemic
Authors: de Rosa Cristina , ZHou Yanjun , Lyons Amy , Chang Yu-Ping
Published: December 2021

To protect one of the most vulnerable populations from COVID-19, nursing homes enacted and enforced visiting restrictions and other measures to limit the spread of this communicable disease. Family members, many of whom are former caregivers, were suddenly cut off from nursing home residents, and struggled to maintain connection with their loved ones residing in nursing homes. The purpose of this study was to describe the experiences of family members of residents in nursing homes in advocating for residents and themselves during a time of uncertainty and many challenges. This study used a qualitative descriptive approach to conduct individual interviews. Ten family members of residents of two nursing homes in a Northeastern state were interviewed by phone or videoconference using a semi-structured guide. Interviews were transcribed verbatim and analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Family members expressed concerns for the lockdown’s impact on residents’ psychosocial wellbeing in addition to the potential physical dangers of COVID-19. They explored creative means of meeting needs for information and interaction, but often felt that these efforts fell short of replicating the connectedness of in-person visits. Family members identified multiple missed opportunities for involvement in care, and voiced willingness to comply with infection prevention guidelines, such as maintaining distance, to be present with residents. Our findings indicate that family members advocated for residents’ interests to ensure quality care. Future research and policy should consider family members as a potential resource for providing care and companionship during times of crisis.
Family Caregiver Burden of Medication Administration for Older Adults Admitted to Home Hospice
Authors: Tjia Jennifer , Clayton Margaret , Smith Jennifer , Wood Olivia , Hurley Susan , Puerto Geraldine , Duodu Vennesa , DeSanto-Madeya Susan
Published: December 2021

OBJECTIVE To characterize FCG burden of medication administration for older adults in home hospice. METHODS Pilot clinical trial of a hospice-staff level communication and medication review program to facilitate goal-concordant prescribing, including deprescribing, for older adults in home hospice. Patients newly admitted to hospice were eligible if >=65 years, prescribed >= 5 medications and had a FCG. Exclusion criteria included being non-English speaking or having a Palliative Performance Score<40. Measurements include 24-item FCG Medication Administration Hassle Scale (range 0-96) at hospice admission and at 2-, 4-, 6-, 8-weeks and monthly until death. Descriptive statistics characterize baseline FCG Hassle score. RESULTS In this actively recruiting study, n=9 patient-caregiver dyads are enrolled to date. Mean patient age is 80.6 years (range 69-101). Of 9 caregivers, 7 were female, 5 children, and 3 spouses. The majority (67%) of caregivers were extremely involved in medication management. Mean FCG Hassle Score =17.1 (SE 5.9; range 2-58), and differed between spouses (mean =5 [SE 1.7; range 2-8]) and children (mean =31.4 [SE 9.53; range 3-58]). The highest burden concern was recognizing medication side effects, followed by feeling comfortable making medication decisions, arguing with the care-recipient about when to take medications, knowing why a medication is being given and whether it is effective, and knowing when to hold, increase, decrease a dose or discontinue the medication. CONCLUSION FCGs of older adults in home hospice report different levels of medication administration hassle depending on their relationship to the patient. The most bothersome concern is recognizing medication side effects.
The Experiences of Family Caregivers of Community-Dwelling Older Adults with Dementia in Providing Daily Oral Care
Authors: Hellem Abby , Zhou Kexin , Chen Xi , Madiloggovit Jirakate , Nguyen Jennifer , Morris Rebecca , Ashida Sato
Published: December 2021

Individuals with dementia increasingly rely on caregivers for daily oral care over time. This study explored the experience of family caregivers of community-dwelling individuals with dementia in providing oral care and their interest in caregiver oral education using the concepts of Social Cognitive Theory. Twenty-three caregivers ages 19-80 participated in a semi-structured qualitative interview that also included a structured questionnaire. Majority of caregivers were female (83%) with an average age of 56 years; 29% were spouses. Fifty-four percent of care recipients had natural teeth only, 42% had teeth and dentures, and 4% had dentures only. Caregivers were generally knowledgeable about the importance of oral health, but some expressed a lack of knowledge in how to perform oral care for others. Caregivers reported high levels of outcome expectation, agreeing that providing oral care would improve care recipient’s oral health. Caregivers expressed mixed levels of self-efficacy; many cited reduced self-efficacy due to resistance or refusal of care. Quantitative data showed that higher confidence in knowledge and oral care skills was associated with greater confidence in providing oral care (r=0.726, p<0.001). Intent to participate in a caregiver oral health education program was associated with positive outcome expectations (r=0.73, p=0.007) and desire to learn the signs and symptoms of mouth pain and infection (r=0.72, p=0.009). Increasing family caregiver’s oral health knowledge and skills, outcome expectations, and self-efficacy to provide care may help improve the oral health of persons with dementia. Additional qualitative and quantitative data and implications for practice will be presented.
"Locked Out of Caregiving": A Case Study of Dementia Caregiving During the Covid-19 Pandemic
Authors: Wood Kristie , Suizzo Marie-Anne
Published: December 2021

It is unclear how ambiguous loss in dementia caregiving is impacted by conditions of the Covid-19 pandemic. Ambiguous loss describes situations in which closure is impossible and ambiguities within a family system ensue. Two situations of ambiguous loss exist. In the first type, one is psychologically absent, yet physically present, e.g. when one has dementia. In the second type, one is physically absent but psychologically present, e.g. moving to a nursing home. Ambiguous loss theory was applied to longitudinal interviews with an adult-child caregiver (age=52) of a mother with dementia, who resided in memory care during the Covid-19 pandemic. Theoretical analysis revealed both types of ambiguous loss were experienced in the dementia caregiving relationship. This was embedded within ambiguous loss type 2 due to the Covid-19 pandemic, e.g. social distancing and quarantine practices led to physical estrangement from others and ambiguity ensued about when, or if, estrangement would end before resulting in death. Further, the coping mechanisms defined in the ambiguous loss framework: restructuring identity, finding meaning, gaining mastery, increasing ambivalence capacity, reframing attachments, and gaining hope, were compromised due to overarching ambiguous loss attributed to the pandemic. Continued panic and frustration regarding lack of communication with and access to the memory care center instilled a sense of being “locked out of caregiving.” Findings suggest dementia caregivers may experience both types of ambiguous loss compounded during the Covid-19 pandemic, suspending grief and coping processes, and inciting poorly understood needs and challenges that must be better understood to support dementia caregivers.
A Natural Experiment Created by Pandemic Restriction: Comparing In-Person, Hybrid, & Teletherapy Formats
Authors: Wharton Tracy , Paulson Daniel
Published: December 2021

The FL-REACH intervention for families in early stage post-dementia diagnosis was originally adapted from the REACH II program for use in an outpatient clinic. Pandemic restrictions forced an adaptation to a teletherapy format. The timing of changes allowed comparison of caregivers who participated in clinic (n=10), switched modalities mid-treatment (n=7), and participated as teletherapy (n=14). Groups were similar in age range, gender, and relationship, with both spouses and adult children participating. Participants in the fully online group were more likely than others to have high school or trade school education than to have graduated from college. All participants in the in-person and hybrid groups had incomes over $40,000/year, while 36% of the online sample had less household income, were more likely to be Hispanic-identifying (43% versus 6%), and had higher burden scores (M=41.43 versus M=32.56 in person, M=29.86 hybrid) and lower preparedness scores (M=19.86 versus M=22.90 in person, M=28.14 hybrid) at baseline (p<.05). The intervention proceeded with the same intervention dosage (8 hours total), and outcomes were essentially comparable, with all groups showing statistically significant improvement on measures of preparedness, burden, and risk. While in-person intervention helped strengthen relationships with the medical team, inclusion of family via telehealth provided opportunity for a more culturally responsive and inclusive engagement, although there remain questions regarding reasons for differences at baseline. Identification of differences in key outcomes for direct comparisons between in-person, hybrid, and teletherapy interventions are limited in the evidence base, making this a unique study at an important moment in time.
Caregiving during the Covid-19 pandemic: Factors associated with caregiver stress and cognition
Authors: Turner Rachael , Harrington Erin , Reese-Melancon Celinda
Published: December 2021

Caregivers are critical in helping persons with dementia (PWD) live at home longer, but the caregiving experience is associated with increased risk of physical (Vitaliano et al., 2003; Son et al., 2007; Fonareva & Oken, 2014) and cognitive decline among caregivers (Pertle et al., 2015; Lathan et al., 2016; Vitaliano et al., 2017). The present study examined the caregiver experience during the time of the Covid-19 pandemic including factors associated with caregiver stress, burden, and self-reported cognition (i.e., prospective and retrospective memory errors). In a sample of 56 caregivers of PWD, caregiver stress was positively associated with reports of greater life change resulting from Covid-19 and a greater frequency of care recipient depressive and disruptive behaviors; however, caregiver stress was not associated with care recipient memory problems. Additionally, caregiver burden was negatively associated with ratings of preparedness for the pandemic, but not with availability of support services or the amount of time spent caregiving. Further, frequencies of prospective and retrospective memory mistakes were positively associated with perceived stress, but not with caregiver burden. These findings reveal that caregivers of PWD report greater experiences of stress associated with the Covid-19 pandemic and other facets of their caregiving responsibilities (e.g., care recipient depressive and disruptive behaviors, frequency of memory mistakes). This work is a first step in identifying areas in which caregivers need assistance and expanding the literature on caregiver cognition by measuring self-reported everyday memory performance.
Direct-to-Caregivers Research Dissemination: A Novel Approach to Targeting End-Users
Authors: Lindquist Lee , Liggett Anna , Ramirez-Zohfeld Vanessa , Baharlou Shahla
Published: December 2021

Dissemination of geriatrics research usually occurs through conference presentations or publications viewed by colleagues in the same field. Older adults and their family caregivers have limited direct access to research findings. We sought to pilot a direct-to-caregiver workshop with the intent to disseminate geriatrics research directly to family caregivers of older adults. As part of an academic national conference, an ‘Updates in Geriatrics Research’ workshop is presented as a compilation of innovative research published in the prior year. We distilled workshop content into a lay format which was presented to family caregivers at two community-based caregiver symposiums. Mixed method surveys were completed by family caregiver attendees with open-ended responses analyzed using content and constant-comparative techniques. Of the 29 survey respondents, all were female, mean age 58.9 yrs. (range 52-72), providing care to older adults, mean age 87.2 years (range 66-97). Respondents unanimously identified learning information pertinent to their care recipient. When asked: Do you feel that direct-to-caregiver research dissemination is useful, all respondents selected yes. Open-ended responses for reasons why revealed two main themes: 1.) Creating informed caregivers: “Caregivers need this information in their toolbox.” and 2.) Empowering caregiver-advocates: “The more we know, the better we can advocate for our loved ones and challenge their health care.” Respondents all planned on sharing information with others, specifically family, friends, and physicians. In conclusion, disseminating geriatrics research direct-to-caregivers is feasible. Researchers, who present their work for scientific conferences, should consider translating their findings into presentations for community-based family caregivers.
Anticipatory Caregiving Scale: Development and Preliminary Validation
Authors: Weber Kendall , Qualls Sara
Published: December 2021

Background: As public awareness of family caregiving has grown, adults likely anticipate the role they may play as a caregiver for an aging loved one. Although anticipatory planning for caregiving has been studied, no measure of multiple dimensions of the anticipated caregiving experience exists. The purpose of the present study is to develop and validate the Anticipatory Caregiving Scale (ACS), an assessment of adult children’s attitudes toward and level of expectation surrounding their potential role as an informal caregiver to a parent or parent-in-law. Method: The ACS consists of six subscales that assess multiple factors that may influence willingness to or expectations about taking on a caregiving role: affect surrounding future caregiving, anticipated lifestyle interference, self-efficacy surrounding future caregiving, anticipated caregiving resources, endorsement of norms of family care which influence anticipated caregiving, and the relationship quality, current and anticipated, with the potential care recipient. A sample of 540 adults aged 18 and over recruited online completed the ACS, along with scales to assess convergent, discriminant, and concurrent validity. Results: Overall, the ACS and its subscales demonstrated good reliability and validity, established through internal consistency, and convergent, discriminant, and concurrent validity. Discussion: The ACS fills a gap in the current literature by providing a comprehensive, multidimensional assessment examining expectations about one’s potential caregiving experience, specific to the adult child-parent dyad. Future studies should examine the psychometric properties of the ACS in a more diverse population of adults across different settings and assess the temporal stability and criterion validity of the scale.
Parenting Style in Childhood and Mental Health Outcomes of Caregiving in Middle and Later Adulthood
Authors: Liu Yujun , Hughes M Courtney , Baumbach Abby
Published: December 2021

Objectives. This study examined the association between remembered parenting style of both mothers and fathers in childhood and mental health outcomes of caregiving in middle and later adulthood. Methods. Data were from the Midlife in the United States (MIDUS) study, a national survey that included 7,108 participants aged 24 to 75 years at baseline. The sample analyzed in the current study included 244 MIDUS participants who had given personal care to their mothers or fathers for one month or more during the last 12 months in the second and third waves. Parenting style variables, which included maternal/paternal affection and maternal/paternal discipline, were from the first wave; mental health outcome variables, which included emotional distress, depressive symptoms, and life satisfaction, were from the second and third waves. Multiple regression and multilevel modeling were applied using R. Results. Maternal affection was negatively associated with emotional distress. Paternal affection was negatively associated with depressive symptoms. The associations between maternal/paternal discipline and mental health outcomes were not significant. Among the caregivers who provided care for parents, those who had mothers with high affection in childhood experienced a lower level of emotional distress, those who had fathers with high affection experienced a lower level of depressive symptoms in middle and later adulthood. Discussion. Our findings have advanced the understanding of the long-term consequences of parenting style in childhood on mental health outcomes among family caregivers in later life. The results have implications in the development of interventions focusing on mental health outcomes among family caregivers.
Cognitive Frailty And Risk Of Functional Disability In Older Japanese Adults: A 4-Year Prospective Study
Authors: Chen Sanmei , Honda Takanori , Chen Tao , Kishimoto Hiro , Kumagai Shuzo , Narazaki Kenji
Published: December 2021

Background: Cognitive frailty is a newly proposed clinical entity, referring to concurrent cognitive impairment and physical frailty in the absence of dementia. The clinical significance of cognitive frailty remains poorly understood. We aimed to investigate the association between cognitive frailty and functional disability in older adults. Methods: A total of 1,644 non-demented older adults aged ≥65 years (mean age: 73 ± 6 years; men: 41.8%) and without functional disability at baseline were followed-up for 4 years. Cognitive frailty was defined as the presence of both physical frailty (based on the modified Cardiovascular Health Study criteria) and cognitive impairment (Mini-Mental State Examination score of <24 points). Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Association between cognitive frailty and functional disability was assessed by using the Cox proportional hazard models. Results: During the follow-up, 152 participants were identified as being functionally disabled. There was a significant interaction between physical frailty and cognitive impairment on the development of functional disability (P <0.1). Compared with being robust both physically and cognitively, the hazard ratio (95% confidence interval) of functional disability was 8.40 (4.05-17.42) for cognitively frailty, after adjustment for age, sex, education, living alone, smoking, drinking, number of comorbidities (hypertension, stroke, chronic heart disease, diabetes, chronic kidney disease, poor hearing, poor vision, osteoarthritis or rheumatism, minor trauma fracture, or cancer). Conclusion: Cognitive frailty was associated with an increased risk of functional disability in community-dwelling older adults. Cognitive frailty could be an underrecognized risk factor for functional disability.
Clinical Geriatrics as a Team Sport: Fostering Interprofessional Experiences in the Community
Authors: Picella David , Woods Diana
Published: December 2021

Team-based care is necessary to provide better healthcare outcomes for the complex needs of older adults. Shared clinical learning experiences prepare practitioners to work in collaborative partnership to achieve optimal outcomes. To promote collaborative partnership, we established interprofessional community based clinical experiences with older adults at home, in assisted living and in skilled nursing facilities. One nurse practitioner faculty member was paired with 2 students for each clinical experience day. Initially these were face-to-face encounters, however, with the onset of COVID-19, all high-risk encounters were converted to a virtual modality. The clinical encounters focused on the Age Friendly Model (4M). Post clinical discussions and recommendations focused on interprofessional treatment plans. A REDCap(TM) survey was completed by all student participants for program evaluation. Of the 14 surveys sent, 11 were completed; 10 (77%) females; 3 (23%) males; 7 (50%) family practitioner students; 7 (50%) adult-gerontology nurse practitioner students. Four had previous home health experience (14%), and 10 had none (86%). 4M Likert scale (1-5) means were “what matters” = 4.27, medications = 4.18, mentation = 4.09, and mobility = 4.09. Students found the overall experience valuable (mean = 4.27). Of 11 students, 3 (27%) were involved telehealth experiences. Students found real community based clinical experiences to be very enlightening, offering a different perspective, and altering their appreciation for the everyday life of the older adult. Future plans include adding social work and physical therapy students to these clinical experiences to enhance interprofessional education.
How 4Ms Age-Friendly Care Led to Improved Compliancy of Older Adult Fall Screenings in Rural Primary Care Clinics
Authors: Tobey Leah , McAtee Robin
Published: December 2021

Past medical history of falls and fear of falling are reliable indicators of future fall risk of an older adult (OA). As one of the HRSA funded Geriatric Workforce Enhancement recipients, the AR Geriatric Education Collaborative (AGEC) worked with a rural federally qualified healthcare clinic system to help incorporate fall screens to satisfy the Mobility factor in the 4Ms age-friendly care framework. After consultation with the practitioners, it was decided to use the Timed-Up-And-Go (TUAG) screen because it is evidence-based and appropriate for OAs. Training on the use of the TUAG was completed next as was the addition of the screen into the EMR. Fall screens in one clinic were only completed 7% before training and 7 months after the training, this rose to almost 100%. In a second clinic, the screens were completed 22% of the time and this was increased to 66% after training. Training on mobility continues to occur on a regular basis as staff turns over and as new priorities arise, but the use of the TUAG as a mobility screen has been a critical component in the process of these rural clinics providing age-friendly care. Next steps with improving fall risks will be the development of flags within the EMR that will force practitioners to complete a full falls plan of care if the OA scored within the moderate or high fall risk categories. The plan will include home safety education and/or evaluation, PT or OT referrals to further support healthy aging for the OA.
Age-related Aortic Stiffness Can Be Transferred and Ameliorated via Fecal Microbiota Transplant in Mice.
Authors: Greenberg Nathan , VanDongen Nicholas , Gioscia-Ryan Rachel , Casso Abigail , Hutton David , Clayton Zachary , Seals Douglas , Brunt Vienna
Published: December 2021

Age-related increases in aortic stiffness contribute to the development of cardiovascular diseases (CVD). To determine whether the gut microbiome (GM) modulates age-related aortic stiffening, we performed fecal microbiota transplants (FMT) between young (Y; 3 month) and older (O; 25 month) male C57BL/6N mice. Following antibiotic treatment (to suppress endogenous microbiota), mice received weekly FMT (fecal samples collected at baseline) via oral gavage for 8-16 weeks from their own (i.e., sham condition: Y-y, O-o [RECIPIENT-donor]) or opposite age group (Y-o, O-y) (N=8-12/group). In vivo aortic stiffness (pulse wave velocity [PWV]) was higher in older vs. young mice at baseline (382±8 vs. 328±7cm/sec, mean±SE, P<0.001). Arterial phenotypes were transferred such that old microbiota transplanted into young mice increased, while young into old decreased, PWV (Y-y: 325±10 vs. Y-o: 362±10cm/sec, P=0.022; O-o: 409±10 vs. O-y: 335±6cm/sec, P<0.001). Intrinsic mechanical stiffness of excised aortic rings (elastic modulus) increased after transplant of old into young (Y-y: 2141±223 vs. Y-o: 3218±394kPA, P=0.022), and decreased with young into old (O-O: 3263±217 vs. O-y: 2602±136kPA, P=0.016), indicating the GM mediates aortic stiffening by modulating structural changes in the arterial wall. Age-related increases in aortic abundance of advanced glycation end products (AGEs), which cross-link arterial structural proteins, tended to be transferred by the GM (Y-y: 0.022±0.001 vs. Y-o: 0.038±0.006 A.U., P=0.11; O-o: 0.120±0.029 vs. O-y: 0.038±0.009 A.U., P=0.06). The aging GM can induce aortic stiffening via promoting AGEs accumulation and crosslinking of arterial structural proteins, and thus might be a promising target for preventing/treating age-related aortic stiffening and CVD.
Sex and Age Differences in Default Mode Network Functional Correlation After Traumatic Brain Injury
Authors: Amgalan Anar , Mayer Alexander , Ha Michelle , Irimia Andrei
Published: December 2021

The extent to which brain functional correlations (FCs) are modulated by age and sex is unknown. We studied default mode network (DMN) FC changes in 136 participants with mild traumatic brain injury (mTBI; 52 females, age range: 19 – 79 years, age μ = 42, age σ = 17; 72 participants younger than 40). Structural and functional magnetic resonance images (MRIs) were acquired ~1 week and ~6 months post-injury; the FreeSurfer Functional Analysis STream (FS-FAST) was used for group-level FC comparisons across sexes and age groups (younger vs. older than 40). FC seeds were two sub-networks of the DMN, M1 and M2, defined by the standard Yeo parcellation scheme. For M1, clusters with significant FC differences across sexes were in the right paracentral lobule, central sulcus, postcentral gyrus, superior frontal gyrus, and precentral sulcus (p = 0.0001), and in the left paracentral lobule and central sulcus (p = 0.022). For M2, clusters spanned the right postcentral gyrus, middle occipital gyrus, transverse occipital sulcus, and central sulcus (p = 0.0001), the left precuneus and inferior parietal lobe (p = 0.0096). Females either exhibited no significant FC change or underwent FC increases. Males underwent significant FC decreases within all clusters, suggesting their increased vulnerability to mTBI-related effects. Clusters whose FCs differed significantly across age groups were localized to the left superior temporal gyrus (p = 0.0078), highlighting the vulnerability of temporal regions to age effects. Future studies should explore the age × sex interaction and uncover the mechanisms for these observed findings.
Toward a Model for Measuring Social and Structural Determinants of Alzheimer’s Disease and Related Dementias
Authors: Stites Shana , Balls-Berry Joyce , Barnes Lisa
Published: December 2021

Social and structural determinants of health (SSDoH) are conditions in the environments in which individuals are born, live, learn, work, play, worship, and age that affect health, functioning, and quality-of-life outcomes across the life course. Growing evidence suggests that SSDoH can help to explain heterogeneity in cognitive, functional, and interventional outcomes in Alzheimer’s disease and related disorders research and clinical practice. The National Institute on Aging (NIA) has prioritized collecting SSDoH data in order to elucidate disease mechanisms and aid discovery of a disease modifying treatments. However, a major nexus of ADRD research, the national network of Alzheimer’s Disease Research Centers (ADRCs), does not routinely collect SSDoH data. We describe a model for feasibly gathering and analyzing SSDoH data across Alzheimer’s Disease Research Centers (ADRCs). We lay out theoretical underpinnings of key constructs and their measure, empirical evidence for their importance, and their potential for elucidating disease and prevention mechanisms. Toward a goal of translation, we describe a general approach to measuring SSDoH along with core set of measures. We also describe empirical support and rationales for assessing SSDoH in standing geographically and culturally diverse research cohorts, and guiding considerations in selecting modules to serve unique communities. We specifically address SSDoH in Black, Hispanic/Latin, and refugee populations with an eye toward conveying how geographic proximity, socioeconomic status, ethnoracial factors, and sex\gender\sexual orientation affect populations in ways directly relevant to Alzheimer’s disease (AD) and Alzheimer’s disease related dementias (ADRD).
Organizational Practices for the Aging Workforce: Validation of an English Version of the Later Life Workplace Index
Authors: Finsel Julia , Wöhrmann Anne , Wang Mo , Wilckens Max , Deller Jürgen
Published: December 2021

Due to aging workforces, research on organizational practices for older employees becomes more important for individuals and organizations. However, existing measures for such organizational practices tend to capture the construct with unidimensional scales, use single-item operationalizations, or focus on a specific area. Hence, Wöhrmann, Deller, and Pundt (2018) developed the Later Life Workplace Index (LLWI) to provide a multidimensional framework to measure organizational practices for older employees on nine dimensions, namely organizational climate, leadership, work design, health management, individual development, knowledge management, transition to retirement, continued employment after retirement, and health and retirement coverage. The LLWI has recently been operationalized and validated in Germany (Wilckens, Wöhrmann, Deller, & Wang, 2020). However, to utilize the index beyond German-speaking countries, a validated English version is required. Thus, we aimed to validate an English version of the LLWI using a sample of older U.S. employees (N = 279). Results support the domain level factor structure of the LLWI but show some redundancy among the 80 items for the overall nine domain factor structure. A comparison between the U.S. sample and a German sample (N = 349) confirmed configural and (partial) metric measurement invariance of the English version. Results further supported convergent, discriminant, criterion, as well as incremental validity. Researchers can utilize the new measure to gain a deeper understanding of organizational practices relevant for older employees, while practitioners are able to assess their organizational readiness for an aging workforce. We envision further translation and validation in other languages and cultural contexts.
Perceptions of Generational Conflict Among Three Age Groups in South Korea
Authors: Lee Ahyoung , Chung Soondool , Kim Juhyun
Published: December 2021

After rapid industrialization during the past few decades, the gap between generations in South Korea has widened and the issue of generational conflict is being discussed as a social problem (Chung & Lim, 2018). The purpose of this study is to find out how each generation perceives generational conflict in the areas of family, politics, economy and social welfare, and culture. An online survey of 1,000 adults aged 20 and over was conducted nationwide in South Korea in January, 2021 with three age groups: the youngest group aged 20-39, mid-age group of 40- 64 and the oldest group of 65 and over. The questionnaire was created using the items developed by a previous research that used a Delphi technique (Chung, 2020). Participants answered how serious they perceive generational conflict in the dyadic relationship on 5-point Likert scales. Descriptive statistics were calculated, and t-tests have been performed to see the generational differences. Results show that the youngest group and the oldest group perceive the highest level of generational conflict each other in the areas of culture and politics. In cultural aspects, ‘use of slang among the same group’, ‘Ability to utilize digital devices’ were the items that had the highest level of conflict. In the political realm, progressive vs. conservative ideology was the area of the highest conflict. In addition, t-test results showed that the oldest group perceived generational conflict even deeper than the youngest group in the ‘economy and social welfare’ and cultural areas. Implications of these findings are discussed.
Serving kinship families During COVID: Pivotal moments
Authors: Smith Andrea , Mongeluzzo Michelle , Drente Tawyna
Published: December 2021

Kinship caregivers, who are relatives or non-family members providing care to children when biological parents are unable to do so, comprise over 2.5 million adults in the United States. The vast majority are grandparent caregivers. The 7.8 million children in their care make up approximately 10.5 percent of all children in the United States under the age of 18 (Generations United, 2017: State of Grandfamilies). Navigating daily life is often challenging. Kinship caregivers routinely face difficulties in multiple aspects of their lives, including finances, physical health, mental health, education, employment, parenting, and family relationships. The COVID pandemic heightened existing challenges and stimulated new issues for many kinship providers and the children in their care. This poster will highlight actions taken by one Family Service agency, annually serving approximately 225 kinship families, to meet the unprecedented needs of family members and kinship program staff during COVID. A timeline of decision-related rationales, specific actions taken and results related to these actions will be presented. Data summarizing results for kinship families (n =32) related to COVID-impacted programmatic responses and changes, including level of involvement with group services, recidivism, perceived isolation, and efficacy related to their caregiving roles will be presented. Results summarizing the impact of the agency's COVID-related responses on kinship staff (n = 6) will also be presented, including data on staff members' level of stress, perceived support, perceptions of programmatic effectiveness, and prioritized importance of changes will also be shared.
A Window to Telehealth Geriatric Social Work Job Market Landscape: A Cross-Sectional Study
Authors: Huang Lihua
Published: December 2021

The purpose of this research study is to explore current Telehealth geriatric social work by describing its most recent job market characteristics. As part of a larger longitudinal research, data for this cross- sectional study was collected in January 2021. Three top job search engines, Google, ZipRecruiter, and Indeed, were used to collect data on Telehealth social work job openings. On each search engine, five searches were completed with the five key words: "social work" Telehealth jobs, LCSW Telehealth jobs, remote LCSW jobs, Telehealth "social work" jobs, and Telehealth "social worker" jobs. It analyzed 112 Telehealth geriatric social work job ads, 12.8% of total 873 ads from these fifteen searches. Results from descriptive and thematic data analysis show large, for-profit organizations are dominating the Telehealth geriatric social work field while small private practices are emerging during the pandemic. The study found Telehealth geriatric social work is providing vital continuum services to older people in communities, hospitals, and long-term care facilities at individual, family, and group levels. The results document innovative technological tools present new methods to engage, assess, and intervene, particularly with mental health needs. The Telehealth organizations are making the pitch to attract competitive professionals. While nearly 1/3 of the sampled organizations stated they intended to make Telehealth/remote positions temporary, the study concludes Telehealth has built its infrastructure and workforce to become an indispensable and ongoing part of gerontological and geriatric social work. Social work education, research, and practice must pay close attention to its implications in skill building.
Exploring Dementia Care in an Acute Care Setting: Perspectives of Social Workers and Nurses.
Authors: Dunkle Ruth , Cavagnini Katherine , Cho Joonyoung , Sutherland Laura , Kales Helen , Connell Cathleen , Leggett Amanda
Published: December 2021

Nurses and social workers in acute care settings have unique perspectives about providing care to persons living with dementia (PLwD) who experience behavioral and psychological symptoms of dementia (BPSD). Their distinctive roles and training have important implications for the recovery and well-being of PLwDs during hospital stays. This study utilized the "rigorous and accelerated data reduction" (RADaR) technique to compare perspectives of social workers (n=12) and nurses (n=5) in a Midwestern tertiary care facility about their caring for PLwds with BPSD. Three major themes were identified: 1) patient engagement and coordination with family and professionals, 2) treatment and medical management, and 3) barriers to care. Similarities between social workers and nurses emerged within the themes, including the importance of family involvement and providing person centered care. Differences emerged particularly within the treatment and medical management theme, as nurses utilize medications to treat BPSD and social workers were more likely to use redirection. While there is distinctive training for nurses and social workers, both identified similar barriers to providing care to PLwDs with BPSD, including time constraints, competing demands, and lack of training on BPSD management. Results demonstrate how an understanding of the critical and complementary roles that nurses and social workers play in dementia care and work together to build a care team can inform best practices to support symptom management and quality of life in PLwDs. Continuing education and training could be beneficial for both professionals to improve the quality of care for PlwDs.
SSDoH in Latinxs: Factors of Influence
Authors: Marquez David
Published: December 2021

Research with Latinxs/os/as regarding Alzheimer’s disease and related dementias (ADRD) is lacking. This is staggering because among Latinxs in the United States, the number diagnosed with ADRD is expected to grow by more than 800% from 2012 to 2060 (Wu et al., 2016). Older Latinxs have a high risk and prevalence of ADRD - partially attributed to their longer life spans and the presence of adverse risk factors such as metabolic syndrome, type 2 diabetes mellitus, and other cardiovascular conditions (Chin et al., 2011). What is often missing in the discussion is the role of social and structural determinants of health (SSDOH) in this population. Overall Latinxs have low levels of formal education, work in physically demanding jobs, and experience immigration stress. How these and other SSDoH influence Latinxs will be discussed; as well as potential resilience factors like familial relationships, and religiosity or spirituality.
The Effect of Home- and Community-Based Services on Activity Engagement
Authors: Sun Peter
Published: December 2021

This study examined the association between home- and community-based services (HCBS) and social, cognitive, and physical engagement among community-dwelling older adults in the U.S. Data were drawn from the 2012 Health and Retirement Study (HRS). The sample consisted of respondents ages 50 and over who answered questions on HCBS utilization and activity engagement (n = 567). Genetic matching and propensity score weighting were used to mimic randomized control and treatment groups, in order to estimate the population average treatment effect on the treated (PATT). HCBS utilization was found to be significantly associated with social engagement (PATT = 0.17, SE = 0.05, p < 0.05) and physical (PATT = -0.20, SE = 0.07, p < 0.05) engagement but not significantly associated with cognitive engagement (PATT = -0.04, SE = 0.12, p > 0.05). Sensitivity analyses found that the results were robust to the estimation model. These findings suggest that HCBS utilization is a promising model for increased activity engagement, and future policies aimed at targeting these outcomes are warranted.
PAEAN: Pain in Aging, Educational Assessment of Need - An Interprofessional Collaboration
Authors: Hogans Beth , Siaton Bernadette , Frey-Law Laura , Brown Lana , Herndon Chris , Buenaver Luis , Katzel Les , Thomas Patricia
Published: December 2021

Pain is prevalent in older adults limiting independence directly and through comorbidity-related effects on functional domains such as mobility, well-being, sleep, productivity, and oligo-pharmacy. Improved outcomes for older adults with pain depends on provider knowledge and competence; concomitantly, Veterans, women, and others at socioeconomic disadvantage may face increased pain, comorbidities, and complications of treatments. Previous guidance for educational programs, from pre-licensure to post-graduate training, in geriatrics and pain have focused on expert opinion, whereas an evidence-based approach is preferred. Our working group is conducting a structured needs assessment regarding comorbidities of common pain-associated conditions in older adults. Methods: To capture expertise in medicine, nursing, pharmacy, clinical psychology, and physical therapy, we extended an open invitation to members of the VA Geriatric Research, Education, Clinical Centers Associate Director-Education network and selected, nationally-recognized clinical education experts outside VA. Results: An eight-member working group, interprofessional in composition, through multiple remote meetings has defined goals of the program, evaluated preliminary evidence addressing the clinical needs of older adults with pain, and posed ‘curious questions’ about the available large-scale data. The overarching goal is evidence-based needs assessment of gaps in education about pain in older adults, with purposeful attention to risks of healthcare inequities for older adult women, Veterans, persons of color, those at socioeconomic disadvantage, and caregivers. Conclusions: Interprofessional collaboration is effective in framing a broad needs assessment regarding pain and common comorbidities in older adults with the intent of meeting the educational needs of clinical trainees. More study is needed.
Saving Senior Smiles: A Community Outreach Educational Program and Pilot Research Project
Authors: Joshi Prajakta , Rawal Kadambari
Published: December 2021

Globally, poor oral health has been evidenced more frequently among older adults. Thus, it is imperative to develop strategies for improving the oral health knowledge and access to dental care amongst the older adult population. The Saving Senior Smiles (S3) pilot outreach program was launched as an oral health education and awareness program for community-dwelling older adults across senior centers in the greater Boston area (Massachusetts, USA). The outreach consisted of oral health educational seminars presented by pre- doctoral dental students from three dental schools in the Boston area. The presentations highlighted the significance of oral health, and the importance of seeking routine dental care. Pre and post-test surveys were administered to assess the participants’ utilization of oral health services and oral health knowledge. The surveys were completed by 85 older adults (Female= 58.8%) across five senior centers. Questions pertaining to utilization of dental services revealed that 78.8% of the participants had a dentist. Expectedly, the center that reported the greatest number of missing teeth (Fenway center= 70.6%) had the least number of individuals who had a dentist (58.3%). With regard to oral health knowledge, before the seminars, less than half of the participants (42.2% ) across all the senior centers were aware of the common oral conditions that affected older adults ( dry mouth, gum recession and changes in oral bacteria) and after the presentation over 60% of the participants responded correctly to these knowledge questions. Overall, these findings emphasize the value of simple community-based interventions for older adults.