bluuebunny/crossref_metadata_2025 huggingface dataset:
THE FALL OF THE BERLIN WALL AND STEREOTYPES OF AGING: AN INTERGENERATIONAL STUDY ABROAD EXPERIENCE
Authors: Macaluso Suzie
Published: November 2019

One of the biggest barriers to encouraging a new generation of students to consider careers in aging are the ageist attitudes that they hold and the negative images of aging that they are bombarded with through the media. Sociologists have learned that an effective way to combat ageism is to bring together individuals from different cultural groups, including different age cohorts, to improve social attitudes. In a 2018 AGHE presentation, Jill J. Naar, explored the idea of promoting age-friendly universities by creating intergenerational education tourism programs. In this presentation I share my experience in leading an intergenerational study abroad in Germany that included five generations studying the creation of public memory on the eve of the 30th anniversary of the fall of the Berlin Wall. I will share some of the logistical considerations along with the way that the study abroad helped to meet some of the AGHE competencies for undergraduate programs in Gerontology.
UNDERSTANDING THE ROLE OF SOCIAL SUPPORTS AND SOCIAL NETWORK FOR DEMENTIA CAREGIVERS’ MENTAL HEALTH
Authors: Morano Carmen , park daejun , Savage Andrea
Published: November 2019

This paper explores the associations of depressive symptoms with social supports and social networks among dementia caregivers. It has been well documented that dementia caregivers are at greater risk of experiencing negative mental health and poorer physical health than non-caregivers. This paper describes a collaborative process between two universities and a community-based provider in designing a Social Network Analyses to examine the network structures used by dementia caregivers participating in a community-based support program. The relationship between the caregiver support networks and depressive symptoms, were analyzed using multivariate regression models. Given the small sample size and missing data multiple imputation was applied to the data. The findings suggest the effects of a variety of supports in the caregiver network on mental health and depressive symptoms. Among the findings it was found that the presence of financial support (B= - 0.58; p = .01) and frequency of contacts (B = -0.58; p = .01) support resulted in a decrease in depressive symptoms and better mental health than for caregivers without similar supports in their networks. This paper will conclude with a discussion of potential uses of social network analysis to better understand how the structure of caregivers’ network can address the concrete physical, emotional and financial needs of dementia caregivers.
FEDERAL POLICY EFFORTS TO SUPPORT FAMILY CAREGIVERS: PAST, PRESENT, AND FUTURE
Authors: Bangerter Lauren R , Ruggiano Nicole , Griffin Joan M , Malley Kelly A O
Published: November 2019

Family caregivers are major providers of long-term care and support for family members with age-related decline and disability. Caregiving is a demanding and complex undertaking that has demonstrated extensive physical, emotional, relational, and financial burden on families. These factors underscore the urgency of addressing the needs of family caregivers at the policy level. This presentation focuses on the origins, goals, and mandates of federal policy efforts that support family caregivers. This includes an analysis on how federal support for caregivers has evolved over time, most notably through the National Family Caregiver Support Program, part of the Older Americans Act. It will also discuss the passage of more recent legislation (e.g., RAISE Family caregiver Act and the Grandparents Raising Grandchildren Act) that will contribute to a national strategy to support family caregivers. Moreover, through the discussion of these policies, we will articulate specific areas where gerontology research and public policy can and should intersect in order to optimize the effectiveness of policy efforts to support family caregivers.
REACTIONS TO AMYLOID PET SCAN RESULTS AND LEVELS OF ANXIETY AND DEPRESSION AMONG CARE PARTNERS: CARE IDEAS STUDY
Authors: Belanger Emmanuelle , D’Silva Jessica , Van Houtven Courtney H , Shepherd-Banigan Megan , Smith Valerie , Wetle Terrie
Published: November 2019

Few studies have examined caregiver reactions to their loved ones receiving the results of an Amyloid PET scan which can be indicative of Alzheimer’s disease. Therefore, we examine: 1) What are care partner’s reactions to their loved one receiving negative or positive amyloid PET scan results?, and 2) To what extent are scan results and diagnostic category (dementia vs. mild cognitive impairment) associated with care partner depressive symptoms (PHQ-2) and anxiety (STAI-6)? Using data from 1,799 care partners in the CARE IDEAS study, we applied a sequential mixed-methods design and explored the reactions of 192 care partners who answered open-ended interview questions after learning about the Amyloid PET scan results. We first conducted qualitative content analysis of transcripts from open-ended questions to explore caregivers’ emotional responses after their loved one received an Amyloid PET scan result. The qualitative data suggest that when the scan results fit care partner’s expectations, i.e. positive scan when the patient has dementia and negative scan when the patient has mild impairment, care partners report satisfaction with this information and relief, rather than shock and frustration. Adjusted logistic regression models of survey responses support this finding; having dementia and a positive scan both increased the likelihood of care partners having high levels of anxiety, and a significant interaction indicated that a positive scan was associated with high anxiety among care partners of patients with mild cognitive impairment but not dementia. Only lower education and higher impairment in everyday cognitive function were associated with high depressive symptoms.
VALUE-BASED HEALTHCARE AS A FRAMEWORK OF CARE FOR OLDER ADULTS AND THEIR FAMILY CAREGIVERS
Authors: McGhan Gwen , Clement Fiona , Ludlow Natalie , Lee Jessica , Cheng Michelle , McCaughey Deirdre
Published: November 2019

Value-based healthcare (VBHC) is a term synonymous with the pursuit of greater value in healthcare, however, the term “value” lacks conceptual clarity. Using Porter’s 2010 seminal VBHC shows promise for placing the older adult and their family caregiver at the center of care models, which is a central tenet in healthcare value. The purpose of our study is to conceptualize how Porter’s VBHC is defined, operationalized, and implemented to address the need for person-and-family centered care models that improve outcomes while being cost effective. A literature search in six academic databases was conducted to identify articles examining VBHC; specifically studies with a Porter-based patient-centric focus. 1,001 articles were retrieved for initial review. Using a consensus-based logic model for inclusion/exclusion, 802 met the inclusion criteria for full text review. Articles were examined using the following objectives: 1) conceptually map the VBHC literature, 2) identify application of Porter’s equation, and 3) identify the methodologies used to measure outcomes, costs, and value. Findings were cross-compared and emergent themes organized to Porter facets of value (outcomes, costs, and value). Our review found the three facets of Porter’s VBHC are established across the literature, however, most studies examine only one or two facets and fail to specify or define all three. Although applied in research, there is a lack of consistency in the actual use of Porter’s definition. Five recommendations for future research using Porter’s VBHC include: (1) pre-selection of outcomes/costs, (2) operationalizing outcomes/costs, (3) value framework creation, (4) data collection, and (5) value calculation.
CAREGIVER SUPPORT RATIO IN EUROPE
Authors: Riberio Oscar , Teixeira Laetitia , Araujo Lia , Paúl Constança
Published: November 2019

The caregiver support ratio (CSR) has been defined as the number of potential caregivers aged between 45 and 64 (the most common caregiving age range) for each person aged 80 and over (subgroup of older adults most at risk of needing long term services and support). In 2010, for the USA, this number was calculated to be 7 to 1, a ratio that was projected to shrink to 4 to 1 in 2030, and to 3 to 1 in 2015 according to the AARP Public Policy Institute. In this study we used data from CENSUS HUB to calculate the CSR in Europe considering a total of 27 countries. Main results revealed that a group of Mediterranean countries (Italy, Greece, Spain and Portugal), along with France, Belgium and Sweden have the lowest CSR (5 to 1); on the other hand, the countries with the highest CSR are Slovakia (9 to 1), and Ireland, Poland, Cyprus and Malta (8 to 1). In average, for the 27 countries, the estimated number of caregivers per frail older person today is 6 to 1. These findings reveal important differences between countries and may inform EU policy decisions regarding long-term care (LTC). Given that informal care forms a cornerstone of all LTC systems in Europe, and that this continent faces a rapidly increasing number of people in very advanced age with extended years of disability living at home, estimating the CSR for the next decades is of crucial importance.
EFFECTIVENESS OF A COMMUNITY HEALTH WORKER-BASED INTERVENTION TO IMPROVE DIETARY HABITS: A CROSSOVER TRIAL IN JAPAN
Authors: Murayama Hiroshi , Taguchi Atsuko , Yamaguchi Takuhiro
Published: November 2019

Background: Community health workers (CHWs), often called “health promotion volunteers” in Japan, are individuals who act as a natural helping resource in the community. This study tested the effectiveness of a CHW-based intervention in improving dietary habits among community-dwelling older people in Japan, using a controlled, cross-over design. Methods: Seventy-eight people aged 65–74 years with poor dietary variety living in four districts in Hikone City (Shiga Prefecture, Japan) were allocated to an immediate-intervened group (IIG; n = 41) or a delayed-intervened group (DIG; n = 37). Participants joined a bi-weekly, four-session program (120 minutes/session), comprising “CHWs’ drama-style lectures,” “group discussion among participants and CHWs,” “tasting of dishes,” and “take-home practical activities.” For the initial 2-month period, the IIG received the intervention and the DIG did not. The groups were crossed over for the subsequent 2-month period. The primary outcome measure was the participants’ dietary variety scale score. Results: The dietary variety scale score in the IIG significantly increased in the initial 2-month period compared with the DIG (effect size 1.60 points; 95% confidence interval 0.75, 2.45). The intervention had a similar effect in the DIG in the subsequent 2-month period. Moreover, an analysis within the IIG showed that the intervention effects persisted for at least 2 months after the intervention. Conclusions: The CHW-based intervention improved dietary habits among older people. Our findings provide evidence that a CHW-based natural helping approach is a possible solution to promote healthy aging in the community.
FEASIBILITY OF A TELEHEALTH-DELIVERED LIFESTYLE INTERVENTION FOR LATE-MIDLIFE LATINOS LIVING IN RURAL CALIFORNIA
Authors: Schepens Niemiec Stacey L , Blanchard Jeanine , Vigen Cheryl , Martínez Jenny , Carlson Mike
Published: November 2019

Late-midlife Latinos (50–64 years old) living in rural regions experience significant health disparities, oftentimes exacerbated by limited access to healthcare services. In a previous pilot study, we observed psychosocial, behavioral, and cardiometabolic health improvements sustained over 12-months in late-midlife Latinos who participated in ¡Vivir Mi Vida! (¡VMV!), a culturally tailored lifestyle intervention led by a Latino community health worker (promotor) and occupational therapist team. For the present study, we assessed the feasibility of telehealth-delivered ¡VMV! modules. Participants (N=10) received an abbreviated three-week version of ¡VMV! consisting of an in-person promotor-led orientation and two one-hour telehealth sessions. Telehealth opinions/experiences were assessed at baseline and follow-up using study-specific questionnaires and by interview. Patient-identified health quality was measured pre-post intervention using the Measure Yourself Medical Outcome Profile (MYMOP2) and a single-item stress index. Participants generally agreed that telehealth session quality was equivalent to in-person sessions, and demonstrated confidence in their ability to communicate freely with the promotor and actively participate in telehealth sessions. We observed significant improvements in nearly all MYMOP2 components and a trend in stress reduction. The intervening promotor reflected that telehealth ¡VMV! extended healthcare to patients impacted by risk factors such as geographic isolation, lack of available services, and hesitancy to access in-person services due to fear of discrimination or deportation. Participants provided highly positive feedback, highlighting the practicality and convenience of the telehealth program. Feasibility of delivering ¡VMV! via telehealth to late-midlife rural-dwelling Latinos and its potential for positive effect was supported.
SOCIAL SUPPORT AND HEALTHCARE-SEEKING BEHAVIOR OF OLDER PERSONS IN NIGERIA
Authors: Togonu-Bickersteth Funmi , Aransiola Joshua O , Oyetunji-Alemede Catherine O , Ekundayo Opeyemi , Oluwaleimu Oluwasegun
Published: November 2019

Abstract The choice of healthcare facility by older persons is an important factor in their healthcare seeking behavior, and this can be associated with a number of factors. This study investigated the relationship between social support and healthcare facility choice of older persons in Nigeria. Other factors associated with the choice of healthcare facilities by older persons were also identified. Quantitative data were collected from a sample of 3,696 elderly aged 60 years above (55.6% male; 44.4% females; mean age = 69.2, SD = 8.60) who were selected through multi-stage systematic random sampling. Binary logistic regression analysis revealed that older persons who received social support were more likely to seek treatment in formal healthcare facilities, while older persons who did not receive any form of social support were more likely to seek treatment in informal healthcare facilities. Membership of social or religious groups was found to be a predictor of health seeking behavior among the older adults. Sex, age, level of education, and ability to handle activities of daily living (ADL), and ease of access to the nearest health facility, were found to be significantly associated with choice of healthcare facilities. The article concludes that there is need for conscious planning to provide formal supports to ease access of older persons to available health facilities. Such facilitation should include financial support and removal of existing physical and cultural barriers to health care utilization by older persons.
GERI-VET: A PROGRAM FOR OLDER VETERANS SEEN IN THE EMERGENCY ROOM
Authors: Kresevic Denise M , Lee Albert , Ascha Mustafa , Smith Todd
Published: November 2019

Older adults made over 21 million Emergency Room (ER) visits accounting for nearly 46% of all ER hospital admissions in 2015. The ER setting provides not only a unique opportunity to assess patients’ health, functional status and social issues, but also provide recommendations to help coordinate care. Geriatric ER assessments have been associated with reduced avoidable hospitalizations, functional decline, and institutionalization. However, few ER clinicians including physicians, nurses and technicians have received adequate training to perform geriatric screenings and implement timely referrals. In 2014 American College of Emergency physicians and American Geriatric Society published guidelines for care. Based on these guidelines A” Geri-Vet Bootcamp” Program was developed and piloted at the Northeast Ohio VAMC. This program included: simulation emphasizing standardized screenings, and the use of decision support aides for management and referrals for older adults seen in the ER. Following this multi-modal education program, 91% clinicians reported greater ability to apply knowledge learned, 82% clinicians were able to more accurately identify geriatric syndromes, and 86% were able to identify additional resources. Of the patients screened over one year, 73% of patients were identified as being at high risk for falls, 32% had high family caregiver burden, 15% had moderate to severe dementia, and 14% had positive delirium screens. Those veterans screened by Geri Vet trained Staff received significantly more referrals than usual care staff, home care 28.7% vs.15.6%, geriatric clinic 20.5% vs. 11.7% and caregiver support 5.0% vs. 1.3%. Data show hospital admissions have decreased 5-7%. Education and dissemination continues
PILOTING AN INTERPROFESSIONAL GERIATRICS COURSE FOCUSED ON SYSTEMS-BASED PRACTICE
Authors: Severance Jennifer J , Ross Sarah
Published: November 2019

Health professionals must be able to work together in the care of older adults to provide competent, value-based care within dynamic healthcare systems. Previous studies cite the need for health professions education addressing systems-based competencies and the interconnected components of health and aging services. With an aim to provide a foundation for systems-based interprofessional practice in the care of older adults, an academic medical center piloted a competency-based curriculum introducing different settings of care for older adults and exploring special topics in geriatric patient care and gerontology. Applying a framework of health and aging services, interprofessional faculty developed a curriculum delivered over six one-hour sessions during the Spring 2019 semester. Session topics included dementia care, end-of-life care, medication safety, activity, and financial and regulatory considerations across the continuum of care. Teaching strategies included didactics, case-based discussions, online reflection questions, shadowing of geriatric encounters in clinic and long-term care settings, and student presentations of a patient case. Post-session evaluation surveys were administered electronically to measure knowledge, skills and confidence using Likert-scale and open-ended questions. Eleven health professions students (medical [n=6], physician assistant [n=3], physical therapy [n=2]) participated. Preliminary findings show improved knowledge about healthcare and community-based options for older adults, value-based care, and the driving forces affecting health care delivery. Analysis of qualitative feedback identified key themes related to teaching methods, course materials, and course improvement opportunities. Interprofessional faculty collaboration can lead to quality health professions student training and increase competency in systems-based practice in the care of older adults.
AN INTERDISCIPLINARY PEDAGOGICAL APPROACH THAT HARNESSES COLLABORATIVE NETWORKS
Authors: Abramson Tobi A , Siegel Martha
Published: November 2019

Opportunities abound in healthcare and non-healthcare for innovative pedagogy, products, and services to address the growth of the aging population and ageism. ‘Aging-in-place’ homes and healthcare settings, often ill-prepared to meet aging needs, require redesign to incorporate designs that are responsive to an older or disabled person’s needs. This pedagogical approach used interprofessional/cross-disciplinary collaborative learning to incorporate a person-centered approach to developing evidence-based interior design solutions to transform homes, healthcare environments, and communities. This pedagogical collaboration built networks across disciplines, provided a unique learning environment by focusing on student learning through engagement of cross-discipline undergraduate and graduate students and external collaborators (older adults, healthcare systems). All students participated in the live project within and outside of the classroom utilizing print materials, didactic learning, experiential activities, research, technology, site visits, client interviewing, recording data, team meetings, and designing and presenting a solution to a panel of judges. Assessments indicated students’ appreciation of the project for their professional development and an enhanced understanding of teamwork strategies and cross-disciplinary classrooms for interprofessional learning. This pedagogical approach broke down academic silos and deserves more attention in academia to prepare students with the skills to work with an aging population. As the population ages, it is essential that college courses include approaches to decrease ageism and lead to the building of the workforce. Collaborative learning builds the foundation and networks that will help emerging professionals meet the needs of an aging population.
ADULT CHILDREN AND THEIR BOOMER PARENTS: THE DYNAMICS OF INTERGENERATIONAL LIVING ARRANGEMENT AND LIFE EVENTS
Authors: Huang Chiu-hua , Lin Ju-ping
Published: November 2019

Taiwan became an aged society in 2018. As Baby Boomers enter late life, relationships with family members gain importance.This research aimed to examine the intergenerational living arrangement between adult children and their baby boomer parents. Taking the perspectives of adult children, five waves of data (2008, 2009, 2010, 2011, and 2012) from the Panel Study of Family Dynamics (PSFD) were analyzed. Latent class growth analysis (LCGA) was used to develop changes types of intergenerational living arrangements. Focus on the life events of the two generations, this research examined the effect on intergenerational living arrangements changes pattern. The main findings are as follow. First, The proportion of intergenerational co-residence is high, especially between adult sons and their parents. There are different types of changes of intergenerational living arrangements. The four types of changes of intergenerational living arrangements for adult sons and daughters are the same: “continuous co-residence,” “continuous non-co-residence,” “from co-residence to non-co-residence,” and “from non-co-residence to co-residence.” Second, Adult children’s life events such as getting married and having children affect changes of intergenerational living arrangements. After marrying, the intergenerational living arrangement between adult children and their parents is inclined to be the “continuous non- co-residence” type. When adult sons have newborn babies, the living arrangement is inclined to be “from co-residence to non-co-residence.”
THE ROLE OF POLICY CONTEXT IN INDIVIDUAL LONG-TERM CARE DECISIONS IN OECD COUNTRIES
Authors: Caldera Selena
Published: November 2019

While family caregiving of the elderly has long been part of the cultural life of most OECD countries, longer life expectancy combined with low fertility rates has increased the share of the population dependent on current workers and minimized the available population of informal caregivers. The demand for expanded public provision of long-term care (LTC) resulting from this demographic shift prompted reforms in many OECD countries in the 1990s and 2000s. Differences in these reforms provide an opportunity to examine how individual choices between formal and informal care types are shaped by the policy context. I use longitudinal data on elders in three OECD countries, Sweden, Germany, and Japan, to examine LTC decisions under three varied approaches to population aging. The direction of LTC reforms in each country has been shaped by the existing model of care provision and financial constraints. In response to cost pressures, Sweden introduced need-based provision, financial devolution, and market-based approaches to its universal care model. Germany and Japan, in contrast, widely expanded restricted LTC coverage through public LTC insurance models. I use three multinomial logistic models of the LTC decision to test how differing policy schemes influence choices between formal and informal care. Using longitudinal Global Gateway to Aging data for each country, I model the LTC decision in each country as a factor of demographic and need characteristics of the elder experiencing limitations, characteristics of their family, and eligibility for publicly-provided LTC.
LOOKING UPSTREAM: THE ASSOCIATION BETWEEN AFFORDABLE HOUSING, NURSING HOME USE, AND UNMET CARE NEEDS IN THE COMMUNITY
Authors: Morales Meghan Jenkins , Robert Stephanie
Published: November 2019

In the U.S., population aging is coinciding with a growing affordable housing crisis. Evidence suggests that housing security contributes to health, but less is known about how affordable housing affects aging in place. We use a nationally representative sample (n=5,117) of older community-dwelling Medicare beneficiaries from the 2015 National Health and Aging Trends Study to test the association between housing cost burden (HCB) and moving to a nursing home, death, or remaining in the community by 2017. Among 2017 community-stayers (n=4,836), we also test the association between HCB and unmet care need, defined as experiencing a consequence related to 12 mobility (e.g., stayed in bed), self-care (e.g., skipped meals) and household (e.g., no clean laundry) activities. HCB is the proportion of income spent on rent or mortgage: low (<30%), moderate (30-50%), severe (≥50%), or home paid off (referent). Among nursing home movers, 26% had moderate or severe HCB in 2015 compared to 16% of community-stayers. Informed by the person-environment fit perspective, weighted stepwise regression models (multinomial and logistic) adjust for race, age, sex (Model 1), self-rated health, probable dementia (Model 2), living with others and high income (Model 3). Severe HCB is significantly associated with nursing home entry (RRR=2.66, SE=0.89) and this association is only partially mediated by health factors (RRR=2.16, SE=0.72) and resources (RRR=1.95, SE=0.64). Among community-stayers, severe HCB is significantly associated with unmet care need across all models. This study suggests that affordable housing is an important protective factor for older adults to age well in the community.
THE DOCTOR-PATIENT RELATIONSHIP, PERSONALITY, MOOD, AND FUNCTIONING IN OLDER ADULTS
Authors: Atlas Lauren S , Zweig Richard
Published: November 2019

Personality pathology has been tied to mental and physical health in older adulthood. Less is known regarding the combined impact of personality and the doctor-patient relationship on mental health outcomes. This study examined relationships between personality, mood, and trust in physicians. Participants (N=170) were a sample of primary care older adults ages 60-99 (M = 70.73, SD = 7.054) who completed self-report measures of personality traits (NEO-FFI), processes (IIP-PD-25), depression (GDS-30; PHQ-9), social adjustment (SAS-SR) and trust in one’s physician (GTIP). Medical burden data (CIRS) were retrieved from medical records. After adjusting for relevant covariates such as age, perceived health, cumulative illness burden, and income security there were several significant predictive relationships. In combined models more neuroticism (NEO-N, ß = .082, p < .000) and lower trust (GTIP, ß = -.025, p = .014) but not agreeableness (NEO-A, ß = -.006) or interpersonal problems (IIP-25, ß = .254) predicted depression. In combined models, higher neuroticism (NEO-N, ß = .018, p < .000) and interpersonal problems (IIP-25, ß = .186, p = .002) but not agreeableness (NEO-A, ß = -.003) or trust (GTIP, ß = -.002) predicted social adjustment. The results are consistent with previous findings that neuroticism predicts both depression and social adjustment in older adults. In addition, lower trust augmented neuroticism to predict depression. Results suggest that apart from general personality risk factors, situational personality processes such as trust in physicians may affect mood state, whereas personality processes such as interpersonal problems contribute to longer term functional impairment.
INDIVIDUAL PREDICTORS OF VOLUNTEERING IN OLDER ADULTS USING STRUCTURAL EQUATION MODELING
Authors: Baumel Zolana J , Kelly Christopher M
Published: November 2019

Why do some older Americans volunteer while others do not? Personality theory is used to explain volunteering behavior. This study used the Big 5 personality domains. Volunteering is also explained by resource theory, which includes personal, social, and cultural capital. Personal capital was measured by age, sex, race, marital status, health, and education (a proxy for socioeconomic status). Social capital was measured by frequency of email/write interactions and interactions with friends. Cultural capital was measured as church attendance. The purpose was to measure the extent to which social and cultural capital mediates between personality and personal capital, and volunteering outcomes. Participants were the 2010 Core Health and Retirement Study who also completed the leave-behind self-administered questionnaire (N=4,299). Structural equation modeling (SEM) tested personality and resource theory in one model. Exploratory factor analysis, followed by confirmatory factor analysis supported development of the final SEM. Extraversion directly predicted volunteering. Age was inversely correlated with volunteering. Health and education directly predicted volunteering. Church attendance and interactions with friends directly predicted volunteering. Conscientiousness predicted church attendance. Open to new experience was inversely related to church attendance and directly predicted frequency of email/write interactions. Extraversion predicted interactions with friends. Measuring direct, indirect, and total effects of predictors on volunteering showed that personality influences volunteering both directly and indirectly. Future applied research could test whether extraversion, which directly influences interactions with friends, would directly predict recruiting outcomes. It could also test whether open to new experience, which directly influences email/write interactions, would directly predict retention outcomes.
IMPROVING MOOD THROUGH PHYSICAL ACTIVITY FOR CARERS AND CARE RECIPIENTS TRIAL (IMPACCT): RESULTS OF A RCT
Authors: Dow Briony , Malta Susan (Sue) , Gaffy Ellen , Russell Melissa , Williams Sue , Moore Kirsten J , Lautenschlager Nicola , Loi Samantha
Published: November 2019

The aim of this Australian study was to investigate effects on depression of a 6-month individually tailored home-based exercise program for caregivers, designed to be done with the person they care for. Ninety-one caregiver-care recipient dyads and 30 caregiver-only participants (caregivers scoring ≥4 on the 15 item Geriatric Depression Scale (GDS-15)) were randomized into one of three groups: exercise intervention (n=50, 34 dyads and 16 caregiver only), social support control (n= 50, 42 dyads and 8 caregiver only) or usual care control (n= 21, 15 dyads and 6 caregiver only). The exercise group completed an individualised program based on the Otago-plus. The primary outcome was the proportion of participants with GDS-15 ≤4. Outcome assessors were blinded to group assignment. There were no significant difference in depression between the physical activity intervention group and the social control (OR 1.06, 95% Confidence Interval (CI) 0.44, 2.56) and the physical activity intervention group and the usual care control (OR 1.51 95% CI 0.46, 4.94) at six months or at 12-months. However, more than 50% of caregivers in all three groups no longer had a GDS-15 score >4 at 6 months. Sub-group analysis revealed that after 6 months caregivers in the exercise group caring for someone with an MMSE ≥24 were significantly less depressed than those caring for someone with an MMSE score of <24 compared with social (p value <0.02) and usual care groups (p value < 0.02). A dyad exercise intervention may be beneficial for those caring for someone without cognitive decline.
DON’T WORRY, BE HAPPY NOW, PET OWNERS: THE RELATION BETWEEN PET OWNERSHIP AND ANXIETY AND DEPRESSION IN LATE LIFE
Authors: Bolstad Courtney J , Adams-Price Carolyn E , Nadorff Michael R
Published: November 2019

Pets can provide older adults a means of social support, which can combat problems faced in later life including loneliness, anxiety, and depression. However, current research findings in this area are mixed. The current study explored the differences in anxiety and depression between pet owners and non-pet owners and how pet ownership was associated with these symptoms after accounting for other established correlates. We hypothesized pet owners would endorse fewer symptoms of anxiety and depression than non-pet owners and owning a pet would be associated with these symptoms even after accounting for other common correlates. Participants included 608 older adults aged 70 to 95 that were included in the University of Alabama at Birmingham Study of Aging. As hypothesized, results indicated that pet owners endorsed significantly fewer symptoms of anxiety and depression than non-pet owners. Hierarchical regressions indicated that owning a pet explained a significant amount of variance in anxiety symptoms even after controlling for depression, self-reported health, and demographics. However, owning a pet did not have a significant association with depressive symptoms after accounting for anxiety, self-reported health, and demographics. These results suggest that lower rates of anxiety and depression are related to owning a pet and that pet ownership is associated with fewer anxiety symptoms, but not depressive symptoms, independent of several established correlates of anxiety. Future research is needed to determine the specific mechanisms of pet ownership that comprise this relationship as well as whether pet ownership may longitudinally reduce or buffer against anxiety in late life.
SELF-RATED HEALTH AS A PREDICTOR OF DEPRESSION AND ANXIETY IN OLDER ADULT INMATES
Authors: Vogel Carlyn E , Barry Lisa C
Published: November 2019

Inmates age ≥50 years (older inmates) are a rapidly growing population within the U.S. correctional system with the highest suicide rate among adult prisoners. Although depression and anxiety are strong precursors of subsequent suicide, little is known regarding factors associated with these outcomes in older inmates. To inform suicide prevention efforts in this high-risk population, we evaluated the role of older inmates’ self-rated health (SRH) in relation to depression and anxiety. We utilized data from the ongoing Aging Inmates Suicidal Ideation and Depression study (Aging INSIDE). Participants (N=175) included men age ≥50 (M=56.5, SD=6.3, range=50-79 years) from eight correctional facilities in Connecticut who completed face-to-face interviews. The outcomes, depression and anxiety, were assessed using the PHQ-9 (range 0-27) and GAD-7 (range 0-21); higher scores on each scale indicated worsening severity. SRH, operationalized as a pseudo-continuous variable (1=excellent; 5=Poor), was correlated with depression (r=0.379; p <.001) and anxiety (r=0.260; p =.001) in unadjusted analyses. Two linear regression models were conducted to determine if SRH was associated with depression and/or anxiety after controlling for age, race (white versus non-white), years of education, visitors (yes versus no), and number of chronic conditions. Increasingly worse SRH was significantly associated with more depressive symptoms (β=1.92, SE=.43, p <.001) and higher anxiety scores (β=1.41, SE=.41, p=.001). SRH explained 10.0% and 6.2% of the variance in depression and anxiety scores, respectively. SRH may be useful for identifying older inmates who are more likely to have depression or anxiety, and thus may be at higher risk for suicide.
RACIAL DIFFERENCES IN PHYSICAL ACTIVITY IN NURSING HOME RESIDENTS WITH COGNITIVE IMPAIRMENT
Authors: Viviano Nicole A , Galik Elizabeth , Resnick Barbara
Published: November 2019

INTRODUCTION: Nursing home residents with moderate to severe cognitive impairment are mostly sedentary. It is more likely that African-American (AA) older adults tend to be more sedentary than their white counterparts. The purpose of this study was to examine racial differences in overall time spent in physical activity (PA), time in sedentary, light intensity, and moderate levels of PA, and participation in activities of daily living (ADLs) among cognitively impaired nursing home residents. METHODS: This was a secondary data analysis from the Function and Behavior Focused Care Intervention study. The sample included 336 cognitively impaired residents from 12 nursing homes. RESULTS: The mean age of the residents was 86.2 (SD=10.1) with an average MMSE score of 7.8 (SD=5.0) where 41% were AA and 59% white. White and AA participants engaged in only 51.2 and 46.1 minutes of light and 1.5 and 1.1 minutes of moderate level PA, respectively. There was a significant difference in time spent in light-intensity PA with whites spending more time in this level of activity [F(4, 242) = 3.360, p = .01]. Conversely, AAs had better functional ability than white residents [F(4, 242) = 4.754, p < .001]. There were no significant racial differences in time in sedentary, or moderate level PA. DISCUSSION: These findings are consistent with prior research showing that AAs had lower PA levels compared to their white counterparts. Future research should focus on increasing PA among nursing home residents and consider specific interventions to increase activity among AA residents.
GENDER DIFFERENCES IN THE EFFECT OF DIFFERENT EXERCISE DOSES ON PREVENTING DEPRESSIVE SYMPTOMS IN OLDER ADULTS
Authors: Chen Mei-Lan , Chang Yu-Chen , Chao Ying-Yu , Gardenhire Douglas S , Burgess Elisabeth O
Published: November 2019

Regular exercise is potentially an effective way to prevent or reduce depressive symptoms for older adults. However, little research has focused on gender differences in exercise dose effects on depressive symptoms in older people. The purpose of this study was to test gender differences in the preventive effects of different exercise doses on depressive symptoms among community-dwelling older adults in Taiwan. This study was a secondary analysis of a longitudinal cohort study in a sample of older Taiwanese adults (N = 2,673; mean age 74.2 ± 5.7 years). Four different doses of moderate-intensity exercise were examined including three 15-min sessions/week, three 30-min sessions/week, six 15-min sessions/week, and six 30-min sessions/week. Descriptive statistics and generalized linear mixed models were used to analyze characteristics of the sample and hypotheses testing. All analysis models were adjusted according to age, gender, education, marital status, smoking, social participation, and chronic conditions. The results indicated that regular exercise with at least 15 min per session, 3 times a week of moderate intensity was significantly associated with lower levels of depressive symptoms for women, but there were no significant preventive effects on depressive symptoms for men. This study suggests that moderate-intensity exercise may play a protective role in depression prevention for older women, even with a very low dose (three 15-min sessions/week). Gender differences should be considered for future research and clinical practice when designing exercise interventions on preventing depression for older adults.
AGE-RELATED FUNCTIONAL RESERVE DECLINE IS NOT SEEN IN PHARYNGEAL SWALLOWING PRESSURES
Authors: Jones Corinne A , Looper Melanie , McCulloch Timothy
Published: November 2019

Age-related decline in functional reserve has been described in tongue strength: tongue pressure during swallowing does not change with age, but maximal-effort isometric tongue pressure decreases with age. Healthy persons show a slight increase in pharyngeal swallowing pressure with age, but it is unknown if there is a similar decline in functional reserve. Fifty-six healthy adults (n=38 60 years) underwent pharyngeal high-resolution manometry during effortful and normal-effort thin liquid swallows. Repeated measures ANOVAs were performed on maximum pressures, pharyngeal contractile integral (PCI), pharyngeal pressure gradients, and upper esophageal sphincter minimum pressures. We hypothesized that older individuals would generate a less-robust pressure increase with effortful swallowing than younger individuals. Maximum pressures, PCI, and gradients increase during effortful swallowing (p<0.001), but there was no interaction effect with age, suggesting a lack of age-related functional reserve decline. Older individuals had greater UES minimum pressures than younger individuals in the effortful swallowing task (p=0.03), which may stem from reduced muscular compliance in this area. These findings do not align with those reported in tongue pressures, suggesting that muscle properties and pressure generation may be fundamentally different between the pharynx and the oral tongue. Alternatively, the effortful swallowing task may not elicit maximum contractility of the pharyngeal musculature. The preserved ability to increase pharyngeal pressure during effortful swallowing may support the use of the effortful swallow exercise in older adults with swallowing disorders.
SELECTIVE NARROWING OF PERIPHERAL SOCIAL NETWORKS PREDICTS POOR LONG-TERM COGNITION IN OLD AGE
Authors: Liao Hsiao-Wen , Shavit Yochai Z , Carstensen Laura L
Published: November 2019

Socioemotional selectivity theory posits that emotionally meaningful goals such as spending precious time with close family and friends are prioritized in late life as a function of limited future time horizons. Research documents that older individuals include a smaller proportion of peripheral social partners than younger individuals in their social networks, and that this selectivity is associated with better daily emotional experience (English & Carstensen, 2014). Such limitation of social partners, however, might adversely affect cognitive function in the long run, since exposure to novel and cognitively stimulating environments has been tied to better cognitive functioning (Park et al., 2014). The current study examined the long-term association between proportions of peripheral social partners in older adults’ social networks and cognitive performance. Sixty-one older participants (Mage = 71.53) reported the size of their inner, middle, and outer social circles using the Social Convoy Questionnaire (Kahn & Antonucci, 1980) and completed Digit Span Backward, Digit Span Forward, and Digit Symbol tasks at baseline and five years later. Results of multiple regression analysis show that participants who had a smaller proportion of social partners in their outer social circle at baseline performed poorer on the Backward Span task assessed five years later than those with a larger outer circle proportion. Results hold controlling baseline cognition, physical health, age, SES, education, and trait openness. We discuss the findings in terms of potential tradeoffs between the age-related social selection and working memory in the long run.
EXPANDING SOCIAL TIES AS A GOAL IN LATER LIFE: THE ROLE OF SOCIAL NETWORK CHARACTERISTICS
Authors: Oleskiewicz Danielle , Rook Karen
Published: November 2019

Older adults often winnow their social ties to focus on emotionally rewarding ties (Charles & Carstensen, 2010). Some older adults, however, have small social networks that preclude much winnowing or aversive social ties from which disengagement is difficult. These individuals might be motivated to expand, rather than contract, their social ties. The current study sought to extend knowledge regarding potential links between social network characteristics and older adults’ interest, effort, and success in creating new social ties. We expected that small social networks and negative social ties might motivate interest and effort directed toward forming new social ties but that positive social ties might foster success in efforts to form new ties. In-person interviews were conducted with participants (N = 351, Mean age = 74.16) in a larger study of older adults’ social networks and well-being. The interviews assessed participants’ social networks, as well as their interest, effort, and success in making new social ties. Participants’ social network composition, rather than size, was associated with greater motivation to establish new social ties. Negative social ties were associated with greater interest and effort directed toward forming new social ties. Positive social ties were related to greater success (due, in part, to their support provision) and, unexpectedly, were also related to greater interest and effort directed toward forming new ties. Older adults sometimes seek to expand, rather than contract, their social ties, and characteristics of their social networks appear to play a role in fueling and influencing the success of such efforts.
THE EFFECT OF OLDER ADULTS’ VOLUNTEERING ON THE SOCIAL SUPPORT
Authors: Kim Meeryoung
Published: November 2019

With increasing longevity, older adults need activities after retirement. Volunteering can be alternate for substituting role after retirement. Social capital is an important resource to start volunteering. Vice-versa, volunteering can increase their social network and social support. This study examined how the factors of volunteering affect emotional, instrumental and esteem support of older adults. This study used the 6th additional wave of the Korean Retirement and Income Study (2016). The sample size was 202 and target population were adults age 65+. Multiple regressions were used for data analysis.. Demographic variables (e.g. gender, age, etc) were controlled. Independent variables included volunteer time, how many places they volunteered at, whether volunteers were professionals providing pro-bono services or not, whether they were self-motivated or asked by others. For dependent variables, social support such as emotional, instrumental and esteem support were used. If volunteers were asked by others, emotional and esteem support were increased. If volunteers were self-motivated, it affected esteem support. If they were volunteering in multiple places, instrumental and esteem support were higher than volunteering in only one place. Length of volunteering time spent affected the instrumental support negatively. There were differences between those who were professionals versus nonprofessional volunteering affecting instrumental support. Nonprofessional volunteering affected instrumental support more than professional volunteering. These findings implied social support motivation, time, and whether the volunteer was a professional or not affected different kinds of social support differently. Findings show the importance of older adults doing volunteering to enhance social support.