bluuebunny/crossref_metadata_2025 huggingface dataset:
FUNCTIONAL STATUS ASSOCIATED WITH RISK OF READMISSION DURING HOME HEALTH CARE FOR PATIENTS WITH DEMENTIA
Authors: Knox Sara , Downer Brian , Haas Allen , Middleton Addie , Ottenbacher Kenneth
Published: November 2019

Approximately 14.0% of Medicare beneficiaries are readmitted to a hospital within 30-days of home health admission. Individuals with dementia account for 30% of all home health care admissions and are at high-risk for rehospitalizations. Our primary objective was to determine the association between functional status and social support at admission to home health and 30-day potentially preventable readmissions (PPR) during home health care. We conducted a retrospective cohort study of 124,119 Medicare beneficiaries receiving home health (7/2013 – 6/2015) and diagnosed with dementia (ICD-9 codes). Approximately 65% of participants were over the age of 81, 61% were female, and 80% were Caucasian. The primary outcome was 30-day PPR during home health. OASIS items were used to create mobility, self-care, social support, and cognition categories. The overall rate of 30-day PPR was 7.6% (95% CI: 7.4-7.7) but varied by patient and health care utilization characteristics. After adjusting for sociodemographic and clinical characteristics, the odds ratios (OR) for the most dependent score quartile versus the most independent was 1.68(1.56,1.80 95% CI) for mobility, 1.78 (95% CI: 1.66- 1.91) for self-care, and 1.10(95%CI: 1.03-1.17) for social support. The OR for impaired versus intact cognition was 1.12 (95% CI: 1.05-1.20). Impaired functional and cognitive status as well as limited social support at admission to home health care are associated with increased risk of PPR for individuals with dementia. Future research is needed to determine if strategies targeted at mobility and self-care can decrease PPR during home health for individuals with severe dementia.
UTILIZING NUTRITION SERVICES PROVIDERS TO PREVENT LATE-LIFE SUICIDE: IMPLEMENTING A RANDOMIZED, CONTROLLED TRIAL
Authors: Fullen Matthew C , Mize Mary Chase , Shannonhouse Laura R
Published: November 2019

A challenge in preventing late-life suicide is identifying and responding to persons-at-risk prior to a suicide attempt. Distressed older adults are less likely to turn to a mental health professional, meaning that community-based prevention strategies are vitally important to comprehensive prevention frameworks. Due to their “natural helper” role, nutrition services (NS) volunteers may be well-positioned to identify suicide warning signs and respond accordingly. Unfortunately, there is a lack of systematic, empirically-tested evaluations of the effectiveness of community-based strategies to prevent older adult suicide, including the use of NS volunteers. To remedy this, the authors partnered with several home- and community-based service organizations to measure the impact of training nutrition services volunteers in suicide prevention skills. The authors will present preliminary findings from this federally-funded randomized, controlled trial of suicide prevention training (i.e., ASIST; safeTALK) on late-life suicidality and its correlates.
CUMULATIVE DIS/ADVANTAGE AND HEALTH TRAJECTORY IN LATE LIFE: A COMPARISON BETWEEN FOUR COUNTRIES
Authors: Lu Peiyi , Shelley Mack
Published: November 2019

Cumulative Dis/Advantage (CDA) theory concerns how societal structure influences individual developmental and health trajectory across the life span, but few studies have applied CDA in the international setting with gender comparisons. This study provides a cross-national perspective to test CDA in explaining health inequality between developing and developed countries. Cross-sectional harmonized data from the international Health Retirement Study-series (United States, China, Mexico, and England) in 2013-2014 were used (n=97,978). Four health indicators were included: self-reported health, depressive symptoms, functional ability, and memory. Sociodemographic information and health behaviors were used as covariates. Regression models were fitted to examine the moderation roles of country and gender in health trajectory in later life. Results indicate self-reported health and mental health remained steady while functional ability and memory declined across late life span. Older Chinese and Mexican respondents had poorer health status than their British and American counterparts consistently except for memory in the Mexican data. Cumulative health gaps between developing and developed countries existed only for functional ability. Females in the four countries had poorer health than their male counterparts except their memory status. We conclude that CDA explains only the temporal decline of functional ability and its increasing gaps in later life between countries. Health inequality between countries could be attributed to the limited availability of healthcare and social resources in developing countries. However, other health status, including general health and mental health, depend more on individuals’ intrinsic capacity and human agency.
THE RELATIONSHIP OF THE TRAJECTORY OF COMORBIDITY ON FUNCTIONAL STATUS IN A COMMUNITY SAMPLE OF ELDERS
Authors: Pieper Carl , Bowling Barrett , Fillenbaum Gerda
Published: November 2019

The Duke Established Populations for the Epidemiologic Study of the Elderly (EPESE) study is a 1:7 random sample elderly over 65YO at baseline living in the Piedmont NC, followed yearly for 10 years beginning in1986. There were 4162 participants at baseline of which slightly over 1100 were still alive and responding at year 10. The participants self-reported on 5 comorbidities (cancer, high BP, diabetes, stroke and heart attack) at each year, as well as 4 functional scales - Katz, Rosow-Breslau, Nagi, and IADL scales. Using Mixed Models, the slope (trajectory) and intercept (level) of comorbidity over 10 years was estimated for each person, and correlated with the function scales in the final year. Correlations of the final comorbidity trajectory with the 4 functions levels ranged between 0.12 and 0.18, the trajectory with function ranged between 0.15 and 0.27. All p-values<0.0001. The first Canonical Correlate of function with comorbidity was 0.28 (p<0.0001). Slope and intercept were related jointly to each outcome and multivariately (p<0.001 for the joint effects, controlling for race, gender, age, and years of education. The multimorbidity relationship with function differed by race (omnibus p-value for the raceXmultimorbidity interaction p=0.03 (by Wilk’s Lambda), controlling for the demographics). This method is an example of combining longitudinal and cross-sectional outcomes and shows that the change in number of comorbidities is associated with functional status level.
THE CLINICAL TRANSLATION OF SENSOR TECHNOLOGY TO IMPROVE PROVIDER AND PATIENT CARE: METHODS AND ACCEPTABILITY
Authors: Huisingh-Scheetz Megan , Xue Qianli , Schrack Jennifer A
Published: November 2019

Sensor-based technologies are rapidly emerging and are capable of collecting objective, dynamic, and high resolution health data not captured in the clinical setting. However, the precise clinical applications of such devices are not yet well delineated; extensive challenges to their implementation remain. The objectives of this symposium are to highlight a) opportunities for sensor technology use in clinical practice, b) implementation challenges reported by key stakeholders, and c) an NIH/VA-sponsored initiative to create an open technology research platform to improve aging technology research. Dr. Young will discuss the novel application of wearable sensors for maintaining proper posture/position during patient transfer including the generation of sensor metrics defining proper lifting technique and body mechanics. Dr. Huisingh-Scheetz will report analytic strategies for identifying frailty using wrist-worn accelerometry data collected in the free-living environment in the NIA-supported National Social Life, Health and Aging Project dataset. She will report her work relating hourly activity and between/within subject hourly activity variance to frailty. Ms. Blinka will report qualitative feedback collected from patients, caregivers, and healthcare providers about their perspectives on the utility and challenges of using sensor technology in a clinical context. Dr. Kaye will discuss ongoing developments addressing challenges to implementing technology use in clinical care, with particular attention to the Collaborative Aging Research using Technology (CART) initiative supported by the NIH and VA. Collectively, these presentations will advance sensor technology to improve healthcare delivery.
THE INFLUENCE OF LIFE-EXTENDING MUTATION AND DIETARY INTERVENTION ON GUT MICROBIOTA
Authors: Masternak Michal , Wiesenborn Denise S , Schneider Augusto , Strowig Till , Schafer Karl –Herbert , Galvez Eric
Published: November 2019

The gastrointestinal microbiota represents a large and complex ecological system of different microorganisms. Recently, there is an increasing interest in the impact of microbiota on development of different age-related diseases. We tested the changes of gut microbiota during development in long-living Ames dwarf (df/df) mice and we compared the effects of this life-extending mutation with the impact of calorie restriction (CR). Importantly, the analysis of microbiome showed significant differences in the ratio of Bacteroidetes and Firmicutes when comparing df/df and normal (N) mice (p<0.001). The LefSe analysis showed distinct microbiome distribution between CR and ad libitum (AL) feeding regimen in N animals (p<0.004), yet there was lack of similar changes in response to CR in df/df mice. In summary, our study showed significant genotype impact on gut microbiota and we showed that life-extending CR regimen provide divergent effects on gut microbiota in N when comparing with df/df mice.
THE IMPACT OF FUNCTIONAL DISABILITY ON HOSPITALIZATION SPENDING IN SINGAPORE
Authors: Chen Cynthia
Published: November 2019

Singapore is one of the fastest-aging populations due to increased life expectancy and lowered fertility. Lifestyle changes increase the burden of chronic diseases and disability. These have important implications for social protection systems. The goal of this paper is to model future functional disability and healthcare expenditures based on current trends. To project the health, disability and hospitalization spending of future elders, we adapted the Future Elderly Model (FEM) to Singapore. The FEM is a dynamic Markov microsimulation model developed in the US. Our main source of population data was the Singapore Chinese Health Study (SCHS) consisting of 63,000 respondents followed up over three waves from 1993 to 2010. The FEM model enables us to investigate the effects of disability compounded over the lifecycle and hospitalization spending, while adjusting for competing risk of multi-comorbidities. Results indicate that by 2050, 1 in 6 older adults will have at least one ADL disability and 1 in 3 older adults will have at least one IADL disability, an increase from 1 in 12 elders and 1 in 5 elders respectively in 2014. The highest prevalence of functional disability will be in those aged 85 years and above. Lifetime hospitalization spending of elders aged 55 and above is US$24,400 (30.2%) higher among people with functional disability compared to those without disability. Policies that successfully tackle diabetes and promote healthy living may reduce or delay the onset of disability, leading to potential saving. In addition, further technological improvements may reduce the financial burden of disability.
RETURNING THE FAVOR: EXPECTATIONS OF CAREGIVING RECIPROCITY AND DEPRESSIVE SYMPTOMS AMONG GRANDPARENTS
Authors: Bui Cindy N
Published: November 2019

This study draws upon social capital and intergenerational reciprocity concepts to better understand how grandparents’ depressive symptoms are related to their provision of grandchild care, within the context of their expectations regarding adult children reciprocating caregiving needs in the future. Analyses used the 2014 Health and Retirement Study dataset. The sample consisted of 9,612 grandparents, 2,595 of whom were providing grandchild care. Linear regression models were used to analyze how depressive symptoms were influenced by grandchild care provision and expectations of future care from adult children. Future care is measured as expectations from (1) any adult child, and (2) from the same adult child for whom the older parent provides grandchild care. Provision of grandchild care was not significantly related to grandparents’ number of depressive symptoms. Among grandparents who provided grandchild care, both expecting any adult child and expecting the same adult child were associated with reporting fewer depressive symptoms. Expecting any adult child to provide future care showed a stronger effect than expecting the same adult child to provide future care. The results suggest that expectations of general reciprocity within the family system, rather than specific dyadic reciprocity, may be more important for a caregiving grandparent’s emotional well-being. Providing grandchild care while expecting future care from adult children can indicate a sense of social capital within an intergenerational family system. Expecting support reciprocity from adult children may be a protective factor that allows caregiving grandparents to feel more secure about their future care needs, and consequently, less depressed.
A TELEHEALTH DELIRIUM COACHING INTERVENTION FOR FAMILY CAREGIVERS OF OLDER ADULTS WITH ALZHEIMER’S DISEASE
Authors: D’Avolio Deborah A , Opalinski Andra , Newman David
Published: November 2019

The purpose of this study is to develop and evaluate the feasibility of a telehealth coaching intervention for delirium prevention among family caregivers (FCs) of community-dwelling older adults with dementia. This study used an explanatory mixed methods design in which survey data was augmented with semi-structured interviews. A purposive sample of 20 older adult dyads participated. The intervention consisted of 6-weeks of telephone coaching sessions. FCs conducted daily delirium assessments. We employed correlations and GLM to investigate the relationships between variables and the outcomes. Results: The model showed a statistically significant positive correlation between the Human Connection Scale and the SF-36 pretest domain of general health (r= .47, p= .04). There were statistically significant positive correlations between the Human Connection Scale and the SF-36 posttest domains of physical functioning (r= .54, p= .014) and general health (r= .76, p<.001). There were a small positive changes in mean scores on each domain between the pre- and post-test scores on the SF-36. The most impressive findings came from FCs identification of delirium using the FAM-CAM. These participants had no history of delirium but 6 of 20 (30%) reported at least one episode of delirium. The qualitative data revealed that FGs found weekly coaching sessions beneficial and supportive. The results suggests that the intervention has a meaningful impact on how we assess delirium in the community and warrants further study.
NUTRITIONAL INTAKE AND STATUS AND PHYSICAL FUNCTION OF OLDER ETHNIC MINORITIES: A LONGITUDINAL STUDY
Authors: Asamane Evans A , Greig Carolyn A , Thompson Janice L
Published: November 2019

There are limited longitudinal data regarding nutritional intake and status, and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n=100) and after 8-months (n=81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Multiple pass 24-hour dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. The Short Physical Performance Battery(SPPB) and handgrip strength measured physical function. Linear and multinomial regression analyses were used to predict the relationship between nutritional intake, status and physical function. Mean(SD) age was 70(8.1) years (60% male), with 62% of the sample being obese. Significant decreases in intakes of vitamin B6(0.88-0.77mg/day, p=0.014); vitamin B1(0.73-0.63mg/day, p=0.029); iron(6.16-5.85mg/d, p=0.045); folate(113.23-106.66µg/d, p=0.043); and magnesium(154.54-144.59mg/d, p=0.031) occurred over time. At both timepoints, across sexes, daily intakes of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes. There were significant declines in SPPB scores(Z=-4.01, p<0.001) and nutritional status(Z=-2.37,p=0.018) over time. At baseline, younger age, better nutritional status, and higher vitamin D and fibre intakes were associated with higher SPPB scores. At follow-up, higher baseline SPPB scores (OR=0.54 95% CI:0.35, 0.81) were associated with reduced decline in nutritional status. The observed declines in nutritional status and physical function, and the inadequate nutrient intakes in the absence of weight loss within eight months pose serious challenges to healthy ageing. There is an urgent need to re-evaluate and tailor appropriate dietary advice for this population to support them to age healthily.
DO BLUEBERRIES ACTUALLY IMPROVE COGNITIVE PERFORMANCE? AN ANALYSIS OF PUBLICATION BIAS IN PUBLISHED RESEARCH
Authors: Brydges Christopher , Gaeta Laura
Published: November 2019

A recent published systematic review (Hein et al., 2019) found that consumption of blueberries could improve memory, executive function, and psychomotor function in healthy children and adults, as well as adults with mild cognitive impairment. However, attention to questionable research practices (QRPs; such as selective reporting of results and/or performing analyses on data until statistical significance is achieved) has grown in recent years. The purpose of this study was to examine the results of the studies included in the review for potential publication bias and/or QRPs. p-curve and the test of insufficient variance (TIVA) were conducted on the 22 reported p values to test for evidential value of the published research, and publication bias and QRPs, respectively. The p-curve analyses revealed that the studies did not contain any evidential value for the effect of blueberries on cognitive ability, and the TIVAs suggested that there was evidence of publication bias and/or QRPs in the studies. Although these findings do not indicate that there is no relationship between blueberries and cognitive ability, more high-quality research that is pre-registered and appropriately powered is needed to determine whether a relationship exists at all, and if so, the strength of the evidence to support this association.
AGING KNOWLEDGE AND SELF-REPORTED AGEISM
Authors: Cherry Katie E , Erwin Marla J , Allen Priscilla D
Published: November 2019

The term, ageism, refers to any form of personal or institutional prejudice or discrimination based on chronological age. Ageism may encompass attitudes and prejudices, as well as behaviors, highlighting the complex nature of ageist behaviors observed among students and professionals alike (Allen, Cherry, & Palmore, 2009). We examined the prevalence of self-reported ageist behaviors in a sample of college students who ranged in age from 18 to 44 years to test the hypothesis that aging knowledge would be associated with self-reported ageist behaviors (positive and negative). The study sample was comprised of adults who were enrolled in classes at Louisiana State University (n = 110). Most of these students were traditional aged college students (18-25 years old). Participants completed the Relating to Older People Evaluation (ROPE; Cherry & Palmore, 2008), the Facts on Aging Quiz (FAQ; Palmore, 1998), and the Knowledge of Memory Aging Questionnaire (KMAQ: Cherry et al., 2003). Results indicated that positive ageist behaviors were more frequent than negative ageist behaviors. Men endorsed positive and negative ageism items more than women reported. Follow-up analyses on participants’ responses to the two aging knowledge questionnaires showed that increased knowledge of aging was significantly correlated with diminished reports of negative ageist behaviors, after controlling for age and gender. These results imply that self-reported ageist behaviors are associated with aging knowledge. Strengthening college curricula by including course offerings in adult development and aging may improve self-reported ageist behaviors among college students.
GENDER DIFFERENCES IN THE ASSOCIATION BETWEEN MODIFIABLE RISK FACTORS AND FINANCIAL HARDSHIP
Authors: Marshall Gillian , Bryson William , Rostant Ola , Canham Sarah
Published: November 2019

Objective: To identify associations between modifiable risk factors (cigarette smoking, alcohol consumption, and obesity) and financial hardship (difficulty paying bills, food insecurity and medication need) among middle-aged and older Americans in a nationally representative sample. Methods: This was a cross-sectional study of 8,212 persons age 50 years and older who completed the core 2010 Health and Retirement Study survey and the psychosocial questionnaire. We ran separate multinomial logistic regressions to assess the association of three modifiable risk factors and three different financial hardship indicators. Results: Adjusting for all covariates, compared to men of normal weight, men who were obese had a 1.4 greater odds of difficulty paying their bills (95% CI: 1.08-1.76); former smokers had a 1.8 greater odds of being food insecure (95% CI: 1.05-2.95); current smokers were twice as likely to be food insecure (95% CI: 1.21-3.73); Compared to women who never smoked, current smokers had a 1.5 greater odds of having difficulty paying their bills (95% CI: 1.11-2.02); current smokers had a 1.8 greater odds of being food insecure (95% CI: 1.13-2.91); and women who were obese had a 1.5 greater odds of reducing medication due to cost (95% CI: 1.11, 2.02). Conclusion: Our findings contribute to the literature on health behaviors and financial hardship by highlighting the cyclical nature between different indicators of socioeconomic status, modifiable risk factors, and poor health outcomes among middle-aged and older adults. Furthermore, findings highlight how modifiable risk factors may culminate in financial hardship in later life.
RECONSIDERING PROTECTIVE FACTORS OF SUICIDALITY IN OLDER ADULTHOOD: RESULTS FROM THE CDC NVDRS NATIONAL DATASET
Authors: Bower Kyle L , Emerson Kerstin G
Published: November 2019

Existing literature comprehensively addresses the issue of suicide; however, there is still much to be understood concerning this phenomenon in later life. For instance, suicide rates are particularly high for older agricultural workers, yet there remains considerable ambiguity concerning the factors contributing to this public health crisis. We conducted exploratory analyses with the Centers for Disease Control (CDC) National Violent Death Reporting System (NVDRS) 2003-2017 dataset. We identified a sample of individuals who committed suicide while working in the agricultural sector (N= 2,106). We coded “farmer” as anyone who worked in the agricultural sector at their time of death, or prior. The majority (>90%) of the sample was Caucasian male, and approximately 38% was age 65 and older. We also found that 40% of farmers were married (or in a domestic partnership) at the time of death. Specifically, of those 65 and older, 26% were married at the time of death (second largest majority as 70% were widowed). This finding is particularly interesting as marriage or long-term partnerships have been shown in the literature to be a protective health factor in later life, especially for older men. Our findings regarding marital status suggest that having a significant other may not be the most critical relationship for suicide prevention. Future mental health interventions should explore alternative social connections as a means to identify more effective methods of preventing suicide in this vulnerable population.
GENDER DIFFERENCES ACROSS THE AGING SEMANTIC DIFFERENTIAL AND THE FRABONI SCALE OF AGEISM
Authors: Intrieri Robert C , Dunterman Rebecca A
Published: November 2019

The purpose of this study was to compare attitudes about aging between groups of raters categorized by gender, using the Aging Semantic Differential (ASD; Rosencrantz & McNevin, 1969) and the Fraboni Scale of Ageism (FSA, Fraboni, Saltstone, & Hughes, 1990). The current study assesses the relationships between the four factors of Aging Semantic Differential (ASD; Instrumentality, Autonomy, Acceptability, and Integrity) as well as the three factors of the Fraboni Scale of Ageism (FSA; Antilocution, Discrimination, and Avoidance) across gender groups. The convenience sample consisted of 471 undergraduate students, with a mean age of 19.68 (SD = 2.28). The mean age for men was 19.88 (SD = 3.31) and for women was 19.56 (SD = 1.37). A series of four ANOVAs were conducted using the ASD factors. Results showed significance for the ASD-Instrumental (F(1, 470) = 4.922, p = .027); ASD-Acceptability F(1, 470) = 8.616, p = .003), and the ASD-Integrity factors F(1, 470) = 4.475, p = .035). Men endorsed more positive attitudes than women on both the Acceptability and Integrity factors. Women endorsed more positive attitudes on the Instrumental factor. Similar ANOVAs were conducted across the three Fraboni Scale of Ageism factors. Significant differences between men and women were only obtained across the Avoidance factor (F(1, 470) = 12.187, p = .001) with endorsing higher avoidance scores than women. Taken together these results show differential effects across three ASD factors between men and women while men demonstrated higher scores on the FSA Avoidance scale.
PSYCHOSOCIAL PREDICTORS OF THE GENDER DIFFERENCE IN DEPRESSION OF OLDER ADULTS IN THE ORANJ BOWL PANEL
Authors: Ferri Christine V , Yang Kaite , Girgus Joan
Published: November 2019

Recent reviews show that the gender difference in depressive symptoms that emerges in adolescence persists in older adults (Girgus, Yang & Ferri, 2017; Salk, Hyde & Abramson, 2017). However, researchers have yet to explain why this gender difference occurs in older adults and if it is for the same reasons as in younger ages. The present study used data collected from 3008 participants over the age of 60 (M=66.45, SD=4.36) from the baseline wave of the ORANJ BOWL, a longitudinal study based in New Jersey (Pruchno, Wilson-Genderson, Rose, & Cartwright, 2010). Depressive symptoms were measured with the CES-D. Six psychosocial predictors of the gender difference in depression were analyzed: functional ability, social support, perceived financial comfort, income level, marital status, and living alone. Women reported significantly more depressive symptoms compared to men (p<.001). Women had significantly lower functional ability, physical health, financial comfort, income level, but more social support than men (all p’s<.02). Women were more likely to live alone and to be separated, divorced, or widowed (all p’s<.001). Significant interactions for gender x functional ability, gender x social support, and gender x living alone were found in predicting depression using hierarchical linear regression. Living alone and poor function were more detrimental for men than women. Low social support was more detrimental for women than men. Understanding the gender difference in depressive symptoms will allow for targeted screening and preventative interventions for women and men at highest risk for depression.
VIRTUAL ONLINE COMMUNITIES FOR AGING LIFE EXPERIENCE (VOCALE) APPROACH: PILOT STUDIES
Authors: Zaslavsky Oleg , Chen Annie T , Teng Andrew , Lin Shih-Yin , Han Soojeong , Chu Frances , Demiris George
Published: November 2019

Emerging evidence suggests behavioral strategies focusing on symptom management can reduce frailty symptoms and improve quality of life. Unfortunately, these interventions are rarely scalable for implementation in geriatric care. Contemporary online technologies have tremendous potential for addressing this need. We developed and pilot tested an approach entitled Virtual Online Community for Aging Life Experience (VOCALE). The approach had two stages. In the first stage, we piloted the use of a Facebook platform to engage older adults with frailty symptoms in ten-week moderated discussions on health-related topics. In the second study, we used data from stage one to develop a prototypical persona of a person with frailty symptoms. The persona was then incorporated into an eight-week Facebook intervention informed by problem solving therapy to facilitate self-management in another group of older adults with frailty symptoms. The results from both rounds showed that it was feasible to recruit, engage, and retain persons ages 69-92 into virtual online community interventions. Attrition ranged from 25% to 33% in rounds one and two. In both rounds, we observed positive trends of change in health measures such as general health self-efficacy, disease self-efficacy, and health literacy. Throughout the studies, older adults shared multiple posts concerning their experience with age-related symptoms and described their self-management practices. These projects, which leveraged a common social media platform, demonstrated preliminary efficacy of an online intervention for frailty management. If confirmed, this approach might provide a viable model for other medically complex geriatric conditions where self-management is essential.
THE IMPORTANCE OF HSP-25 IN CAENORHABDITIS ELEGANS LONGEVITY
Authors: James Niaya , Scheirer Jessica L , Rodriguez Karl
Published: November 2019

Karl A. Rodriguez’s laboratory at the University of Texas Health Science Center, San Antonio, Texas, is interested in the role of small heat shock proteins in the proteostasis network and aging using the model organism, Caenorhabditis elegans. Molecular chaperones facilitate protein folding and improve the degradation activity of the proteasome and autolysosome hence decreasing disease-associated aggregates. Previous work in rodents have shown an increase in expression levels of the small heat shock protein 25 (HSP-25) correlates with maximum lifespan potential. To further explore the role of HSP-25 in C. elegans, two HSP-25 knock-out strains were exposed to a one-hour heat stress, heat shock, and two non-heat stress conditions.
DEVELOPMENT AND EVALUATION OF THE NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS (NICHE) LONG-TERM CARE PROGRAM
Authors: Pettis Jennifer , Bristol Alycia A , Brody Abraham A , Gilmartin Mattia J , D’Amico Catherine O , Greenberg Sherry , Sullivan-Marx Eileen M
Published: November 2019

Nurses Improving Care for Healthsystem Elders (NICHE) is a geriatric care model that positions nurses as leaders to address the unique care needs of older adults. From 2016 to 2019, we developed and piloted the NICHE-LTC program. NICHE-LTC program includes the three interrelated components of 1). the Geriatric Resource Nurse (GRN) and Geriatric Certified Nursing Assistant (GCNA) clinical leadership roles; 2) research-based clinical protocols and assessment tools; and 3). staff development, quality improvement (QI), and care coordination models to build clinician and organizational capacity in geriatrics. We report the results of a summative program evaluation of the NICHE-LTC program. We collected data on organizational and participant demographics, facility enrollment and retention, program completion rates, clinical quality improvement project plans, and participant satisfaction data from 369 individuals working in 79 facilities participating in NICHE-LTC program from January 2016 to February 2019. The majority of participants (80%) reported a positive learning outcome after completing NICHE-LTC program. Additionally, 80% reported they agreed or strongly agreed that their knowledge and ability to implement quality improvement initiatives in their facilities improved. The NICHE-LTC supported facilities ability to move from process-oriented QI priorities to patient-based outcome QI priorities such as falls, pain management, and managing behaviors of dementia. Over the three-year pilot period, NICHE-LTC program maintained an 89.4% annual retention rate. The high annual retention rate suggests that members value the program as an approach to address the clinical quality and nursing workforce development needs in LTC settings.
PILOT OUTCOMES OF A COMMUNITY-BASED FALLS PREVENTION PROGRAM TARGETING OLDER ARAB AMERICANS
Authors: Yao Lan , Kridli Suha , Talab Amne
Published: November 2019

Arab American (AA) is the 3rd largest ethnic population in the state of Michigan. Previous studies found that Michigan Arabs were less healthy than the general population in Michigan. Older AAs have higher mortality risk than non-Arab and non-Hispanic Whites, particularly due to chronic diseases. Community-based programs are an effective approach to prevent disease and injury, improve health, and enhance quality of life. While evidence for functional gains resulting from Tai Chi exercise is accumulating, there is little research and support for its feasibility and effectiveness that target older AAs, who are not culturally related to Tai Chi. Participants in this report were 8 older female AAs (mean age 62.4±3.2, range 58-66) who sought services at a not-for-profit Arab Community Center, which aims to enable and empower residents and communities to lead informed, productive and culturally sensitive lives. A certified Tai Chi instructor led the classes using Yang-style Tai Chi moves. The participants completed a 12-week twice-weekly 1-hour Tai Chi classes and post-program focus group discussion, held in a classroom of the Community Center. Post-intervention improvement in timed up & go test (p>.05), comfortable & fast gait speed (p>.05), unipedal stance time (p>.05) were observed. Themes identified from focus group supported Tai Chi’s benefits in balance and salient mental health benefits. The pilot data provides preliminary evidence for therapeutic gains resulting from Tai Chi practices. Agencies serving older AAs play important roles by creating and promoting evidence-based health promotion practices to address the growing needs among older adults.
SOCIODEMOGRAPHIC AND HEALTH DISPARITIES IN USE OF PREVENTIVE HEALTHCARE SERVICES
Authors: Joergensen Terese Sara Hoej , Allore Heather , Nagel Corey , Quiñones Ana R
Published: November 2019

Introduction: Older adults experience multiple health problems necessitating medical care. However, studies have shown that healthcare is not equally accessible for older adults in the US. In 2011, Medicare introduced Annual Wellness Visits to improve access to preventive healthcare including influenza vaccination. Objectives: Ascertain whether sociodemographic factors, multimorbidity, and other health indicators pose a barrier for older adults to access Annual Wellness Visits and influenza vaccination. Methods: We analyzed data from the 2012 and 2014 waves of the Health and Retirement Study linked with Medicare records. 4,858 older adults aged 65+ years were included in Conditional Random Forests to identify the most important predictors of Annual Wellness Visits and influenza vaccination during this two-year period. The predictors included: age, sex, race/ethnicity, partnered, geographical region, wealth, educational level, Medicaid coverage, body mass index, activities and instrumental activities of daily living, proxy interview, cognitive impairment, dementia diagnosis, and multimorbidity. Results: In total, 1,142 (23.6%) older adults had an Annual Wellness Visit and 3,316 (68.4%) older adults received an influenza vaccination. 11.9% were non-Hispanic black, 6.3% were Hispanic, with a median of 6 chronic conditions and 16.9% had dementia. The most important predictors of Annual Wellness Visits were region, wealth, dementia diagnosis, and race/ethnicity. The most important predictors of influenza vaccination were multimorbidity, race/ethnicity, educational level, and wealth. Conclusion: The importance of geographical region for Annual Wellness Visits suggests that the service has not been adopted equally throughout the US, whereas multimorbidity is the most important factor for receiving influenza vaccination.
EFFECTS OF A 6-WEEK TASK SPECIFIC POWER TRAINING WITH AND WITHOUT COGNITIVE TRAINING AMONG OLDER ADULTS WITH SLOW GAIT
Authors: Ogawa Elisa F , Harris Rebekah , DeGutis Joseph , Ward Rachel , Brach Jennifer , Halasz Ildiko , Bean Jonathan
Published: November 2019

Task-specific power training (InVEST) targets leg power and mobility skills that are beneficial for treating slow gait speed for older adults. This study investigated the efficacy of a short-term InVEST training on leg power, mobility performance, and gait characteristics and further examine whether the addition of cognitive training would augment the impact on the outcomes. Mobility limited community-dwelling older Veterans age ≥65 years were recruited. Participants were randomly assigned to either InVEST training (n=10) or InVEST+cognitive training (n=11). Training occurred 3 times per week for 6 weeks. Sessions were either 70 minutes (InVest+cognitive training) or 40 minutes (InVEST) in duration. Leg power, mobility performance (Short Physical Performance Battery), and gait characteristics (gait speed, stance time, step width, swing time, step length and their variabilities under single-task, simple and complex dual-task walking conditions) were evaluated. Twenty-one men with mean age 76±7 years completed the study and 86% were of white race. Among all participants, clinically relevant and statistically significant improvements in leg power, mobility performance, and gait characteristics (gait speed, step length, stance time under all three gait conditions) were observed. There were no statistically significant or clinically relevant group differences among any of the outcomes based on cognitive training status. Short-term InVEST training led to clinically meaningful improvements in leg power, mobility performance, and gait characteristics. These findings add to the body of evidence supporting the benefits of InVEST training on mobility and do not support the contention that mixed modes of training (cognitive and physical) may augment mobility outcomes.
LONG TERM OUTCOMES OF THE IN-HOSPITAL MOBILITY INTERVENTION (WALK FOR) IN A SAMPLE OF OLDER ADULTS
Authors: Zisberg Anna , Agmon Maayan , Shadmi Efrat , Gil Efrat , Hait Yehudit , Gur-Yash Nurit , Shulyaev Ksenya
Published: November 2019

Evaluation of in-hospital mobility programs is usually short-term. To examine the sustainability of Walk-FOR (Walk for Outcome and Recovery), an in-hospital mobility program in internal-medicine older (70+) patients, we conducted a quasi-experimental pre-post four-group comparative study. Walk-FOR incorporated policies encouraging patients to walk more than 900 steps/day and addressed conditions limiting patients’ in-hospital mobility. Self-reported mobility was assessed in intervention (N=159), control (N=154) and two-year follow-up groups: previous-intervention (N=75) and non-intervention (N=95) units. Two-years post-implementation, in previous-intervention units 82.7% of patients reported walking at least twice a day outside their room, similarly to the within-implementation intervention phase (81.2%, p=ns) and significantly more than in the control group (57.2%, p<.0001). No differences in walking were found between intervention and non-intervention units (84.2%, p=ns) two-years post-implementation. Multivariate analysis compering 4 study groups applying logistic regression with covariance of age, sex, walking and function ability at admission, comorbidities and length of stay demonstrated similar results. Patients from intervention units two years after it implementation had a higher odds of walking at least twice a day outside their room (OR=3.82, 95% CI 1.636-8.899, p=0.002) then patients from the same units before intervention. Logistic regression didn’t show significant differences between probability of walking at least twice a day outside their room in the group evaluated immediately after intervention implementation and two-years letter. Also there were no significant difference between not-intervention and intervention units two-years post-intervention. Walk-FOR is a sustainable practice and tends to spread to additional hospital-units probably due to hospital leadership and organizational commitment.
AGE-RELATED DECLINES IN SOCIAL COGNITIVE PROCESSES OF OLDER ADULTS
Authors: Yow W Quin , Lee Jiawen , Li Xiaoqian
Published: November 2019

Despite current literature suggesting that various social cognitive processes seem to be impaired in late adulthood, e.g., processing of social gaze cues, the trajectory decline of social cognition in late adulthood is not well understood (e.g., Grainger et al., 2018; Paal & Bereczkei, 2007). As part of a multi-institutional research project, we began to systematically investigate whether there is age-related decline in older adults’ ability to infer others’ mental states, integrate multiple referential cues, and identify emotional states of others using prosodic cues. Sixteen older adults aged 71-85, of which 9 were cognitively healthy and 7 with mild-to-moderate dementia, and 7 younger adults aged 19-37 underwent three tasks. In a theory-of-mind story task, participants answered true/false questions about the beliefs of the protagonists in the stories. A cue integration task assessed participants’ ability to integrate the experimenter’s gaze and semantic cues to identify a referent object. In an emotion-prosody task, participants judged whether the speaker sounded happy or sad in low-pass filtered audio. Non-parametric tests revealed that younger adults outperformed both groups of older adults (both ps=.001) in inferring the protagonists’ beliefs in the stories. Younger adults were also better and more accurate than both groups of older adults in integrating cues to identify the referent object and in using prosodic cues to identify emotional states respectively (ps<.001). Both groups of older adults did not differ significantly from each other in the tasks. These findings provide emerging and important insights into the decline of social cognitive processes in late adulthood.
ORAL CANCER SCREENING IN NON-INSTITUTIONALIZED OLDER ADULTS LIVING IN RURAL COMMUNITIES OF SOUTHEAST GEORGIA
Authors: Pattanaik Swaha , Apenteng Bettye , Cohen Adrienne L , Dounis Georgia , Lawrence Raymona
Published: November 2019

The older population in the United States is growing at an unprecedented rate. Oral diseases such as oral cancer can affect physical, psychological, and social well-being in older adults. Oral cancer screening can prevent development of the disease in high-risk individuals. The purpose of this research was to assess determinants of preventive oral health behavior including oral cancer screening in noninstitutionalized older adults living in rural/medically underserved communities of southeast Georgia. A mixed methods sequential explanatory design was used. Surveys were administered to 206 individuals aged 50 and older. Phone interviews were conducted with 22 individuals from the survey sample and 11 key informants. The majority of the participants (83.01%) said they had never been examined for oral cancer by a doctor or a dentist. Those who correctly recognized the most common sign of oral cancer were about three times more likely (OR=3.75; 95% CI: 1.04 – 13.50) to have had an exam for oral cancer (p=0.04). The survey participants who lived alone were more likely (OR = 4.39; 95% CI = 0.95 – 20.26) to have been examined for oral cancer (p = 0.05). During the interview, older adult participants rarely mentioned oral cancer with regards to an unhealthy mouth. The interview participants revealed that living alone gave them more time to pay attention to their health. For the older adults, prevention of oral diseases was grounded in the autonomy in their own behaviors, while the key informants saw more macro community and systems- level factors as the solution.
POLYGENETIC SCORE IS ASSOCIATED WITH T2D; EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: Youkhana Fadi , Wu Yanyan , Thompson Mika , Pirkle Catherine M
Published: November 2019

Type 2 diabetes (T2D) is a complex chronic disorder influenced by genetic and environmental factors. Studies that use a combined polygenetic score (PGS), calculated based on the number of risk alleles an individual may have, are rarely applied to a representative national sample. We used data from the Health and Retirement Study (HRS), a nationally representative study of older U.S. adults 50-years or older to examine the impact of PGS and behavioral risk factors (education, poverty ratio, BMI, smoking status, alcohol consumption and physical activity) with incident T2D. We used ethnic-straitifed Poisson generalized estimating equation (GEE) models with robust standard errors to estimate prevalence ratios (PRs) and risk ratios (RRs). Our sample included genotyped Black (N=2,823) and White (N=11,178) men and women.The highest PRs for T2D were among those in the 5th PGS quintile in both Whites (PR=2.24, 95%CI 1.89, 2.65, P-value <0.0001) and Blacks (PR=1.73, 95%CI 1.28,2.33, P-value 0.0003). The highest risk for T2D was among obese Whites (RR=3.35, 95%CI 2.93,3.82, P-value <0.0001) and Blacks (RR=1.60, 95%CI 1.28, 2.00, P-value <0.0001). Our findings found associations between PGS and T2D as well as some lifestyle factors among both Black and White individuals in a nationally representative sample with similar patterns in age, physical activity and poverty ratio. Our study supports the importance of including modifiable and non-modifiable life-style factors in the analysis of risk alleles for T2D to continue addressing the disparities between T2D risk between race/ethnicity groups
PERCEIVED PHYSICAL FATIGABILITY PREDICTS ALL-CAUSE MORTALITY: THE LONG LIFE FAMILY STUDY
Authors: Glynn Nancy W , Gmelin Theresa , Renner Sharon W , Boudreau Robert M , Feitosa Mary , Andersen Stacy L , Christensen Kaare , Newman Anne B
Published: November 2019

Fatigability, the likelihood of fatigue with lower versus higher levels of exertion, is associated with declines in physical function and disability and related to fitness. Thus, fatigability may be a good predictor of mortality. We examined this relationship in the Long Life Family Study (LLFS), an international family cohort enriched for longevity and their spousal controls. We measured perceived physical fatigability at Visit 2 (2014-2017) using the Pittsburgh Fatigability Scale (PFS, 0-50 with higher score=greater fatigability). We identified deaths by family members notifying field centers, reporting during annual phone follow-up, or finding an obituary when unable to reach. Otherwise, we censored participants at most recent contact date when confirmed alive. Covariates included age, sex, and self-reported physical activity using the Framingham Physical Activity Index. We adjusted all analyses for field center and family structure. Participants alive ≥60 years (range 60-108, mean 73.6±10.5) and completed the PFS (N=2,326) at Visit 2 were predominantly white (99.5%) and female (55.1%). Post-Visit 2, 195 (8.4%) died during mean 2.5±1.0 years of follow-up. Age-adjusted PFS score was 7.7 points greater (p<.0001) for those who died (19.8) compared to alive (12.1). Using Cox Proportional-Hazard modeling, each 5-point greater PFS score was associated with 31% (HR: 1.31, 95% CI 1.18,1.43) higher all-cause mortality rate adjusted for covariates listed above. Further adjustment for comorbidities did not attenuate association. PFS’s perceived physical fatigability score may be a useful self-report clinical tool to predict higher risk of mortality among older adults when objective measures of fitness and function are unavailable.