bluuebunny/crossref_metadata_2025 huggingface dataset:
STRENGTHENING PERSONAL AND COMMUNITY DISASTER SUPPORT NETWORKS OF OLDER ADULTS
Authors: Ashida Sato , Thompson Lena , Robinson Erin L
Published: November 2019

The Ecological Model posits a multilevel approach to understanding of and strengthening social networks of community based older adults. We present findings from our intervention, network analysis, and efforts at influencing policy making at the state level to better prepare them for pre and post disaster and emergency situations. At the individual-level, we implemented the Disaster PrepWise program to help community-based older adults develop personal disaster plans. We found increases in personal emergency network size by an average of three non-familial individuals. At the community-level, we evaluated two disaster management networks in Eastern Iowa counties. We found strong collaborations in disaster planning and response among 44 governmental and community-based organizations, but weaker collaborations in supporting older residents, suggesting a need in this area. At the policy-level, we are developing a state-level network of organizations to address policy barriers to effectively support older Iowans.
THE EFFECTS OF CHRONIC PAIN AND LONELINESS ON FUNCTIONING AMONG LATINO AND WHITE OLDER ADULTS
Authors: Camacho David , Aranda Maria P , Burnette Denise , Lukens Ellen
Published: November 2019

The detrimental effects of loneliness and chronic pain on functioning in later life are well documented, yet there is little evidence of whether these patterns hold across racially diverse older adults. Guided by the Biopsychosocial Model of Assessment, Prevention, and Treatment of Chronic Pain, we used data from Waves 2 and 3 of the National Social Life, Health, and Aging Project (NSHAP) to examine the additive and interactive effects of loneliness and chronic pain on Elemental and Instrumental Activities of Daily Living (ADLs & IADLs) among a sample of 1046 Latino and White adults aged 50 and over. Using linear regression analyses, our final models (Adjusted R-squares: .316 & .304) included demographic characteristics, physical and mental health, medication, health behaviors and social factors. In this sample, approximately 33% experienced chronic pain, 50% reported at least transitory loneliness and 22% experienced both. Neither loneliness nor chronic pain was independently associated with functioning impairment. However, these two factors in combination were associated with lower scores on ADLs and I-ADLs. In addition, Latinos who reported chronic pain were more likely to report lower scores on ADLs only. Results highlight variations in the detrimental effects of loneliness and chronic pain for white and Latino elders. Findings suggest the need for interventions that address chronic pain and loneliness simultaneously. Future studies should examine how culturally-grounded experiences of loneliness and chronic pain may contribute to worsening of functioning among diverse groups of Latino elders.
VITAMIN K ANTAGONISM AND CHONDROCALCINOSIS IN THE OSTEOARTHRITIS INITIATIVE
Authors: Shea M Kyla , Loeser Richard F , McAlindon Timothy E , Booth Sarah L
Published: November 2019

Calcification of articular cartilage, known as chondrocalcinosis, becomes more prevalent with age. Although chondrocalcinosis can be characteristic of osteoarthritis, it has been associated with more joint pain and disability independent of osteoarthritis severity. Identifying novel modifiable risk factors for chondrocalcinosis may help reduce joint pain and disability. One potential risk factor involves vitamin K because vitamin K-dependent proteins that inhibit calcification are present in articular cartilage. To test the hypothesis that vitamin K antagonism is associated with more chondrocalcinosis, we evaluated the cross-sectional association between warfarin use and chondrocalcinosis prevalence in the Osteoarthritis Initiative (n=1472, 60% female, mean age 64 years). Warfarin is a vitamin K antagonist that interferes with vitamin K-dependent protein function. In a secondary analysis we evaluated whether the prevalence of chondrocalcinosis differed according to dietary vitamin K intake. Chondrocalcinosis of the knee, evaluated using plain x-rays, was detected in 8% of participants. It was three times more prevalent in warfarin users (n=20) compared to non-users [prevalence ratio (95% confidence interval) (PR(95%CI)): 3.02(1.42-6.46); p=0.004, adjusted for age, sex, race, BMI]. Chondrocalcinosis prevalence did not differ according to vitamin K intake [PR(95%CI), compared to tertile 3 (≥189 mcg/d): tertile 1 (<96 mcg/d) =1.30(0.82-2.07), tertile 2 (96-189 mcg/d) =1.17(0.76-1.81), p-trend=0.623, adjusted for age, sex, race, BMI, energy intake]. That chondrocalcinosis prevalence differed according to warfarin use, but not vitamin K intake, suggests vitamin K-dependent protein function may be involved in chondrocalcinosis development. Since warfarin was not commonly used in this cohort, additional studies are needed to substantiate our findings.
THE RELATIONSHIP OF APOE ε4 TO THE RELATIVE TIMES AND HAZARDS OF DEMENTIA
Authors: Powell Danielle , Kuo Pei-Lun , Deal Jennifer A , Gottesman Rebecca , Palta Priya , Knopman David , Gross Alden L
Published: November 2019

Although APOE ε4 is an established risk factor for dementia, it is unclear whether it is associated with elevated risk or earlier symptom onset. Longitudinal study of 10,400 white-race individuals in the ARIC cohort followed from age 60 to incident dementia diagnosis, death, or censoring. All-cause dementia was defined using standardized algorithms incorporating longitudinal cognitive change, proxy report, and hospital or death certificate dementia codes. Death was ascertained via the National Death Index and death certificates. We used a parametric mixture of generalized gamma distributions to simultaneously estimate the distribution of event times and the proportion of individuals who experience each outcome (i.e., dementia and its competing risk, dementia-free death) by APOE ε4 status (≥ 1 allele vs. no alleles). Age-adjustment was through use of age as the time scale. APOE ε4 carrier status was associated with a doubling of the overall frequency of dementia incidence to 25% compared to 13% (p < 0.001) in non- ε4 carriers. The distributions of time to dementia was modified by APOE ε4 status (p=0.007): median time to dementia onset among APOE ε4 carriers was 81.9 years compared to 83.3 years in non-APOE ε4 carriers (p = 0.005). No differences in results were found by sex. APOE ε4 carrier status is associated with both elevated risk and earlier time to dementia onset. These findings clarify the causal role of APOE in dementia etiology, could help better identify at-risk subgroups, and may help facilitate better research recruitment.
MECHANISMS OF BRAIN REJUVENATION
Authors: Villeda Saul
Published: November 2019

A growing body of work has shown that systemic manipulations, such as heterochronic parabiosis and young blood administration, can partially reverse age-related cellular impairments and loss of cognitive faculties in the aged brain. These studies have revealed an age-dependent bi-directionality in the influence of the systemic environment indicating anti-aging factors in young blood elicit rejuvenation while pro-aging factors in old blood drive aging. It has been proposed that introducing anti-aging factors or mitigating the effect of pro-aging factors may provide effective strategies to rejuvenate aging phenotypes. Despite this potential, much is unknown as to the systemic and molecular mechanisms regulating anti-aging and pro-aging effects of blood-borne factors. I will discuss work from my research group that begins to provide mechanistic insight into the systemic and molecular drivers promoting rejuvenation in the aging brain.
EARLY-LIFE INFLUENCES ON LATER-LIFE HEALTH
Authors: Moorman Sara M , Smith Jacqui
Published: November 2019

This symposium identifies risk and protective factors in childhood and adolescence that continue to influence the physical and cognitive health of older adults. Dimensions of early life inequality include geographic location, educational opportunities, and total amount of adversity faced. Papers in the symposium use data from three major U.S. longitudinal studies: the Health and Retirement Study (HRS), the MacArthur Study of Midlife in the U.S. (MIDUS), and the Wisconsin Longitudinal Study (WLS). Each paper focuses on the mechanisms (i.e., mediators and moderators) linking well-being in childhood and adolescence to health in older adulthood. Greenfield, Akincigil, and Moorman find that net of IQ, college education boosts later life cognition, especially for men who had a low probability of college attendance. Kemp and Montez further find that state economic policy and adult health behavior explain later life disparities in health by educational attainment. Herd, Sicinski, and Asthana continue the theme of geographic place, finding that rural children who were raised on farms are at a cognitive disadvantage in later life. Both Ferraro and Sauerteig and Homan and Kong generate indices of total childhood misfortune. Ferraro and Sauerteig conclude that childhood misfortune affects obesity by way of adult health behavior, specifically, physical activity. Homan and Kong find that childhood misfortune affects subjective and functional health by way of the psychological mechanism of purpose in life. Together, these five papers begin to identify the ways in which experiences in childhood and adolescence have long-lasting consequences for a variety of health outcomes in later life.
GEO-LIFE COURSE DETERMINANTS OF EDUCATIONAL DISPARITIES IN U.S. ADULT HEALTH
Authors: Kemp Blakelee , Kemp Blakelee R , Montez Jennifer K
Published: November 2019

Educational attainment is one of the strongest social determinants of adult health. However, recent studies show that it is a stronger determinant in some areas of the country than others. This study investigates geographic and life course contexts that may explain the pattern. We merge data on adults aged 50+ in the Health and Retirement Study (1998-2014) with contextual data on their state(s) of birth and residence. We examine: (1) how the education-health association varies across regions, and (2) how childhood (e.g., poverty, compulsory schooling) and adulthood experiences (e.g., smoking, minimum wage) explain the variation. Findings reveal that the education-health association varies across regions and is more pronounced for outcomes further along in the disablement process. Poor childhood health, adult behaviors, and states’ economic policies partly explain why the association varies across regions. The findings underscore the importance of geographic and life course contexts for understanding educational disparities in health.
LONELINESS AND SUICIDE IDEATION IN OLDER ADULTS: A LONGITUDINAL INVESTIGATION
Authors: Heisel Marnin J
Published: November 2019

Older adults have the highest rates of suicide globally, necessitating theory and research investigating suicide and its prevention in later-life. The experience of loneliness is significantly associated with depression, hopelessness, negative health outcomes, and mortality among older adults. Yet, relatively little research has focused on the role of loneliness in conferring suicide risk in later life. The purpose of the present study was thus to investigate the potential associations between loneliness and suicide ideation and behavior in a sample of community-residing older adults recruited into a larger two-year longitudinal study of psychological risk and resiliency to later-life suicide ideation. We specifically recruited 173 adults, 65 years or older, from community locations in a medium-sized Canadian city, for a study on “healthy aging.” Participants completed measures of positive and negative psychological variables, including depression, loneliness, and suicide ideation at a baseline assessment, and again at 2-4 week, 6-12 month, and 1-2 year follow-up points. Findings indicated that loneliness (UCLA Loneliness Scale) was significantly positively associated with concurrent depression and suicide ideation, negatively associated with psychological well-being and perceived social support, and differentiated between participants who endorsed or denied having ever engaged in suicide behavior. Baseline loneliness also explained significant variability in the onset of suicide ideation over a 1-2 year period of follow-up, controlling for age, sex, and baseline depression and suicide ideation. These findings will be discussed in the context of the need for increased focus on psychosocial factors when assessing and intervening to reduce suicide risk in older adults.
BEHAVIORAL MARKERS OF RESILIENCE IN CARE PARTNERS OF PERSONS WITH DEMENTIA: A THEMATIC ANALYSIS FROM A SCOPING REVIEW
Authors: Zhou Yuanjin , O’Hara Avery , Ishado Emily , Borson Soo , Sadak Tatiana
Published: November 2019

Caring for a person with dementia (PWD) requires commitment, flexibility, and resilience - the ability to endure and recover from stressors that arise during the caring process. However, it is unknown what behaviors can indicate resilience in care partners (CPs) of PWDs. We examined 46 peer-reviewed articles (1990 to 2018) that included measures or definitions of resilience in CPs of PWDs. Our goal is to identify resilience-related behaviors and create a behavior-based model/framework for CPs of PWDs. Three major themes emerged: (1) Problem-response behaviors (problem-identifying, problem-solving, problem-distancing, learning, and reflection); (2) self-growth behaviors (self-care, creative/spiritual activities, and developing/maintaining meaningful social relationships); (3) help-related behaviors (help-seeking and help-receiving). These findings informed the development of a behavior-based Care Partner Resilience (CPR) measure. Future steps in this research include evaluating to what extent behaviors in the CPR framework are associated with CPs’ self-assessed resilience and can predict CPs’ resilience following specific caregiving-related stressors.
WALKABLE NEIGHBORHOODS AND BRAIN HEALTH IN LATER LIFE: A SCOPING REVIEW
Authors: Kim Boeun
Published: November 2019

Brain health is critical in independent living and well-being in later life. There have been growing interests in investigating the role of walkable neighborhoods in brain health. The purpose of this scoping review was to understand the influence of walkable neighborhoods on cognitive outcomes in older adults. The physical features of walkable neighborhoods and their measurements were examined. Database search identified 2957 peer-reviewed articles and eight studies (2012-2018) met inclusion criteria. Community facilities and land-use mix were consistently associated with cognitive outcomes across studies. The measures of walkable neighborhoods were under development and the measurement properties were not reported in most studies. Further research on the definition of walkable neighborhoods that accounts specifically for older adults with/without cognitive impairment is needed. Additionally, more rigorous, valid, reliable standardized instruments for measuring walkable neighborhoods, as well as a standard for evaluating the quality of instruments are warranted.
REDUCING THE IMPACT OF CHILDHOOD MISFORTUNE: THE ROLE OF ADULT PHYSICAL ACTIVITY ON LATER OBESITY
Authors: Ferraro Kenneth F , Sauerteig Madison R , Williams-Farrelly Monica M
Published: November 2019

This study investigates the effects of childhood misfortune and adult physical activity on later-life body mass index (BMI) and waist circumference. We use ordinary least squares regression to examine the impact of childhood misfortune (30 indicators), and adult physical activity (frequency and intensity) on waist circumference and BMI (kg/m²) using data from the Health and Retirement Study (N=5,732). Results emphasize that experiencing childhood misfortune is associated with a larger waist circumference and BMI in later life, while adjusting for social status and lifestyle variables. Adjusting for adult physical activity decreases the effect of childhood misfortune on waist circumference, suggesting mediation. The analysis reveals that the effects of childhood misfortune on BMI and abdominal adiposity are remediable. Although childhood misfortune is associated with larger waist circumference and BMI in later life, regular physical activity reduces the risk on both indicators of obesity.
CAREERS IN ACADEMIC GEROPSYCHOLOGY: STRENGTHENING THE PIPELINE
Authors: Strong Jessica , Wynn Matthew , Moye Jennifer , Carpenter Brian
Published: November 2019

The shortage of clinical geropsychologists is further imperiled by the shortage of geropsychologists entering academia. The current study analyzed data collected during the implementation of a national webinar series (Advancing your Confidence as an Educator in Geriatrics and Gerontology). The development and implementation of the series has been previously reported. In the current study, we report on n=66 psychologists’ and psychology trainees’ responses to academia. Results included quantitative ratings of feelings towards imaging oneself in an academic role. Feelings rated included Excitement (41%), Intimidated (18%), Overwhelmed (30%), and Enthusiastic (30%), among others. These results were triangulated with open-ended qualitative responses on the frustrations and rewards of being an educator. Results are discussed in the context of the geropsychology pipeline shortage and implications for the future of clinical geropsychology. Suggestions for how to remedy this concern will be discussed.
GEROPSYCHOLOGY STUDENTS’ EXPERIENCES OF THE INTERNSHIP MATCH AND IMPLICATIONS FOR TRAINING
Authors: Bloom-Charette Lisa
Published: November 2019

There has been little literature on the effectiveness of the clinical psychology internship match program within the specialty of geropsychology. This study reports student responses to a 2018 survey conducted by the Council of Professional Geropsychology Training Programs (CoPGTP). Students reported that they completed a mean of 18.4 (SD = 7.23) internship applications, and had a mean of 8.4 (SD = 2.3) interviews. Compared to generalists, geropsychology students applied to and interviewed at more programs, felt slightly less supported, but matched more frequently at their first choice site. All respondents matched to generalist rather than geropsychology programs, and all matched to their first ranked programs. The majority of students felt strongly supported, and noted that seminars, essay review, and the Pike’s Peak training model were important resources. Reasons for not choosing geropsychology programs included geographical preferences and the belief that adequate geropsychology training can be obtained in a generalist track.
PREDICTORS OF INTENTION TO WORK WITH OLDER ADULTS: THE CASE FOR STUDYING SOCIAL NORMS
Authors: Graham Kirsten
Published: November 2019

The expanding population of older adults, coupled with provider hesitance, is expected to result in a large service gap in the healthcare field. Research has largely focused on the impact of attitudes toward older adults and professional competency, with some recent explorations of social influences. There is currently no comprehensive measure that includes all of these areas. The present study outlines the development of the Working with Older Adults Scale (WOAS), which is grounded in the theory of planned behavior. Results indicated that the measure has an excellent factor structure and good internal reliability and construct validity. Intention to work with older adults was significantly predicted by attitudes, subjective norm, and perceived behavioral control, with subjective norm accounting for the greatest amount of variance. The WOAS offers new insights and ideas for future exploration of the service gap between older adults needs and professional availability across health service fields.
HIS AND HER EVERYDAY LIFE: GENDER DIFFERENCES IN OLDER ADULTS’ SOCIAL AND PHYSICAL ACTIVITY
Authors: Huo Meng , Fingerman Karen L , Ng Yee To
Published: November 2019

The literature links social integration to better physical health, but little research asks how contact with diverse social partners influences older adults’ physical activity in a daily context. We examined this link using the Daily Experiences and Well-being Study and explored whether this link varied by gender. The sample included 175 older women and 138 older men who reported their contact with close partners (e.g., family/friend) and not-close partners (e.g., acquaintances) throughout each day across 5 days. Participants also wore Actical accelerometers to track physical activity. Multilevel models revealed significant gender differences. Older men had reduced physical activity when having contact with close partners, whereas older women maintained physical activity during such contact. Both older men and women had increased physical activity when having contact with not-close partners, but this link was stronger for men. This study advances our understanding of gender differences in older adults’ social experiences and well-being.
BEYOND REPRODUCTION: EXPLORING DETERMINANTS OF FUNCTIONAL HEALTH AND WELL-BEING IN AGING WOMEN
Authors: Germain Cassandra M
Published: November 2019

The goal of this symposium is to explore the various factors that influence functional health and general well-being in women during late life. We will explore 1) the role of depression on functional impairment in a group of diverse community dwelling women; 2) the relationship between chronic pain and depression, as well as strategies for intervention; 3) the desire for sexual intimacy among older women and it’s relationship to wellbeing and 4) the importance of physical appearance in older women and its association with self confidence and wellbeing.
DISPARITIES OF DENTAL CARE AND CONSEQUENCE OF POOR ORAL HEALTH AMONG OLDER ADULTS IN THE U.S.
Authors: Wu Yanyan , Zhang Wei , Wu Bei
Published: November 2019

Oral health is an essential part of staying healthy. Neglect of dental care may lead to tooth decay/ loss, poor nutrition, and affects individuals’ quality of life. Over the past decades, dental care utilization has risen considerably, however, racial/ethnic and socioeconomic disparities still persist in the U.S. Additionally, poor oral health is a contributing factor to, and a consequence of chronic diseases such as cognitive impairment, diabetes and cardiovascular disease. Faced with the complex and intertwined health and social challenges, it’s imperative to understand the disparities of dental care utilization and the relationships among oral health and chronic diseases so that effective policies and preventions can be implemented to improve quality of care. In this symposium, we present findings for older adults from diverse racial/ethnic populations in the U.S. We begin with results from two national-wide trend analyses: a 15-year review of dental care utilization and the evaluation of dental care performance over a 16-year period in nursing homes. The next study presents the barriers of dental care utilization in Hawaii. Finally, we present results of the negative effects of diabetes and poor oral health on cognitive function. Our studies address the disparities of dental care utilization among minority and under-represented ethnic groups as well as the connections between oral health and chronic conditions. Our results are helpful in educating policy makers and health practitioners about how to improve dental care and how dental care can be effectively integrated into chronic disease prevention and health promotion activities.
DISCORDANT CHRONIC CONDITIONS AND DEPRESSIVE SYMPTOMS AMONG MIDDLE-AGED AND OLDER COUPLES
Authors: Polenick Courtney A , Birditt Kira S , Turkelson Angela , Bugajski Benjamin , Kales Helen C
Published: November 2019

Discordant chronic conditions (i.e., those with competing management requirements) have adverse consequences for well-being, yet little is known about their implications among couples. We evaluated how depressive symptoms are linked to discordant conditions within individuals and between spouses across an 8-year period. The U.S. sample included 1,116 middle-aged and older couples from five waves (2006 – 2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models controlled for age, minority status, education, depressive symptoms in the previous wave, and each partner’s report of baseline marital quality and number of chronic conditions in each wave. Wives and husbands with their own discordant conditions reported higher depressive symptoms, and this association intensified over time. Over and above this link, husbands had higher depressive symptoms when there were discordant conditions between spouses. Both individual-level and couple-level discordant chronic conditions appear to have enduring implications for depressive symptoms in middle and later life.
HOME VIDEO TELEHEALTH TO SUPPORT RURAL VETERAN CAREGIVERS
Authors: Hicken Bret , Grant Marren , Turner Christopher , Reynolds Christy , Wright Pamela
Published: November 2019

VA offers multiple programs and services to support caregivers of US military Veterans. However, access for rural Veterans and caregivers is challenging due to distance from VA medical facilities. VA Video Connect (VVC) is a remote healthcare platform that enables Veterans to connect directly with VA clinicians through a secure, encrypted video connection. Rural caregivers and Veterans can participate in caregiver services through their own computer or another device from their home, reducing the need for travel to distant VA facilities. In 2018, VA’s Caregiver Support Program and Office of Rural Health developed an implementation pilot to engage eighteen VA Caregiver Support Coordinators (CSCs) in using VVC to monitor and support 180 Veteran/caregiver dyads enrolled in VA’s Program of Comprehensive Assistance for Family Caregivers. The presentation will provide an overview of each phase of implementation, report usability and outcome data from CSCs and caregivers, and discuss implications for broader implementation.
COMPARING THE PROGNOSTIC VALUE OF GERIATRIC HEALTH INDICATORS: A POPULATION-BASED STUDY
Authors: Zucchelli Alberto , Vetrano Davide , Grande Giulia , Calderon-Larranaga Amaia , Fratiglioni Laura , Marengoni Alessandra , Rizzuto Debora
Published: November 2019

Several indicators associated with poor outcomes in older persons have been developed, but a direct comparison of their accuracy is lacking. Knowing which indicator performs better in the prediction of specific outcomes could help health care providers to choose the most suitable one. We compared the accuracy in predicting different clinically-relevant outcomes of five indicators: frailty index (FI), frailty phenotype (FP), the Health Assessment Tool (HAT), walking speed (WS), and multimorbidity. Data from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing population-based study including 3363 people 60+, were used. The ability of the five indicators to predict mortality (3- and 5-year), unplanned hospitalizations (1- and 3-year), and 2+ health provider contacts (6 months prior and after assessment) was compared using the area under the ROC curves (AUC). FI, WS, and HAT showed the best accuracy in the prediction of mortality (AUC for 3-year mortality: 0.84, 0.85, 0.87 respectively; AUC for 5-year mortality: 0.84, 0.85, 0.86 respectively; all p < 0.05). Unplanned hospitalizations were better predicted by the FI (AUC: 1-year 0.73; 3-year 0.72) and HAT (AUC: 1-year 0.73; 3-year 0.71).The most accurate predictor of multiple contacts with health providers was multimorbidity (AUC: 0.67; p < 0.05). All indicators, but multimorbidity, showed higher accuracy among older individuals (75+ years). Different indicators can be used to support physicians during their decision-making process. Some of these tools may also be used to forecast future use of health-care resources, including both hospital-based services and outpatient ones .
COGNITIVE PERFORMANCE, EXERCISE, AND AMYLOID BURDEN: A RANDOMIZED CONTROLLED TRIAL
Authors: Watts Amber , Vidoni Eric , Morris Jill , Perry Mark , Johnson David , Burns Jeffrey
Published: November 2019

Exercise is a promising strategy for prevention of Alzheimer’s disease (AD). Amyloid neuroimaging can identify individuals at risk of developing AD prior to displaying symptoms. We screened adults (65+) with Florbetapir PET imaging and a comprehensive cognitive battery. We randomized 117 participants with normal cognition into a 52-week aerobic exercise program to examine the effects of aerobic exercise on cognitive performance. We compared an intensive exercise treatment group to a standard of care control group. Cognition was assessed at baseline, 26 weeks, and 52 weeks in the domains of verbal memory, visuospatial processing, attention, and executive function. Interim results on 87 participants show cardiorespiratory fitness improved in the exercise group vs. control group (t=3.66(81), p< .001). The degree of change in cardiorespiratory fitness did not differ between those with and without elevated amyloid (t=-0.37(81), p=.710). Greater improvements in cardiorespiratory fitness predicted better performance on cognitive tests including trailmaking test, Stroop test, and digit symbol substitution test, which did not differ by amyloid status. Elevated amyloid levels predicted lower cognitive scores in logical memory, space relations, and identical pictures test. Our findings suggest PET imaging is a valid marker of cognitive performance in non-impaired older adults, and that this pre-clinical amyloid status did not reduce the cognitive benefits of exercise for those who improved in cardiorespiratory fitness. Exercise interventions hold promise for cognitive maintenance among pre-symptomatic older adults with elevated amyloid levels. Finally, results highlight the importance of evaluating multiple cognitive domains which are associated differently with exercise and amyloid status.
FOLLOW-UP OF A 6-MONTH LOW-TO-MODERATE INTENSITY VIRTUAL-HOME EXERCISE PROGRAM TO PREVENT FALLS
Authors: Tomita Machiko R , Fisher Nadine M
Published: November 2019

The aim of this study is to determine 3-month post effects of and adherence to a 6-month virtual-group exercise at home (V-GEAH) program, which offered low-to-moderate intensity exercise to community-dwelling older adults with past falls. The V-GEAH program converted solitary exercise to group exercise connecting participants via web-conference technology. A treatment group (n=25, 60 – 90 years old) exercised three times a week for 30-45 minutes each session. The program achieved 84.4% – 93.3% adherence, reducing fall risks. This study measured falls, balance confidence, lower extremity muscle strength and endurance, gait speed, stride length, and activities of daily living, and compared with baseline and posttest (at 6 months) data using Repeated measures ANOVA with contrasts. During the follow-up period, 40% of the treatment group exercised 2+ times/week (Adherer, or A), and 60% did 1 time/week or less (Non-adherer or NA). Half of NA joined a community exercise group and the rest did not do exercise due to pain in various body parts. None of A fell while 26.7% of NA and 20% of C did. At follow-up, the control group (C, n=25) showed no change or significant decline from posttest for all measures. A maintained gains made in the intervention period in all measures, but NA significantly lost strength in hamstrings, hip abduction, and quadriceps and hamstring endurance. These results indicate that low-to-moderate intensity exercise and technology use for providing visual instruction, regular monitoring and evaluation, and environments to increase participants’ accountability are elements for successful home-based exercise programs.
RESPONDERS TO A PHYSICAL ACTIVITY COACHING PROGRAM IN COPD
Authors: Nguyen Huong Q , Liu Amy , Lee Janet , Xiang Anny
Published: November 2019

Rationale: Physical inactivity is associated with worse outcomes in COPD. There remains a critical gap regarding the real-world effectiveness of improving physical activity (PA) in large representative samples of older adults with COPD and its impact on hospitalizations. Methods: A pragmatic randomized trial was conducted to determine the effectiveness of a 12-month home-based physical activity coaching intervention (Walk On!, WO) compared to standard care (SC) in 2,707 patients at high risk for COPD exacerbations. The WO intervention included collaborative monitoring of steps, semi-automated step goal recommendations, individualized reinforcement, and peer/family support. This is a subgroup analysis of 321 patients who were randomized to WO and participated in the program, matched to SC patients based on their propensity scores (PS). Multivariate cox proportional hazards models were used to determine differences in all-cause hospitalizations in the 12-months following randomization. Results: WO patients with low PS (n=160) were matched to 888 low PS SC patients and 161 WO patients with high PS (n=161) were matched to 405 high PS SC patients. Characteristics of the cohort were: age: 72±10; 54% females; 74% Caucasian; FEV1% predicted: 61±23. WO-low PS patients had lower risk of all-cause hospitalizations compared to SC-low PS patients [HR:0.69, (95%CI, 0.50, 0.96), P=.03]. WO-high PS patients did not have significantly lower hospitalization risk compared to SC-high PS patients [HR:0.87, (95%CI, 0.64, 1.20), P=.40]. Conclusions: Patients with COPD who had a lower propensity to participate in the physical activity coaching intervention had lower hospitalization risks compared to those with a higher participation propensity.
AN OLDER CARER, BUT STILL A CHILD: UNEXPECTED IDENTITIES OF OLDER ADULTS CARING FOR A NEAR-CENTENARIAN PARENT
Authors: Riberio Oscar , Macedo Typhanie , Sousa Liliana
Published: November 2019

According to the National Alliance for Caregiving (2015), the typical definition of an older adult caregiver points to a 79-year-old white female who cares for a close relative due to a long-term physical condition; in such cases the care-recipient is often a spouse, an adult child or a sibling, but not a parent. This cross-sectional qualitative study explores the experience of a group of fifteen children in their 70s who are main care-providers of their parents (mean age 98; range 95-105); it focuses on their overall caregiving experience with a particular emphasis on how they feel being still a child at such an advanced age. In-depth interviews were conducted and analyzed for recurrent themes using thematic analysis. Main findings revealed that although being in an overall positive experience, often socially exalted (proudness of having a parent alive/being in an unique situation), none had expected to be holding the identity of a child at their current age. These children’s views of their ageing self were strongly embedded in their caregiving role, and some reported losing awareness of their own age and a mixture of feelings of being simultaneously a child, a parent and a grandparent. Role captivity (late life prison) and disregarding self-care shaped their current situation in terms of caregiving burden and altered life plans as older adults. This study adds to the limited available knowledge on very old caregiving dyads, and raises awareness on how personal and family identity may be shaped in older age by unforeseen family dynamics.
HEALTH CARE PROVIDER ATTITUDES ABOUT INTEGRATING FAMILY CAREGIVERS INTO CLINICAL ENCOUNTERS
Authors: Griffin Joan M , Havyer Rachel , Schaepe Karen , Riffin Catherine , Bangerter Lauren R
Published: November 2019

The presence of family caregivers in clinical encounters is becoming more common with the aging of the US population and the continued shift of care responsibilities from health professionals in clinical settings to family caregivers at home. Patients accompanied to clinical encounters by caregivers are more likely to be older, sicker, and have lower health literacy. Research shows, however, that providers often do not initiate any caregiver participation and when they do, conversations center on relaying technical medical information rather than preferences and capacity to provide caregiving assistance. Little is known about provider perceptions of engaging caregivers in clinical encounters. Using data from 20 semi-structured interviews with physicians from primary and specialty care, we identified 3 inter-related themes about engaging caregivers in clinical encounters: 1) ambivalence about caregivers’ role in clinical encounters; 2) trepidation about posing questions directly to caregivers; and, 3) beliefs that systemic barriers exist that inhibit integration of caregivers. Providers, especially in primary care encounters, chiefly view caregivers as sources of supplemental information or for absorbing or reinforcing clinical instructions for care at home. Providers also voiced concerns about the ethics of assessing caregiver capacity to provide assistance to the patient without having clinical authority to treat or adequate resources to provide to caregivers. Finally, providers identified structural barriers, including time constraints, for integrating caregivers into the clinical care team. Findings provide insight into provider attitudes on the caregivers’ role, a perspective that is essential for understanding opportunities and challenges for implementing caregiver interventions in clinical settings.
PROVIDING AND RECEIVING FAMILY CARE ACROSS THE LIFE COURSE: INSIGHTS FROM THE OLDEST OLD
Authors: Patskanick Taylor , Miller Julie , Lee Chaiwoo , D’Ambrosio Lisa
Published: November 2019

Unprecedented longevity comes with an increased need for providing and receiving care. A 2015 report estimated 39.8 million adults in the United States provided unpaid care to an adult in 2014 (NAC & AARP). Previous research has focused disproportionately on experiences of providing care to older adults, but little has explored experiences of providing care and receiving care among the oldest old. Adults aged 85 and older are likely to have provided care to an adult family member at some point in their lives, but now may be receiving care themselves. The presentation will report on findings from a mixed methods study investigating the experiences of providing and receiving care across the life course among a sample of the “oldest old.” Data draw from focus groups and a survey with the MIT AgeLab Lifestyle Leaders, a bimonthly panel study of adults ages 85 and older. Findings suggest the Lifestyle Leaders had extensive experience providing care, particularly in older age. They most often cared for family members with long-term physical or cognitive conditions. Opinions on learning new technologies to help with caregiving and robot caregivers were mixed. The majority of the Lifestyle Leaders received regular help with at least one care task regardless of household composition or living situation. Many reported help had improved their health, but they felt like a burden to their caregivers. Even in later life, the Lifestyle Leaders had few ideas about who might take care of them if they needed care in the future.
HIGHER COPING SELF-EFFICACY ASSOCIATED WITH LOW SELF-PERCEIVED LONELINESS IN OLDER ADULTS WITH CHRONIC DISEASE
Authors: Hladek Melissa D , Nersesian Paula V , Cudjoe Thomas K , Gill Jessica M , Szanton Sarah L
Published: November 2019

Loneliness is an emotional state involving social network perceptions and linked to worse health outcomes. Coping self-efficacy evaluates confidence in ability to manage problems effectively using problem-solving, emotional regulation and social coping. The purpose of this cross-sectional study (N=151 community dwelling adults ages ≥ 65) was to evaluate associations between loneliness and coping self-efficacy. All participants had at least one chronic condition and were cognitively intact. In this sample, 32.08% were lonely (score ≥ 5 on UCLA 3-item loneliness scale (range 3-9). Higher coping self-efficacy was significantly associated with low loneliness after adjustment for age, sex, race/ethnicity, social support, depressive symptoms, body mass index, and a chronic disease-function score (β= -0.03, p=0.014). Causality could not be assessed; higher loneliness may lead to lower self-efficacy or lower self-efficacy may lead to higher loneliness. Nonetheless, loneliness and self-efficacy are both modifiable with great potential for improvement, possibly bettering health outcomes.
RELIGIOUS DIFFERENCE, MARITAL SATISFACTION, AND PSYCHOLOGICAL WELL-BEING OF CHINESE MIDDLE-AGED AND OLDER ADULTS
Authors: Li Jia , Wang Qi
Published: November 2019

Objectives: Religion plays an important role in people’s individual and interpersonal life. Spousal religious difference is a potential risk factor of marital satisfaction, which will further influence people’s psychological well-being. This study aims to explore the associations between spousal religious differences, marital satisfaction, and psychological well-being of Chinese middle-aged and older adults. We also investigated the gender differences in the captioned associations. Method: We adopted a sample of 1285 adults aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS). We conducted descriptive statistics, multiple regression models and a path analysis based on a general structural equation model (GSEM). Results: Spousal religious difference was only associated with wives’ marital satisfaction. Marital satisfaction was associated with depression and life satisfaction for both genders, and wives’ marital satisfaction had a stronger association with life satisfaction than husbands’. Wives’ marital satisfaction mediated the relationship between spousal religious difference and their psychological well-being, including depression and life satisfaction. Discussion: This study calls for more further research on the individual and interpersonal outcomes of religiosity in middle-aged and older adults. Gender differences should be paid attention to in academic research, service provision and clinical settings.
LINKS BETWEEN SOCIAL ENGAGEMENT AND SUCCESSFUL AGING AMONG AFFORDABLE SENIOR HOUSING RESIDENTS
Authors: Webster Noah J , Webster Noah , Antonucci Toni
Published: November 2019

We report on a study designed to integrate the convoy model of social relations with the successful aging model. The combined approach draws on the natural resources of interpersonal relations to promote successful aging thus minimizing risk of disease and disability, enhancing\maintaining mental and physical functioning, and facilitating continued engagement in life. We describe the MacHouse Affordable Housing Study, a field experiment conducted in an affordable senior housing community. The experiment involved a resident driven intensive intervention program designed to increase social activities and engagement. Based on an extensive needs assessment and interviews with the resident council as well as individual residents a program of activities was developed. This included group meals, an exercise program that included a walking group and an exercise class, communal gardens, computer classes and resident outings. Results indicate that more frequent participation in these activities was associated with increased life satisfaction over time.
WHICH ASPECTS OF HEALTH PREDICT LATE-LIFE SOCIAL INTEGRATION OVER TIME?
Authors: Toyama Masahiro , Toyama Masahiro , Fuller Heather R
Published: November 2019

Associations between late-life social integration and health have been found to be reciprocal. The present study focuses on the direction of health predicting social integration as it is not yet fully understood how different aspects of health may affect social integration. Using two-wave data from a community-based sample (N = 413, mean age 80 at baseline), the present study investigates whether depressive symptoms, chronic health conditions, functional limitations, and self-rated health independently predicted multiple dimensions of social integration over two years. The results of multiple regression and path analyses indicated that self-rated health was the most consistent predictor for social integration over time as the other health measures predicted no or fewer dimensions of social integration. Subjective perception of health appeared to have greater implications for social integration over time than more objective health symptoms/conditions. These findings highlight the important role of subjective health for maintaining late-life social integration.
NEUROPROTECTIVE EFFECT OF APOE2: EVIDENCE AND IMPLICATION FOR COGNITIVE AGING
Authors: Sebastiani Paola , Raghavachari Nalini
Published: November 2019

Apolipoprotein E is a glycoprotein mediator and regulator of lipid transport and uptake. The APOE4 allele has been associated with higher risk of Alzheimer’s disease and of mortality, but the protective effect of the less prevalent APOE2 allele is less well established. This symposium will bring together experts in epidemiology, molecular biology, neurology and systems biology to clarify the role of APOE2 in longevity and cognitive health, to describe molecular targets of APOE alleles, and to suggest mechanisms of protection conferred by APOE2 using IPSc derived systems. Dr Seshadri will show the strong association between APOE2 and human longevity using data of 38,537 individuals of European ancestry. Mr Sweigart will examine longitudinal trajectories of cognitive function in participants of the Long Life Family Study and the New England Centenarian Study and show that carriers of the homozygote genotype of APOE2 have a significant slower rate of decline of their cognitive function compared to carriers of other genotypes. Dr Monti will present an association analysis of APOE genotype data with 4137 human proteins in serum of 222 New England Centenarian Study participants. The analysis discovered a signature of 16 proteins that associated with different APOE genotypes, and replicated in 3 independent studies. Dr. Ellerby will summarize her recent analyses that used transcription analysis of isogenic iPSCs with APOE2 and APOE4 homozygote genotypes differentiated into inhibitory GABAergic neurons to show that E2 inhibitory GABAergic neurons regulate genes involved in nuclear division, DNA integrity and DNA damage checkpoint.
CHRONIC PAIN CONTRIBUTES TO INJURIOUS FALLS IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Cai Yurun , Leveille Suzanne , Shi Ling , You Tongjian , Chen Ping
Published: November 2019

Fall injuries are a leading cause of death among older adults, and chronic pain has been identified as a fall risk factor. However, the potential impact of chronic pain on injurious falls is unknown. This prospective study examined the relation between chronic pain and injurious falls in a 4-year follow-up of community-dwelling older adults. The MOBILIZE Boston study recruited 765 older adults aged ≥70y living in the Boston area. Pain characteristics, including pain severity, pain interference, and pain location, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Musculoskeletal pain distribution was categorized as “no pain”, “single site pain”, or “multisite pain”. Injurious falls were ascertained in telephone interviews following reports of falls on the monthly fall calendar postcards. The overall rate of injurious falls was 35/100 person-years. Negative binomial models, adjusting for sociodemographics, BMI, chronic conditions, mobility difficulty, analgesic and psychiatric medications, and depression, showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls. Participants in the highest third of pain interference scores had a 53% greater risk of injurious falls compared to those in the lowest pain interference group (adj.IRR=1.53, 95% CI: 1.15, 2.05). Older adults with multisite pain had a 50% higher risk of injurious falls than those without pain (adj.IRR=1.50, 95% CI: 1.16, 1.93). Risk of injurious falls related to pain was stronger among women than men. Research is needed to determine effective strategies to prevent fall injuries among older adults with chronic pain.