bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Quality of Care via Effective Pain Management
Authors: Rose Jennifer
Published: December 2021

Pain is neither a vital sign nor a normal part of aging. Yet, older adults frequently experience pain chronically or from an acute event. Pain was identified as a gap per the Centers for Medicare & Medicaid Services Quality Measures report (2019). The purpose of this quality improvement project was to improve the assessment of pain at a skilled nursing facility (SNF) by using a standardized tool. The Comprehensive Pain Assessment Tool for the Cognitively Intact evaluates the complex sensation and emotional reaction of the pain experience. Nurse managers (N=7) received 1:1 education on pain, pain assessment, use of the pain assessment tool, and took a post-test. Chart audits were conducted to identify tool use and evaluate the patient response. Additional data were collected from nurse managers via a questionnaire. All nurse managers received education and completed the post-test. Pain assessments and care plans were completed for 100% of the SNF residents in the cohort (N=22). Follow-up assessments were completed on only 75% of the cohort. Of the cohort, 95% demonstrated improved physical ability and functioning in activities of daily living as their pain experience improved. Only 4.5% of the cohort participated in the anticipated level of minutes of therapy as a result of facility infection control limitations due to the COVID-19 pandemic. This project demonstrated improved pain management through use of a tool to comprehensively assess pain. An organizational policy to comprehensively assess pain at this SNF could promote a higher level of independence and functioning for older adults.
Loneliness Predicts Development of Pain, Fatigue, and Depression in Older Adults
Authors: Powell Victoria , Kumar Navasuja , Kabeto Mohammed , Galecki Andrzej , Clauw Daniel , Silveira Maria
Published: December 2021

Pain, fatigue, and depression form a well-recognized symptom cluster that is posited to have a shared mechanism. It is possible that chronic psychosocial stressors such as loneliness may impact the central nervous system and immune system, potentially leading to symptom cluster development. Loneliness is an increasingly recognized type of psychosocial stress, especially among older American adults. Thus, we investigated whether loneliness increased risk of developing the symptom cluster of pain, fatigue, and depression over time. Using Health and Retirement Study data from 2006 – 2016, we examined self-respondents ≥50 years-old for the presence of co-occurring pain, fatigue, and depressive symptoms surpassing threshold levels (ie., the symptom cluster). Loneliness (measured by the 3-item UCLA Loneliness Scale) at baseline was used as the predictor of interest. Of the total sample (n=11,766), n=5,956 (50.6%) had up to two complete sets of follow-up symptom cluster measurements. Logistic regression models for longitudinal data were fitted using a generalized estimating equation (GEE). After adjusting for demographic and clinical variables, loneliness strongly predicted the development of the symptom cluster (adjusted OR=3.16 (95% CI 2.77, 3.61)) as well as each component symptom (pain adjusted OR=1.54 (95% CI 1.42, 1.67); fatigue adjusted OR=1.88 (95% CI 1.74, 2.03); depression adjusted OR = 3.87 (95% CI 3.55, 4.21). Further research should investigate whether interventions targeting loneliness or other psychosocial stressors may have a role in prevention of this symptom cluster.
Personality Change Profiles and Changes in Cognition Among Middle-Aged and Older Adults
Authors: Stieger Mirjam , Liu Yujun , Graham Eileen , DeFrancisco Jenna , Lachman Margie
Published: December 2021

Previous research on the relationship between personality traits and cognitive abilities has primarily focused on cross-sectional studies or on specific personality traits in relation to selected cognitive dimensions. The present study extends existing research by exploring associations among 20-year personality change profiles and 10-year cognitive change in middle-aged and older adults. The present study included 2,652 participants of the Midlife in the United States study (MIDUS) ranging in age between 20 - 74 years (M = 46.61, SD = 11.26) at the first of the three measurement occasions. Latent Profile Analysis (LPA) was used to capture profiles of change across the Big Five personality traits of extraversion, conscientiousness, agreeableness, openness, and emotional stability combined. Results of the LPA identified three personality change subgroups: Decreasers, Maintainers, and Increasers. Across the 20 years, the Decreasers showed greater decreases on the Big Five personality traits, the Maintainers remained mostly stable, and the Increasers showed greater personality trait increases. Also, the Maintainers and Decreasers were significantly older than the Increasers. Longitudinal multilevel models were used to examine the relationship between these three personality change profiles and cognitive change. Age, sex, education, physical activity, functional health, and self-rated health were added as covariates. Results show that cognitive decline was greater for the Decreasers and less for the Increasers compared to the other personality change profiles. The results have implications for developing interventions to target personality trait change in middle and later adulthood as a potential means for reducing declines in cognitive functioning.
Vision Impairment in Dementia Care
Authors: Whitson Heather
Published: December 2021

Epidemiological evidence indicates that 3-4% of community-dwelling adults over age 65 years old have functionally limiting deficits in both vision and cognition. The comorbidity prevalence is higher in older age strata and in long-term care. Seniors with co-occurrence of vision impairment and dementia have six times higher odds of disability and higher average annual Medicare fee for service costs ($13,655 [95% confidence interval: $9,931-$18,798], compared to peers with dementia alone ($8,867 [95% confidence interval: $7,360-10,683]) or neither condition ($4,518 [95% confidence interval: $4,360-$4,682]). This talk will review evidence that people with early dementia and vision problems can experience improved function through appropriately tailored vision rehabilitation interventions. The talk will provide recommendations for unbiased cognitive assessment in visually impaired people. The session will outline research opportunities regarding the question of whether preventing or treating vision impairment may improve cognitive trajectories and neuropsychiatric symptoms in people with dementia.
Fit for the Next Fifty Exercise Program: 25 Years of Reflections, Results, and Partnerships
Authors: Pagan Mary
Published: December 2021

Consistent exercise provides a multitude of physical, social, and emotional benefits. Common barriers to regular exercise for older adults include time, transportation, risk of injury, existing limitations, and negative experiences or attitudes about exercise. Fit for the Next Fifty is a comprehensive exercise and wellness program designed to address barriers and excuses. The program , based in CNY, has an impressive 25 year history of providing a unique mix of aerobic, strength training, yoga, and balance-based ballet. Participants (100-120) attend up to 5 classes per week at no charge during summer months and continue through winter months for a small fee. Developing and sustaining funding partnerships has been critical to the long-term success of Fit for the Next Fifty. Participants, ages 60-96, are active providers of feedback and suggestions, a key component to keeping the music, movements, and fellowship enjoyable and meaningful for over two decades. Program details, participant pictures and testimonials, research results, surveys across the years, and partnering/funding strategies provided. Of special interest is the social support dimension of the program. Participants have developed a sophisticated network to support each other outside of the exercise and wellness programs provided by Fit for the Next Fifty.
Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis
Authors: Prevett Christina , Moncion Kevin , Phillips Stuart , Richardson Julie , Tang Ada
Published: December 2021

Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.
Stimulating a Mature Body’s Defense System by Maintaining Physical Activity: A Literature Review
Authors: Murphy Mary
Published: December 2021

This review provides summary of research findings on the effects of exercise for changes in the immune system most associated with aging. Immunosenescence is identified as an immune dysregulation with aging that leaves an older adult susceptible to infections and a host of immune-related disorders. Extrinsic modulators of immunosenescence include pathogens, mental stress, nutrition, and exercise. Moderate short acute exercise over time enhances the immune system. Heavy exertion or prolonged exercise bouts may contribute to immunosenescence. In one study, a J-curve result was identified for upper respiratory tract infection. A moderate exercise workload was associated with a 40-50% decrease in upper respiratory tract infections while a 2-6-fold increase was identified among individuals consistently completing heavy exertion. Transient increases of the inflammatory markers of C-reactive protein and Interleukin-6 are noted after excessive exercise. The older adult should consider small increments of change in an exercise load to limit exercise-induced inflammation. These same inflammatory markers are chronically expressed in obese individuals in a resting state. Strategies to manage weight within recommended range to avoid obesity will limit activation of proinflammatory immune cells. In conjunction with physical activity, the lifestyle behaviors that most support immune system health include adequate sleep, nutrition, hydration, and avoidance of excessive alcohol intake. When planning a safe moderate exercise workload, additionally consider hygienic practices to lower transmission of pathogens. Transmission decreases with hand washing, limited hand-to-face contact, distance from large crowds or those with cough, avoiding spaces with poor ventilation and update vaccinations.
Home- and Community-Based Services Use Patterns and Functional Improvement among Older Care Recipients in Taiwan
Authors: Yu Hsiao-Wei , Wu Shih-Cyuan , Chen Ya-Mei
Published: December 2021

The new version of Taiwan’s 10-Year Long-Term Care Plan launched in 2016 aims to reinforce the integration of home- and community-based services (HCBS). The underlying HCBS use patterns and effectiveness of functional improvement among care recipients merit investigation. The purpose of the study was to examine the association of HCBS and changes in ADLs among care recipients with different levels of disabilities in Taiwan. We accessed the sub data of Taiwan’s Long-Term Care Services Management Online System. Samples were aged 65 and over and had completed records of baseline and reassessment information during 2018 (N = 4787). Latent class analysis and multivariate linear regression were applied to examine the relationship of HCBS and functional changes. Four HCBS subpatterns were found: home-based personal care services (home-based PS) (59.16%), home-based reablement services (home-based RS) (23.90%), home-based multiple services (home-based MS) (11.93 %), and community-based services (5.01%). In the cases with mild disabilities at baseline, recipients receiving home-based RS had higher probabilities of improving in ADLs among four HCBS subgroups (for example: β = 2.65, SE = 1.19 in comparison to home-based PS). Care recipients with moderate-to-severe disability at baseline, ADLs improvement was only found in home-based PS (β = 1.63, SE = 0.82 in comparison of home-based MS). In the cases with profound disabilities, home-based PS showed positive effects on ADLs improvement (β = 2.45, SE = 0.80 in ADLs, compared to home-based RS). The study suggested that HCBS subpatterns had different impacts on older adults with different disability levels.
Abuse of and Intervention for Older Adults During the COVID-19 Pandemic
Authors: Teaster Pamela , Bolkan Cory
Published: December 2021

Beginning in the United States in 2020, SARS-CoV-2 lead to unprecedented changes in the lives of both younger and older people. Efforts to mitigate the spread of the novel coronavirus, which included physical distancing and self-quarantine not only upended the lives of many people but also created natural laboratory conditions for the mistreatment of older adults. Exploring the mistreatment of older adults during the pandemic presented an unprecedented opportunity to examine perspectives of service providers and affected older adults. This symposium offers four perspectives on this subject. Dr. Karen Roberto and colleagues will present changes and challenges that COVID-19 brought for Adult Protectives Service staff and the vulnerable adults whom they serve. Ms. Lori Smetanka and colleagues will present changes and challenges that COVID-19 created for state and local Long-Term Care Ombudsman. Dr. Holly Ramsey-Klawsnik and Ms. Tammy Seaver will report on how the pandemic affected Nevada Adult Protective Services clients, casework, and staff. Finally, Dr. Pamela Teaster and colleagues will discuss how older adults experienced exploitation attempts during the early months of the pandemic. Dr. Cory Bolkan will begin the discussion, highlighting how conditions brought about by COVID-19 both enabled and thwarted efforts to address elder abuse.
Making the Most of Adversity: A Fully Remote Ecological Momentary Assessment and Actigraphy Study of Hospital Nurses
Authors: Vigoureux Taylor , Mu Christina , Lee Soomi
Published: December 2021

The COVID-19 pandemic has created challenges and opportunities for research. This is especially true for research on essential workers, such as hospital nurses. In adaptation to the pandemic, the current study aimed to assess the feasibility and acceptability of a fully remote study to collect data on psychological and behavioral measures such as daily stress and sleep, utilizing ecological momentary assessments (EMA) and sleep actigraphy. Our remote study protocol was conducted through a web platform that provided detailed video and written instructions regarding the study and facilitated virtual onboarding meetings with participants. Outpatient day shift nurses (n=86) responded to a background survey, 84 of whom completed 14 days of EMA and sleep actigraphy. Feasibility was assessed by compliance rates to the 14-day study protocol. Acceptability was assessed by analyzing qualitative feedback provided during onboarding meetings (n=82). The compliance rates of EMA (91.8%) and actigraphy (97.9%) were high. The EMA compliance was higher than that from a pre-COVID, non-remote study of inpatient day shift nurses from the same hospital (86.6%, p=.030). Themes from content analysis were mostly positive with 51.2% reporting “easy, clear, simple onboarding process” and 16.3% reporting “helpful website”. Only six participants provided solely negative feedback (e.g., “communication problems” or “technical difficulties/preferences”). Our remote study protocol was feasible and well-accepted by nurses. A similar methodology could be used in studies on broader healthcare workers and those caring for aging populations to better understand their unique challenges and develop effective strategies to help them, both during and after the pandemic.
Trends in short sleep duration in the National Health and Interview Survey 2004-2018: A Decomposition Analysis
Authors: Xu Jiahui , Buxton Orfeu , Luo Liying , Gamaldo Alyssa , Verdery Ashton , Hardy Melissa , Xiao Qian
Published: December 2021

Since the early 2000s, it is increasingly common that people have short sleep durations (<=6 per 24-hour), making this a high-prevalence public health issue, especially among Black individuals. We investigate how trends in short sleep duration are influenced by changes in population aging, socioeconomic factors (e.g., education, labor force participation, marital status), and health conditions and behaviors (e.g., pain, smoking, drinking, obesity, psychological distress). We use the pooled cross-sectional data from the 2004-2018 National Health and Interview Survey, a large and nationally representative study. We partition overall trends in short sleep duration into (a) compositional effects due to distributional changes in age structure, socioeconomic and health factors and (b) unexplained rate effects. Subsequently, we compare the relative contribution of each factor to the total compositional effects among Black and White participants. Results demonstrate that greater education is associated with greater prevalence of short sleep duration among Black Americans, but reduced prevalence among White Americans. For both racial groups, population aging contributes relatively little to temporal patterns in short sleep duration; by contrast, higher distress and lower labor force participation in recent years are associated with the increasing prevalence of short sleep duration.
Aging Men and Masculinity Ideologies: Variance Composition of the MRNS-BF and Measurement Invariance by Men's Age
Authors: Thompson Edward , Levant Ronald
Published: December 2021

The construct traditional masculinity ideology (TMI, Levant & Richmond, 2016), like the construct dominant masculinities (Coles, 2009; Messerschmidt, 2019), refers to culturally-based principles about proper gender practices for men. The present study aimed to create a briefer and psychometrically stronger form of the Male Role Norms Scale (MRNS), a long-standing and important measure of TMI. Using an archival data set (N = 626) with men age 25 and older, the MRNS was shortened using a set of recommended practices. Confirmatory factor analysis and assessment of measurement invariance showed the resulting MRNS-BF satisfies good fit principles with configural, metric, yet not reliable scalar invariance for age. It is a 6-item measure whose common factor measures TMI through two dimensions that mimic tenets Brannon (1976) and Connell (1995) theorized as underlying principles of masculinity ideologies in Western cultures: Earning and maintaining Respect/status, and No sissy stuff/avoidance of femininity in gender practices. Mean scores importantly show perhaps generational, certainly age cohort differences – aging men differed from established and middle-aged men by more moderately endorsing norms that specify men must strive to earn others’ respect and the cultural emphasis on no sissy stuff. Younger age cohorts strongly adopted principles of gender equality. These observed differences must be interpreted with great caution, since the men in the three age groups did not seem to have a common zero point. Still, the MRNS-BF has good psychometric properties, and its brevity can assist future research on how gender guidelines influence aging men’s health decisions and behavior.
Associations Between Neighborhood SES Disadvantage and Feelings of Depression and Loneliness in Older Adults
Authors: McCain Dextiny , Morgan Adrienne Aiken , Wright Regina
Published: December 2021

Previous research suggests depressive symptoms and loneliness are increasingly prevalent among older adults living in lower-income neighborhoods. The purpose of this study was to examine the extent to which neighborhood socioeconomic status (SES) was associated with depressive symptoms and loneliness among a sample of older adults from the Healthy Heart and Mind Study (N = 165; mean age = 68.48 (SD = 6.26); 66.7% women; 40.6% African American). It was hypothesized that older adults living in neighborhoods with greater socioeconomic disadvantage would report more depressive symptoms and loneliness than those residing in neighborhoods with less socioeconomic disadvantage. Depression was assessed with the Beck Depression Inventory-II (BDI-II), and loneliness was assessed using the Revised University of California, Los Angeles (UCLA) Loneliness scale. Neighborhood SES was measured with the Area Deprivation Index (ADI), which allows rankings of neighborhoods by SES disadvantage both statewide and nationally. After controlling for demographic variables (age, sex, and race), linear regression analyses showed that greater neighborhood SES disadvantage was associated with higher depression scores (β = -.094; p = .041) and higher loneliness scores (β = -.258; p = .003). These findings highlight the importance of neighborhood context on mental health in older adults, as underserved populations are more likely to experience declines in mental health under strenuous circumstances. Future research should investigate the impact of neighborhood SES on mental health in aging adults.
Typology of Traumatic Events and Physical Function
Authors: Dong Gabriella , Li Mengting
Published: December 2021

Individuals experience various traumatic events over the life course, but little is known about the patterns of lifetime exposure to traumatic events. This study aims to identify traumatic event typology and examine its relationship with physical function. Data were from the 2017-2019 PINE study (N= 3,125). Traumatic events were evaluated by earthquake, typhoon, tornado, residential fire, physical assault, robbery, sexual assault, divorce, bereavement, cancer, homeless, imprisonment, and falsely accused. Physical function was measured by activities of daily living (ADL), with lower scores indicating better physical function. Analysis was conducted using latent class analysis and the four-class model fits the data best. We identified four typologies: limited trauma, severe trauma, natural disaster, and mild-to-moderate trauma. The “limited trauma” (33.8%) has the lowest exposure to all traumatic events except typhoon and homeless. In contrast, an equivalent “severe trauma” (33.3%) has the highest exposure to all traumatic events except natural disasters. A small “natural disaster” (4.8%) has the highest exposure to natural disaster and moderate exposure to other traumatic events. The “mild-to-moderate trauma” (28.2%) has mild-to-moderate trauma exposures. The mild-to-moderate trauma group (M=0.38, SD=2.12) has better physical function than limited trauma (M=0.69, SD=3.08), severe trauma (M=0.61, SD=2.81), and natural disaster (M=0.71, SD=3.22) groups. After controlling confounding variables, the mild-to-moderate trauma group has lower risks of ADL impairment than the limited trauma group (OR=0.66, 95%CI=0.47-0.93). The findings suggest mild-to-moderate exposure to traumatic events might benefit older adults’ health, while limited trauma might not be able to develop resilience and severe trauma overwhelms coping strategies.
Longitudinal Relationship Between Living Alone and Activity Engagement of Chinese Older Adults
Authors: Tang Fengyan , Li Ke
Published: December 2021

The living arrangement of older adults plays a key role in their health status and psychological well-being. Yet the relationship between living arrangement and activity engagement remains unclear. Using data from three waves of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) with a study sample of 7,479 respondents aged 60 or older, this study examined the effect of living alone on the frequency of activity engagement among Chinese older adults. Two types of activity engagement were examined in this study, including social interaction with friends and leisure activity (i.e., play chess, go to a sport or club). The multinomial logistic regression analyses were performed using generalized structural equation modeling (GSEM). Compared with those living with others, older adults living alone were older, more likely to be female and living in urban areas, and with fewer years of education and more functional limitations. The results also indicated that after controlling for a set of covariates, living alone status was significantly associated with the increased likelihood of high and medium frequency of both social interaction and leisure activity in reference to no engagement. This study not only improves the understanding of activity engagement preference of Chinese older adults who are living alone but also indicates the importance of improving community facilities and outdoor spaces to promote activity engagement among older adults.
Preliminary Impact of a Social Connection Program on Older Adults
Authors: Ungar Rachel , Tkatch Rifky , Cheng Yan , Kraemer Sandra , McGinn Michael , Wicker Ellen
Published: December 2021

Background: Research demonstrates social connections decrease loneliness and improves life satisfaction among older adults. Unfortunately, the COVID-19 pandemic has limited social connectedness, specifically for older adults. Thus, programs aiming to increase social connectedness among older adults are imperative. Purpose: The primary objective of this study was to determine if the telephonic Peer-to-Peer (P2P) program can improve social connectedness and loneliness among older adults. A secondary objective was to determine whether additional improvements in life satisfaction and perception of aging were achieved. Methods: Eligible older adults (age 65+) were recruited via outbound calls and/or a mailer. Participants were mailed a T1 survey, completed intervention training, and matched into a dyad. The matched dyad engaged in weekly telephone calls for 12 weeks. Post 12 weeks, participants completed a T2 survey, and a T3 four weeks later. Results: Overall, 7,544 individuals were contacted to participate, and 759 expressed interest in participation. A total of 475 participants (62%) completed a T1, 372 (78%) completed training, and 348 (94%) were matched. Gender distribution was skewed towards females (74%), and most were 65-74 years old (53%). Preliminary results show significant differences between lonely and not lonely participants, with lonely participants reporting more negative health associations across all measures. Conclusion: Once agreeing to participate, results showed a high likelihood of continuing in P2P, thus demonstrating a social connectedness opportunity for older adults. Delay in mailing and scheduling training may contribute to challenges in attrition. However, developing automated processes utilizing technology may decrease lag time for future phases.
Effects of Loneliness and Stress Management on Perceived Stress in Older Adults
Authors: Gifford Angela , Fouche Hayley , Beadle Janelle
Published: December 2021

In older adulthood, individuals may experience acute and chronic stressors, such as the loss of independence, mobility, or the experience of chronic diseases. Loneliness is also a concern in older adulthood as many experience the loss of close others and smaller social networks. Loneliness is well-established as being associated with higher stress levels in younger adults, but there are mixed findings on the impact in older adulthood. Furthermore, while older adults may engage in behaviors designed to reduce and manage stress, it is not known whether these behaviors modulate the relationship between loneliness and chronic stress. The current study examined the relationship between loneliness and stress in older adulthood and the degree to which stress-management moderated this relationship (note: data collected prior to COVID-19 pandemic). We hypothesized that loneliness and perceived stress would be positively associated, but that stress-management would moderate this relationship. Participants included 40 healthy older adults (Mage= 69.18, Range:55-86yrs; 29 females) who completed the UCLA-Loneliness Scale, the Perceived Stress Scale, the NEO-FFI (to assess neuroticism), and demographic information about participation in stress management activities. We found that loneliness was significantly associated with chronic stress, r(38) = .517, p < .001. Furthermore, loneliness and neuroticism were significant predictors of perceived stress, F(2, 37) = 9.618, p < .001, R2 = .342. These findings demonstrate that loneliness is a significant predictor of perceived stress in older adulthood and point to a need for further exploration of effective stress-management tools in later life.
Need to Belong and Social Ties in Late Life
Authors: Zhou Zexi , Kim Yijung , Zhang Shiyang , Fingerman Karen
Published: December 2021

According to socioemotional selectivity theory, older adults are more selective and tend to shrink their social network to their closest ties. However, a heightened need to belong, which is characterized by a stronger desire for acceptance and motivation to affiliation, may alter this common pattern. We know little about how the need to belong shapes social network structure, especially in late life. This study investigated the associations between the need to belong, size of social network, and engagement with social ties among older adults. Participants (N = 314) aged over 65 years from the Daily Experiences and Well-being Study completed a baseline interview regarding their close ties (i.e., social convoy members), and weak ties, as well as a self-report measure of need to belong. They completed ecological momentary assessment (EMA) surveys reporting their social encounters every 3 hours over 5 to 6 days. Need to belong was unrelated to the number of close ties. In contrast, participants with a higher need to belong reported more less close (but still important) ties and weak ties than those with a lower need to belong, but spent a similar amount of time (i.e., proportion of EMA involving social encounters) with either their close ties or weak ties. These results suggest that the need to belong may motivate older adults to go beyond their closest ties to weaker ties, and highlight the discrepancies between the sense of being connected to social partners and the actual engagement with them in this process.
Financial Exploitation of Older Adults During the Early Months of the COVID-19 Pandemic
Authors: Teaster Pamela , Roberto Karen , Savla Jyoti , Du Chenguang , Hoyt Emily , Beach Scott , Charness Neil , Lichtenberg Peter
Published: December 2021

COVID-19 created a “perfect storm” for financial exploitation directed at older adults. We invited adults aged 60 and older enrolled in gerontology research registries at Virginia Tech, Florida State University, Wayne State University, and University of Pittsburgh to complete an on-line survey about experiences with financial exploitation by strangers. The 997 respondents ranged in age from 60 to 98 (M = 71.3; SD = 6.8); most identified as White (93.4%), female (64.2%) and living with a spouse/partner (58%). Approximately one-half of respondents (56.87%) reported experiencing a scam attempt about COVID-19 issues. Most contact by scammers was electronic (49%) and frequently occurred two or more times (40%). Most respondents ignored the request (i.e., hung up phone, deleted text/email, threw away mail). However, 9% sent the requested payment, and 4% gave the scammer their personal information. Confidence in financial matters and having attended financial educational programs protected older adults from being scammed.
The Association between Social Support and Attitude toward Technology Differs by Educational Level
Authors: Joo Susanna , Lee Changmin , Kim Kwang Joon , Kim DaeEun , Jun Hey Jung
Published: December 2021

The present study aimed to examine the moderating effects of the educational context on the association between social support from family members and attitude toward using gerontechnology among Korean older adults. The sample was Korean older adults without dementia (N=310, Age: 65-89, M=70.18, SD=4.58). Data were collected by online recruiting in February 2021. The dependent variable was the attitude toward using gerontechnology, especially, an exoskeleton robot for exercise. Independent variables were four types of social support (emotional, instrumental, physical, and financial support) from family members. Moderating variable was the binary educational group (high school and below, or college and over). We analyzed four regression models including each interaction term between education and a type of social support using PROCESS macro and bootstrapping. Results showed educational context had a single significant moderating effect on the association between emotional support and attitude toward using gerontechnology. Specifically, emotional support had a significant effect on having a positive attitude toward using gerontechnology among older adults who graduated high school or were less educated. However, it was not significant among older adults who were highly educated. Moreover, other types of social support did not have significant main effects as well as interaction effects with education on the attitude toward using gerontechnology. Findings of the present study implied emotional support from family members, such as spouse, children, or siblings, was useful to enhance having a positive attitude toward using new technology, especially for older adults who did not experience college-level educational context.
A Digital Intervention to Alleviate Loneliness and Depression Among Older Persons During the COVID-19 Outbreak
Authors: Cohn-Schwartz Ella , Shapira Stav , Yeshua-Katz Daphna , Aharonson-Daniel Limor , Clarfield A Mark , Sarid Orly
Published: December 2021

Social distancing has been proven to be effective in reducing infections but may cause ill effects on the mental health of older adults. We evaluated the effects of a short-term virtual group intervention that provided tools to promote better coping, and mitigate adverse mental health effects during the outbreak of the covid-19 pandemic. A Randomized controlled trial tested the effects of a guided intervention comprised of seven online group sessions in which cognitive-behavioral techniques targeting maladaptive beliefs and appraisals were learned and practiced via ZOOM. A total of 82 community-dwelling adults from Israel, aged between 65 - 90 were randomized to either an intervention group (n=64) or a wait-list control group (n=18). Loneliness (UCLA loneliness scale) and depressive symptoms (PHQ-9) were measured pre-intervention, post-intervention, and at 1-month follow-up. The findings showed a significant decrease in loneliness and depression scores in the intervention group with results maintained at 1-month follow-up. There were no significant changes in the wait-list control group. In addition, ten participants (16%) from the intervention group demonstrated a clinically meaningful decrease in depression between baseline and post-intervention, and this was maintained among 7 participants (10%) at 1-month follow-up, compared to only 1 participant (5%) in the control group. Our intervention presents a simple and easy-to-implement tool. Its relevance extends beyond the current pandemic as the skills acquired can be applied in other forms of social crises and during routine life, in order to promote the mental health of older adults who live alone and/or reside in remote areas.
A fat-promoting plant extract from Artemisia scoparia exerts geroprotective effects on C. elegans health & lifespan
Authors: Ghosh Bhaswati , Guidry Hayden , Johnston Maxwell , Bohnert Adam
Published: December 2021

Like other biological processes, aging is not random, but subject to molecular control. Natural products that act on conserved metabolic pathways may provide entry points to extend animal lifespan and promote healthy aging. Here, we show that a botanical extract from Artemisia scoparia (SCO), which promotes fat storage and metabolic resiliency in mice, exerts pro-longevity effects on the nematode Caenorhabditis elegans, even when administered in mid-adulthood. SCO-treated worms exhibit significantly higher levels of fat compared to controls but live up to 40% longer, with signs of improved stress resistance in late age. Molecularly, SCO links elevated fat to enhanced longevity and stress resistance via activation of the transcription factor DAF-16/FOXO and upregulation of DAF-16-targeted Δ9 desaturases, lifespan-extending metabolic enzymes that oversee the biosynthesis of monounsaturated fatty acids. These findings identify SCO as a natural product that can modify fat regulation for longevity benefit and add to growing evidence indicating that elevated fat can be pro-longevity in some circumstances.
Advance Care Planning and Hospice Use Among People with Dementia: A Report from the Health and Retirement Survey
Authors: Coccia Kathryn
Published: December 2021

People with Alzheimer’s disease and related dementias (ADRD) frequently receive sub-optimal end-of-life care (EOLC), often enduring invasive procedures such as tube feeding, resuscitation, and surgery within days of their death. While advance care planning (ACP) has shown effectiveness in improving EOLC for those with ADRD, there are many barriers to ACP specific to the ADRD population. Research suggests that hospice care is optimal in reducing end of life suffering for ADRD patients. This study aimed to empirically assess hospice utilization and ACP for individuals with ADRD compared to individuals without ADRD, and to assess the impact of ACP on hospice utilization for individuals with ADRD. Data came from the 2016-2018 wave of the Health and Retirement Study (HRS), a national longitudinal study collecting health and demographic data on older Americans. This analysis evaluated survey responses from 1,224 proxy respondents for individuals who died during this period. In this sample, people with ADRD were both significantly more likely to have utilized hospice care (OR=1.37) and to have written EOLC instructions in place (OR=1.19). Those with ADRD were 22% less likely to have discussed their EOLC wishes with their proxy than those without ADRD. Having a written EOLC plan in place significantly increased the odds of hospice utilization (OR=1.37) but discussion around EOLC preferences increased odds of hospice utilization at a higher rate (OR=1.59). These results support policy to advance earlier ACP conversations around EOLC preferences and the implementation of written EOLC instructions to reduce suffering for individuals with ADRD diagnoses .
Challenge or Opportunity? Impacts of Falls among Older Adults Living with Dementia on their Care Partners
Authors: Zhou Yuanjin , Ishado Emily , Sadak Tatiana
Published: December 2021

Previous studies suggest that falls among community-dwelling older adults living with dementia (OLWD) harm the health and wellbeing of their family/friend care partners. However, little is known about the process through which falls impact care partners. We conducted a grounded theory analysis using 59 semi-structured interviews with care partners of OLWD who were recently hospitalized and had a history of falls. We identified several areas of care partners’ functioning that were affected by falls in positive and negative ways: everyday life, health management for OLWD, and interactions with healthcare providers. Both the fall events and fall risks had negative consequences of reducing care partners' self-care activities and work productivity. Other adverse consequences of fall risks were (1) care partners’ fatigue and conflicts with OLWD due to the intense requirement of daily monitoring, and (2) hesitance to ask healthcare providers for assistance because clinicians frequently did not teach care partners how to address fall risks and might recommend institutionalization. However, OLWD's fall events became a transition point for some care partners to seek support and gain more information and skills about managing OLWD’s health conditions, which might reduce care partners’ burden in the long term. Because OLWD’s falls may have negative and positive consequences for care partners, both problem-solving and strength-based fall management approaches are needed. These strategies focus on developing and sustaining care partners’ self-care, developing collaborative relationships with OLWD, enhancing successful capacity for OLWD’s health management, and cultivating partnerships with healthcare providers.
Challenges and benefits: Volunteerism among older adults during Covid-19
Authors: Sellon Alicia , Newsham Tina K , DuMont Renee , Hollifield Claire , Thomas Alicia
Published: December 2021

Social distancing restrictions and regulations, put in place to reduce the spread of COVID-19, disrupted the daily lives of active older adult volunteers. One year into the pandemic, we used a mixed-methods approach to explore how these regulations had impacted the quality of life, loneliness, and volunteer behavior of 26 older adults who were active volunteers (i.e., at least an hour a week) prior to the start of the pandemic. All the participants were white and non-Hispanic, and the majority were female (65.4%). The average age was 71, with a range from 53 to 87 years old. On average, participant scores on the UCLA loneliness scale (4.23 ±1.39) indicated a low amount of loneliness and high scores on the Brunnsviken Brief Quality of Life (BBQ) scale (83.54 ±10.97) indicated a high quality of life. Thematic findings from the interviews conveyed that, despite the challenges and risks associated with volunteering during a pandemic, participants valued volunteer work enough to make adjustments or seek out new volunteer activities. The research team identified two overarching themes related to participants' discussions of volunteering during the pandemic: Challenges and changes and Benefits of volunteering during a pandemic. Participants' discussions of how volunteer work changed and why they continued to or sought out new volunteer activities during a pandemic can guide organizations seeking to support or recruit older volunteers, particularly as the pandemic continues. These findings also provide further evidence of the important role that volunteerism can play in the well-being of older adults.
Coupling Effects of Depression and Functional Disability: Using Bivariate Latent Change Score Model
Authors: Lee Gina , Martin Peter
Published: December 2021

The purpose of the study was to examine the coupling effect of depression and functional disability over four time points using the data from the Health and Retirement Study (HRS). The sample included participants who survived to 98 years or older (N = 458). Four alternative latent change score models were computed to examine the univariate and bivariate effects among depressive symptoms (CES-D) and functional disabilities (ADL): No-coupling, univariate model of ADL to change in CES-D, univariate model of CES-D to change in ADL, and bivariate model. As hypothesized, the no-coupling model did not fit the data well, χ2 (26) = 164.86, CFI = 0.85, RMSEA = 0.11. Model 2, ADL predicting change in CES-D, did not fit the data well, χ2 (25) = 164.18, CFI = 0.85, RMSEA = 0.11. Model 3, CES-D predicting change in ADL, also did not fit the data, χ2 (25) = 148.06, CFI = 0.87, RMSEA = 0.10. The bivariate model fit the data well, χ2 (21) = 66.94, CFI = 0.95, RMSEA = 0.07, and was the best fitting model. All level to change effects were significant in model 4. One’s CES-D at prior waves was positively associated with change in ADL at subsequent waves, and ADL at prior waves was positively associated with change in CES-D at subsequent waves. In conclusion, there is a significant coupling effect between depressive symptoms and ADL over time. Future health policies should monitor older adults’ mental and functional health simultaneously for their possible spillover effects.
Discourse Analysis Uncovers Compulsory Altruism and Power Paradoxes for Family Caregivers of Those with Dementia
Authors: Harrington Candace
Published: December 2021

Rural female family caregivers are under-represented, under-reported, and under-studied in rural caregiving and Alzheimer's disease-related dementias (ADRD) research. Caregivers' power struggles are often invisible and unknown. These constructs have social, policy, and practice implications for both family caregivers and their care recipients with ADRD. The purpose of this study was to explore how Foucauldian discourse analysis (FDA) elucidates rural female family caregivers' acquisition of caregiving roles for those with ADRD. FDA focuses on power structures and relationships in society as expressed through language and practices that affect marginalized groups. Textual data for this secondary analysis consisted of 157 pages of interview transcripts with 10 rural female caregivers. The systematic discourse analysis elucidated two socially constructed power and relationship structures. Compulsory altruism described complex socially constructed caregiving and gender role expectations, grounded in reciprocity, duty, and filial piety. A power paradox occurred when filial piety, duty, and reciprocity were in direct opposition to the caregivers' beliefs and value systems. In this sample, the subsequent sense of ambiguity about violating personhood and autonomy delayed black and white caregivers' responses to intervene with family members with ADRD. These delays resulted in near misses from wandering, driving-related accidents, cooking-related fires, financial exploitation by other family members, mistreatment that involved both caregiving dyad partners, and one tragic incident of a parent's death resulting from wandering-related exposure to elements. FDA was a valuable qualitative approach to elucidate family caregivers' power struggles that were previously invisible and unknown. These findings have broad implications for clinicians and researchers.