bluuebunny/crossref_metadata_2025 huggingface dataset:
Data From a Mindfulness Program for Family Caregivers to Persons With DD, and Application for Older Individuals
Authors: Kahana Jeffrey , Force Lawrence , Monthie Roger
Published: December 2020

Parents who care for their children (young and adult) with developmental disabilities face many stressors and challenges. This paper reports on an intervention using mindfulness and cognitive reframing to improve psychological well-being of care-givers. We report on results based on 92 care-givers who participated in the program. An innovative component was utilizing parent care-givers along with trained peer facilitators. The program was conducted over six weeks, with three in person sessions, and three at home web-based sessions. The content emphasized mindfulness practice (meditation) along with cognitive reframing (aimed at boosting optimism) to address the stress family-caregivers experience in managing worry and the perceived lack of control that accompanies caring for children (young and adult) with developmental disabilities. Post-test data revealed increased awareness of stress coupled with greater competence in stress management. Given the life-long demands for care-giving of parents to the developmentally disabled, normative stressors of aging interact with stressors posed by care-giving demands. Implications for improving well-being of older parental care-givers will be discussed around the topics of (1) optimism and hope; (2) support of healthy behaviors; and (3) development of a mindset of gratitude.
Accessibility to Parks and Trails and Physical Health Measures in CATSLife: Evaluating Selection
Authors: Reynolds Chandra , Knaap Elijah , Corley Robin , Gebelin Kyle , Munoz Elizabeth , Rhee Soo , Wadsworth Sally
Published: December 2020

Associations of obesity and cardiovascular health with neighborhood walkability have been observed in the literature; however, limited research has evaluated self-selection that may underlie associations. We measured accessibility to parks and trails using geospatial measurements as well as self-reported activity-friendliness of neighborhoods (ease of walking, biking, and recreating) in 1140 participants (ages 28-49 years) in the ongoing Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (CATSLife). Physical health indicators included BMI, resting heart rate, and mean arterial blood pressure. The relative similarity of siblings’ accessibility was evaluated to consider self-selection; all models were adjusted for sociodemographics including education. BMI was associated with accessibility to parks, with each increasing log(mile) distance associated with 1.2 BMI unit increase (se=.49, p<0.02). Self-reported neighborhood activity-friendliness was comparable in prediction of BMI (p<0.01). Greater trail accessibility was associated with lower resting heart rate (b=-.30, se=.14, p<0.04) and mean arterial pressure (b=-0.33, se=0.14, p<0.03), whereas self-reported neighborhood activity-friendliness was not associated (p>0.40). Measures of park accessibility tended to be more similar among identical twins (median ICC = 0.30) than fraternal twins or siblings (median ICC = 0.15) or siblings in adoptive families (median ICC = 0.12), excluding siblings who live together. Measures of trail accessibility were consistent across sibling types (median ICCs = 0.25-0.27). Sibling similarity for park accessibility modestly increased with genetic relatedness suggesting potential heritable contributions, whereas comparable similarity was apparent for trail accessibility. Altogether, small associations were observed for park and trail access with physical health, with indications of environmental selection.
Intergenerational Caregiving Patterns, BMI, and Gender Gaps Among the Sandwich Generation in China
Authors: Liu Jingwen , Chen Feinian
Published: December 2020

Existing literatures yield established evidence about the heightened stress brought by multiple roles and potential role overload across work-family context, but little is known about the BMI levels of the “sandwich” caregivers within families and the associated gender inequalities. Indeed, the Chinese pivotal generations are exposed to unshared stress and higher health risks considering that intergenerational support still predominates the caregiving patterns for the oldest old and dependent children under current socioeconomic backgrounds. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study (CHARLS, N = 12186), we examine associations of BMI and intergenerational caregiving patterns among the “sandwich generation” aged 45 to 69. We find that the sandwich generation with at least one parent alive and one grandchild under 16 have higher BMI (24.2, within obesity range) than their counterparts (23.7, within normal range). A higher proportion of females act as caregivers and especially high-intensity caregivers than males, and they also score one-unit higher in BMI than males (23.4). Fixed effect regression results indicate that simultaneous caregiving to both parents and young grandchildren significantly advances individuals’ BMI levels, while no evidence shows similar negative effect of providing care to one generation. Moreover, high-intensity caregiving (1000 hours and above during the past year) is associated with elevated BMI for females but not for males. The gendered caregiving patterns and health implications inform the physical and psychological vulnerability of the pivotal generation and the necessities of gender-specific intervention in middle and later life.
Within-Family Patterns of Sharing Instrumental Support to Older Parents of Multi-Child Families in China
Authors: Chen Jia , Zhou Xiaochen
Published: December 2020

In different multi-child families, adult children may share their instrumental support to older parents in distinct ways regarding its family mean level and differentiation among multiple offspring within families. Based on the family systems theory and the collective ambivalence perspective, we aimed (1) to identify different within-family patterns in relation to multiple offspring’s sharing instrumental support to an older parent in Chinese multi-child families; (2) to investigate potential individual and family predictors for different within-family patterns. Applying data from the China Family Panel Studies (2016, N=5791 older adults aged 60+), we employed latent profile analysis for classifying patterns and multinomial logistic regression for investigating predictors. Results showed three within-family patterns identified: independent (59.78%), highly-ambivalent (30.41%) and filial-cohesive (9.81%). Compared with the independent families, older parents in highly-ambivalent families were more likely to be older (OR=1.03), divorced/widowed (OR=0.61), to have lower educational levels(OR=0.84, ), poorer physical health (OR=0.92), to live in rural areas (OR=0.84), to have at least one adult daughter (OR=1.95)and one coresiding adult child (OR=3.22). Older parents in filial-cohesive families tended to be mothers (OR=0.82), divorced/widowed (OR=0.62), to have fewer adult children (OR=0.78) ,to have at least one adult daughter (OR=1.67) and one coresiding adult child (OR=2.16). The youngest adult children in filial-cohesive families tended to be older (OR=1.04). This study highlighted the importance of capturing different within-family dynamics regarding instrumental support to older parents among multiple adult children at the family level. It also uncovered the commons and differences between multi-child aging families in contemporary China.
Cystatin C Trajectories Among Middle-Aged and Older Americans
Authors: Zhao Erfei , Crimmins Eileen , Ailshire Jennifer , Kim Jung Ki , Wu Qiao
Published: December 2020

Deterioration in kidney functioning is associated with aging and is a major risk factor for mortality and other poor health outcomes. Medicare expenses for poor kidney functioning are about 100 billion dollars every year. High Cystatin-C is an indicator of poor kidney functioning. We do not know if cystatin-C increases gradually as an individual ages. We use the Health and Retirement Study 2006/2008 Biomarker sample with follow-up for 8 years to examine this. Demographic and socioeconomic differences in trajectories of Cystatin-C trajectories were examined for 22,984 participants aged 50 and older. Growth curve models reveal that, although Cystatin-C increases with age (beta=0.025, p<0.001), the annual increase varies by age (60-69 = 0.005, 70-79 = 0.013, 80+ = 0.017, p<0.001), controlling for other socioeconomic variables. Cystatin-C increases faster for males than females. Cystatin-C of non-Hispanic Whites is lower than non-Hispanic Blacks but higher than Hispanics; there is no racial/ethnic difference in change over time. People who spent fewer years in school have higher Cystatin-C, and college graduates have slower growth in Cystatin-C compared to people who did not graduate from high school. These novel findings highlight the disparities in the process of kidney aging among older Americans.
Later-Life Health Disparities in Nepal: Intersection of Gender and Socioeconomic Status
Authors: Bhatta Tirth , Langa Neema , Lekhak Nirmala , Burnette Denise
Published: December 2020

This study focuses on Nepal, a country still undergoing capitalist expansion, to examine intersectional effects of fundamental causes on later life health outcomes. Sandwiched between the republic of China and India, Nepal still has remnants of pre-capitalist social and economic formations. Despite growing focus on independent effects of SES and gender on health, the intersectional influences of such fundamental causes on later life health in Nepal has, however, been largely unexplored. Drawing from the World Health Survey (WHS) survey data (n=2,250 aged 50 years and older), we rely on negative binomial regression models to examine whether the effect of education and household wealth on chronic diseases and functional limitations differs between men and women. Findings indicate intersectional effects of gender, wealth, and education on health. Women do not incur health benefits from education and wealth. Statistically significant negative effect of education on functional limitations (OR=0.87, p<0.01) was documented only for men. Contrary to our theoretical expectations, we observed significantly higher count of chronic diseases among women (OR=1.13, p<0.01) with higher levels of education relative to lower educated women. Similarly, men in higher wealth quintiles reported significantly higher count of chronic diseases (OR=1.05, p<0.01) than their counterparts in lower wealth quintiles. Our study paves a way for future research on a range of structural mechanisms such as gendered labor market, patriarchal cultural expectations, and inequities in health care that could mediate intersectional effects of gender and education on later life health disparities in the Global South.
Mothers’ Health and Relationships With Adult Children: The Moderating Role of Gender and Race
Authors: Stepniak Catherine , Suitor J Jill , Gilligan Megan
Published: December 2020

Consistent with theories of the life course and intergenerational solidarity, families are generally closely tied groups in which one family member’s event affects other members as well. Although the literature has documented that parents and adult children affect one another’s well-being, less is known about how parents’ health shapes relationship quality between family members. In this paper, we utilize data from the Within-Family Difference Study (WFDS) II to explore how mothers’ functional limitations affect relationship quality between mothers and their adult children, as reported by both family members. We hypothesized that the association between mothers’ health and intergenerational relationship quality would be moderated by gender and race. Using multi-level regression modeling, we found that mothers’ reports of relationship quality were not predicted by the presence of mothers’ functional limitations, nor were there any moderating effects of race or gender. In contrast, adult children who perceived that their mothers had limitations reported higher tension with them. Further, daughters were more likely than sons to report greater tension when they perceived that their mothers had limitations (differences between coefficients p < .10). White adult children reported lower levels of closeness and higher levels of tension when they perceived that their mothers had health limitations (differences between coefficients p < .05; p < .10 respectively). However, limitations did not predict Black children’s reports of closeness or conflict with mothers. This study sheds new light on the complex ways in which race and gender moderate the role of mothers’ limitations in intergenerational relationship quality.
Sex Differences in Response to Metformin in a Longitudinal Study in Mice
Authors: Teixeira Camila Vieira Ligo , Alfaras Irene , Camadola Simonetta , Price Nathan , Bernier Michel , de Cabo Rafael
Published: December 2020

Sexual dimorphisms have been recognized in most aspects of human health and disease, and there is now clear evidence for more pronounced differences in response to pharmacological interventions of aging. Here, male and female C57BL/6J mice at six months of age were administered 0.5% metformin in their diet every-other-week (EOW) for the remainder of their lives. The intervention was well tolerated and did not result in lifespan extension. Male mice treated with metformin EOW lost weight and augmented lean-to-fat ratio. In contrast, EOW females were refractory to changes in body weight and body composition compared to controls. The intervention did not influence non-fasted plasma glucose levels, while causing an increase in lactate in mice of both sexes. Indirect calorimetry was performed to measure energy expenditure in EOW mice that were either ON or OFF metformin during testing. Focusing on the respiratory exchange ratio (RER), males, but not females, preferentially utilized carbohydrates (RER ~0.9-1.0) when OFF metformin, switching to lipids (RER ~0.8-0.9) when ON metformin. This resulted in significant differences compared to controls in both periods (OFF and ON). RER of EOW females was different from controls during OFF metformin (RER ~0.8-0.9), while exhibiting significantly lower RER when ON metformin (RER ~0.7-0.8). These results clearly point at a strong dimorphism in the action of metformin in mice, including its role in metabolic homeostasis and overall health span. A better understanding of how sex influences the health and prolongevity benefits of metformin will benefit our understanding of the longterm clinical implications.
Post-Operative Delirium and Cognitive Decline in Kidney Transplant Recipients
Authors: Chu Nadia , Chen Xiaomeng , Segev Dorry , McAdams-DeMarco Mara
Published: December 2020

Post-operative delirium may be a marker for cognitive reserve, or a greater cognitive vulnerability to stressors. As a result, those with post-operative delirium may experience steeper decline in cognitive performance following stressors of surgery post-KT. We leveraged a single-center cohort study of 912 adult KT recipients with delirium assessments abstracted from medical records. Global cognitive function (3MS) and executive function (time to complete TMT-B minus TMT-A) were measured at time of KT, 1-month, 3-months, 6-months, 1-year, and annually thereafter post-KT. We used mixed effects models with fixed and random effects for person and time to describe repeated measures of cognitive performance and compared trajectories by post-operative delirium. Among 912 KT recipients, 44 (4.8%) had post-operative delirium. Post-operative delirium was associated with higher levels of cognitive impairment at KT (18.2% vs 8.0%), and was associated with lower 3MS component scores including in memory, identification/association, and orientation. After adjustment, those with delirium had 3MS scores that were on average 3.6 points lower than those without delirium (95%CI: -6.9, 0.3) at time of KT; delirium was not associated with differing global cognitive trajectories post-KT (difference=0.04 points/month, 95%CI:-0.1, 0.2). However, delirium was associated with lower executive function at KT (difference=44.0s, 95%CI: 17.4, 70.6) and steeper decline in executive function post-KT (difference=-1.1s/month, 95%CI:-2.1,-0.05). KT recipients with delirium experience greater decline in executive function, indicating greater cognitive vulnerability with potential vascular etiologies. Transplant centers should be aware of the cognitive risks associated with post-KT delirium and implement available preventative interventions to reduce risk of delirium.
Balance and Reactive Steps in Older Adults With and Without Self-Reported Musculoskeletal Conditions
Authors: Delgado Ferdinand , Ananian Cheryl Der , Peterson Daniel
Published: December 2020

Older adults with musculoskeletal conditions (MSC), including arthritis and osteoporosis, may have a higher risk of falls and falls-related injuries. Differences in balance between individuals with and without self-reported MSC are not well understood. Therefore, this study compared measures of balance (static and dynamic) and reactive stepping between older adults (N=99) with (75.79±5.38 years, n=38, 82% female) and without (75.93±6.36 years, n=61, 67% female) MSC. A cross-sectional design was used. Static balance was assessed via postural sway area (PSA) and PSA root mean square (PSARMS) during quiet stance. Dynamic balance was assessed with the Timed Up & Go (TUG), a dual-task cognitive TUG (TUG-COG), and the Four Square Step Test (FSST). Reactive stepping was measured as the first step latency, length, width, time, total number of recovery steps, and time until balance recovery after a backward lean and release. Linear regression was used to assess group differences. After adjusting for age, sex, body mass index (BMI), and grip strength, there were no significant differences between groups in static balance (PSA (p=0.884); PSARMS (p=0.246)) and reactive stepping outcomes (first step latency (p=0.184); total number of steps (p=0.423); step width (p=0.964)). The other reactive step outcomes are not reported since explained variance was not statistically significant (p>0.05). With dynamic balance, significant group differences showed individuals with MSC took more time to complete TUG (p=0.011) and TUG-COG (p=0.005), but not the FSST (p=0.493). Our findings suggest improving dynamic balance, especially with a walking component, in older adults with self-reported MSC is needed.
Motor Adaptation to Cognitive Challenges and Destabilizing Treadmill Walking in Healthy Older Adults
Authors: Kao Pei-Chun , Pierro Michaela
Published: December 2020

To develop effective fall prevention intervention, it is necessary to understand how older adults respond to challenges that demand cognitive-motor dual-tasking capability, an important capability in the daily lives. The purpose of this study is to investigate how older adults adjust their motor responses when encountering cognitive and walking perturbations simultaneously. We recorded kinematic data as subjects walked on a treadmill with or without 1) continuous random-amplitude treadmill platform sways (Perturbed vs. No-perturbed walking); and 2) each of the four cognitive tasks: Paced Auditory Serial Addition test (PASAT), clock test, visual color-word incongruent test (V-stroop), and auditory pitch-word incongruent test (A-stroop). We computed dynamic margins of stability (MOS), gait variability, and short-term local divergence exponent (LDE) of the trunk motion (local stability). Data of ten older subjects (age: 72.2±4.9) show that cognitive performance did not differ between standing, Perturbed or No-perturbed walking. Subjects demonstrated significantly greater local instability and variability in step measures, joint angle and MOS during Perturbed than No-perturbed walking (p<0.001). During dual-task conditions, subjects walked with significantly larger medio-lateral MOS (MOSML) compared to walking only, especially during early phase of the trial. During Perturbed walking, subjects had significantly larger MOSML during PASAT and Vstroop than walking only. Our data showed that subjects tried to increase their dynamic MOS during Perturbed walking or a cognitive task more difficult or taxing visual attention. However, the adjustments do not sustain throughout the trial. These findings suggest older adults tend to prioritize cognitive over walking tasks even when encountering walking perturbations.
No Longer Aging in Place: Housing Decisions After 100
Authors: Bowers Susan
Published: December 2020

The number of aging individuals is growing and, along with it, a subset of the oldest-old (those over 85 years), including centenarians. Although researchers have begun identifying issues and needs related to this population (Dunkle & Jeon, 2016), still little is known about decision-making processes as they relate to housing. In rural areas, in specific, centenarians are limited by few residential choices and lack of geographic mobility. In this study, decision-making processes are examined, with an emphasis on interactions between aging individuals and their rural family caregivers. In addition, since family caregivers typically experience a pattern of burnout over time (Yilmaz, Turan & Gundogar, 2009; Yikikan, Aypak, & Görpelioğlu, 2015), a second focus of the study is caregiver stress. Data for the study are drawn from semi-structured interviews with a sample of family caregivers in the Midwest. All caregivers had a 100-plus family member recently placed, or in process of placement, at a residential long-term care facility. To meet criteria, all facilities were in towns of 4000 individuals or less. Data consisted of qualitative interviews with the primary family contact (female in all cases), and were analyzed according to Strauss & Corbin (1990). Decision-making themes centered on health and family pressure. Stress themes centered primarily around work. Data are discussed in terms of family strengths, health and wellness, and the need for continued programming for family caregivers, particularly in rural areas.
Type 2 Diabetes Reduces the Muscle Anabolic Effect of Resistance Exercise Training in Older Adults
Authors: Randolph Amanda , Moro Tatiana , Odejimi Adetutu , Rasmussen Blake , Volpi Elena
Published: December 2020

Type 2 Diabetes Mellitus (T2DM) accelerates the incidence and increases the prevalence of sarcopenia in older adults. This suggests an urgent need for identifying effective sarcopenia treatments for older adults with T2DM. It is unknown whether traditional approaches, such as progressive resistance exercise training (PRET), can effectively counteract sarcopenia in older patients with T2DM. To test the efficacy of PRET for the treatment of sarcopenia in older adults with T2DM, 30 subjects (15 T2DM and 15 age- and sex- matched controls) underwent metabolic testing with muscle biopsies before and after a 13-week full-body PRET program. Primary outcome measures included changes in appendicular lean mass, muscle strength, and mixed muscle fractional synthesis rate (FSR). Before PRET, BMI-adjusted appendicular lean mass was significantly lower in the T2DM group (0.7095±0.0381 versus 0.8151±0.0439, p<0.0001). As a result of PRET, appendicular lean mass adjusted for BMI and muscle strength increased significantly in both groups, but to a lesser extent for the T2DM group (p=0.0009) . Preliminary results for FSR (n=25) indicate that subjects with T2DM had lower basal FSR prior to PRET (p=0.0197) . Basal FSR increased significantly in the control group after PRET (p=0.0196), while it did not change in the T2DM group (p=0.3537). These results suggest that in older adults the positive effect of PRET on muscle anabolism and strength is reduced by T2DM . Thus, older adults with T2DM may require more intensive, multimodal and targeted sarcopenia treatment. Funded by NIH R01AG049611 and P30AG024832.
Compromised Vision Impairs Successful Aging Among Assisted Living Residents
Authors: Scott Judith , Mayo Ann
Published: December 2020

Community dwelling independent older adults’ successful aging is known to be hampered by sensory and cognitive impairments. However, little is known about to what degree these impairments affect successful aging among assisted living (AL) residents. The purpose of this quantitative study, conducted in three (AL) facilities, was to describe factors affecting successful aging. A total of 88 older adults (M=89.0, SD=7.54), mostly women (n=68), completed hearing (CALFRAST-Strong procedure at 75cm, 35cm, and 2cm), vision (Jaeger reading [proximate], Snellen Acuity [visual acuity]), and cognitive screening (MiniCog, Borson et al), as well as the Lawton Instrumental Activities of Daily Living (IADL) and Successful Aging Inventory (SAI, Troutman et al, 2011). Most (68%) demonstrated hearing loss >25DB, with a significant difference demonstrated between age groups (age 65-89; n=38) (90-100; n=49) with the older group demonstrating worse hearing (F(1,80)=5.9, p=.017). Some vision compromise was noted for both reading (14.3%) and visual acuity (10.8%). Over one third of participants (34.1%) demonstrated compromised cognition. The SAI results indicated most participants were managing IADLs well (M=6.11, SD=1.42) and aging successfully (M=63.39, SD=9.04). Hearing, cognition and IADLs were not significantly related to successful aging. However, when compared to those without vision issues, participants with compromised vision, both reading and visual acuity, scored significantly lower on the SAI (reading F(1,75)= 24.9,p=.000; visual acuity F(1,28)=4.31, p=000). The infrastructure provided by AL settings may compensate for hearing, cognition, and IADL problems, but not as well for vision problems. Interventions supporting AL residents’ vision should be a priority to improve successful aging.
Divides Within the LGBT Community: Exploring the Impact of Generational Stereotypes
Authors: Bryant-Lees Kinsey , Kite Mary
Published: December 2020

Age is a unique, often overlooked, aspect of identity, which is particularly problematic within the LGBT community. While sexuality, sexual orientation, and gender identity are central to the identities of LGBT people, they are verboten for older adults. Thus, older LGBT individuals’ voices are inadvertently silenced. This talk will present data that demonstrates the reinforcing role that stereotypes play in maintaining the generational divide and address some of the unique inter-generational differences within the LGBT+ community that arise from differential experiences of cultural acceptance and historical events of LGBT youth coming of age across decades. For example, in the 1970’s the DSM criteria would have classified LGBT people as mentally ill; stark contrast to the 2010’s in which LGBT youth have grown up with legal protections against hate crimes, and marriage equality as a basic right. We will conclude with a discussion on cultivating community and productive conversations across generations.
Diagnosed Opioid Use Disorder Among Older Adults: Complex Comorbidity and Management Challenges
Authors: Treitler Peter , Crystal Stephen , Hermida Richard
Published: December 2020

In the face of a widespread opioid epidemic and many policy changes affecting opioid access and management, it is important to understand the prevalence and characteristics of diagnosed opioid use disorder in older people and their implications for effective management of this high-risk population. We examined these issues in an ~40% random sample of Medicare beneficiaries with Part D coverage. In 2017, .8% of beneficiaries ages 65+ were diagnosed with OUD (opioid abuse or dependence diagnoses), an increase from .5% in 2015. The late-2015 transition from ICD-9 to ICD-10 may have contributed to this change, but the rate also increased post-ICD-10 by 9.1% from 2016-2017. The profile of individuals diagnosed with OUD reveals a population with complex comorbidity and multiple health challenges: 45% were diagnosed with major depression, 7% with alcohol disorders, 45% with anxiety, 8% with hepatitis C, 26% with cancer, 38% with COPD and 19% with pneumonia (risk factors for opioid overdose), 56% with diabetes and 27% with heart failure. 97% were diagnosed with pain conditions, 85% received opioid prescriptions, and 38% received benzodiazepine prescriptions. These patients represent complex and potentially competing challenges in concurrent management of pain, opioid use disorder, multi-substance use and opioid use disorder. Development of effective, integrated care models to simultaneously address these interrelated problems in this high-risk population should be informed by a closer focus on their multiple needs and monitoring of the adequacy of health system response.
The Utah Experience: Our Secret Sauce for Long-Term Care Nurse Residency Programs
Authors: McLeskey Nanci , Gallegos Joan , Telonidis Jacqueline
Published: December 2020

Nurses working in long-term care (LTC) have a paucity of geriatric knowledge and leadership skills. One method of meeting this challenge is by offering an online geriatric-focused nurse residency program (NRP) to LTC nurses. The goal of the NRP is to provide geriatric nursing competencies to prepare LTC nurses to care for complex older residents and lead staff. Construct measures include geriatric knowledge and skills, self-rated efficacy, and attitudes towards QI. To date, 46 nurses have enrolled in the program. Completers’ state they have increased knowledge and confidence; but turnover and workload issues often prevent nurses from completing the program. Thus, the current NRP with 6 nurse residents is streamlined to be completed in 4 months and with a focus on the 4 M’s, leadership and geriatric competencies and resilience. Future plans are for the NRP to be available for nurses from all long-term services and supports settings.
Intergenerational Homesharing: Community Cohered by Story
Authors: Wenrick Rachel , Kaschock Kirsten
Published: December 2020

Drexel’s Writers Room is a university-community literary arts program engaged in creative placemaking and art for social justice. Since 2014, our work has focused on two major themes: how we, as a community of writers ages 18-80, can create and connect through story; and how together we can address some of the changes we are seeing in the local neighborhood around Drexel’s campus. This presentation will provide an overview of how the method of co-creation, core to our program since its inception, has allowed us to develop the concept for a writers house and intergenerational homesharing network as an aging-in-place and anti-displacement strategy; build the extensive cross-sector partner network needed to implement it, and earn crucial neighborhood and institutional support. The goal is for attendees to leave with ideas for how this concept might be adapted in their own communities.
Evaluating Age-Friendly Intergenerational Classrooms: Insights From Instructors and Students
Authors: Montepare Joann
Published: December 2020

Age-friendly University (AFU) campuses are reshaping how we think about teaching and learning in higher education. In particular, intergenerational classrooms are on the rise as shifting age demographics call for institutions to create new opportunities for older learners and encourage intergenerational exchange. Age diverse classrooms have distinctive needs and dynamics that instructors, and students, will need to learn how to navigate. This presentation will describe outcomes of one AFU institution’s attempt to identify the challenges and triumphs of intergenerational classrooms through facilitated instructor and student reflections in different classrooms over the course of several semesters. Recommendations will be offered for enhancing intergenerational exchange in classrooms across disciplines, as well as evaluating attitudes, logistics, and learning outcomes. Part of a symposium sponsored by Intergenerational Learning, Research, and Community Engagement Interest Group.
Rethinking and Co-Design of Beloved Board Games for People With Mild Cognitive Impairment and Their Care Partners
Authors: Kerssens Chantal , Gandy Maribeth , Cohen Kara , Levy Laura , Janssens Cecile , Mitzner Tracy , Perkins Molly , Binford Suzette
Published: December 2020

Mild cognitive impairment (MCI) affects millions of older Americans and progression to dementia is common. Although people with MCI may experience impairments, they are often highly verbal, able, and eager to uphold beloved routines. Moreover, many seek opportunities to stay active, physically and mentally, to support their brain health. Some forms of cognitive training and social engagement potentially delay the onset and progression of disease, including dementia. This 12-month project used mixed methods to co-design and test an accessible version of well-known board games for people with MCI and a care partner without MCI. The overall goal was to foster a meaningful, joyous, social activity for players with differing capabilities using adapted game mechanics to create a compelling experience for both players. Coping strategies of care partners were studied to learn ways to foster positive interactions. Findings inform recommendations for game design and clinical interventions. Part of a symposium sponsored by Technology and Aging Interest Group.
A Novel Touch-Screen, Dual-Language Intervention Program for Older Adults
Authors: Yow W Quin , Chen Hui-Ching , Lokanathan Tharshini , Achenbach Attila , Blessing Lucienne
Published: December 2020

Although cognitive training in healthy older adults (OA) has been controversial, specific and isolated cognitive skills such as semantic memory can be improved with appropriate designs. Semantic memory has been considered as a clinical marker for cognitive decline in dementia. The current study, as part of a larger touch-screen dual-language intervention program with cognitive training tools, aims to slow down the rate of cognitive decline in OA with dementia (OwD). A set of neuropsychological tests was conducted before and after the training program. After 24 training sessions over 8-12 weeks, OwD (11 females, 1 male, mean=85.8yo) improved significantly in their verbal working memory (Rey Auditory Verbal Learning Test; RAVLT) while performance of the cognitive-healthy OA (5 females, 3 males, mean=76.3yo) remained the same post-intervention. Our findings suggest that touch-screen technology can help OwD improve their semantic memory. The strengths and limitations of our game design and intervention will be discussed. Part of a symposium sponsored by Technology and Aging Interest Group.
Community-Based Participatory Research Strategies to Collect, Analyze, and Disseminate Qualitative Data
Authors: Hanks Roma , Min Hosik , Lio Shoon , Moss Brandon , Wraight Sarah , Lewis Denise
Published: December 2020

Project 1: Community Health Advocates participated in a photovoice project that evolved into an invited installation at the Alabama Contemporary Art Center, giving statewide exposure to health issues in communities in South Alabama that had been identified as those with the highest health disparities. The context of the project was a multi-generational approach to community health advocacy. Project 2: This project focused on employing CBPR methods in Cambodian and Laotian immigrant communities in South Alabama to discover barriers to disaster preparedness, response, and recovery and to better understand the intersections of culture, spirituality, and social justice along the path to community empowerment and resiliency. Community engagement in the development of emergency plans is typically at the organization-to-organization level. This paper analyzes multi-generational, multi-disciplinary, multi-method approaches using qualitative data to build effective strategies for advocacy through community engagement in research.
Positive Role of Purpose in Life in Health Outcomes and Perspectives on Environment
Authors: Tan Shyuan Ching , Gamaldo Alyssa , Sardina Angela
Published: December 2020

Having a sense of purpose directs behaviors, hence, purpose in life (PIL) can be a useful indicator/moderator of healthy mental and physical behaviors and outcomes. As such, purpose in life, particularly in lower income older adults, might encourage meaningful engagement in activities and life that lead to positive health. Thirty-nine residents (M=68.01, SD=10.26) of affordable housing for older adults in Wilmington, NC and State College, PA were surveyed on demographics, mental health, well-being (i.e., PIL), health behaviors, and their perceptions on immediate housing and the community resources. Findings suggest that for higher educated, younger and Black older adults, PIL moderates or protects against negative mental outcomes (p<.05). For higher educated older adults, PIL moderates or encourages positive perception of job opportunities in the community (p<.05) and healthier behaviors (p<.05). More research is needed to understand how environment interacts with PIL to promote healthy behaviors and outcomes.
Neighborhood Socioeconomic Disadvantage and Health Status Among African Americans Living in Low-Income Housing
Authors: Aiken-Morgan Adrienne , McCain Dextiny , Phillips Karon , Whitfield Keith
Published: December 2020

Research has shown the importance of social determinants of health in explaining racial/ethnic disparities in many health outcomes; however, less attention has been given to within-group differences in social determinants of health among low-income African American older adults. The Physical and Cognitive Health Pilot Study (n=50) was utilized to examine associations between level of neighborhood socioeconomic disadvantage and self-reported health in African American older adults living in public housing in Durham, NC and Annapolis, MD. Results from ANOVA showed that Durham participants living in more disadvantaged neighborhoods had statistically significantly worse cardiovascular health, higher depression symptoms, worse sleep quality, and higher alcohol use (p=.05) than Annapolis participants living in a more resource-rich neighborhood. These findings suggest that among low-income African American elders, greater neighborhood/state socioeconomic disadvantage is associated with worse health status. Future research should consider neighborhood context as an essential variable when assessing health status among aging African Americans.
The Black-White Mental Health Paradox Among Older Adults: Evidence From the Health and Retirement Study
Authors: Brown Lauren
Published: December 2020

Most studies of middle-aged adults find blacks have higher levels of psychological distress compared to whites but have lower risk of common psychiatric disorders. For instance, there is evidence of lower rates of depressive and anxiety disorders among blacks relative to whites despite large disparities in stress, discrimination and physical health in midlife—commonly referred to as the black-white mental health paradox. We examine evidence of the black-white paradox in anxiety and depressive symptoms among older adults. Data come from 6,019 adults ages 52+ from the 2006 Health and Retirement Study. Unadjusted models show older blacks report more anxiety and depressive symptoms than whites. After adjusting for socioeconomic factors, everyday discrimination, chronic conditions, and chronic stress, there are no black-white differences in anxiety and depressive symptoms. Findings suggest the black-white mental health paradox only extends into older adulthood for blacks living under similar stress and health landscapes as whites.
Family Changes and China’s Elderly Support System
Authors: Hu Zhan , Shen Ke
Published: December 2020

Population aging has become the norm in China. Improving or reconstructing the elderly support system is therefore essential. While the government and institutional support has been improving and enhancing in China, family remains the most important source of elderly support for a long period in the future. Based on data from censuses and national surveys (1982-2015), we examine recent changes in household size and structure across ages from an individual life course perspective, to reveal the complexities and ambiguities behind the nationwide household change. Our findings suggest that multi-generational co-residence is a major vehicle to accommodate the needs of family members at critical stages of life. These salient features of family change in China call for new family-oriented policies, including pragmatic incentives to strengthen intergenerational solidarity, essential support for family caregivers, and diversified community services to care for frail elders.
Examining the Impact of Aging-Related Mindsets and Motivation on Activity Engagement in Older Adults
Authors: O’Brien Erica , Hess Thomas
Published: December 2020

This study examined short- and long-term patterns of engagement in health-promoting activities due to implicit beliefs about cognitive aging (mindsets) and Need for Cognition (NFC; motivation) in older adults. Prior research suggests higher NFC and growth-oriented mindsets bolster participation by enhancing perceived benefits and minimizing perceived costs of engagement. Survey responses across three bursts of an ongoing longitudinal study (N=678-725 observations) were collected from 148 people aged between 64 and 81 and subjected to three-level multi-level analyses. Results show naturally-occurring, weekly variations in NFC and mindsets that also contribute to short-term variation in activity frequency, diversity, and selectivity. Additionally, NFC and age significantly mediated and moderated the effect of mindsets on some outcomes, respectively. Initial findings highlight the value of taking a dynamic approach and using Selective Engagement Theory to understand activity maintenance. They may also inform efforts to develop interventions that promote healthful behaviors in later life.
Getting Under the Skin: The Association Between Social Isolation and Inflammatory Markers
Authors: Cudjoe Thomas K M , Latkin Carl , Roth David , Thorpe Roland , Boyd Cynthia
Published: December 2020

Social isolation is a risk factor for morbidity and mortality comparable to well-established risk factors including smoking, hypertension, and a sedentary lifestyle. Specific mechanisms that connect social isolation to important health outcomes remain unclear. We examine the cross-sectional relationship between social isolation and two biological markers: Interleukin-6 (IL-6) and C-Reactive Protein (CRP) in a nationally representative population of community dwelling older adults (IL-6: n=4336, CRP: n=4178) from the National Health Aging Trends Study in 2017. Adjusting for age, gender, race, income, tobacco use, body mass index, and multiple chronic conditions, we found that social isolation compared to no social isolation was associated with higher levels of IL-6 (p = 0.043) and CRP (p = 0.038). These results suggest that investigating inflammatory pathways between social isolation and morbidity and mortality is important.
Investigating the Longitudinal Relationship Between Subjective Cognitive Complaints and Objective Cognition
Authors: Falzarano Francesca , Siedlecki Karen , Minahan Jillian
Published: December 2020

Research examining the relationship between subjective cognitive complaints and objective cognitive performance has been mixed. Despite the lack of clear evidence demonstrating an association, subjective cognitive complaints are used as a criterion for the diagnosis of mild cognitive impairment and is considered a risk factor for Alzheimer’s disease. Cross-lagged panel analyses were used in the current study to examine the longitudinal relationships between subjective cognitive complaints (using the Memory Functioning Questionnaire) and objective cognition (e.g., reasoning, memory, spatial visualization, processing speed, and vocabulary) in healthy adults over 60 from the Virginia Cognitive Aging Project (N=441). Results indicated that objective and subjective cognition were only weakly related but that objective cognition is a stronger predictor of subjective cognitive complaints then vice versa. Although subjective cognitive complaints may be an early indicator of pathological aging, results indicate that subjective cognitive complaints may not be a valid predictor of objective cognitive decline.
Age Cohort Differences and Depressive Symptoms Among Community-Dwelling Older Americans
Authors: Cheung Ethan Siu Leung , Mui Ada
Published: December 2020

This study uses Wave 3 National Social Life, Health and Aging Project to examine the correlation between age cohorts [60s (n=1204); 70s (n=1176); 80 and older (n= 724)], cognitive status, and depression symptoms. In the total sample, 53.90% were females, 76.15% Whites, 15.29% Blacks, and 8.56% Asians. Compared to the 60s and 70s cohorts, 80+ cohort was cognitively more impaired [Mean (SD) of MoCA Short Form were 10.7(2.9), 10.0(3.2), and 8.1(3.6)]. There were no age cohorts’ differences in depressive symptoms experienced (Mean of CESD Short Form = 21.03; SD = 4.06). In order to identify predictors of depression, multiple hierarchical regressions were performed. The 60s sample was the reference group to compare with 70s and 80s cohorts. Results showed that age cohort variables had a significant independent effect as well as a joint effect with cognitive status in explaining depression scores. For each age cohort group, parallel regression analyses were conducted and all models were significant. Findings suggest that ADL impairment was the only common predictor for depressive symptoms for the three cohort groups, and the association was the strongest for the 60s cohort (b = .31). Other unique predictors for 60s cohort were lower-income, more IADLs impairment, higher stress and cognitive impairment. For the 70s cohort, unique predictors of depressive symptoms were female gender, unmarried, and less socialization. For the 80 and above group, correlates of depression are female, White, and high stress level. Findings highlight the necessity of age-sensitive programs on depression support for community-dwelling older Americans.
Forgotten Variables in Gerontological Evaluation of Religiosity and Spirituality
Authors: Firdausya Nadia , Bishop Alex , Finchum Tanya
Published: December 2020

Data for this study originated from the Oklahoma 100 Life Project. The purpose of this investigation was to explore oral history storytelling surrounding centenarian religious practices in childhood. Thematic content analysis of oral narratives revealed three prominent themes surrounding the transmission, accessibility, and socialization of religion. Reflection upon the intergenerational transmission of religion, one centenarian recounted if her mother didn’t go to church then, “the kids didn’t go.” Another centenarian noted the influence of rural opportunity structure stating, “Out there in the cotton patch, we didn’t have no church.” Finally, one centenarian participant highlighted value of social value of church during childhood by exclaiming, “We went to church all the time. . .we didn’t know what it was to stay home from church.” Findings will be used to further highlight how assessment of early life experiences is essential to gaining a fuller understanding of religiosity in human longevity.
Daily Marital Strain and Sleep in Same-Sex and Different-Sex Couples
Authors: Garcia Michael
Published: December 2020

Marital strain has consistently been linked to many indicators of daily health and well-being, including sleep. Prior studies show that, on days when marital strain is higher, women in different-sex couples experience poorer sleep outcomes. However, this work has not yet considered whether and how these relationships differ for men and women in same-sex couples. Using 10 days of dyadic diary data from 756 midlife U.S. men and women in 378 gay, lesbian, and heterosexual marriages, we examine the associations of daily marital strain with sleep quality and duration and consider whether these relationships differ across union type. Results suggest that increased marital strain is associated with poorer sleep quality and shorter sleep duration, but only for women married to men. These findings underscore the importance of including same-sex couples when exploring linkages between marital dynamics and health, especially when considering how gender impacts these processes.