bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing Sensory Impairment in the ICU: Critically Important for Improving Outcomes
Authors: Ferrante Lauren
Published: December 2020

Millions of older adults are admitted to an intensive care unit (ICU) every year. Many of these patients have preexisting impairment in hearing or vision, but sensory impairment is rarely addressed in the ICU. This talk will present recent work evaluating the association of sensory impairment with functional outcomes among older ICU patients, and discuss barriers to and potential strategies for addressing sensory impairment in the ICU.
A Smartwatch-Based Framework for Real-Time and Online Assessment and Mobility Monitoring
Authors: Karnati Yashaswi , Reddy Rohith Reddy Kessi , Thakkar Aseem , McConnell Matthew , Mendoza Tonatiuh , Mardini Mamoun , Manini Todd , Ranka Sanjay
Published: December 2020

Pervasive computing is changing the monitoring landscape for patients to communicate their healthcare information in real-time to clinicians and researchers. We developed a framework based on a smartwatch application allowing researchers to execute a study that is customized to their needs. The application is configured to collect patient generated data in remote settings from both sensor-based (location and movement) and user-reported health factors through the visual display. For example, data are used to investigate concurrent symptoms and mobility patterns in free-living conditions. To support the collection and analysis of this data in a robust and scalable fashion, we have developed an event driven, serverless computing platform using Amazon cloud services. This system also allows multiple campaigns to run concurrently each under the auspices of a different researcher. The framework is ideal for harnessing and scaling the utilization of smart wearable devices in research and clinical settings.
SmartPrompt Reminder Application Improves Everyday Task Completion and Reduces Inefficient Behaviors
Authors: Katherine Hackett , Lehman Sarah , Drivers Ross , Ambrogi Matthew , Gomes Likhon , Tan Chiu , Giovannetti Tania
Published: December 2020

The SmartPrompt phone-based reminder application was designed according to neuropsychological theory and pilot testing to facilitate everyday functioning. A laboratory-based pilot of ten participants with MCI and mild dementia showed significantly greater task completion with significantly fewer checking behaviors when using the SmartPrompt versus a control condition. Younger individuals and those who engaged in more checking behaviors completed more tasks in the control condition, but these relations were not significant when using the SmartPrompt. After 15 minutes of training, caregivers achieved near perfect scores on a SmartPrompt configuration quiz. Participant and caregiver usability ratings were strong, even though participants reported relatively low computer proficiency and neutral/unfavorable attitudes towards technology. Piloting informed modifications of the SmartPrompt to enhance personalization (e.g., customized alarms/rewards) and improved human-computer-interaction for in-home testing. Preliminary in-home test data on individually-owned smartphones and conclusions regarding barriers and facilitators to the effectiveness of the modified SmartPrompt will be discussed.
Prevalence of Multiple Sensory Deficits in Older Adults in BLSA and ARIC Studies
Authors: Armstrong Nicole , Deal Jennifer , Wang Hang , Schrack Jennifer , Tian Qu , Simonsick Eleanor , Agrawal Yuri , Lin Frank
Published: December 2020

Individual sensory deficits have been associated with adverse outcomes, including dementia, in older adults. Using data from the Baltimore Longitudinal Study of Aging (BLSA) (N=259) and Atherosclerosis Risk in Communities Study (ARIC) (N=962), we examined the prevalence of one, two, or three sensory deficits (hearing, vision, and olfaction) among older adults ≥70 years. Any hearing loss was the most prevalent sensory deficit (70-79 year-olds: 41.3% [BLSA] and 51.2% [ARIC]; ≥80 year-olds: 82.6% [BLSA] and 74.2% [ARIC]), followed by vision loss and olfactory loss. Hearing and vision impairments were more prevalent than hearing and olfactory losses as well as vision and olfactory losses in both age groups and studies There were few people with deficits in all three senses (70-79 year-olds: 3.3% [BLSA] and 2.0% [ARIC]; ≥80 year-olds: 5.8% [BLSA] and 7.4% [ARIC]). Further research should investigate the potential impact of multisensory impairments on older adults.
Vaccination to Promote Healthy Aging: The Five Ws
Authors: Friedland Leonard , Friedland Leonard
Published: December 2020

This symposium addresses the role of vaccination to promote healthy aging and the process of developing and maintaining the functional ability that enables wellbeing in older age. Adults age 65 and over are at increased risk of certain infectious diseases due to immunosenescence. Therefore, immunization of older adults against targeted infectious diseases, including pertussis, shingles, influenza, and pneumococcal disease, can help to reduce morbidity and premature mortality. Vaccines in development to protect against additional infectious diseases causing significant morbidity and mortality in older adults, such as respiratory syncytial virus, can further promote healthy aging. The population of older adults in the US is projected to grow significantly over the next 30 years, with a corresponding increase in the incidence and economic costs of vaccine-preventable diseases. Immunization of older adults is a proven, cost-effective strategy that is critical for reducing the public health impact and societal costs in an aging US population. Implementation of evidence-based recommended vaccines for older adults presents challenges, including financial barriers, addressing disparities and inequities in health care delivery for older adults, and overcoming vaccine hesitancy. We plan to review these topics and present data we have generated to support the value of vaccination in adults age 65 and over. Health Behavior Change Interest Group Sponsored Symposium.
Updates on Vision From the Global Burden of Disease Study
Authors: Adelson Jaimie , Briant Paul , Flaxman Seth , Taylor Hugh , Resnikoff Serge , Reinig Nikolas , Bourne Rupert , Vos Theo
Published: December 2020

The Global Burden of Disease study estimates the prevalence of vision loss by WHO severity group, and the distribution of vision loss due to underlying causes such as cataract, glaucoma, and uncorrected refractive error. Data sources include national and local surveys, and scientific literature, with over 500 sources in 113 countries. Cause-specific prevalence estimates were proportionally fit into estimates of total vision loss by severity. Globally, 821.9 million (95% UI=682.2–970.4) people experienced moderate or worse distance vision loss or near vision loss in 2019 (age-standardized prevalence = 0.10, UI=0.08–0.12). Of these, 41.9 million (UI=36.4–46.8) were blind. The majority of Years Lived with Disability due to vision loss occurred in people with cataract and uncorrected refractive error. Vision loss numbers will continue to increase due to aging populations. Main causes of vision loss are correctable and, therefore, should be major targets of interventions.
Is Working Longer the Solution to an Aging Society?
Authors: Moen Phyllis
Published: December 2020

Population aging, together with increases in life expectancy, women’s employment, dual-earner households, and unraveling safety nets, are transforming the demography of work and retirement in the later life course. A seemingly obvious policy solution is to encourage Boomers and those following to work longer, postponing retirementt. And yet there is insufficient understanding of factors that predict ongoing older adult participation in paid work. The simple work/retirement dichotomy no longer fits the experience of growing numbers of Americans. Drawing on census data, I show six such pathways differing by age, gender, and race/ethnicity. Needed is policy development recognizing the new realities of different and unequal pathways. The challenge is recognizing disparities in capacities and constraints among our aging population, along with the need to change the way we work, opening up flexible options in order to enable working longer.
Does Nursing Home Residents’ Right to Self-Determination Improve Their Quality of Life in South Korea?
Authors: Lee Minhong , Kim Kyeongmo , An Sok
Published: December 2020

Background and Purpose: Addressing issues of quality of life of nursing home residents based on the human rights-based approach has been a top priority in the long-term care system in Korea but no study has yet examined the relationship between self-determination of nursing home residents and their quality of life. This study aimed to examine whether greater levels of self-determination in the provision of daily care were associated with higher levels of quality of life of the residents. Methods: We collected data from 332 residents (+65) at 20 nursing homes in a metropolitan city. We measured residents’ right to self-determination using the autonomy scale of the Client-centered Care Questionnaire. We also included quality of life, socio-economic characteristics, ADLs, depressive symptoms, and social networks. We ran multiple regression analysis using SPSS 26.0. Results: The findings of this study revealed that greater levels of residents’ right to self-determination were associated with higher levels of quality of life (β =-.425, p <.0001). Older residents who were higher levels of depressive symptoms were likely to have lower levels of quality of life (β = -.265, p < .001). Conclusions and Implications: This study adds to the growing literature on the ways nursing home residents’ self-determination contributes to their quality of life. More opportunities for self-determination in their treatment should be given to promote recovery and to encourage participation in the decision-making process. Nursing practitioners and policymakers in Korea should develop programs and/or services that enhance residents’ self-determination to improve their quality of life.
GSA COVID-19 Task Force: Supporting Transitions to Online Teaching
Authors: Montepare Joann , Howe Judith
Published: December 2020

GSA COVID-19 Task Force members collaborated with AGHE to develop multiple teaching briefs and biblio briefs on various topics to support faculty who had to adjust to online teaching quickly. Task Force members will review those documents, as well as the AGHE listening session to identify where educators and students need additional support.
Development of Scales for Generative Concern and Generative Acts Among Older Singaporeans
Authors: Malhotra Rahul , Maulod Ad , Lee June May Ling , Cheng Grand Hak-Land , Lu Si Yinn , Thang Leng Leng , Chan Angelique W M
Published: December 2020

Generativity (concern in establishing and guiding the next generation) at older ages is increasingly relevant with population ageing and realization of older people as a resource for younger generations. Generativity encompasses two aspects, concern (attitudes/motivations for generativity) and acts (activities to enact/achieve generativity). Existing scales for generative concern and acts pertain to Western populations, limiting their valid measurement in Asian populations. We conducted 12 focus group discussions with 103 older adults in Singapore, to inform a conceptual model of generativity. A striking finding was the family-centric focus of generativity. It led to the development of content-validated scales for generative concern (38-items; e.g. I am concerned that younger people are too pampered) and generative acts (56-items; e.g. In past 3 months, how many times did you teach younger people right from wrong), in English, Mandarin, Malay and Tamil. Future work will establish their structural, convergent/divergent and predictive validity, and reliability.
Evaluation of an early implementation of the revised Opening Minds Through Art Program
Authors: Kelly Christopher , Holley Lyn , Fogle Stephen
Published: December 2020

The established international program Opening Minds through Art (OMA) has been revised; this presentation reports evaluation of an early implementation with Gerontology university students and Alzheimer’s nursing home patients. Ten patients were paired with student volunteers meeting once a week for eight weeks to co-create original artwork in structured one-hour sessions. Before and after art creation each volunteer recorded personal feelings and their partner’s mood and satisfaction. Findings indicate the revised program is satisfying for patients and improves their mood. Families seeing the art expressed surprise and appreciation regarding patient creative capacity. Analysis of data indicates positive outcomes for student volunteers and Alzheimer’s patients. Student volunteer reflections link program participation with expanded knowledge, insight, and especially empathy for Alzheimer’s patients and their families. The current study contributes to robust support in the literature for efficacy of arts programming for student learning and the morale of Alzheimer’s patients and their families.
It’s Late, But Everything Comes Next: Creative Aging in the Modern United States
Authors: Gleason Shayna
Published: December 2020

The emergence of “creative aging” programs, or fine arts programs exclusively for older adults, invites analysis of these new institutions and their influence on the social elements of the aging process. While past studies have demonstrated the cognitive and health-related benefits of arts participation in old age, little research has examined how participation might influence the older person’s self-esteem or perceptions of aging. The present study draws on ethnographic methods including participant observation at eight creative aging programs, six semi-structured in-depth interviews with teaching artists leading these programs, and content analysis of paintings and vignettes made by participants. The results show the observed creative aging programs to have a unique, cyclical pattern of discourse characterized alternately by older adults’ recurring self-deprecation and the affirming responses of instructors. This pattern of interaction renders such programs sites for the contestation of negative popular discourses around aging.
Pharmacological Interventions That Target Biological Aging
Authors: Kaeberlein Matt
Published: December 2020

There is a high level of interest in drugs that may delay or even reverse the functional declines and disease risks that accompany biological aging. Several interventions have been shown to improve age-related outcomes and increase lifespan in laboratory animals by targeting the hallmarks of aging. A number of these small molecules are being clinically evaluated for age-related indications, including mTOR inhibitors such as rapamycin, the anti-diabetic drug metformin, and senescent-cell clearing senolytics. Others are being marketed to consumers outside of the federal regulatory process as “anti-aging” natural products with little information about safety or efficacy. Here I will provide an overview of the current state of “anti-aging drugs” with an emphasis on potential mechanisms of action and evaluation of the existing pre-clinical and clinical data.
Immigrant Older Adults: Is Diversity a Challenge for a Global Initiative?
Authors: Toyokawa Noriko , Lou Vivian
Published: December 2020

Although the global community has discussed needs for establishing international standards of health care for immigrant older adults for decades, it is challenging for policy makers to consider international standards that could meet diverse needs for older adults from various migrant groups. The purpose of this symposium is to discuss challenges and possible strategies to develop global standards to protect immigrant older adults. There will be four presentations on the topic of various needs of older adults from different migrant groups. Noriko Toyokawa will present a study in diversity in parents’ expectations on filial piety among immigrant older adults from different racial/ethnic groups in the Southern California. Weiyu Mao and her colleagues will present their study in the perceived neighborhood cohesion as a protective factor for older Chinese immigrants’ oral health. Allen Glicksman and his colleagues will report the diversity across migrant groups and State Policies that create a challenge in using finding to establish global standards for best practices with older migrants based on a series studies on Mandarin speaking Chinese and Puerto Rican older immigrants. Finally, Mika Marumoto will suggest the ‘reframing of aging initiative’ as a possible means of leading the way of cultivating transformative solutions. Vivian Lou will comment on each presentation, discuss common themes among the presented studies, and address future research directions. With the audience, the presenters will discuss challenges in dealing with diversity issues and suggestions for a global initiative to protect human rights and health care accessibilities for immigrant older adults.
Neighborhood Cohesion, Acculturation, and Oral Health Problems Among Older Chinese American Immigrants
Authors: Mao Weiyu , Wu Bei , Chi Iris , Yang Wei , Dong XinQi
Published: December 2020

The influences of neighborhood characteristics remain understudied in relation to oral health, especially within the context of immigration. Acculturation exerts influences on the oral health of immigrants. This study investigated the relationship between neighborhood cohesion and oral health problems among older Chinese American immigrants and examined the moderating role of acculturation in such a relationship. The working sample included 3,157 older Chinese American immigrants aged 60 years or older from the baseline of the Population Study of Chinese Elderly in Chicago. Stepwise logistic regression models with interaction terms were conducted. Individuals experiencing higher levels of neighborhood cohesion reported a lower likelihood of having oral health problems. The protective effect of neighborhood cohesion against having oral health problems was stronger when individuals resided in ethnic enclaves such as Chinatown. To promote optimal oral health, interventions need to account for individuals’ perceptions and levels of integration into their neighborhoods and communities.
The Housing Experiment: Citizen Science Engaging Older Adults and School Pupils to Assess Housing Accessibility
Authors: Iwarsson Susanne , Brounéus Fredrik , mårtensson Knut , Granbom Marianne
Published: December 2020

Citizen science is gaining momentum as an approach in many scientific fields. However, it is scarcely used in aging research. Since 2009 in Sweden, Public & Science (NGO) has coordinated an annual mass-experiment where thousands of school pupils have collected data that would have been impossible for researchers to collect on their own. Designed as a cross-generational endeavour, the 2020 mass-experiment, the Housing Experiment, is based on scientific methodology for data collection on housing accessibility. The aim of this presentation is to describe the iterative development process involving older adults, stakeholders in the housing sector, teachers and pupils. We will present the app and instructions developed and piloted for data collection, as well as usability and interrater reliability results. With media attention already in the planning phases, this citizen science initiative has the potential to both generate a unique dataset and increase engagement in housing matters concerning the aging population.
Technology Use of Older Adults and Caregivers: Discoveries and Opportunities for Improvement
Authors: Sefcik Justine , Huh-Yoo Jina
Published: December 2020

Innovative technology can improve the lives of older adults, including those diagnosed with dementia, and their caregivers. Yet a lack of careful attention to preferences and needs of end-users and continuous updates to resources could leave consumers without a valuable user experience. This symposium will cover exemplar cases of innovative technologies, available resources, and current research. The first presentation will discuss virtual reality used among older adults with dementia and the opportunities to further explore it’s use as an intervention. The second presentation will share the process of seeking stakeholders’ preferences in the design specifications for a socially assistive robot and how the perspectives shaped the development of the Quori robot. The third presentation will focus on detailing the Information Quality Framework for Online Dementia Care Resources. The fourth presentation will discuss the implications of a systematic review that revealed researchers are reporting on all older adults within a category of 65 and older, thus failing to present variance among different older age cohorts. These presentations will all conclude with a discussion on opportunities for improvement in the respective areas.
Predictors of Everyday Care Preference Importance Ratings for Veterans Living in the Nursing Home Setting
Authors: Madrigal Caroline , Jiang Lan , Mills Whitney , Wu Wen-Chih , Berish Diane , Roberts Tonya , Van Haitsma Kimberly , Rudolph James
Published: December 2020

Preference-based care is required by the Centers for Medicare and Medicaid Services and is linked to improved quality of nursing home care. The federally mandated Minimum Data Set (3.0) Preference Assessment Tool (PAT) is a 16-item standardized measure used to facilitate preference-based care through rating how important residents’ daily and activity preferences are. Little work has explored how Veterans’ unique demographic backgrounds and functional/cognitive abilities may influence how they rate their preferences (compared to general nursing home residents). Therefore, the purpose of this retrospective study was to explore the relationships between Veterans’ demographic/clinical characteristics and number of preference importance ratings. Our sample (n=194,068) consisted of Veterans admitted to community nursing homes after hospitalization at a Veterans Affairs facility for heart failure between 2010-2015. We used ordinal regression to explore predictors of preference importance ratings. Veterans were, on average, 78-years-old (SD=10.42) and mostly male (95%), white (81%), married (46%), cognitively intact (74%) with extensive functional impairment (60%) and minimal depressive symptoms (74%). Veterans rated an average of 12.47 preferences as important (SD=2.86; range=0-16). Veterans living with cognitive impairment, depression, and extensive functional impairment who were not married or separated had a lower number of important preferences (all p<0.0001). Veterans that were female, under the age of 85, and any race but white had a higher number of important preferences (all p<0.0001). Discussion will include implications for planning and delivering preference-based care for Veterans as well as next steps in research and practice to better understand and fulfill Veterans’ everyday care preferences.
Psychological Sense of Community and the Use of Condoms and PrEP Among a Sample of Aging Black MSM
Authors: Brown Andre , Brennan-Ing Mark , Meanley Steven , Haberlen Sabina , Ware Deanna , Egan James , Friedman Mackey , Plankey Michael
Published: December 2020

Psychological sense of community (PSOC) in Black men who have sex with men (BMSM) may facilitate condom and pre-exposure prophylaxis (PrEP) use to prevent HIV transmission. Understanding BMSM’s PSOC contribution to HIV risk reduction may inform HIV prevention efforts for this population, that is disproportionately affected by HIV. Adjusted for sociodemographic characteristics and HIV status, we conducted logistic regressions to test the association between PSOC and condom use among aging BMSM (n=176). Multivariate analyses exhibited no association between PSOC and condom use (AOR= 0.994, 95% CI= 0.942, 1.049). HIV+ participants had higher condom use odds compared to HIV- participants (AOR= 4.031, 95% CI= 1.723, 9.426). A sub-analysis of HIV- participants (n=61), showed no associated between PSOC and PrEP use (AOR= 1.002, 95% CI= 0.904, 1.112). These results have implications for secondary HIV prevention and future research on alternative aspects of social support that may increase BMSM’s HIV risk reduction behaviors.
Self-Perception of Aging and Frailty Phenotype Among HIV+ and HIV- Older Men
Authors: Plankey Michael , Nieves-Lugo Karen , Ware Deanna , Haberlen Sabina , Althoff Keri , Egan James , Brown Andre , Friedman Mackey
Published: December 2020

Self-perception of aging is an important predictor of health. We examined the relationship of self-perception of aging (age discrepancy and aging satisfaction) with frailty phenotype between HIV+ and HIV- men in the Multicenter AIDS Cohort Study. 499 HIV+ and 549 HIV- men were included in the analytic sample (median age 61 years IQR 56-66 years). Frailty status was based on the Fried frailty phenotype and measured at semi-annual study visits beginning 3/2015 or 9/2015, 3/2016 and 3/2019. Baseline frailty was: HIV- 8.9%; HIV+ 13.9%. Low aging satisfaction and feeling older was positively associated with remaining frail (ORs: 6.64;95%CI:3.88-11.38; 5.68; 95%CI:3.06-10.56) or transitioning between non-frail and frail states (ORs: 2.72;95%CI:1.56-4.74; 2.50; 95%CI:1.11-5.64),), over a 3-year period. There was no statistically significant difference by HIV status. Assessment of self-perception of aging may be useful in the setting of frailty evaluation among HIV+ and HIV- men.
Theorizing Cultural and Social Intersections of Age and Gender: The Approach of Anocriticism
Authors: Maierhofer Roberta
Published: December 2020

This contribution discusses empirical applications of the approach of ‘anocriticism’ in interdisciplinary gerontological research. Despite the connection in terms of epistemology and ontology, the intersection of gender and age has been mostly ignored, privileging works focusing either on age or gender (Calasanti & Slevin 2001:27; Denninger & Schütze 2017:7). Age/ing Studies, however, would not have been established as a field without the theoretical and methodological approaches of feminist theory (Maierhofer (2019:2). Anocriticism was originally developed in order to investigate cultural representations of age/ing (Maierhofer 2003, 2004b, 2004a, 2007, 2012), but has recently been taken up in social sciences (Ratzenböck 2016a, 2016b, 2017a, 2017b; Gales and Loos 2020, forthcoming) in order to draw attention to four dimensions: (a) age and aging’s collective cultural construction and relation to gender, (b) the individual dimension of aging, (c) people’s interpretative power and narrative performance, and (d) age/ing’s potential for resistance and change.
Implications and Recommendations for Research, Education, and Practice
Authors: Bettger Janet , Hughes Susan , Raj Mina , Hughes Jaime
Published: December 2020

Throughout this symposium, we have advocated for increased attention to how the chronicity and complexity of older adults’ health might impact their ability to maintain health behaviors over time. This final presentation will explore some implications of this chronicity and complexity on research study designs, formal education and professional training, and routine clinical practice. For example, existing research designs and funding mechanisms such as tightly controlled randomized controlled trials within a five-year grant may not permit researchers to study behaviors over an extended period of time and to do so within the real-world environments and social contexts in which older adults live. In contrast, integrating principles of community-engaged and participatory research, adaptive designs, pragmatic trials, and implementation science may encourage researchers to design for widespread dissemination. This session will close with recommendations to enhance educational initiatives and professional development to promote cross-disciplinary teams.
How to Get a Grant From the National Institute on Aging
Authors: Santora Kenneth
Published: December 2020

Dr. Santora will provide an overview of grant mechanisms available at the National Institute on Aging, with an emphasis on mechanisms of value to early career researchers.
Conceptualizing Resilience: Impacts of Adverse Stressor Severity, Chronicity, and Relevance
Authors: Griswold Michael , Windham B Gwen , Henegan James , Bandeen-Roche Karen , Mcmullan Matthew , Kucharska-Newton Anna , Palta Priya , Mosley Thomas
Published: December 2020

Guidance on frameworks for physical resilience, resistance and reserve are underdeveloped. We examined different “physical resilience” characterizations within n=6,538 Atherosclerosis Risk in Communities Study participants (median age: 75 years), followed for 5+ years. Fifteen illustrative clinical, lifestyle and social stressors, each having varying levels of severity, chronicity and relevance, were paired with six functional outcome measure trajectories. Contrasts were made against four fundamental comparator groups (including those without stressors). Particular pairings of stressors and functional measures substantially impacted resilience classifications and related determinants. For example, 5-year recurring robustness (0/5 frailty indicators) was only 12% for participants after Heart Failure (HF), versus 47% with no HF event; relative-risk: RR=0.26 (95%CI: 0.15,0.44). Conversely, recurring robustness was 43% after reporting low social support versus 51% with adequate support; RR=0.87(0.73,1.02). We highlight major components that impacted resilience determinations and outline a broad conceptual framework to help optimize physical resilience assessment and aid future research. Part of a symposium sponsored by Epidemiology of Aging Interest Group.
Future Caregiving Scenarios: Effects of Technology Innovation and Adoption
Authors: Rudnik John , D’Ambrosio Lisa , Lee Chaiwoo , Coughlin Joseph
Published: December 2020

Based on the expert panel’s response to the first round of the study, four scenarios that describe possible futures for the intersection of caregiving and technology were created. These scenarios differ along two dimensions – focus of technology deployment and adoption promotion – along which stakeholders’ decisions make a crucial difference for outcomes. These four scenarios describing possibilities for the year 2030 will be illustrated during this presentation, along with results from the second round of the study, which include the expert panel’s evaluations of their likelihood and impacts on caregiving.
Using Technologies to Address Caregiving Challenges
Authors: Lee Chaiwoo , Rudnik John , Coughlin Joseph
Published: December 2020

As the caregiver ratio declines, technology will play an increasingly important role in supporting formal and informal caregivers. This presentation will report on the particular effects that frontier technologies may have on various tasks associated with caregiving, including assisting with basic Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The expert panel predicted that different technologies and new products will have varied effects on caregiving tasks, and that some tasks may be more impacted than others. Some of the key opportunities and barriers to integrating technologies into various tasks of caregiving will be discussed.
Patient Risk Factor Profiles Associated With Timing of Goals-of-Care Consultation Before Death
Authors: Starr Lauren , Ulrich Connie , Junker Paul , Huang Liming , O’Connor Nina , Meghani Salimah
Published: December 2020

Early palliative care consultation to discuss goals-of-care (“PCC”) benefits seriously ill patients. To identify risk factor profiles associated with inpatient PCC timing before death, we conducted a secondary analysis of seriously ill adults who had PCC at a high-acuity hospital and died 2014-2016. Of 1,141 patients, 54% had PCC “close to death” (0-14 days before death); 26% had PCC 15-60 days before death; 21% had PCC >60 days before death (median 13 days). Classification and Regression Tree modeling showed Hispanic or “Other” race/ethnicity intensive care patients with extreme illness severity (85%) were most likely to have PCC close to death, with age <46 or >75 increasing probability (98%). Among age groups, the highest proportion of patients with PCC close to death was >75 years. Complex variable interactions associated with PCC timing suggests we need a systematic process for initiating PCC earlier and effective primary palliative training for providers across settings.
Socioeconomic Status, Health Behaviors, and Oral Health of Older Adults In China
Authors: Pei Yaolin , Chen Xi , Saunders Michele
Published: December 2020

Many Chinese older adults suffer from oral health diseases and problems due to low oral health literacy, limited dental coverage and lack of dental care services for this segment of the population in China. However, so few studies have been conducted to examine social and behavior factors related to oral health among Chinese older adults. This symposium examines how socioeconomic status (SES) and health behaviors are associated with oral health among Chinese older adults. The first paper used the Nanjing Centenarians Study to examine the association between health behaviors and oral health among Chinese centenarians. The results showed that health behaviors were associated with self-rated oral health and edentulism. Using the Chinese Longitudinal Healthy Longevity Survey, the second one employed an ‘after death’ approach to examine risk factors for orofacial pain symptoms at the end of life among Chinese older adults. The third paper investigated the association between SES and tooth loss among middle-aged and older adults in ten cities of China. SES played a stronger role in tooth retention for non-migrants and migrants with high education vs those migrants with low education. The last paper examined the association between health behaviors and retention of teeth among Chinese older adults using data from the Chinese 4th National Oral health Survey. This symposium provides empirical evidence on the current status of oral health and health behaviors at the national level, and also suggests that is critical to improve oral health education and access to dental care.
Best Practices in Museum Programming for People With Dementia and Their Care Partners
Authors: Halpin-Healy Carolyn , Noble James
Published: December 2020

As more people are living longer with dementia, museums can play an important public health role to support individuals, families, and communities. Arts & Minds programs for people with dementia and their care partners are designed according to principles of person-centered care and adult learning theory. The approach builds on research and evaluation to provide contact with art, which has been shown to reduce apathy and soothe agitation in persons with dementia and also to reduce caregiver stress. According to our observation- and feedback-based assessments of more than 500 program participants over the past 10 years, the processes of collective looking and art making specifically address symptoms of dementia and support human dignity. This presentation addresses the growing research base on the benefits of museum programming, and the ways in which research and evaluation support best practices in museum education to address the challenge of living well with dementia.
I’m Completely Satisfied But…: Barriers and Facilitators to Fulfilling Nursing Home Residents’ Preferences
Authors: Madrigal Caroline , Behrens Liza , Burshnic Vanessa , Murpy Julie , Abbott Katherine , Van Haitsma Kimberly
Published: December 2020

The US federal government mandates nursing homes (NHs) provide preference-based, person-centered care for residents. Yet only 2% of NHs successfully implement person-centered care. The Care Preference Assessment of Satisfaction (ComPASS) is a 16-item tool that facilitates residents’ preference fulfillment (i.e., satisfaction with quality of daily care and activities). This study examines barriers/facilitators to preference fulfillment from the perspective of residents who completed ComPASS. Secondary data analysis from an R21 (NR011334-01) provided qualitative data from 196 residents across 28 NHs on why residents were satisfied (or not) with the fulfillment of their individual preferences. Most residents were female (70.4%) and white (80.1%) with a range of cognitive/physical abilities. Content analysis revealed six thematic codes classifying barriers/facilitators to preference fulfillment: resident agency, values, and physical characteristics; social support systems; staff competence; communication success; built environment; access to resources. Discussion will include implications for ameliorating barriers to preference fulfillment while meeting government mandates. Part of a symposium sponsored by the Research in Quality of Care Interest Group.
Facts and Fictions: Rethinking Vulnerability and Resistance in Late-Life Narratives and Why Age Matters
Authors: Kriebernegg Ulla , de Medeiros Kate
Published: December 2020

Narrative gerontology examines the experience of aging through life stories and other first-person accounts. Literary gerontology explores cultural narratives (e.g., novels, films) that link us to our own aging through stories of others, real or imagined. Our paper focuses on narrative constructions of vulnerability, resistance, subjectivity and agency in life stories, interviews and fictional texts (e.g., Margaret Atwood’s short story “Torching the Dusties.”) It considers how aspects of vulnerability are embedded in stories and what they reveal about the cultural construction of age and aging or what makes us vulnerable as we age. Overall, our paper highlights the socio-cultural construction of vulnerability in narratives related to age and aging, focusing on the representation of vulnerability as a form of resistance and position of strength.
Toward a Greater Contextualization of Music and the Arts in Aging and Cognitive Disorders
Authors: Lee Sophie , Moss Hilary , O’Neill Desmond
Published: December 2020

Research suggests that group music-making can improve well-being and cognitive function in people with dementia and their family carers. The importance of the music facilitator’s role is recognised. However, empirical studies rarely capture their experiences and perspectives. Semi-structured interviews were conducted with three music therapists and three community musicians with specialisms in dementia care. The interviews sought to gain a detailed understanding of their work with people with dementia. Interpretative Phenomenological Analysis revealed eight super-ordinate themes: (1) benefits of music-making for people with dementia; (2) challenges of working with people with dementia; (3) involving family carers; (4) musical content; (5) impact of the facilitator; (6) developing field of Arts and Health; (7) work as a privilege; and (8) potential for misuse of music. This study provides a useful basis from which to further develop concepts for the amelioration of people living with dementia and their families.
Diet Composition, Adherence to Calorie Restriction, and Cardiometabolic Disease Risk Modification
Authors: Das Sai Krupa , Senior Alistair , Silver Rachel , Gilhooly Cheryl , Couteur David Le
Published: December 2020

Calorie restriction (CR) is a promising strategy to attenuate age-related disease risk. Higher protein diets enhance satiety but may also impair metabolic health and accelerate aging. The effect of higher protein intake on adherence to CR and cardiometabolic markers of healthspan remains unknown. We used the Geometric Framework for Nutrition to examine the association between diet composition and 1) CR adherence; and 2) cardiometabolic risk factors during a 2-year intervention. The CR group consumed higher percentage energy from protein and lower fat at 12 months compared to baseline (logit % protein=0.1; 95% CI=0.05, 0.15; logit % fat= -0.12; CI=-0.29, -0.18). Higher protein intake over the 2-year intervention was associated with higher adherence to CR. No effect of diet composition on cardiometabolic risk factors was observed. These findings suggest that dietary protein plays a critical role in adherence to CR with no adverse effects on cardiometabolic markers of healthspan. Part of a symposium sponsored by the Nutrition Interest Group.
Ageism and People With Early-Onset Disability
Authors: Heyn Patricia
Published: December 2020

People with disabilities are underrepresented in health research and usually they are explicitly excluded from research participation. There are no longitudinal studies that follows cohorts with disabilities to learn about their healthspan and aging processes. Thus, we know very little about how people with early onset disability age, and the medical conditions and health risk factors contributing to the “accelerated aging” phenomena commonly observed in this population. Our research group has been following a cohort group of individuals with pediatric onset disability since 2013. We collected pediatric and adult data from 70 persons with cerebral palsy and we evaluated key health outcomes as well as their access to care. In this session, we will present some of the key findings from our longitudinal study. We will discuss future research and key areas that needs to be addressed for us to properly move forward this urgent unmet area of aging research.
Critical Intersectionality, Ageism, and Intergenerational Supports Foregrounding Black SGL and Gay Older Men
Authors: Perone Angela , Reed Beth Glover , Ross Danae
Published: December 2020

Using critical intersectionality frameworks, this project foregrounds how Black same-gender-loving (SGL), gay, and bisexual older men navigate complexities of interacting positionalities (e.g. race, gender, sexual orientation, HIV-status, and class). This study employs and further develops intracategorical and intercategorical analytic methods with data from eight focus groups, conducted as part of a larger collaborative project in Detroit. Data from two intragroup focus groups with Black same-gender-loving older men and six subsequent intergroup focus groups with Black and white lesbian, gay, bisexual, SGL, and queer participants of various ages revealed concerns and responses to barriers and facilitators for intergenerational support and intergenerational transfer of knowledge. Building on intersectionality frameworks of power, this research provides new insights from a vastly underrepresented and understudied community about how shifting contexts shape how experiences of oppression like racism, ageism, and homophobia interact and reveal potential opportunities for intergenerational supports moving forward.
HIV and Aging: Tracking the Epidemic Via the 30-year History of GSA’s HIV Interest Group
Authors: Emlet Charles
Published: December 2020

The HIV and Aging Interest Group at GSA begin30 years ago. At that time, Highly Active Antiretroviral Treatments (HAART) did not exist. The Ryan White CARE act was newly enacted and older adults living with HIV/AIDS were primarily infected in later life. HIV was considered a life threatening disease. This Interest Group‘s existence has paralleled the epidemic including its challenges, innovations and rewards. The number of sessions focusing on HIV and aging has grown at GSA, with shifting emphasis toward longevity, quality of life and comorbidity. This symposium, celebrating the theme of “Turning75: Why age Matters” calls upon past and current IG conveners, including the founding convener, to review the history of the HIV and Aging interest group. Tepper discusses the group’s origins and the historical context of HIV as an emerging issue for older people. Emlet will discuss the changes in HIV care and treatment during the early2000s and how these advances were reflected in the interest group and GSA sessions. Brennan-Ing reviews significant changes between2012 through2015, when the proportion of older adults with HIV was projected to surpass50%, and the NIH Office of AIDS Working Group on HIV and Aging published its first set of recommendations. Finally, Taylor and colleagues brings us to the IG’s current activities including the importance of HIV Cohort studies and national policy highlights such as the National HIV/AIDS and Aging Awareness Day. The symposium provides a thoughtful account of the importance of this interest group. HIV, AIDS and Older Adults Interest Group Sponsored Symposium.
Traumatic Brain Injury and Dementia in Medicare Population: Differences in Risk Between Veterans and Non-Veterans
Authors: Yashkin Arseniy
Published: December 2020

The aim of this study was to assess differences in the effect of traumatic brain injury (TBI) on the onset of Alzheimer’s disease (AD) and other dementias between veteran and non-veteran respondents of the Health and Retirement Study as well as to measure the sensitivity of these differences to the introduction of controls for groups of demographic, medical co-morbidity and polygenic risk scores reflecting AD hallmarks. Using the Fine-Gray proportional hazards model we found that TBI was a strong predictor of dementia in community dwelling residents age 65+: for AD associated risk was 181% [Hazard Ratio (HR): 2.81; CI:2.05-3.86] sample-wide and 142% [HR: 2.42; CI:1.31-2.46] in veteran males. Effect magnitude decreased with the addition of risk-related control variables but remained associated with significantly increased risk. Large differences in risk were observed between veteran and non-veteran males for AD, vascular dementia, senile dementia, and dementia with Lewy Bodies
Policy Series: Interdisciplinary Public Policy Discussion
Authors: Lindberg Brian , Harootyan Linda
Published: December 2020

Aging and health care public policy in Washington can be driven and influenced by the work of GSA researchers, educators, and practitioners from across the nation. This session will examine and explore public policy priorities from an interdisciplinary perspective and consider opportunities for communicating these policies with key policymakers. This session is an interdisciplinary look at policy issues in aging with the speakers representing views from the six sections of GSA. This session, organized by the GSA Public Policy Committee, will provide both GSA section leadership and attendees an opportunity to have an open dialogue on important public policy issues of significance in the field of aging. The session discussant will help to facilitate a robust discussion of the presentations by speakers. Organized by the GSA Public Policy Committee, this dialogue will benefit the work of the Committee in 2021.