bluuebunny/crossref_metadata_2025 huggingface dataset:
THRIVING OR SURVIVING? FACTORS ASSOCIATED WITH NURSING HOME SOCIAL SERVICE DIRECTORS REPORTING THRIVING AT WORK
Authors: Kusmaul Nancy , Bern-Klug Mercedes , Smith Kevin , Cheek Dana
Published: December 2022

Nursing homes (NHs) provide care to medically complex residents. Social services (SS) are primarily responsible for addressing residents’ psychosocial needs. High staff turnover in nursing homes is a significant problem. When SS staff leave, training and experience goes with them. Much research has explored nursing staff turnover, far less about SS staff turnover. Social service workers who are thriving are more focused, innovative, and engaged. This study explored characteristics contributing to NH SS directors reporting thriving at work. We surveyed 924 NH SS directors from randomly selected nursing homes. Guided by Spreitzer’s model, a hierarchical logistic regression was conducted utilizing unit contextual factors and individual agentic behaviors to examine likelihood of thriving. Unit contextual factors, i.e. being valued, feeling influence, and the NH providing quality care had the greatest influence on SS directors reporting thriving at work. These results suggest great potential for NHs to foster thriving in SS directors.
POINT-OF-CARE TESTING FOR THE FRAILTY PHENOTYPE PREDICTS POSTSURGICAL OUTCOMES
Authors: Mardini Mamoun , Kaufmann Christopher
Published: December 2022

Frailty is a cornerstone in geriatric medicine and is known to be strongly associated with poor postsurgical outcomes. Fried and colleagues defined frailty as a syndrome with five interlinked components, including weakness, low energy, slow walking speed, decreased physical activity, and unintentional weight loss. Consequently, frailty could serve as a useful measure for the purposes of pre-probability risk assessment for clinical outcomes after a surgery. Electronic health records (EHR) are a rich source of information, and when harnessed appropriately, could provide a valid presurgical frailty screening metric and be used towards anticipating adverse postsurgical outcomes. The growing adoption of EHR in clinical settings can help in identifying patients in need of enhanced intervention to promote recovery following a surgery. However, to date, few studies have fully characterized how individual frailty components, as assessed in the clinic, could be a predictor of postsurgical outcomes. This symposium will examine how presence of frailty and its individual components predict three postsurgical clinical outcomes: length of stay, 30-day mortality, and discharge disposition. We will present data from a unique dataset of approximately 14,000 patients who underwent frailty assessment at the University of Florida-Health (UFHealth) presurgical clinic as part of their standard clinical evaluation. Our presentations will examine each frailty syndromic components and overall frailty as predictors of the outcomes of interest. Findings will demonstrate the utility of electronic health records data for the allocation of at-risk patients for poor postsurgical outcomes. Funding: UF Claude D. Pepper Older Americans Independence Center P30AG028740 and R01 AG055337.
THE MEANING OF FAMILYHOOD FOR GRAY DIVORCE IN ISRAEL
Authors: Koren Chaya , Cohen Yafit , Demeter Naor , Egert Michal
Published: December 2022

Israel is a society that values familyhood alongside self-determination. Gray divorce rates in Israel are low, yet they have nearly doubled since 1996 from 2% to 3.65%. Little is known about grey divorce in modern societies and even less in societies located between tradition and modernity such as Israel. Deriving from data analysis, our aim is to present the meaning of familyhood for gray divorce in Israel from the experiences of individuals and couples who divorced at age 60+ and their adult children, using a life course perspective. 72 in-depth qualitative interviews were audio recorded and transcribed verbatim with divorced men, women, and their adult children, analyzed as individuals, dyads, and family units based on principles of dyadic interview analysis. Findings include three themes: (a) The value of familyhood as a divorce delay. (b) Between couplehood dissolution and familyhood preservation. (c) Gray divorce shaping a new familyhood. Implications are discussed.
A BIOPSYCHOSOCIAL-ECOLOGICAL, FAMILY-FRAMED APPROACH TO DEMENTIA CARE
Authors: Podgorski Carol
Published: December 2022

An individual’s experience of cognitive impairment is shaped by biopsychosocial factors, including their own perceptions of illness as well as interactions with family members, healthcare providers, and the communities in which they live. With advancing illness an individual’s dementia care requires the involvement and commitment of others, usually family. Hence, the quality of a person’s illness experience is shaped largely by relationships with family members and others throughout their respective communities. Current models of dementia care recognize family members as an important part of the care team, but fail to consider a patient’s family system and relationships as social determinants that affect care outcomes. This presentation will introduce a biopsychosocial-ecological, family-framed approach to dementia care that addresses factors that influence care considerations at both the individual and relational levels of the social ecological networks that the patient and their family members occupy.
USE OF TECHNOLOGY TO DELIVER AND MONITOR NONPHARMACOLOGICAL INTERVENTION FOR ADRD WITH BEHAVIORAL SYMPTOMS
Authors: Rhodus Elizabeth , George Rosmy , Kryscio Richard , Barber Justin , Gibson Allison , Wilcock Donna , Jicha Gregory
Published: December 2022

Onset of the COVID-19 pandemic created numerous barriers to providing care supports and clinical research for persons living with Alzheimer’s disease and related dementias (ADRD). Technology offered one avenue for continued care support and clinical data collection. This study reports on the use of technology to deliver a 6-week, non-pharmacological care intervention directed toward caregivers of persons with ADRD and remote data collection including cognitive assessment, biometric data, and survey data for community-residing persons with ADRD and behavioral symptoms (N=28). Benefits and challenges of such technology use for intervention delivery and data collection will be discussed. Benefits include increased geographical outreach, no travel time, and greater scheduling flexibility. Challenges include access to technology (equipment and/or internet), internet connection quality, ease of use, and equipment return at study completion. These findings offer specific aspects to consider while designing and implementing remote care programming and clinical research for community-residing persons with ADRD.
APS PERSPECTIVES ON CHALLENGES AND STRATEGIES SERVING CLIENTS DURING THE COVID-19 PANDEMIC SURGE
Authors: Elman Alyssa , Gottesman Elaine , Makaroun Lena , Chang E-Shien , Clark Sunday , Rosen Tony
Published: December 2022

The initial surge of the COVID-19 pandemic and public health measures in response dramatically impacted Adult Protective Services’ (APS) ability to conduct investigations and provide services, requiring agencies to quickly adapt. Our goal was to describe challenges for APS and strategies they developed to respond. We conducted 6 focus groups and 7 interviews during March-April 2021 used a semi-structured topic guide, with 31 participants from APS leadership, supervisors, and case workers in New York City, a community hard hit by the initial COVID surge. Focus groups and interviews were recorded and transcribed, with data analyzed to identify themes. Participants identified 9 major challenges, including: clients using concern about COVID-19 to refuse APS workers’ access to their home, necessity to perform home visits/wellness checks on behalf of other agencies who had suspended home visits, and dependence on in-office activities including receiving paper mail. Participants reported 30 formal and informal strategies adopted to address challenges. These included 13 focusing on maximizing client engagement while maintaining client and APS worker safety, such as: adding a pre-investigation before a home visit to assess COVID-19 risk/exposure, offering clients masks and hand sanitizer to build trust, and close collaboration with other agencies/programs including joint visits. Also, 17 strategies were reported to allow for remote work and support staff, including: modifying processes to replace paper mail with electronic communication/processing, offering counseling services, formally recognizing excellent performance, and leadership reaching out personally to check on staff members. These findings may inform APS planning for future large-scale societal disruptions.
SELF-NEGLECT OF OLDER ADULTS: HOW CAN ADULT PROTECTIVE SERVICES HELP?
Authors: Liu Pi-Ju , Hass Zach , Stratton Sara , Conrad Karen , Conrad Ken
Published: December 2022

Adult Protective Services (APS) is the only government agency dedicated to investigating elder mistreatment. This frontline agency also provides and coordinates needed services to its clients, but their service effectiveness has not been extensively investigated. Over half of all APS cases investigated are self-neglect. Although no universal definition of self-neglect exists in the literature, self-neglecting older adults fail to perform self-care tasks, such as getting adequate nutrition, maintaining personal hygiene, obtaining medical care, protecting oneself from danger, managing one’s finances– all of which may threaten their health or safety. In partnership with San Francisco and Napa APS, levels of self-neglect were measured using the Elder Self-Neglect Assessment Short-Form during case investigation (before APS interventions) and at case closure (after APS interventions). Services accepted and received by clients at case closure were also documented. A total of 634 older adults’ (on average 77 years old; 50% females) were found to be self-neglecting during the six-month pilot demonstration. Overall, levels of self-neglect decreased after APS interventions (t=-16.97, p<.001). Most common services included care/case management (7%) and mental health services (12%). Services associated with decreased levels of self-neglect included in-home assistance services (b=-1.14, p<.05) and care/case management (b=-0.79, p<.10). Using standardized measures before and after implementing the services needed by older adults allows identification of services that decrease mistreatment. In this study, standardized assessment by APS impacted both practice and research to help advance the understanding of this elder mistreatment type.
AGE GROUP DIFFERENCES IN VIEWS ON ONE’S OWN OLDER ADULTHOOD
Authors: Turner Shelbie , Jarrott Shannon , Hooker Karen
Published: December 2022

Most of the current scholarship on views on one’s aging focuses on middle and older adulthood, prompting lifespan theorists to call for studies about views on one’s aging throughout the entire lifespan (Kornadt et al., 2020). In this study, we established a factor structure to Kornadt et al.’s (2020) Domain Specific Future Selves Scale, which prompted respondents to rate their thoughts on their self in old age across 9 different items. We then utilized measurement invariance testing to analyze how the factor structure differed between 433 young (18-39), 485 middle-aged (40-64), and 286 older adults (65 and older). Via Exploratory and Confirmatory Factor Analyses, three latent factors emerged, constituting future older selves in the domain of social lives (a=0.78), work and finances (a=0.62), and physical health (a=0.76). The model maintained configural (RMSEA = 0.06, CFI = .96; TLI = .95), metric (RMSEA = 0.06, CFI = .97; TLI = .96), and scalar (RMSEA = 0.06; CFI = .96; TLI = .95) invariance across all three age groups. Latent mean testing revealed that older adults thought more positively about their future social lives (p=0.005), work and finances (p=0.05), and health (p=0.02) than did younger adults, and more positively about their social lives (p=0.001) and health (p=0.05) than middle-aged adults. Results from this study offer additional psychometric validation of a measure of future selves that researchers can use across the lifespan, and deeper theoretical understanding of how domain-specific views on one’s own older adulthood might differ between age groups.
LIPID REGULATION BY DGA1, CUT6, AND SRE1 CONTRIBUTE TO THE GENOTOXIC STRESS RESPONSE IN FISSION YEAST
Authors: Escorcia Wilber , Dominguez Mauricio , Khzyr Maryam , Burek Sam , Pluth Jack , Graber Meghan , Barta Hayley , Rausenberger Alex
Published: December 2022

Lipids are essential for cell growth and maintenance, intracellular signaling, and cellular energetics. When exposed to environmental insults, cells activate lipid metabolism programs that facilitate the response, recovery, and exit from stressful conditions. Failure to regulate lipid storage and utilization is associated with accelerated aging, which compounds genomic instability. In this study, we test the physiological consequences of disruptions to three lipid regulator genes frequently found to be mutated in human cancers. Since the products of these genes show functional homology in fission yeast, we examine how lipid deregulation by two enzymes (Dga1DGAT2 and Cut6ACC) and one transcription factor (Sre1SREBF1) influence the response to genotoxic stress in this organism. Using microscopy quantification of lipid staining, we observe abnormal homeostatic control of lipid levels in cells lacking Dga1, Cut6, and Sre1. These phenotypes are enhanced in sub-lethal doses of DNA damage (UV-C light) and are associated with altered cell fitness and proliferation. Furthermore, in response to genotoxicity, these lipid regulator mutants exhibit disrupted nuclear segregation, abnormal cell dimensions, and altered lifespan. These data suggest functional mechanisms that may contribute to the deregulated metabolic and physiological environments of prematurely aged cells and of tumors in human cancers.
CLARIFYING THE ROLE OF RESILIENCE IN NONHUMAN PRIMATE AGING USING A BABOON CELL MODEL
Authors: Adekunbi Daniel , Li Cun , Nathanielsz Peter , Salmon Adam
Published: December 2022

Aging is associated with defects in homeostatic maintenance. Delineating the dynamics of the homeostatic network is challenging in vivo and often limited by endpoint measurements. However, we have developed carefully controlled translatable cellular models to bridge some of these challenges using primary cells obtained from male and female baboons across the life course (4 to 21 years). We recently published findings showing that donor age corresponds to loss of cellular resilience to oxidative stress in males but not in females. Responses to thapsigargin-induced endoplasmic reticulum (ER) stress were also age and sex dependent, though with different pattern than that of oxidative challenge. Young females alone were vulnerable to ER stress, while young males and old females were not affected. These data highlight that primary cells retain donor characteristics regarding molecular mechanisms associated with aging including those dependent on sex. To further investigate these mechanisms, we investigated whether the proteostatic machinery contributes to cellular resilience outcome following ER stress. In female donors, we find significant decrease in 20 S proteasome activity and expression of its catalytic subunit (PSMB 8) in female-derived fibroblasts under basal or ER stress conditions when compared to males. ER oxidoreductin 1 (ERO1) as well as autophagy marker, LC3-II/I ratio, were significantly higher in young females compared to young males during ER stress. These data highlight the propagation of sexual dimorphisms in cellular resilience at the molecular level and suggest that sex differences in maintenance of proteostasis contributes to the vulnerability of young females to ER stress.
CHANGING TALK (CHAT) ONLINE COMMUNICATION EDUCATION FOR ADULT DAY CARE STAFF: EVALUATION AND FUTURE DIRECTIONS
Authors: Williams Kristine , Coleman Carissa , Hein Maria , Shaw Clarissa , Perkhounkova Yelena , Beachy Tim
Published: December 2022

Communication education has been effective in reducing elderspeak use for nursing home staff and subsequently reduces resistiveness to care and inappropriate antipsychotic medication use in residents living with dementia. Communication is fundamental for dementia care and educating staff in other long-term service and support settings such as Adult Day Care (ADC) is needed. Tailoring education to the specific setting is indicated to optimize acceptability and effectiveness. ADC staff (N=22) from 3 ADC centers participated in the Changing Talk: Online Training (CHATO). Results for the 19 staff who completed the education program were analyzed. A focus group was conducted with a subset of participants to evaluate feasibility, applicability, and directions for tailoring for ADC settings. Knowledge gain was demonstrated by score increases 15.0 percentage points (p<.001) from pre- to post-education on the Changing Talk Scale (CHATS). Confidence in Dementia Care (CODE) scores significantly increased after CHATO (p=.05), indicating an increase in confidence in caring for clients with dementia. The mean Modified Diffusion of Innovation scale score was 2.2 (1=intend to use skills in practice to 5=don’t intend to use), indicating intent to use with clients. Program evaluation ratings were positive indicating satisfaction. Focus group participants reported that the CHATO was valuable and recommended ADC specific scenarios. The results support the value of CHATO for ADC staff as well as specific directions to better tailor the education to increase applicability in this LTSS setting.
THE EFFECT OF DISRUPTIVE MEDICAL EVENTS ON MORTALITY IN PEOPLE WITH AND WITHOUT DEMENTIA
Authors: Hunt Lauren , Morrison Sean , Gan Siqi , Espejo Edie , Boscardin W John , Rodin Rebecca , Ornstein Katherine , Smith Alexander
Published: December 2022

Disruptive medical events such as pneumonia and hip fracture occur more frequently among older adults with dementia than those without dementia. It is not well-understood whether these events increase the risk of mortality to a greater extent for people with dementia (PWD) compared to people without dementia (PWoD). Using data from the Health and Retirement Study linked to Medicare claims, we estimated the impact of hip fracture and pneumonia on risk of mortality among 700 PWD and 12,438 PWoD using a Cox proportional hazards model. PWD had a higher risk of mortality both in the case of hip fracture (HR 1.64, 95% CI 1.31, 1.96) and pneumonia (HR 1.21 95% CI 1.09, 1.34) compared to PWoD who experienced those events. This study provides evidence that dementia may increase mortality after a disruptive medical event and suggests that the clinical course of dementia may not always be slow and gradual.
ENRICHING THE LIVES OF OLDER VETERANS: THE GEROFIT WAY
Authors: Hall Katherine , Gepner Adam
Published: December 2022

Gerofit is a clinical exercise program for Veterans ages 65 years and older with multi-morbidities and functional limitations that place them at elevated risk for institutionalization. It was declared a VHA “Best Practice” in 2017 and was selected for widespread dissemination and implementation, with over 30 Gerofit programs spanning the country. The original Gerofit program consists of supervised, facility-based exercise, offered 3 days per week in a group setting. Each exercise prescription incorporates aerobic training, progressive resistance training, and specialized exercises for balance and physical function. Everything changed in March 2020 when facilities began receiving orders to shut down face to face encounters and social distancing measures were put in place. Within six weeks, all of our sites had transitioned to group-based virtual classes, aptly called Gerofit to Home (GTH). This symposium includes 2 presentations that explore the effect of GTH on physical functioning and health-related quality of life outcomes in veteran participants during the pandemic: one focusing on resilience among GTH adopters vs. non-adopters in patients formerly participating in facility-based Gerofit; and the second focusing on patients enrolled directly in to GTH (no facility-based experience). The third presentation describes differences in physical function and health gains among Gerofit participants with and without peripheral artery disease (PAD). The fourth and fifth presentations describe augmented models of care to enrich the Gerofit experience for a) participants with supplemental nutrition programming and b) advanced physical therapy trainees through a Gerofit resident training model.
PLACEMAKING AS CIVIC PARTICIPATION: A STORY OF AGENCY AND RESISTANCE AMONG BLACK AND LATINX IMMIGRANT OLDER ADULTS
Authors: Reyes Laurent
Published: December 2022

Placemaking is a collective process that happens every day. However, little has been written about the ways older African Americans and Latinx immigrants create place in their everyday lives. Less has been said about the ways these efforts are examples of civic participation in the context of systemic inequality and oppression. Results from this phenomenological study that applies an intersectional life course perspective shows how older Black and Latinx immigrant adults maintain, preserve, and build their place in a society that continuously threatens their erasure. These results shine light on the ways Black and Latinx communities work to maintain the physical space (i.e., community safety and sanitation), preserve their culture and history, and build structures to ensure access to resources that will empower their communities. Their efforts across the micro, meso, and macro social environments and across time, demonstrates a concerted effort towards creating a dignified and just place in our society to nourish and sustain future generations.
MEDICAID POLICY AND ASSISTED LIVING ACCESS
Authors: Smith Lindsey
Published: December 2022

Funding for home and community-based services (HCBS), including assisted living (AL), using Medicaid is limited to either Medicaid program waivers or state plan amendments. The Affordable Care Act (ACA) created a new option for the state plan, the Community First Choice 1915(K), that mandates all care is self-directed and inclusive of families in decision making while disallowing waiting lists. This presentation will provide an overview of the various combinations of Medicaid waivers and amendments used by states to cover services in AL. We will then share the results of a study that used coincidence analysis, a configurational comparative method, to compare states’ approaches to HCBS Medicaid coverage and a measure of AL geographic access. We found that both Medicaid waivers and 1915(K) amendments are associated with increased geographic access to AL.
INTERRATER RELIABILITY OF AN ADVANCED NONCONTACT WOUND MEASUREMENT SYSTEM USING ARTIFICIAL INTELLIGENCE
Authors: McDaniel Jodi , Tan Alai , Parinandi Narasimham
Published: December 2022

Venous leg ulcers (VLU) are recurring, disabling wounds that develop primarily in older adults with comorbidities. In an ongoing clinical trial testing a nutritional intervention researchers use advanced technology (Swift Skin and Wound) to measure VLU healing over time. This noncontact wound measurement system uses artificial intelligence to automatically calculate wound measurements and track healing progress. However, a subjective component of the Swift system involves delineating wound perimeters on photographs captured with a tablet or smartphone. To evaluate interrater reliability of the system in the current study, measurements of 11 wounds by two independent raters were assessed using an intraclass correlation coefficient (ICC). ICC estimates and their 95% confidence intervals were calculated using SPSS statistical package version 27 based on a mean-rating (k = 2), consistency, 2-way mixed-effects model. For area measures, ICC = 0.99 with 95% confidence interval = 0.998-1.0, indicating the Swift measurement system has excellent interrater reliability.
EXPERIENCES USING A SMARTHEALTH SYSTEM: TWO CASES OF DEMENTIA FAMILY CAREGIVERS
Authors: Rose Karen , Ko Eunjung , Kim Sooyoung , Gordon Kristina , Wang Hongning , Stankovic John
Published: December 2022

Family caregivers for persons with dementia often times experience stress and burden while caregiving. The COVID-19 pandemic has worsened this situation with increased physical and social isolation, further resulting in health risks in this population. Technology-based interventions have become more commonplace in today’s world to address ongoing caregiver needs although gaps in technological literacy and usage still exist among many users. This case study aims to report on the implementation of an ongoing Smarthealth technology intervention for two older adult family caregivers of persons with dementia and to explore their experiences with this system. Data were collected through acoustic monitoring, survey administration, and semi-structured interviews. Intervention effects on changes in emotional states will be discussed. Study findings showed the intervention improved self-awareness of emotional care and reactions to care recipients. Findings in this study highlight the importance and challenges of real-time technology-based intervention implementation in older adult caregiving populations.
CURRENT APPLICATIONS OF PATIENT COMMUNICATION TECHNOLOGIES IN GERIATRIC CRITICAL CARE
Authors: Happ Mary Beth , Miller Emika , Tate Judith , Shin JiWon
Published: December 2022

The availability and utility of patient-centered communication technologies in acute-critical care settings have evolved slowly over the past 30 years with wide variability, little standardization, and few randomized controlled clinical trials (RCT). The COVID-19 pandemic forced rapid expansion and use of communication technologies, particularly between patients and remote family caregivers. To capture changes responsive to the pandemic, this paper reviews current literature (< 5 years) on communication technologies in acute-critical care settings focusing on the user experience among older adult patients. We supplement these findings with case-based evidence from a pilot RCT of an electronic tablet communication application provisioned to mechanically ventilated ICU patients, and efforts toward hospital-wide implementation. Recent literature on patient communication technology consists primarily of qualitative, descriptive accounts of video communication (i.e., ICU visits) or provision of augmentative and alternative communication. Recommendations for required skills, standardization, and research regarding patient communication technology are provided.
PARALLEL MEASUREMENTS OF PROTEIN AND CELL TURNOVER REVEAL HOW TISSUE CONTEXT AND AGING SHAPE PROTEIN LIFETIMES
Authors: Buchwalter Abigail , Welle Kevin , Hryhorenko Jennifer , Ghaemmaghami Sina , Hasper John
Published: December 2022

The lifespans of proteins can range from moments to years within mammalian tissues. Protein lifespan is relevant to organismal aging, as long-lived proteins can accrue damage over time. It is unclear how protein lifetime is shaped by tissue context, where both cell division and proteolytic degradation contribute to protein turnover. We have developed turnover and replication analysis by 15N isotope labeling (TRAIL) for parallel quantification of protein and cell lifetimes. We have deployed TRAIL over 32 days in 4 mouse tissues to date to quantify cell proliferation with high precision and no toxicity and determine that protein lifespan varies independently of cell lifespan. Variation in protein lifetime is non-random: multiprotein complexes such as the ribosome have consistent lifetimes across tissues, while mitochondria, peroxisomes, and lipid droplets have variable lifetimes across tissues. To model the effects of aging on tissue homeostasis, we apply TRAIL to a mouse model of Hutchinson-Gilford progeria syndrome and uncover fat-specific alterations in cell lifetime and proteome composition, as well as a broad decrease in protein turnover flux. These data indicate that environmental factors influence protein turnover in vivo and provide a framework to understand proteome aging in tissue context.
THE EFFECT OF SUBJECTIVE AGING ON HEALTH AND SURVIVAL: A SYSTEMATIC REVIEW OF LONGITUDINAL DATA
Authors: Westerhof Gerben , Nehrkorn-Bailey Abigail , Brothers Allyson , Siebert Jelena , Tseng Han-Yun (Heidi) , Diehl Manfred , Wahl Hans-Werner , Wurm Susanne
Published: December 2022

Longitudinal effects of subjective age on adult health and survival are well-documented (Westerhof et al., 2014). This systematic review provides an updated and expanded evaluation of the state of the field. A systematic search in PsycInfo, Web of Science, Scopus, and PubMed resulted in 103 articles: 19 articles from the 2014 meta-analysis and 84 newer articles. Sixty-five articles focused on physical health (e.g., subjective health, objective health, and health behaviors), 41 studied mental health outcomes (e.g., mental health disorders, well-being, and quality of life), and 18 articles used mortality as the outcome. Important developments during the past years include new instruments, particularly multidimensional assessment of subjective aging, and a more fine-grained representation of health outcomes, including bio indicators. A major outcome is that most studies confirmed the longitudinal effects of subjective aging on health as reported previously, but on a much broader study portfolio.
STRATEGIES FOR PARTNERING WITH CARCERAL SETTING STAFF AND LEADERSHIP
Authors: Prost Stephanie Grace
Published: December 2022

The mission of carceral agencies--the pursuit of public safety andsecurity--often conflicts with the primary aim of social justice-oriented scholarship, most notably research objectives related to health promotion in jails and prisons. However, such research is essential to awareness building, policy reformation, and revisions today-to-day practices that increase the health and well-being of historically marginalized populations. As a result, the conduct of aging research within carceral settings requires specialized knowledge and skills including frequent, targeted communication,transparency, humility, and flexibility. This presentation includes discussion of strategies for building and maintaining successful partnerships with local and state-level agencies with examples drawn from four distinct aging research projects, specifically. These partnerships resulted in primary data collection with over 800 carceral constituents including prison hospice program representatives, persons who are incarcerated, and experts in correctional health and art therapies. Lessons learned and opportunities for future partnerships are also described.
DEVELOPMENT OF A FRAILTY INDEX FOR PEOPLE WITH DEMENTIA IN THE HEALTH AND RETIREMENT STUDY
Authors: Wilkie Rachel , Ailshire Jennifer
Published: December 2022

Frailty indices (FI) have been found to predict adverse outcomes, such as, mortality, hospitalization, and institutionalization in older adults. However, traditional FIs often exclude people with dementia (PWD), who may not be able to consent to or complete all of the standard frailty items. While frailty is a known risk factor for onset of dementia and PWD have higher rates of frailty, little is known regarding how frailty predicts outcomes among PWD. Our study aims to develop an FI for PWD and to examine how this index relates to mortality, hospitalization, and nursing home stays. We used data from the Health and Retirement Study to create a 52-item FI for community-dwelling adults aged 50 years and over classified as having dementia (n = 1,107) in 2014. The index includes deficits in four domains: chronic health conditions, functional status, sensory problems, and overall health and wellbeing. A standardized FI score between 0 and 1 was calculated for each respondent. We used logistic regression to examine associations with FI and 2-year mortality, hospitalization, and nursing home stay, adjusting for age and gender. We found that a 0.1 unit increase in FI was significantly associated with higher odds of 2-year mortality (OR 1.39, p< 0.001), hospitalization (OR 1.45, p< 0.001), and nursing home stay (OR 1.38, p< 0.001) for people with dementia. This study developed an FI which is predictive for adverse outcomes among PWD. Future work should explore how socioeconomic and neighborhood factors contribute to the relationship between frailty and adverse outcomes among PWD.
EFFECTS OF DEPRESSIVE SYMPTOMS ON COGNITIVE BEHAVIORAL INTERVENTIONS WITH CUSTODIAL GRANDMOTHERS
Authors: Musil Carol , Jeanblanc Alexandra , Burant Christopher , Zausniewski Jaclene
Published: December 2022

Over 25% of custodial grandmothers report elevated depressive symptoms, which may affect situational appraisals and learning/retaining new information, and thus the effectiveness of cognitive-behavioral interventions. We examined the effect of depressive symptoms on self-appraised stress and reward associated with caregiving to co-residential grandchildren in a sample of 342 grandmothers who participated in a nationwide behavioral RCT testing two methods of stress reduction. Participants completed a baseline questionnaire, one of 2 cognitive-behavioral interventions (guided journaling or journaling with Resourcefulness Skills Training ©), and 3 subsequent questionnaires over 6 months. We analyzed self-appraised stress and reward with RM-ANOVAs to evaluate whether level of depressive symptoms (CES-D below-16, 16-29, 30+) affected the effectiveness of each arm with regard to self-appraised stress and reward. We found differences by depressive symptom category and interaction effects of depressive symptoms by arm in self-appraised stress. The below-16 group had relatively constant appraised stress over time, but the 16-29 and 30+ groups had significant decreases in stress over time. The Resourcefulness Skills Training © group had an average decrease in stress of .68 over time compared to .2 points for the journal-only group; there were no intervention effects in the below-16 group. The highest symptom group showed a stronger effect for the journal-only intervention, perhaps reflecting the challenges in learning and applying new skills. Self-appraised reward increased over time across groups. Participants' level of depressive symptoms have significant effects on the effectiveness of interventions and should be taken into consideration when designing studies and analyzing effectiveness.
HEARING LOSS AND ITS CONSEQUENCES FOR SPOUSAL MENTAL HEALTH: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: West Jessica , Smith Sherri , Dupre Matthew
Published: December 2022

Hearing loss (HL) is an increasingly prevalent chronic stressor among older adults and is associated with numerous adverse health outcomes. The life course perspective and stress process framework highlight that an individual’s stressors may have a short and/or long-term impact on the health of others. However, little is known about how HL influences the proliferation of stress within married couples. Drawing on nationally-representative data from 11 waves (1998-2018) of the Health and Retirement Study (n=9,000 individuals, 4,500 couples), we use age-based mixed models to examine how one’s own HL, spouse’s HL, or both spouses have HL shape the level and changes in depressive symptoms. For men, we find that their wives’ HL, their own HL, and both spouses having HL are each associated with an increase in depressive symptoms—and that the associations persist as spouses age. For women, we find that their own HL and both spouses having HL is associated with an increase in depressive symptoms. Furthermore, we find that the differences in women’s depressive symptoms between spouses who both have HL and those who do not have HL significantly declines with age. We also find no evidence to suggest that husbands’ HL is associated with wives’ depressive symptoms. Together, these findings suggest that the connections between spouses’ HL and their depressive symptoms are a dynamic process that unfolds differently by gender over time. Interventions that recognize the proliferation of stress associated with HL may help both individuals with HL and their spouses reduce their depressive symptoms.
NETWORK SIZE, SOCIAL ACCOMPANIMENT, AND GENDER: PROTECTIVE OR RISK FACTOR FOR REAL-TIME LONELINESS, AND FOR WHOM?
Authors: Compernolle Ellen , Goldman Alyssa
Published: December 2022

Large personal networks are a key marker of social integration that protect against loneliness. Yet how such social integration shapes loneliness on a momentary basis remains unclear. This study examines (1) the role of personal network size in shaping older adults’ momentary loneliness, (2) how momentary social accompaniment modifies this association (protective or risk factor), and (3) whether this moderation varies by gender. We use three waves of ecological momentary assessments (n = 12,251) and personal network data collected from 333 older adults as part of the Chicago Health and Activity in Real-Time (CHART). Findings from multilevel regression models suggest that older adults with large social networks experience greater intensity loneliness when momentarily alone compared to those with smaller social networks. This association is also more pronounced among men compared to women. Results support our deviation-from-baseline hypothesis, which is further supported by additional analyses that find a similar association between more frequent interaction with network ties and heightened loneliness when alone. Additional analyses provide insight into observed gender differences as well: women’s networks and momentary social company tend to be familial ties characterized by caregiving, compared to men’s ties, which are characterized as peers or companions. Here, moments of momentary social isolation may be a welcome reprieve from otherwise demanding social relationships (“tethering”). We conclude that extending the well-documented links between global measures of social integration and loneliness into a real-time framework offers novel insight into existing, high-level trends in loneliness among older adults.
CONVOYS OF CARE
Authors: Antonucci Toni , Ajrouch Kristine
Published: December 2022

Many existing Alzheimer’s disease (AD) caregiving interventions focus narrowly on thechallenges and needs of a primary caregiver rather than the family systems in which they areembedded. We advance a family systems framework by invoking convoys of caregiving to adaptan existing AD caregiver intervention to Middle Eastern/Arab American families in metroDetroit (N=56). The composition of caregiving networks is described, followed by assessment ofcare burden, depressive symptoms, care satisfaction and family conflict. Results show thatsiblings and children are the predominate support network members who accompanied theprimary caregiver to the program. Paired t-tests show that care burden and family conflictdecreased while caregiving satisfaction increased following program participation. Depressivesymptoms did not change. Findings illuminate how convoys of care may serve as valuablesupport resources, yet may also be the source of stress and conflict.
MAPPING THE INTERPLAY OF SOCIAL HEALTH AND COGNITIVE FUNCTIONING: A MIXED RESEARCH KNOWLEDGE SYNTHESIS
Authors: Wiegelmann Henrik , Seifert Imke , Lenart-Bugla Marta , Łuc Mateusz , Gerhardus Ansgar , Szcześniak Dorota , Rymaszewska Joanna , Wolf-Ostermann Karin
Published: December 2022

Introduction

Dementia is a syndrome with complex underlying bio-psycho-social mechanisms relevant for prevention and intervention. This work presents a mixed research knowledge synthesis, mapping the multidimensional interplay of social health and cognitive functioning in dementia.

Methods

Data integration from 1) systematic review, 2) group model building workshops, (3) iterative integration of multi-national cohort studies (4) ongoing revisions of the social health concept via expert discussions.

Results

The map comprises more than 50 markers, clustered in six domains (social health, psychological pathways, physiological pathways, health behavior pathways, brain/cognitive reserve, cognitive functioning). The social health domain is structured in six sub-domains representing a novel conceptual understanding. Three pathways (physiological, psychological, health behavior) reflect principal mechanisms connecting social health with brain/cognitive reserve and cognitive functioning.

Conclusion

The map depicts dynamic relationships between social health and cognitive functioning that can serve as a basis for recommendations, both for prevention and for improved dementia care.
SKILL BUILDING BLOCKS: ASYNCHRONOUS ONLINE LEARNING THROUGH INTERACTIVE THEMATIC INSTRUCTION
Authors: Sterns Harvey , de Klerk-Rubin Vicki
Published: December 2022

Whether professional or as a family carer, interactions with an older adult living with or without cognitive decline should be person-centered. Learning behavioral skills requires more than watching a demonstration or cognitive learning; it requires practice, feedback and more practice. Online learning has become the best way to reach carers of older adults, partially due to the COVID pandemic and partially due to time, money and energy resources being stretched to their limits. The Validation Training Institute has developed 6 self-directed, online Skill Building Blocks that uses thematic instruction strategy, interactive exercises, and videos demonstrating why each skill is important and how to best utilize the skill in real life situations. Learners have completed pre and post-questionnaires using the Likert scale and the IMMS (Instructional Material Motivation Survey) which measures attention, relevance, confidence, and satisfaction. An online focus group of participants concluded the data collection process. Techniques taught through Skill Building Blocks proved to be relevant to the learners’ life experience. There was effective retention and transfer of skills, and the training proved to be motivating for continued application in the real world. Learners expressed confidence and satisfaction with the user-friendly, thematic design of each block.
AGE-FRIENDLY CAMPUS PRACTICES IN HIGHER EDUCATION: A HEAT MAP VIEW
Authors: Fassi Janelle , Beaulieu Celeste , Bowen Lauren , Montepare Joann , Whitbourne Susan , Silverstein Nina
Published: December 2022

The Age-Friendly University (AFU) initiative aims to increase the participation of age-diverse older adults in higher education communities. The present study investigated age-friendly practices across 23 institutions in the United States. The ICCS Inventory (Silverstein et al., 2022), which identifies 192 potential age-friendly campus practices was completed by administrators representing major campus units. A heat map was used to graphically represent age-friendly practices and identify where universities differed in the presence of those practices. Heat map findings indicated campuses are low in some auxiliary services that assist retired faculty and staff. However, campuses consistently gave retired faculty and staff access to university library services. Campuses also had limited age-friendly teaching and learning services. None of the campuses reported having resources to help faculty deliver teaching materials in formats specifically geared toward older learners. In addition, none of the campuses reported having teaching and learning staff visiting campus departments to provide resources for older learners, and very few campuses offered courses that focused on aging and age diversity issues. Common age-friendly practices were seen with respect to providing instructional technology support for faculty/staff/students and community partnerships for intergenerational activities. Physical environment and personnel evidenced the most frequent age-friendly practices likely because they are mandated by the ADA (e.g., clear signage, handicapped parking close to buildings, spaces free of obstacles, training in ageism as a form of discrimination). Overall, the present study highlighted the areas where college campuses are most age inclusive, while also revealing areas for improvement in age inclusive practices.
TUTORIAL-STYLE EDUCATION FOR UNDERGRADUATES IN AGING
Authors: Deason Karley , Sadeq Nasreen , Stanback Brianne
Published: December 2022

At almost every university, there is an option for undergraduates to enroll in directed readings or research, independent studies, or some other form of tutorial-style education, although not much is known about them or best practices associated with them for undergraduate students interested in aging. This project reviews available literature about tutorial-style education and describes the multidimensions involved in these learning experiences. Search phrases such as “history of Oxford tutorials”, “tutorial classes”, and “student traits in tutorials” were used in Google Scholar to find literature, returning 142 articles. Articles were included if the literature was published in a periodical, findings were not redundant, and measures connected to the objectives of this project, and, by these criteria, ten articles comprised the final sample for review. Student characteristics, instructors, and other factors, like the time intensity of the tutorial course and the student’s connection to the subject area, have been found to impact tutorial-style education. The review is the first of its kind to use its findings to propose a set of best practices to enhance the experience for students interested in aging, including the fit of student and instructor, skillsets of successful students, and modalities, and advance a research agenda to better understand and communicate practices in tutorial-style education for undergraduates in aging.
BDNF VAL66MET MODERATES THE EFFECTS OF HYPERTENSION ON EXECUTIVE FUNCTIONING IN OLDER ADULTS DIAGNOSED WITH AMCI
Authors: Louras Peter , Brown Lisa , Gomez Rowena , Warren Stacie , Fairchild Kaci
Published: December 2022

Brain-derived neurotrophic factor (BDNF) has a demonstrated role in promoting memory functions and neuronal survival. A common variant in the BDNF gene, the Val66Met polymorphism, has been found to reduce BDNF expression and increase vulnerability to neurocognitive impairments and age-related cognitive declines. Research suggests that BDNF Val66Met may be associated with hypertension, a well-established risk factor for health and brain functioning across the lifespan. While BDNF is most studied for its effect on learning and memory, its role in moderating other cognitive domains is not as well understood, especially those most affected by hypertension. Furthermore, no study to date has investigated these relationships exclusively with older adults and those at increased risk for cognitive decline. Therefore, the aim of this study was to investigate the effect of BDNF Val66Met and hypertension on the executive function ability of older adults (mean age 71.3±9.2 years) diagnosed with amnestic Mild Cognitive Impairment (aMCI) (N = 108). Results showed that BDNF Val66Met moderated the relationship between hypertension and executive functioning, such that hypertensive carriers of the BDNF Met allele performed significantly worse compared to Val-Val homozygotes, and independent to the effects of aging. These results indicate that genetic and vascular risk interactions can predispose older adults with aMCI to impairments in multiple cognitive domains, and potentially increase susceptibility to further declines or conversion to dementia. These findings have implications for future research on dementia disease pathology, and highlight the importance of strategies that target fixed and modifiable risk factors to promote cognitive resilience.