bluuebunny/crossref_metadata_2025 huggingface dataset:
TOWARD AN UNDERSTANDING OF IN-HOSPITAL INACTIVITY
Authors: Pedersen Mette Merete , Hansen Maria , Bandholm Thomas , Kirk Jeanette
Published: January 2025

Lack of mobility during hospitalization is a common problem in older adults (+65) and is associated with an elevated risk of hospital-associated disability. In a recent study, we have shown that there is unclarity among health professionals on priorities and responsibilities concerning mobility, and barriers to the promotion of mobility are present. Also, in recent years, it has become clear that in-hospital inactivity is rooted in the hospital culture and that multi-dimensional and multi-professional interventions are required to incorporate and implement mobility into clinical practice. However, important factors for such interventions to succeed are patient and caregiver engagement and interaction. Therefore, for future interventions to be successful in routine care it is important to know what characterizes clinical practice and communication around physical activity and what influences current levels of activity. We will present data from clinical studies on older adults (65+) in a geriatric and an orthopedic ward in which we have investigated 1) current and previous levels of physical activity during acute hospitalization; 2) clinical practice about mobility and physical activity - how local culture mediates care routines; and 3) if and how a technological artifact can mediate increased physical activity. Also, we will include the perspective of patients and ward staff on what influences mobility and levels of physical activity among patients hospitalized following hip fractures and for geriatric conditions.
LIVE DISCHARGE FROM HOSPICE AS A CRITICAL CARE TRANSITION: MEASUREMENT, EXPERIENCES, AND SOLUTIONS
Authors: Wallace Cara , Hunt Lauren
Published: January 2025

Hospice care has been shown to improve end-of-life outcomes for adults with chronic illness, yet with eligibility limited to a six-month prognosis, the hospice system is not structured to meet longer-term needs. Many adult patients stabilize, or have a change in terminal prognosis, leading to a ‘live discharge.’ In 2021, 17.2% of all Medicare discharges were patients discharged alive, with 6.3% of these due to decertification (patient stabilization). This symposium examines live discharge as a critical care transition, including potential measures of quality and continuity, how hospice care coordination or caregivers’ social contexts impact experiences of the transition, and a potential intervention to improve the overall process. The first presentation considers utility of the Care Transition Measure (CTM-15) and the Patient-Perceived Continuity of Care from Multiple Clinicians Measure in live discharge from hospice, highlighting the positive and statistically significant relationship between relational continuity—how well a patient feels known and understood by their primary hospice clinician and overall team—and the quality of the care transition. Next, using scores from the CTM-15 to classify participants’ experiences as “positive” or “negative,” presenters will provide information about the important role of hospice care coordination in the overall experience of the transition off hospice. Third, presenters will showcase the social context among ADRD caregivers, including the way support systems help caregivers during and following a discharge. Last, presenters will demonstrate the development and preliminary usage of a Live Discharge Protocol that hospices can use for a standardized approach to improving this care transition.
THE ROLE OF HOSPICE CARE COORDINATION IN THE EXPERIENCE OF LIVE DISCHARGE TRANSITIONS
Authors: Wallace Cara , Wladkowski Stephanie , Juboori Ruaa Al , Becker Todd , Trinitas Joseph , Hinyard Leslie , Hendricks-Ferguson Verna
Published: January 2025

Hospice care improves end-of-life outcomes for patients, while a live discharge results in lost access to supportive services and resources. The quality of this transition is critical for ensuring that a caregiver and patient are prepared for the termination of hospice services, and to avoid negative outcomes, such as a hospitalization or a burdensome transition. This study interviewed 32 caregivers of patients across diagnoses who experienced a discharge from hospice due to decertification—when a patient is removed from hospice due to a stabilized condition. Participants were placed in a priori groups (16 in each group) depending on whether their care transition was more positive (designated by a score of 66.67 or higher on the CTM-15) or more negative (scores of 66.66 or below). There were no statistically significant differences between groups based on demographics. However, qualitative codes relating to care coordination differed based on these a priori groupings. Specifically, the positive transition group was more likely than the negative transition group to report hospice action related to the discharge in the following areas: awareness and information, communication between providers, medication, and receiving support from hospice after the discharge. Alternatively, those in the negative transition group were more likely to report hospice inaction related to awareness and information, communication about the discharge, communication between providers, and lack of help generally. Differences in access to healthcare service and availability of social support and how this impacted quality of life also differed across groups. Research, clinical, and policy implications will be discussed.
AN EXPLICIT LIVE DISCHARGE PROTOCOL (LDP) TO IMPROVE CARE TRANSITIONS
Authors: Wladkowski Stephanie , Enguidanos Susan , Schroepfer Tracy
Published: January 2025

Discharge planning for care transitions is required in hospitals, skilled nursing facilities, and home health agencies within the United States under Medicare guidelines. Yet, no required discharge planning or clear guidelines are available to guide practitioners in transitioning patients and their caregivers out of hospice care. A live discharge from hospice can occur when a patient stabilized under hospice care no longer meets the life expectancy hospice eligibility criteria. For these individuals and their caregivers, the result is a disruption of care continuity. Further, an increased burden is placed on primary caregivers who may be unprepared for this transition. Presenters have developed a live discharge protocol (LDP), to standardize the live discharge process and assess for psychosocial support needs for patients and their caregivers post-discharge. This presentation will describe the development of the LDP through several steps: first, with an advisory committee made up of research experts, clinicians, and caregivers. Next, through focus groups to gain a deeper understanding of current approaches and accompanying challenges of a discharge protocol. Finally, the LDP was drafted and reviewed by practicing social workers and nurses for usability. Further, this presentation will report on how each step provided valuable feedback and informed the final LDP currently being used by hospice agencies and the complexities of conducting a live discharge, the uniqueness of each hospice agency, and the need for more research to support a standardized and reimbursable discharge process.
CENTER FOR SCIENTIFIC REVIEW: YOUR APPLICATION’S JOURNEY BEGINS WITH THE DIVISION OF RECEIPT AND REFERRAL
Authors: Boulay Marc
Published: January 2025

The first stop for your application is at the Division of Receipt and Referral (DRR), the central receiving point for all competing grant applications submitted to the NIH. Here, your application will receive: (a) an initial check for its compliance with both NIH policy and the specific requirements of the Notice of Funding Opportunity used for the submission, (b) an assignment to a funding Institute, and (c) an assignment to the most appropriate study section for review. Attendees will become acquainted with the process used by DRR and will receive some tips to help them avoid common errors with their submission. This session will also highlight tools that applicants may use to inform their application’s review assignments and will be introduced to the ENQUIRE process (Evaluating Panel Quality in Review), ongoing evaluations of CSR’s study sections to ensure that the scientific scope of the study sections align with the current state of the science. By the end of the presentation, attendees should have a greater understanding of the factors they should consider when preparing their NIH submissions.
AFTER REVIEW AND TIPS FROM NIH STAFF
Authors: Nguyen Emerald
Published: January 2025

After the review meeting, the SRO prepares the summary statement, which is the primary outcome of peer review. Program staff and advisory councils at the institutes use this official document to make recommendations about which applications to fund. How can you best prepare for the next steps for your application? Understand the qualities of a competitive NIH application, talk to program staff, and take advantage of the opportunity to become a peer reviewer yourself. From the field, apply the tips shared by applicants and reviewers about what they do and what they look for in a well-written application. Receiving the summary statement can be daunting and discouraging; but by de-mystifying the process and getting involved, you can help position your application towards maximum success.
IMPLEMENTATION OF THE PAIN MANAGEMENT CLINICAL PRACTICE GUIDELINE USING THE EVIDENCE INTEGRATION TRIANGLE
Authors: Galik Elizabeth
Published: January 2025

To optimally implement the Pain Management CPG and change behavior among residents and staff in nursing homes we developed a theoretically based approach that incorporates the Social Ecological Model, Social Cognitive Theory and was guided by the Evidence Integration Triangle. The PAIN-CPG-EIT was implemented by a research nurse facilitator 10 hours per week for two months and then 4 hours per week for an additional four months to provide four components: Component I: Establishing and working with a stakeholder team monthly; Component II: Education; Component III: Mentoring and motivating the staff; and Component IV: Ongoing monitoring of pain assessment, diagnosis and management for residents. The first stakeholder team meeting included information about the Pain Management CPG and a brainstorming session to develop community goals. The ongoing role of the stakeholder team was to provide positive reinforcement for the staff caring for residents and support the champions. As per Component II, the research nurse facilitator provided education to staff based on the Pain Management CPG. Component III included reviewing pain related issues among residents with the staff and brainstorming about solutions, implementing treatments and adjusting care plans. In addition, contests were held to have staff share innovative approaches to addressing pain among residents. Weekly pain management tidbits were provided via email to all stakeholder members to share with staff. Component IV included the ongoing re-evaluation of pain among residents and monitoring of pain related interventions to determine if these were effective, still needed or if changes in care plans were necessary.
FEASIBILITY AND PRELIMINARY EFFECTIVENESS OF IMPLEMENTATION OF THE PAIN-CPG-EIT
Authors: McPherson Rachel
Published: January 2025

The primary aim of this pilot study, testing the implementation of the Pain-CPG-EIT, was to evaluate feasibility (delivery and enactment) and preliminary effectiveness. Delivery was based on the intervention being provided as intended and enactment was based on expected behaviors being performed. It was hypothesized that: (1) all components of the intervention would be delivered; and (2) the goals established by each community would be achieved as expected or greater than expected, there would be an increase in nonpharmacologic interventions, and a decrease in unnecessary pharmacologic medications. Effectiveness was based on evidence that residents would have a: (1) pain assessment completed, diagnosis for the pain, and an individualized pain management care plan developed; (2) decrease in pain; and (3) evaluation of appropriate use of opioids. This was a pragmatic trial and no identifiable data was obtained on residents. Participants had a mean age of 70 (SD=8), over half were male (N=25, 51%), and the majority were Black residents (N=33, 67%), Non-Hispanic (N=48, 98%), not married (N=45,92%) and had at least a high school education (N=37, 76%). The mean score on the BIMS was 6 (SD=4) they had 4 (SD=1) comorbidities. The intervention components were delivered as intended and goals achieved. There was significant improvement in the appropriate pain assessments, no change in diagnosis of pain, an increase in the percentage of residents with pain addressed in their care plan, some improvement in assessment for appropriate opioid use, and a decrease in the percentage of residents on opioids.
SEX/GENDER DIFFERENCES IN DIAGNOSIS OF PAIN AMONG OLDER MEDICARE BENEFICIARIES
Authors: Milani Sadaf , Shan Yong , Kuo Yong-Fang , Raji Mukaila
Published: January 2025

Pain is often underdiagnosed among women, especially Black women, but the extent of underdiagnosis is unknown. Cognitive status can also complicate pain reporting and diagnosis. Our objective was to assess the odds of having a pain diagnosis, by sex/gender, while considering race/ethnicity and cognitive status. We used data from the 2018 Health and Retirement Study linked to Medicare claims. We included individuals with complete 2018 Part A and B enrollment and complete information on covariates, excluding those with HMO. Our outcome combined self-reported frequent pain and diagnosis of chronic pain: no pain, self-report only, and diagnosed (both diagnosed only and diagnosed + self-report). Our exposure was sex/gender. We used multinomial logistic regression models to assess the odds of pain diagnosis, by sex/gender, controlling for age, education, race/ethnicity, rurality, cognitive status, and Elixhauser comorbidity index. Among our participants (n=3,523), 12.0% had no pain, 4.6% had undiagnosed pain, and 83.4% had diagnosed pain. Compared to men, women had higher odds of diagnosed pain. The interaction between gender and race/ethnicity was significant (p=0.02). When stratified by sex/gender, non-Hispanic (NH) Black women had lower odds of diagnosed pain, compared to NH White women. Compared to NH Black and Hispanic men, NH White men had lower odds of any type of pain (both diagnosed and self-reported). The main effect of cognitive status and interaction with gender was not significant. Contrary to our hypothesis, women had higher odds of diagnosed pain than men. Within racial/ethnic group differences exist in men and women and warrant future studies.
RURALITY MATTERS: UNDERSTANDING THE CRITICAL AND NUANCED ROLE OF PLACE-BASED FACTORS IN RURAL AGING
Authors: Cassidy Jessica , Cohen Steven , Jensen Leif
Published: January 2025

Although only 15% of all Americans live in rural communities, 22% of U.S. older adults live in rural areas. Despite the prevalence of rural older adults, there are significant gaps in the gerontological literature regarding this vulnerable sub-population and furthermore, the multidimensional factors that characterize rurality and influence their healthy aging. To highlight the impact of place-based factors on the breadth of needs and outcomes found in rural aging populations, this symposium will host five research projects spanning the social and health sciences. The first study applies multi-level models to estimate the spatial distribution of aging and disability service organizations by sociodemographic and sociocultural characteristics in U.S. rural counties. The second uses multiple methods to contrast challenges facing older adults aging in place in rural areas with assets and opportunities for supporting healthy aging in rural older adults. The third examines rural-urban differences in health outcomes and the lived experiences of informal caregivers to suggest culturally appropriate intervention strategies, tailored to the needs of rural caregivers. The fourth analysis compares differences in rural health disparities among diverse aging populations living in rural Wyoming and Mississippi. The fifth investigates benefits of examining claims versus survey data when comparing rural and urban areas to better understand access to healthcare services. Our discussant will lead conversation to emphasize the important nuances of healthy aging in rural communities and to increase awareness on research and policy strategies that may support the needs of older adults and caregivers living in rural communities.
SOCIO-SPATIAL DETERMINANTS OF COMMUNITY-BASED LONG-TERM CARE AVAILABILITY IN RURAL COUNTIES
Authors: Pendergrast Claire
Published: January 2025

Community-based long-term care services are critical resources to support aging in place in communities across the country. These services may be especially important to rural older adults’ health and independence, as declining numbers of working-age adults in rural communities may reduce access to informal family supports. This study examines the spatial distribution of two forms of community-based long-term care in rural U.S. counties: aging and disability services organizations and home health agencies. Using data from the American Community Survey (ACS) and the National Neighborhood Data Archive (NaNDA) for 1708 rural counties, multi-level mixed-effects negative binomial models were estimated to examine the association between the availability of both forms of community-based long-term care services with county sociodemographic and sociocultural characteristics. Findings suggest significantly lower availability of aging and disability services per capita in rural counties with higher crime rates. Greater availability of these services was observed in more Republican counties, those with higher voter turnout, poverty rates, and shares of residents aged 65 and older, as well as shares of Black and Hispanic residents. Home health agency availability per capita was significantly greater in rural counties with higher crime rates, poverty rates, and shares of residents aged 65 and older. State-level factors explained 17.7% of the variation in rural counties’ aging and disability services availability and 4.5% of the variation in home health agency availability. Further investigation is needed to understand place-based factors driving inequalities in community-based long-term care access in rural areas.
SUPPORTING RURAL OLDER ADULTS AGING IN PLACE: IMPLICATIONS FOR RESEARCH
Authors: Henning-Smith Carrie
Published: January 2025

Most older adults, including those living in rural areas, want to age in place; that is, remain in their home and community as they age. Rural areas have many strengths related to aging in place, including generally high levels of social cohesion and strong community ties. However, rural areas also have unique challenges related to aging in place, including more limited housing, transportation, and health care infrastructure and residents with poorer health outcomes and fewer financial resources. Rural areas are older, on average, than urban areas, making them especially important to glean lessons from related to supporting aging in place. This presentation will synthesize recent research on rural aging in place – including new, unpublished results – using a combination of national survey data (the National Health Aging Trends Study and National Health Interview Survey) and qualitative interview data from subject matter experts. Results from this research show that rural older adults are more likely to be aging in place (as measured by longer duration in their current homes and communities) and face specific challenges, including homes that are less physically accessible for people with mobility limitations, poorer health outcomes, and poorer access to care. However, results from this research also show that rural older adults aging in place demonstrate strong social connectedness and key informant interviews illuminated several assets and opportunities inherent to supporting older adults aging in place in rural areas. This session will share key results from this research, as well as implications for rural aging research.
WORKPLACE PERSPECTIVES ON CAREGIVER-FRIENDLY WORKPLACE POLICIES
Authors: Pallis Maryssa , Nadash Pamela
Published: January 2025

Roughly 60% of all family caregivers are employed, and it is well-established that they experience stresses related to work-life balance, which may cause them to leave employment altogether. Thus, an important goal of the 2022 National Strategy to Support Family Caregivers focuses on caregivers’ financial security, specifically noting the importance of workplace protections and supports. This presentation provides a workplace perspective on caregiver-friendly workplace policies, drawing on data collected to support the RAISE Family Caregiving Advisory Council, created under the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (2018). It draws on a data collection effort involving listening sessions, focus groups, and key informant interviews with over 150 entities (including employers and employer intermediaries). The study aimed to identify what employers had to say about the challenges and benefits of creating caregiver-friendly workplaces. Issues raised included the importance of workplace policies such as paid family and medical leave, flexible work policies, and caregiver support programs. Findings suggest consensus among employers regarding the need for caregiver-friendly workplace policies; however, barriers to creating a supportive culture included caregivers’ reluctance to self-identify and utilize formal policies. Beyond adopting formal caregiver-friendly workplace polices, the most critical area for action would be to explore best practices for proactively integrating a caregiver-friendly workplace culture alongside formal policy interventions.
PATTERNS OF MULTIPLE CAREGIVING AND DEPRESSIVE SYMPTOMS AMONG MIDDLE-AGED AND OLDER ADULTS IN CHINA
Authors: Zhao Xinyi , Lou Vivian Weiqun
Published: January 2025

Objectives

With extended life expectancy, middle-aged and older adults have become more involved in multiple caregiving. This study aimed to investigate the patterns of multiple caregiving, and whether these patterns predicted follow-up depressive symptoms.

Methods

Data were obtained from the 2011–2015 waves of the China Health and Retirement Longitudinal Study. A total of 11,422 participants aged 50 and older in 2011 were included in the latent class analysis to identify the patterns of multiple caregiving. A regression model was used to analyze the association between baseline caregiving patterns and subsequent depressive symptoms.

Results

Four caregiving patterns were established: “part-time care for all”, “parent care and full-time grandchild care”, “part-time spouse care and full-time grandchild care” and “full-time spouse care”. Compared with the “part-time care for all” group, the “full-time spouse care” group and “part-time spouse care and full-time grandchild care” group reported significantly greater depressive symptoms four years later.

Conclusion

The use of categorizing multiple caregiving could vividly describe middle aged and older adults’ engagement in caregiving activities and provide a comprehensive prediction of mental health outcomes. Social services should be tailored to sandwiched caregivers in certain caregiving patterns.
SUICIDE RISK ASSESSMENT: INSIGHTS, CHALLENGES, AND INNOVATIONS
Authors: Colombowala Fatema , Van Orden Kimberly
Published: January 2025

Suicide is a major public health problem, accounting for over 700,000 deaths globally each year. Worldwide, suicide rates are highest among adults 70 years and older. Suicide attempts in later life are highly lethal and many who die by suicide do not endorse suicidal ideation, challenging efforts to detect and manage risk. This symposium will provide an in-depth exploration of suicide risk assessment amongst older adults, highlighting unique challenges across settings and providing recommendations for best practices and future research. Speaker 1 will present on the acceptability and feasibility of using ecological momentary assessment (EMA) to measure daily fluctuations in suicidal thoughts and psychosocial risk factors amongst older adults with subjective cognitive decline. Speaker 2 will discuss challenges of assessing suicidality within rural in-home care settings amongst older adults with hoarding disorder, emphasizing safety considerations when conducting in-home suicide risk assessments. Speaker 3 will examine the relationship between hoarding disorder and suicidal ideation, emphasizing the impact of social cohesion risk factors in rural environments. Speaker 4 will share findings from a comparative analysis of two validated suicide assessment tools (clinician-administered versus self-report) commonly used in research and practice, with a focus on areas of differential response across the two scales. The Discussant will synthesize findings and highlight areas for future research and innovation to improve detection of suicidal ideation and behavior amongst older adults. Collectively, these presentations will offer insights into the complexities of suicide risk assessment and recommend strategies tailored to the needs of older adults.
ECOLOGICAL MOMENTARY ASSESSMENT OF SUICIDE RISK: FEASIBILITY AMONG OLDER ADULTS WITH MEMORY CONCERNS
Authors: Loskot Taylor , Bower Emily
Published: January 2025

Given heightened suicide risk among older adults,, effective and timely risk assessment strategies are imperative to inform suicide prevention. Ecological momentary assessment (EMA) may help detect fluctuations in socioemotional suicide risk factors, including loneliness, depression, and suicide ideation (SI). The aim of the present study was to examine feasibility of an EMA battery for assessing momentary SI and socioemotional risk factors in older adults with subjective cognitive decline (SCD). Participants (n=27; M age=69; 82% female) were recruited from a larger study and were classified into “higher risk” (n=13) and “lower risk” (n=14) groups based on history of suicidal behavior or recent SI. Using an EMA app on their smartphone, participants were notified to complete four surveys daily for 14 days. EMA items included questions about SI, mood, loneliness, and cognitive concerns. After the survey period, participants completed validated “paper-and-pencil” assessments for comparison and provided feedback about app usability. On average, participants completed two-thirds of assigned surveys (M = 37, SD = 10) and completion rates did not vary significantly by suicide risk, (t(25) = 0.73, p >.05) or SCD severity (r = -.11, p >.05). Participants reported an easy and non-disruptive experience and provided helpful feedback regarding the structure of notifications, survey wording, and app interface. Additional demographic and psychosocial predictors of EMA response rate will be explored in regression models. Overall positive feedback suggests that EMA may be a feasible risk assessment method for use with older adults facing cognitive concerns.
PRESENCE OF RISK FACTORS FOR SUICIDALITY IN RURAL-DWELLING OLDER ADULTS WITH HOARDING DISORDER
Authors: Schaff Branden , Porter Ben , Nix Caitlyn , Dozier Mary
Published: January 2025

Because one in three older adults with hoarding disorder has co-morbid major depressive disorder, it is critical to understand the potential presence of additional risk factors for suicidal ideation in this population. There is currently a dearth of information about social cohesion risk factors for suicidality in older adults, particularly those living in a rural context. Rurality has the potential to exacerbate issues related to loneliness and access to instrumental support, both of which can increase risk for suicide. Forty-four older adults (mean age: 69, SD=9.43; 23% male; 20% Black or African American) with hoarding disorder completed a comprehensive baseline assessment as part of an in-home intervention study that included the Columbia-Suicide Severity Rating Scale, a semi-structured diagnostic interview, and the NIH Emotion Toolbox. No participants reported a history of suicide attempts, and only two participants reported a history of an aborted attempt; however, 30% reported having had the thought that they “wished to be dead or not alive” and 11% reported previously having had “active suicidal ideation with some intent to act.” Within our sample, 29% reported a previous depressive episode. On the NIH Emotion Toolbox, 33% were elevated on Loneliness, 33% were elevated on Perceived Rejection, 21% were low on Instrumental Support, and 33% were low on Social Satisfaction. A considerable percentage of participants reported social cohesion factors that could influence their risk for suicidal ideation. Targeted modular interventions aimed at mitigating loneliness and improving instrumental support may bolster the impact of evidence-based treatments within this population.
THE M. POWELL LAWTON AWARD LECTURE AND PRESENTATION
Authors: Mueller Christine
Published: January 2025

The M. Powell Lawton Award Lecture will feature an address by the 2023 recipient Sam Fazio, PhD, FGSA of the Alzheimer’s Association. This session will also include the presentation of the 2024 M. Powell Lawton Award to recipient Stephen M Golant, PhD, FGSA, of the University of Florida. The M. Powell Lawton Award is presented annually to an individual who has made outstanding contributions from applied research that has benefited older people and their care. The Lawton Award is generously funded by the Polisher Research Institute of Abramson Senior Care.
THREE DECADES OF PERSON-CENTERED DEMENTIA CARE: LESSONS LEARNED AND FUTURE CONSIDERATIONS
Authors: Fazio Sam
Published: January 2025

Dr. Fazio has been involved in person-centered dementia care for more than three decades. In this presentation, Dr. Fazio will review the origins of person-centered care and ongoing research, as well as share highlights of his personal research and his dedicated work at the Alzheimer’s Association. At the same time, he will discuss how we might need to reconsider the overall concept and its implementation for greater impact.
THE APPLICATION OF USER-CENTERED DESIGN TO A DIGITAL PLATFORM FOR OLDER ADULTS: THE PRISM SOFTWARE SYSTEM
Authors: Czaja Sara , Boot Walter , Rogers Wendy , Charness Neil
Published: January 2025

Technology holds promise for enhancing the social connectivity and reducing loneliness among older adults, especially those that are socially isolated. However, technology systems can be overly complex and challenging especially for those with limited technology experience. Common barriers to technology uptake among aging adults include usability issues, and lack of training and support. User-centered design is critical to maximize the uptake of supportive technologies among older adult users. This presentation will provide an example of how the user-centered design process was applied to the design of a digital platform for older adults, the PRISM software system. The iterative design approach and the incorporation of user feedback into the design process will be highlighted. PRISM, an integrated software system, was designed to foster social connectivity, cognitive engagement, and resource access among aging adults. Versions of PRISM have been evaluated in diverse contexts and geographic regions, and with diverse populations, including individuals with a cognitive impairment. Data will be presented regarding participants use of and perceptions of the usability and value of PRISM. Findings regarding the impact of the use of PRISM on social connectivity and perceptions of loneliness will also be presented. A focus will be on the adaptation of PRISM for aging adults with a cognitive impairment and strategies used to provide training for this population. Recommendations for needed future research in the aging and technology domain will also be provided to ensure that the emerging technology applications are designed to meet the needs, abilities, and preferences of aging adults.
NATIONAL RECRUITMENT OF DIVERSE CAREGIVERS TO TEST AN ONLINE PLATFORM TO MANAGE BEHAVIORAL SYMPTOMS
Authors: Webster Melinda , Kales Helen , Parker Lauren , Scerpella Daniel , Marx Katherine , Bouranis Nicole , Gitlin Laura
Published: January 2025

Online platforms are promising scalable approaches to support diverse family caregivers. Testing these approaches requires recruiting nationally representative cohorts in terms of race, ethnicity, and geography. However, large-scale national recruitment is challenging given lack of best practices and inability to rely on local resources. We describe the recruitment sources used to enroll caregivers in an NIA-funded trial to test WeCareAdvisor, an online platform providing strategies to manage dementia-related behavioral symptoms. Over two years, 40 recruitment sources were pursued, yielding 892 inquiries from which 262 (29.3%) caregivers were enrolled. Recruitment sources were categorized into six types: 1) registries yielded the most study participants (550 inquiries, 112 enrolled, 42.7% of sample); 2) community-based providers/organizations (87 inquiries, 41 enrolled, 15.6%): 3) caregiver resources/respite services (50 inquiries, 34 enrolled, 13%); 4) dementia societies/associations/organizations (55 inquiries, 30 enrolled, 11.5%); 5) miscellaneous sources (87 inquiries, 23 enrolled, 8.8%); and 6) articles/professional talks (63 inquiries, 22 enrolled, 8.4%). Regarding diversity, registries yielded more non-spouses as compared to other recruitment sources; articles/professional talks yielded more racial/ethnic diversity proportionate to the number enrolled from that source (54.5% of 22 enrolled versus 15% of 112 enrolled through registries). Enrolled participants resided in 36 states, representing all 10 Department of Health & Human Services regions of the US. Costs (media ads, registry fees) totaled $22,438; $85.64 per participant. Although registries yielded the most enrollees, personal contact through articles/professional talks was more effective enrolling racially diverse caregivers. Recruiting caregivers nationally requires numerous strategies and fielding voluminous inquiries with implications for staffing/budgeting.
GOING MOBILE: ADAPTING LATE-LIFE PSYCHOTHERAPIES FOR MOBILE DEVICES
Authors: Jain Felipe , Gutierrez-Ramirez Paulina , Melero-Dominguez Maria , Zea Miranda , Gomez Liliana Ramirez
Published: January 2025

Smartphone psychotherapy applications have the potential for broad scalability, objective treatment compliance monitoring, and passive monitoring of symptom changes (e.g. by leveraging smartphone sensors such as accelerometer). The majority of older adults own and utilize smartphones, but older adults are underrepresented in smartphone research. Moreover, considerations for adapting psychotherapy information for older adults to the smartphones are not well-described. Older adult family caregivers of persons living with dementia (PlD) describe numerous barriers to participation in in-person therapies including travel time and caregiver burden. Mentalizing imagery therapy is a guided imagery and mindfulness approach that has been shown in in-person studies in family PlD caregivers to reduce depression and anxiety, and to strengthen cognitive control (dorsolateral prefrontal) brain connectivity. We present a case study of the adaptation of mentalizing imagery therapy and caregiver skills training for family caregivers of PlD to a mobile application supported by optional virtual groups. We describe user-centered participatory design of the mobile and virtual therapy application including mobile architecture, data storage and security, feature development, collection of passive accelerometer data, embedded chat group, and development timeline. Initial feasibility results are presented from forty older adult family caregivers of PlD, including retention, compliance, system usability, and usage information. These results demonstrate meeting pre-specified feasibility benchmarks and describe important challenges with adaptations of psychotherapy to smartphone. We also demonstrate feasibility of collecting continuous smartphone accelerometer data, and preliminary results from a machine learning data analytic pipeline that achieved >85% accuracy for estimation of weekly mood ratings.
POLICY SERIES: TRENDS IN ELDER ABUSE AND INITIATIVES TO PREVENT ELDER ABUSE IN JAPAN DURING THE PAST 20 YEARS
Authors: Putnam Michelle , Teaster Pamela
Published: January 2025

This symposium begins by briefly introducing activities of Japan Academy for the Prevention of Elder Abuse, cerebrating 20 years, and features the Japanese Act on the Prevention of Elder Abuse. First, using data collected by the Ministry of Health, Labour, and Welfare (MHLW), research analyses present trends in elder abuse case reports substantiated as “elder abuse”, trends in reporters in both institutional and domestic settings, and introduce recent amendments of operational standards made by ministerial ordinance. Second, using data (N=171) on elder abuse from Matsudo-City collected in 2019, analysis examines relationships between trends in the increasing number of elder abuse reports made by the police (about 43% of all cases) and trends in the number of cases regally considered to be “elder abuse” (only 17.8% of those reported to the police were legally considered to be “elder abuse”). It examines possible reasons and propose necessary policy changes in definitions of elder abuse. Third, using longitudinal data collected by Matsudo-city and by the MHLW from 2006 through 2022, this analysis examines the impacts of COVID-19 on the occurrence of elder abuse. Analyses revealed that neither data set showed significant increase in frequencies of occurrence of elder abuse due to COVID-19. Rather, it showed a decrease for the MHLW data. This study examines possible reasons and make recommendations to further decrease frequencies of occurrence of elder abuse cases. Abuse, Neglect and Exploitation of Older Persons Interest Group Sponsored Symposium
ETHNORACIAL DIFFERENCES IN FORMAL AND INFORMAL VOLUNTEERISM AMONG OLDER ADULTS IN THE US: A FOCUS ON ASIAN AMERICANS
Authors: Lai Patrick Ho Lam
Published: January 2025

This study questions the assertion that socioeconomic resources are the primary driver behind ethnoracial disparities observed in volunteerism among older adults. Existing literature fails to account for why Asian older adults, with resources comparable to Whites, exhibit lower volunteerism rates. This paper improves upon prior literature by differentiating formal and informal volunteerism and centering Asian American older adults as the reference group to better understand these differences. Utilizing data from the 2019 and 2021 Current Population Survey, bivariate probit models were estimated for formal and informal volunteering. The results indicate that, after accounting for income and education, White individuals have 1.42 times the odds of participating in formal volunteerism compared to Asians, while other ethnoracial groups (Black, Hispanic, American Indian, and Alaskan Native) show 1.09 to 1.31 times the odds of Asians (p <.05). Notably, irrespective of volunteerism type, Asians persist as the least likely to volunteer compared to both White individuals and other ethnoracial groups, underscoring the imperative to investigate other factors such as culture. Implications extend to directing future research toward the cultural underpinnings that may elucidate lower volunteerism rates among Asian older adults. The findings advocate for policy revisions recognizing the intricate interplay between SES and cultural factors. Moreover, social work practices and theoretical models must advance to incorporate cultural considerations, acknowledging the diversity within ethnoracial groups. This nuanced approach is vital in fostering a supportive environment for volunteerism among all older adults, with particular attention to the unique circumstances of Asians.
GENDER DISPARITIES IN WAGES AMONG OLDER WORKERS: THE ROLE OF OCCUPATIONAL SEGREGATION AND EDUCATION
Authors: Carpenter Rebekah
Published: January 2025

Women have a long history of being underpaid relative to men, and many argue that these differences are driven by the concentration of women in jobs that pay less, along with differences in skills and education. Despite increased educational attainment and labor market participation by women over the last 50 years, today, men continue to outearn women. One way to assess structural/contextual factors contributing to gender disparities in pay involves evaluating occupational sex segregation (i.e., the unequal distribution of men and women across different occupations and industries) and the extent to which college education leverages differing levels of financial remuneration among older men and women at the latest phases of their working lives, a sample often excluded from studies on gender pay disparities. Leveraging data from the American Community Survey (2015-2019), I examine the relationship between occupational sex segregation, college degree status, and gender disparities in earnings for a nationally representative sample of 2,101,547 older workers ages 50-70. Findings from regression analyses show that older women earn significantly less than older men across each occupational sex segregation category (i.e., male-dominated, gender-neutral, or female-dominated), regardless of college degree status. Moreover, the greatest disparities in earnings are among college-educated older workers in gender-neutral occupations, where women earn only 70 cents for every one-dollar men earn. Findings from this study highlight the structural/contextual factors shaping the basis of gender pay disparities in later phases of working careers, which has important implications for contextualizing gender differences in retirement preparation and later-life wealth and wellbeing.
DONALD P. KENT AND ROBERT W. KLEEMEIER AWARD LECTURES
Authors: Howe Judith
Published: January 2025

The Donald P. Kent Award lecture will feature an address by the 2023 Kent Award recipient Kathleen Wilber, PhD, FGSA, FAGHE of the University of Southern California. The Robert W. Kleemeier Award lecture will feature an address by the 2023 Kleemeier Award recipient David M. Almeida, PhD, FGSA of Pennsylvania State University. The Kent Award is given annually to a member of The Gerontological Society of America who best exemplifies the highest standards of professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society. The Kleemeier Award is given annually to a member of The Gerontological Society of America in recognition for outstanding research in the field of gerontology.
THE NATIONAL STUDY OF DAILY EXPERIENCES: CHARTING QUOTIDIAN LIFE OF ACROSS ADULTHOOD
Authors: Almeida David
Published: January 2025

This presentation delves into the intricate tapestry of daily experiences across the adult lifespan, drawing insights from the MIDUS daily project of a US national sample of 3,509 individuals. Through analysis of over 42,000 daily telephone interviews collected across 20 years, we investigate the nuances of quotidian life, uncovering patterns, and determinants that shape individuals’ daily routines and emotional landscapes. Leveraging a diverse sample spanning different age groups, socio-economic backgrounds, and geographic locations, we illuminate the multifaceted nature of daily experiences. Findings reveal dynamic trajectories of well-being, stress, and activities, shedding light on how these dimensions fluctuate with age and life circumstances. Furthermore, we explore the influence of contextual factors such as work, family, and social interactions on daily experiences, unraveling their complex interplay with individual characteristics. This research contributes to a deeper understanding of the lived realities of adults, offering implications for enhancing daily well-being and quality of life.
DEVELOPING A CULTURALLY TAILORED INTERVENTION FOR AFRICAN AMERICAN PARENT–ADULT DAUGHTER DEMENTIA DYADS
Authors: Johnson Kalisha Bonds , Lyons Karen , Monin Joan , Daniel Gaea , Powell Wizdom , Hepburn Kenneth
Published: January 2025

African American older adults are suggested to be two times more likely to develop Alzheimer’s disease and related dementias (ADRD) compared to non-Hispanic White older adults. Thus, there is a need for more African American care partners. The largest group of care partners of African American persons living with ADRD, African American adult daughters, must navigate formal care decision making through the lens of race, gender, culture, and associated health disparities. Formal care—paid health care services for older adults usually associated with an institution— is important in the treatment of ADRD and maintenance of quality of life. Guided by the NIA Health Disparities Research Framework, Black Family Social-Ecological Context Model, and Superwoman Schema (SWS), this presentation will describe the first aim of this explanatory sequential design of a culturally tailored prototype intervention to support the formal care decision-making process for African American parent-adult daughter dementia dyads. Results from the preliminary analysis of 20 dyads highlight most are mother-daughter dyads (90%) with parents, on average, experiencing moderate cognitive impairment. Both parents and adult daughters report “good” health, “some” difficulty with family listening to their opinions, moderate to high decision self-efficacy, and moderate quality of life. Daughters report low SWS characteristics but high cultural justification for caregiving. Using these results, we will showcase the next steps of data collection, how theory guided our study, the intentionality of relationships status, and the role of community engagement as important considerations for dyadic prototype intervention development.
MIXED-METHODS RESEARCH DESIGNS FOR EARLY-PHASE DYADIC HEALTH RESEARCH
Authors: McCarthy Michael , Cerino Eric , McCoy Megan , Martinez Margarita
Published: January 2025

Individuals and family caregivers living in rural areas face a double bind when it comes to health. First, they may be at increased risk for chronic health conditions. Second, they are frequently hampered in seeking support for these conditions due to factors including geographic isolation, cultural barriers, and lack of financial resources. These inequities result in delayed diagnosis and treatment and poor health outcomes. Researchers seeking to address these issues are often faced with recruitment challenges in small rural communities and subsequently modest sample sizes. Mixed-methods designs offer advantages for early-phase dyadic studies including strengthening participant engagement, maximizing resources, surfacing new questions to be explored in future research, and in general, providing a deeper understanding of the phenomenon being studied. In this presentation, we draw on several of our mixed-methods early-phase dyadic studies in stroke, dementia, and cognitive health to provide examples. We identify mixed-methods designs that deepen understanding in early-phase dyadic health research and the advantages of certain mixed-methods designs for certain inquiries. Finally, we discuss recommendations for maximizing the approach, and strategies for blending analytical methods.