bluuebunny/crossref_metadata_2025 huggingface dataset:
NIA SBIR-FUNDED JUVENA THERAPEUTICS TRANSLATION OF POWERFUL PROTEINS INTO TRANSFORMATIVE THERAPEUTICS
Authors: O’Connell Jeremy
Published: January 2025

Juvena Therapeutics, which received NIA SBIR funding in 2021, was founded to restore tissue health by repairing protein signaling and intercellular communication. Juvena maps the therapeutic potential of natural secreted proteins and engineers them into biologics that restore tissue homeostasis. Juvena’s artificial intelligence-enabled platform mines thousands of proteins secreted by human stem cells, screens their potential to restore tissue homeostasis, and engineers novel biologic medicines into life-saving treatments. Juvena’s SBIR funding had multiple benefits as it enabled optimization of their lead compound, additional compound screenings, as well as the rigorous feedback that resulted from peer review. Since receiving NIA SBIR funding and showcase support, Juvena has now raised close to $60 million in venture capital funding and is rapidly advancing its efforts. Juvena’s journey is a great example of how SBIR funding can be a critical resource early in a biotech startup’s development path.
MARITAL STATUS AND DRINKING BEHAVIORS AMONG OLDER HISPANIC ADULTS IN THE UNITED STATES
Authors: Nazario-Acevedo Jaminette , Yamashita Takashi , Bulanda Jennifer , Brown J Scott
Published: January 2025

On average, Hispanics are not the most frequent alcohol consumers, however, when Hispanics consume alcohol, the chance of excessive drinking is greater than for other racial and ethnic groups. Excessive drinking can be seen as a stress-coping response and harmful, especially to the health of older Hispanic adults. Hispanic culture places particular importance on family relationships (a.k.a., Familismo). The size of social networks tends to shrink in later life and a specific social relationship-- marriage -- becomes a crucial social support network. Studies show that marital relationships facilitate stress-coping processes and, in turn, benefit health. A social support system can be a resource to prevent stress-induced excessive drinking among older Hispanic adults. Thus, the current study aims to examine how marriage is associated with alcohol consumption behaviors among older Hispanic adults in the United States. The data of the nationally representative samples of Hispanic adults aged 51 years and older (n = 316) are obtained from the 2018 U.S. Health and Retirement Study (HRS). Results from the negative binomial regression indicate that on average, married older Hispanic adults consume 66% fewer alcoholic drinks per week (b = -1.10, p < 0.01) than their unmarried counterparts. Also, older Hispanic women consume 90% fewer alcoholic drinks per week (b = -2.29, p < 0.01) than older Hispanic men. The roles of culturally valued social relationships and gender differences, along with other predictors of alcohol consumption patterns are evaluated from sociocultural and public health perspectives (e.g., prevention of excessive drinking through social support).
A SCOPING REVIEW OF PHYSICAL ACTIVITY IN ADULTS OVER 50 WITH AUTISM: MANY BARRIERS AND SPARSE DATA
Authors: Kartoz Connie , Jefferson Rebeca , Eisenberg Chase , Antonakakis Antigone
Published: January 2025

The population of older adults with autism is growing, yet the literature for this group is still relatively sparse (Mason et al., 2022). Adults with autism are reported to have comorbidities and a reduced lifespan (Hand et al., 2020). While physical activity (PA) is known to reduce chronic disease burden, extant research indicates young adults with autism do not engage in physical activity (PA) with the same frequency as neurotypical peers. Little is known about PA for older adults with autism. This scoping review aimed to explore research about PA for older adults with autism.

Methods

Following the PRISMA-ScR guidelines, 5 databases were searched (2018 and later) with keywords ‘autism,’ ‘older adults’, ‘PA,’ and age group delimiters.

Results

Initially, no articles were found, and the search was expanded to include all adults. After eliminating duplicates, 121 studies were reviewed, with 25 meeting the criteria (PA, autism, and no participants less than 18) and 9 having any participants over 50; in each of these 9 studies, the number of participants over 50 was less than 100. Only 2 studies focused on adults over 50. The level of evidence was low. The limited data suggests those aging with autism do not engage in recommended levels of PA and experience barriers to the same, but that interventions improve PA and possibly quality of life. IMPLICATIONS: There is a dire need to design interventional research to increase PA in older adults with autism to improve equitable health outcomes for this at-risk group.
ANALYSIS OF IMPACT OF DAILY OBJECTS’ SHAPE ON STANDING AND SITTING BEHAVIOR OF FRAIL OLDER PEOPLE
Authors: Handa Satoru , Kitamura Koji , Kawai Hisashi , Nishida Yoshifumi
Published: January 2025

One promising approach to supporting the independent lives of frail older people is the design of living environments. The objective of this study is to clarify the effect of slight changes in the three-dimensional shape of daily environments, such as a desk, on standing and sitting by conducting experiments on frail older people. To this end, the authors fabricated four types of desks with different shapes and then measured the standing and sitting movements of frail older people (N=85, 65 to 90 years old) using the desks, a motion capture system, three-axis force sensors, and pressure sensors. The measure data were analyzed from psychological and physical viewpoints. Eight of the 85 applicants had severe sarcopenia. The results showed that handrails and fingerholds significantly increased the force to hold the desk (p< 0.0001), and analysis using a musculoskeletal model (AnyBody) revealed that they decreased the muscle activity to push the desk (p=0.015).The cluster analysis results using posture data present that the handrails and handholds of the desk contributed to shifting the center of gravity of the upper body forward, leading to a decreasing burden on the muscles. A post-measurement questionnaire indicated that over 80% of the participants felt desks with handrails or handholds were more accessible to support and stand on. Some participants commented that the slight shape change improved a sense of safety. These results suggest that even minor design features such as handrails and fingerholds can assist the older in shifting their upper body posture without increasing the muscles’ burden.
INTERSECTION OF GENDER, PHYSICAL DISABILITY, AND EXPERIENCES OF ELDER MISTREATMENT IN DEMENTIA
Authors: Pickering Carolyn , Browning Wesley , Winstead Vicki , Hernandez Jessica , Yildiz Mustafa
Published: January 2025

A gerofeminist perspective highlights the intersection of gender, age, and power dynamics that influence the experience of aging women, while recognizing that age can also come with beneficial resources. Since gender-based power dynamics play significant roles in women’s experiences of aggression at younger ages, this study investigates the intersection of gender, physical disability, and elder mistreatment among older adults with dementia. Family caregivers provided self-reports on their care recipients’ characteristics and the frequency of engaging in physically aggressive, psychologically aggressive, and neglectful behaviors at three time points (enrollment, 6-, and 12-month follow-ups). We utilized mixed models for repeated measures to assess whether women experienced more aggressive and neglectful behaviors than men and whether physical disability heightened this risk. Care recipients (N=453) were more often women (58%). Women care recipients required significantly more assistance with ADLs (p<0.001), were more often wheelchair or bedbound (p<0.001) and lived in larger (p=0.003) and more multigenerational households compared to men (p=0.03). Gender-only models revealed that women experienced significantly less neglect than men (p=0.02). When physical disability was considered, wheelchair or bedbound women experienced significantly more neglect (p<0.001) and physical aggression (p<0.001) than men or non-physically disabled women. Findings support a gerofeminist view that women accumulate strengths as they age, such as larger social networks, that may protect against neglect. Findings also suggest that older women with physical disabilities face heightened risks of mistreatment, underscoring the importance of further research into the intersectionality of gender and disability.
GENDER DIFFERENCES ON THE EFFECT OF RECIPROCITY ON NEGLECT AND ABUSE BY DEMENTIA CAREGIVERS
Authors: Winstead Vicki , Pickering Carolyn , Browning Wesley , Hernandez Jessica , Yildiz Mustafa
Published: January 2025

Reciprocity, a balanced exchange in interactions, is a crucial element of most social exchanges and impacts caregiving outcomes. This paper aims to investigate whether reciprocity plays a protective role against elder abuse and neglect and to explore potential gender variations associated with this relationship. A sample of 453 family caregivers reported daily perceptions of reciprocity in a micro-longitudinal study over 21 days. Perceived reciprocity was measured by the participant’s level of satisfaction with the amount of affection/appreciation shown by their relative with dementia in the previous 24 hours. Generalized linear mixed models examined the effect of perceived reciprocity on the odds of the caregiver engaging in psychologically aggressive, physically aggressive, and neglectful behaviors that day. Perceived reciprocity was associated with lowered daily odds of neglect (OR= 0.76 p= 0.006) and psychological abuse (OR = 0.6 p< 0.001). We calculated an interaction term of the effects of gender and perceived reciprocity on abuse/neglect to assess gender differences. Increased reciprocity reduced the odds of neglect for both males and females, but the reduction in odds was greater for males (p=0.041). Results suggest that receiving attention and affection for caregiving may act as a protective factor, particularly for male caregivers. While female caregivers might face socially constructed role expectations, males, often taking on caregiving out of obligation, may benefit from reciprocal interactions regarding reduced likelihood of neglecting the care recipient. These insights contribute to a nuanced understanding of gender dynamics in caregiving and can inform interventions to prevent elder abuse and neglect.
IMPROVING QUALITY IN ASSISTED LIVING: FINDINGS FROM STATEWIDE INITIATIVES
Authors: Zimmerman Sheryl , Sloane Philip
Published: January 2025

Almost 1.7 million people in the U.S. receive residential long-term care, more than half who reside in assisted living -- broadly defined as congregate settings that provide at least two meals a day, around-the-clock supervision, and help with personal care. Whereas nursing homes are federally regulated, assisted living is state regulated, which recognizes it as a community-based setting and allows for innovative practices and policies to promote better care and outcomes. Over the years, numerous state-based initiatives have been enacted across the country; this session will discuss new initiatives in two states, addressing their implementation, findings, and broad implications. Minnesota’s legislation recently created an online report card based on resident and family surveys; the presentation by Dr. Shippee will overview three years of data from more than 12,000 residents, noting the areas scored most favorably (e.g., environment) and least favorably (e.g., engagement). Dr. Moone will discuss the Minnesota assisted living regulatory framework and how the absence of broad representation in licensure development resulted in inconsistency in and preparation for survey inspections, as well as inadequate reimbursement. North Carolina recently undertook a statewide randomized trial of accreditation for assisted living; Ms. Efird-Green will discuss challenges implementing accreditation in more than half of the communities, and Dr. Zimmerman will present two years of outcome data comparing control and accreditation arms in relation to workforce and resident outcomes, care coordination and transitions, medication management, and person-centered care. Results will be put in context to inform quality initiatives across the country.
THE ASSOCIATIONS BETWEEN DAILY MEMORY LAPSES, FAMILY RELATIONSHIPS, AND DAILY AFFECT IN MIDDLE-AGED AND OLDER ADULTS
Authors: Jang Heejung , Hill Nikki , Turner Jennifer , Almeida David , Mogle Jacqueline
Published: January 2025

Daily memory lapses represent an understudied approach to understanding daily experiences of cognitive functioning. Because family relationships greatly influence individuals’ daily lives, the present study explores how the quality of family relationships impact daily memory lapses and the moderating influence of family relationship quality on the link between daily memory lapses and daily affect. We used data from 1,236 middle-aged and older adults (Mage= 62.48 years, SD= 10.21, range 43-91; 57% female) drawn from the third waves of the Midlife in the United States and National Studies of Daily Experiences. Participants completed 8 nightly telephone diaries that included both prospective and retrospective memory lapses as well as daily positive and negative affect. At baseline, participants reported on the emotional support they experienced with their family. Latent class analysis (LCA) models identified four family relationship types: pleasant, ambivalent, neutral, and unpleasant. Compared to pleasant relationships, ambivalent (b=.23, p<.05) and neutral (b=.35, p<.01) relationships are strongly associated with frequency of prospective memory lapses, but not retrospective lapses. Compared to pleasant relationships, ambivalent (b=.02, p<.05), neutral (b=.02, p<.05), and unpleasant (b=.07, p<.001) relationships are associated with increased negative affect on days with a retrospective lapse, but not on days a prospective lapse. This study contributes to the literature by revealing that family relationships influence cognitive problems individuals experience in their daily lives and how these cognitive problems may contribute to affective symptom load over time.
NURSING HOME INFECTION PREVENTIONISTS: THEIR ROLE DURING COVID-19
Authors: Vogelsmeier Amy , Popejoy Lori , Miller Steven , Young Lisa , Johnson Alisha , Thompson Roy
Published: January 2025

While U.S. nursing homes were required to employ infection preventionist (IP) prior to the COVID-19 pandemic, little is known about their role during the pandemic. Leaders and IPs were interviewed about IP duties as part of a larger study conducted in 24 Midwestern nursing homes to understand nursing homes’ response to COVID-19. Homes were purposively selected for the larger study to assure diverse pandemic experiences. Interviews were analyzed by four PhD researchers, doctoral student, and project coordinator using qualitative content analysis. IPs included registered nurses (RN) (16, 66%), licensed practical nurses (LPN) (7, 30%) and respiratory therapist (1, 4%) and had varied education levels including some college (6, 25%), associate’s (13, 54%) bachelor’s (3,13%) and master’s (2, 8%) degrees. Most homes (n=22; 92%) assigned IP duties to existing clinical roles e.g., directors/assistant directors of nursing, supervisors/charge nurses. COVID-related duties included reporting COVID testing to external agencies, administering vaccinations, and monitoring/training PPE use. A few, primarily RNs, also performed traditional IP duties including surveillance of residents/staff symptoms, tracking/trending unit outbreaks, implementing strategies to reduce spread, and collaborating with medical providers. Mandated reporting, a high-stakes, high-burden activity, was often shared with administrators and corporate leaders. Despite IP training, LPNs more often described not understanding their role beyond tasks. Most IPs discussed other assigned clinical roles as taking priority over their IP responsibilities. The IP role has important implications for infection prevention and management in nursing homes, however licensure differences, role clarity, and competing demands may affect the IP’s influence in this setting.
CAREGIVING CRISIS: NURSING ASSISTANT TRAINING REQUIREMENTS AND QUALITY OF LIFE IN SKILLED NURSING FACILITIES
Authors: Barragan Cassandra , Dean Devlon
Published: January 2025

Nursing Assistants (NAs) provide the majority of hands-on care for older adults in skilled nursing facilities (SNFs) while also providing companionship and psychological support. NAs receive a minimum of 75 hours of training in every state with 12 states requiring 120 or more (M=95.2). However, many NAs feel unprepared for the complexities of caring for older adults (Trinkoff et al., 2017). This lack of preparedness likely contributes to high staff turnover in SNFs (Gaivin, 2022) and directly impacts the quality of care (Castle & Endberg, 2006). This research explored the relationship between NA training hours and SNF quality of care citations in the United States. Data from the Centers for Medicare and Medicaid Services (CMS) SNF Quality Reporting Program (QRP) were used to determine the number of quality of life (QOL) citations for 5408 facilities in all 50 states and cross-referenced with the number of training hours required in each state. To control for the influence of a social worker, not required in smaller facilities, only facilities with 100 or more beds were examined. Regression analysis found for every hour increase in training hours, there will be an approximate 4% decrease in the predicted percentage of facilities with less than satisfactory QOL deficiencies. This research provides additional evidence that providing NAs with more training can improve QOL outcomes for residents of SNFs. This has implications for SNFs, assisted living, home health care, adult foster care, and other settings where NAs are employed.
GENDER DIFFERENCES IN THE RELATIONSHIP BETWEEN POLYPHARMACY AND DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS
Authors: Qiu Xiao , Xu Ziyao , Sun Na , Hua Cassandra , Brown J Scott
Published: January 2025

Polypharmacy is prevalent among older adults and is associated with increased depressive symptoms, yet differences in the relationship by gender are not well known. Understanding these gender-specific differences is crucial for developing targeted interventions to address depressive symptoms among older adults. This study examines the relationship between polypharmacy and depressive symptoms among US community-dwelling older adults aged 65 or older (n = 3,143), utilizing data from the 2006 and 2008 waves of the Health and Retirement Study (HRS) core survey and its supplementary drug surveys. Employing negative binomial generalized estimating equation (GEE) models, polypharmacy is defined as the concurrent use of five or more prescription medications, while depressive symptoms are assessed using the 8-item version of the Center for Epidemiologic Studies Depression (CESD-8). Over 40% of respondents aged 65 or older from the 2006 and 2008 waves regularly use five or more prescription medications. Polypharmacy is associated with increased depressive symptoms (CIRR=1.20, 95% CI= 1.15 -1.25). Notably, the relationship between polypharmacy and depressive symptoms varies by gender. Among women, polypharmacy is linked to a lower number of depressive symptoms (AIRR = 0.90, 95% CI = 0.84 - 0.95), whereas among men, it is associated with an increased number (AIRR =1.12, 95% CI = 1.05 -1.19). These findings highlight the importance of tailored interventions and healthcare strategies.
COGNITION AND PAIN ARE ASSOCIATED WITH DISCREPANCIES IN ACTIGRAPHY AND SELF-REPORTED SLEEP MEASURES IN OLDER ADULTS
Authors: Calderon Russell , Liu Sofia , McPhillips Miranda , Liu Michelle , Liu Yifan , Li Junxin
Published: January 2025

Sleep is a key determinant of health in older adults and is assessed using accelerometer-based (Actigraphy) and self-reported methods. This study aims to describe and identify factors associated with potential discrepancies between Actigraphy and self-reported sleep parameters (“Actigraphy/self-reported discrepancies”) in 125 community-dwelling older adults without dementia [Montreal Cognitive Assessment (MoCA) ≥17] using data from a randomized clinical trial (NCT03959202). Participants were 70.4±6.3 years old, 79.2% females, 21.6% with mild cognitive impairment. Actigraphy and corresponding self-reported sleep measures, including time in bed (TIB), sleep onset latency (SOL), total sleep time (TST), and sleep efficiency (SE) were collected using Actiwatch 2 for 7-10 days, sleep diaries, and Pittsburgh Sleep Quality Index (PSQI). Relative to Actigraphy measures, 11.2%, 38.4%, 52.0%, 35.2%, and 36.0%, of participants reported longer TIB(diary) (>15 minutes), TIB(PSQI) (>15 minutes), SOL(PSQI) (>5 minutes), TST(PSQI) (>15 minutes), and better SE(PSQI) (>5%) respectively, whereas 38.4%, 52.0%, 12.0%, 54.4%, and 28.0% of participants reported shorter TIB(diary), TIB(PSQI), SOL(PSQI), TST(PSQI), and worse SE(PSQI) by the same magnitudes. Multiple linear regression analyses adjusted for demographics suggest higher MoCA was associated with reduced Actigraphy/self-reported discrepancies (TIB(Actigraphy-diary):β=-13.6, p=0.037; TIB(Actigraphy-PSQI):β=-11.2, p< 0.01; SOL(Actigraphy-PSQI):β=-3.3, p=0.019; TST(Actigraphy-PSQI):β=-7.4, p=0.01; SE(Actigraphy-PSQI):β=-1.5, p=0.013). Higher pain behavior expression (TIB(Actigraphy-PSQI):β=7.3, p=0.011; SOL(Actigraphy-PSQI):β=2.7, p=0.014) and pain interference (TIB(Actigraphy-diary):β=8.8, p< 0.01) were associated with greater Actigraphy/self-reported discrepancies. In summary, cognitive function and pain were associated with Actigraphy/self-reported discrepancies among older adults without dementia. Given that cognition and pain may interfere with self-perceptions of sleep quality, sleep must be carefully assessed and interpreted in this population.
GENDERED RACIAL DISPARITIES IN FUNCTIONAL LIMITATIONS: EXPLORING THE ROLE OF LIFE-COURSE FAMILY CARE
Authors: Lee Chioun , Park Soojin
Published: January 2025

Objectives

This study addresses the dearth of research on culturally embodied factors influencing health disparities, focusing on cultural aspects such as family formation timing, living arrangements, familism, and family care responsibilities. By employing “intersectionality” and a life-course approach to “family care,” we aim to understand why minority women are vulnerable to functional limitations.

Methods

Data come from the MIDUS II, Refresher, and Milwaukee surveys, with a sample of Non-Hispanic Whites and Blacks (N=8,848; 18% Blacks; 53% Women). Measures of family care included age at first childbirth, number of biological children, single or nonmarital parenthood, child loss, co-residence with a disabled child, family caregiving history, and major grandparenting responsibilities. We identified racial disparities in family care profiles and assessed their contribution to health disparities.

Results

Adverse family care profiles were more common among women, particularly Blacks. Compared to White women, Black women were more likely to experience early and non-marital motherhood, current family care, and major grandparenting roles. Adverse family care profiles were linked to more functional limitations, with differing effects between Black and White women. While early childbearing was more detrimental to White women, caring for disabled family members had a greater adverse effect on Black women. Adverse family care profiles explained one-third of Black-White disparities in functional limitations.

Discussion

Our findings highlight the social costs of family care, disproportionately affecting minority women. They offer insights into public health policies and interventions aimed at easing the burdens of family care to improve their quality and length of life.
NOVEL METHODS AND DATA IN POPULATION AGING RESEARCH
Authors: Chen Ruijia , Hayes-Larson Eleanor
Published: January 2025

Causal inference in population health research on aging is critical for understanding determinants of healthy aging and informing potential avenues of intervention. Such research faces a number of methodological challenges including data availability, detection bias, selection bias, confounding, and reverse causation. Novel statistical methods and approaches to leveraging data have been developed to address these issues. This session features cutting-edge research that incorporates novel methods and data to address key methodological challenges in aging research. Speakers will address (1) the use of hypothetical intervention approaches to address confounding and reverse causation to understand the impact of loneliness on memory function in older adults, (2) a multiple-exposure data reduction approach to identify important determinants of exercise in an aging population, (3) ways to uncover and account for detection bias in electronic health record studies of dementia, (4) pooling of cohorts to address gaps in data availability across the lifecourse, and (5) challenges and opportunities related to extending findings from selected aging samples to broader populations of interest. Epidemiology of Aging Interest Group Sponsored Symposium
EXTENDING FINDINGS FROM AGING COHORTS TO BROADER POPULATIONS OF INTEREST: CONSIDERING TRANSPORTABILITY
Authors: Hayes-Larson Eleanor
Published: January 2025

Aging cohorts and other commonly-used data sources are typically not the populations of interest for scientific inferences in epidemiologic aging research. Rather, inferences are desired about particular target populations (e.g. defined by geography, age, birth cohort, or medical history), making external validity of study findings a particularly relevant concern. Recent developments in epidemiologic methods facilitate quantitative assessment of external validity and offer statistical solutions when study samples are not representative of the target population of interest. In this presentation, we discuss approaches to evaluating external validity in aging research, and methods for extending findings to a given target population when external validity appears threatened. We emphasize estimators that are valid for lifecourse research questions, and offer several recent examples from cognitive aging research.
EXPLORING THE IMPACT OF NURSE WAGES ON NURSING HOME QUALITY
Authors: Pradhan Rohit , Ghiasi Akbar , Orewa Gregory , Davlyatov Ganisher , Weech-Maldonado Robert
Published: January 2025

Nurses are the primary caregivers in nursing homes (NHs) and providing high-quality care hinges significantly upon their adequacy and expertise. However, NHs have historically struggled with inadequate nurse staffing, partly due to nurse wages in NHs being lower than those in other healthcare settings, such as hospitals. This study aimed to explore the relationship between nurse wages and the quality of care in NHs. This study used secondary datasets such as the Payroll-Based Journals and Care Compare (2017-2022). Multivariate ordinal logistic regression with two-way (state and year-level) fixed effects was employed. The study included all U.S. NHs certified by the Centers for Medicare and Medicaid Services (CMS). Analytic data comprised 80,244 facilities, averaging 13,374 unique NHs per year. We focused on the CMS NH Five-Star Quality Rating System’s quality star rating (1-5 scale) as the dependent variable, with independent variables being the inflation-adjusted hourly wages for registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs), while controlling for facility and community characteristics that influence quality. The findings revealed that a one-dollar increase in hourly RN wages was linked to a three percentage-point increase in the odds of an NH receiving a higher star rating (p<.01). Increased RN and CNA hours per resident day (PRD) were positively associated with higher quality ratings, whereas higher LPN hours PRD were correlated with lower quality ratings (p<.001). These results highlight the need for targeted policy and managerial interventions to adjust nurse compensation strategies, particularly for RNs, to enhance NH quality.
NURSE WAGES AND NURSING HOME FINANCIAL PERFORMANCE
Authors: Lord Justin , Ghiasi Akbar , Gupta Shivani , Pradhan Rohit
Published: January 2025

Nursing home (NH) care is labor intensive, with staff compensation being the most significant expense. Balancing higher wages to attract qualified nurses against the allocation of resources to other facility areas is crucial. This study examined the impact of nurse wages on NH financial performance. This study used secondary datasets such as the Payroll Based Journals, Medicare cost reports. and Care Compare (2017-2022). It included all U.S. NHs certified by the Centers for Medicare and Medicaid Services (CMS). Analytic data comprised 80,244 facilities, averaging 13,374 unique NHs per year. We modeled the data using multivariate linear regression with two-way fixed effects (year and state). The operating margin at the facility level served as the dependent variable, with inflation-adjusted nurse wages as the main variable of interest. Separate models for registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs) showed that a 10% wage increase correlated with operating margin decreases of 7.3%, 9.6%, and 11.5%, respectively (p<.01). Positive operating margins were associated with for-profit status, chain affiliation, larger facilities, higher occupancy, and a greater proportion of Medicare residents, while higher uninsured rates and Medicare Advantage penetration negatively impacted margins. These findings underscore the necessity for striking a strategic balance between nurse compensation and NH financial health. Given the important role nurses play in NHs, and amidst an acute staffing shortage, our study emphasizes the need for policy measures that support both competitive nurse wages and the sustainability of NH operations, ensuring high-quality care and long-term viability.
USING THE ACT-OUT QUESTIONNAIRE TO INFORM ON COMMUNITY MOBILITY AND PARTICIPATION FOR PEOPLE LIVING WITH DEMENTIA
Authors: Margot-Cattin Isabel , Gaber Sophie
Published: January 2025

For people living with dementia to continue living in their current residences or “age in place”, it is essential for them to sustain their participation in daily activities and maintain mobility within their communities. Community mobility encompasses the ability to reach places where they can participate in meaningful everyday life activities. It also includes transportation modes such as walking, biking, driving, or using public transport. Thus, we developed the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire based on a transactional perspective and understanding of the person-environment relationship as unfolding and dynamic, embedded and situated, and enacted and emplaced. The ACT-OUT, used in a sit-down interview setting, which can be followed by mobile (walking) interviews, to enable the collection of rich data about around 25 important places that people currently visit, have abandoned, or wish to visit. A second part of the questionnaire collects information on traveling to the place (e.g., frequency, transportation, familiarity) and on activities performed there. The ACT-OUT has been used in multiple countries, including Switzerland, Sweden, the UK, and Canada, and among different populations, notably people with and without dementia. Results show that people with dementia experience a higher rate of abandonment of places and for many more places than people without dementia. It highlights the importance of addressing community mobility and how we conceptualize, design, and adapt important places to support people living with dementia to participate in places and activities that can maintain their well-being and health as they age in their communities.
RESPONSE TO THE DECADE OF HEALTHY AGING: AN EXEMPLAR ICOPE-BASED CARE MODEL
Authors: Yu Doris Sau Fung , Tang Yiting
Published: January 2025

The United Nations Decade of Healthy Aging 2021-2030 calls for proactive and collaborative strategies to enable older adults to “live well” with optimized functional capacity, considering both intrinsic capacity (IC) and the environment. The Integrated Care of Older People (ICOPE) framework has been established as a comprehensive approach to guide IC assessment and care prescription for promoting healthy aging. In line with this global initiative, Hong Kong, a city with accelerated aging, has implemented the “Jockey Club Pathway to Healthy Aging” (Path-HA) program. This 12-week program incorporates the concepts of clinical critical care pathway, goal-oriented empowerment-based behavioral modification, asset-based capacity building, and health-oriented peer support. The program aims to optimize the functional status of local older adults across Hong Kong districts. The signs of accelerated aging and risk factors related to ICOPE health concerns are identified through the assessments. To date, more than 5,500 older adults are involved in this study and more than 1,800 have been recruited into the program and have received person-centered care and interventions for reducing the risks corresponding to critical pathways to healthy aging. This symposium is aligned with the ICOPE framework to address healthy aging in Hong Kong: (a) IC profiles of older adults, (b) promoting IC with a synergistic way to enhance care prescription, (c) critical pathways of the Path-HA program, and (d) the effects of critical care pathways on IC conditions. With these efforts endeavored, we will share the outcomes, insights and foresight regarding the regional contribution to optimizing functional capacity.
PROMOTING INTRINSIC CAPACITY OF OLDER ADULTS: A SYNERGISTIC APPROACH TO ENHANCE CARE PRESCRIPTION
Authors: Zhou Yu , Chen Shuangzhou , Tang Yiting , Chen Feng , Yu Doris Sau Fung
Published: January 2025

The United Nations has declared the Decade of Healthy Aging 2021-2030 to prioritize proactive and collaborative strategies for older adults to live well. The World Health Organization’s Integrated Care of Older People (ICOPE) framework aims to guide the assessment of intrinsic capacity (IC) and the environment to promote healthy aging. Based on a research initiative that employs the WHO-ICOPE approach to promote healthy aging, a territory-wide ICOPE-based comprehensive health assessment was conducted in Hong Kong. Those with signs of accelerated aging were referred to a 12-week Jockey Club Pathway to Healthy Aging Program. The program adopts a health-social collaborative approach, clinical critical pathway, empowerment-based behavioral modification, and health-orientated peer support to provide person-centered care to optimize the functional status of older adults. From April 2022 to May 2023, a sample of 3,073 community-dwelling older adults [mean age (SD) = 74.7(7.5)] were recruited from eight geographic districts in Hong Kong and assessed with validated instruments. Latent class analysis identified five IC functional profiles of older adults according to the ICOPE framework. These five patterns include (1) compromised psycho-cognitive functional class, (2) compromised musculo-mobility functional class, (3) compromised metabolic-mobility functional class, (4) compromised nutritional-metabolic equilibrium but preserved functional class, and (5) preserved functional class. After controlling for the demographic profile, chronic disease burden and polypharmacy, the identified IC classification significantly predicted the health-related quality of life and frailty status of the older adults. The study provide new insights on the development of an integrative assessment and care planning for healthy aging promotion.
COUPLES’ VIEWS OF THEIR JOINT AGING: DEVELOPMENT OF A NEW SCALE
Authors: Bodner Ehud , Segel-Karpas Dikla , Estlein Roi
Published: January 2025

The construct of subjective views of aging (VoA) constitutes a growing field of research, relating to individuals’ general cognitions about the aging process, and their individual experience of aging. VoA develop throughout the life-course and have significant implications for individuals’ health and well-being in later age. Although VoA often develop within a relational context of the married couple, suggesting the construct has an inherent interpersonal component, no theoretical framework or empirical studies have explored VoA from a dyadic perspective to consider the couple as an aging unit. We developed and tested a new scale to assess the way individuals expect to age within their current intimate relationship. Based on experts’ evaluations, we identified five domains that are meaningful to couples’ joint aging: (1) changes in health, (2) changes in family roles, (3) the transition to retirement, (4) changes in appearance and sexuality, and (5) coping with death. We then developed an initial pool of 39 items and tested these on a sample of over 300 midlife adults. Using factor analysis, we extracted a scale of 9 items relating to the 5 domains. We tested for validity against constructs of VoA and couple’s relationships. The scale showed good internal reliability and validity.
THE LONGITUDINAL PROCESSES LINKING PSYCHOSOCIAL FACTORS AND STRESS-RELATED EXPERIENCES TO HEALTH
Authors: Luo Jing , Pfund Gabrielle , Mroczek Daniel
Published: January 2025

Psychosocial factors, including individual factors (e.g., personality, sense of purpose), contextual factors (e.g., employment status), and stress-related experiences, have been demonstrated as important protective/risk factors of health. However, little is known about the processes and mechanisms linking these factors to health and aging. The current symposium tackles the longitudinal associations between psychosocial factors and health with five presentations investigating the interindividual and intraindividual processes linking these factors to various health outcomes (physical, cognitive, physiological health and well-being) as people age. In the first study, from a life-course perspective, Brown and colleagues examined the effects of low SES and perceived stress in childhood on two physiological health indicators in midlife and the underlying mediators. Zooming into late adulthood, the second study by Choi and Mejía examined the joint effects of spousal combinations of employment status and socioeconomic resources on older couples’ individual and shared manifestations of cumulative health risk. The third study by Chopik examined the prospective effects of subjective well-being on stress reactivity decline and their dynamic reciprocal relations over time at the intraindividual level. The fourth study by Luo and colleagues examined the how the dynamic interplays between personality and people’s stress experiences and health behavior engagement contribute to individual differences in health change. In the fifth study, Pfund and colleagues investigated the dynamic intraindividual associations among sense of purpose, social stress-related perception (loneliness), and cognitive decline over time. Collectively, this set of studies improves our understanding of how psychosocial factors shape people’s health and healthy aging.
THE RECIPROCAL RELATIONSHIPS AMONG SENSE OF PURPOSE, LONELINESS, AND COGNITIVE DECLINE
Authors: Pfund Gabrielle , Ong Anthony , Mroczek Daniel , James Bryan , Jackson Kathryn , Graham Eileen
Published: January 2025

Dementia is the leading cause of disability in older adults worldwide. As of yet, there are no easily accessible cures. Thus, a wide range of research has focused on modifiable intra- and interpersonal factors that may contribute to lower risk for dementia and generally slow down cognitive decline. A promising protective intrapersonal factor from the well-being literature is sense of purpose, as higher levels of sense of purpose are tied to a swath of healthy cognitive aging outcomes. Meanwhile, greater experiences of loneliness are typically a risk factor for poorer cognitive aging. The current study calls upon data from the ongoing Memory and Aging Project from the Rush Alzheimer’s Disease Center (N = 1,736; waves: up to 18; age: M = 81.07, SD = 8.04, 65-101). Every year, participants complete an extensive cognitive battery and report on their sense of purpose and loneliness. Given the likely reciprocal relationship between these three constructs, the current project uses random intercept cross-lagged panel models to better establish the between- versus within-person and concurrent versus longitudinal processes behind these relationships. Findings highlight the bidirectional relationship of these variables across time metrics and levels. For example, lower levels than one’s average of sense of purpose predicts decreases in cognitive functioning a year later, and decreases in cognitive functioning also precede decreases in sense of purpose. Future research would benefit from exploring combined efforts to bolster sense of purpose and reduce loneliness, while continuing to mind the potential influence of cognitive decline on these constructs.
PSYCHOSOCIAL DISADVANTAGE DURING CHILDHOOD AND MIDLIFE HEALTH
Authors: Brown Ryan
Published: January 2025

Psychosocial disadvantage in childhood contributes to health disparities in aging-related health outcomes through biological and behavioral pathways. We leveraged the 30-year longitudinal NHLBI Growth and Health Study to examine associations between (a) low childhood SES (age 10) and (b) perceived stress in childhood (age 11) with midlife insulin resistance and epigenetic aging (age 40) in a sample of 433 Black and white women. We also explored whether late adolescent (age 19) waist circumference would mediate the relationships between SES and perceived stress and aging-related outcomes. Epigenetic aging was assessed in saliva and quantified through the GrimAge2 and DunedinPACE clocks. Insulin resistance was represented by the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). For each aim, multivariable linear regression models were estimated. Covariates included age, race, diabetes status, smoking status for all outcomes, and analysis cluster and estimated cell type composition variables for epigenetic clocks only. Higher parental education was associated with lower insulin resistance (b=-0.22, SE=0.10, p=.03), lower midlife GrimAge (b=-1.76 years, SE=0.56, p=.002), and slower midlife DunedinPACE (b=-0.03, SE=0.2, p=.04). Childhood perceived stress was significantly indirectly associated with midlife insulin resistance, b=0.01, 95% CI [0.001,0.01], p=.02, and midlife GrimAge, b=0.016 years, 95% CI [0.003,0.04], p=.01, through late adolescent adiposity. This highlights preliminary evidence for this life-course perspective on psychosocial stress, adiposity, and aging-related health. Future work may examine these individual factors in the context of broader structural systems (e.g., schools) and other facets of SES to better understand area-level effects (e.g., familial, neighborhood, region) for tailoring social interventions.
THE NEW MAP OF LIFE: TRANSFORMING THE COURSE OF LONG LIVES THROUGH IMPACT-DRIVEN RESEARCH
Authors: Shavit Yochai , Carstensen Laura
Published: January 2025

The global rise in life expectancy and the emergence of societies that are more age-diverse than ever before in human history call for a re-design of the life course.The Stanford Center on Longevity released the New Map of Life- a report detailing principles to guide research, policies, and interventions aimed at improving long lives and age-diverse societies, taking advantage of the opportunities these demographic changes entail. These have already influenced recommendations by key organizations, including the National Academy of Medicine and the World Economic Forum. This symposium offers the first look into research findings guided by the New Map of Life and their translation into actionable recommendations. First, Weiss presents an innovative approach to model long life trajectories based on Artificial Intelligence that outperforms current life expectancy and morbidity calculators. On the population level, Ashwin presents macroeconomic challenges and advantages of longevity, highlighting differences between aging societies and long-living societies. Growney describes a pilot program leveraging older adults’ strengths in early childhood education classrooms. Rangan presents findings from a study of graduating medical students highlighting the need to revamp medical education to address a severe lack of training in older adult medical care. Finally, Chu presents focus-group findings exploring older adults’ technological needs and challenges in daily life, which can alter aging experiences. All presenters detail specific ways in which their findings can inform stakeholders’ actions. Prof. Carstensen will conclude by discussing the broad picture emerging from these studies and their importance for further development of the framework.
GRADUATING MEDICAL STUDENTS’ PERFORMANCE ON A GERIATRICS KNOWLEDGE TEST IS ASSOCIATED WITH ATTITUDES
Authors: Rangan Apoorva , Shavit Yochai , Kado Deborah
Published: January 2025

Older adults are overrepresented among patients, with half of outpatient visits and 40% of hospitalizations for adults over 65. Training physicians in age-friendly care is imperative. Yet, medical school graduates’ knowledge of core geriatrics competencies is unknown, as are factors associated with students’ knowledge base. 30 of the 82 graduating students at the Stanford School of Medicine completed a three-part survey. Geriatrics knowledge was assessed using a validated 18-item UCLA Geriatrics Knowledge Test (GKT) and ten questions from the Geriatrics Review Syllabus (GRS). Attitudes towards older patients were assessed using the validated 14-item UCLA Geriatrics Attitudes Assessment. Finally, students reported their curricular exposure to geriatrics and career interests. The Stanford Institutional Review Board waived institutional review. Two researchers independently analyzed results in R. Geriatrics exposure was limited; 1 student took a preclinical elective and 2 took clinical electives. Most students incorrectly completed at least half of the knowledge assessment. All students missed at least 7/28 questions overall (M = 8.0, SD = 6.7), with students performing better on the GKT (M = 8.4, SD = 5.1) than the GRS portion (M = -0.4, SD = 3.0). Most students had neutral or slightly positive attitudes towards older adults (M = 3.58, SD = 0.87). Attitude scores were moderately associated with improved performance on the knowledge assessment (r = 0.55, p < 0.0001). In conclusion, graduating students did not meet minimum geriatrics competencies measured by a knowledge assessment. Attitudes towards older adults were associated with performance, supporting future intersectional interventions in ageism.
REGIONAL NEUROANATOMIC EFFECTS ON BRAIN AGE INFERRED USING MAGNETIC RESONANCE IMAGING AND RIDGE REGRESSION
Authors: Irimia Andrei
Published: January 2025

TBD