bluuebunny/crossref_metadata_2025 huggingface dataset:
FACTORS INFLUENCING DEMENTIA DIAGNOSIS AWARENESS AMONG RACIALLY/ETHNICALLY DIVERSE OLDER ADULTS
Authors: Roche-Dean Maria , Baik Sol , Webster Noah , Moon Heehyul , Zahodne Laura
Published: January 2025

Black and Hispanic adults arrive in later life with a greater risk for Alzheimer’s Disease and Related Dementias (ADRD). Untimely dementia diagnoses continue to be a challenge in non-Hispanic Black and Hispanic-identified older individuals, delaying symptom management and access to health services. In this study, we examine whether social factors are associated with awareness of dementia diagnosis among older adults with probable dementia. Data were from the National Health and Aging Trends Study round 1, a nationally representative sample of Medicare beneficiaries aged 65 and older assessed in 2011. Those selected for analysis met algorithmic criteria for probable dementia (N=561). Logistic regression was performed to assess the influence of marital status, social network size, and number of helpers on the odds of reporting a dementia diagnosis, controlling for demographics. In the whole sample, younger individuals and women had greater odds of dementia diagnosis awareness. Race/ethnicity, marital status, the number of helpers, and social network size were not associated with dementia diagnosis awareness. Analyses stratified by race/ethnicity indicated that being married was only associated with greater odds of dementia diagnosis awareness among Black participants. The lack of association between social network, number of helpers, and dementia awareness could reflect limitations on how probable dementia and dementia awareness were operationalized in this dataset. Furthermore, marital support may be important for timely diagnosis for Black individuals with dementia.
IMPACT OF A KINESIOLOGY COURSE ON EXPECTATIONS REGARDING AGING AND AGEIST BEHAVIORS
Authors: Hamel Kate
Published: January 2025

Students majoring in Kinesiology often aspire to work in healthcare or fitness professions where they will frequently work with older adults. Many students don’t recognize this opportunity however, and are often initially drawn to Kinesiology through their own experience with exercise or as athletes and generally assume that they will work with a young, active population in their future careers. Younger adults have also been shown to have negative perceptions and attitudes toward aging and this may shape the way they interact with older adults and could impact their career choice. The purpose of this study was to examine the expectations regarding aging (ERA) and the prevalence of ageist behaviors in students taking a Kinesiology elective course on aging, prior to and after the completion of the course. Students taking the course in two different semesters completed the ERA-12, the Relating to Older People Evaluation and open-ended questions to assess their perceptions, attitudes and behaviors toward aging and older adults. No differences were found between the two cohorts of students in any of the baseline or end of semester measures. Following the completion of the course, students had significantly higher ERA-12 scores and expectations regarding physical health, cognitive functioning and mental health in older adults all improved. There was no difference in positive ageist behaviors, but there was a reduction in negative ageist behaviors. These findings suggest that course-based interventions such as this one, may significantly improve attitudes toward aging and increase student’s interest in working with older adults.
IPE CASE STUDY ON COMMUNICATION AND ASSESSMENT OF OLDER ADULTS: A COMPARISON OF THREE ONLINE MODALITIES
Authors: Sharpp Tara , Gaeta Laura
Published: January 2025

Interprofessional education (IPE) is critical for health profession students to learn teamwork, shared experiences, and communication. In this mixed-method study, we compared an IPE activity for Nursing, Audiology, Communication Sciences, Gerontology, and Health Science students using three online modalities: (1) Synchronous online, (2) Asynchronous online, and (3) Bichronous online (combination of asynchronous and synchronous). In IPE groups, the students examined the same unfolding case study about an older adult with hearing loss, depression, and dementia. Over three terms, 168 students completed pretest and posttest measures, including a standardized IPE scale (IPAS subscale), a knowledge quiz, and an evaluation. Knowledge quiz scores significantly improved in all three groups (synchronous: t = -2.586, 2-sided p = 0.013; asynchronous: t = -4.129, 2-sided p < 0.001; bichronous: t = -3.748, 2-sided p < 0.001). Students also demonstrated significantly increased attitudes toward working in teams in the IPAS subscale in the posttest in all three groups. ANOVA and Kruskal Wallis tests demonstrated no statistically significant differences in the IPAS scale and evaluation scores between groups, indicating that students in all three modalities had similar levels of learning regarding their IPE. In the open-ended responses of the evaluation, students reported they learned practical examples of how to work with team members from their group and that they valued the online experience. The results indicate that health professions students can effectively learn from a case study activity how to communicate with older adults and work in interprofessional teams in various forms of online modalities.
EFFECTS OF HEARING INTERVENTION ON BRAIN HEALTH: FINDINGS OF THE ACHIEVE TRIAL AND AND ACHIEVE-MRI SUBSTUDY
Authors: Huang Alison , Lin Frank , Rosano Caterina
Published: January 2025

This session will present the primary findings of the ACHIEVE-MRI (Aging and Cognitive Health Evaluation in Elders Magnetic Resonance Imaging) study, a substudy of the ACHIEVE randomized controlled trial (Clinicaltrials.gov Identifier: NCT03243422). Prior observational studies have linked hearing loss with changes in brain structure and function. Hearing loss may directly modify brain morphology and exacerbate mechanistic pathways such as greater cognitive load (diversion of cognitive resources to effortful listening to the detriment of other cognitive functions) and reduced social connection. Whether treatment of hearing loss can effectively reduce age-related brain atrophy is unknown and has yet to be tested in randomized trials. The ACHIEVE trial (2018-2022) tested the effect of a best-practices hearing intervention versus health education control on three-year change in cognition (primary outcome) among 977 adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment. MRI imaging data was gathered on a subset of participants (n=445) in the ACHIEVE-MRI substudy. This session will first describe the overall study design of the ACHIEVE study and ACHIEVE-MRI substudy and then present the primary findings of the ACHIEVE- MRI substudy – the effect of the hearing intervention vs. health education control on 3-year change in brain structure and function. This session will also examine the effect of hearing intervention on speech understanding in the presence of noise. The session will close with an investigation of for whom hearing intervention may be most effective for, examining moderation by baseline levels of dementia risk in the ACHIEVE study.
COMPARING PHYSICAL HEALTH CHALLENGES OF RURAL AND URBAN CAREGIVERS OF PEOPLE WITH DEMENTIA IN THE UNITED STATES
Authors: Wang Fei , Chang E-Shien , Tran Phoebe
Published: January 2025

Increased dependence on informal caregiving and limited access to healthcare services in rural U.S. communities may contribute to worse physical health in rural informal caregivers of persons with dementia (PWD) relative to urban counterparts. We used nationally representative 2020-2022 Behavioral Risk Factor Surveillance Systems surveys to examine the association between rural/urban residence and poor physical health days in caregivers of PWD (N=17405). Self-reported physical health within previous month was categorized as follows: 0 poor physical health days (PPHD), 1-13 PPHD, 14+ PPHD. Information on rural/urban county of residence, sociodemographic characteristics, and caregiving factors were obtained from the surveys. Our results showed that 1 in 4 rural caregivers (25%) reported 14+ PPHD in the previous month as compared to 1 in 10 urban caregivers (10%). Findings from multinomial logistic models indicated that rural caregivers had 2.16 times the odds (OR: 2.16, 95% CI:1.03-4.53) of having 14+ vs 0 PPHD compared to urban caregivers after adjusting for sociodemographic characteristics and caregiving factors. These findings suggested prolonged physical health challenges for rural caregivers. In contrast, the odds of having 1-13 vs 0 PPHD were not significantly different between rural and urban caregivers (OR: 0.92, 95% CI: 0.53-1.62). Efforts to enhance long-term physical health for rural caregivers are warranted. Given that geographical isolation and limited resources in rural settings may impede physical health, community-based activities promoting physical activity and social connections should be prioritized. Policy advocacy is crucial to raise awareness of urban-rural health disparities and support targeted interventions for rural caregivers of PWD.
ELDER ABUSE IN OLDER ADULTS WITH DEMENTIA: PROTECTIVE FACTORS AND ADVERSE EFFECTS
Authors: Wei Wenxing , Balser sarah , Nguyen Ann , Qin Weidi
Published: January 2025

With the rapid increase in the aging population, more attention has been paid to studying older adults with dementia. Despite the fact that older adults with dementia are more likely to be abused compared to their cognitively intact counterparts, little attention has been paid to abuse within this population. It is important to recognize the unique characteristics and vulnerabilities of this specific group. This systematic review, conducted using the PRISMA model, aims to critically examine, evaluate, and synthesize literature on protective factors and adverse effects of elder abuse among individuals with dementia. A search was undertaken using the Ageline, Medline, CINAHL, and PsycINFO databases for peer-reviewed articles published in English up to June 2023. A total of 291 articles were identified by the systematic search, and eight articles were included in the review. The results showed that protective factors related to elder abuse are mainly examined at a perpetrator level, including caregiver-related factors (e.g., caregiver coping strategies), relational factors (e.g., premorbid relationship rewards), and contextual factors (e.g., informal support from family and friends during the COVID-19 pandemic). Adverse effects, specifically an increased risk of various medical conditions and poor medication adherence, were identified but less frequently discussed. This review highlights the need for better support and training for caregivers of older adults with dementia, as well as comprehensive policies to prevent elder abuse. It also calls for future research to find ways to protect these older adults and mitigate the adverse effects of elder abuse.
WORKFORCE ENHANCEMENTS FOR HEALTHY AGING AND INDEPENDENT LIVING: COLLABORATION TO IMPROVE HEALTH CARE
Authors: Knebl Janice , Severance Jennifer , Murphy Sara
Published: January 2025

There are 48 Geriatric Workforce Enhancement Programs (GWEP) funded by the Health Resources and Services Administration in 2019 to integrate geriatrics education into primary care training, increase patient and family engagement, and improve health outcomes. The University of North Texas Health Science Center (UNTHSC) GWEP collaborates with a county hospital, a private university, an Area Agency on Aging, and other community-based organizations to align education and training enhancements and activities with community needs. Using a multipronged strategy focused on engaging local primary care and long-term care teams to identify community needs and learner preferences, a GWEP team of interprofessional faculty and community and health care partners combined critical resources to develop and enhance curricula in geriatric best practices using the Age-Friendly Health Systems 4Ms framework. Partners also developed an infrastructure to reach rural and underserved communities using learning technologies, social media platforms, and community health educators. This presentation will address the impact on medical professions students and professionals, the community partnerships that were built, and the advancement of interprofessional geriatric education.
PERSON-CENTERED CARE PRACTICES PREDICT STAFF BURNOUT AND ENGAGEMENT IN LONG-TERM CARE STAFF
Authors: Geisser Sophia , Smith Kate , Snow A Lynn , Collins Amber , Curyto Kimberly , Hartmann Christine , Camp Cameron , Hilgeman Michelle
Published: January 2025

Long-term care (LTC) staff experience above-average rates of burnout, which have personal and professional consequences. Little is known about the effects on staff of implementing person-centered care practices to improve LTC residents’ quality of life. We examined the relationship between staff perceptions of person-centered care and staff burnout and engagement in Veterans Affairs Community Living Centers (CLCs). We used baseline staff survey data (N=205) from a randomized Montessori implementation-effectiveness clinical trial in eight CLCs across five states. Data were collected anonymously online across all shifts (day/evening/night) from RNs (37.6%), nursing assistants (31.2%), and a variety of staff job types (31.3%). GLM models were used to examine the association between Person-Centered Practices in Assisted Living subscales (PC-PAL; Workplace Practices, Social Connectedness, Individualized Care and Services) and burnout and engagement measures from existing VA administrative data. Omnibus tests significantly predicted indicators of employee burnout and engagement (p=.05-p<.001). Individualized Care and Services predicted all three burnout indicators: 1) feeling burned out (F=4.289, p=.04); 2), considering leaving the job this year (F=5.477, p=.02), and 3) the job is emotionally hardening (F=4.026, p=.046); and one of the three engagement indicators (F=4.793, p=.03). Workplace Practices predicted all three measures of positive engagement: 1) seeing job as more than a paycheck (F=5.167, p=.02); job-related accomplishments (F=5.772, p=.017); and “doing more than is actually required” (F=8.888, p=.003). Social Connectedness was not a predictor in any model. Results demonstrated positive outcomes of person-centered care practices include impacts on LTC staff burnout and engagement.
THE ROLE OF PERCEIVED CARING AND PARTNERSHIP IN PATIENT–PHYSICIAN RELATIONSHIPS
Authors: Kim Yulri , Lee JeongEun , Svec Joseph , Kahana Eva
Published: January 2025

The rise of health care consumerism, facilitated by the internet use, empowers patients to seek information beyond their physicians (Martijn et al., 2020). Extant studies have shown that this shift toward healthcare consumerism, characterized by self-care movements such as proactive attitude and seeking health information (Haug, 1979), could challenge the patient-physician relationship (Haluza et al., 2017). On the other hand, the patient-physician relationship could be strengthened when patients feel a connection with their physician who show caring attitudes (Takeshita et al., 2020). Drawing data from 232 older adults (M= 76.16 years, SD= 8.27) in Miami, we examined the association between healthcare consumerism and patient-physician relationships using multiple linear regression. Respondents were randomly sampled from a probability-based research panel of community-dwelling older residents of Miami, Florida. The data showed that higher healthcare consumerism was linked with lower levels of patient-physician relationships. A moderation analysis revealed that greater perceived care from physicians and partnership attenuated the association between health consumerism (e.g., proactive attitude, health information seeking) and the patient-physician relationship. The findings highlight the significance of perceived caring and partnership in fostering strong patient-physician relationships. Findings suggest that healthcare consumerism, a growing trend, does not have to come at the expense of patient-physician relationships. By cultivating a sense of caring and patient-physician partnerships, healthcare providers can help build trust and collaboration, culminating into a more positive healthcare experience for patients.
OLDER ADULTS’ EXPERIENCES WITH INNOVATIONS IN HEALTH CARE DELIVERY: FINDINGS FROM THE NPHA AND AARP SURVEYS
Authors: Solway Erica , Keenan Teresa , Keenan Teresa
Published: January 2025

Innovations in health care delivery have resulted in dramatic shifts in the experience of seeking and receiving health care services. Many of these innovations, like telehealth and patient portals, predated the COVID-19 pandemic, but the pandemic quickly spurred rapid changes in availability and use. It is important to understand how older adults view and experience these innovations and the opportunities and challenges these innovations present. Since its launch in 2017, the National Poll on Healthy Aging (NPHA) has surveyed a nationally representative sample of adults ages 50-80 to gauge their perspectives on health care and health policy-related topics, including health care innovations, and assess trends and changes in views and experiences over time. In addition, AARP regularly conducts surveys to offer additional timely insights on important related topics. This symposium will focus on lessons learned from the NPHA related to telehealth, patient portals, direct-to-consumer health care services, and use of alternative sites for health care, like urgent care and retail clinics. In addition, it will highlight key findings from recent AARP surveys related to views on innovations in health care delivery among adults and older adults and will share how these insights can inform policy and practice.
RELATIONSHIP OF MULTISENSORY IMPAIRMENT WITH PHYSICAL PERFORMANCE IN OLDER ADULTS IN SOMMA
Authors: Thompson Atalie , Mansfield Tyler , Johnson Eileen , Cawthon Peggy , Strotmeyer Elsa , Williamson Jeff , Cummings Steve , Kritchevsky Stephen
Published: January 2025

There is growing evidence that various sensory and cognitive functions can impact physical performance but the relationship of multisensory impairment (MSI) and cognition with mobility in older adults is not well understood. We hypothesized that MSI would be associated with worse performance on timed physical mobility assessments, but that the association would be attenuated by controlling for tests of cognitive processing speed. Participants (N=799) were older adults (mean age 76.25+/-4.95 years; 59.82% female; 84.46% Non-Hispanic White) who completed tests of physical performance, cognitive function, and multiple sensory domains (vision, olfaction, peripheral sensation, self-reported hearing). An 8-point MSI scale was created: 1 point for moderate and 2 points for severe impairment in each sense. Separate linear regression models examined the association of MSI with 400-m gait speed, extended short physical performance battery (eSPPB), 4-square step test (FSST) and stair climb test, adjusting for demographic and clinical covariates. Each additional point on the MSI scale was associated with 0.009 m/s slower walking speed (p=0.049), 0.05 lower eSPPB score (p=0.0001), and 0.2 s longer FSST time (p=0.008), but there was no association with stair climb time(p=0.59). After adjusting for DSST and Trails B, the association of MSI with 400-m gait speed and FSST were no longer significant (p>0.05) and the association with eSPPB was partially attenuated (-0.03 units/MSI point, p=0.0037). Older adults with MSI had worse mobility function which may be partially related to cognitive processing speed. Future studies should investigate if older adults with MSI would benefit from interventions to improve mobility.
RELATIONSHIP OF VISUAL IMPAIRMENT AND POOR MOBILITY TO MORTALITY IN OLDER ADULTS
Authors: Thompson Atalie , Rigdon Joseph , Miller Michael , Neiberg Rebecca , Williamson Jeff , Kritchevsky Stephen
Published: January 2025

Older adults with visual impairment (VI) have greater risk of mortality but the reasons are poorly understood. We have shown that older adults with VI are more likely to have poor mobility performance on the short physical performance battery (SPPB). In this analysis we examined whether VI predicted mortality over 10 years and if this was related to poor baseline mobility (SPPB< 9). We included 2457 older adults who completed three vision tests at the year 3 visit in the Health, Aging and Body Composition study. VI was defined by visual acuity < 20/40, log contrast sensitivity < 1.55 or stereoacuity >85. Cox proportional hazard models for mortality were adjusted for age, sex, black race, education, body mass index, smoking, depression, hypertension, heart disease, stroke, and diabetes. In separate models, VI (Hazard ratio (HR) 1.475, 95% CI (1.313-1.658), p< 0.0001) and SPPB< 9 (HR 1.469, 95% CI (1.233-1.75), p< 0.0001) each predicted mortality. When adding poor mobility (as a main effect and interaction with VI) and using unimpaired vision and mobility as the reference, those with only VI (HR 1.451, 95% CI(1.28-1.645), p< 0.0001) or only poor mobility (HR 1.495, 95% CI(1.117-2.0), p=0.0068) had similar HRs while those with both VI and poor mobility had an increased mortality risk (HR 1.943, 95% CI(1.562-2.418), p< 0.001), but the interaction was not significant (p=0.55). After accounting for major comorbidities, older adults with VI and poor mobility are at a greater risk of mortality. Future studies should consider if interventions to improve visual function and mobility improve survival in older adults.
RACIAL AND ETHNIC DIFFERENCES IN AGEISM AND HEALTH: EVIDENCE FROM THE EXPERIENCES OF AGING IN SOCIETY PROJECT
Authors: Allen Julie Ober
Published: January 2025

Age-based stereotypes, prejudices, and discrimination (ageism) are implicated in a variety of poor health outcomes, yet it is unclear if all segments of the older adult population are affected similarly. This study examined racial and ethnic differences in ageism and health using data from the Experiences of Aging in Society project (2021-2023) with a sample equally divided between NonHispanic Black, White, and Asian American and Hispanic US adults age 50+ (N=236; Mage 65; 72% female). We identified variations in amount and types of routine ageism (Everyday Ageism Scale and subscales) and associations with health using ANCOVA and z-tests of differences in race/ethnicity-stratified regression parameters. While all racial/ethnic groups reported comparable amounts of routine ageism overall, differences were detected in types: exposure to ageist messages, White=most, Black=least; age discrimination, Black=most, White=least; and internalized ageism, Hispanic=most, Black=least. In the full sample, ageism was associated with more chronic physical health conditions and greater odds of a mental health disorder (p-values<.02); of the three types, age discrimination was most closely associated with physical health outcomes and internalized ageism with mental. Relationships differed by race/ethnicity: ageism was only associated with physical health among Black (association driven by age discrimination) and White adults (driven by internalized ageism) and with mental health among White adults (driven by internalized ageism) (p-values<.05). Exposure to routine ageism may be universal; yet, healthy aging initiatives should attend to nuances at the intersection of age, race, and ethnicity that contribute to divergent experiences of ageism and consequences for mental and physical health.
RESILIENCE AND SOCIAL CONNECTION AMONG MARGINALIZED OLDER ADULTS: CHALLENGES AND OPPORTUNITIES
Authors: Levasseur Melanie , Wister Andrew
Published: January 2025

Resilience, i.e., the ability to cope and thrive in the face of adversity, and social connection are recognized factors of older adults’ health, well-being and community integration. Improving resilience and social connection is especially challenging in marginalized older adults, who face multiple barriers to social participation. This symposium will present first theoretical contribution followed by empirical evidence where resilience and social connection were enhanced in marginalized older adults. The presentations will provide a forum to discuss the challenges and opportunities for better supporting resilience and social connection among marginalized older adults from Canada. Levasseur and colleagues examined the associations between vulnerability and life satisfaction, and the moderating effect of social support. Wister and colleagues discuss a resilience model designed to support recovery from social isolation and loneliness, which relies on internal and external resources across a socio-ecological spectrum. Majón-Valpuesta and colleagues considered the determinants regarding social participation opportunities for older transgender baby boomers in Canada. Meynet and colleagues identified and described studies assessing the efficacy of home-based and collective interventions on older adults’ social participation, isolation, loneliness, and social connectivity. Li and colleagues verified the association of loneliness in long-term spousal caregivers with social participation and social support. Together, these presentations provide insights to understand how resilience and social connection can alleviate the risk of marginalization and promote health.
SOCIAL PARTICIPATION OF OLDER ADULTS AT RISK OF MARGINALIZATION: RESULTS FROM A SCOPING REVIEW OF INTERVENTIONS
Authors: Meynet Stéphanie , Nguyen Trang , Alaux Alexia , Levasseur Melanie
Published: January 2025

Considering demographic aging, it is essential to better consider the heterogeneity of older adults in promoting the health of all, especially by fostering social participation of the population at risk of marginalization and social exclusion. Despite vulnerability to isolation and loneliness this population, knowledge about social participation interventions lack integration, and this group is under-represented in studies. This study thus aimed to identify, describe, and integrate knowledge about interventions that foster the social participation of older adults at risk of marginalization and social exclusion. Using 61 keywords in 6 databases, a scoping review identified 24 studies that assessed the influence of interventions on older adults’ social participation, isolation, loneliness, social interactions, and social connectivity. While almost half of the interventions were individualized home-based, the others involved collective activities in the community. Most studies focused on older adults having low income, and only two studies documented interventions with older adults from minority groups of different gender identity or sexual orientation. Interpersonal relationships with peers, and free group activities based on older adults’ interests and life experience were identified as favoring social participation. Perceived isolation, lack of access to transportation and the diversity of older participants represented challenges to successful interventions. While some initiatives were promising, further studies are needed to better develop and evaluate these interventions including assess their efficacy for this population. Providing integrated knowledge on the current initiatives, this exploratory study is the first step towards better crafted interventions that support healthy aging and more inclusive societies.
TESTING A RECRUITMENT STRATEGY FOR A NATIONAL SAMPLE OF OLDER LGBT ADULTS
Authors: Schumm Phil , O’Muircheartaigh Colm
Published: January 2025

This presentation describes a recently completed feasibility study (SAMLAP) of procedures to screen and recruit a nationally-representative, probability sample of older LGBT adults, intended to serve as the basis for a large-scale, longitudinal study of their health trajectories as they age. SAMLAP used push-to-web with an ABS sample of 70,000 addresses in order (i) to identify LGBT household members aged 40 or more, and (ii) to follow up in-person with a sample of about 300 identified individuals. The sample was stratified by region, urbanicity, and legislative environment. We conducted several randomized experiments to test the effectiveness of different recruitment strategies, including: 1) varying incentive amounts and timings, 2) including an SAQ with the first web-push mailing, and 3) implementing a last-ditch contact via FedEx. We also varied invitation wording to test the effectiveness of different approaches to increase participation by sexual and gender minorities (SGM). We discuss the effectiveness of these strategies and suggest best practices to recruit a high-quality sample of older LGBT adults. The overall response rate to the screener was 15%. 13% of screened individuals who were over 40 years of age identified as LGBT; TK3% of households containing an age-eligible LBGT individual contained 2 or more eligible people. Of these eligible individuals, 47% were successfully interviewed either in person or by phone on a range of health and related social factors. We conclude that it is possible to identify a high-quality, U.S. national probability sample of older LGBT adults and to recruit them for follow-up interviews.
SEXUAL ORIENTATION AND AGING: A US–ENGLAND COMPARATIVE STUDY OF SAME-SEX AND DIFFERENT-SEX HOUSEHOLDS
Authors: Azar Ariel , Becares Laia , Kneale Dylan
Published: January 2025

This study compares the health, income, and housing situation of same-sex and opposite-sex households in the United States and England. The research uses data from the English Longitudinal Study of Ageing (ELSA) and the U.S. Health and Retirement Study (HRS) to examine how these inequalities change over time. The study shows that individuals in same-sex households in both countries face distinct challenges in chronic health conditions, mental health status, and economic well-being. We argue that these challenges are due to the interaction between life transitions and varying policy, legislative, and societal attitudes toward same-sex relationships. For example, disparities in housing tenure and retirement income, which are more pronounced in the U.S. than in England, reflect these dynamic, divergent social and policy landscapes. The study takes into account relationship quality and satisfaction, gender, age, urban and rural living environments, and employment status. The findings highlight the cumulative impact of national contexts on the experiences of aging individuals in same-sex relationships. The study acknowledges data limitations due to the underrepresentation of sexual minorities in large nationally representative studies. However, the insights gained are essential for understanding how different policy contexts across the life course can shape the specific challenges and inequalities faced by this demographic group. The study emphasizes the need for informed policies and interventions.
WHY IS PSYCHOLOGICAL WELL-BEING ASSOCIATED WITH THE COMPOSITION OF OLDER ADULT’S CARE NETWORK?
Authors: Swinkels Joukje , Abbing Jens , Van Groenou Marjolein Broese
Published: January 2025

Objectives Older care recipients differ in types of care used: some receive mostly partner or other types of informal care, whereas others use mostly formal or privately paid care. This is mainly due to variation in health impairment, but it may also add to differences in psychological wellbeing. Applying Self-Determination Theory (SDT) to the care context, we hypothesize that care network types differ to the extent that they foster feelings of relatedness, autonomy and competence, resulting in different levels of psychological well-being. Methods Data are from ten three-yearly waves of the Longitudinal Aging Study Amsterdam (N= 18,434 observations from 4,837 older Dutch adults, from 1992 until 2022). Five care network types are created a priori composed of no care, (mainly) partner, informal, formal or privately paid care. Mixed-model regression analysis of depressive symptoms as measure of well-being is applied on care network type and loneliness (indicator of relatedness), mastery (autonomy) and care sufficiency (competence). Hybrid models disentangle between and within subjects effects. Results Receiving no care or care from a partner care network contributes the most to psychological wellbeing. Those with a formal care network type are worse off. Loneliness and care sufficiency partly explain these differences. Results of between and within effects are comparable. Discussion The findings support that applying SDT concepts of basic needs helps to understand how care impact psychological wellbeing. Results imply that decreasing loneliness by supporting informal care and increasing care sufficiency by improving the quality of formal care facilitates the functioning of care networks.
CARING FOR FAMILY MEMBERS WITH ADVANCED DEMENTIA: MEN’S EXPERIENCES
Authors: Mooney Aimee , Boardman Charles , Gothard Sarah , Tupper Emily , Zonker Christina , Lindauer Allison
Published: January 2025

About one-third of dementia family caregivers are men, and this number is increasing due to societal changes, shifting family patterns, and financial drivers. Caregiving men are an understudied group, representing about 30% of participants in caregiving research. A better understanding of men in caregiving can facilitate personalization of interventions, increase research participation, and sustain retention. Here we describe a subgroup of men who participated in the intervention study, Tele-STELLA (Support via Technology: Living and Learning with Advancing dementia, R01AG067546). Tele-STELLA is a multi-component, psychoeducational intervention designed to facilitate effective management of behavioral symptoms in those with advanced dementia. Of the 150 Tele-STELLA caregivers in the sample, 37 (25%) were men. Burden was measured using the Revised Memory and Behavior Problems Checklist reactivity subscale. Using a two-tailed t test at 0.1 α, we found that there was significant improvement in reactivity scores (burden) for the men that completed the intervention (n=27). Depression did not change over the 8-week intervention period despite disease progression in their family members with dementia. Ten Tele-STELLA men participated in focus groups post-intervention. Employing thematic analysis, three important themes emerged. First, the men signed up for the study because it was recommended by their health care professionals. Second, men found the solution-focused curriculum increased their sense of “capability” as caregivers, and third, Tele-STELLA provided a sense of camaraderie with their caregiving men peers. Future studies may focus recruitment strategies on informing health care providers, tailor interventions to be solution-focused, and foster communication between men to build solidarity.
PHYSICAL ACTIVITY, HEART RATE VARIABILITY, FRAILTY, AND COMPLICATIONS IN GYNECOLOGIC ONCOLOGY
Authors: Barber Emma , Foley Olivia , Wang Connor , Grubbs Allison , Bilimoria Karl
Published: January 2025

Gynecologic oncology patients undergo complex operations with high rates of postoperative complication. Frailty is consistently associated with complication but is not routinely measured in clinical practice. This study aimed to examine the association of physiologic and activity data with frailty and postoperative complications in presurgical gynecologic oncology patients. We performed a prospective cohort study of gynecologic oncology surgery patients who wore wearable actigraphy rings before and after surgery from 03/2021-11/2023. Exposures were physiologic data (heart and respiratory rates, heart rate variability), preoperative activity intensity and level. Primary outcomes included frailty (Pajewski frailty score) and 30-day complications. Multivariable models were adjusted for age, cancer and surgery type. We enrolled 96 patients and 87 met inclusion criteria. 41.3% were not frail, 44% were pre-frail and 14.7% were frail. Average heart rate and respiratory rate differed between frail and non-frail patients (HR 78.6 vs 68.3bpm, aOR=1.10,95%CI1.01-1.20; RR 18.6 vs 16.7b/m,aOR=2.1,95%CI1.20–3.55). Heart rate variability (RMSSD) also differed (24 vs 30.9ms,aOR=0.81,95%CI0.68-0.97). Preoperative physical activity was also associated with postoperative complications. Overall, 29.9% experienced a complication and higher activity was associated with fewer complications: 500-1000 MET-mins (OR=0.26,95%CI=0.07-0.92) and >1000 MET-mins (OR=0.25,95%CI=0.07-0.94) vs <500 MET-mins; ≥8000 steps (OR=0.25,95%CI=0.08-0.73) vs <8000 steps. In conclusion, physiologic data and activity levels differ in frail compared to not frail patients independent of age. Wearable devices may be useful in the preoperative assessment of frailty. Furthermore, higher preoperative activity levels are associated with fewer postoperative complications. Physical activity may be a modifiable risk factor for adverse postoperative outcomes.
OPTIMIZATION OF WEB-BASED COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA NITECAPP IN RURAL DEMENTIA CAREGIVERS
Authors: McCrae Christina
Published: January 2025

Informal dementia caregivers (CGs) often experience chronic insomnia that contributes to stress and poor health. Rural CGs are particularly vulnerable but have limited access to CBT for insomnia (CBT-I), a recommended treatment for chronic insomnia. Web delivery holds promise for improving outcomes and access to this frontline treatment. Here we describe the iterative development of web CBT-I for rural dementia CGs. Qualitative and quantitative evaluations were conducted to explore user needs and adapt/validate content using a stepwise approach: 1- advisory panel of rural CGs (n=5) and primary care providers (PCPs; n=5) gave feedback used to adapt NiteCAPP, 2-focus groups of CGs (n=5) and PCPs (n=7) reviewed the newly adapted intervention and gave additional feedback, 3-NiteCAPP CARES was piloted in CGs (n=5) to test feasibility and establish preliminary effects. Fourteen daily electronic sleep diaries and questionnaires assessing arousal, health, mood, burden, subjective cognition, and interpersonal processes were collected pre/post treatment. Feedback recommended streamlining content, eliminating jargon, and including CG focused content. Multiple features were evaluated positively (comprehensive and engaging information, CG focus, layout, easy-to-access material, easy-to-understand sleep graphs). Suggestions for improvement included giving day/night viewing options, collapsible text, font size options, tabbed video access, and a glossary. Preliminary effects on CG sleep, arousal, health, mood, burden, cognition, and interpersonal processes (ps<.05) were promising. Targeted web CBT-I may increase access and improve CG outcomes. NiteCAPP CARES is now being evaluated in NIA-funded RCT.
MINDFULNESS-BASED COGNITIVE THERAPY STUDY FOR DEPRESSION AMONG KOREAN SPEAKING OLDER ADULTS
Authors: Kim Jenny , Lee Eun Jeong , Shallcross Amanda , Ahn Seon Ah , Visvanathan Pallavi , Park Bohye , Chae Hwa Young , Ko Linda
Published: January 2025

Korean American (KA) older adults experience higher risk for depression compared to Non-Hispanic whites. Healthy Mind Healthy Living (HMHL) is a single arm, pre/post pilot intervention study to test and evaluate the effect of an abbreviated telephone-based mindfulness-based cognitive therapy (MBCT-brief) protocol to reduce depression and improve sleep quality and stress. MBCT-brief was adapted culturally and linguistically for older KA adults; participants attended one of three MBCT-brief groups (8-10 participants, N=24), delivered virtually over the span of 8 weeks by a licensed bilingual/bicultural (English/Korean) clinical therapist. Survey data were collected at baseline and 9 weeks post intervention and measured depressive symptoms (QIDS-SR16), sleep quality (PROMIS Sleep Disturbance 4a), and stress (Perceived Stress Scale). The differences in the three outcome measures from pre and post were calculated using paired T-tests. We observed significant differences for changes in mean±SD for depressive symptoms and sleep quality. Post MBCT-brief, participants had a significant reduction in depressive symptoms (8.04±4.70) compared to baseline (10.29±4.22, t(23)=2.87, p=0.004). Similarly, participants had a significant improvement in sleep quality post MBCT-brief (51.03±2.82) compared to baseline (53.23±4.14, t(23)=2.53, p=0.009). Participants also had reduction in stress (17.54±4.56) compared to the baseline (17.21±3.99, t(23)=0.28, p=0.39), but it was not statistically significant. These findings indicate that culturally and linguistically adapted MBCT-brief has potential to improve symptoms of depression, sleep quality, and stress among older KA adults with limited English proficiency. Future larger trials may want to explore the efficacy and effectiveness of MBCT-brief on depression, sleep quality, and stress with a control group.
MEETING NEEDS: LINKING CLIENTS WITH A SELF-NEGLECT ALLEGATION TO HOME- AND COMMUNITY-BASED SERVICES
Authors: Tuft Samantha , Ejaz Farida , Reynolds Courtney
Published: January 2025

This paper describes results from a federal grant in which Oklahoma Adult Protective Services (APS) collaborated with the Oklahoma City Indian Clinic and gerontological researchers to enhance APS self-neglect practice. A total of 188 APS clients from 11 counties were interviewed by phone at baseline during the COVID pandemic. This paper focuses on a subset of 45 randomly selected clients who were offered extensive case management services for a period of four months beginning shortly after they were reported to APS. The clients were primarily white and female with a mean age of 62 years and average annual income between $12,000-$15,000. During the study, 24% of the clients were screened as experiencing self-neglect based on the Recognizing Abuse Tool (Ejaz, et al., 2017). More importantly, 76% of the 45 clients reported that they needed help in at least one area, resulting in a total of 175 identified needs. The top five most identified needs were home repairs/maintenance, in-home care, public benefits, transportation, and case management. We will describe whether client needs were met during the study along with barriers to service utilization. Findings will be explored in light of their implications for APS practice and policy, particularly the role time-limited, intensive case management can play in preventing further reports to APS.
ADVANCES IN INTERDISCIPLINARY SCIENCE: BRAIN CONTROL OF MOBILITY IN AGING AND DISEASE POPULATIONS
Authors: Holtzer Roee , Liu-Ambrose Teresa
Published: January 2025

Interdisciplinary research has demonstrated that cognitive and mobility performance and decline are inter-related and potentially coupled implicating the brain as a key common denominator shared by both domains of function. Novel studies in the current symposium utilize advanced neuroimaging methods to elucidate how structural and functional measures of brain integrity are utilized to predict mobility outcomes and mitigate against risk of developing mobility decline and impairments. Mark Wagshul demonstrates that whole brain latent patterns have differential associations with gait speed in older adults with and without multiple sclerosis. Paul Laurienti uses brain networks connectivity data to define cognitive reserve demonstrating that associations between amyloid beta and mobility decline are attenuated among older adults with high cognitive reserve. Chun Liang Hsu uses functional neural networks to define a novel construct - physical reserve. He demonstrates that among older adults with subcortical ischemic vascular cognitive impairment (SIVCI), high physical reserve attenuates the negative effect of white matter hyperintensities on postural stability. Roee Holtzer uses functional-near-infrared-spectroscopy (fNIRS) to assess oxygenated hemoglobin (HbO) in the prefrontal cortex during walking under single and dual-task conditions. He shows that higher fNIRS-derived HbO during dual-task walking is protective against future falls in older adults with relapsing-remitting but not progressive MS subtype. Combined, these studies shed light on novel discoveries concerning brain control of mobility in aging and disease populations. Furthermore, emphasis is placed on demonstrating how brain data are utilized to define constructs (cognitive and physical reserve) and elucidate theoretical models (compensatory reallocation) vis-à-vis mobility outcomes. Brain Interest Group Sponsored Symposium
ASSOCIATIONS BETWEEN FUNCTIONAL NETWORKS OF PHYSICAL RESERVE, POSTURAL INSTABILITY, AND WHITE MATTER LESIONS
Authors: Hsu Chun-Liang , Holtzer Roee , Tam Roger , Alkeridy Walid , Liu-Ambrose Teresa
Published: January 2025

White matter hyperintensities (WMH) are clinical markers of subcortical ischemic vascular cognitive impairment (SIVCI) associated with impaired postural balance and falls. Physical reserve (PR) is a recently established construct that reflects one’s capacity to maintain physical function despite brain pathology. This cross-sectional study aims to map functional networks associated with PR, and examining the relationship between PR, WMH, and postural balance. Physical reserve was defined in 22 community-dwelling older adults with SIVCI as the unexplained residual variance in Timed-Up-and-Go test (TUG) after accounting for age, global cognitive function measured by Alzheimer’s Disease Assessment Scale-Cognitive-13 (ADAS-Cog-13), and hippocampal volume. Functional neural networks associated with PR were extrapolated as TUG-correlated network connectivity maps computed using general linear models that removed the effects of age, ADAS-Cog-13, and hippocampus volume. Subsequent analyses examined whether PR and its associated brain networks moderated the relationship between WMH and postural balance under two conditions – eyes open while standing on foam (EOF) and eyes open while standing on floor (EONF). Physical reserve and its associated functional neural networks - frontoparietal network (FPN) and default mode network (DMN) - significantly moderated the association between WMH and postural balance. Specifically, in those with high PR, postural balance was maintained regardless of WMH load while in those with low PR, postural balance worsened as WMH load increased. These results suggest the attenuated effects of WMH on postural stability due to PR may be underpinned by functional neural network reorganization in the FPN and DMN as a part of compensatory processes.
SUPPORTING THE UPTAKE OF PERSON-CENTERED COMMUNICATION STRATEGIES IN NURSING HOMES USING THE PRISM
Authors: Douglas Natalie
Published: January 2025

The implementation of quality, person-centered care into nursing home (NH) settings is challenging due to the complexity of NH organizational structures, nationwide staffing shortages, and significant federal regulations. We used the Practical, Robust Implementation and Sustainability (PRISM) Model to assess key contextual factors that may influence the implementation of Dementia Collaborative Coaching, an evidence-informed communication coaching program designed to decrease negative, responsive behaviors and improve quality of life for people living with dementia in NHs. Employees (n=27) from three urban NHs including corporate leaders, managers, and direct care providers across a variety of disciplines engaged in n=5 focus group sessions to deepen understanding of barriers and facilitators to the implementation of Dementia Collaborative Coaching. Participants identified barriers to Dementia Collaborative Coaching implementation including the need to improve dementia care overall, inadequate leadership support, staffing concerns, and misinterpretation of NH federal regulations. Facilitators included enthusiasm for the program as well an agreed upon need for an NH-wide implementation and sustainability plan. Outcomes most relevant to the participants included decreased behavioral incidents and falls as well as increased engagement in both leisure and activities of daily living. Pre-implementation guided by the PRISM proved to be a critical step in maximizing the success of implementation of this intervention and developing relationships with key players in the NH. During this process, site-specific system and clinician level factors will inform future Dementia Collaborative Coaching implementation efforts which may also contribute to the implementation of other quality interventions for NH residents.