bluuebunny/crossref_metadata_2025 huggingface dataset:
ADULT CHILDREN’S DIVORCE AND DEPRESSIVE SYMPTOMS IN OLDER KOREANS: THE MODERATING EFFECT OF GENDER
Authors: Kim Taeeun , Lee Seolah , Lee Hyo Jung
Published: January 2025

The study aims to investigate how adult children’s divorce is associated with older parents’ depressive symptoms in South Korea, which values Confucian ethics and collectivism. It additionally examines if parents’ gender moderates such an association. It applies the principle of linked lives, signifying that the lives of family members are closely linked to one another. Using nationally representative data from the three waves of the Korean Longitudinal Study of Aging (KLoSA) biennially conducted from 2006 to 2010, we applied mixed ANOVA, hierarchical regression analyses, and Process Macro model 1 to 1,254 parents aged 65 and over. The results indicated that parents with divorced children showed a significantly higher level of depressive symptoms over time compared to parents with only married children. In addition, children’s divorce is significantly associated with a higher level of parents’ depressive symptoms. Gender differences in depressive symptoms were observed; older mothers with divorced children reported a higher level of depressive symptoms than older mothers with only married children, whereas no significant effects were found for older fathers. The findings imply that adult children’s divorce has a negative impact on older parents’ depressive symptoms in the Korean context. Especially older mothers may suffer from stress due to their adult children’s divorce. The study also provides evidence to support the principle of linked lives through upward intergenerational transmission.
ARTS THROUGH INTERGENERATIONAL SOCIAL ENGAGEMENT (ARISE) PROGRAM
Authors: Krok-Schoen Jessica , Clutter Jill , Handra Amy , Paoletta Camille , Young Dominic , Feyh Lauren
Published: January 2025

Introduction

Limited research shows that fine arts within intergenerational (IG) programming helps reduce communication barriers and bias between different generations. In summer 2023, a five-week IG program focused on storytelling through fine arts, the ARISE (ARts through Intergenerational Social Engagement) program, with the Columbus Association for the Performing Arts (CAPA), was piloted at a long-term care facility.

Methods

Pre-post measures were collected from the older adults and teens regarding self-rated health, depressive symptoms, sense of community, and perceptions of older adult-teen interactions. Fisher’s exact tests and paired samples t-tests were used to analyze the quantitative measures. Pre-post open-ended responses were analyzed by four independent coders to identify common themes using deductive and inductive methods.

Results

Both the teens (n=6) and older adults (n=6) had positive increases from pre- to post-program in four out of the five depressive symptom questions. The teens and older adults reported that spending time together made them feel energized, useful, and part of their community. Before the program, teens (n=6) and college students (n=3) reported negative preconceptions of older adults, due to limited exposure to older adults. After the program, they denoted personal growth and an increased desire to socialize with older adults. Students learned life lessons and their negative perceptions of older adults transitioned to positive perceptions. Conclusions: Positive changes in depressive symptoms, and IG interactions and perceptions were experienced among all the ARISE participants. These findings promote the implementation of IG programs to decrease negative stereotypes, enhance personal growth, and enrich quality of life.
CONFLICTS BETWEEN OLDER ADULTS AND THEIR CAREGIVERS DURING ACUTE HOSPITALIZATION: AN ECOLOGICAL PERSPECTIVE
Authors: Band-Winterstein Tova , Masarwa Malek , Zisberg Anna , Shadmi Efrat , Gur-Yaish Nurit , Shulyaev Ksenya
Published: January 2025

Family support is important for older adults during hospitalization; however this stressful period can exacerbate or precipitate conflicts between patients and their caregivers. We aimed to identify predictors of conflicts between hospitalized older adults and family caregivers across individual, social, and cultural levels of ecological model, utilizing data from prospective HOPE-MORe Study. The sample comprised 583 cognitively intact older adults (65+) admitted to internal units in Israeli hospitals. Additionally, questionnaires filled 73 family caregivers of these patients. 29.3% of older adults and 27.4% caregivers reported some kind of conflict during hospitalization. Multiple logistic regression analysis revealed several significant predictors of conflicts. Female patients’ gender emerged as a protective factor (β=.607, 95% CI [.409,.901]), while an increased number of visitors (β=1.044, 95% CI [1.001,1.089]) and family involvement in instrumental care (β=1.221, 95% CI [1.018,1.466]) were associated with a higher likelihood of conflict. Additionally, being an immigrant from the ex-USSR was linked to an increased risk of conflict (β=1.692, 95% CI [1.069,2.679]). Notably, other factors such as age, functional and cognitive status, anxiety, duration of visits, or Arab ethnicity were found to be non-significant in predicting conflicts. Among subsample of caregivers, spousal caregivers (β=7.390 (95%CI [1.593,34.287])) and those with anxiety attachment (β=1.628 (95%CI [1.029,2.578])) were more likely to report conflict. Findings highlight the importance of ecological perspective considering individual, social, and cultural conflict risk factors. Moreover, it is important to consider both family caregivers’ and patients’ perspectives of conflict as risk factors exist on both sides, leading to a more holistic picture.
PARENTAL STYLE MEDIATES GRANDCHILD DISTRESS: PARENTAL ROLE DEMANDS RELATIONSHIPS AMONG CUSTODIAL GRANDPARENTS
Authors: Hayslip Bert , Montoro-Rodriguez Julian , Fassi Janelle
Published: January 2025

While limited work has explored parenting practices among custodial grandparents, none has incorporated parental style, a construct proven valuable in predicting a variety of child outcomes of significance, in understanding parenting among custodial grandparents. This study evaluated the impact of grandchild distress (internalizing/externalizing behaviors) on Parental Efficacy, Parental Role Strain, and Parental Role Stress as mediated by parental styles (Laissez-Faire, Authoritative, Authoritarian) in a sample of 238 custodial grandparents (M age = 58.06). AMOS structural equation findings yielded a model which fit the data well (X2/df = 1.72, CFI = 0.939, TLI = 0.910, RMSE = 0.055). This model indicated that the Laissez-Faire and Authoritarian styles each predicted either Role Stress or Parental Efficacy. Laissez-Faire’s mediating role was driven to a minimal extent by grandchild internalizing/externalizing behaviors per se, while its mediating role was defined principally by grandparent age as it related to such behaviors in predicting Parental Efficacy (beta = -.54, p <.05). and Parental Role Stress (beta =.36, p <.05). The mediating role of the Authoritarian style was principally explained by child externalizing behaviors (beta =.22, p <.05) in predicting Parental Efficacy. Additionally, while the Authoritative style did not emerge as mediational in nature, both internalizing and externalizing behaviors had direct relationships (p <.05) to Role Stress and Role Strain. These finding illuminate the role of parental styles as key to understanding the parental challenges that grandparents face in managing the distress that their grandchildren are experiencing.
SOCIOECONOMIC STATUS AND INTERGENERATIONAL LIVING ARRANGEMENTS: BOTH CHILD- AND PARENTS-BASED ANALYSES
Authors: Ofstedal Mary Beth , Kim BoRin , Liang Jersey , Xu Xiao , Raymo James
Published: January 2025

Intergenerational living arrangements are closely associated with intra-family transfers of support and decision-making between older parents and adult children. Guided by the rational choice and the life course frameworks, we simultaneously examined the linkages between socioeconomic status of older parents and their adult children and changes in their living arrangements over a 20-year period. Data came from the 1998-2018 Health and Retirement Study. Our sample was restricted to parents over age 65 (n=6,284) and their children over age 21 (n=31,289) at the baseline. The number of total person-period observations over 20 years was 152,344. Three-level hierarchical linear models were used to examine the association of parents’ and children’s socioeconomic characteristics with their living arrangements, including co-, proximate (≤10miles), and distant residence (>10miles). The most common living arrangement for children over time was distant residence, followed by proximate residence. During the study period, the predicted probability of coresidence increased from 1% to 4%, whereas the probability of distant residence declined from 72% to 64%. Proximate residence remained relatively stable at 27% to 32%. The socioeconomic status of both generations was important. Low income and assets of parents and/or children increased the probability of coresidence and decreased the probability of proximate residence. Higher education of parents and children was associated with distance residence. Interestingly, parents’ health status was not significantly associated with living arrangements. Results highlight the importance of accounting for the opportunities, resources and preferences of both older parents and their children when examining intergenerational living arrangements.
ENGAGING ASIAN AMERICAN FAMILY CAREGIVERS IN CLINICAL TRIALS: FINDINGS FROM A NATIONWIDE STUDY
Authors: Rubovits Eve , Yedavalli Anjali , Sadruddin Sabeen , Lavari Kavin , Mudar Raksha , Leung Vania , Raj Minakshi
Published: January 2025

Ensuring representation of older racial and ethnic minority participants in clinical trials requires considering the family, community, and sociocultural context within which older adults make decisions about their healthcare and participation in trials. This study sought to evaluate Asian American caregivers’ (a) knowledge and experiences with clinical trials; (b) trusted and utilized sources of clinical trial information, (c) perceptions of ideal types of information to receive before enrolling their older relative in a clinical trial, and (d) concerns about their relative’s participation in clinical trials. We conducted a cross-sectional, online nationwide survey with Asian American family caregivers supporting an older relative between July 2022 and April 2023. Of all respondents (n=98), 62.2% reported knowing a little about clinical trials and 11.2% supported a relative who had been invited to participate in a clinical trial. Over one-third of respondents reported they most trust their relative’s healthcare provider as a source of information, and over half said they would use information from health organizations/groups or their relative’s provider for information. Respondents expressed wanting information about (a) the purpose, design, and components of the trial; (b) trial research ethics and safety; and (c) their responsibilities as the caregiver. Greater engagement between clinicians and family caregivers of culturally diverse older adults could help address concerns related to sociocultural barriers to participating in clinical trials. Providing key information to family caregivers in a comprehensive and accessible way without adding burden could help caregivers understand their responsibilities through the clinical trial process.
PROBLEM-SOLVING THERAPY FOR HOSPICE FAMILY CAREGIVERS: DOES TIMING MATTER?
Authors: Oh Oonjee , Washington Karla , Oliver Debra Parker , Demiris George
Published: January 2025

Although problem-solving therapy (PST) shows promise in alleviating hospice caregivers’ distress, the best timing for its implementation (e.g., closer to admission or later) is unknown. Our aim was to compare changes in hospice caregivers’ depressive and anxiety symptoms based on whether they received PST during or after their transition to hospice. We conducted a secondary analysis using pre- and post-intervention data from a PST intervention labeled PISCES (Problem-solving Intervention to Support Caregivers in End-of-life care Settings). Among 218 hospice family caregivers who were actively caring for their loved one at baseline, 79 caregivers received PISCES face-to-face (F2F), 72 caregivers received PISCES via both F2F and videoconferencing (Hybrid), and 67 received an enhanced hybrid version of PISCES (PISCESplus), which additionally focused on recognizing positive aspects of caregiving following a positive reappraisal approach. The timing of the intervention was dichotomized into starting either during recent transition to hospice (within 14 days of hospice admission) or later. Caregivers who received PISCES F2F, whether during or after hospice transition, demonstrated improved depressive symptoms (p value 0.013 and < 0.001, respectively). PISCES Hybrid group did not show a significant change in their depressive symptoms at either timing. Within the PISCESplus group, only those who received the intervention later demonstrated a significant decrease in depressive symptoms (p value=0.043). Regarding anxiety symptoms, all caregivers experienced significant decrease, irrespective of the intervention type and its timing. Further efforts are needed to optimize the timing of PST in real-world hospice settings to increase its translatability and effectiveness.
PERCEIVED STRESS AS A MEDIATOR OF THE ASSOCIATION BETWEEN PSYCHOLOGICAL RESILIENCE AND FUNCTIONAL DECLINES
Authors: Kim Eunsaem , Lee Yunhwan , Kim Miji , Kim Sukyung , Shin YooGyung , Han Jimin
Published: January 2025

Because older adults are highly likely to experience physical and functional losses during the aging process, resilience, the ability to cope with age-related stress and navigate adversities, is key to healthy aging. Although a growing number of studies have acknowledged the protective effects of psychological resilience on the onset of frailty, cognitive impairment, and physical disability, little is known about underlying mechanisms explaining the association between psychological resilience and functional declines in later life. To explore mediators that account for the path between psychological resilience and frailty, we used data from the 2023 Korean Frailty and Aging Cohort Study (KFACS), with 1397 aged 72-90 (Mean = 82.2). Mediating effects of perceived stress, cognitive function, and physical functioning were examined by a parallel-serial mediation model using PROCESS macro. Older adults with high psychological resilience were less likely to develop frailty (β = -.093, p <.05) after controlling for socio-demographic covariates and health-related factors. Psychological resilience influenced levels of frailty indirectly through perceived stress (β = -.04, 95% CI = -.078, -.002) and physical functioning (β = -.031, 95% CI = -.056, -.009). Also, there were simultaneous indirect effects of cognitive appraisal of stress through both cognitive function (β =-.01, 95% CI = -.019, -.003) and physical functioning (β = -.034, 95% CI = -.05, -.021) in the association between psychological resilience and frailty. These findings suggest that stress-coping abilities of older adults play a crucial role in promoting favorable stressor appraisals, which may mitigate functional declines.
RISK FACTORS ASSOCIATED WITH FRAILTY STATUS CHANGE: A PROSPECTIVE STUDY IN A GERIATRIC OUTPATIENT SETTING
Authors: Wen Chiung-Jung , Lee Chung-Sheng , Huang Wei-Jia , Lin Ching-Huang , Chan Ding-Cheng (Derrick)
Published: January 2025

Background

There has been limited research on the factors that predispose individuals to changes in frailty status. This study aims to identify the risk factors that lead to changes in frailty status among older adults.

Methods

Participants were recruited from a prospective geriatric outpatient cohort at a medical center. Frailty status was evaluated at baseline and during a 1-year follow-up using a modified version of Fried’s criteria. Additionally, demographic characteristics, health status, and geriatric assessments were collected.

Results

The mean age of the 140 participants was 79.5 ± 7.3 years. During the one-year follow-up period, 47.1% of participants experienced a worsening of frailty status, while 12.9% showed improvement, and 40% remained at the same frailty status. After adjusting for confounding variables, individuals who experienced more than one fall in the past year tended to exhibit deteriorating frailty status (□ □= -0.226, p = 0.005). The absence of teeth, which affects eating habits, also correlated with deteriorating frailty status (□ = -0.144, p = 0.061). Conversely, individuals with higher scores on the Mini-Mental State Examination tended to show improvements in frailty status □ = 0.198, p = 0.027).

Conclusion

Our findings could contribute to the development of interventions and strategies designed to prevent and manage frailty in older adults.
STAYING WITH A POSITIVE MIND: STEPPING AWAY FROM ACCELERATED AGING
Authors: Liu Yuchen , Cai Wenjie , Wittenberg Eve , Kim Dae Hyun , Bloom David , Kubzansky Laura , Seligman Benjamin
Published: January 2025

Subjective wellbeing (SWB) is a crucial measure of life quality in older adults. Understanding its relationship with frailty may inform strategies to promote healthy aging. We analyzed data for older adults aged ≥ 60 years old from Waves 3 and 4 of the China Health and Retirement Longitudinal Study. SWB was measured based on participants’ self-reported overall satisfaction with life. A frailty index was developed using the deficit accumulation approach. We conducted a cross-sectional Poisson regression to investigate the relationship between SWB and counts of frailty deficits. Additionally, we conducted a longitudinal analysis to determine the three-year relative risk of clinically significant frailty progression or mortality for different levels of SWB. The analyses were adjusted for individual weights, including adjustments for household nonresponse. The cross-sectional analysis included 9,702 individuals. After adjusting for covariates, lower baseline life satisfaction was associated with higher counts of frailty deficits (mean deficit counts ratio [95% confidence interval]: 1.66 [1.54, 1.78] for “not satisfied” and 1.06 [1.02, 1.10] for “somewhat satisfied” relative to the reference “very satisfied”). The longitudinal analysis included 8,599 individuals. Participants who were “not satisfied” with life at baseline were at a greater risk of frailty progression compared with those who were “very satisfied” (risk ratio: 1.16 [1.00, 1.35]). Our study finds that a lower level of SWB is associated with more severe frailty. It is also associated with frailty progression or death. These results emphasize that both psychological wellbeing and physical health are essential components of healthy aging.
COGNITIVE INTRAINDIVIDUAL VARIABILITY IN ADULTS WITH AND WITHOUT HIV-ASSOCIATED NEUROCOGNITIVE DISORDER
Authors: Vance David , Blake Jason , Li Wei , Wheeler Pariya , Collette Christopher , Jacob Alexandra , Kamath Vidyulata , Bene Victor Del
Published: January 2025

Cognitive intra-individual variability (IIV) is a sensitive marker of reduced top-down cognitive control related to neuropathology and increases with age. Prior work has shown increased cognitive IIV in people living with HIV (PLWH). For those with HIV-Associated Neurocognitive Disorder (HAND), it is likely that cognitive IIV is greater compared to PLWH without HAND (Non-HAND). In a sample of older PLWH from the Deep South of the United States, we examined differences in cognitive IIV in those with and without HAND, and the relationship of IIV with clinical and demographic factors. HAND (n=108) and Non-HAND (n=23) participants completed a neuropsychological assessment as part of a larger cognitive training protocol. Our primary outcome measure was the coefficient of variation (CoV), a widely used measure of IIV that corrects for mean-performance. Group differences were examined with analysis of covariance, followed by correlations of CoV with clinical and demographic variables. Cognitive IIV was greater in the HAND than the Non-HAND Group, consistent with our hypothesis. When exploring demographic variables included as covariates, we found race was statistically significant. Specifically, Black individuals with HAND had greater cognitive IIV than White individuals with HAND. However, these observed race differences in cognitive IIV were no longer significant after including reading ability and years of education in the model. Relative to PLWH without HAND, those with a HAND diagnosis have greater cognitive IIV attributable to more advanced HIV and cerebral dysfunction. Race-related differences in cognitive variability are best explained by historical disparities in education and reading levels.
EXPLORING THE PERSPECTIVES OF NURSING STUDENTS ABOUT WORKING IN THE LONG-TERM CARE SECTOR
Authors: Sun Winnie , McCabe Janet , Rudoler David
Published: January 2025

Background

The purpose of this study was to understand the perceptions of prospective registered nurses about working in the long-term care sector and identify workplace attributes that attract prospective nurses to the sector.

Methods

A sequential mixed methods study was conducted with nursing students at Ontario Tech University. Focus groups (n=14) asked students to comment on views about working in the long-term care sector, and job attributes that may attract them to the sector. A cross-sectional survey asked students to respond to elicited choice job scenarios, informed by the thematic analysis of focus group interviews. The survey data (n=139) was analysed using least absolute deviations estimator. Willingness-to-pay (WTP) values of wages gained or forgone were generated for each job attribute.

Results

Focus group interviews suggested fair compensation, optimal client-to-staff ratios, unionized work environments, comprehensive benefits packages, and flexible work arrangements were important job attributes. In survey results, 18.0% expressed interest in working in long-term care sector compared to 75.5% in acute care. Regression analysis suggested that higher amounts of paid vacation (WTP: -5.983; 95% CI: -13.749, -0.037) and higher risk of injury (WTP: 0.684; 95% CI: 0.124, 1.208) were associated with work in the long-term care sector.

Conclusion

Long-term care can attract nurses by offering flexible options such as part-time positions and paid vacation, and by actions that potentially mitigate the risk of workplace injury, violence, and abuse. Nursing students should be shown the positive aspects of working with older adults and dispel negative perceptions about the long-term care sector.
FACTORS ASSOCIATED WITH HAND HYGIENE COMPLIANCE OF NURSING STAFF IN LONG-TERM CARE FACILITIES
Authors: Kim EunKyo , Cho Eunhee , Kim Gwang Suk , Lee Kyung Hee
Published: January 2025

This study was performed to identify hand hygiene compliance factors of registered nurses (RN) and nurse aids (NA) in long-term care facilities. This cross-sectional study surveyed 78 RNs and 50 NAs who worked at long-term care facilities. Data were collected from October 1st to December 30th, 2020. The hand hygiene knowledge, perception, and infrastructure were measured by translated versions of the World Health Organization(WHO)’s hand hygiene knowledge, perception, and infrastructure tool(2009). Hand hygiene compliance was calculated as ‘number of conducted WHO’s hand hygiene at five moments’ out of ‘number of chances to conduct WHO’s hand hygiene at five moments’ multiplied by 100, which participants wrote. Data were analyzed using Spearman’s rank correlation coefficient and multiple linear regression. The hand hygiene compliance rate was 78.85%. The mean score of hand hygiene knowledge was 13.55±2.21 out of 25 points, the perception mean score was 73.41±11.65 out of 96 points, and the infrastructure mean score was 32.42±5.18 out of 40 points. Hand hygiene compliance positively correlated with the perception (r=0.177, p=0.045) and the infrastructure(r=0.194, p=0.028). Factors influencing hand hygiene compliance were the infrastructure (β=0.223, p=0.042) and working in a specialized unit (β=0.221, p=0.013) for residents who need nursing treatments (e.g., indwelling catheter exchange and wound management) and with mandating minimum registered nurse staffing level. Hand hygiene compliance was affected by infrastructure and working units with different nursing staffing levels. The results suggest expanding the infrastructure and ensuring adequate nursing staffing in long-term care facilities to improve hand hygiene compliance.
IDENTIFYING IMPORTANT AND FEASIBLE ITEMS FROM THE PREFERENCES FOR EVERYDAY LIVING INVENTORY-KOREAN (PELI-K)
Authors: Shin So Young , Kwon Jenny
Published: January 2025

Purpose

As a follow-up study for the translation and cultural adaptation of the Preferences for Everyday Living Inventory-Korean (PELI-K), this pilot study identified the ranking of the PELI-K items selected as most important/feasible from the original PELI-K 72 items in the Korean nursing home (NH) context.

Methods

A purposive snowball sampling strategy were used. The NH stakeholder advisory panel was recruited from five unique sites in one metropolitan city in Korea: two NHs, one general hospital, one teaching hospital, and one university. A total of 34 stakeholder advisory panel, including 22 experts and 12 care consumers, conducted a self-administered, in-person survey asking to score the importance and feasibility of the 72 PELI-K items. Four answer choices were available, ranging from 0 (low) to 3 (high). The sum of the scores, which adds all the scores received from participants, was calculated to rank items. The score ranges from 3 to 102 and the higher the score, the higher the importance/feasibility.

Results

The top 12 important and top 11 feasible items are reported. Items related to human basic needs such as sleeping, bathroom needs, safety, and privacy were selected as important priorities. Having regular contact with family and using electronic devices to communicate with others were the most feasible preferences.

Conclusion

The results from this study will help NH providers plan and deliver care that is geared toward residents’ most salient preferences and play a huge role in creating a short version of the PELI-K.
THE USE OF INVOLUNTARY TREATMENT AMONG NURSING HOME RESIDENTS IN THE NETHERLANDS: A CROSS-SECTIONAL STUDY
Authors: Biesmans Guido , Hameleers Niels , Hamers Jan , Bleijlevens Michel
Published: January 2025

Several studies indicate that care-dependent older adults with cognitive impairments, living in a nursing home, are at risk of care without their consent, referred to as ‘involuntary treatment’. This includes the use of physical restraints (e.g. belt restraint or bedrails), off-label use of psychotropic medication (e.g. anti-depressants, sedatives) and non-consensual care (e.g. forced hygiene, hiding medication). To explore the prevalence and associated factors of involuntary treatment in nursing home residents with cognitive or functional impairment we conducted a cross-sectional study in the southern part of the Netherlands using association analyses. Involuntary treatment was measured using the International Prevalence Measurement of Care Quality (LPZ). In addition, sociodemographic data were collected from residents, including gender, age, functional or cognitive impairment, diagnosis of dementia, confusion, aggression and dependency in activities of daily living. Involuntary treatment was used in 30% of the total sample. Among the residents who received at least one form of involuntary treatment, physical restraint was most commonly used (92%), followed by off-label use of psychotropic medications (20%) and non-consensual care (10%). Involuntary treatment was most common among residents with cognitive impairments (38%). Within the group of residents with functional impairment, the prevalence was 20%. Cognitive impairment and dependency in activities of daily living were strongly associated with involuntary treatment. Involuntary treatment is often used among nursing home residents with cognitive impairment. It also shows that residents with functional impairments are at risk. Future research should focus on understanding and preventing inappropriate involuntary treatment in nursing homes.
LONG-TERM MOBILITY DEVICE USE AND SOCIAL WELL-BEING AMONG COMMUNITY-DWELLING OLDER ADULTS IN THE UNITED STATES
Authors: Liu Xinran , Baumann Sara , Rosso Andrea , Venditti Elizabeth , Yao Yao , Albert Steven
Published: January 2025

The prevalent use of mobility devices among older adults is largely driven by the increased incidence of mobility disability in later life. While these devices are designed to enhance activities and participation for individuals with mobility disability, their long-term effects on social well-being remain unclear. This study assesses whether mobility device use contributes to improved activities, participation, and life satisfaction among community-dwelling older adults over time, comparing users with their non-user counterparts. We utilized data from the National Health and Aging Trends Study (NHATS) waves 1-9 (2010-2019) to identify incident mobility device users with over two years of experience. These users were matched on a 1:1 basis with non-users by age (±5 years), gender, race, and baseline Short Physical Performance Battery scores (±1 point). Follow-up assessments were conducted at the time of incident use, and 1- and 2-year later. Guided by the NHATS late-life disability framework, we applied mixed-effects models, adjusting for personal and environmental factors, health status, body impairments, functional capacity, and accommodations. The results indicate that mobility device users have overall significantly lower participation in paid work compared to non-users (p< 0.05). Over time, mobility device use was associated with decreased driving but increased reliance on rides from others, and more frequent visits with family and friends (ps< 0.05). Notably, older mobility device users exhibited lower life satisfaction in the long term (p< 0.05). These findings underscore the critical need to address the social well-being of older adults who use mobility devices in communities to improve their overall quality of life.
PAIN AND LOWER EXTREMITY FUNCTIONAL LIMITATION IN AMERICAN OLDER ADULTS: A SIX-YEAR FOLLOW-UP STUDY
Authors: Sodhi Jaspreet , Snih Soham Al
Published: January 2025

The objective of this study was to examine the relationship between pain and lower extremity functional limitation (LEFL) among American older adults without LEFL at baseline over 6-years of follow-up. Participants (N=1,717) aged ≥ 65 years were from the National Health and Aging Trends Study (2011-2016). Measures included pain, socio-demographics (age, gender, race/ethnicity, and education), depressive symptoms, obesity, and comorbidities. LEFL was defined as limitation in ≥ one of the following five activities (walking 6 blocks, walking 3 blocks, walking up 20 stairs, walking up 10 stairs, or able to get down on knees). General estimation equation model was fitted to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of any LEFL as a function of pain. All variables were treated as time varying except for gender, education, and race and ethnicity. Participants with pain had greater odds (OR=1.52, 95% CI=1.42-1.63) of reporting any LEFL over time than those without pain after controlling for all covariates. Older age and comorbidities were associated with greater odds of any LEFL while married status and high level of education were factors associated with lower odds of reporting any LEFL. In conclusion, pain was a significant predictor of limitations in lower extremity function. Therefore, early assessment of pain and appropriate treatment could prevent future disability and maintain independence in this population.
SOCIAL DETERMINANTS AND THE VULNERABILITY TO LOSS OF INDEPENDENCE IN OLDER ADULTS
Authors: Lee Young-Shin , Jun Hee-jin , Lee Jung-Ah
Published: January 2025

Over 41% of Americans with disabilities are aged 65 and older, with two in five seniors experiencing at least one disability, such as mobility limitations or depending on others for daily activities. As life expectancy increases, the prevalence of disability in later life is also expected to increase. Vulnerability of independence and unmet needs in daily activities present a significant personal burden and a growing concern for public health. While mMobility disabilities contribute significantly to this vulnerability, yet a comprehensive understanding is still lacking. This study aims to explore the impact of social determinants on functional vulnerability of older adults, utilizing data from the 2017 National Health Aging Trends Study (NHATS). It evaluates functional vulnerability with the Vulnerable Elders Survey tool and applies logistic regression analysis to assess the effects of age, gender, race/ethnicity, income, and living arrangements on this vulnerability. The analysis included 6,312 individuals aged 65 years and above, revealing that 30% have an income under the poverty level and 35% live alone. The results show that 43.6% of older adults are at a high risk of functional vulnerability. Significant risk factors identified include being of ‘old’ age, female, NH Black, living with others, and having an income at the poverty level. These findings underscore the urgency of developing targeted interventions for these at-risk groups.
GENDER DIFFERENCES IN MUSCLE STRENGTH AND TISSUE ASYMMETRY CHANGES OVER FIVE YEARS AMONG OLDER ADULTS
Authors: Chang (Gudjonsson) Milan , Recenti Marco , Ricciardi Carlo , Ponsiglione Alfonso Maria , Amato Francesco , Gislason Magnus Kjartan , Gargiulo Paolo
Published: January 2025

Background

The declines in muscle strength during aging process is linked to reductions in tissue integrity and underlying cellular processes. It suggests potential gender differences in these fundamental mechanisms. The current study investigates whether the decline in muscle strength over a 5-year period correlates with changes in tissue asymmetry and explores potential gender differences between men and women.

Methods

The longitudinal study comprised 3156 participants residing in Reykjavik, Iceland, with a baseline mean age of 74.9. The analysis included 1,150 men and 1,587 women (n=2,737). Tissue asymmetry, assessed through CT scans, was defined by differences between the right and left sides across 11 soft tissue composition parameters for fat, muscle, and connective tissue. Changes in leg strength and asymmetry parameters over 5 years were calculated by subtracting follow-up values from baseline. Linear regression analysis was performed to assess the association between changes of maximum knee extension strengths and changes in soft-tissue asymmetry over 5 years, adjusting for confounders by gender.

Results

In men, a decline in leg strength over 5 years was significantly associated with an increased asymmetry across five parameters (2 related to fat and 3 related to muscle (p< 0.05)). In women, associations were observed with an increased asymmetry parameters involving fat, muscle, and connective tissue (p< 0.03).

Conclusion

Gender-specific variations in asymmetry parameters highlight how fat and muscle composition in men uniquely contribute to leg strength changes over time. This emphasizes the need to consider gender-specific factors in understanding age-related muscle strength changes, informing targeted interventions for older adults.
PLASMA AND SKELETAL MUSCLE METABOLIC PATHWAYS ASSOCIATED WITH WEIGHT LOSS, LOW MUSCLE, OR POOR FUNCTION IN CANCER
Authors: Anderson Lindsey , Xia Lu , Kerr Haiming , Wu Peter , Dash Atreya , Gharib Sina , Garcia Jose
Published: January 2025

Cancer cachexia (muscle wasting leading to functional impairment) is experienced by most individuals with cancer and increases with age. There are no approved treatments in the U.S./E.U. because Phase III trials have failed to achieve functional endpoints. Identification of metabolites/metabolic pathways related to poor functional performance may reveal therapeutic targets but metabolomics analyses in cancer cachexia have only examined weight loss and/or muscle mass. We characterized metabolomic perturbations in plasma and abdominal wall skeletal muscle from men (n=75; median age=65) with cancer undergoing laparotomy and tested associations with function (handgrip strength “HGS” and stair climb power “SCP” assessed within two weeks pre-surgery), muscle mass (CT L3: cross-sectional area “CT-CSA”), or weight loss (six months pre-surgery). We hypothesized that metabolomic signatures in plasma and muscle would be associated with poorer HGS and SCP and alterations would be distinguishable from associations with weight loss or lower CT-CSA. Spearman correlations and pathway analyses (global test) were performed using “R.” Benjamini-Hochberg false discovery rate (FDR)< 0.1 indicated significance. Lipid/fatty acid peroxidation/transport/metabolism was disrupted in muscle with lower CT-CSA (FDR≤0.09) and in plasma (FDR≤0.07) and muscle (trend; FDR=0.14) with weight loss. Phenylalanine/tyrosine/tryptophan biosynthesis (p=0.045) and amino/nucleotide sugar metabolism (p=0.018) were disrupted in muscle with worse SCP, but not after adjustment (FDR>0.5). Significant/trending dysregulation was not detected in plasma with worse SCP or in muscle/plasma with worse HGS. Lipid metabolism was associated with cancer-related weight loss and low muscle mass. Future studies should analyze metabolomics in activity/mobility-related muscles to elucidate metabolite/pathway dysregulation in cancer-related functional impairment.
PM2.5 IS ASSOCIATED WITH DAILY OUTPATIENT VISITS FOR ANKYLOSING SPONDYLITIS: A TIME-SERIES ANALYSIS IN CHINA
Authors: Chen Hongbo
Published: January 2025

Exposure to ambient fine particulate matter (PM2.5) has a great impact on human body’s immune system, but the correlation between PM2.5 and ankylosing spondylitis has not yet been clarified. We extracted 58,600 outpatient visits for ankylosing spondylitis from the Beijing Medical Claim Data for Employees database from 2010 to 2017. The percentage of outpatient visits following PM2.5 concentrations was estimated using generalized additive models with Poisson connections. Increase by 10 μ g/m3, PM2.5 is associated with daily outpatient visits for ankylosing spondylitis. In this test, the average concentration of PM2.5 was 86.8 (74.3) μ g/m3. For every 10 μg/m3 increase in PM2.5 concentration, there was a 0.34% (95% CI, 0.26-0.42%) increase in the risk of patients who visited the doctor on the same day. Females and younger patients were most susceptible to the impact of PM2.5 exposure (P<0.05). This study revealed the relationship between exposure to PM2.5 and ankylosing spondylitis, and future research can further confirm this finding and explore the potential mechanisms.
A LIFE COURSE APPROACH TO NEIGHBORHOOD SEGREGATION AND HEALTH AMONG BLACK AND WHITE AMERICANS
Authors: Fike Kayla , Sun Huaman , Esposito Michael , Sylvers Dominique , Duchowny Kate , Lee Hedwig , Hicken Margaret
Published: January 2025

Research documents a positive association between high levels of neighborhood segregation and several negative health outcomes among Black Americans. However, few studies examine the relationship between neighborhood segregation and the health of both Black and White Americans. We apply a lifecourse framework to better understand how exposure to neighborhood segregation earlier in life may lead to racial inequities in health byway of cumulative advantages/disadvantages (CAD). Utilizing data from the nationally-representative Americans’ Changing Lives study (ACL), we employ growth curve models to investigate the relationship between neighborhood segregation in 1990 and the trajectories of two health outcomes over the adult lifespan: the number of chronic conditions and the probability of experiencing functional limitations. Our analysis reveals that, for Black participants, the baseline level of black segregation does not significantly impact their trajectories in these health outcomes. However, among White participants, residing in neighborhoods with lower levels of white segregation is associated with an increased probability of developing more chronic conditions and experiencing functional limitations later in life. We explore the roles of systemic and cultural racism as shaping forces in neighborhood structures and as contributors to negative health outcomes for both Black and White Americans. Research implications include further parsing different types of white underrepresentation in neighborhoods (i.e., living in predominantly Black neighborhoods vs racially diverse integrated areas) to examine their unique effects on health trajectories. Further, we discuss how intervention efforts may identify and address detractors from healthy aging for White Americans who are underrepresented in their neighborhoods.
EDUCATION AND MIDLIFE COGNITIVE FUNCTIONING: EVIDENCE ABOUT MEDIATORS FROM THE HIGH SCHOOL AND BEYOND COHORT
Authors: Warren John , Muller Chandra , Grodsky Eric , Brickman Adam , Manly Jennifer
Published: January 2025

Educational attainment is associated with cognitive functioning and risk of Alzheimer’s disease and related dementias (ADRD). However, (1) aspects of schooling that precede degree completion have rarely been considered and (2) the social and biological pathways through which education shapes ADRD risk are not well understood. Do schools’ social and academic contexts, students’ schooling outcomes, and students’ degree completion independently predict cognitive outcomes? If so, how do life course social and biological factors mediate the effects of various dimensions of education? This study included a nationally representative sample of 12,530 Americans followed prospectively from high school through age ~60. We estimated associations between aspects of schooling and multiple dimensions of cognition, before and after adjustment for confounders. We then considered the mediating roles of midlife socioeconomic factors (e.g., income, financial precarity, debt, bankruptcy risk) and biological/health factors (e.g., cardiovascular disease, immunological function, inflammatory markers). We employ a variety of methodological approaches informed by recent advances in approaches to mediation analysis within causal frameworks. Education is more than just degree attainment. Understanding how and through what pathways education shapes cognitive functioning and ADRD risk requires longitudinal data with nuanced information about schools, schooling, and student performance.
FAMILY HEALTH STRESS AND INSOMNIA SYMPTOMS AMONG OLDER ADULTS: THE MODERATING ROLE OF ACTIVITY ENGAGEMENT
Authors: Jang Jeein , Burr Jeffrey
Published: January 2025

Insomnia symptoms that arise from stress pose a significant physical and psychological health concern for older adults. Yet, little empirical research has explicitly examined the association between stress caused by family health concerns and insomnia symptoms, along with the role that activity engagement plays in moderating this relationship. Pearlin’s stress process model is used to frame this study. Using data from the 2018 and 2020 waves of the Health and Retirement Study (N=9,003), this study employed ordered logistic regression models to assess the link between family health stress and insomnia severity using four items (i.e., trouble falling asleep, nighttime awakening, early morning awakenings, and feelings of nonrestorative sleep). Additionally, the moderating role of overall activity engagement, as well as three activity domains (cognitive, social, and physical activities) were included in the analysis. All statistical analyses were adjusted for sociodemographic characteristics, health-related factors, and caregiver status. The results of the regression analysis show older adults experiencing ‘somewhat upsetting’ and ‘very upsetting’ family health stress had 23% and 49% higher odds, respectively, of experiencing more severe insomnia symptoms compared to those with no family health stress. In addition, the relationship was buffered by overall activity engagement between the ‘very upsetting’ group and insomnia symptoms in the logistic regression. For the specific activity domains, cognitive activities were the only ones that moderated the association between family health stress and insomnia symptoms. These findings offer implications for public health interventions that seek to promote activity engagement among older adults.
US MEN’S SHEDS: MAINTAINING PURPOSE AND CONNECTION WITH OTHERS
Authors: Heinz Melinda , Kent-Thomas Kaylin , Hinders Julie Smith
Published: January 2025

The purpose of this study was to explore U.S. Men’s Sheds, learn how they operate, who attends them, and how participants perceived them. It is the first study exploring Men’s Sheds in the U.S. An explanatory sequential mixed methods study was conducted, and paper-based surveys were sent to sheds registered with the U.S. Men’s Sheds Association. Shed chairpersons encouraged members to complete surveys (N = 76), and results showed that most members were male (91%), older adults (M = 70), in good/excellent health (76%), and joined to make new friends or learn new skills. Four interviews were also conducted and two themes and a subtheme were noted. Theme 1: Purpose of the Men’s Shed represented the varied perspectives on what the Men’s Shed was meant to do for the community. Some members saw it as an extension of the church and felt it was important to share religious perspectives with the community, while others disagreed. A Subtheme on Serving the Community was also noted where members did agree on the importance of serving the community. Theme 2: Building Connections- Possibilities and Challenges illustrated the opportunities Men’s Sheds create for men in/approaching retirement. However, the lack of a formal space for members to meet was a barrier and reduced informal socializing that might otherwise occur. These findings revealed that many of the men joined because they wanted something worthwhile to do with their time. The interviews revealed that there may be opportunities to start Men’s Sheds within existing faith- based organizations.
POWER EXPANDS FUTURE TIME PERSPECTIVE AMONG OLDER ADULTS
Authors: Wang Liru , Su Mengxuan , Lu Minjie
Published: January 2025

Social power has been conceptualized as the ability to control or influence others in meaningful ways (Fiske, 1993). According to Socioemotional Selectivity Theory (Carstensen, 2006), when aging, individuals tend to perceive their future as more limited. This project aims to examine whether older adults with power may perceive their future as more expanded. In Study 1, 241 participants aged from 18 to 80 (154 females, Mage=50.27, SD=16.76) reported their sense of their own power and perception of the future. Results showed that the sense of power was positively associated with an expanded future time perspective, measured by a future time perspective scale and a life-axis index. In Study 2, 55 older adults (24 females, Mage=64.25,SD=3.09) who are currently in authority at work were recruited for the high-power group, and 52 older adults (25 females, Mage=65.38,SD=3.68) without authority at word were recruited for the low-power group. Consistent with Study 1, the high-power group of older adults reported a more expanded future than did the low-power group. In addition, the high-power group of older adults displayed a stronger inclination to pursue knowledge-related goals (e.g., obtaining new skills and experiences, knowing new friends). In both studies, the effect of power on expanding future time perspective was mediated by the participants’ sense of control. These findings highlight that role of power in counteracting the age-related changes in future time perspective.