bluuebunny/crossref_metadata_2025 huggingface dataset:
FAMILY CAREGIVING IN LTC SETTINGS DURING THE PANDEMIC: COMMUNICATION CHALLENGES AND LEVERAGING TECHNOLOGY
Authors: Tefera Gashaye Melaku , Robinson Erin , Park Geunhye
Published: December 2022

COVID19 related lockdown and protocols caused disruptions in family caregiving for older adults living in LTC settings. However, there is a paucity of research on the challenges and experiences of family caregivers in maintaining their caregiving role during the pandemic. Hence, this qualitative study explores family caregivers’ communication challenges and the role technology played in performing their caregiving roles. One-on-one in-depth interviews (N=25) were conducted with family caregivers (Mean age= 59.7; 92% female; 76% child) via phone/Zoom. Interviews were transcribed and thematically analyzed using Nvivo12. Findings demonstrate that family caregivers of older adults in LTC settings experienced severe communication barriers with staff at those facilities in the early onset of the pandemic, including delays of important information about their care recipients. Participants highlighted high staff turnover, inadequate training, staff unfamiliarity with technology, and poor internet connections as perpetuating communication barriers. During this time, their older care recipients experienced visual and hearing impairments that affected their ability to communicate, as well as cognitive decline. Despite this, family caregivers were able to successfully utilize various forms of technology to continue providing care supports and social support to their loved ones. Although participants relied on phone calls and email communications, they also used other platforms including Zoom, FaceTime, Nixplay, and TextNow. Participants used devices including landline phones, cellphones, computers, tablets, Ipads, and walkie-talkies to execute their communication. Implications of this study suggest that improving access and utilization of technology in LTC settings can enhance family caregiving during unprecedented events like the COVID19 pandemic.
NEIGHBORHOOD COHESION, LIVING ALONE, AND ALL-CAUSE MORTALITY IN COMMUNITY-DWELLING OLDER CHINESE AMERICANS
Authors: Jiang Yanping , Li Mengting , Chung Tammy
Published: December 2022

This study aimed to examine whether neighborhood cohesion would mitigate the adverse effect of living alone on all-cause mortality in community-dwelling older Chinese Americans. Data were drawn from the Population Study of Chinese Elderly (PINE, N = 3,157, 59-105 years, 58% female), a longitudinal study started in 2011. Mortality was tracked through December 2021 (N = 642 deceased). Cox regression indicated that neighborhood cohesion moderated the association between living alone and all-cause mortality (HR = 0.74, 95%CI [0.57, 0.97]), showing that among participants living alone (N = 678), those with high neighborhood cohesion had a 41% lower mortality risk than their counterparts with low neighorhood cohesion. In contrast, among participants living with others, those with high and low neighborhood cohesion had a similar mortality risk. These findings highlight that strong neighborhood cohesion may protect against the increased risk of premature mortality associated with living alone in older Chinese Americans.
SOCIAL ISOLATION AND DEMENTIA ONSET: THE ROLE OF DENTAL VISITS AND TOOTH STATUS
Authors: Qi Xiang , Wu Bei
Published: December 2022

Using data from the Health and Retirement Study, this study investigated the mediating effects of dental visits and tooth status (measured by edentulism) on the association between social isolation and dementia onset. Social isolation (exposure) and covariates in 2008, mediators (dental visits and edentulism) in 2012, and the onset of dementia between 2012 and 2018 were obtained. Dementia was identified through self- or proxy-reported physician diagnosis. We included 8,744 participants, and 576 (6.6%) had dementia during follow-up. There was a significant effect of social isolation on the onset of dementia (Hazard Ratio [HR], 1.14; 95% CI, 1.01-1.28). Controlling for mediators, the effect of social isolation was reduced to 1.10 (95% CI, 0.98-1.25), leaving an indirect effect of 1.03 (95% CI, 1.02-1.04). The proportions mediated by dental visits and edentulism were 4.4% and 7.5%, respectively. Our findings highlight the importance of improving oral health and dental care for older adults.
DISPARITIES IN ACCESS TO DENTAL CARE IN COMMUNITY-DWELLING OLDER ADULTS WITH COGNITIVE DISABILITY
Authors: Zanwar Preeti , Wood Elizabeth , Gimm Gilbert
Published: December 2022

Older adults with cognitive disability are worse off with being up-to-date with preventive care and routine dental care is not considered a clinical preventive visit covered by insurance for this population. I examine disparities in access to dental and clinical preventive services (e.g. dental visit, blood pressure visit, flu shot) in the past year in 28,068 older adults with cognitive disability using the nationally representative Medical Expenditure Panel Survey from 2009-2016. I conduct multivariate logistic regressions and find older adults with cognitive disability vs. no disability have higher odds of receiving annual blood pressure check (AOR, 1.97, 95% CI 1.34-2.88) but lower odds for having an annual dentist visit (AOR, 0.61, 95% CI 0.53-0.71) with only one-tenth of those with cognitive disability report having dental insurance. These findings have implications for integrated community-and-clinical care partnerships for closing the gap for routine dental care services among older adults with cognitive disability.
OUTDOOR FALLS PREVENTION: PROMOTING SAFETY IN URBAN NEIGHBORHOODS
Authors: Chippendale Tracy
Published: December 2022

Outdoor falls present a significant challenge to the well-being of community dwelling older adults. There are a number of existing evidence-based programs that address fall risk, including multifactorial and exercise-based programs. However, despite the difference in risk factors for indoor and outdoor falls, no existing program specifically targets outdoor falls. To fill this gap, the Stroll Safe program was developed and refined based on a prior feasibility study. The 7-week group-based manualized program is focused on promoting safe behavioral strategies to reduce the risk of outdoor falls. In addition to presentations and community mobility coaching by the group leader, an occupational therapist, the program includes group discussion and problem solving, capitalizing on the life experiences of participants. Action planning facilitates implementation of the strategies discussed. Given that the neighborhood environment impacts both risk and fear of falling, a walkability audit (i.e. the SWAN) focused on environmental hazards is included and is used to promote awareness of hazards and as a tool for self-advocacy. Data science and machine learning facilitate the creation of resources for route planning. Vision Zero resources help to identify hotspots for pedestrian injuries, and a map of shadow is used to create a user friendly map of potential hotspots for black ice. In this symposium, we will present 1) Findings from the efficacy trial for Stroll Safe, and 2) Describe data science research that can be used to inform outdoor falls prevention programs.
ENDING AGEISM ISN'T ENOUGH: INFUSING AN INTERSECTIONAL LENS TO ADVANCE PRODUCTIVE AGING RESEARCH AND HEALTH
Authors: Gonzales Ernest
Published: December 2022

This presentation integrates anti-racism, anti-ageism, and health equity lenses into the productive aging scholarship. Ageism and racism undermine population health and compromises choices to work and volunteer. These isms, among others, intersect and disproportionately impact populations of color and older adults; nonetheless, these oppressive systems create a culture of intergenerational conflict within the workplace and in general society. I will review key theoretical concepts and values in productive aging scholarship and how intersectionality as a framework has informed the development of new and important research questions for the field. This presentation will also analyze a variety of methodological approaches to examine productive aging and health inequities by race, ethnicity, gender, and age. A discussion on the implications for research, policy, and practice will conclude the presentation.
DEMYSTIFYING NIH PEER REVIEW: YOUR APPLICATION FROM SUBMISSION TO SCORE
Authors: Ortenberg Elia , Roberto Karen , Plude Dana , Lun Janetta , Gabor Helena
Published: December 2022

What happens to applications after they are submitted to the National Institutes of Health, and how can you better prepare for the process of peer review? The Center for Scientific Review (CSR) works closely with the 24 funding institutes and centers at the National Institutes of Health that provide funding support for projects of high scientific merit and high potential impact. CSR conducts the first level of review for the majority of grant applications submitted to the NIH, which includes 90% of R01s, 85% of Fellowships, and 95% of Small Business Innovation Research (SBIR) applications as well as many other research and training opportunity activities. In this capacity, CSR helps to identify the most meritorious projects, cutting-edge research, and future scientists who will advance the mission of the NIH: to enhance health, lengthen life, and reduce illness and disability. The purpose of this symposium is to provide an overview of 1) what happens to NIH applications before, during, and after peer review at CSR; 2) new and current peer review policies and practices that impact application submission; and 3) strategies for developing a strong NIH grant application. Peer review is the cornerstone of the NIH grant supporting process, and demystifying the process can help attendees understand what’s inside the “Black Box” and the criteria used to identify the most meritorious applications.
PROGRAMS, POLICIES, AND SERVICES TO FACILITATE AGING IN PLACE
Authors: Yan Mengzhao , Nabors Emily , Pynoos Jon
Published: December 2022

Rooted in the person-environment-fit theory, home modification has been tested as an intervention to support older adults to age safely at home by improving functioning and reducing fall risks. Home modification is often a complex process, involving multiple steps and various stakeholders. As such, proper implementation is important to its effectiveness. However, limited research has focused on how to implement home modification from a comprehensive perspective. To advance the implementation science of home modification for older adults and achieve a better understanding of promising practices, we conducted a scoping analysis of review articles, referred to as umbrella review, to identify strategies that have been found effective in implementing home modification. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P), after performing a thorough literature search from six electronic databases, including MEDLINE, PubMed, Embase, CINAHL, Web of Science, and Cochrane Review, we identified 16 highly relevant review articles from 1,310 articles retrieved. From these, we derived a set of practical strategies for service delivery professionals and developed an implementation matrix with the strategies clustered under two dimensions: (1) types of home modification based on demands of effort and level of evidence, including evidence-based practices, best practices, emerging practices; and (2) the critical stages of home modification, including preparation, home assessment, installation, follow-up visit. Our findings highlight the importance of maintaining cohesion between different stages of home modification and sustaining consensus among service delivery professionals and residents when implementing home modification for older adults.
CHALLENGES AND RECOMMENDATIONS TO MEETING THE PALLIATIVE CARE NEEDS OF RESIDENTS IN ASSISTED LIVING
Authors: Dobbs Debra , Meng Hongdao , Haley William , Vogel Carlyn , Buck Harleah
Published: December 2022

Of the more than 800,000 assisted living (AL) residents in the U.S. approximately 25% remain until the end of life and can benefit from palliative care (PC) and hospice care. Although the AL population is the fasting-growing segment of hospice care, increasing by 40% in the past five years, ALs still have special challenges in providing quality end-of-life care. ALs have a lack of nurse staffing and adequate training about how to care for those with serious illnesses. We present findings from studies over the last decade in Florida ALs (N=100) related to PC and hospice care practices. Some of the findings reveal gaps in care related to PC staff education, documentation of pain and advance directives and recognizing the need for more family involvement in decisions, especially for those with dementia. Recommendations on how to improve processes of care for residents who can benefit from PC will be discussed.
CAREGIVERS' EXPECTATIONS OF A MIND-BODY THERAPY FOR COMPLICATED GRIEF
Authors: Buck Harleah
Published: December 2022

Accelerated Resolution Therapy (ART) is a psychotherapy for the treatment of complicated grief, defined as unusually prolonged, functionally impairing grief. The purpose of this study was to qualitatively examine caregiver’s expectations of ART. The sample included 29 primarily female, older (67.4 + 7.1 years) former informal caregivers; a little over half (n=18) had been married to their care recipient. Thematic analysis resulted in three themes and six sub-themes arising: The role of knowledge in expectations (sub-themes uncertainty, prior knowledge); The role of personality in expectations (sub-themes openness, positive affect); and Expecting a process (sub-themes cognitive processes, affective processes) which described the interaction of person and process in shaping expectations of our intervention. An across theme analysis of the specificity of the participants’ expectations uncovered that knowledge and personality inform expectations of ART and that individuals who verbalize a process for recovery tend to be very specific in their expectations.
THE PARTNERSHIP BETWEEN THE CENTER FOR SCIENTIFIC REVIEW AND THE NIH INSTITUTE
Authors: Plude Dana
Published: December 2022

The playing field for NIH funding is highly competitive, and having a great idea is only the start of the process. There are many funding mechanisms for early career investigators, trainees, and research institutions. Understanding about different application types, who to talk to about your application at different stages of development, finding the right review panel, and learning about the policies and procedures pertaining to review are important first steps in preparing an application. In recent years, the Center for Scientific Review has undergone changes and updated its structure, policies and practices to stay aligned with its mission. In this presentation, attendees will learn about the roles played by CSR and the NIH Institute as applications move from review to funding.
EVALUATION OF A CAREGIVER FINANCIAL PREPAREDNESS PROGRAM: SIGNIFICANT SHORT- AND LONG-TERM IMPACTS
Authors: Judge Katherine , Grant Claire , Moreno Monica , Lanigan Kerry , Stratton Lauren , Fazio Sam
Published: December 2022

Over 50 million informal caregivers provide care to an older adult age 50 or older. Negative financial impacts include significant out-of-pocket expenses, decreased income and future earnings. The program, Managing Money: A Caregiver’s Guide to Finances, was developed to address the lack of evidence-based programs and evaluated using a randomized control trial across 5 time points: Time 1 (baseline); Time 2 (after condition completion); Time 3 (30 days after Time 2); Time 4 (60 days after Time 2); and Time 5 (90 days after Time 2). The mean age of participants was 55.45 (SD=14.85); 80% female; 72% White and 69% married. Forty-six percent provided care to their parent/in-law, 36% to a spouse/partner, and 40% were employed full-time. Participants were randomly assigned to the program (N=76) or waitlist condition (N=98). No significant differences on demographic or care context variables were found between conditions. A 2 x 5 repeated measures analyses examined significant change across time based on condition. For significant outcomes, post-hoc analyses examined whether change was short-term (T2,T3); long-term (T4,T5); or both. Results found: 1) significant short- and long-term improvements for Unmet Needs (F(1,4)=8.34,p=.01); Self-efficacy (F(1,4)=4.27,p=.01); and Behavioral Intentions (F(1,4)=3.63,p=.01) and 2) significant long-term improvements for Unmet Needs Distress (F(1,4)=5.82,p=.01) and Behavioral Actions (F(1,4)=4.55,p=.01). Results indicated the program was efficacious in positively impacting key financial preparedness measures. Discussion highlights key study elements including program accessibility and scalability; generalizability of findings and limitations; and contextualizing results within the larger literature.
HOW DO OLDER AFRICAN AMERICAN COUPLES TAKE CARE OF EACH OTHER? A DYADIC, QUALITATIVE ANALYSIS
Authors: Rauer Amy , Cooke Wendy McClean , Hornbuckle Lyndsey
Published: December 2022

Guided by Lyons and Lee’s (2018) Dyadic Theory of Illness Management, the current study explored covariation in dyadic health management behaviors within a sample of seventeen older African American married couples (Mage=61.68 years; Mmaritalduration=32.29 years). We also examined if spouses agreed on how they took care of each other’s health and whether these patterns changed after couples participated in a health-focused intervention together. Prior to beginning a 12-week walking plus resistance training exercise intervention, spouses completed questionnaires asking them to list the common things they did to help take care of their partner’s health as well as what their partner did for them. Thirteen couples completed these questionnaires post-intervention. Data from both waves were analyzed using thematic analysis (Braun & Clarke, 2006). Five health management behaviors domains were identified (diet, exercise, self-care, medical compliance, relationship maintenance). Although both partners reported encouraging healthier diets and exercise, wives also reported promoting other health management behaviors. Couples had greater congruence in their appraisals of wives’ health management behaviors compared to husbands’, as wives recognized many things husbands did to take care of them that husbands did not report themselves. Patterns appeared stable over time. Findings suggest the incongruence in couples’ health management behaviors represented complementary efforts to support each other and revealed that husbands may be underestimating how much care they are providing to their wives. A promising method for addressing health disparities in this population may involve capitalizing on this clear investment that older African American couples have in each other’s health.
HEARING, COGNITION, AND PHYSICAL FUNCTION: LEVERAGING LARGE-SCALE EPIDEMIOLOGIC STUDIES TOWARD INTERVENTION
Authors: Nieman Carrie , Deal Jennifer , Wallhagen Margaret
Published: December 2022

Hearing loss and aging represent the intersection of two major public health challenges. Over 1.5 billion individuals or almost 20% of the global population have hearing loss, where the largest burden is among older adults secondary to age-related hearing loss. By 2030, the end of the UN Decade of Healthy Aging, almost 2 billion individuals are expected to be living with hearing loss. Evidence continues to grow related to the negative consequences of hearing loss in the context of aging, both on cognitive and physical function. This symposium will share the latest findings on hearing loss and its relationship to a range of negative consequences from diverse large-scale cohorts. Specifically, the session will cover hearing loss and its relationship to cognitive health, including subjective cognitive decline and neuropsychiatric symptoms among persons living with dementia, as well as physical health, including frailty and physical function. Each presentation draws upon datasets from a large-scale epidemiologic study with varying types of data on hearing status and measures of cognitive and physical health. The covered datasets include nationally representative cohorts, such as the National Health and Aging Trends Study (NHATS), to longitudinal cohorts, such as the Atherosclerosis Risk in Communities Study (ARIC). The session will serve as a primer on available datasets that include data on hearing status and hearing care, including strengths, limitations, and analysis considerations. This symposium will provide tangible ways to leverage existing data in order to move toward intervention and build capacity around hearing health within gerontology.
DIFFERENCES IN THE EXPERIENCES AND BEHAVIORS OF OLDER ADULTS IN NSHAP DURING THE COVID-19 PANDEMIC
Authors: Hawkley Louise , Carr Dawn
Published: December 2022

This symposium uses data from the National Social Life, Health & Aging Project to examine how and for whom older adults’ social relationships and experiences changed with the advent of the COVID-19 pandemic. Zhang et al. examine video call usage among older adults with hearing impairment and how this might mitigate loneliness. They find that although this population reported greater loneliness during the pandemic, video calls attenuated this relationship in a dose-response manner. Wilder et al. evaluate 2015 resilience and socioeconomic status as predictors of older adults’ reports that the pandemic led to a positive change in their lives. Results revealed greater odds of reporting a positive impact of the pandemic for those with higher education, adjusting for resilience. Compernolle et el. assess differences by cognitive status in changes in mental health from pre- to during the pandemic. Higher 2015 cognitive functioning was associated with greater pandemic loneliness, with decreased pandemic emotional support partly explaining this association. Copeland & Liu investigate the role of 2015 personal networks in receiving instrumental and emotional support during the pandemic, finding that larger and denser pre-pandemic confidant networks each predicted higher odds of receiving various types of support during the pandemic. Wong et al. explore whether and for whom relationship quality changed since the pandemic started. Two-thirds of partnered respondents reported unchanged relationship quality, and Black respondents were more likely to report improved relationship quality. These investigations highlight sub-group differences in older adults’ changes in experiences, behavior, and well-being since the pandemic began.
HEARING LOSS AND FRAILTY: LONGITUDINAL ASSOCIATIONS
Authors: Reed Nicholas , Jiang Kening
Published: December 2022

Hearing Loss (HL) is common among older adults and is associated with factors (e.g., walking speed and social isolation) that may mediate an association with frailty. In the National Health and Aging Trends Study (NHATS) 2011-2018 data, frailty was defined by the physical frailty phenotype composite (exhaustion, low physical activity, weakness, slowness, and shrinking) while HL was self-report. Among, 6897 baseline participants in 2011, 1132 (16%) were frail. In a cox proportional hazard model adjusted for demographic, socioeconomic, and clinical risk factors, HL (n=1607; Hazard Ratio[HR]=1.15; 95% Confidence Interval[CI]=1.00-1.32) was associated with higher risk of incident frailty relative to those with no HL (n=5290). In a generalized estimating equation longitudinal model (2011-2018), HL was associated with higher odds of frailty at baseline (Odds Ratio[OR]=1.52; 95%CI=1.49-1.96) and a 1.06 (95%CI=1.04-1.09) annual increase in odds of frailty. Future research should focus on mechanisms underlying association and determine the impact of HL treatment.
JOURNAL OF GERONTOLOGY SOCIAL SCIENCES: FEATURED 2021 EDITOR’S CHOICE ARTICLES
Authors: Kelley Jessica
Published: December 2022

Social science inquiry on age, aging, and the life course spans many topics and methodologies. This symposium highlights papers that were selected as Editor’s Choice articles in the Journal of Gerontology Social Sciences in 2021. These papers highlight methodological innovations, important advancements in our state of knowledge in an area, or emerging issues in the study of aging and older adults. Nguyen et al. discuss a qualitative study of the causes and consequences of financial exploitation of older adults. Newmyer et al. present a 31-country comparative study of measures of loneliness with their reliability and validity. Rurka et al. present a mixed-methods study of sibling dynamics and tensions when caring for an older parent. Dennison and Lee provide a novel method for studying intergenerational selection effects of education and older adult health. Lin and Brown demonstrate gender differences in the economic consequences of later-life divorce and potential impact of repartnering versus staying single.
PERCEIVED TYPES, CAUSES, AND CONSEQUENCES OF FINANCIAL EXPLOITATION: NARRATIVES FROM OLDER ADULTS
Authors: Nguyen Annie , Han Duke
Published: December 2022

We investigate the perception of financial exploitation and its causes and consequences by older adults who have firsthand experience of being exploited. Thirty-one cognitively healthy older adult participants aged 50 or older were drawn from the Finance, Cognition, and Health in Elders Study. In-depth, one-on-one interviews were conducted. Interview transcripts were analyzed using an iterative, data-driven, thematic coding scheme and emergent themes were summarized. Categories of financial exploitation included (a) investment fraud, (b) wage theft/money owed, (c) consumer fraud, (d) imposter schemes, and (e) manipulation by a trusted person. Themes emerged around perceived causes: (a) element of trust, (b) promise of financial security, (c) lack of experience or awareness, (d) decision-making, and (e) interpersonal dynamics. Perceived consequences included negative and positive impacts around (a) finances, (b) financial/consumer berhaviors, (c) relationships and trust, (d) emotional impact, and (e) future outlook. These narratives provide important insights into perceived financial exploitation and experiences.
THE CAREGIVER IDENTITY IN CONTEXT: CONSEQUENCES OF IDENTITY THREAT FROM SIBLINGS
Authors: Rurka Marissa , Suitor J Jill , Gilligan Megan
Published: December 2022

We draw from theories of identity and stress to examine the impact that siblings have on caregivers’ psychological well-being. Using data collected from 404 caregivers nested in 231 families as part of the Within-Family Differences Study, we conduct mediation analyses to examine whether perceived sibling criticisms are associated with caregivers’ depressive symptoms (a) directly and/or (b) indirectly through sibling tension. Qualitative data from the same caregivers give insight into the processes underlying statistical associations. We found an indirect relationship whereby perceived sibling criticisms were associated with greater sibling tension, which in turn was associated with higher depressive symptoms. Qualitative interviews show that efforts to mitigate the negative impact of sibling criticisms can lead to caregiver strategies that fuel sibling tension. These findings demonstrate how identity processes, as well as the family networks in which caregiving takes place, shape the experiences and consequences of parent care.
MULTIDIMENSIONAL CONSTRUCTS OF SLEEP IN OLDER ADULTS
Authors: Kaufmann Christopher , Stone Katie
Published: December 2022

Sleep disturbances are common in older adults and are associated with a variety of adverse mental and physical health outcomes. While most studies have characterized sleep based on a single dimension of sleep (typically sleep duration or self-reported sleep quality), there is a growing paradigm shift to characterize “Sleep Health” as multidimensional. More research is needed to identify the clinical utility of a multidimensional approach to characterizing sleep specifically in older adults. In this symposium, we will present five studies that explore how multidimensional Sleep Health relates to age-related health outcomes (e.g., fall risk). Our first presentation will identify associations between subjective/objective sleep quality and physical activity, and examine the moderating role of chronotype. Second, we will examine the extent to which a multidimensional index of Sleep Health and its individual dimensions relate to fall risk. Third, we will ascertain the impact of mindfulness on various Sleep Health dimensions. Fourth, we will identify the extent to which discordance in subjective and objective sleep metrics are related to cognitive functioning. Finally, we will explore how the accumulation of disturbances in Sleep Health may increase risk for early mortality. Findings from this symposium will highlight the clinical relevance of a multidimensional approach to Sleep Health in older adults, and identify the ways in which sleep interventions can be tailored to specific sleep dimensions to promote health in later life.
FOCUS ON PRESENT MOMENT FOR YOUR SLEEP: MINDFULNESS PROMOTES MID-LIFE ADULTS' SLEEP HEALTH
Authors: Smith Claire , Mu Christina , Venetto Angelina , Khan Arooj , Lee Soomi
Published: December 2022

Sleep health during midlife sets the stage for health over the lifespan. Mindfulness, or present-moment awareness and attention, is shown to benefit sleep, yet mechanisms explaining these benefits are missing. Applying self-regulation theory, we test affective and cognitivemechanisms linking mindfulness to quantitative and qualitative sleep health. Across two independent samples of nurses (N1=60; N2=84), ecological momentary assessment (measuring mindfulness, sleep quality and sufficiency, positive and negative affect, and rumination) and actigraphy (sleep duration and wake-after-sleep-onset [WASO]) were collected over fourteen days. Multilevel mediation revealed that, between people, mindfulness generally associated with better sleep quality and sufficiency, mediated by lower rumination and negative affect. Within people, daily mindfulness associated with better sleep sufficiency, mediated by higher positive affect. Our findings position mindfulness as an emotional and cognitive self-regulation strategy that promotes midlife adults’ qualitative – but not quantitative -- sleep health. Results may inform health interventions during this pivotal life stage.
SOCIAL RESOURCES, COGNITION, AND MENTAL HEALTH DURING THE COVID-19 PANDEMIC
Authors: Hawkley Louise , Finch Laura , Waite Linda , Compernolle Ellen
Published: December 2022

This study assesses the extent to which changes in mental health among older adults from pre- to during the pandemic varied by cognitive functioning and the role that decreases in social resources played in this association. We use data from the National Social Life, Health, and Aging Project (NSHAP)—a population-based panel study of older U.S. adults that has surveyed respondents every 5 years since 2005—and the NSHAP COVID-19 supplement, conducted between September 2020 and January 2021 (N=2,672). Results from linear regression models suggest that (1) higher cognitive functioning in 2015 was associated with greater loneliness (β=-0.03; p<.05) during the pandemic; (2) this association is explained in part by a decrease in emotional support during COVID-19 (β=0.94; p<.001); and (3) cognitive status did not moderate links between social resources with happiness nor loneliness. Results emphasize the importance of social resources for older adults’ mental health, regardless of cognitive ability.
PHYSICAL FUNCTION AMONG OLDER ADULTS AND CAREGIVERSARTHRITIS AMONG CAREGIVERS—BRFSS 2017, 2019
Authors: Jackson Eva , Boring Michael , McGuire Lisa , Omura John , Olivari Benjamin , Odom Erica , Croft Janet
Published: December 2022

Unpaid caregivers are people who provide support to a family member or friend with a health condition or disability. While there are benefits to caregiving, it can negatively affect caregivers’ physical and mental health. Arthritis and caregiving affect 58.5 million and 53 million U.S. adults, respectively, and these numbers are expected to increase with increasing numbers of older adults. Little is known about the experience of caregivers with arthritis.Data from the 2017 and 2019 BRFSS were combined for all states that administered the optional Caregiving and the core Arthritis modules (17 states; n=91,224). Analyses accounted for the complex sampling design using SUDAAN (version 11.0; RTI International). Statistical significance was determined at α=0.05.Overall, 20.6% of respondents were caregivers, among whom 35.1% had arthritis compared with 24.5% of non-caregivers (p < 0.001). Arthritis among caregivers was higher in all 17 states compared to non-caregivers. Among adults with arthritis, caregivers were more likely to be younger, female, White, and more physically active than non-caregivers. Caregivers were also more likely to experience arthritis-related activity and work limitations than non-caregivers. Arthritis-related limitation outcomes varied at the individual state levels.Among caregivers, those with arthritis provided more care in weekly hours and duration (years) and were more likely to report difficulty walking or climbing stairs, dressing or bathing, and doing errands alone than caregivers without arthritis. Given the disparities between caregivers with and without arthritis, it is crucial for public health to collect data on the experience of caregivers with arthritis.
WHO GETS HELP? A NATIONAL LONGITUDINAL STUDY OF PERSONAL NETWORKS AND PANDEMIC SUPPORT AMONG OLDER ADULTS
Authors: Copeland Molly , Liu Hui
Published: December 2022

Personal networks are a key component in the provision of social support for older adults. Such support is particularly critical during the COVID-19 pandemic, when traditional avenues of social engagement or assistance are disrupted. Here, we use nationally representative data from the National Social Life, Health, and Aging Project that assesses older adults’ pre-pandemic personal networks and receiving instrumental help and emotional support during the pandemic. We find that larger pre-pandemic confidant networks predict higher odds of receiving needed help and support, higher odds of receiving help and support more often than before the pandemic, and lower odds of being unable to get help. Denser pre-pandemic networks also predict higher odds of receiving instrumental help and support during the pandemic, while having a greater proportion of kin in pre-pandemic networks predicts higher odds of receiving pandemic help for non-white older adults only. Together, results suggest that features of older adults’ pre-pandemic confidant network structure and composition can provide underlying conditions for receiving social support during the pandemic.
REACHING THE LIMIT: CENTENARIANS IN THE HEALTH AND RETIREMENT STUDY
Authors: Martin Peter , Ailshire Jennifer
Published: December 2022

Although life expectancy has increased significantly over the last century, it is still unlikely that individuals reach the century mark of their lives. As a result, it is difficult to study a large enough sample of centenarian survivors; it is even more difficult to follow developmental trajectories of those who survive into very late life. The AHEAD sample of the Health and Retirement Study (HRS) contains longitudinal data of older adults who first participated in 1993. More than 500 HRS participants survived to at least 98 years of age. In this symposium, we present three uses of the data: first, we compare centenarians to older adults who did not survive into their nineties. Second, we compare different cohorts of centenarians with regard to health and psychosocial behavior. Third, we follow participants from their eighties to 100 years of age. The first presentation provides an overview of the HRS subsample. The second presentation highlights the personality profiles of centenarians. The third presentation traces health and psychological well-being among centenarians in the HRS. Finally, we discuss trajectories of cognition and functional limitations for three cohorts of centenarians. The results provide important information for policies and practical implications for families and service providers to older adults, highlighting available resources and health and well-being changes in very late life.
THE TRAJECTORIES OF COGNITION AND FUNCTIONAL LIMITATIONS OF CENTENARIAN SURVIVORS
Authors: Lee Gina
Published: December 2022

The purpose of this study is to explore cohort differences in the trajectories of cognition and functional limitations among oldest-old adults. Using 1992-2018 data from the Health and Retirement Study, participants included those who survived to at least 98 years (N=494). The study included three cohorts (i.e., 1890-1900, 1901-1910, and 1911-1920) predicting intercept and slope of cognition and functional limitations. Two separate latent growth curve models were computed, and models of cognition, χ2(5)=6.935, p=.226 and functional limitation, χ2(7)=7.743, p=.35 fit the data well. There was a significant decline in cognition levels and a significant increase in functional limitation over time. When adding cohort, results indicated that older cohorts were more likely to have a decrease in cognition and increase in functional limitations compared with the younger cohort. Future research should investigate trajectories of other health variables for a better understanding of health changes of centenarians.
ENROLLING PARTICIPANTS WITH DEMENTIA IN A RURAL SETTING: GEISINGER RECRUITMENT STRATEGIES FOR D-CARE
Authors: Lichtenstein Maya , Borek Pamela , Ladd Ilene
Published: December 2022

Geisinger Health System serves a large, geographically stable population in central and northeast Pennsylvania and was chosen to participate in D-CARE due to its rural population, which is often under-represented. To reach potential participants, we used a multi-pronged recruitment approach including local radio, television, and newspaper advertisement; publication in a health system newsletter targeted to 55+; outreach to senior-care managers and primary care providers to encourage referrals; and leveraged an extensive electronic health record (EHR) database to identify a pool of almost 9,000 potential participants. Initial barriers to enrollment stemmed from geographic challenges and the dyad’s inability and/or unwillingness to travel long distances to lengthy in-clinic appointments. A post-pandemic transition to virtual visits helped ease the travel burden and increase study enrollment. Despite varied recruitment strategies, by far the most effective recruitment method remained direct referrals of patients and caregivers with whom the provider had discussed the D-CARE study.
CLINIC-BASED RECRUITMENT STRATEGIES WITHIN AN INTEGRATED HEALTH CARE SYSTEM FOR THE DEMENTIA CARE STUDY (D-CARE)
Authors: Stevens Alan , Green Aval-Na’Ree , Abraham Sitara , Reese Jordan
Published: December 2022

At Baylor Scott and White Health (BSWH), 4,564 patients with a diagnosis of dementia were identified via search in the EHR, direct referrals from BSWH Providers and self-referrals. Of 2,296 potential participants (dyads of person with Dementia [PWD] and their family caregivers) screened, 2,034 were deemed eligible, and 626 dyads were enrolled. The BSWH D-CARE leadership team provided a 20-minute presentation to Medical Directors and Providers of 32 BSWH primary care clinics followed by a request to review Provider-specific patient lists. After Provider review, research team members sent letters and/or made phone calls to dyads. Providers were also invited to make direct referrals using an EHR referral link and the research team pinned appointment notes to upcoming PWD clinic appointments to remind Providers of the project. Recruitment strategies shared during monthly meetings of the Recruitment & Retention Committee also proved helpful in the identification of successful outreach and recruitment activities.
ASSESSING THE POTENTIAL OF DIGITAL HOME ASSISTANTS TO SUPPORT OLDER ADULTS WITH MOBILITY DISABILITY
Authors: Blocker Kenneth , Lim Ki , Hussaini Husna , Williams Kyreon , Sreenivas Ramavarapu S , Rogers Wendy
Published: December 2022

Digital home assistants (e.g., Amazon Echo devices) hold great potential for supporting older adults in completing a wide range of daily living activities and improving their overall quality of life. As these devices can wirelessly connect with other smart technologies to increase their capabilities (e.g., environmental control), digital assistance technologies may benefit older adults who need support within their home such as those living with mobility disabilities. However, research is needed to better understand the facilitators and barriers of using these technologies by these individuals, as well as the resources that best support their onboarding and continued use. To assess the potential efficacy of integrating smart and connected technologies into the homes of older adults with mobility disability, we are conducting a field trial to understand how best to introduce these devices and support their use. Design considerations and initial findings are discussed.
OLDER INDONESIAN WOMEN’S EXPERIENCE TO MAINTAIN INDEPENDENCE IN FOOD-RELATED ACTIVITIES
Authors: Ramadhani Widya , Dearborn Lynne
Published: December 2022

The ability to conduct food-related activities such as cooking, eating, and cleaning are central to older adults’ health. Such ability is especially critical for older women who are more likely to live alone or become caregivers for their spouses and other family members. We investigated the experience of older Indonesian women, an understudied population in aging research, when engaging in food-related activities. Using the grounded theory approach, we examined the challenges and adaptive behavior of twelve community-dwelling older women in Indonesia (60+) when conducting food-related activities at home. We employed two data collection strategies: photo and video elicitation, followed by an interview. Through photo and video elicitation, participants took photos and videos of the space where they conducted food-related activities to provide physical environmental data. In the interview, participants explained their routine, activity challenges, and adaptation strategies in food-related activities. We discovered that participants’ view of their role in cooking food for the family is central to their sense of identity. When faced with age-related challenges, participants accepted assistance from others for activities less connected to food production, such as sweeping, mopping, or cleaning the kitchen. However, they are less likely to accept assistance for cooking activities. Instead, they adapted by modifying the physical environment, simplifying the tasks, and adjusting the method to remain engaged in cooking. Older Indonesian women’s cultural identity influenced their strategy to face age-related challenges and maintain independence. This finding highlights the importance of a culturally sensitive approach when planning support for older adults.
TRANSITIONS IN SOCIAL SUPPORT EXCHANGE PROFILES OVER TIME AMONG OLDER ADULTS
Authors: Sung Pildoo , Malhotra Rahul , Cheng Grand , Chan Angelique
Published: December 2022

Despite increasing interest in social support exchanges among older adults, little is known about the interplay between giving and receiving social support, how social support exchanges change over time, and factors associated with such change. Using data on 1,305 older Singaporeans participating in two waves of a national, longitudinal survey conducted in 2016-2017 and 2019, we investigated (1) distinct social support exchange profiles that comprise different types of giving and receiving social support, (2) transitions in social support exchange profiles over time, and (3) association of sociodemographic characteristics and health status with such transitions. Gender-stratified random intercept latent transition analysis (RI-LTA) produced three main findings. First, we identified four social support exchange profiles—multi-exchange, provider, receiver, and low exchange—for both males and females at both waves, although the distribution of profiles varied by gender and waves. Second, males were more likely to transition from the multi-exchange profile to other types, whereas females were relatively more likely to transition into the multi-exchange profile over time. Third, among males, those older, of ethnic minority, unmarried, employed, and with depressive symptoms were more likely to transition into the receiver profile from other types. Females who were younger, of ethnic majority, married, and less educated were more likely to transition into the multi-exchange type from low or receiver profiles. The findings capture the temporal dynamics in social support exchange profiles and their gendered characteristics. Policy interventions should focus on older adults who lack social support exchanges and those who lose social support exchanges over time.
SOCIAL ISOLATION, LONELINESS, AND MATTERING AMONG OLDER ADULT FACEBOOK USERS FROM DIVERSE BACKGROUNDS
Authors: Francis Jess , Brauer Simon
Published: December 2022

Older adults who are childless and live alone are at risk for social isolation and loneliness. Studies show Facebook communication to be associated with feelings of mattering – the feeling that we are significant to others - a protective psychosocial resource. Despite being at similar stages in life, older adults, their technology use, and their experience of social isolation can vary greatly. This study explores how older adults from different demographic and socioeconomic backgrounds use Facebook and how that use is associated with perceptions of mattering, loneliness, and social isolation. This study employed online survey methodology among a sample of older adult Facebook users (n = 517; Mage=70; 50% Female; 92% White). Preliminary results show significant differences among income level, age, and gender regarding Facebook communication and mattering among older adults who are childless and live alone. We discuss our full results in tandem with qualitative data from our sample.
STORIES FROM THE INSIDE OF DEMENTIA: CONSTRUCTING IDENTITIES AND RELATIONSHIPS THROUGH THE DISCOURSE OF EXPERIENCE
Authors: de Medeiros Kate , Saunders Pamela
Published: December 2022

Dementia is often characterized as a time of decline and loss. The grand narrative (i.e., the biomedical narrative) of dementia describes it as a time of meaninglessness given the inevitable loss of memory and language, fraught with difficulties recognizing familiar faces, recalling autobiographical events, and orienting to time and place. This unfortunate depiction negatively positions people living with dementia as living a ‘social death’ and overlooks the potential of forming meaningful relationships and experiencing a sense of community. Elements often overlooked can be found in the careful reading and analysis of individual interactions that make up constructions of identity, relationships, and community. In this symposium, we draw data from the “Friendship Study,” a 6-month ethnographic study on the social environments of people living with dementia in long-term care to consider meaning-making in dementia through three perspectives: phenomenological, gerontological, and discursive. The first paper considers the phenomenology of friendship, moving away from linear narratives to look at micro-constructions of identity. The second considers the co-construction of friendship through discursive elements found in conversational interactions. The third challenges staff’s construction of residents, highlighting how negative assumptions about resident capabilities can affect personal relationships and the social environment.