bluuebunny/crossref_metadata_2025 huggingface dataset:
BEYOND THE CLASSROOM: A STUDENT INTERNSHIP MODEL THAT BUILDS AGE FRIENDLINESS AND CAREER READINESS
Authors: Leedahl Skye , Souza Kristin Fratoni , Morelli Alexandra
Published: December 2022

For seven years, the University of Rhode Island (URI) Engaging Generations Cyber-Seniors Program has utilized university student mentors through an internship format and integration within service learning courses. In 2019, community interest in the program significantly increased as did student interest in gerontology internships. This led us to develop a robust internship program focused on building age and digital inclusivity across campus and the state of RI. The program integrates a three-pronged approach where students complete field hours within the URI Cyber-Seniors program, focus on enhancing the Career Readiness Competencies employers seek in graduates today as determined by the National Association of Colleges & Employers, and complete the components necessary to earn the Geriatric Education Center Interprofessional Teamwork in Geriatrics and Gerontology Certificate. This process has enabled 350 students from different majors, including Pharmacy and Human Development & Family Science, to complete internship experiences ranging from 30 to 210 hours.
MARGRET M. AND PAUL B. BALTES AWARD PRESENTATION AND LECTURE
Authors: Baker Tamara
Published: December 2022

The Margret M. and Paul B. Baltes Award Lecture will feature an address by the 2021 Baltes Award recipient, Laura B. Zahodne, PhD, of the University of Michigan. This session will also include the presentation of the 2022 Margret M. and Paul B. Baltes Award to recipient Eric S. Kim, PhD, of the University of British Columbia. The Margret M. and Paul B. Baltes Foundation Award in Behavioral and Social Gerontology recognizes outstanding early-career contributions in behavioral and social gerontology. The award is generously funded by the Margret M. and Paul B. Baltes Foundation.
BIOPSYCHOSOCIAL RISK AND RESILIENCE PATHWAYS IN DEMENTIA INEQUALITIES
Authors: Zahodne Laura
Published: December 2022

In the United States, racial/ethnic inequalities in Alzheimer's disease and related dementias persist even after controlling for socioeconomic factors and physical health. Persistent and unexplained disparities suggest: (1) there are unrecognized dementia risk factors that are socially patterned and/or (2) known dementia risk factors exhibit differential impact across social groups. This talk will present data from multiple longitudinal studies of brain and cognitive aging to support each possibility. On average, marginalized racial/ethnic groups are more likely than non-Latinx Whites to experience structural and interpersonal discrimination, social and economic constraints, as well as barriers to accessing high quality education. However, these same groups also show evidence of greater psychosocial resilience that is linked to better late-life cognitive health. This talk will demonstrate how specific psychosocial factors can contribute to or offset dementia disparities, illustrate major challenges to this work, and introduce new data collection efforts to advance the field.
RECRUITMENT OF TRANSGENDER, NONBINARY, AND GENDER DIVERSE OLDER ADULTS IN HEALTH RESEARCH: A SYSTEMATIC REVIEW
Authors: Cicero Ethan , Flatt Jason
Published: December 2022

Despite the urgency reported by the National Institutes of Health and National Academy of Sciences to advance health knowledge about transgender, nonbinary, and gender diverse (TNGD) older adults, TNGD populations remain underrepresented in aging research. This review examines TNGD older adult recruitment approaches in health-related research. PubMed, CINHAL, and PsychINFO databases were searched using key terms/subject headings related to TNGD and aging/older adults to identify health-related, U.S.-based empirical studies published since 2011. Twenty-four studies met inclusion criteria (quantitative=15, qualitative=8, mixed-methods=1). Most (n=13) focused recruitment efforts on the broader LGBTQ community, whereas 9 studies (qualitative, n=5) specifically targeted TNGD older adults. One study that recruited from Amazon Mechanical Turk, but most TNGD-specific recruitment efforts used community-engaged approaches, including snowball and purposive sampling via listservs; groups, organizations, and events serving the transgender/nonbinary community; and outreach through researchers’ personal and professional networks. Novel approaches are needed to increase TNGD representation in aging research.
SOCIOEMOTIONAL EXPERIENCE IN CLOSE PERSONAL RELATIONSHIPS AND TRAJECTORIES OF COGNITIVE AGING
Authors: Moorman Sara , Hamilton Lucas
Published: December 2022

Linked lives is a key tenet of the life course framework: Individuals age and develop in the company of a social convoy, or core set of relationships. The quality and quantity of relationships with friends and family are well-known predictors of physical and mental health outcomes, with research on how relationships affect cognitive health just beginning to blossom. This symposium presents four sociological studies of how positive and negative experiences in central, long-term personal relationships – marriages, parent-adult child relationships, and friendships – relate to cognition and the development of cognitive impairment over long periods of the life course, using data from the Health and Retirement Study (HRS) and the Wisconsin Longitudinal Study (WLS). Stokes, Prasad, and Barooah find that experiences of loneliness in marriage are negatively related both to one’s own cognition and to the spouse’s cognition. Herd and Sicinski also highlight potential negative and gendered aspects of marriage, showing no differences in cognitive performance between married and single men, while married women’s cognition is not as strong as single women’s cognition. In parent-adult child relationships, Zhang and Liu demonstrate that social support has stronger positive effects, and social strain, stronger negative effects, for mothers as compared to fathers. Moorman and Pai examine friendships with non-kin, and find benefits of emotional and instrumental support to cognition in the long term. Discussant Lucas Hamilton will provide perspective from psychology, addressing ambivalence in relationships and the potential for bidirectional associations between social experience and cognitive function.
UNEXPECTED CAREGIVING: LIFE AFTER A COVID-19 INTENSIVE CARE UNIT HOSPITALIZATION
Authors: Robinson-Lane Sheria , Johnson Florence , Leggett Amanda , Carmichael Alicia , Leonard Natalie , Gonzalez Richard
Published: December 2022

The coronavirus pandemic has led to an exceptional number of critical care hospitalizations followed by extended recovery periods that necessitate familial support. Using a qualitative descriptive approach, this study aimed to examine the strategies used by families to adjust to the caregiving role. Semi-structured interviews of patients who had been recently discharged from the Intensive Care Unit (ICU) (n=16) along with their family caregivers (n=16) were thematically analyzed. Three major themes were identified that highlight how family caregivers adapt to the caregiving role following an ICU COVID-19 related hospitalization including 1) engaging the support of family and friends, 2) shifting responsibilities to accommodate caregiving, and 3) managing one’s emotions. Additional themes more specifically related to managing COVID-19 care included: 1) managing infection control, 2) care recipient’s need for independence, and 3) managing support services. Flexibility and sufficient support allowed family caregivers to manage their new caregiving role and function optimally.
THE IMPACT OF THE COVID-19 PANDEMIC ON DEMENTIA CARE: A MULTISTAKEHOLDER PERSPECTIVE
Authors: Masoud Sara , White Carole , Glassner Ashlie , Rhodes Shanae , Mendoza Mayra , Meyer Kylie
Published: December 2022

Persons living with dementia (PLWD) and family caregivers are particularly vulnerable to the effects of the COVID-19 pandemic. A multi-methods study was conducted to describe the impact of the pandemic on dementia care from the perspectives of stakeholders, including PLWD, family caregivers, and health and social care professionals (HCPs).The study was conducted using a community engaged approach. Cross-sectional surveys were conducted with PLWD (n=27), family caregivers (n=161), and HCPs (n=77), followed by focus groups and interviews with a sub-sample of survey participants (n=55). Participants reported declines in health and quality of life for PLWD and family caregivers. Participants experienced delayed or cancelled dementia care attributed to the pandemic. Most reported telehealth and tele-support were effective alternative models to care. The pandemic impacted the quality and accessibility of dementia care. Results highlight opportunities to improve quality of care through addressing inequities and identifying approaches to address isolation and virtual care.
AGING-RELATED CHANGES IN DAILY STRESSOR CONTROL AND GENERAL PERCEIVED CONTROL ACROSS THE LIFESPAN
Authors: Cerino Eric , Charles Susan , Mogle Jacqueline , Rush Jonathan , Piazza Jennifer , Lachman Margie , Almeida David
Published: December 2022

Perceived control is an important psychosocial resource for healthy aging. Using data from the National Study of Daily Experiences (N=2,021, M=55.82 years, SD=10.35, 57.27% Female), we examined aging-related changes in stressor control across 10 years and compared these trajectories with measures of general control (mastery, constraints). Over 8 consecutive days in waves conducted in ~2008 and ~2017, people reported their perceived control over four types of stressors (arguments, avoided arguments, work, home). Longitudinal analyses revealed declines in stressor control across 10 years (p<.001), driven by declines in home stressors specifically. The rate of decline did not depend on baseline age. General control trajectories showed unique patterns of age differences in aging-related change such that declines (less mastery, more constraints) were steeper among older adults (p<.001). Results suggest that stressor control is a distinct domain of control beliefs with aging-related declines that differ based on type of stress experienced.
AGE MODERATES THE LINK BETWEEN DAILY POSITIVE EVENTS AND WELL-BEING: A META-ANALYSIS
Authors: Klaiber Patrick , Ong Lydia , Sin Nancy
Published: December 2022

Daily positive events are linked to better health and well-being, and this association might be stronger for older adults due to age-related changes in motivations and emotion regulation. We therefore investigated whether age moderated the links between positive events and health-related outcomes, using data from a meta-analysis of 142 studies spanning 50 years of research. Multilevel meta-analytical moderation analyses revealed stronger correlations of positive events with better well-being (i.e. higher positive affect and life satisfaction), mental health, and lower disability in older compared to younger samples (p’s < .05). No age moderation was found for links of positive events with social connection, health behaviors, physical symptoms, perceived stress, self-reported health, and inflammation. Findings suggest that although daily positive events were protective for health and well-being for all adult age groups, these experiences may be especially beneficial for positive well-being and mental health in late life.
FEELINGS OF BURDEN AMONG OLDER CHILDREN OF VERY OLD PARENTS IN THE US AND KOREA
Authors: Kim Kyungmin , Kim Yijung , Kim Joohyun , Boerner Kathrin , Jopp Daniela , Han Gyounghae
Published: December 2022

Very old adults (80+) are the fastest growing population worldwide. Children of the very old adults may see their prolonged relationship with parents as a benefit (e.g., longer time together) but also as burden (e.g., prolonged responsibility in their own late life). Using a sample of older children (N = 219) from the Boston Aging Together Study and Korean Aging Together Study, we investigated the factors associated with older children’s (aged 62–76) reports of burden in their relationships with very old parents (aged 81–101), focusing on how family relations were imbedded in different cultural contexts. Overall, American older children showed lower levels of burden, compared to Korean older children. The factors associated with burden differed by country; support given to parents and relationship quality were associated with American older children’s burden, whereas support received from parents, familism, and negative relationship quality were associated with Korean older children’s burden.
WEEKLY MOBILITY AT HOME AND ITS HEALTH AND ENVIRONMENTAL CORRELATES IN OLDER ADULTS LIVING ALONE
Authors: Wu Chao-Yi , Dodge Hiroko , Reynolds Christina , Barnes Lisa , Silbert Lisa , Lim Miranda , Kaye Jeffrey , Beattie Zachary
Published: December 2022

Mobility features are important for health. In this study, we quantified in-home mobility and explored potential health and environmental correlates. Participants included community-dwelling older adults living alone (n=139). Two indoor mobility features were developed (frequency; interdaily stability) using passive, room-level (bathroom; bedroom; kitchen; living room) infrared motion sensors, and contact sensors attached to homes’ egress doors at entryways. Existing data on gait and cognition, weekly online surveys assessing mood (blueness; loneliness) and pain severity, and publicly available locality-based atmospheric (daylight hours) data were leveraged. On average, higher indoor mobility frequency was associated with faster gait speed (p=0.04), less time out-of-home (<.001), and less hours of daylight per week (p=0.003). Lower interdaily stability was associated with mild cognitive impairment (p=0.04), less time out-of-home (p=0.01), more severe pain (p=0.02), and loneliness (<.001). Pervasive sensing technology can be used to delineate multi-domain health in older adults who live alone.
UNPACKING MILD COGNITIVE IMPAIRMENT/YOUNG ONSET DEMENTIA IN THE WORKPLACE: EMPLOYER VERSUS EMPLOYEE
Authors: Taylor Philip , Levy AnneMarie , Gibson Allison
Published: December 2022

The symposium includes four studies exploring the impact of mild cognitive impairment and/or young onset dementia on the workplace, and area of increasing interest due to the aging workforce and government interest in prolonging work life. The papers adopt a rare, multi-level approach by examining both employee and employer perspectives, and how the interaction of both individual and organizational factors impact their self-reported outcomes. Following the paper presentations, Dr. Allison Gibson will lead a paper discussion. The goal of the symposium is to foster a research conversation amongst the presenters and symposium participants interested in exploring overlaps, potential for multi-disciplinary collaboration and future research into resolution of workplace and workforce optimization with worker satisfaction that are identified with progressive cognitive impairment.
THE DIMENSIONS OF YOUNG ONSET DEMENTIA (YOD) AND WHAT THESE MEAN FOR EXTENDED WORKING LIVES
Authors: Taylor Philip
Published: December 2022

Drawing from a review of the literature and international statistical sources, this paper identifies the global prevalence of young onset dementia (YOD), its complex aetiology and its social and economic costs. YOD is often defined as dementia affecting those aged 65 or under, although definitions vary. Prevalence estimates also vary but recent evidence suggests a rate in the region of 119.0 per 100,000 population for those aged 30-64, and this is expected to increase markedly in the coming decades. Research identifies that the causes of YOD vary greatly among younger people. Individuals experiencing YOD face a complex range of psychological, familial, and socioeconomic challenges, while often being active in the labour market at the time of diagnosis. Costs of YOD cannot be easily disentangled from those for dementia generally but include: the direct costs of the ‘resources’ drawn on by the person with dementia; indirect costs, usually considered in terms of the value of lost productivity by the person with dementia or their carer, and less tangible costs, such as in terms of psychological wellbeing, social exclusion and time costs. The paper concludes by considering the potential significance of YOD for the future labour market in the context of ongoing efforts to prolong working lives.
TRANSITIONS EXPERIENCED BY PEOPLE DIAGNOSED WITH DEMENTIA WHILE IN THE WORKFORCE
Authors: Boger Jennifer , Marashi Sheida , Mäki-Petäjä-Leinonen Anna , Issakainen Mervi , Nedlund Ann-Charlotte , Ryd Charlotta , Nygard Louise , Astell Arlene
Published: December 2022

Dementia is a progressive, irreversible neurological disorder that causes changes in cognitive function and behaviour. While at least 5% of people who develop dementia every year are under the age of 65, dementia in the workplace is currently not well recognised or supported. The changes associated with dementia present multiple challenges for individuals who wish to continue with their employment. Many lose their positions before receiving a diagnosis, whilst others take sick or disability leave or early retirement. The process of understanding what is happening and coping with this new situation is highly individualistic and involves several transitions. The MCI@work project is an international initiative taking place in Canada, Finland, and Sweden where we examine these transitions through the personal narratives of individuals who have either currently or recently gone through the experience of developing dementia whilst in the workforce. From these data, we have developed a framework for understanding the transitions experienced by people who develop dementia whilst in the workforce. The aim is to assist individuals and their employers to better understand the needs of people living and working dementia as well as engage in appropriate actions that support choices and dignified transitions either within the context of employment or out of the workforce.
RELEVANT YET UNCONTROLLABLE: PERCEIVED CONTROL AS A MEDIATOR OF CROSS-CULTURAL DIFFERENCES IN OLD-AGE PREPARATION
Authors: Fung Helene , Fung Nicole Long Ki , Tse Dwight Cheuk Kit
Published: December 2022

Previous studies have shown that there are cross-cultural differences in old-age preparation rate (e.g. Kornadt et al., 2019). Drawing from the transactional stress-and-coping model (Lazarus & Folkman, 1984), we proposed that perceived control, self-relevance and responsibility for old-age preparation could mediate the cultural differences in old-age preparation. We recruited a sample aged 18 to 96 from Germany (N=366, Mage=52.63) and Hong Kong (N=252, Mage=57.47) to complete two online questionnaires across two years. Compared with German adults, Hong Kong adults prepared less (b=-2.159, p<.001), had lower perceived control (b=-0.899, p<.001) and responsibility (b=-0.713, p<.001), yet similar level of self-relevance over preparation. Preparation at time2 was related to self-relevance (b=1.004, p<.001) and control (b=0.785, p<.001) at time1. The cultural differences in preparation at time2 were only mediated by perceived control at time1 (indirect effect=0.706, p<.001). Findings highlight the importance to enhance individual perceived control over old age in promoting society-wide old-age preparation.
PUBLIC HEALTH PRIORITIES AND FUTURE DIRECTIONS FOR ALZHEIMER'S DISEASE RISK REDUCTION
Authors: Baumgart Matthew
Published: December 2022

Reducing risk for diseases and chronic conditions is a fundamental priority of public health. Since 2007, the Alzheimer’s Association has partnered with the CDC on the development of a series of Public Health Road Maps to guide the public health community in addressing cognitive health. In addition, the Alzheimer’s Association’s Public Health Center of Excellence on Dementia Risk Reduction, funded by the CDC, provides guidance on how public health can address the risk factors for cognitive decline and dementia. With recent advancements in the science on dementia risk factors, we can now identify targets for public health action. The addition of a national goal to address dementia risk factors underscores the urgency to act. This presentation will offer a perspective on how public health can move forward, through prioritization and action, in addressing risk factors for cognitive decline and dementia, including by addressing social determinants of health and health equity.
ACCELERATED AGING AMONG ADULTS LIVING WITH CEREBRAL PALSY
Authors: Peterson Mark , Dayanidhi Sudarshan , McPhee Patrick , Haapala Heidi
Published: December 2022

Cerebral Palsy (CP) is the most common pediatric-onset physical disability, with an estimated prevalence ranging from 2.6-3.1 cases per 1,000 live births in the United States. There is a lack of clinical follow-up for individuals with CP after they transition from pediatric to adult primary care, and insufficient surveillance to track patients with CP longitudinally. Despite the shortage of research to examine the natural history of CP and chronic disease trajectories in this population, a range of secondary conditions arise at an accelerated rate as compared to the adult population without CP, prompting the widespread notion and clinical hypothesis that patients with CP are prone to accelerated aging. These factors further worsen functional status and quality of life, as well as lead to decreased independence. Despite the well-established interrelationships between physical and mental health disorders in the non-CP older adult population, the extent to which, mechanisms underlying, and time course associated with the development of these chronic conditions among adults living with CP has received little empirical attention. The proposed course will build upon our ongoing work by highlighting new findings from three centers doing research pertaining to aging with CP, and will cover novel mechanisms of musculoskeletal pathophysiology in CP, risk factors of and unique CVD profiles among adults with CP, and new findings related to health trajectory differences of adults with CP from clinical and population-representative cohorts. We will also provide insights into the pathophysiologic mechanisms linking early frailty and long-term health outcomes among persons with CP.
NAVIGATING THE PATHWAY TO CARE IN ADULTS WITH CEREBRAL PALSY
Authors: Haapala Heidi
Published: December 2022

As individuals with CP age, they face unique challenges which complicate their ability to access and receive appropriate health care. These problems exist at the level of the health care system, the clinician, and the individual. At the system level, there is an inadequate number of professionals who are informed of and interested in the care of adults with CP. Adult caregivers are often not knowledgeable about and may feel less competent about patients with CP. Differences in the physiologic development of individuals with CP render well-established clinical protocols for risk screening of chronic diseases less effective. Dr. Haapala runs an adult CP clinic and will present her clinical experience with treating complex patients with CP. She will present specific information pertaining to her work in studying and treating chronic overlapping pain in adults with CP, as well as her efforts to reduce polypharmacy and opioid dependence in her patients.
MOSAIC CHROMOSOMAL ALTERATIONS AND LONGEVITY
Authors: Leshchyk Anastasia , Xiang Qingyan , Monti Stefano , Perls Thomas , Andersen Stacy , Gurinovich Anastasia , Song Zeyuan , Sebastiani Paola
Published: December 2022

Mosaic chromosomal alterations (mCAs) are structural alterations that are associated with mortality, age, cancer, cardiovascular disease, and diverse infections. The distribution of mCAs in long-lived subjects and individuals with familial longevity is not well described. We applied MOsaic CHromosomal Alteration (MoChA) caller on genome-wide genotype samples of 2025 centenarians, their siblings, and offspring and 273 unrelated controls from the New England Centenarian Study (NECS) and 3642 subjects with familial longevity and 920 controls from the Long-Life Family Study (LLFS). MoChA utilizes a Hidden Markov Model to detect mCA-induced deviations in allelic balance at heterozygous sites with Log R Ratio and B-allele frequency (BAF) with phased genotype information. We analyzed somatic mCAs in samples with genome-wide BAF phase concordance less than 0.51, LOD score greater than 10, and estimated cell fraction less than 50%. The results in the two studies showed that autosomal mCAs spanning over 100 kbase pairs increase with older age until approximately 102 years. However, the prevalence of the subjects with mCAs tends to plateau after that age, suggesting that the accumulation of mCAs is less prevalent in long-lived subjects. We also found that offspring and siblings of centenarians accumulate less autosomal mCAs (fixed-effect meta-analysis for NECS and LLFS: RR=0.78, p=0.033) compared to unrelated controls. In addition, consistent with results from other studies, mCAs are associated with increased risk for mortality (HR=1.08, p=0.02) and sex (Male RR=1.37, p=4.15e-05), and impact incident events of cancer, dementia, diabetes, and cardiovascular diseases even at extreme old ages.
ARE RECENTLY INCARCERATED OLDER ADULTS MORE LIKELY TO DEVELOP DEMENTIA THAN THE NEVER INCARCERATED?
Authors: Byers Amy , Fortinsky Richard , Williams Brie , Boscardin W John , Li Yixia , Barry Lisa
Published: December 2022

Increasing numbers of older adults are reentering the community following incarceration (i.e., reentry). Yet, their risk of developing dementia and mild cognitive impairment (MCI) is unknown. We leveraged a national cohort of veterans who experienced reentry at age ≥ 65 years (N=5,920) and compared their risk of dementia or MCI to an age- and sex-matched never incarcerated sample (N=29,600). Those in the reentry sample were incarcerated for ≤10 consecutive years, experienced reentry between 10/01/2012 and 9/30/2018, and did not have a pre-incarceration MCI or dementia diagnosis per VA and CMS healthcare records (N=5,920). Fine-Gray models, controlling for race and pre-incarceration chronic conditions, serious mental illness, traumatic brain injury, and posttraumatic stress disorder, derived hazard ratios (HRs) and 95% Confidence Intervals (CIs). Samples were 99% male with average age 70 (±4.3) years. Reentry adults had a higher proportion of non-Whites (29% vs. 17%; p< 0.001) and more chronic conditions (2.1[±1.8] vs. 1.6[±1.6] p< 0.001). MCI incidence did not differ between reentry and never incarcerated groups (3.1% vs. 2.6%; HR=1.03; 95%CI 0.86-1.24). However, risk of any dementia was higher in reentry older adults (7.2% vs. 5.0%; HR=1.27; 95%CI 1.12, 1.44), as was risk of specific subtypes, e.g., vascular dementia (1.9% vs. 1.2%; HR=1.37; 95% CI 1.06-1.75) and frontotemporal dementia (0.2% vs. 0.1%; HR=2.3; 95% CI 1.2, 4.3). Those reentering the community in late life following incarceration may be a group that is especially at risk of developing dementia. These findings raise awareness of the need for appropriate transition planning for this vulnerable group.
FOOD INSECURITY AND COGNITIVE TRAJECTORIES IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Kim Boeun , Szanton Sarah , Thorpe, Jr. Roland J , Crews Deidra , Samuel Laura
Published: December 2022

Food insecurity, defined as limited access to nutritionally adequate and safe foods due to social and economic conditions, has adverse effects on physical health and well-being. However, it remains unclear whether food insecurity accelerates cognitive decline in older adults. This study examined the association of food insecurity with cognitive decline. We analyzed data from 4,508 community-dwelling participants in the National Health and Aging Trends Study (NHATS) collected from 2011 to 2020, a prospective cohort study of a nationally representative sample of Medicare beneficiaries ages 65 years and older. Food insecurity was measured using 5 items within functional, social support, and financial limitations domains. Immediate and delayed recall were assessed by a 10-item word-list memory task (range: 0—10). Executive function was evaluated by the Clock Drawing Test (range: 0—5). Each year’s cognitive functions were linked to the prior year’s food insecurity values. Weighted linear mixed effect models were fitted. Prevalence of food insecurity at baseline was 3.5% (95% CI: 2.9 — 4.3). Persons with food insecurity were more likely to have Black race or Hispanic ethnicity, low income, and less than high school education. Food insecurity was associated with faster decline in executive function accounting for demographic and socioeconomic characteristics: the average difference, over 1-year, in executive function score between people exposed to and not exposed to food insecurity was 0.038 points (95% CI: -0.072 — -0.003). Food assistance programs or increasing healthy food access may reduce food insecurity and delay cognitive aging in community-dwelling older adults.
RESPONSES OF PERSONS LIVING WITH DEMENTIA TO VALIDATING COMMUNICATION BY FAMILY CAREGIVERS: A SECONDARY ANALYSIS
Authors: Campbell Kaitlyn , Coleman Carissa , Williams Kristine
Published: December 2022

Validation is a person-centered approach for communicating with people living with dementia (PLWD). This study evaluated how PLWD respond to caregiver communication that includes or fails to include validation. This secondary analysis of homecare videos (N=41) of family caregivers interacting with a PLWD during daily care used behavioral coding of validating communication (affirmation, acknowledging emotions, encouraging emotional expression, verbalizing understanding) in relation to responses of PLWD (resistiveness to care, apathy, or cooperation). A 10 second time-lag sequential analysis identified an 11% probability of a cooperative response when caregivers communicated using affirmations. Caregiver verbalizations of understanding resulted in a 6% probability and silence had an 8% probability of cooperative responses. Use of validating communication did not result in a significant probability of negative PLWD responses (apathy or resistiveness to care). Use of validating communication strategies may assist caregivers to achieve goals of care without negative responses from PLWD.
TEMPORAL RELATIONSHIPS OF PERSON- AND TASK-CENTERED DEMENTIA CARE AND MEALTIME BEHAVIORS: SEQUENTIAL ANALYSIS
Authors: Liu Wen , Perkhounkova Yelena , Hein Maria , Bakeman Roger
Published: December 2022

Person-centered mealtime care is highly recommended in dementia care. While current research examined associative relationships between person- and task-centered care and resident mealtime behaviors, few studies evaluated their temporal associations. Videotaped mealtime observations (N=160) involving 36 staff and 27 residents (53 staff-resident dyads) in 9 nursing homes were coded. Staff person-centered and task-centered approaches were conceptualized as antecedents of resident positive behaviors, functional impairments, and resistive behaviors using 5-, 10-, and 15-second time windows. Immediately after staff person-centered approaches, resident positive and resistive behaviors were more likely (p range=<.001–.29) and functional impairments less likely (p range=<.001–.62) with diminished effects in time. Immediately after staff task-centered approaches, resident positive behaviors were less likely (p range=<.001–.09). Person-centered mealtime care should be individualized, context-based, and resident-oriented. Resident resistiveness to care may be behavioral responses to person-centered care indicating mismatch to individual preferences and needs, warranting adequate awareness and appropriate assessment.
IMPLICATIONS FOR MORTALITY RISK: CONSEQUENCES OF SURVEY NONRESPONSE IN HOME-DWELLING OLDER ADULTS
Authors: Razavi Marianne , Dale William , O'Muircheartaigh Colm , Schumm L Philip , Kotwal Ashwin , Waite Linda
Published: December 2022

Nonrespondents generally suffer from worse health outcomes than respondents. Are they unwilling or unable to respond? Our aim was to address this issue. Data (N=3,130) from 2010-2015 waves of National Social Life Health and Aging Project (NSHAP, W2, W3) was used. Four groups of participants were considered based on their response status at W3: alive, incapacitated, deceased, and nonrespondents. Nonrespondents represented cases with no information at W3, beyond their disability and death information. General linear models were used to compare group means at baseline (W2) in terms of mortality risk (Lee index) or cognitive impairment (MOCA), adjusted for demographic variables. Like the deceased or incapacitated groups, the nonrespondent group displayed significantly worse outcomes (Least Squares Means) than the alive group: Lee index alive=5.82, deceased=9.66, incapacitated=8.29 and nonrespondents=7.80; MOCA alive=21.57, deceased=19.79, incapacitated=19.19 and nonrespondents=19.84. Being a nonrespondent likely indicates incapacity, not reluctance to responding. Earlier follow-up surveys could optimize response rates.
EMBRACING DIVERSITY BY FOSTERING STRONG COMMUNITY CONNECTIONS
Authors: Golden Robyn , Emery-Tiburcio Erin , Snyder Rani
Published: December 2022

Age-Friendly Health Systems are essential; however, most health and healing take place outside of the walls of a hospital or physician’s office. Thus, it is imperative that health systems foster strong community connections, in particular with older adults from underserved communities who experience multiple barriers to quality, age-friendly health care. At Rush, there are several interdisciplinary initiatives designed to ensure that the 4Ms reach beyond the medical center and impact historically marginalized communities. In this symposium, we present three of these innovative approaches to bringing the 4Ms to into the community. Each presentation will describe the program and community served, explore how the 4Ms concepts are integrated, and present outcomes data on the program impact to date. Facilitating Caregiver Health and Wellness: Age-Friendly Health System Caring for Caregivers (AFHS-C4C) is an initiative to expand the age friendly health system to include caregivers. CATCH-ON Connect enables older adults to do What Matters to them by expanding virtual access to older adults, often from underserved communities. Finally, Rush@Home addresses the 4Ms by removing barriers to care and enabling older adults with medically complex needs to receive care in their home. The interactions of these programs will be discussed briefly by the session chair, along with service and policy implications of multiple programs addressing the 4Ms of an Age-Friendly Health System within one community.
ESPO AND SOCIAL RESEARCH, POLICY, AND PRACTICE SECTION SYMPOSIUM: WHAT AROUND THE PERSON MATTERS: REIMAGINING ENVIRONMENTAL JUSTICE AND AGING
Authors: Yu Kexin , Dys Sarah
Published: December 2022

From Lawton’s seminal Ecological Theory of Aging (ETA) to the recent development of Wahl’s COntext Dynamics of Aging (CODA), conceptual and empirical work has repeatedly shown that the living environments fundamentally influence health and wellbeing in later life. The CODA framework posits five correlated contexts that can predict developmental outcomes in aging: physical, social, service, socioeconomic, and technological contexts. The ongoing COVID-19 pandemic further manifested the lack of environmental justice for marginalized and minoritized older adults, calling for reflection on the paradigm for ecological aging research, practice, and actionable policymaking. This SRPP/ESPO symposium featured emerging and established scholars’ work that shed light on reimagining environmental justice for older adults with diverse abilities, backgrounds, and resources. Panelists will share stories of their professional development journeys, highlighting empirical evidence with under-researched, systematically excluded populations and examining new directions in aging and environment research. Topics include accessible and affordable housing, built environment, neighborhood contexts, conceptualizing the community, and the experiences of those most likely to bear the burden of precarious housing in later life. This symposium will hold the space for emerging scholars to learn and discuss short- and long-term practice and policy priorities for promoting environmental justice for older adults and provide tools to conceptualize their research informed through ecological and equity-centered perspectives.
FORECASTING THE REGIONAL DISTRIBUTION OF HOME CARE PATIENTS USING BIG DATA OF INSURANCE CLAIMS IN JAPAN: 2015 TO 2045
Authors: Nakanishi Yasuhiro , Nishioka Yuichi , Tsugihashi Yukio , Kakinuma Tomohiro , Noda Tatsuya , Imamura Tomoaki , Akahane Manabu
Published: December 2022

Regional distribution of home care patients and future demand in Japan are unknown. This study aimed to reveal the actual situation of home care patients by region and forecast demand up to 2045. Linked complete health and long-term care insurance claims data on Nara Prefecture (around 1% of the total population and area of Japan) patients aged 75 years or older who received planned and/or urgent medical treatment by physician home visit between April 2015 and March 2016 were extracted and analyzed by sex, age group, and municipality. We calculated the proportion of home medical care utilization and projected the number of home care patients for every five-year period up to 2045 across five administrative areas of the medical service in Nara Prefecture. Data on 12,656 patients, including 1,455 aged 75–79 years, 2,753 aged 80–84, 3,854 aged 85–89, and 4,594 aged 90 years or older, were extracted. The current proportion of patients receiving home medical care (unadjusted for age) by medical service administrative area showed a difference of up to 1.6 times for those aged 90 years or older. Results of forecasting showed a marked increase in the number of patients aged 90 years or older, with overall numbers continuing to increase up to 2040, reaching a maximum of around 25,759 then decreasing thereafter. The future increase in home care patient numbers could vary by age and area, and our findings suggest that public health policy based on the future demand in each area will be required.
IMPLEMENTATION AND IMPACT OF MANAGED LONG-TERM SERVICES AND SUPPORTS IN PENNSYLVANIA
Authors: Degenholtz Howard
Published: December 2022

In 2018, Pennsylvania began implementing a mandatory Medicaid managed care program called Community HealthChoices (CHC). CHC replaces the 1915(c) aging waiver and 4 other waiver programs that covered adults with disabilities and people with acquired brain injury. The new program covers people receiving long-term services and supports (LTSS) in both nursing homes and home and community-based settings as well as people dually eligible for both Medicaid and Medicare. The program is administered by 3 managed care organizations (MCOs) that are obligated to coordinate with Medicaid Behavioral Health, Medicare Advantage and D-SNP plans. The MCOs are incentivized to serve people with LTSS needs in community-based settings by increasing access to HCBS and supporting transitions from nursing homes back into the community. This symposium will present findings from a comprehensive, mixed-methods evaluation of the program. Drawing from our qualitative interviews with key stakeholders and examination of program materials, we will describe some of the challenges of the implementation process. Next, we will share findings from interviews with cohorts of participants conducted before and after implementation of the new program. Next, we will present findings from analysis of Medicaid claims data to examine changes in use of home and community-based services as well as overall rebalancing. Finally, we will present both qualitative and quantitative data on person-centered service planning- a critical requirement for HCBS programs.
EFFECT OF COMMUNITY HEALTHCHOICES ON PARTICIPANT QUALITY OF LIFE AND PSYCHOLOGICAL WELL-BEING
Authors: Degenholtz Howard
Published: December 2022

A stratified random sample of participants was interviewed in each region of Pennsylvania during each phase of the implementation. In addition, comparison groups were interviewed from the third implementation region. This allowed us to draw causal inferences regarding the effect of the program on participant quality of life and psychological well-being. The sample was stratified to represent: people age 21-59 and those over age 60 who receive home and community based services (HCBS), plus people age 21 and older who are dually eligible for Medicaid and Medicare but do not use long-term services and supports. We found that engagement in preferred activities both inside and outside the home increased among people who used HCBS and those who did not. In addition, psychological well-being improved slightly while the prevalence of depressive symptoms declined. In general, the implementation of Community HealthChoices appears to have led to improvements in several measures of well-being.
IMPLEMENTATION OF THE COMMUNITY HEALTHCHOICES PROGRAM
Authors: Beigay Teresa
Published: December 2022

The Community HealthChoices program was implemented in three phases, starting in 2018 in the SouthWest region of Pennsylvania, followed by the SouthEast in 2019 and the remainder of the state in 2020. Interviews were conducted with participants in each region during the first several months of each implementation. Focus groups were conducted in the months immediately following each phase. We reviewed all participant materials and public education events in each region. The percentage of participants who reported having received information about the new program increased in each phase. This is consistent with our observation that more public education events were held in 2018 and 2019 than in 2017. However, satisfaction with information did not improve over time. Focus groups revealed a mixed picture of successes (new benefit cards were received and claims were paid) and challenges (providers were not aware of the program; selecting primary care providers was confusing).
ASSESSING INNOVATIVE ASSISTIVE TECHNOLOGIES FOR OLDER ADULTS; A KNOWLEDGE AND TECH DEVELOPER'S PERSPECTIVES
Authors: Syme Robin
Published: December 2022

Objective

Can Assist is a University of Victoria organization that has been developing assistive technologies (ATs) for almost two decades aimed at developing client-centred broad-impact solutions that address unmet need and help people improve their independence and quality of life. CanAssist’s interest and involvement in this study is predicated on our belief that their approach to technology development align with the criteria needed for determining better tools for evaluating assistive technologies need to be developed and implemented. This is critical to our goal of providing successful customized technology solutions to sustain our clients’ independence and autonomy.

Methods

From the beginning of the project, as a Research User Co-Lead, CanAssist has actively participated in regular advisory committee and expert panel meetings along with several other research activities to co-create all dimensions of the study.

Results

The results from the Rapid Realist Review and preliminary analyses of the interview data with older adults and caregivers have validated the need for more appropriate assessment/evaluation tools to address the varied AT needs of older adults and their caregivers. In particular, the study has provided opportunities for our staff and clients to examine and discuss important factors/processes for successful AT development and implementation.

Conclusions

As a key partner on this implementation science team, CanAssist will use the study’s findings to provide information to our development and management teams on how to appropriately scale-up, spread, and sustain the use of ATs in the health and social care system.
A RAPID REALISTIC REVIEW TO INFORM AN IMPLEMENTATION PROJECT; ASSISTIVE TECHNOLOGIES WITH CO-DESIGN AND OLDER ADULTS
Authors: Navarrete Matilde Cervantes
Published: December 2022

Objective

This presentation reports on a rapid realist review of participatory co-design approaches to developing assistive technologies with older adults. It provides an evidence synthesis of the key mechanisms, contexts and outcomes that drive success and failure in the use of participatory co-design in this field. This KISSS-AT sub-project, was undertaken to help inform stakeholder partners and the wider gerontechnological community of the key challenges and opportunities, that participatory co-design offers the field.

Methods

We conducted a rapid realist review (Saul et al., 2013). We identified 1060 citations from databases (AgeLine, BSC, CINAHL, MEDLINE, PycINFO, Sociological Abstracts and Web of Science), and 936 from hand journal searches (Ageing and Society, CSCW, Gerontechnology). We screened 311 full-text articles, with 19 articles for extraction. We extracted an additional 9 articles in order to capture post-search publications and a few articles identified through additional snowball citation searches. We analyzed the data for context-mechanism-outcome configurations (Pawson, 2015; Wong et al., 2013) that we found were relevant to our initial program theory, and used analytical induction to test emerging themes with our data set.

Results

We identified two key theoretical dimensions (1. Epistemological 2. Ethico-political) of participatory co-design with older adults, as part of our program theory, along with several C-M-O-Cs related to each dimension.

Conclusions

We found that paying attention to the underlying dimensions of participatory co-design, and the key mechanisms and contexts that support its successful implementation is fundamental to realizing the promise of this approach to gerontechnology development and implementation.
ASSESSING INNOVATIVE ASSISTIVE TECHNOLOGIES (ATS) FOR OLDER ADULTS: AN EXECUTIVE SPONSOR'S PERSPECTIVE
Authors: Saini Manik
Published: December 2022

The BC Ministry of Health (BC MoH)’s Health Technology Assessment unit is part of the Partnerships and Innovation Division. Our interest in this project concerns the status of ATs and the health technology assessment (HTA) process. The role of AT implementation as a key feature of the potential for new ATs to maximize health impact for older adults is something the Ministry sees as critical to meet the goal of enhancing healthy ageing and sustaining independence and autonomy.

Methods: From the beginning of the project, as Executive Sponsor, the Partnerships and Innovation Division helped to co-create the research program and played a key role in developing partnerships with health authorities and other stakeholders. With monthly meetings and several other research activities, the project has provided multiple opportunities for genuine policy engagement.

Results: The results so far have seen the project extend the scope of its partnerships with key stakeholders in BC. The Ministry was on a local reference group of knowledge users for a rapid realist review of participatory co-design, and Mr. Saini is a co-author on a publication based on that work. The project received additional funding from the BC MoH, and recently the Ministry collaborated on a successful University of Victoria Research Acceleration Fund grant application.

Conclusions: The BC MoH sees this as a key implementation science project, which will provide guidance to the HTA process, as it inevitably confronts increased demand for the public provision of ATs for older adults, particularly vulnerable and disadvantaged groups.