bluuebunny/crossref_metadata_2025 huggingface dataset:
LONGITUDINAL METHODS FOR ASSESSING PROGRESSION OF MULTIMORBIDITY AND RELATED HEALTH OUTCOMES
Authors: Bishop Nicholas , Nagel Corey , Botoseneanu Anda , Allore Heather , Newsom Jason , Dorr David , Quiñones Ana
Published: December 2023

The growing body of longitudinal research on multimorbidity (≥ 2 chronic conditions) has identified that multimorbidity progression in mid and late life is associated with change in other health domains (e.g., mobility limitations) and can have far-reaching effects on person-centered outcomes such as health-related quality of life. Several increasingly accessible quantitative methods can be applied to the longitudinal study of multimorbidity and related health outcomes, but there has been relatively little work describing and synthesizing the merits and limitations of methods available for this purpose. We will discuss the application and limitations of popular longitudinal methods that can be applied to the study of change in multimorbidity and associated health outcomes. We will consider overarching issues in the longitudinal study of multimorbidity including operationalizing multimorbidity, data-related concerns such as measurement invariance, and choice of time scale (i.e., change in age or calendar time). We will then cover methods aligned to four specific research objectives: 1) examining individual change in multimorbidity, 2) identifying population sub-groups that follow similar trajectories of multimorbidity progression, 3) understanding when, how, and why individuals/groups shift to more advanced stages of multimorbidity, and 4) examining the co-progression of multimorbidity with key health domains over time. This work will help establish a common language for assessing longitudinal changes in multimorbidity, inform research that can fill gaps in our knowledge regarding multimorbidity progression and critical periods of change, and support the identification of groups that experience divergent rates and etiological pathways of disease progression.
PRESIDENTIAL SYMPOSIUM: FRAMING, BRIDGING, AND TRAVERSING SOCIAL DETERMINANTS OF HEALTH, DISPARITIES, AND INEQUITIES IN OLDER ADULTS
Authors: Bakerjian Deb , Sin Mo-kyung
Published: December 2023

In alignment with the theme of this year’s conference, Building Bridges>Catalyzing Research>Empowering All Ages, this symposium focuses on research that frames, bridges, and transverses various constructs of the social determinants of health, intersectional frameworks, and inequities that impact older adults at various times in life from mid to older adulthood through death. We start with a framework for how to consider social and structural conditions in which people live and the cumulative effects that an individual’s life course might impact their trajectory with Alzheimer’s disease and other related dementias and their families. Continuing on with the theme of family, dementia, and caregivers, we delve into the differences in caregiver burden across and within gender and racial/ethnic groups, looking at the linkage with financial, emotional, and physical burdens. From there, we go on to explore whether there is an association between negative family interactions and mental health outcomes and discuss how those outcomes might vary by race and ethnicity. Building upon several concepts in these first three papers, we will discuss how one can evaluate the intersectional impact of race and gender on end-of-life outcomes including pain, anxiety/depression, patient autonomy, and overall care quality. Our last speaker will share intriguing, and somewhat unexpected findings related to social inequities on health from midlife to death and the impact of early exposure to socioeconomic disadvantages might have on disparities. Given the importance of reducing inequities to improve health outcomes, this HS section Presidential Symposium is sure to challenge and enhance our thinking.
INFLUENCES OF CULTURAL VALUES ON THE INDIGENOUS DEMENTIA CAREGIVERS’ EXPERIENCE
Authors: Kim Steffi , Lewis Jordan
Published: December 2023

This symposium will outline and discuss the unique circumstances and challenges of American Indian, Alaska Native, and Native Hawaiians and Pacific Islander dementia caregivers. Dementia is one of the top causes of death worldwide, with Alzheimer’s disease currently being the ninth leading cause of death among American Indian and Alaska Native people (AI/AN). One in three American Indians and Alaska Natives over 65 will receive a dementia diagnosis in the next 25 years. Yet, we know very little about caregivers’ experiences in these communities. Presenters will present on how cultural influences shape caregiver’s experiences within American and Alaska Native, Native Hawaiians and Pacific Islanders. The second presenter will discuss the need for culturally safe dementia caregiver resources based on recommendations from Alaska Native caregivers. The third presenter will examine decision-making processes of dementia caregiver involved in the use of governmental and tribal dementia care resources within the ONEIDA Nation to improve utilization of existing services.
THE RELATIONSHIP BETWEEN HURRICANE STRESSORS AND COGNITION IN PUERTO RICAN OLDER ADULTS
Authors: Thompson Sheila , Guinn Victoria , Ballard Erin , Crowe Michael , Brown Lisa
Published: December 2023

Acute and chronic stress exposure negatively impact cognition in older adults. There is little research on this relationship within the context of an acute disaster. This presentation explores the relationship between perceived stress, hurricane stressors, subjective cognition, and cognition in Puerto Rican older adults post-Hurricane Maria. 613 Puerto Rican older adults completed Wave 3 measures for the longitudinal PREHCO study. Perceived stress was measured via a 4-item version of the Perceived Stress Scale. Hurricane stressors were classified as three factors: Home Damage, Family/Friends Network, and Work/Health. Subjective cognition was measured by asking the participant to rate their memory based on a 5-point Likert scale. Cognition was measured via the Telephone Interview for Cognitive Status assessment and the Minimental Cabán. Analyses included two multiple linear regressions with cognitive status and cognitive functioning as the outcomes, respectively, while controlling for age, depressive symptoms, education, gender, and race. There was a significant relationship between higher concern for others post-hurricane and worse generalized cognitive functioning (p<0.05, t=-2.04). Higher levels of cognitive status were significantly associated with better perceptions of memory function (p= 0.015, t=-2.43). Yet higher levels of perceived stress were significantly associated with worse perceptions of memory function (p<0.001, t=7.037). Older adult Puerto Ricans presented with worse cognitive functioning when they were worried about their loved ones’ well-being. Even those who maintained an intact cognitive status believed their memory was worse when they were experiencing more stress. This highlights the importance of differentiating the impact of stress on cognitive ability from subjective cognition.
ASSOCIATIONS BETWEEN HURRICANE-RELATED STRESSORS AND PERCEIVED STRESS IN A SAMPLE OF PUERTO RICANS
Authors: Ballard Erin , Guinn Victoria , Thompson Sheila , Andel Ross , Brown Lisa , Crowe Michael
Published: December 2023

This project examines the relationship between hurricane-related stressors and perceived stress using data from the latest (third) wave of the Puerto Rican Elder: Health Conditions (PREHCO) study. A total of 617 PREHCO survivors, age 78 and older, were asked questions about their experience with stressors related to hurricane Maria. We assessed self-reported fright felt immediately after the hurricane as a primary stressor. A list of secondary stressors was examined using a principal components analysis (PCA) that yielded three components related to concern over home damage, family/friends, and employment/health. Demographic factors (age, education, race, sex) and length between the hurricane and interview date (conducted 2021-2022) were included in analyses. The majority (97%) of our sample was in Puerto Rico at the time of the hurricane. Approximately 41% of participants reported being “somewhat” or “very” frightened following hurricane Maria and over half of participants reported stressors like home repairs, damage to their neighborhood, and concern about bill payment. Regression analyses revealed higher reported fright immediately following hurricane Maria was associated with higher levels of perceived stress at the time of interview (b=.53, p<.001). In addition, all three secondary stressor components were significantly associated with higher perceived stress in separate models (home damage: b=.44, p<.001; family/friends: b=.40, p<.001; employment/health: b=.31, p<.05). Being female was associated with higher perceived stress across each of the regression models. Results suggest long-lasting relationships between hurricane-related stressors and perceived stress several years later, further implicating the role of these stressors on long-term mental and physical functioning.
A HISTORICAL-CONTEXTUAL PERSPECTIVE ON GRANDPARENTS’ ACTIVITIES WITH GRANDCHILDREN
Authors: Juris Jill , Rauer Amy
Published: December 2023

Grandparenting is one of the most positive roles for many older adults, yet there is limited understanding of what activities grandparents and grandchildren actually engage in together or how these may vary based on both context (e.g., residential grandparenthood, grandparents’ marriage) and historical events (e.g., COVID-19). Drawing from multiple theoretical frameworks and methodological approaches, this symposium begins with Flood providing a broad view of time grandparents and grandchildren spend together using large-scale population-level data from IPUMS. Illustrating how such activities may vary based on context, Stephan and Chan provide insights into how activity engagement varies by caregiver status and whether activity engagement with grandchildren is related to grandparents’ perceived roles. Extending this examination of context to consider specific processes, Juris and Zvonkovic will then describe the process of family leisure among grandparent couples by examining how both individuals in a couple experience family leisure with their grandchildren. Providing a historical perspective on these experiences, Fruhauf and colleagues reveal the challenges of raising grandchildren in the context of COVID-19 and the importance of engaging in different and new activities with their grandchildren during this time. Finally, as discussant, Rauer will draw upon Bronfenbrenner’s socioecological framework to illustrate how grandparenting is situated within a complex network of interdependent systems and dynamic contexts. Together, this symposium will highlight the implications of grandparenting for catalyzing development and enhancing well-being across multiple generations.
EXAMINING THE ROLE OF AGE STEREOTYPES FOR DEVELOPMENT IN CONTEXT
Authors: de Paula Couto M Clara P , Wirth Maria
Published: December 2023

This session will focus on age stereotypes, that is, beliefs individuals hold about older adults and the aging process. Two types of age stereotypes will be addressed: those related to how older adults are assumed to be (i.e., descriptive stereotypes) and those related to how older adults should be (i.e., prescriptive stereotypes). Age stereotypes have been shown to be incorporated into older adults’ self-concepts (via stereotype internalization) and to influence their development in old age by shaping their expectations, motivations, and behaviors (stereotype embodiment). Considering the relevance of age stereotypes for developmental outcomes, the talks in this symposium will address how they shape individual aging and to what extent age stereotypes and their effects on development are context dependent. The first two presentations focus on cross-cultural differences in age stereotypes. de Paula Couto et al. examine prescriptive age stereotypes across different countries and investigate underlying factors that may influence their differential endorsement. Fung and Fung investigate cultural and age-related differences in the internalization of age stereotypes. The developmental consequences of negative age stereotypes will be addressed by Kornadt et al., whereas their malleability and specificity will be examined by Wirth et al. The last talk by Degen et al. will focus on the fear of loneliness in older adults, and how it affects their motivation to engage in behaviors that can prevent being lonely in old age.
“OLDER ADULTS SHOULD…”: CROSS-NATIONAL DIFFERENCES IN ENDORSEMENT OF PRESCRIPTIVE AGE STEREOTYPES
Authors: de Paula Couto M Clara P , Fung Helene , Graf Sylvie , Hess Thomas M , Liou Shyhnan , Nikitin Jana , Rothermund Klaus
Published: December 2023

Normative expectations about how older adults should behave are known as prescriptive age stereotypes (or “prescriptive views of aging,” PVoA). Previous research has shown that endorsement of PVoA varies across age groups but has not yet examined the variability of PVoA endorsement across countries. Considering that context may influence the endorsement of PVoA, we investigated differences in endorsement reported by an international sample of adults (N = 2,902) from the Aging as Future study covering the age range from 40 to 90 years in five countries: Czechia, Germany, Hong Kong, Taiwan, and the United States (US). We focused on endorsement of two types of PVoA, that is, disengagement (older adults should make way for the younger generation), and activation (older adults should remain socially engaged). Overall, participants reported a stronger endorsement of activation compared to disengagement (i.e., a focus on activation). Replicating previous studies, compared to young and middle-aged adults, older adults more strongly endorsed PVoA. Most importantly, cross-national differences emerged, indicating that overall endorsement of PVoA (averaged across activation and disengagement) was the strongest in Taiwan and the weakest in Czechia and Germany. However, the focus on activation (vs. disengagement) was the highest in the US followed by Hong Kong and Germany, and then by Czechia and Taiwan. Cross-national differences in the belief that the State should support older adults, in cultural values, and in views of own aging predicted the focus on activation and partially explained differences in the strength of this focus between countries.
CARING FOR A VERY OLD PARENT WITH DEMENTIA: STRATEGIES EMPLOYED TO MANAGE BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS
Authors: Gallagher Elizabeth , Boerner Kathrin , Kim Yijung , Kim Kyungmin , Jopp Daniela
Published: December 2023

Population aging has given rise to an increasingly common new group of caregivers, older adult children caring for their very old parents. These caregivers often find themselves balancing several other roles and responsibilities on top of caring for their parent, such as navigating their own health issues, caring for grandchildren, or transitioning into retirement. When a parent has dementia, this presents an additional challenge to caregivers, especially given that most persons with dementia exhibit behavioral and psychological symptoms of dementia (BPSD). The goal of the present research was to examine the range of strategies older caregivers employ in their daily lives in response to parents’ BPSD, using applied thematic analysis. Specifically, we sought to identify and describe the different caregiver strategies for managing BPSD and examine how these strategies are connected, including whether certain strategies co-occur. We conducted in-depth interviews with 100 caregivers (aged 65+) caring for parents with dementia (aged 90+) as part of the Boston Aging Together Study. Results revealed seven strategies used by child caregivers in managing BPSD—including “setting the record straight,” “going along with it,” distracting and redirecting, ignoring, telling “fiblets” or lies, medicating their parent to alleviate symptoms, and altering their physical environment. The most frequently co-occurring strategies employed by child caregivers included telling “fiblets” or lies as well as distracting and redirecting. This study has the potential to inform future caregiver interventions aimed at effectively addressing BPSD and improving quality of life for older child caregivers and their very old parents with dementia.
TRAINING THE NEW SCIENTISTS OF AGING: BUILDING ON GEROSCIENCE OPPORTUNITIES
Authors: Thompson LaDora
Published: December 2023

Geroscience is focused on improving health and well-being by beneficially altering or reversing the cellular and molecular changes that take place as we age. These changes, uncovered by the biology of aging research, can contribute to a progressive loss of function and the onset of frailty and many diseases prevalent at older ages. In the 21st century there is a need for increased engagement with researchers and clinicians across multiple disciplines to translate these geroscience discoveries more effectively into new medical advances. This presentation will highlight efforts to increase awareness and understanding of these geroscience discoveries to stakeholder groups and to build a more diverse and interdisciplinary geroscience workforce, including researchers, clinicians, and members of the public. To date, there are creative education programs aimed at enhancing and expanding broader awareness of geroscience research (e.g., skills development, hands-on research experiences, formal curriculum informed in the science of aging, engagement activities dealing with ethical, economic, political and societal ramifications of extending human lifespan, development of shared methods, networking with experts in the geroscience field, materials and outreach programs on the topic of geroscience), which target basic, translational, clinical researchers and members of the public. Lastly, this presentation will outline the activities within the Translational Rehabilitation in Geroscience Initiative and the Translational Geroscience Network, a collaboration of researchers looking at clinical interventions that target fundamental mechanism of aging to delay, prevent or treat age-related diseases and disabilities as a group, instead of one at a time, enabling more-rapid translation of therapies.
RETRAUMATIZATION WHEN AN ADULT CHILD CARES FOR THEIR PARENTAL PERPETRATOR THROUGH SERIOUS ILLNESS OR THE END OF LIFE
Authors: Goldberg Jaime , Kong Jooyoung
Published: December 2023

Current trauma-related literature does not readily include the experiences of the caregiving population. While the caregiving literature does recognize that caregivers experience trauma, it has not yet explored when the caregiver’s source of trauma is the care recipient. To begin to address this gap, this research explores the retraumatization adult survivors of parental childhood maltreatment may experience when they become caregivers for their parental perpetrator during serious illness or the end of life. Participants were recruited through purposeful sampling techniques, via social media and word-of-mouth. Using a phenomenological approach, 22 semi-structured, virtual interviews were conducted; 13 participants identified retraumatization as part of their caregiving experience. Focused content analysis revealed three subthemes under the umbrella of retraumatization: 1) reminders of past abuse; 2) re-experiencing abusive behaviors; and 3) physical contact with the body of the former abuser. Results suggest that memories of past abuse, ongoing abusive behavior, and proximity to the parental perpetrator’s body evoke feelings of fear/anxiety, worthlessness, shame, anger, and disgust in participants, reminiscent of the feelings they experienced in childhood. Taking on the roles/responsibilities of caregiving triggered these feelings unexpectedly, as the adult children were now interacting with their parent more frequently and in new/more intimate ways. These findings invite health and mental health professionals to have heightened awareness of and sensitivity to this often-overlooked population and use trauma-informed assessment and intervention techniques to support caregivers’ health and well-being. Results can inform future research at the nexus of caregiving and trauma.
POLICY SERIES: THE MOVING FORWARD NURSING HOME COALITION: NURSING HOME REFORM AND THE RESIDENTS’ GOALS, PREFERENCES, AND PRIORITIES
Authors: McMullen Tara , Shippee Tetyana , Degenholtz Howard
Published: December 2023

The 2022 National Academies of Sciences, Engineering, and Medicine (NASEM) report called for nursing facilities to provide “care aligned to the individual’s goals and preferences.” Missing has been an efficient process to uncover the individual’s detailed goals, preferences, and priorities (GPPs). GPPs are a care planning process that translates into actionable interventions, supported by quality measurement to determine whether the care provided aligns with those GPPs, and health information technology to collect GPPs efficiently and to determine if the care provided is concordant with the individual’s GPPs. A diverse set of experts representing the Moving Forward Nursing Home Quality Coalition are collaborating to develop an integrated approach to these shortcomings and will discuss these issues in detail including new approaches to the identification and documentation of GPPs for use in a modified care planning process, the status of health information technologies (HIT) processes being developed to support these changes and the development of new quality measures. While the Moving Forward Coalition is focused on nursing facilities, the approaches being developed here to improve care and to standardize the vocabulary for GPPs are applicable to all care settings. Three committees from the Moving Forward Nursing Home Coalition will present work focused on the development of a standardized GPP care planning process to enhance the identification, documentation, communication, and implementation of resident GPPs, the measurement of the care planning process to support process improvement, and the creation of a HIT-enabled process to measure the concordance of care provided with an individual’s GPPs. This is a collaborative symposium between the Aging Workforce, Hospital Elder Life Program, Measurement, Statistics, and Research Design, Systems Research in Long Term-Care, and Technology and Aging Interest Groups.
METHODOLOGICAL CONCERNS FROM A MIXED-METHODS STUDY OF FRIENDSHIP IN PERSONS WITH DEMENTIA LIVING IN LTC
Authors: Saunders Pamela , de Mederios Kate
Published: December 2023

This paper will examine the methodological issues that arose as part of the Friendship Study (de Mederios, Saunders, Doyle, Mosby, 2012). These issues range from tracking to integrating data as well as ethical considerations of multiple participants living with dementia and their legally authorized representatives. The Friendship Study investigated ‘friendships’ in people with dementia living in long-term care. We used a mixed-methods approach that emphasized qualitative methods over quantitative ones, with integration during the analysis stage. Specifically, we investigated friendships among 31 assisted living residents with moderate to advanced dementia. The Friendship Study was based on the growing literature on social interactions in dementia settings. ‘Social interactions’ describe communicating, verbally and non-verbally, at least once with another person while ‘friendship’ suggests a deeper, more meaningful connection that may include reciprocity, intimacy, and shared trust. From our qualitative analyses, we found that friendships among residents were characterized by voluntary participation and accommodation in conversation, and recognition of the uniqueness of the other. Further quantitative results revealed no correlation between memory test scores, or demographic characteristics (except gender) and friendship dyads identified by staff. Staff’s perceptions of residents’ friendships were not supported through observation. This paper will explore the variety of qualitative methods employed (e.g., ethnographic observation, semi-structured interviews, transcription, coding) and outline how these data were collected, managed, and synthesized. Best practices will be provided.
QUANTIFYING CONTRIBUTIONS OF WORK CHARACTERISTICS TO EDUCATIONAL DISPARITIES IN HEALTH-INDUCED WORK LIMITATIONS
Authors: Abrams Leah , Berkman Lisa
Published: December 2023

While public policies are incentivizing longer working lives, poor health and inhospitable working conditions pose challenges to working longer, especially for Americans with low educational attainment. This analysis sought to quantify how poor health and inhospitable working conditions each contribute to educational disparities in work disability in mid life and old age. Using the Health and Retirement Study (2006-2016), we showed that educational disparities in reporting “any impairment or health problem that limits the kind or amount of paid work” in ages 51-80 have been profound and persistent over time. Blinder-Oaxaca three-fold decomposition revealed that distributions of income and employer insurance made the largest contribution to explaining different rates of work limitations among respondents with versus without high school degrees, followed by work characteristics (physical job demands, insufficient hours) and health conditions (diabetes, lung disease). Comparing respondents with high school versus college degrees, distributions of health conditions mattered most (high blood pressure, lung disease, heart disease, stroke), followed by health behaviors (smoking, drinking). Health-induced work limitations are often used as a health outcome, but we found that work characteristics explained 57% of the disadvantage of those without a high school degree and 44% of the disadvantage of high school compared to college graduates. Therefore, improving work environments holds promise for reducing educational disparities in mid-to-late-life disability.
EARLY-LIFE CIRCUMSTANCES AND RACIAL DISPARITIES IN COGNITION AMONG US OLDER ADULTS
Authors: Lin Zhuoer , Ye Justin , Allore Heather , Gill Thomas , Chen Xi
Published: December 2023

There are marked racial disparities in cognitive outcomes between non-Hispanic Black (Black) and non-Hispanic White (White) older adults in the US. Existing studies concentrate on exploring mid-life to late-life risk factors, yet the early-life circumstances through which the racial gaps may arise remain under-explored. Using a wide spectrum of early-life factors assembled from the Health and Retirement Study, including demographics, SES, health, trauma, family relationships, and genetics, we investigated how racial gaps in cognitive score and cognitive impairment among older Americans were tied to racial differences in early-life circumstances. 9,015 (7,381 White, 1,634 Black) Americans aged 50 and older were included in the analysis. Using Blinder-Oaxaca-Decomposition, we showed that Black participants generally had less favorable early-life circumstances than White participants, especially in early-life residence, education level, quality and experience. We demonstrated that overall, differences in early-life circumstances explained up to 61.9% of the racial gaps in cognitive score, and 80.9% of the racial gaps in cognitive impairment between White and Black participants. Disentangling racial gaps by individual factors, we found that differences in the level and quality of education contributed the most. Years of education and school racial segregation respectively accounted for 22.7-24.8% and 26.0%-42.8% of the gaps in cognitive outcomes. Early-life educational experience and place of birth/residence additionally contributed to the disparities. However, childhood trauma, health, and genetic factors were not significant contributors. These findings suggest that exposure to less favorable early-life circumstances is associated with clinically meaningful and statistically significant racial gaps in cognition, which warrants targeted interventions.
SOCIOECONOMIC STATUS AND WORKING LIFE EXPECTANCY IN SWEDEN
Authors: Högnäs Robin
Published: December 2023

Longer life expectancy and fertility decline have increased concerns about the security of old-age pensions. Raising retirement ages is one strategy to offset rising costs, though the option to retire varies considerably by socioeconomic status (SES) and sex. The level of variation in SES may depend the measure used. Also, many workers now transition into retirement slowly, e.g., move from full- to part-time work. Thus, retirement age may not sufficiently capture how long people work. Working life expectancy (WLE)—the expected average number of years worked—better measures total working life. We use data from the Swedish Longitudinal Occupational Survey of Health (SLOSH) from 2008 to 2020 (n=4,940 people age 50+ and n=74,093 person-observations) to examine WLE by SES. We estimate a three-state multistate model (i.e., working, not working, dead) and a four-state model (working part-time, working full-time, not working, and dead); both assume a continuous-time first-order Markov process. Models are sex-stratified models, cross-classified by: 1) occupation; 2) education; 3) income. We find that professionals work full-time 1 year more than routine workers, regardless of sex. The low educated work full-time 1 year less than the highly educated. In our weighted three-state model, where part-time work contributed ½ of full-time work, the difference increased to 1.14 and 1.05 years, respectively. Our unweighted three-state model showed slightly larger education differences. Findings suggest that WLE differs by SES, regardless of sex, and the differences are greater by education than occupation. This has implications for extending working life policies.
LONG-TERM PAID CARE WORKFORCE: SHORTAGE, BURNOUT, TRAINING, TURNOVER, WHAT’S NEXT?
Authors: Rhodes Ann , Martin-Matthews Anne
Published: December 2023

Although the long-term care workforce has struggled historically with staff satisfaction, safety, and retention, the pandemic triggered increased turnover and higher levels of staff burnout. As a result, many residential care organizations are using agency staff at unprecedented levels. Given that continuity of care is central to high-quality person-centered care, and the workforce should have access to a physically and psychologically safe environment, it is imperative that the gerontological research and practical community understand the changing conditions experienced by this workforce in crisis and offers solutions at the workplace, industry, and policy levels. In this symposium, authors explore different facets of paid long-term care workforce to stimulate thought and discussion. One paper contrasts the well-being of the workforce to that of the residents during COVID-19. A second paper presents workforce management capabilities and strategies and posits essential questions for the capacity of management and leadership needs of the workforce. Two papers highlight the struggles that are presented as paid long-term care relies increasingly on contract, short-term workers. Paper three discusses how the use of the contract workforce does not support the provision of person-centered care for conditions like dementia. Paper four uses payroll-based journal data to delve into short and long-term use of contract workforce and discusses the nature of contract staffing, and considers how contract staffing may be disruptive to both the direct care worker and the nursing home environment. The discussant will draw out the policy and practice implications arising from the papers. This is a collaborative symposium between the Aging Workforce and Paid Caregiving Interest Groups.
STRESS AND COPING AMONG NURSING ASSISTANTS AND PERSONAL CARE AIDES IN LONG-TERM CARE
Authors: Efird-Green Lea , Sloane Philip , Lathren Christine , Perreira Krista , Bluth Karen , Zimmerman Sheryl
Published: December 2023

Care in nursing homes and assisted living communities is largely provided by direct caregivers (nursing assistants [NAs] and personal care aides [PCAs]), who are >50% minoritized, 20% immigrant, 90% female, 87% without a college degree, and often in poverty. The well-being of direct caregivers is critical to quality of care, but research aimed at improving well-being is hampered because existing measures of stress and coping translate poorly to their backgrounds and work-related experience. To address this gap, we designed and conducted research aimed at describing the range of coping approaches used to address work-related stress, gathering data on a diverse sample of 391 direct caregivers from 9 nursing homes and 4 assisted living communities in 3 states, of which 75% were racially or ethnically minoritized and 21% were immigrant – mirroring the national workforce. Results indicated that 78% of respondents often felt stressed at work, with 30% screening positive for depression and 28% for anxiety, with some caregivers experiencing both (21%). However, working with residents and their families, while stressful (76%), was considered less stressful than workload (90%) and lack of support (83%); in fact, 89% of caregivers said that caring for residents makes them feel appreciated. Coping strategies were diverse, but the most common includedresilient coping (93%), mindfulness (89%), recognizing common humanity (84%), self-kindness (83%), and planning (69%). This presentation will address differences in coping based on demographic characteristics, as well as the relationship between types of coping strategies and reasons for staying in a direct caregiver position.
THE AGING PROFESSOR OF GERONTOLOGY: MINING THE PLATINUM
Authors: Donorfio Laura , Holley Lyn , Levy Becca
Published: December 2023

This symposium explores evidence of the subtle, pernicious influence of unconsciously internalized ageist stereotypes on the engagement, job performance, perception of self and life satisfaction of older persons who are teachers of Gerontology in higher education. Unsolicited responses to the Tibbitts Award Lecture at the 2022 Conference of the Gerontological Society of American inspired this symposium and comments that indicated many older teachers of Gerontology in institutions of higher learning had become more aware of how internalized ageism and the ageism of others influences one’s pedagogy of aging. This includes one’s gerontological imagination, self-disclosure, thoughts about retirement, and organizational self-esteem. Learning to accept one’s own aging, personal growth, and activities to maintain professional competence are challenges to continuing in one’s role. This symposium captures the reflections of four established Gerontologists about these issues and how they shape careers, especially late life work. Results of a scoping literature review and some case studies of topics relevant to breaking the age code are reported. Topics to be covered include: the intersection of personal aging and aging pedagogy, career self-management of late life work, assessing and dealing with career competence and incompetence in late life work, and the Role of Age Friendly Environments. The discussant will capture the impact of ageism on these topics, and how working on beliefs about aging can influence and improve late life work and empower a productive lifespan.
TRANSLATING AGING: REACHING STUDENTS ACROSS DISCIPLINES AND GEOGRAPHY
Authors: Borrero Lisa
Published: December 2023

What does it mean to translate gerontological concepts among groups of very different students? How can this be optimized for online graduate education? Even within a field that is itself interdisciplinary, it can feel challenging to meaningfully convey key information about aging when students are already firmly established in their own, unique disciplines and are learning from a distance. This lecture will reflect on ways in which gerontology instructors can connect a wide array of graduate students to the universality of aging, promote the relevance of aging to their chosen field, and, hopefully, engender a deeper interest in working with older adults. From the importance of maintaining social and cognitive presence in the online classroom to offering experiential engagement with course content, we can communicate about aging in purposeful and novel ways to a variety of students – and reap the benefits of learning from their expertise in return.
CAREGIVING FOR OLDER ADULTS: EXPLORING THE IMPLICATIONS FOR FAMILIAL RELATIONS, DYNAMICS, AND FRIENDSHIP
Authors: Chia Arthur , Malhotra Rahul
Published: December 2023

In this symposium, we discuss about various aspects of caregiving for older adults who require care because of chronic illness, frailty, and/or long-term disability. Their needs take many forms and so do the demands and concerns of their caregivers, comprising family members and close friends. Under these trying circumstances, relationships are put to the test; shared sensibilities and understandings built over decades of marital and family life begin to unravel, and friendships fray. Thus, caregiving has profound implications for the family as well as non-family members who provide care. Caregiving itself is marked by varying intensities expressed in anguished voices of loss, frustration, and anger but they also convey a deep sense of responsibility, gratitude, and love. There is much that caregiving could offer in terms of the potential for deeper meaning, connection, satisfaction, and goodness. Hence, the papers in this symposium will examine how caregiving responsibilities are distributed among family and non-family members; analyze the implications of caregiving on the notion of home/homeliness for caregivers; account for the meaning of caregiving for a parent or older family member as diverse expressions of filial piety; and explore the issues and challenges around caregiving for older adults with cognitive impairment including dementia from the perspectives of family and non-family members who are caregivers. Collectively, the papers highlight the relational and reciprocal nature of caregiving, and in which intimate relational and cultural processes shape not only the quality and experiences of caregiving but also foundations of the family and notions of home.
EXAMINING OPPORTUNITIES TO ALIGN WITH THE UNIFYING GOAL OF HELPING CAREGIVERS: A STRENGTH-BASED MODEL
Authors: Lee Jeong Eun , Meinertz Naomi , Savla Tina
Published: December 2023

Caregiving is a complex and multifaceted experience, yet it is often addressed from a deficit model. Recent research indicates that strength-based interventions or programs from person- centered approach demonstrate improvements in caregivers’ experiences. The purpose of this symposium are is to highlight a collection of studies that each bring a unique perspective to family the care issues by, reporting improved caregiver psychosocial factors contributing to caregiver outcomes and strength or person centered approach to enhance caregiver outcomes. The first session will demonstrate the effectiveness of a person-centered caregiver intervention, Powerful Tools for Caregivers (PTC), in reducing depressive symptoms, improving self-efficacy, and utilizing emotion management skills. The second session will share a baseline data from a live online intervention, Chronic Grief Management Intervention-Video (CGMI-V), and identifying intervention targets by examining caregivers’ feelings of role captivity and grief. The third presentation will introduce the results of a pilot intervention , called “Building a Bridge,” which that improved caregivers’ knowledge and access to community resource. The final session will introduce a program based on the Acceptance and Commitment Therapy (ACT) model that reduces caregiver burden for community-dwelling parents and grandparents raising grandchildren or children in the community setting. Together, these presentations underscore the benefit of using strength-based models to relieve caregiver burden of caregivers. Savla , the discussant, will integrate key points from these interventions while and addressing considerations for future research to optimize outcomes for caregivers. This is a Mental Health Practice and Aging Interest Group Sponsored Symposium.
COMPARISON OF STEREOLOGY METHODS FOR ASSESSING AGE-RELATED EFFECTS ON IMMUNOSTAINED BRAIN CELLS
Authors: Denham Grant , Alahmari Saeed , Anderson Aidan , Sanchez Krystal , Dag Dominick , Hall Lawrence , Goldgof Dmitry , Mouton Peter
Published: December 2023

The primary benefit of stereology methods is quantification of well-stained biological objects in tissue sections with the ability to adjust sampling intensity to achieve desired levels of precision. The advent of hand-crafted algorithms and artificial intelligence-based deep learning (DL) provides an opportunity for more standardized collection of stereology data with enhanced efficiency and higher reproducibility compared to state-of-the-art manual stereology. We contrasted and compared the performance of four manual, semi-automatic, and fully automatic approaches for generating data for total number of Neu-N immunostained neurons in neocortex (NCTX) in the mouse brain. The gold standard for these studies was manual counts using the state-of-the-art optical fractionator method on 3-D reconstructed serial z-axis image stacks through a known tissue volume (disector stacks). To allow for direct methodological comparisons on the same images, disector stacks were automatically converted into extended depth of field (EDF) images in which all neurons in the disector stack were imaged at each cell’s maximal plane of focus. Total number of Neu-N neurons on the same EDF images were counted by a fully automatic hand-crafted method [automatic segmentation algorithm (ASA)] and a semi-automatic method [ASA counts manually corrected for false positives and negatives]. All comparison counts were done using unbiased frames and counting rules with total counts of NeuN-immunostained neurons by the optical fractionator method. The results were comparable across methods with wide variations in throughput efficiency and inter-rater agreement. These results are discussed with respect to applications to experimental studies of brain aging, neuroinflammation and neurodegenerative disease.
The past as present in health promotion: the case for a ‘public health humanities’
Authors: Kehoe Thomas J , May Andrew , Holbrook Carolyn , Barker Richie , Hill David , Jones Hayley , Moodie Rob , Varnava Andrekos , Westmore Ann
Published: December 2023

Health promotion is conceived as a unifying concept for improving the health of populations. This means addressing the socio-cultural, economic and commercial causes of ill-health, which are necessarily informed by past policies and socio-cultural contexts. However, historical scholarship has rarely figured in health promotion practice or scholarship. This gap resides in the determinants of health, and notably in the analyses of tobacco control and skin cancer prevention, two long-running campaigns that have shaped modern health promotion in Australia. Both highlight a need for understanding the profound impact of history on the present and the value of learning from past successes and failures. Doing so requires integrating historical analyses into existing health promotion scholarship. To achieve this aim, we present a new ‘public health humanities’ methodology. This novel interdisciplinary framework is conceived as a spectrum in which historical studies integrate with existing health promotion disciplines to solve complex health problems. We draw on the many calls for more interdisciplinarity in health promotion and derive this methodology from proposals in the medical humanities and cognate fields that have wrestled with combining history and present-focused disciplines. Using tobacco control and skin cancer prevention as case studies, we demonstrate how public health humanities uses interdisciplinary teams and shared research questions to generate valuable new knowledge unavailable with traditional methods. Furthermore, we show how it creates evaluation criteria to consider the powerful impact of issues like colonialism on current inequities that hinder health promotion strategies, and from which lessons may be derived for the future.
Strawberry soluble solids QTL with inverse effects on yield
Authors: Fan Zhen , Verma Sujeet , Lee Hana , Jang Yoon Jeong , Wang Yu , Lee Seonghee , Whitaker Vance M
Published: December 2023

Sugars are the main drivers of strawberry sweetness, and understanding their genetic control is of critical importance for breeding. Large-scale genome-wide association studies were performed in two populations totaling 3399 individuals evaluated for soluble solids content (SSC) and fruit yield. Two stable quantitative trait loci (QTL) on chromosome 3B and 6A for SSC were identified. Favorable haplotypes at both QTL for SSC decreased yield, though optimal allelic combinations were identified with reduced impacts on yield. Metabolites in the starch and sucrose metabolism pathway were characterized and quantified for 23 contrasting genotypes in leaves, white fruit, and red fruit. Variations in sucrose concentrations/efflux indicated genetic variation underlying sucrose accumulation and transportation during fruit ripening. Integration of genome-wide association studies and expression quantitative locus mapping identified starch synthase 4 (FxaC_10g00830) and sugar transporter 2-like candidate genes (FxaC_21g51570) within the respective QTL intervals. These results will enable immediate applications in genomics-assisted breeding for flavor and further study of candidate genes underlying genetic variation of sugar accumulation in strawberry fruit.
Application of integrative taxonomy combining phylogenetic and geometric morphometric techniques in a snapping shrimp (Alpheus) species complex (Decapoda: Caridea: Alpheidae)
Authors: Casaubon Anchita , Hultgren Kristin M , Murray Chris , Hanscom Ryan J , Hurt Carla
Published: December 2023

Snapping shrimps of the genus AlpheusFabricius, 1798 exhibit remarkable diversity, with over 300 described species. The genus is well-known for its prevalence of species complexes, necessitating the need of new tools to facilitate species discrimination. Traditional taxonomic methods in Alpheus have primarily relied on the examination of morphological traits or comparative morphometric measurements, with an emphasis on variation in the major chela and rostro-orbital region. We applied an integrated approach that combines molecular genetics and geometric morphometrics to investigate the A. gracilipesStimpson, 1860 species complex. We additionally applied geometric morphometric techniques to study the major chela and the rostrum across different species, and used three mitochondrial genes (12S, COI, and 16S) to reconstruct phylogenetic relationships of this complex. Our results demonstrate the first application of geometric morphometric techniques to Alpheus snapping shrimps, and highlight the significance of the major chela and rostrum as taxonomically informative traits. Furthermore, we use DNA barcodes and geometric morphometric techniques to the A. gracilipes species complex to reveal two previously unidentified cryptic species. We present the first phylogenetic reconstruction of this species complex, with new localities and expanded distribution ranges reported for many species.