bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Review of the Psychometric Properties of the Geriatric Anxiety Inventory
Authors: Landreville Philippe , Champagne Alexandra , Gosselin Patrick
Published: December 2020

The Geriatric Anxiety Inventory (GAI) is a widely used self-report measure of anxiety symptoms in older adults. Although much research has been conducted on the psychometric properties of the GAI, previous reviews have examined only a small proportion of studies and have not evaluated the methodological quality of this work. In view of this, we conducted a systematic review of the psychometric properties of the GAI and it’s short form (GAI-SF). Relevant studies (N = 31) were retrieved through a search of electronic databases (Pubmed, PsycINFO, CINAHL, EMBASE and Google Scholar) and a hand search. The methodological quality of the included studies was assessed by two independent reviewers using the ‘‘COnsensus-based Standards for the selection of health status Measurement INstruments’’ (COSMIN) checklist. Based on the COSMIN checklist, internal consistency and test reliability were mostly rated as poorly assessed (63% and 72.7% of studies, respectively) and quality of studies examining structural validity was mostly fair (60% of studies). Both the GAI and GAI-SF showed adequate internal consistency and test-retest reliability. Convergent validity indices were highest with measures of generalized anxiety and lowest with instruments that include somatic symptoms. Substantial overlap with measures of depression was reported. While there is no consensus on the factorial structure of the GAI, the short version was found to be unidimensional. Our review therefore suggests that the GAI and GAI-SF have satisfactory psychometric properties while indicating that future efforts should aim to achieve a higher degree of methodological quality.
Association Between Mental Health Conditions and Care Fragmentation: A National Study of High-Risk Older Veterans
Authors: Trivedi Ranak , Rossi Fernanda , Javier Sarah , Greene Liberty , Singer Sara , Vanneman Megan , Goldstein Mary , Zulman Donna
Published: December 2020

Fragmented healthcare causes information loss, duplicative tests, and unwieldy self-care regimens. These challenges may be amplified among older, high-risk patients with co-occurring mental health conditions (MHC). We compared healthcare fragmentation for chronic physical conditions among Veterans with and without MHC (depression, PTSD, schizophrenia, bipolar disorder, anxiety, personality disorder, or psychosis based on ICD-9 codes). Sample included Veterans who were □65y, at high risk for 1-year hospitalization, and had □4 non-MHC visits during FY14. Visits were covered by Veterans Affairs (VA), VA-purchased care (both from VA Corporate Data Warehouse), or Medicare Parts A/B (claims data from VA Information Resource Center). Outcomes were two fragmentation measures calculated in FY15: 1) non-mental health provider count, where a higher number indicates more fragmentation, and 2) Usual Provider of Care (UPC), the proportion of care with the most frequently seen provider, where a higher number indicates less fragmentation. We used Poisson regression and GLM with binomial distribution and logit link to test the association between MHC status and fragmentation, controlling for sociodemographic characteristics (e.g., age), medical comorbidity, and driving distance to VA. Of the 125,481 Veterans included, 47.3% had 1+ MHC. Compared to older, high-risk Veterans without MHC, those with MHC saw fewer providers (pseudo R2 = 0.02) and had a higher UPC (more concentrated care; OR = 1.07). Within the VA, older, high-risk Veterans with MHC do not experience greater healthcare fragmentation. Further research is needed to determine if this is due to different needs, underuse, or appropriate use of healthcare across the groups.
Architecture of a Smart Home for Aging in Place
Authors: Norouzi Neda
Published: December 2020

The United States Department of Health and Human Services (2017) estimates that there are 65 million people age 60+ residing across the fifty states. A national survey conducted by the American Association of Retired Persons (AARP) indicates that 76% of people ages 55+ prefer to age-in-place and live independently (2018). The Census Bureau American Community Survey (2015) estimates that 13 million adults have difficulties living independently, 80% of which receive assistance in their private homes. However, only 50% of these homes meet the physical needs of people who choose to age-in-place (AARP, 2018). Recent advancements in technology have led to the development of smart homes. Technology can support aging-in-place and independent living by offering necessary tools for building systems that identify behavioral patterns and offer automated decision-making. However, not all older adults are customed to using technology or comfortable with being monitored with artificial intelligence (Wang et al., 2019). In response to this concern, the current study used grounded theory framework to analyze 62 interviews of people ages 55-93 to indicate if and how older adults prefer to utilize technology in their homes. The results of the study presented that while some older adults felt they might be too old to learn and use technology, nearly 85% of the interviewers agreed that incorporating technology in the built environment could benefit them. They are especially willing to learn and use technology in their homes when the benefits are related to their health, social and emotional connection, entertainment, safety, and daily chores.
Developing a Dementia Care Training Curriculum for Registered Dietitians
Authors: Douglas Joy , Ferguson Christine , Nolan Beth
Published: December 2020

Research supports the need for healthcare providers who are trained in providing care to older adults with dementia. However, few training options exist for Registered Dietitians (RDs) seeking dementia care training that is specific to nutrition. The purpose of this project was to adapt an existing dementia care training curriculum to meet the learning needs of RDs. The development team included two experts in dementia training and two RDs with expertise in gerontological nutrition. The new training module was based on the existing Positive Approach to Care™ (PAC) curriculum, which incorporates Kolb’s Experiential Learning Theory and the Adult Experiential Learning Cycle. The development team first identified learning objectives for content that would be relevant to RDs who work with persons living with dementia, and modified components of the existing PAC curriculum to meet these objectives. After a preliminary pilot, the 2-hour program was presented to 20 RDs using a combination of lecture presentation, experiential learning, and skill-building techniques. Participants were provided written materials to reinforce the concepts presented. Participants answered five dementia-specific questions before and after the training, and overall, the average percentage of correct answers improved following the training. Two weeks following the training, participants completed an open-ended survey to provide feedback on the training. Participants responded favorably to the mixed learning formats in the training. When asked to rank their preferred learning methods, participants indicated lecture-based learning and experiential learning as their top preferred methods. These findings indicate that the adapted curriculum may improve dementia knowledge among RDs.
Exploring Reactions to Disrespect and Sensitivity to Social Rejection in Older Adults
Authors: Chappell Amanda , Smith Kelly , Steele Jenessa , Strough JoNell
Published: December 2020

Disrespect involves having low regard or low esteem for someone. Disrespect is a universal experience and has the potential to negatively impact relationships and fosters anger and aggression (Hawkins, 2015; Shwalb & Shwalb, 2006). In the current study, younger (ages 19-25) and older adults (ages 50-77) imagined a person they knew had disrespected them in six different hypothetical situations. For each situation, participants rated their emotional reactivity. Participants also indicated their sensitivity to social rejection (i.e. being left out/excluded). The primary research questions for this study included: do reactions to disrespect differ based on age? Also, does one’s relationship status with a disrespect perpetrator matter? In the current study, participants had a stronger emotional reaction to disrespect when imagining the disrespect perpetrator was someone close to them rather than someone not close to them, regardless of age. An age by gender by relationship closeness ANOVA revealed three significant main effects: of age (older are less sensitive), gender (males are less sensitive), and relationship closeness (those more distant to perpetrator are less sensitive) on sensitivity to social rejection. Sensitivity to social rejection mediates the relationship between closeness to a disrespect perpetrator and emotional reaction, even after controlling for age as a covariate, p<.001. The findings of this study highlight the component of rejection that is typically involved within disrespect situations and may help to explain just why disrespect feels so hurtful. These findings also highlight that there may be some protection from disrespect based on age or gender.
Connecting Age-Friendly University Principles to Undergraduate Education Builds Campus-Wide Buy-In
Authors: Luz Clare
Published: December 2020

Michigan State University became an Age-Friendly University (AFU) in December 2019. The path to campus-wide buy-in started years earlier by AgeAlive, a program established to serve as MSU’s central aging hub and to promote wellbeing throughout life. University approval and awareness of AgeAlive and what it means to be an AFU remains a key goal and crucial to sustainability. Central to strategic planning is ensuring that AgeAlive and MSU missions and values are aligned, visibility remains high, and outcomes are tangible and substantial. This presentation provides concrete examples of initiatives that meet these criteria and are building university support including a program that matches students to isolated seniors at risk for loneliness and multi-university research to help college students caring for older family members succeed as students and caregivers. Recommendations for developing and executing a strategic plan will be described and of interest to others on their own AFU journey.
Cultural Dimensions, Unique Challenges, and Interventions for Dementia Care in the Asian Context
Authors: Chee Kyong Hee , Ejaz Farida
Published: December 2020

Asians in and outside of Asia are facing a rapidly-growing need for dementia care in familial, institutional, or community settings. This multidisciplinary symposium addresses issues of formal and informal dementia care in the Asian cultural context to suggest novel, culturally-appropriate interventions for education and practice. Presenters in this symposium will specifically speak to cultural dimensions, challenges, and approaches involved with caring for persons living with dementia (PLWD) in Singapore and South Korea, as well as their Japanese/Japanese-American counterparts. Malhotra and colleagues will present their qualitative study from Singapore on 26 familial care partners’ preference for life-extending interventions for persons with severe dementia, such as intravenous antibiotics, tube feeding, and cardiopulmonary resuscitation. Lee and Chee will then examine how the occupational identities of 303 long-term care workers are associated with their practice of human rights for PLWD in South Korea. Next, Yen and Mayen-Cho will explain a video project that they developed at Alzheimer’s Los Angeles to reach out to the Japanese American community – they conducted and filmed in-depth interviews with 7 Japanese/Japanese American family care partners of PLWD. Finally, Park will examine the emergent themes in the narratives of these Japanese/Japanese American interviewees. She will also demonstrate the relevance of the life-course perspective in developing a template for designing similar interventions to serve other ethnic communities. As a discussant, Ejaz will highlight versatility in interventions for dementia care among Asians and Asian Americans. She will also discuss broader implications of the findings within and beyond the Asian context. Aging Among Asians Interest Group Sponsored Symposium.
Singaporean Dementia Caregivers’ Preference for Care Recipients’ Life-Extending Interventions
Authors: Malhotra Chetna , Mohamad Hazirah , Østbye Truls , Pollak Kathryn , Balasundaram Bharathi , Yoon Sungwon , Malhotra Rahul ,   PISCES study Group PISCES study Group
Published: December 2020

Family caregivers of older adults with severe dementia are decisive in use of potentially life-extending interventions for their care recipients. We conducted in-depth interviews with 26 caregivers of community-dwelling older adults with severe dementia in Singapore to assess their preferences for intravenous (IV) antibiotics for a life threatening infection, tube feeding, and cardiopulmonary resuscitation (CPR), and reasons thereof. Most caregivers’ (77%) end-of-life care goal was ‘no life extension’. Yet, 80%, 60% and 45% preferred IV antibiotics, tube feeding and CPR, respectively, as they: 1) perceived letting go by withholding interventions as unethical, 2) felt they had no choice, deferring to health care providers (HCPs), 3) wanted to alleviate suffering, and 4) desired trying minimally invasive (and potentially withdrawable) interventions. There was discordance between caregivers’ end-of-life care goal and preferences for life-extending interventions. HCPs can suggest intervention options that concur with caregivers’ end-of-life care goal, and use a shared decision-making approach. Part of a symposium sponsored by the Aging Among Asians Interest Group.
Partnerships Connecting Healthcare and Community-Based Organizations in Virginia
Authors: Slattum Patricia , Parsons Pamela , Rubino Mary , Waters Leland
Published: December 2020

The Virginia Geriatric Education Center (VGEC)’s Geriatrics Workforce Enhancement Program (GWEP) partners with two programs, Senior Strong at Eastern Virginia Medical School in Norfolk, VA and the Richmond Health and Wellness Program at Virginia Commonwealth University in Richmond VA to support their age-friendly initiatives. These programs enhance primary care for an older population experiencing adverse social determinants of health by providing screening around the 4Ms pillars of age-friendly healthcare and connecting participants with healthcare and community-based organizations. These programs offer a rich learning environment for interprofessional students. The VGEC GWEP strengthens these programs by developing faculty and student training in collaboration with the programs and facilitating program participation in the GWEP-CC Age-Friendly Action Community to develop and refine age-friendly practice workflows, referral pathways and documentation.
Older Adults as Teaching Allies: Opportunities for Age-Friendly University Innovation
Authors: Montepare Joann , Farah Kimberly
Published: December 2020

Changing age demographics are reshaping societies and challenging institutions of higher education to consider how they can respond to aging populations through new approaches to teaching, research, and community engagement. As well, institutions are facing a range of challenges as they look to respond to the contemporary needs of traditional-aged students. The pioneering Age-Friendly University (AFU) initiative, endorsed by GSA’s Academy for Gerontology in Higher Education (AGHE), offers a framework within which institutions can begin to address these issues through more age-friendly programs, practices, and partnerships. This symposium will feature AFU advocates discussing innovate ways in which older adults can serve as teaching allies and support the educational mission of higher education. Farah (Lasell University) will discuss how older adults can engage in diverse teaching and learning activities with examples as crime scenario developers in a forensics class, conversation partners in an international oral communication class, and professional interviewers in an internship skills class. Kaye (University of Maine) will discuss how older adults can serve as citizen scientists performing critical functions in participatory research and in community-based test-beds and co-design laboratories. Ermer (Montclair State University) will discuss how older adults can engage students in discourse as guest speakers and panel participants in classes across the curriculum. Manoogian (Western Oregon University) will describe the innovative ways that older adult students (for credit or audit) mentor and engage younger student peers in course activities as well as increase their own understanding of the aging process.
Using Community-Impact Internships to Broaden AFU Commitment on Campus
Authors: June Andrea , Andreoletti Carrie
Published: December 2020

Ongoing efforts to support Age Friendly University (AFU) principles must be campus-wide and include commitment from upper administration, faculty, staff, and students. This presentation will describe the leveraging of a new community-based collective partnership to develop a student internship model at Central Connecticut State University (CCSU) that could be used across campus to create a deeper investment in the AFU initiative. We will discuss the valuable collaboration with the Connecticut Healthy Living Collective, an emerging hub of state, regional and local agencies and organizations dedicated to healthy aging in communities throughout our state. The presenters will describe the process of establishing the Matter of Balance internship in psychological science with the support of our dean, knowing that it would eventually serve the broader AFU mission. We will highlight the value this intentional effort offers at multiple levels and how it might be replicated on other AFU campuses.
Making the Case and Laying the Groundwork for Integrating Age-Friendly Practices Into a University Strategic Plan
Authors: Cannon Melissa
Published: December 2020

A crucial first step in preparing to become an Age-Friendly University (AFU) is seeking endorsement from the campus community and leadership. This presentation describes the mapping of the AFU principles to the strategic plan and initiatives of Western Oregon University, leading to endorsement by its faculty senate, and highlights a study of the older community members’ use of the university, laying the groundwork for advancing age-friendliness on campus. Data were collected through surveys (N=46), interviews (N=9), and photovoice method (N=7) with older adults, and data were analyzed using SPSS, team coding, and intensive group discussion to develop categories and themes. Themes emerged related to how the college campus is used by older adults, the need to promote lifelong learning to the community, and the need to address accessibility issues in order to be more age-friendly, providing helpful insight to other institutions of higher education seeking to join the AFU network.
Considering Gender Within the Four Theoretical Domains of Subjective Age
Authors: Turner Shelbie , Settersten Richard , Hooker Karen
Published: December 2020

The broad construct of subjective age is informed by four theoretical domains – self-perceptions of aging, old age stereotypes, age identity, and awareness of age related change (Kotter-Gruhn, Kornadt, & Stephan, 2016). Each of the theoretical domains is distinct yet interconnected, and analyzing how gender operates within each yields a more nuanced understanding of gender’s influence on subjective age. In our presentation, we will offer a review of researchers’ consideration of gender in studies of each subjective age theoretical domain, describing (1) how gender has and has not been included, (2) key findings when gender has been included, and (3) insights into how researchers might better include – or even center – gender when studying each domain. In so doing, we highlight the contributions of past scholarship on gender and subjective age and offer insights for future studies on the topic.
Personal Aging Is Political: A Feminist Perspective on Subjective Aging
Authors: Barrett Anne , Michael Cherish , Noblitt Jessica
Published: December 2020

An extensive literature examines subjective aging – a construct encompassing many aspects of individuals’ views of aging, such as age identity, aging anxiety, awareness of aging, and views of life stages. A factor receiving attention within this research is gender, with studies revealing much about gender differences not only in subjective aging but also its health and behavioral consequences. However, we argue that the literature is limited by its focus on gender as an individual-level characteristic – rather than a profoundly social element emerging within interactions, pervading institutions, and constituting a system of inequality that intersects with others, including age. Addressing this limitation, our chapter applies a feminist perspective to the study of subjective aging. This perspective draws into focus the implications for subjective aging of gender’s social embeddedness and provides an illustration of the interconnection between the personal and political spheres.
Building Trust in Ethnically Diverse Older Adults Using Technology-Based Physio-Feedback
Authors: Thiamwong Ladda
Published: December 2020

There is no research exploring how to build trust in the context of falls risk assessment and prevention. This study describes strategies to build trust in ethnically diverse older adults using technology-based physio-feedback from two studies. The technology includes a portable BTrackS balance plate and BTrackS Balance Software running on a computer device. Participants were provided instant playback showing their static balance performance with a scale from 0 to 100. Sixty-seven community-dwelling older adults participated in the first study, and 41 of them (61.2%) participated again in the second study using the same procedures. 70% were women, 43% were immigrants, 34% Hispanics, 15% African Americans, and 9% Asians. Three reasons for participation were reported: 1) specific objective feedback on the test results that supported by technology, 2) ability to record changes over time; and 3) ability to access the fall risk technology-based test at a place of their convenience. Part of a symposium sponsored by the International Aging and Migration Interest Group.
Links Between Rumination and Sleep Quality Among Older Adults: An Examination of the Role of Social Support
Authors: Marini Christina , Wilson Stephanie , Nah Suyoung , Martire Lynn , Sliwinski Martin
Published: December 2020

Rumination is a maladaptive coping strategy that gives rise to and sustains stress. Individuals who ruminate more, therefore, tend to sleep more poorly. Studies of rumination and sleep often neglect the role of social context. Social support may buffer the degree to which rumination predicts poorer sleep quality. Further, individuals with more support may ruminate less, resulting in better sleep quality. Finally, rumination may also erode social support, resulting in poorer sleep quality. The current study tested these three hypotheses within a sample of 131 partnered older adults. We examined support from spouses and friends/family separately. Findings indicated that spousal (not family/friend) support buffered the negative association between rumination and sleep quality. Neither type of support predicted rumination; however, rumination predicted lower levels of family/friend (not spousal) support. Thus, spousal support protects older adults’ sleep quality from rumination, and support from their peripheral ties may be more vulnerable to rumination.
Do Depressive Symptoms Shape Blacks’ Perceptions of Stress Over Time?
Authors: Byrd DeAnnah , Thorpe Roland , Whitfield Keith
Published: December 2020

The established association between stress and depression is typically examined only in one direction and cross-sectionally. Data from the Baltimore Study of Black Aging-Patterns of Cognitive Aging was used to longitudinally examine the bi-directional relationships between (1) stress-depression and (2) depression-stress, and age as a modifier. The sample consisted of 602 community-dwelling Blacks, aged 48-92 years at baseline and 450 at follow-up 33 months later. While the stress-depression relationship was non-significant; the depression-stress was (b= 0.236, p< 0.000) and this association varied by age with the impact of baseline depression on changes in stress greatest among Blacks in their 60’s versus those in their 50’s (b= 0.257, p= 0.002), controlling for model covariates. Findings highlight the importance of depression in shaping Blacks’ perception of stress over time. Future work should continue to identify stress and mental health risk factors that contribute to poor health and health disparities in older Blacks.
Cognitive Aging in the United States and Mexico
Authors: Rote Sunshine , Angel Jacqueline , Torres-Gil Fernando
Published: December 2020

The Latino population is rapidly aging, with the number of adults 65 and older expected to increase by more than six times to 17.5 million by 2050. Mexico’s population is also aging and will increase by 227 percent over the next 25 years. We focus on the consequences of rising longevity and increasing numbers of older Latinos living with dementia both in the U.S. and in Mexico. Providing cost-effective and appropriate services to aging Latinos with dementia will require a clear understanding of the intra-diversity among this group in different social and national circumstances. The purpose of this symposium is the understand how migration between and within countries and other social and health factors (e.g., diabetes) impact risk for cognitive impairment and dementia using three national datasets: the HRS, MHAS, and HEPESE. Four paper presentations and one discussant will examine several thematic issues as they relate to cognitive aging for Latinos, including: (1) cross-national estimates of dementia prevalence in Mexico and the U.S.; (2) the healthy immigrant effect and health convergence hypothesis for cognitive impairment for Latinos in the U.S. and Mexico; and (3) implications of these trends for long-term care service needs for Latinos living with dementia in the U.S. and Mexico. The resulting discussion will provide new empirical and theoretical insights on the determinants of cognitive aging for this population. It will also inform debates and aid in implementing innovative strategies and solutions to mitigate risk for impairment and improve dementia care for older Latinos.
Rural and Urban Dwelling Across the Life-Course and Late-Life Cognitive Ability in Mexico
Authors: Saenz Joseph
Published: December 2020

BACKGROUND: Research has consistently suggested urban dwelling in late adulthood is associated with better cognitive ability. Whether early life rural/urban dwelling and its interaction with late-life rural/urban dwelling relate with late-life cognitive ability in the context of Mexico is not well understood. METHOD: Data comes from the 2003 Mexican Health and Aging Study. Early life rural/urban was assessed as respondents’ reports of growing up in an urban/rural area. Current rural/urban was assessed by locality size (greater/fewer than 100,000 residents). RESULTS: Both early life and current rural residence were associated with poorer cognitive ability independent of education, literacy, early life SES and health, income/wealth, healthcare access, health, and health behaviors. Compared to individuals who always lived in rural areas, rural to urban migration was associated with better cognitive ability. DISCUSSION: In addition to current rural/urban dwelling, researchers should consider where individuals lived in early life and migration across the life-course.
Likely Dementia and Its Implication for Support Among the Oldest-Old in Mexico and the United States
Authors: Lopez-Ortega Mariana , Mejia Silvia , Aguila Emma , Gutiérrez-Robledo Luis , Vega William , Andrade Flavia , Grasso Stephanie , Angel Jacqueline
Published: December 2020

This study examines sources of vulnerabilities to dementia in low resource populations in two specific contexts—Mexico and the United States. Data are drawn from comparable waves of the Mexican Health and Aging Study (MHAS) and the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) in 2012, which include representative samples of the oldest-old (82 and over), the fastest growing segment of the populations worldwide. Likely dementia prevalence is 30.9% (±0.46SD) for Mexicans in Mexico and 36.3% (±0.48SD) for Mexicans in the U.S. Odds of likely dementia in both populations were increased by age, living in extended households, depressive symptoms, and Seguro Popular and Medicaid receipt. Being female and having comorbid cardiovascular conditions were also associated with likely dementia but only for older Mexicans. There is a need to strengthen the caregiving capacity of memory care services in low resource communities in Mexico and the U.S.
Use of Cannabis for Sleep: Patterns of Use Among a Sample of Patients in a Geriatrics Clinic
Authors: Kaufmann Christopher , Yang Kevin , Malhotra Atul , Nguyen Khai , Nafsu Reva , Moore Alison
Published: December 2020

Cannabis may be useful for treatment of sleep problems in older adults. Little is known about use patterns of cannabis for sleep. We conducted a clinic-based anonymous survey in a geriatrics clinic in La Jolla, CA. Among n=568 surveys, 10% reported recent use (within past 6 months). Among recent users, 30% reported using cannabis for sleep, most finding it helpful. Compared to cannabis users for other conditions, cannabis users for sleep were more likely to use THC containing products (62.5% vs. 32.1%), use cannabis on a daily or weekly basis (76.2% vs. 43.2%), use vape pens (29.2% vs. 6.9%), and to obtain cannabis via a delivery service (33.3% vs. 14.0%) (all p’s<0.05). Only 40% reported their doctor knew about their cannabis use. Our findings suggest sleep is a common reason for using cannabis. Future research should assess how use patterns can result in effective treatment for sleep in older adults. Part of a symposium sponsored by the Sleep, Circadian Rhythms and Aging Interest Group.
Discrimination, Stress, and Health Across the Life Course
Authors: Thorpe Roland , Hill Carl
Published: December 2020

There is a paucity of research that seeks to understand why race disparities in health across the life course remain elusive. Two such explanations that have been garnering attention is stress and discrimination. This symposium contains papers seeking to address the impact of discrimination or stress on African American health or health disparities across the life course. First, Nguyen and colleagues examine 1) the associations between discrimination and objective and subjective social isolation and 2) how these associations vary by age in using data from the National Survey of American Life. Discrimination was positively associated with being subjectively isolated from friends only and family only. This relationship varied by age. Discrimination did not predict objective isolation. Second, Brown examines evidence of the black-white paradox in anxiety and depressive symptoms among older adults using data from 6,019 adults ages 52+ from the 2006 HRS. After adjusting for socioeconomic factors, everyday discrimination, chronic conditions, and chronic stress, there are no black-white differences in anxiety and depressive symptoms. Third, Cobb and colleagues investigate the joint consequences of multiple dimensions of perceived discrimination on mortality risk using mortality data from the 2006-2016 HRS. The authors report the number of attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life. This collection of papers provides insights into how discrimination or stress impacts African American health or health disparities in middle to late life.
Gender Differences in the Life Course Effects of Unemployment on Mid- and Later-Life Health
Authors: Harrati Amal , Heburn Peter
Published: December 2020

There is substantial evidence that unemployment is associated with adverse health. Given different lifetime employment patterns, these effects may differ between men and women. However, current studies often only characterize unemployment as a one-time shock, and measure the effects on health shortly thereafter. Using unique data available from The National Longitudinal Study of Youth 1979, we characterize employment trajectories for a nationally-representative sample of American men and women for every week of their lives between the ages of 18 and 50 years old. We then explore associations between unemployment and a number of health conditions including cancer, hypertension, diabetes, and depression at age 50--when the onset of chronic health conditions often begins—to examine the cumulative effects of unemployment over the life course on later-life health. We find that men and women have different patterns of lifetime unemployment and that these patterns have strong associations with poorer health at age 50.
Informal Caregiving and Health in Middle and Late Adulthood
Authors: Jang Joy Bohyun , Tang Sandra
Published: December 2020

With average life expectancy increasing, informal caregiving has become increasingly common among aging families. Much of the research in this area suggests that informal caregiving is associated with negative psychological and physical health outcomes for the caregiver. However, there is an emerging body of work indicating that these negative associations may be overstated, and that the associations may vary by gender and race. Using NLSY79 who completed Age 50 Health Module (n=7,844), we will examine how informal caregiving is associated with health in mid/late adulthood and how the association varies by race and gender of the caregiver. Preliminary results showed that caregivers (10.6% of the sample) were less likely to report good health than non-caregivers (OR=0.43, p<0.001) but African-American caregivers were more likely to report good health than other racial groups (OR=1.43, p<0.05). Our findings will contribute to better understanding of the role of informal caregiving in older adults’ health.
Trauma and Adversity: Factors Impacting Vulnerability and Resilience Among Older Disaster Survivors
Authors: Davis Molly , Bellamy Nikki
Published: December 2020

Most would agree that older adults represent a highly vulnerable group prior to, during and post disaster. Age-related vulnerabilities often lead into an increased risk for traumatic experiences and post-traumatic stress symptoms after a disaster. Trauma informed principles offer a possible way to reduce the vulnerability of older adults after a disaster. For example, utilizing the trauma informed question “what has happened to you” shifts the focus from a deficit approach and allows for a deeper understanding of the impact of traumatic life experiences on current functioning and reaction to the disaster. It is this understanding of trauma’s impact that may have a role in how older adult disaster survivors view, respond, and recover after a natural disaster (Seery et.al. 2010; Iacoviello & Charney, 2014). In addition, understanding the role of lifetime adversity provides critical insights for disaster planning, reducing vulnerability and promoting resilience among older disaster survivors.
Contexts That Exclude: Loneliness in North America, Europe, and Africa
Authors: Keating Norah , Roos Vera
Published: December 2020

Loneliness is a key indicator of exclusion from social relations. Its prevalence among older people is of increasing global concern given the powerful impact of loneliness on health and wellbeing. To date, empirical and theoretical advancements in understanding loneliness have been focused on the micro contexts of networks of social relationships surrounding older people. Yet these relationships occur within broader socio-cultural, political and geographical settings that may help us better understand the experiences and manifestations of loneliness. In this presentation we draw on our research on loneliness on three continents. Findings from Canada show how ageing in a foreign land can truncate social connections. Research across Europe reveals differences in values and expectations about social connections. South African findings illustrate the long-term impact of dislocation resulting from political ideologies. We draw together these findings to create an ecological model of contexts that may lead to cumulative disadvantage in social relations.
Heterogeneity in Self-Reported Cognitive Impairment Life Expectancies Among Older Latino Subgroups in the United States
Authors: Garcia Marc , Ortiz Kasim , Chui Chi-Tsun , Downer Brian , Warner David
Published: December 2020

Research suggests the prevalence of cognitive impairment among older U.S. Latinos is increasing relative to the older U.S. population which has experienced and overall decline. This has been attributed in part to extended longevity, lower educational attainment, and a higher prevalence of diabetes and cardiovascular disease among older Latinos. However, less is known regarding the number of years and proportion of late life spent with self-reported cognitive impairment among this rapidly aging group and whether cognitive impairment life expectancy outcomes vary across U.S. Latino subgroups by country of origin. To fill this gap, our investigation uses data from the National Health Interview Survey (1997-2015) to estimate Sullivan-based life tables of cognitively normal and cognitively impaired life expectancies for adults 50 years and older. Results indicate significant heterogeneity among Latinos, with island-born Puerto Rican women spending the most years, and foreign-born Cuban men the fewest years lived with self-reported cognitive impairment.
Emotional Flexibility, Biomarkers, and Cognitive Resilience in Latino Adults at Midlife
Authors: Diminich Erica
Published: December 2020

A growing body of evidence underscores the important role of emotional responding and emotional flexibility in healthy adaptation. Considerable research further demonstrates that being flexible in how one copes and regulates emotions when faced with stressful events is paramount for healthy aging. However, the adaptive benefits of emotional flexibility have not been studied in Latina/o’s, despite converging evidence indicating that Latina/o’s report greater symptoms of depression and anxiety in the context of exposure to potentially traumatic events and stress. We demonstrate across two studies, how the ability to regulate emotional responses is associated with cognitive health in a community-based population of Latinos and a cohort of Latino responders from the World Trade Center attacks on 9/11. Furthermore, given that individual differences in emotional flexibility predict cognitive decline, we present data examining the utility of plasma biomarkers of pre-clinical Alzheimer’s disease and neuropathy as diagnostic screeners of cognitive functioning and health.
Translating Behavioral Interventions: It Is More Than Just Language
Authors: Marx Katherine , Gitlin Laura
Published: December 2020

In the United States, over 5 million people are living with Alzheimer’s disease or a related dementia. Providing care are an estimated 16 million unpaid caregivers and millions of paid caregivers. Neuro-psychologic symptoms (NPS) such as agitation, aggression, depression, rejection of care, and apathy are almost universal in persons living with dementia (PLwD). Caring for NPS often leads to poor physical, mental and financial outcomes. There have been hundreds of non-pharmacologic interventions tested and found efficacious to help caregivers with NPS and daily care challenges. However, very few of these interventions have been widely adopted in different languages and settings. One promising intervention used in various countries is the Tailored Activity Program (TAP). TAP, delivered by occupational therapists, customizes activities to PLwD’s current capabilities and prior roles and interests and instructs caregivers in their use. This session will examine TAP’s reach and how it has been translated and adapted. First, Ms. Sokha Koeuth will present modifications needed to the program to facilitate widespread dissemination including placing training in the program online and virtual. The next two presentations will discuss adaptations to TAP in different countries and cultures; Dr. Marcia Novielli will present TAP-Brazil, and Dr. Jean Gajardo Jauregui will present TAP-Chile. Finally, Dr. Katherine Marx will examine the adaptations needed to place TAP into a long-term care setting with both family and paid caregivers. These papers highlight the cross-cultural adaptations that need to be considered in taking a program from research to different real world clinical and community-based settings. Behavioral Interventions for Older Adults Interest Group Sponsored Symposium.
Daily Emotional Well-Being and Cardiometabolic Syndrome in Adulthood: The Role of Sleep Deficiency
Authors: Chai Hye Won , Joo Susanna , Lee Sun Ah , Almeida David
Published: December 2020

Previous studies note daily emotional well-being and sleep duration as significant correlates of cardiovascular health including cardiometabolic syndrome. However, not much is known about the interactive effects of emotional well-being and sleep. Expanding upon current research, this study examined whether sleep deficiency, defined as having on average <7 hours of sleep a day, moderated the associations between daily emotional well-being and cardiometabolic syndrome. Data was drawn from the Midlife in the United States Biomarker Project and the National Study of Daily Experiences (N = 1,163; Mean age = 53.3). Results showed significant interaction effects- higher negative affect was associated with worse cardiometabolic syndrome and higher positive affect was associated with better cardiometabolic syndrome only among those with deficient sleep. Such association was stronger for older adults compared to young adults. These findings suggest that individuals with insufficient sleep are more affected by health-related benefits and costs of daily emotional experiences.
Why Biopsychosocial Determinants Matter: Is Age Just a Number?
Authors: Steptoe Andrew
Published: December 2020

Aging is a physiological and dynamic process enduring time, which is influenced by various underlying mechanisms occurring within the biological, psychological and social spheres. We investigated biopsychosocial determinants of subsequent health and mortality in the English Longitudinal Study of Ageing (ELSA) (Steptoe). Cognitive impairment and dementia, particularly Alzheimer’s disease (AD), represent significant challenges to individuals, families and healthcare. We found an indication of socioeconomic differentials influencing the mediating biological and psychological pathways in relation to subsequent cognitive health, which was ascertained with a latent g factor across various cognitive domains in the Harmonised Cognitive Assessment Protocol in ELSA (Cadar). We also identified an interplay between socioeconomic markers and genetic factors influencing the time of dementia and Alzheimer’s disease (AD) diagnosis in individuals from the English Longitudinal Study of Ageing, particularly in those with a polygenetic predisposition to AD (Ajnakina). Within the same cohort, we found that participants who transitioned into a single household due to divorce or bereavement had a higher risk of mortality (Abell). The adverse health outcomes associated with loneliness are well documented, but less is known in terms of hospitalization and accessing health care. In the Healthy Ageing in Scotland (HAGIS), we found an increased hospitalization for older individuals reporting higher loneliness (Douglas); and various loneliness patterns in relation to age, gender, marital status and socioeconomic status in participants from first wave of the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) (Neville). Our findings highlight the imperative need for policy interventions and tailored strategies.
Overview of the English Longitudinal Study of Ageing
Authors: Steptoe Andrew
Published: December 2020

The English Longitudinal Study of Ageing (ELSA) is a unique and rich resource of information on the health, social, wellbeing and economic circumstances of the English population aged 50 and older. The current sample contains data from up to nine waves of data collection covering a period of seventeen years (2002-2019). The multidisciplinary and longitudinal nature of the data allows the examination of complex relationships and causal processes. The survey data are designed to investigate a broad set of topics to help understand the ageing process. These include predictors of well-being, health trajectories, disability and healthy life expectancy, the determinants of economic position in older age, the links between socioeconomic status, physical health and functioning, cognition and mental health, the nature and timing of retirement and post-retirement labor market activity, household and family structure, social networks and social supports; patterns, determinants and consequences of social, civic and cultural participation.
Breaking the Silence Associated With Death and Dying: New Directions in End-of-Life Research
Authors: Stemen Sara , Lichtenberg Peter
Published: December 2020

Conversations surrounding end-of-life care and bereavement continue to remain relatively silenced within gerontology and the general population. The purpose of this symposium is to break the silence associated with death, dying, and bereavement by sharing emerging perspectives and interventions related to end-of-life experiences. This symposium features four presentations that examine bereavement and end-of-life care from the viewpoints of individuals, families, practitioners, and researchers. Carr provides a comprehensive overview of the current state of research regarding death, dying, and bereavement - mapping out how current technological and demographic shifts have changed the nature of end-of-life experiences. Stemen presents an illustrative case study that examines how cause of death (e.g., chronic illness, suicide) shapes grief and subsequent social relationships for surviving individuals. Utz explores conversations that occur between families and professionals embedded within the hospice system, showcasing reactions from families who experienced live discharge from hospice services. Last, Ogle sheds light on the roles taken on by state tested nursing assistants (STNAs) in end-of-life care as well as the training and education they receive and need on end-of-life issues. Lichtenberg, our discussant, will tie these emerging perspectives together in order to initiate an important dialogue with attendees regarding the actions needed to break the silence associated with death and dying so that we can better serve individuals, families, and professionals.