bluuebunny/crossref_metadata_2025 huggingface dataset:
LATE-LIFE PLASMA PROTEINS ASSOCIATE WITH PREVALENT AND INCIDENT FRAILTY: A PROTEOMIC ANALYSIS
Authors: Liu Fangyu , Austin Thomas , Schrack Jennifer , Walston Jeremy , Mathias Rasika , Coresh Josef , Walker Keenan
Published: December 2023

Proteomic approaches have unique advantages in the identification of biological pathways that influence physical frailty, a multifactorial geriatric syndrome predictive of adverse health outcomes in older adults. To date, few proteomic studies included prefrailty as a separate state or follow the participants for incident frailty. We evaluated 4955 plasma proteins (log 2-transformed and standardized) measured using SomaScan in the Atherosclerosis Risk in Community (ARIC) study. We used multinomial logistic regression models for the cross-sectional associations of the proteins with prefrailty and frailty as two distinct states (N=3838), and logistic regression models for the longitudinal associations with incident frailty over the 6-year follow-up (N=1708). After adjusting for demographics, health indicators, and comorbidities, 136 and 186 proteins were cross-sectionally associated with prefrailty and frailty, respectively, after Bonferroni correction (p< 1.01x10-5); 24 and 84 of which were replicated in the Cardiovascular Health Study (CHS) using the same models (FDR p< 0.05). Notably, higher odds of prefrailty and frailty were observed with higher concentrations of growth differentiation factor 15 (GDF15; OR[discovery]=1.50 and 2.17, respectively), transgelin (TAGLN; OR[discovery]=1.43 and 2.43, respectively), and insulin-like growth factor-binding protein 2 (IGFBP2; OR[discovery]=1.43 and 2.08, respectively), and lower concentration of growth hormone receptor (GHR, OR[discovery]=0.70 and 0.47, respectively). Longitudinally, triggering receptor expressed on myeloid cells 1 (TREM1) predicted incident frailty (OR[discovery]=1.64). Pathway and upstream regulator analyses revealed that mechanisms related to lipid metabolism, axonal guidance, inflammation and cell senescence became dysregulated in the prefrail stage and persisted into frail stage, offering new insights into frailty etiology and targets for early intervention.
PROSPECTIVE MULTI-OMIC ANALYSIS OF HUMAN LONGEVITY COHORTS IDENTIFIES ANALYTE NETWORKS ASSOCIATED WITH LONGEVITY
Authors: Pflieger Lance , Watanabe Kengo , Robinson Max , Glusman Gustavo , Lapidus Jodi , Fiehn Oliver , Moritz Robert , Rappaport Noa
Published: December 2023

Serum based biomarkers of longevity have long been sought to explain the mechanisms of healthy aging and longevity. Using a 1:3 case cohort design, the Longevity Consortium has produced untargeted mass spectrometry based proteomic and metabolomic datasets from serum of four cohorts with longevity status, defined as those that reached the age corresponding to the 98th percentile of survival using sex specific and birth cohort specific survival percentiles. The cohorts are the Osteoporotic Fractures in Men study, the Study of Osteoporotic Fractures, the Health, Aging, and Body Composition Study, and the Cardiovascular Health Study. In this study, we integrate metabolomics and proteomics using machine learning and system biology approaches to construct multi-omic signatures predictive of longevity and healthy aging. We identify networks enriched for biomarkers previously shown to be associated with longevity such as apolipoproteins, along with novel associations, and we further compare with our findings in a mouse omics LC dataset of molecular changes induced by life-extending interventions. We show substantial differences between male and female longevity networks. The study highlights the effectiveness of using integrative systems biology methods to capture the heterogeneity of underlying molecular aging phenotypes, in order to generate a robust signature of longevity. The identified biomarker signatures may have significant implications for the development of personalized interventions aimed at promoting healthy aging and preventing age-related diseases.
INTERRUPTED TIME SERIES ANALYSIS OF THE 2015 DUTCH LONG-TERM CARE: ACUTE HOSPITAL UTILIZATION OF OLDER ADULTS
Authors: Wammes Joost , Bakx Pieter , Wouterse Bram , Buurman Bianca , Murphy Terrence , Vroomen Janet MacNeil
Published: December 2023

In 2015, the Dutch government implemented a long-term care (LTC) reform primarily designed to promote older adults (≥65 years old) to age-in-place. Increased proportions of older adults living in the community may have resulted in more and longer acute hospitalizations. We evaluated the reform’s association with the monthly rate of acute clinical hospitalization and monthly average hospital length of stay (LOS), using an interrupted time series design of national hospital data (2009 to 2018) that controlled for population growth and seasonality, and calculated adjusted incident rate ratios (IRR). The pre-reform trend of hospitalization rate was increasing (IRR 1.002, 95% CI 1.001-1.002). A positive average reform effect was observed (IRR 1.116, 95% CI 1.070-1.165), accompanied by a negative change in trend (IRR 0.996, 95% CI 0.995-0.998). This resulted in a decreasing trend over the post-reform period (IRR 0.997, 95% CI 0.997-0.999). The pre-reform trend of LOS was decreasing (IRR 0.998, 95% CI 0.997-0.998), and the 2015 reform exhibited a positive change in trend (IRR 1.002, 95% CI 1.002-1.003). This resulted in a stabilization of LOS in the post-reform period (IRR 0.999, 95% CI 0.999-1.00). Our findings suggest that the increase in the rate of acute hospitalization after the reform implementation was temporary, whereas the LOS appeared to be longer than expected.
A MOBILE HOME HEALTH CARE PHYSICIAN FOR OLDER PERSONS WITH EXTENSIVE HEALTH CARE NEEDS
Authors: Emmesjö Lina , Hallgren Jenny , Aslan Anna Dahl , Gillsjö (Gillsjo) Catharina
Published: December 2023

Background

The rapidly increasing older population with extensive care needs has shifted health care from institutions to the older person’s home. A cross-organisational integrated care model was created by health care authorities to meet these challenges, the Mobile integrated care model. The Mobile integrated care model with a home health care physician is a collaboration between regional and municipal health care, working in the patients’ home.

Methods

Semi-structured interviews with patients, next of kin and health care professionals.

Results

The home was described by all as the best place to provide health care to these patients, creating safety and increasing autonomy for the patients. The health care professionals found trust in working together as a team, but struggled because of the divided organizations. Patients and next of kin found the Mobile integrated care model to be hierarchic, where the structure sometimes improved participation, and at other times prevented it.

Conclusion

All participant groups emphasized that there was a need for more time for the health care personnel to spend with the patients. Furthermore, the patients and next of kin longed for a personal contact and being able to form a relationship with the health care personnel. The health care professionals found being employed by separate organizations as a challenge, where divided documentation systems and lack of equipment hindered the work.
RELIGIOSITY AND THE CONTROL OF DIABETES MELLITUS TREATMENT IN THE ELDERLY
Authors: Sales Juarez , Volpe Cris Renata , Lima Luciano , Stival Marina , Funghetto Silvana
Published: December 2023

Introduction

Diabetes Mellitus (DM) is an important health problem that affects thousands of Brazilians. Patients affected by the disease have many difficulties in following the correct treatment. Many studies point to religiosity as a factor that influences the health conditions of individuals. Objective: The study aimed to evaluate the influence of religiosity on diabetes mellitus treatment control in the elderly. Method: This is an outpatient-based explanatory cross-sectional study, in which a quantitative approach was taken. The study was conducted with 72 elderly people treated in primary health care in the Federal District. The instrument to evaluate the religiosity of the elderly was constructed through the defining characteristics and related factors of the NANDA-I nursing 6 diagnosis of impaired religiosity.

Results

Environmental barrier to the practice of religion was found to be a risk factor for DM treatment uncontrolled.

Conclusion

Religiosity plays an important role in the lives of the elderly, so it is becoming increasingly important to conduct research that assesses the importance of religion in the health-disease process of individuals. Nevertheless, nursing professionals must be attentive to this field of life attribute of the elderly and always encourage better relations of the patient with his religiosity.
ACCELEROMETRY-BASED PHYSICAL ACTIVITY (MIMS/DAY) AND FALL RISK APPRAISAL MATRIX IN OLDER ADULTS
Authors: Choudhury Renoa , Park Joon-Hyuk , Banarjee Chitra , Fukuda David , Xie Rui , Stout Jeffrey , Thiamwong Ladda
Published: December 2023

Fall Risk Appraisal Matrix (FRAM) is vital for understanding the discrepancy between perceived fall risk (i.e., Fear of Falling, FOF) and physiological fall risk (i.e., balance performance) in older adults. However, little is known about how habitual physical activity (PA) levels, expressed in Monitor Independent Movement Summary (MIMS) units, differ across FRAM categories. This cross-sectional study examines the associations of FRAM and wrist-worn accelerometer-based daily PA in community-dwelling older adults. FOF (Short FES-I scale), balance performance (BTrackS Balance) and PA data (ActiGraph GT9X) were collected from 156 older adults (Mean age = 76.74±9.62 years). FRAM categorizes the participants into four groups: i) Rational (low FOF-normal balance), ii) Incongruent (low FOF-poor balance), iii) Irrational (high FOF-normal balance), and iv) Congruent (high FOF-poor balance). PA data were summarized as MIMS/day (the average of daily MIMS) and peak 30-minute MIMS (the average of highest 30 non-consecutive MIMS minutes/day, representing a PA index of higher intensity epochs). Differences across groups were examined using one-way analysis of variance (ANOVA). Results indicate that, total accumulated PA (i.e., average daily MIMS) was 17% lower in Congruent FRA group than Rational FRA group (p=.02). The peak PA effort (i.e., peak 30-minute MIMS) decreased in Incongruent (9%, p=.027), Irrational (12%, p=.002) and Congruent (16%, p=.003) groups as compared to the Rational FRA group. Our results suggest that fall intervention strategies should integrate both cognitive behavioral therapy (for reducing FOF) and balance exercises to promote high-intensity PA in older adults.
ADHERENCE TO INTERVENTIONS AT A FALL CLINIC: PRELIMINARY DESCRIPTIVE DATA FROM A SINGLE ACADEMIC INSTITUTION
Authors: Shichijo Yuka , Ko Fred , Slon Renee , Rughwani Nisha , Yamada Yuji
Published: December 2023

Background

Falls and fall-related injuries are major public health concerns. Approximately 50 billion dollars are spent on annual medical costs related to falls. Fall prevention is a priority for promoting active and healthy aging in older adults. Fall prevention clinics enable focused evaluation, identification, and treatment of modifiable risk factors, specifically for falls; however, their effectiveness is dependent upon patient adherence to preventive interventions.

Methods

We analyzed patients aged > 65 years who visited our fall clinic between February 2021 and February 2023. We took an interdisciplinary approach to improve adherence to recommendations, including follow-up phone calls by a dedicated nurse to confirm adherence, nurse-directed interventions such as Tai Chi sessions, and home environment assessments by a social worker.

Results

48 patients were included in this analysis, with a mean age of 84 (65-99), and 85% were female. Fall-specific risk factors identified included impairment of strength, gait, or balance (96%); use of fall-risk-increasing medications (54%); problems with feet affecting gait (40%); visual impairment (29%); and postural hypotension (6%). The adherence rates for our interventions were 48% for physical therapy referrals, 28% for podiatry referrals, 36% for ophthalmology referrals, 47% for other referrals, 75% for vitamin D prescriptions, and 50% for assistive device prescriptions.

Conclusions

There is room for improvement in adherence to referrals. A larger sample size and longer follow-up period are required to investigate factors related to non-adherence. The delivery of both verbal and written recommendations, the identification of each patient’s barriers, and same-day referrals may help improve adherence.
ARE COMPLETING ONLINE ASSIGNMENTS CORRELATED TO KIRKPATRICK’S LEVEL 2 AND 3 LEARNING OUTCOMES?
Authors: Cheng Huai
Published: December 2023

Background

Pre-class assignments such as online assignments are critical to a flipped classroom-based curriculum. However, it is unknown whether medical students are following online assignments and whether such compliance is associated with learning outcomes. The aim of this study was 1) to examine the compliance of the online assignments and 2) explore whether such compliance was associated with Kirkpatrick’s Level 2 and 3 learning outcomes. Summary of Works: Prior to classroom teaching, fourth-year medical students (MS4) were recommended (not required) to complete six online assignments. A simulated patient (SP) with chief complaint of fall was developed to assess students’ skills in interview, physical examination, and communication (Kirkpatrick’s level 2 learning outcome). Students’ clinical practice behavior was based on chart review (Kirkpatrick’s level 3 learning outcome). Pearson/Fisher correlations were used to examine the association of completing online assignments with SP performance and clinical practice behavior. Summary of

Results

158 from Class 2017 participated in this study. The complete rate of 1-6 online assignment was 88%, 86%, 82%, 61%, 51%, 34%, respectively. Completing three of six online assignments was significantly associated with higher SP performance, but not clinical practice behavior. Discussion and

Conclusions

Majority of MS4 didn’t complete online assignments. Online assignments should be required. Completing online assignments was associated with improving Kirkpatrick’s level 2, but not 3 learning outcomes. Take-home Messages: Online assignments need to be required. Improving Kirkpatrick’s level 2 learning outcome via a flip-based curriculum for MS4 might not improve Kirkpatrick’s level 3 learning outcomes.
ASSOCIATION BETWEEN COGNITIVE FRAILTY AND THE RISK OF FALLS AMONG OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: Wang Shanshan , Yin Yueheng , Leung Isaac Sze Him
Published: December 2023

Background

Falls lead to numerous negative health outcomes and jeopardize the physical function and quality of life in older adults. Cognitive impairment and physical frailty were found to be associated with the risk of falls, but there was no systematic review that estimated the association between cognitive frailty and the risk of falls.

Methods

A systematic literature search of the cross-sectional, cohort, and case-control studies in Cochrane library, Scopus, CINAHL, EMBASE, and PsycINFO was conducted. Study quality was assessed by using the Joanna Briggs Institute (JBI) critical appraisal tool. A random effects meta-analysis was performed to estimate the odds ratio (OR) of the incidence of falls in older adults with cognitive frailty.

Results

Seven studies were included. The overall quality of the studies was acceptable. The meta-analysis of cohort studies showed older adults aged 60 and above with cognitive frailty had a pooled OR of 1.45 (95%CI 1.30, 1.61) for at least one fall compared with those without cognitive frailty. The meta-analysis of cross-sectional studies showed that the odds of older adults with cognitive frailty experiencing at least one fall was 1.64 times (95%CI 1.51, 1.79) higher than those without cognitive frailty.

Conclusion

Cognitive frailty is significantly associated with the risk of falls. Timely detection of cognitive frailty is essential for preventing falls in older adults
CAREGIVING APPROACHES TO RESISTIVE BEHAVIORS AMONG PERSONS LIVING WITH DEMENTIA IN LONG-TERM CARE
Authors: Lee Kyung Hee , Lee Ji Yeon , Park Ji Yeong
Published: December 2023

Many older adults living in long-term care have dementia sufficiently severe to interfere with the performance of basic activities of daily living; this number is expected to increase rapidly. Although resistive behaviors are common among long-term care residents with dementia during care, caregivers face difficulty to prevent and manage them. The purpose of this study was to examine how caregivers responded to resistiveness to care of persons living with dementia. We analyzed 107 videos from 24 residents with dementia and 34 caregivers in four long-term care facilities. Each interaction between resident with dementia and caregiver was taken nine times at 0, 3, and 6 months at three care events (i.e., personal care, mealtime, and activity). Resistiveness to care was assessed using the Resistiveness to Care Scale for Dementia of the Alzheimer’s Type; caregiving approaches were coded by the Person-Centered Behavior Inventory and the Task-Centered Behavior Inventory. Lag sequential analysis was conducted to examine caregiving approaches right after resistive behaviors of residents with dementia. We analyzed 25.1 hours of care events; 544 episodes of resistiveness to care were observed. When residents with dementia showed resistiveness to care, caregivers provided person-centered behaviors in 34.4% of cases, task-centered behaviors in 35.8% of cases, and nothing in 29.8% of cases. Caregivers used task-centered care approaches or nothing to manage resistiveness to care in more than 65% of cases. It is recommended to provide person-centered caregiving approaches to deal with resistiveness to care among persons living with dementia.
EXPLORING THE IMPACT OF AN EBOOK CLUB PROGRAM ON APATHY AMONG OLDER CANADIANS IN LONG-TERM CARE: A FEASIBILITY STUDY
Authors: Agboji Aderonke , Freeman Shannon
Published: December 2023

Apathy is a common and persistent problem among older people in institutional settings. Research has shown that apathy can lead to rapid decline in cognitive status, serious functional impairments and decrease in the life span of those affected, yet it is under-researched, and under-managed. The aim of this study was to explore ways by which apathy can be mitigated in this population using eReader technology during book club program implementation. We recruited participants from various long-term care facilities (N=18) and each participants took part in semi-structured interviews, and self-reported apathy assessment both at the start and end of the program. We tracked engagement in the eBook club and time commitment to reading using a logbook. The findings suggest that older people, including persons with mild to moderate dementia, are open to adopting new technologies and the use of eReaders during book club programs is feasible for long term care facilities. Overall, we found that the use of eReader technology is a safer and more effective way of delivering book club program to older people in long term care facilities particularly during pandemic such as COVID 19 as they are easy to disinfect in comparison to physical books. We recommend that long term care staff should adapt eReaders into their existing book club or literacy programs and consider utilizing it as a strategy to prevent or manage apathy in this population.
FEASIBILITY OF THE NUDGELTC CLINICAL DECISION SUPPORT APPLICATION
Authors: Ashcraft Alyce , Owen Donna , Culberson John
Published: December 2023

Long-term-care residents are at risk for under reporting of urinary tract infections due to insufficient point-of-care testing and indirect communication. Aim: Examine the feasibility of a Clinical Decision Support application (NudgeLTC) designed to guide Licensed Vocational Nurses (LVNs) in data collection to improve communication confidence and satisfaction between LVN and Primary Care Provider (PCP). Sample size: 4 LVNs and 4 PCPs across 10 events. Qualitative description of interview comments and NudgeLTC output documented data collection and communication between LVN and PCP within the app. Forced choice questions about resident signs, symptoms, and laboratory values guided LVN data collection. Information was collected and stored within NudgeLTC. A summary was relayed directly to the PCP and followed with a PCP response to the LVN. Questionnaires included visual analogue scales for confidence (LVNs M=81.6; PCPs M=100 [0 low, 100 high]), satisfaction (LVNs M=7.8; PCPs M=10 [0 low, 10 high]), and the Systems Usability Scale (LVNs M=85.4; PCPs M=100 [0 poor, 100 high]). The NudgeLTC summary included resident assessment, vital signs, and lab values. Particular signs and symptoms noted included indwelling catheter and confusion. Select Challenges: PCP received LVN message and data, but was unable to respond via app; LVN stated the app did not work as “expected.” Transmission issues occurred and were resolved. Asynchronous communication was valued and facilitated confidence in resident data. Difficulties with data collection may, in part, be due to discomfort with technology or infrequent use of electronic charting. Future studies should focus on improving point-of- care data collection.
IMPACT OF UNIFORMS IN LONG-TERM CARE FACILITIES: SYNTHESIS OF INTERNATIONAL EVIDENCE AND SURVEY OF UK STAFF VIEWS
Authors: Liddle Jennifer , Thomson Katie , Al-Azawi Abdulwahab , Esslemont Dawn , Hanratty Barbara , Henderson Christine , Jones Louise , Wilson Lisa
Published: December 2023

Non-uniform-based staff dress codes are beginning to emerge in UK long-term care facilities for older people. However, there is little research evidence on the impact of staff clothing on resident, staff and visitor experiences, wellbeing or quality of life. Uniforms may be reassuring and facilitate identification of staff; a non-uniform approach may create a home-like, relaxed environment. This study aimed to synthesise existing international evidence and explore staff views about work clothing in three not-for-profit long-term care facilities in the UK. Five bibliometric databases were searched from inception. A narrative synthesis of included papers was conducted due to heterogeneity of study designs and outcome reporting. 77 (49%) of 158 staff responded to the survey. 68 staff (88%) did not currently wear a uniform at work. Views about the importance and impact of uniform were mixed: 25 (32%) believed that their role needed a uniform; 60 (78%) thought staff clothing made no difference in resident care quality but 45 (58%) agreed the environment felt more home-like when staff did not wear a uniform. 36 staff (47%) would choose to wear a uniform and 17 staff (22%) reported finding it difficult to afford clothes for work. In the context of limited research evidence, staff clothing is perceived to have little impact on care quality but considerable impact on long-term care facility atmosphere and staff working experiences. There is a need to research the impact of staff clothing to support evidence-based decisions about staff clothing policies in long-term care settings.
REDUCING UNPLANNED HOSPITALIZATIONS OF NURSING HOME RESIDENTS: A PROCESS EVALUATION OF INTERCARE
Authors: Zuniga Franziska , Brunkert Thekla , Basinska Kornelia , Guerbaai Raphaëlle-Ashley , Serdaly Christine , Wellens Nathalie
Published: December 2023

The INTERCARE study provided evidence for a complex intervention to reduce unplanned hospitalizations in 11 Swiss nursing homes. The six intervention components were strengthening of interprofessional collaboration, introduction of a nurse with in-depth geriatric training (INTERCARE nurse), comprehensive geriatric assessment, advanced care planning, evidence-based tools, and data-driven quality improvement. This process evaluation aims to describe the intervention components’ use in practice and understand the mechanisms of change to optimize intervention components for scale-up. We used qualitative data from individual and focus group interviews and meetings notes from the research team’s conversations with nursing home care workers and leadership, INTERCARE nurses and physicians from five nursing homes participating in the INTERCARE study. Data was extracted into spread sheets before starting inductive coding. Findings were summarized and consolidated in a conceptual model. In connection with the four intervention elements interprofessional collaboration, INTERCARE nurse, advanced care planning and evidence-based tools, we identified four intervention mechanisms, grouped into 1) those changing reasoning of care workers e.g., following a more structured approach to do things and 2) those enabling existing resources e.g., availability of a responsible contact person. We also identified behavior changes in care workers, including faster reaction to changes in resident situations, more comprehensive assessment of resident situations and improved communication which contributed to reductions in hospitalizations. Understanding how interventions work in practice is crucial for informing potential adaptations to the intervention and the implementation strategies. Our findings can help optimize the intervention components for scale-up, ultimately reducing unplanned hospitalizations from nursing homes.
WHAT IS THE DIFFERENCE BETWEEN OLDER PERSONS WHO CONTINUE HOME CARE AND THOSE WHO DO NOT?
Authors: Sumikawa Yuka , Eltaybani Sameh , Fukui Chie , Igarashi Ayumi , Yamamoto-Mitani Noriko
Published: December 2023

Enabling older people to remain in and return to their homes after hospitalization or institutionalization (i.e., admission to care institutions, such as nursing homes), if they wish so, is a key principle of aging-in-place worldwide. This prospective cohort study examined the characteristics of older people who returned to their homes after hospitalization or their stay at other care facilities. The study started with 1,450 older persons (≥75 years) receiving home care services at multiple places in Japan. Data were collected at the baseline and 6-month follow-ups. The study was approved by the Research Ethics Committee of the Graduate School of Medicine, The University of Tokyo (No. 2019087NI). At the 6-month follow-up, 256 clients (female: 152 clients, mean age: 85.1 ± 6.1) were hospitalized or institutionalized at least once, of which 54 clients (female: 38 clients, mean age: 83.6± 6.8) returned home afterward. A multivariate logistic regression showed that females (odds ratio [95% confidence interval]: 2.01 [1.06 to 4.09]), those with more care assistance (1.27 [1.03 to 1.55]) were more likely to return to their home, whereas older clients had a lower likelihood (0. 93 [0.88 to 0.98]). Based on this finding that younger females were more likely to return home if hospitalized or institutionalized, older males may have different needs than females, influencing the type and level of support they require. Further research might identify the support needed for older males with less care assistance.
ACTIVITY LEVEL AND SUCCESSFUL AGING, SUBJECTIVE AGE, AND MENTAL, PHYSICAL, AND GENERAL HEALTH
Authors: Mancilla Isabel , Rivera Lucia , Bergstrom Jaclyn , Molina Anthony
Published: December 2023

Perceived well-being refers to an individual’s subjective evaluation of their quality of life. Importantly, perceived well-being takes into account an individual’s emotional, social, and psychological health, which are all critical components of a fulfilling and satisfying life. The purpose of this study is to evaluate the correlations between activity level from the International Physical Activity Questionnaire (IPAQ) and self-reported outcomes related to perceived well-being (successful aging, subjective age discrepancy), and mental, physical, and general health outcomes from the 36 Item Short Form Survey (SF-36). We utilized existing data from 595 individuals aged 50 years or older enrolled in UC San Diego’s Successful Aging Evaluation (SAGE) study. Participants were stratified into low, medium, and high activity levels from the IPAQ. Groups were then compared to self-rated successful aging, subjective age questions, and the SF-36. Our results indicate that increased physical activity is positively associated with subjective successful aging. We observed a significant linear trend in IPAQ physical activity correlated to mental health (p=.0242), physical health (p=<.0001), and general health (p=(<.0001). A possible limitation of this study includes that of the 595 participants, 81% of participants identified as Caucasian. It is critical for future studies to incorporate a more diverse sample size to accurately present future findings. Understanding the factors that influence perceived well-being can lead to strategies for improving the overall outlook to support successful aging.
DETERMINANTS OF PHYSICAL ACTIVITY IN COMMUNITY-DWELLING OLDER ADULTS: AN UMBRELLA REVIEW
Authors: D’Amore Cassandra , Saunders Stephanie , Bhatnagar Neera , Griffith Lauren , Richardson Julie , Beauchamp Marla
Published: December 2023

Physical activity (PA) is an important modifiable factor for noncommunicable diseases, mental health, and functional trajectories as we age. The World Health Organization highlights the need to mobilize policies targeted toward modifiable determinants of healthy aging. Therefore, understanding the current evidence for PA determinants is crucial to achieving these goals. This umbrella review aimed to summarize the determinants of PA in older adults. A research librarian searched six databases. Systematic and scoping reviews were included if they investigated community-dwelling people with a mean age of 60 years or older and examined a relationship between any type of PA and a determinant. Two independent reviewers screened 17,277 references and 11 reviews were ultimately included. Of the countries reported, 78% were high-income and zero were lower-income countries. Three of the eleven reviews focused on specific clinical populations living in the community. Only 6% of studies included in all reviews had longitudinal designs. Included studies focused on a variety of types of PA (e.g., total PA, walking, leisure-time PA) and measures of PA, with 76% using self-report, 15% using direct measures (e.g., accelerometry), 3% using both types, and 6% with no outcome measure reported. Physical environment determinants were the most commonly assessed (6/11) with more than 70% of the summarized relationships demonstrating null associations. Three out of four reviews reported a positive relationship between walkability and PA in general community-dwelling older adults. Further prospective longitudinal studies are needed to improve our current understanding of the determinants of PA in community-living older people.
TELEMEDICINE CONSULTATIONS IN SWEDEN 2020–2022: EXPLORING AGE DIFFERENCES
Authors: Gabrielsson-Järhult Felicia , Kåreholt Ingemar
Published: December 2023

Health care in Sweden is heavily subsidized and costs for the user are small, both for physical consultation and telemedicine, and for public and private health care. It has been argued that telemedicine consultations will increase care consumption, lead to higher costs, and create inequalities. As older people often are less skilled in digital technology, increased digitalization of care might increase inequalities. Telehealth is mainly conducted by private companies. This study is based on all private telemedicine consultations in two regions in southern Sweden 2020-2022, with approx. 656,000 inhabitants. 106,000 persons had 343,000 telemedicine consultations, 3.2 consultations p/p. The number of consultations differed neglectable between age groups, for women median was 2.0 for the age groups (< 65/65-79/80+), and for men it was 1.0. The proportion of people WITH telemedicine consultations differed heavily between the age group as well as months. Total number of telemedicine consultations per month varied 4-8.5 thousand among women, and 2-4 thousand among men. The months with most consultations were March-June 2021. Proportion of telehealth consultations was low in the age group 65-79, and even lower among 80+. The proportion of consultations by people 65-79 years increased steadily and reached its peak July-September 2021 with >20%. After that, it increased rapidly down to < 3% among women and < 4% among men. The pattern was similar among people 80+ with peaks at approx. 2% among women and close to 2% among men. The conclusion is that there is still a huge age difference in the use of telehealth consultations.
AGEISM IN THE LABOR MARKET: LEARNING AND EDUCATION FOR OLDER ADULT JOB SEEKERS
Authors: Jin Bora , Baumgartner Lisa
Published: December 2023

Despite older workers’ value to an organization and no differences in job performance or productivity from younger workers (Rego et al., 2018), older job seekers encounter ageism in employment during their job search (Zaniboni et al., 2019). Ageism in employment and the workplace have detrimental effects on older job seekers, organizations, and society. Therefore, this conceptual paper explores the financial, emotional, psychological, and physical factors that should be considered when supporting older job seekers in navigating reeducation and learning to obtain employment. We collected and reviewed extant literature on this topic by consulting the following databases: EBSCOhost, PsycINFO, Google Scholar, and PubMed and using search terms such as “older adult,” “workplace,” “ageism,” “employment.” Ageist practices and stereotypes can occur at any stage of the employment process, including application, interview, hiring, training, job duties, benefits, downsizing, or termination. Older job seekers or employees may experience age discrimination in the workplace directly (e.g., if employers consider candidates cannot project the youthful image that the business desires, they may decline to offer the position) or indirectly (employers reject older applicants for a job because of their overqualification). We provide practical implications for older job seekers by exploring workplace learning strategies for older adults, including peer mentoring, intergenerational learning (Arthanat, 2019), proactive personality, and effective job search activity (Zacher, 2013). In addition, we discuss how older workers need to see the relevance of tasks to be individually motivated to learn and explore the need for personalized learning programs (Seo et al., 2019).
DEFINING OLD AGE IN SUB-SAHARAN AFRICA: THE PERSPECTIVE OF AFRICAN SCHOLARS AND PROFESSIONALS
Authors: Ashirifi Gifty , Teshome Abraham , Adamek Margaret , Adeniji Dolapo
Published: December 2023

The older adult population in Africa is projected to experience the fastest growth rate among regions in the world. Although in most Global North nations, 60-65 is considered old, the issue of what age should be accepted as “old” in Sub-Saharan Africa has remained a controversial issue with governments and scholars. The imminent increase in aging in Africa is a call for action since age definition is directly linked to access to programs and policies necessary to ensure older adults’ well-being. Through an online survey, this study investigated the perspectives of Gerontology and Social Work professionals from Sub-Saharan Africa (n=78, 55% female, age range 24-75) on what age should be accepted as “old” or “elderly” for policy development and research purposes. A descriptive analysis indicated that the most endorsed old age marker in Sub-Saharan Africa was 50 years old (33.3%) ---a full decade lower than the United Nation’s designation of old age. The primary factors respondents indicated should be considered when defining old age in Sub-Saharan Africa are health status (73.6%), retirement age (61.1%), and quality of life (56.9%). Age 60 was identified as the most appropriate age to determine eligibility for aging programs (45.1%) and for conducting research on later life (43.5%). We recommend that age guidelines used in Global South regions such as Sub-Saharan Africa should not necessarily mirror the guidelines for age used in the Global North but should fit the context of aging in those regions.
IS MIDDLE-AGED INEQUITY LIKELY TO PERSIST INTO OLD AGE?: TRAJECTORIES OF SOCIAL EXCLUSION IN KOREA
Authors: Jung Jae Yeon , Nam Seok In
Published: December 2023

Korea has the highest rate of older adult poverty among the OECD countries. The poverty of the older adult continues even with the government’s policies, as the loss of social roles, the reduction of the network, and the difficulty of escaping exclusion are complex. The goal is to find out how the trajectory of social exclusion changes as people get older. We used the data of the Korean Longitudinal Study of Ageing conducted by the Korea Employment Information Service. The target population is middle-aged people aged 45 to 52 (based on the first year), mainly the baby boom generation in Korea, and the total number of cases included in the analysis is 1,348. The trajectory of social exclusion change for 14 years from 2006 to 2020 was confirmed by composing on into economics, health, employment, housing, and social relationships. The group-based multi-trajectory model analysis was performed using Stata 16.1. The groups were identified as four: the low exclusion continuous maintenance group, the employment high exclusion maintenance group, the economic/housing high exclusion maintenance group, and the multi-domain high exclusion continuous maintenance group. All four types showed a tendency to maintain social exclusion from middle age until old age. Factors that caused differences between groups were gender, residential area, marital status, education, and income. These findings suggest that as people get older, the cumulative inequity in their lives becomes more pronounced. As a result, it will provide important clues for establishing policies for the welfare of older adults and alleviating social inequality.
APPLICATION OF A NEW TOOL FOR PLANNING IMPLEMENTATION EVALUATIONS IN CLINICAL TRIALS
Authors: Mills Whitney , Thomas Kali , Huang Yuan , Wininger Michael , Hummel Scott
Published: December 2023

The VA Cooperative Studies Program (CSP) study “Geriatric OUt-of-hospital Randomized MEal Trial in heart failure – Veterans Affairs” (GOURMET-VA) is a randomized, single-blind, multi-center, clinical trial investigating the effects of home-delivered meals in Veterans discharged from hospitalization for heart failure. GOURMET-VA is one of the first CSP studies to integrate implementation scientists during protocol planning. We describe how the three phases of the new Implementation Planning Assessment (IPA) Tool was used proactively to guide planning of the implementation evaluation for the trial, oriented towards future adoption and sustainment of the intervention. Phase 1 (“Planning, Framing, & Aligning Interested Parties”): During early protocol development, the implementation team helped identify and facilitated meetings with relevant VA national leadership. These meetings resulted in plans for engagement throughout the trial and input on trial design. Phase 2 (“Implementation Process Data Collection”): Guided by IPA, the implementation evaluation uses mixed methods to understand the context into which the intervention is being implemented, experiences of Veterans and clinicians with the intervention, and barriers and facilitators to implementation at the patient, healthcare provider, and leadership levels. Phase 3 (“Planning for Sustainment of Effective Trials”): A preliminary dissemination and sustainability plan was drafted, including how the implementation evaluation data may be used to inform adaptations of the GOURMET-VA intervention to improve effectiveness and uptake. We found that the structured guides that comprise the IPA were valuable in helping the implementation scientists and the trial team to find common ground in terms of rationale, methods, and language.
REPEAT AND SERIAL EMERGENCY DEPARTMENT (ED) OLDER ADULT USERS—A STATE-LEVEL ANALYSIS USING THE NYU-JHU ALGORITHM
Authors: Kelekar Uma , Gupta Debasree Das , Abdesslem Amel Ben , Tran Diep , Shepherd Jewel , Turner Sidney
Published: December 2023

Older adults account for 12-24% of all Emergency Department (ED) visits and studies have shown a 25-35% increase in older adult ED visits over time. While some studies have analyzed ED encounters over a single healthcare system, a year or a specific condition, research comparing the long-term frequent use of the ED across cohorts of older adults in the United States is limited. We address this gap by identifying characteristics associated with repeat (>1 visit during the time period) and serial/frequent (>=4/year) ED utilization for Maryland. Using the 2017-2019 State Emergency Department Databases (SEDD), we extracted ED visits among the elderly (>=60 years) population. By applying the modified New York University Algorithm by John Hopkins University (NYU-JHU-EDA), we classified ED visits into 11 categories, and we conducted bivariate and multivariate analyses to identify inter-age variations in the type of visits to the ED across single, repeat and serial users, after controlling for covariates. Of the total 5,331,843 ED visits between 2017 and 2019, 1,244,878 (~23%) were older adult visits. Relative to the 60–69-year-olds, those 80 and above had higher odds of being repeat users for emergent issues [OR=1.34, CI:1.07-1.67], primary-care treatable condition [OR=1.29, CI:1.03-1.62], and severe [1.30, CI: 1.03-1.64] and non-severe injuries [1.61, CI:1.28-2.01]. Relative to 60-69 year olds non-serial users, the oldest cohort demonstrated lower odds for psychiatric/alcohol and drug-related diagnoses [OR=0.63, CI:0.42, 0.95]. Our findings highlight the need to design age-group specific interventions to reduce the frequent ED utilization among the elderly in Maryland.
BEHAVIORAL HEALTH PREDICTORS OF PREMATURE MORTALITY IN A BLACK AMERICAN LONGITUDINAL COHORT
Authors: Green Kerry , Bugbee Brittany , Doherty Elaine
Published: December 2023

Life expectancy among Americans is now the lowest it has been in 15 years. While startling, more alarming are the persistent racial disparities in mortality. Black Americans continue to die at significantly younger ages with Black men living, on average, 7.0 fewer years and Black women living 4.4 fewer years than their White counterparts. To inform intervention strategies and resource allocation, we need a complete understanding of the role that malleable factors, such as substance use and depression early in the life course, play in premature mortality for aging Black Americans. This study illuminates behavioral health factors that can be targeted to eliminate mortality disparities among a longitudinal cohort followed from childhood into their 60s. Utilizing data from the Woodlawn Study, a well-defined neighborhood cohort study of 1,242 Black Americans that began in 1966 (age 6), we examined the predictive value of family history of substance use, adolescent substance use and depression, and young adult substance use and depression. Through 2021 (modal age 61), based on National Death Index reports, 21.6% of the original cohort (n=268) has passed away. The poster will present cause and timing of death by gender and adjusted logistic regression findings showing that depression symptoms as early as adolescence (age 16) predict midlife mortality occurring between ages 32 and 60 (p=.003) and that those diagnosed with depression or a substance use disorder in young adulthood are 61% (p=.025) and 85% (p=.001) more likely to die by age 60. Policy and prevention implications will be presented.
INTERSECTION OF RACE AND PLACE-BASED DISPARITIES AMONG 65+ IN MISSISSIPPI
Authors: Jansen Taylor , Su Yan-Jhu , Lee Chae Man , Silverstein Nina , Dugan Elizabeth , White Kina
Published: December 2023

Disparities in healthy aging have been attributed to race, gender, SES, and zipcode. The Mississippi Healthy Aging Data Report (HADR) is a new resource in the state to advance age-friendly progress reporting 150 indicators related to healthy aging for 82 counties. The present study explored how race and place may be associated with community health outcomes. The main data sources include the American Community Survey, the Behavioral Risk Factor Surveillance System, and the Centers for Medicare and Medicaid Services. Bivariate statistical analyses and mapping were conducted to compare the 65+ population in Mississippi living in rural (N=65) and urban areas (N=17); counties with high (N=44) and low (N=38) proportions of 65+ black residents; and high and low black populations by rural (high: N= 38; low: N=27) and urban counties (high: N=6; low: N=11). Bivariate analyses found that the rural counties with high proportions of 65+ black residents reported consistently worse rates for 26 out of 28 indicators of healthy aging. ArcGIS Mapping demonstrated that the Mississippi rural, black population tended to be centralized to the Delta region, a historically impoverished area. This population reported the highest rates of chronic conditions and poverty, lowest rates of education and life expectancy, and the lowest access to primary care providers and hospitals. This study underscores the importance of data tools like HADR to improve healthy aging for everyone. Understanding the distribution of community rates makes disparities evident and may help practitioners and policymakers to allocate resources to areas of highest need.
RHYTHM AND NATURE: APPLYING TRAUMA-INFORMED APPROACHES TO RESEARCH TO PRIORITIZE CHOICE, EXPRESSION, AND JUSTICE
Authors: Ihara Emily , Hand Michelle
Published: December 2023

Trauma-informed approaches are widespread in direct clinical and particularly in social work practice, and have gained momentum in other areas such as research, organizational culture, supervision, and leadership. Given the recent collective global trauma of the pandemic and the cumulative effects of historic and ongoing racial injustice, a trauma-informed approach to research with older adults, especially with those who have disabilities, such as relating to dementia, can contribute to the movement for access, justice, equity, and inclusion for all. Closely aligned with practices of community-based participatory action research, trauma-informed research pays particular attention to the consideration of the design of studies, the analytical and theoretical frameworks, collaboration among researchers and participants, data collection methods, research questions that capture the knowledge and experiences of participants’ resiliency, strengths, and challenges, and the processes of reflexivity. Rhythm & Nature was a 10-week pilot study designed to incorporate trauma-informed research approaches to promote principles of safety, trustworthiness, collaboration, choice, self-expression, and justice. We created a modifiable drumming and nature-based intervention to promote opportunities for self-expression and confidence. Before and after each drumming and nature-based session, we collected data using emojis (e.g., to increase access for people with limited language or literacy) to indicate how participants felt in the moment and used their ongoing feedback to continuously tailor the program to their unique abilities and needs. Both quantitative and qualitative results of this pilot study and implications for future research, policy, practice and education with older adults, particularly with disabilities, will be discussed.