bluuebunny/crossref_metadata_2025 huggingface dataset:
CAREGIVER HEALTH LITERACY AS A MODIFIABLE TARGET TO PROMOTE OLDER ADULT HEALTH
Authors: O'Conor Rachel , Eifler Morgan , Opsasnick Lauren , Curtis Laura , Benavente Julia Yoshino , Lindquist Lee , Wolf Michael
Published: December 2022

Many older adults receive assistance in managing chronic conditions. Yet complicating the utility of caregiver support is whether caregivers have sufficient skills to aid in a patient’s self-care. Health literacy (HL) is as an important determinant of older adults’ health outcomes, but few studies have examined caregiver HL and patient outcomes. We interviewed 162 patient-caregiver dyads during an ongoing cognitive aging cohort study to examine associations between caregiver HL, measured using the Newest Vital Sign, and older adults’ health outcomes. Physical function and mental health symptoms were assessed using PROMIS short form assessments. Patients’ also self-reported emergency department (ED) visits and hospitalizations over the past 12 months. Chi-square and t-tests were performed, as appropriate. Patients were on average 73 years old and managing 4 comorbidities. The majority were female (70%), identified as Black (35%) or White (60%). Caregivers’ mean age was 64 years; half were female (56%) and had limited HL (48%). Limited caregiver HL was associated with poorer physical function (M=43.0 (8.5) vs. M=46.0 (9.1), p=0.05), greater comorbidities (M=4.0 (1.9) vs M=3.3 (1.8), p=0.02) and more ED visits in the past year (36.7% vs. 19.3%, p=0.01). No differences by caregiver HL were observed for patients’ mental health or hospitalization. Findings suggest that caregivers with limited HL are caring for medically complex patients, and further research should examine whether limited caregiver HL leads to poorer self-management of chronic conditions. The development of HL training for caregivers may better equip them to assist older adults and improve older adult health.
FACTOR STRUCTURE OF PRE-LOSS GRIEF-12 IN CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Park JuYoung , Galvin James
Published: December 2022

While several studies on post-loss grief have been conducted, little research has examined assessment and treatment for pre-loss grief in family caregivers of persons living with dementia (PLWD). A total of 699 caregivers of PLWD were recruited through relevant dementia associations. The recruitment e-mail provided information about the study and instructions on how to participate by a link to the online survey. Confirmatory factor analysis (CFA) was performed to test the fit of the data from the caregivers and to assess the factor structure of the Prolonged Grief-12 (PG-12) to evaluate pre-loss grief accurately by identifying relevant items and eliminating items that are not appropriate for caregivers of PLWD to assess pre-loss grief accurately. CFA was conducted via the Full Information Maximum Likelihood estimation method to test the unidimensional model of the PG-12 in the study population. The initial model was modified to develop a better-fitting model and to detect misfitting parameters in the PG-12 by deleting irrelevant items for caregivers of PLWD. The adjusted dementia-specific 10-item version (PG-10-D) had significantly improved fit indices with RMSEA = .064, CFI = .972, and GFI = .963. An overall assessment of fit indicated that the model adequately approximated the data. Factor loadings ranged from 0.53 to 0.85. This study suggests that the dementia-specific, unidimensional PG-10-D, modifying the original PG-12, may be useful and parsimonious in assessing and quantifying pre-loss grief in caregivers. Further research is required to establish psychometric properties, including factorial validity and reliability, factorial invariance analysis and further factor analysis.
COGNITION IN CONTEXT: INVESTIGATING THE ROLE OF BUILT, SOCIAL, AND NATURAL ENVIRONMENTS IN COGNITIVE AGING
Authors: Finlay Jessica , Clarke Philippa , Besser Lilah
Published: December 2022

While a growing body of evidence points to potentially modifiable individual risk factors for Alzheimer’s Disease and Related Dementias (ADRD), the contexts in which people develop and navigate cognitive decline are largely overlooked. Geographic variation in ADRD rates suggest that environmental risk and protective factors may be important in cognitive aging and dementia caregiving. Community hazards are often heavily concentrated in underserved and underrepresented neighborhoods. This symposium aims to identify specific built, social, and natural environmental features associated with cognitive aging outcomes. The papers provide much-needed evidence on the role of neighborhoods and community networks for cognitive health and well-being among diverse older adults. First, Godina finds significant associations between neighborhood greenspace and microstructural indicators of brain health. Second, Westrick investigates the role of neighborhood disadvantage on long-term memory aging of older adults with and without a cancer diagnosis in later-life. Third, Finlay presents a new concept of Cognability to demonstrate which constellation of positive and negative neighborhood features may contribute most to healthy cognitive aging. Fourth, Nkimbeng identifies community networks and resources needed to inform dementia education and support care among African immigrants. Fifth, expert discussant Besser will share how these findings may inform upstream health promotion and reduce ADRD risk. She will discuss critical future research directions and methods to investigate environments of cognition. The symposium advances research assessing contexts of aging, and may inform public health and policy efforts to ameliorate community barriers and create more equitable opportunities to promote healthy aging in place.
DOES NEIGHBORHOOD DISADVANTAGE ALTER MEMORY AFTER A CANCER DIAGNOSIS? A US HEALTH AND RETIREMENT STUDY
Authors: Westrick Ashly , Ospina-Romero Monica , Clarke Philippa , Kobayashi Lindsay
Published: December 2022

We aimed to determine the influence of neighborhood socioeconomic status (NSES) on long-term cancer-related memory decline of older adults. Incident cancer diagnosis and memory were assessed in the U.S. Health and Retirement Study (N=15,074, 1998-2016). Proportion of female-headed households with children, households with public assistance income, people with income below poverty, and proportion 16+ years unemployed was categorized into NSES tertiles. Linear mixed-effects models compared the standardized memory trajectories by cancer status and NSES. Cancer-free individuals living in more disadvantaged neighborhoods had worse mean memory function at age 75 and steeper memory declines than participants from less disadvantaged neighborhoods. An incident cancer diagnosis was associated with an acute memory drop at diagnosis for those living in the least disadvantaged neighborhoods. Cancer survivors had better memory prior to but not after diagnosis compared to cancer-free individuals across NSES. These findings could inform future interventions to promote cancer survivor’s long-term aging.
IMPACT OF COVID-19 MITIGATION POLICIES: LESSONS LEARNED FROM US AND MIDDLE-HIGH INCOME COUNTRIES
Authors: Zanwar Preeti , Vinod Joseph K J , Omar Zaliha , Santos Flavia , Zazdravnykh Evguenii , Heyn Patricia , Perianayagam Arokiasamy
Published: December 2022

The COVID-19 pandemic has been a natural global epidemiological experiment unique to our century and a massive shock to older adults and to systems that care for them. There was a lack of a global unified plan to mitigate and control the spread of COVID-19. Several middle-or-high income nations struggled to control the viral spread resulting in increased mortality due to a combination of lack of public health measures and existing disparities which were magnified during the pandemic. The purpose of this review by a team of international experts is to (1) to examine reasons for the varied COVID-19 responses within U.S. and among other middle-or-high-income countries and the emergence of variants and vaccine inequities, and (2) to examine the country specific burden of cultural/structural/political determinants on access to care and mortality among older adults in various settings.
INFECTION PREVENTION CHALLENGES AND OPPORTUNITIES IN SMALL LONG-TERM CARE FACILITIES
Authors: Ham Carolyn
Published: December 2022

Small, individually owned long-term care facilities experienced unique challenges to accessing infection prevention knowledge and resources during the COVID-19 pandemic. Three data sets were analyzed: 1) Multi-state qualitative interviews with public health and regulatory staff in spring 2021; 2) Online survey of Washington state adult family home providers on infection control knowledge and practices in fall 2020; 3) Non-regulatory Infection Control Assessment and Response evaluations conducted between March 2020 and January 2021. Consistent findings across datasets were ongoing difficulty obtaining personal protective equipment (PPE), inability to implement isolation precautions and high vulnerability to staffing shortages. Small facilities showed strengths in consistency of leadership and engagement with public health outreach. Facility size is a key factor in infection prevention disparities for older adults living in residential care. Promising policy interventions are prioritization of small facilities for PPE distribution and increasing the availability of public health infection prevention expertise.
ESPO AND ACADEMY FOR GERONTOLOGY IN HIGHER EDUCATION SECTION SYMPOSIUM: TEACHING STRATEGIES FOR INTEGRATING DIVERSITY IN AGING EDUCATION PRACTICES
Authors: Su YanJhu , Qu Shan , Montepare Joann
Published: December 2022

This symposium intends to echo one of the core values for the GSA 2022 Annual Scientific Meeting — embracing diversity. In an increasingly humanistic society, addressing and accommodating diversity is a constant topic in the field of education. Diversity includes many different factors: race, ethnicity, gender, sexual orientation, socioeconomic status, ability, age, religious or political beliefs. There is no longer just one type of student in the classroom. Therefore, it is very important to adjust our teaching methods to accommodate the diverse backgrounds of students and to help students understand their different fellow classmates. In accordance with the AGHE gerontological education competencies, these authors will provide insightful teaching strategies for integrating diversity in aging education practices. The first speaker will introduce a new pedagogy in promoting learning in diverse classrooms — Sharestart. The second speaker will focus on building community-based partnerships to promote diverse, intergenerational service-learning opportunities for interprofessional gerontology students. The third speaker will discuss their experience on fostering connections across generations in the LGBTQ+ community through intergenerational conversations. The fourth speaker will present humanist values on understanding aging diversity. Finally, the fifth speaker will discuss curriculum mapping as a strategy to teach diversity in gerontology programs.
HOPELESSNESS AMONG MIDDLE-AGED AND OLDER ADULTS: A COMPARISON OF NATIVE WHITES, NATIVE MINORITIES, AND IMMIGRANTS
Authors: Guo Man , Wang Yi , Carter Kara
Published: December 2022

Sense of hopelessness is closely linked to poor physical/mental health and elevated suicidal risk. The aging and immigration processes put middle-aged and older immigrants at a greater risk of feeling hopeless. However, we know little about hopelessness among this population. This study asks two questions: do middle-aged and older immigrants have higher levels of hopelessness compared to native-born Whites and native-born ethnic minorities? If so, what factors contribute to such differences? Data was from the 2018 psychosocial assessment of the Health and Retirement Study (N = 5,534). ANOVA was used to compare levels of hopelessness among three groups of middle-aged/older adults (50 yrs+): native-born Whites (n =3,603), native-born minorities (n = 1,209), and immigrants (n = 722). Linear regressions were used to examine the association between nativity/race and hopelessness, with five sets of explanatory variables (i.e., SES, health, social support, social engagement, and neighborhood characteristics) entered in the models individually and then collectively. The findings showed that middle-aged/older immigrants had the highest levels of hopelessness, followed by native minorities, and then native Whites. Controlling for each set of the explanatory variables respectively reduced the group differences between native Whites and native ethnic minorities, but not between Whites and immigrants. When controlling for all the explanatory variables, the levels of hopelessness no longer differed significantly between immigrants and native Whites. Findings suggest that immigrants’ multiple disadvantages in personal, family, and social lives may contribute to their heightened levels of hopelessness. Interventions are sorely needed to protect against hopelessness for this population.
TELEPHONE FRAUD AGAINST OLDER ADULTS IN CHINA: EVIDENCE FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
Authors: Zhan Rong-Fang , Mpofu Elias , Yin Cheng
Published: December 2022

Background

Falling victim to telephone fraud is a devastating crisis for older adults because they can lose their life savings, adversely affecting their well-being. This study aimed to identify risk factors associated with telephone fraud among Chinese older adults. Method: A case-control study was conducted using the fourth wave of the 2018 China Health and Retirement Longitudinal Study data on older adults 60 years and above (N = 445 with telephone fraud experience; 9,994 with no fraud and other fraud experience). Control variables for the logistic regression analysis included the individual’s demographics of gender, residential location, marital status, and educational level.

Results

Older adult males (OR = 1.424, 95% CI = 1.156-1.755, p = 0.001), urban residence (OR = 2.257, 95% CI = 1.706-2.986, p < 0.001), urban-rural integration zone (OR = 2.322, 95% CI = 1.654-3.260, p < 0.001), received higher education [OR = 1.704, 95% CI = 1.211-2.397, p = 0.007]), and higher pension classification (OR = 1.352, 95% CI = 1.220-1.500, p < 0.001) were associated with increased risks of telephone fraud.

Conclusion

Telephone fraud affects older adults in China at the upper rather than lower end of the socio-economic gradient, suggesting vulnerability from their use of digital technologies compared to those on the lower ladder of the socio-economic gradient. Findings highlight the need for fraud education of older adults with access to the digital broad band to reduce their risk for telephone fraud.
LEISURE PARTICIPATION AND COGNITIVE IMPAIRMENT AMONG HEALTHY OLDER ADULTS IN CHINA
Authors: Zhang Wei , Feng Qiushi , Fong Joelle , Chen Huashuai
Published: December 2022

Leisure participation is beneficial to various health outcomes. This study examined a comprehensive list of leisure activities in relation to incidence of cognitive impairment among healthy older adults (65+) in China. Using data from the 2002-2018 Chinese Longitudinal Healthy Longevity Survey, we found that most of the leisure activities were protective of cognitive decline and three leisure activities (watching TV, doing housework, and playing cards/mah-jong) stood out as the most important ones. Additionally, our results revealed subgroup variations in the association between leisure participation and cognitive function: Leisure activities such as reading newspapers/books (not significant for the illiterate), gardening (not significant for the illiterate), and regular exercise (not significant for the rural residents) had different effects across different demographic social groups. Our findings suggest that intervention programs designed to prevent cognitive decline for older adults should consider subgroup and cultural variations in order to yield the best outcomes.
LEISURE ACTIVITIES AND COGNITIVE IMPAIRMENT: HOW IS IT MODIFIED BY LIFE COURSE SES AND AGE AMONG CHINESE OLDER ADULTS?
Authors: Sun Rongjun
Published: December 2022

Recent research shows that not only do life course socioeconomic status and engaging in leisure activities have independent effects on cognitive performance of older adults, but also there are significant interaction effects between them. What is less clear is whether these effects, both separate and interactions between them, vary by age among older adults. We use data from the Chinese Longitudinal Healthy Longevity Survey 2005-2014 and a Generalized Linear Mixed Model to examine these relationships. Results show that engaging in leisure activities is significantly associated with cognitive impairment even into very old ages (85+), although such associations are partially absorbed by life course SES. Furthermore, interaction effects of leisure activities and life course SES are also detected across all age groups, although they vary by specific activities. Virtually all interaction effects point to one direction: individuals of higher life course SES enjoy extra benefits from engaging in leisure activities.
RNA PROCESSING MECHANISMS DURING AGING AND CALORIC RESTRICTION
Authors: Rhoads Timothy , Clark Josef , Anderson Rozalyn
Published: December 2022

Caloric restriction (CR), a reduction in caloric intake without malnutrition, was first described in the 1930s and is a robust model to extend lifespan. While the specific mechanisms that produce delayed aging are still unknown, work has demonstrated the importance of metabolism – dysregulated mitochondrial metabolism is an aging hallmark, while CR upregulates energy metabolism. Crucially, transcriptional regulation plays a key role in implementing this metabolic program although details are still unclear. Splicing factors that are required for the beneficial effects of dietary restriction in nematodes have been identified, and large-scale exon usage changes have been observed across the metabolic network engaged by CR in various tissues from non-human primates, suggesting a translational mechanism that might contribute to how CR delays aging. We will discuss the landscape of RNA processing across multiple organism, tissue, and intervention contexts and provide a broad perspective of how RNA processing contributes to enhanced longevity.
PERCEPTIONS OF DEMENTIA FRIENDLY COMMUNITY STAKEHOLDERS IN THE US: CHALLENGES AND STRATEGIES DURING COVID-19
Authors: Sun Fei , Kim Ha-Neul , Fredrika Opur , Conyers Christian
Published: December 2022

This study examines the challenges faced by Dementia Friendly Communities (DFC) during COVID-19 pandemic and the strategies used to address these challenges from the perspectives of DFC stakeholders in the U.S. Data were collected in 2020 through an online survey of 183 stakeholders (Mage =35.3, SD=8.8, 43.6% being female) involved who were in DFC design, implementation, or evaluation. Three challenges rated most critical by participants included limited funding (40.4%), difficulties to provide services due to policies to contain COVID-19 (35.7%), and lack of staffing (29.3%). Three rated most important strategies included seeking funding and government support (31.1%), developing partnerships and relationships with multiple sectors (29.1%), and recruiting persons with dementia and family caregivers as advocates (27.5%). Communities demonstrated resilience during the COVID-19 pandemic to implement DFC- related activities. To sustain DFC, enhancing national awareness, acquiring additional funding, and firm cogency from staff members, local/state government, and local communities are needed.
SENIOR CENTER INVOLVEMENT WITH DEMENTIA-FRIENDLY COMMUNITIES: COMMUNITY AND ORGANIZATIONAL FACTORS
Authors: Somerville Ceara , Scher Clara , Coyle Caitlin , Greenfield Emily , Akincigil Ayse
Published: December 2022

As local hubs for aging services, senior centers are well-positioned to engage in dementia-friendly community (DFC) work. Yet centers vary in their engagement, especially as the DFC concept has been introduced only recently in the US. Using a mixed-methods approach, we drew on data from a survey of senior centers in Massachusetts, the US Census, and qualitative interviews with senior center staff to examine factors associated with DFC engagement. Centers that reported greater engagement were in municipalities with higher proportions of older residents from vulnerable groups (e.g., adults ages 80+, limited English proficiency, with a disability, living alone). They also reported greater programmatic, social service, funding, and staff capacity. Qualitative findings elucidated how senior center leaders drew on intrapersonal, interpersonal, organizational, and community assets to support local DFC efforts. We discuss implications for policies and practices to cultivate senior centers and other community-based organizations as leaders and partners toward DFCs.
PLAN: PREPARING AND LIVING FOR AGING NOW; A DESCRIPTIVE STUDY INVESTIGATING READINESS TO PLAN FOR AGING AND FRAILTY
Authors: Frechman Erica , Maxwell Cathy , Dietrich Mary , Buck Harleah , Rhoten Bethany
Published: December 2022

Population aging and the universality of the aging process offers individuals and society the opportunity to consider strategies to optimize older adults’ well-being and proactively prepare across their aging trajectory. Understanding aging through a holistic lens is essential to promote healthy aging in light of the risk for increasing chronic conditions, frailty, and disability that affect older adults. Planning for aging and frailty encompasses five domains that entail change as individuals age (communication/socialization, environmental, financial, physical care, cognitive status), and provides foci for a proactive approach to planning across life course. The aims of this research were to examine the stages of change through the Transtheoretical Model within the domains of aging, experiences (personal & experiences with others), and associations between contextual factors and stages of change for readiness to plan for aging and frailty. Using a cross-sectional design, 252 community dwelling-adults (aged 50-80) completed a survey on planning for aging and frailty. Results revealed a distribution of stages of change in readiness across domains of planning for aging and frailty with highest levels of planning in the financial domain (68.7%), and lowest levels in cognitive domain (28.2%). Participants reported increased experiences with others compared to personal experiences. Factors most indicative of planning include: older age, marital status, living situation, social support, and vulnerability. Planning for aging and frailty is an innovative concept that takes a comprehensive approach to the aging process. Future study is needed to promote planning across one’s life course and develop interventions focused on enhancing well-being.
SUBJECTIVE COGNITIVE DECLINE AS A PREDICTOR OF INCIDENT HOMEBOUND STATUS AMONG OLDER ADULTS
Authors: Burgdorf Julia , Reckrey Jennifer
Published: December 2022

In the US, over 2 million older adults are homebound, meaning they never or rarely leave their home. Being homebound increases risk for negative outcomes, including depression and mortality. Dementia diagnosis is a risk factor for becoming homebound, but over half of those with dementia do not receive a formal diagnosis. Subjective cognitive decline (SCD)—self-reported increase in memory loss over a given timeframe—is an early indicator of dementia that can be easily determined during routine medical encounters. SCD screening could be a valuable tool for identifying older adults at risk of becoming homebound—a critical first step towards supporting these individuals and their caregivers—but its predictive value is not yet known. We examined a nationally representative sample of 4,914 (weighted n=34,381,060) community-living older adults who responded to the 2016 and 2017 National Health and Aging Trends Study (NHATS). We modelled incident homebound status as a function of SCD using weighted, multivariable logistic regression while adjusting for older adult sociodemographic characteristics, health status, and caregiving support. In adjusted models, those who reported SCD experienced 43% greater odds of becoming newly homebound from 2016-2017 (aOR: 1.43; p=0.03). This relationship persisted among individuals without a formal dementia diagnosis (n=4,735); among these individuals, those who reported SCD experienced 50% greater odds of becoming newly homebound (aOR: 1.50; p=0.02). Findings suggest the potential value of SCD screening as an efficient method of identifying older adults who may benefit from resources that reduce the risk and/or mitigate the negative effects of becoming homebound.
APATHY AND ANXIETY ARE RELATED TO POOR FUNCTION IN PERSONS WITH EARLY-ONSET ALZHEIMER'S DISEASE
Authors: Crouch Adele , Massimo Lauren
Published: December 2022

Neuropsychiatric symptoms are prevalent in persons with early-onset Alzheimer’s disease (EOAD) and may contribute to the inability to perform instrumental activities of daily living. We examined associations between frequently observed symptoms in persons with EOAD: apathy, anxiety, depression, and patient function. Caregivers of 94 persons with EOAD completed questionnaires including the Neuropsychiatric Inventory and the Functional Activities Questionnaire. Regression analyses were performed for each neuropsychiatric symptom as a predictor with covariates (age, sex disease duration) and our outcome was patient function. We then performed multivariate analysis with the significant predictors. We observed that apathy explained 20.51% [F(4,68)=5.65, adjusted R2=0.2051; p<0.001], anxiety explained 6.63% [F(4,70)=2.31, adjusted R2=0.0663 p<0.05], and depression was not a significant predictor of patient function. In a multivariate model, apathy and anxiety explained 21.03% [F(5,67)=4.83, adjusted R2=0.2103; p<0.001] of the variance in patient function. These results suggest apathy and anxiety contribute to diminished ability to complete functional activities.
STARS AND WISHES: INSIGHTS AND SUGGESTIONS FOR ACADEMICS IN GERONTOLOGY AND GERIATRICS EDUCATION
Authors: Fruhauf Christine
Published: December 2022

In 2002, I presented a student paper at the annual meeting and educational leadership conference of the Association for Gerontology in Higher Education (AGHE) about co-teaching with my mentor an undergraduate adult development and aging course. Little did I know then, presenting about collaborative teaching methods and proven student assessment of learning such as, ‘Stars and Wishes’, that the AGHE presentation would lead me on a rewarding career path resulting in receiving the 2022 AGHE Distinguished Faculty Award. The purpose of this presentation is to discuss seven ‘Stars’ that I believe were pivotal points in my career whereby gerontological education and students studying gerontology benefited, and my ‘Wishes’ for gerontology and geriatrics education to inspire future academics as they navigate the next 20 years.
END-OF-LIFE HEALTH LITERACY: VALIDATION STUDY OF A NEW INSTRUMENT, THE END-OF-LIFE HEALTH LITERACY SCALE (EOL-HLS)
Authors: Meier Clément , Vilpert Sarah , Borasio Gian Domenico , Jox Ralf J , Maurer Jürgen
Published: December 2022

Measuring health literacy allows to assess individuals’ competencies to deal with health issues; it influences how individuals perceive their health problems, communicate with healthcare providers, or make medical decisions. The end of life is commonly characterized by one or several diseases, healthcare services’ uses and requires individuals to make complex medical decisions. Although the end-of-life concerns everyone, the level of competencies of individuals to get through this stage of life has been little explored. This study aims to fill this gap by validating a new instrument, the End-of-life Health Literacy Scale (EOL-HLS), in a representative sample of older adults aged 58+ living in Switzerland. We use the Swiss wave 8 (2019/2020) of SHARE. Based on the seminal work of Nutbeam (2000), end-of-life health literacy skills are measured using questions on the difficulty in understanding medical interventions, finding information, communicating, deciding in advance, and choosing end-of-life care options. In addition, we compare the findings to the European Health Literacy Survey questionnaire (HLS-EU-Q16). The results confirmed the suitability for performing factor analysis (KMO = 0.924, Bartlett’s test of sphericity statistically significant), a three-factor model was established and showed good fit properties (CFI = 0.964, TLI = 0.958, RMSEA = 0.047, SRMR = 0.067) and good reliability (α = 0.93). The associations found between individuals’ sociodemographic characteristics and the HLS-EU-Q16 were also present in our instrument, but higher EOL-HLS scores were associated with more positive end-of-life outcomes. The EOL-HLS is a reliable and valid instrument to target individuals with low end-of-life health literacy.
DAILY CONTEXTS AND HEALTH OUTCOMES ACROSS ADULTHOOD
Authors: Hong Joanna , Huo Meng , Almeida David
Published: December 2022

Different daily contexts (i.e., social, behavioral, emotional) influence psychological and physical health. In particular, daily contexts change across adulthood and identifying salutary daily contexts is vital for improving the health of middle-aged and older adults. This symposium adds to a burgeoning literature and presents studies that examine how different daily contexts (social - friend interactions, behavioral - electronic usage, emotional - affective response) impact health outcomes across adulthood. Ng et al. found that friend interactions were associated with poorer heart rate variability throughout the day among Black, but not White adults. Kim et al. showed that evening computer use, a health-impairing behavior, is associated with greater sleep disturbances on the following nights among older adults. Rush et al. found that low and high levels of negative affect reactivity to stressors (increased negative affect in response to stress) were associated with poorer health. Yet, moderate levels of stress reactivity predicted better health. Similarly, Hong et al. found that less positive affect reactivity to stressors (decreased positive affect in response to stress) was protective against elevated systolic blood pressure across stressful days. Lastly, Huo et al. identified an association between older adults’ empathy and daily rumination (i.e., repetitive thoughts) over distress, but observed that the link was attenuated on days when older adults maintained more stable levels of negative affect. Together, findings may inform future interventions aimed at increasing health across adulthood. Dr. Almeida will serve as the Discussant and summarize these studies with regard to their theoretical and methodological contributions.
CUSTODIAL GRANDPARENTS' DEPRESSION AND ACCESS TO HEALTH CARE DURING COVID-19: THE ROLE OF RACIAL DISCRIMINATION
Authors: Xu Yanfeng , Harrison Theresa
Published: December 2022

The COVID-19 pandemic has exacerbated racism against racial minorities and widened racial/ethnic disparities in health outcomes and access to health care services. This study analyzed cross-sectional data (N=219) collected from custodial grandparents via Qualtrics Panels in February 2022 to understand the role of race and perceived racial discrimination in contributing to custodial grandparents’ depressive symptoms and access to health care services. Results indicated that a higher level of perceived racial discrimination was positively associated with grandparents’ more depressive symptoms, but it was also associated with lower odds of custodial grandparents’ access to health care services. Furthermore, racial/ethnic disparities in depressive symptoms and access to telemental health services among custodial grandparents were identified. Results imply the importance of addressing racial/ethnic disparities in depressive symptoms and access to health care services among custodial grandparents.
RACIAL TRAUMA IN EMERGING ADULTS RAISED BY GRANDPARENTS: PROTECTING AGAINST DISCRIMINATION
Authors: Lopez Acacia , Scott Rachel , Olson Marin , Nadorff Danielle
Published: December 2022

Experiences of racial trauma are linked with psychopathology, but a strong ethnic identity may serve as a protective factor. Grandparents primarily influence the development of ethnic identity, and BIPOC children are increasingly being raised by grandparents. Secure attachments influence stronger ethnic identities, yet custodial grandchildren are at higher risk of disrupted attachments. The current study investigated whether ethnic identity would mediate the relation between attachment and racial trauma symptoms in emerging adults previously raised by their grandparents and their peers (N = 370; 33% raised by grandparents; 25.6% non-white), with race as a moderator. Across all races, there were group differences in symptoms of racial trauma, with those not raised by grandparents experiencing a direct effect of race on ethnic identity. Attachment was a significant predictor of trauma symptoms of discrimination, moderated by race. Implications may provide support for clinical interventions addressing attachment and ethnic identity to decrease trauma symptoms.
INCLUDING FEEDBACK FROM OLDER ADULTS WITH VARYING HEALTH CONDITIONS TO INFORM EXERGAME DESIGNS
Authors: Crane Breanna , Drazich Brittany , Taylor Janiece , Moored Kyle , Ahmad Omar , Krakauer John , Carlson Michelle
Published: December 2022

Exergames are emerging technologies that combine “exercise” and “video games” to promote enjoyable cognitive and physical activities. Exergame studies often exclude individuals at greatest risk for adverse health outcomes (e.g., oldest-old, living with chronic conditions, comorbidities, or functional limitations). Thus, it is important to 1) understand motivators and barriers for joining and adhering to exergame studies and 2) capture perspectives from individuals commonly excluded from these studies. We conducted three focus groups among 14 older adults (mean age=79±9 years) with varying health conditions who participated in a novel three-dimensional exergame feasibility study. Data were analyzed using the “Sort and Sift, Think and Shift” approach. Motivators for joining were generativity, peer referrals, self-improvement, and curiosity. Motivators for retention were accomplishment, enjoyability, and exercise. Barriers to participation included frustration and pain/fatigue. We also discuss how participants’ feedback influenced future exergame design. Findings will aid in promoting scalable, enjoyable, and accessible exergame interventions for all.
INTEGRATING RESEARCH, TEACHING, AND SERVICE: AN INTERGENERATIONAL BONDING PROGRAM AT THE UNIVERSITY OF NEBRASKA
Authors: Saidi Ladan Ghazi
Published: December 2022

To establish an Intergenerational Bonding (IGB) program that pairs undergraduate students at the University of Nebraska at Kearney with older adults of this rural community, we first tested acceptability and feasibility of such a program. We surveyed both groups to identify their interest level in IGB and identify their common interests in activities. Older adults residing in independent dwellings, assisted living homes, and nursing homes and members of community groups were invited to participate in the survey. However, the response rate was low. Given the restrictions of the pandemic, accessing community older adults was challenging. Internet access was low, which made virtual and digital participation modalities impossible; recruitment from assisted living facilities was not successful; and, establishing collaboration with nursing homes was not easy despite initial interest. Building trust and working with community activity group facilitators was ultimately beneficial in recruiting older adults. Collaboration with community-based organizations facilitated the study.
SEVEN YEARS OF IMPLEMENTING AN INTERGENERATIONAL PROGRAM WITH UNIVERSITY/COMMUNITY PARTNERSHIPS
Authors: Leedahl Skye , Estus Erica , Souza Kristin Fratoni , Capolino Alexandria
Published: December 2022

The University of Rhode Island Engaging Generations Cyber-Seniors Program was first implemented in the fall semester of 2015. URI students from 15+ majors have supported the digital competency of older adults in Rhode Island each semester and summer session since its inception. Gradually over time, we modified and expanded this in-person program to meet student, older adult, community partner, and faculty needs. The pandemic led to our program expanding exponentially due to new grant funding opportunities, new partnerships, and student interest. This presentation will address strengths and challenges of implementing this program state-wide in a small, mostly urban state with community partners, mostly involving senior centers. We will describe moving from in-person to phone/virtual and now to a hybrid model. Last, we will explain the program’s efforts to conduct formative and summative evaluation research to assess program output and examine outcomes for students and older adults in the program.
GENE REGULATION IN AGING
Authors: Mendenhall Alexander
Published: December 2022

The regulation of genes can both influence aging, and be influenced by the aging process itself. That is, the rate of aging can be altered by changing the gene expression program. And, the aging process itself causes changes in gene expression, including the ways in which genes are regulated. Understanding the consequences of differences in gene expression on aging rate, and the consequences of aging on gene regulation will continue to have profound impacts on our ability to manipulate the aging process. This symposium on gene regulation in aging will focus on how genes are regulated by the aging process and can be regulated differently to affect the aging process. We have an expert on the regulation of gene expression in the immortal germline and soma of the hydra, Dr. Celina Juliano. Dr. Roger Brent is an expert on the mechanisms of cell to cell variation in gene expression. Dr. Monica Driscoll is an expert on both the genetics of aging and gene expression changes with age. Finally, Dr. Alex Mendenhall’s studies are focused on understanding intrinsic (epigenetic) variation in the regulation of gene expression as a cause and consequence of aging. Together these experts will present their research as it relates to gene regulation and the aging process.
HOW THE SAME GENETIC PROGRAM RUNS DIFFERENTLY IN INDIVIDUAL ANIMALS TO AFFECT AGING AND DISEASE
Authors: Mendenhall Alexander , Sands Bryan , Yun Soo
Published: December 2022

Monozygotic human twins will age at different rates. The same is true for isogenic laboratory animals. Some of these differences in the rates of aging are caused by differences in the expression of genes. And, some of the differences in gene expression between isogenic individuals are caused by seemingly non-heritable, stochastic epigenetic differences. Here we discuss how differences in chaperone expression can influence aging and a model of Ras-driven neoplasia risk and survival in the model nematode Caenorhabditis elegans. We review evidence suggesting differences in epigenetic silencing machinery contribute to differences in chaperone gene expression. We suggest models for germline and somatic epigenetic regulation of chaperones. We discuss potential means of targeted epigenome modification, and potential implications for human health during aging.
FAMILY CAREGIVING FOR OLDER ADULTS IN LONG-TERM CARE DURING THE PANDEMIC: STRESS, SOCIAL SUPPORT, AND ADAPTATION
Authors: Park Geunhye , Robinson Erin , Tefera Gashaye Melaku
Published: December 2022

Older adults residing in long-term care (LTC) are especially vulnerable to the COVID-19 pandemic. Federal and local health officials have issued strict visitation guidelines, including family caregivers. Given that family caregivers are essential in the well-being for older adults in LTC, these measures have had an enormous impact. As little is known about the experiences of family caregivers, the purpose of this study was to explore how the COVID-19 pandemic impacted family caregivers’ roles, mental health, and adaptation. Semi-structured interviews (N=25) were conducted with family caregivers of older adults in LTC (Mean age= 59.7; 92% female) via phone/Zoom. An interview guide led the question asking process and participants were asked open-ended questions about the impact of COVID-19 related protocols on their caregiving, mental health, and sources of social support. Interviews were transcribed verbatim and analyzed in Nvivo, guided by Grounded Theory methods. The majority of participants (76%) identified as a child of their care recipient. Findings highlight that most participants experienced numerous changes to their caregiving tasks, such as assisting with activities of daily living (ADLs), limited monitoring for their loved ones, and a reduction of social support provided to the care recipient. Family caregivers also reported other changes in their roles that resulted in increased stress and mental health concerns. These concerns were discussed in detail, including ways in which family caregivers adapted to their new roles and managed their stress. Findings from this study will inform interventions geared to better support family caregivers, particularly during times of crisis.
DYSPHAGIA FOLLOWING HOSPITALIZATION IN NURSING HOME RESIDENTS WITH ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Rogus-Pulia Nicole , Robison Raele , Patel Sweta , Bunker Jennifer , Rudolph James , Teno Joan
Published: December 2022

Dysphagia frequently occurs in nursing home (NH) residents with Alzheimer’s Disease and Related Dementias (ADRD), often leading to serious health outcomes (e.g., pneumonia, malnutrition, reduced quality of life). While it is known that hospitalized NH residents with ADRD experience high rates of iatrogenic complications, dysphagia following discharge has not been examined. A retrospective cohort of all NH residents in the US (older adults aged ≥66) with advanced ADRD (Cognitive Function Scale ≥2), hospitalized between 2013-2017, and without a feeding tube or reported dysphagia on a Minimum Data Set (MDS) 3.0 assessment within 120 days prior to hospitalization was constructed. Treatment with intermittent mandatory ventilation (IMV) or non-invasive ventilation (NIV) during hospitalization and dysphagia status on the first post-hospitalization MDS was recorded. Data were analyzed using descriptive statistics and random effects multivariate logistic models that adjusted for age, gender, race/ethnicity, CFS score, ADL score, and comorbidities. Among the 805,199 residents with ADRD who survived the hospitalization and returned to the NH, new onset dysphagia occurred in 53,807 (6.7%; 95% CI 6.6-6.7) of residents. After adjustment, invasive mechanical ventilation (IMV) use was associated with increased risk of new onset of dysphagia (AOR 1.5; 95% CI 1.4-1.6) and non-invasive mechanical ventilation (NIMV) only slightly increased the risk (AOR 1.3; 95% 1.2-1.3). NH residents with ADRD are at risk for dysphagia following hospitalization. These findings emphasize the importance of swallowing evaluation and dysphagia treatment during hospitalization for ADRD patients, especially those treated with IMV or NIV, to prevent further negative health outcomes.
ONLINE EXERCISE CLASS EXPERIENCE AMONG OLDER ADULTS' MEMBERS OF COMMUNITY CENTERS IN HONG KONG DURING COVID-19
Authors: Lee Janet Lok Chun , Lou Vivian Wei Qun , Kwan Rick
Published: December 2022

Due to the social distancing measures, community-centres in Hong Kong has been converting exercise classes to online delivery mode through video-conferencing software since the outbreak of COVID-19. The phenomenon is new, and no research has been done to investigate older adults’ experience on it. This study adopted a descriptive qualitative methodologically orientation to understand the phenomenon. Twenty-three older adults (aged 55-89 years), with experience of participating online exercise class since COVID-19 participated in the study. Six major themes regarding their experiences emerged. Regarding positive experiences, older adults experienced convenience, increased exercise regularity, technical transformation and motivation in this new form of home-based exercise. At the same time, they experienced specific technical barriers and compensated supervision quality from the instructor. The findings of the study gave important future research direction and implications to the development of smart aging in community centres in Hong Kong.
UNDEREXPLORED SOLUTIONS IN DETROIT'S NEIGHBORHOODS: THE IMPORTANCE OF LEGACY TO ADDRESS ENVIRONMENTAL CONCERNS
Authors: Perry Tam , Villeneuve Evan , Butler Brenda , Hazimeh Fatima , Asana Ventra
Published: December 2022

Neighborhood infrastructure challenges and changes are possibly understood and experienced in unique ways across the lifespan. This study presents findings on neighborhood conditions and underexplored solutions from the perspective of older adults in Detroit, Michigan. This project obtained multiple perspectives on these issues from older Detroiters through interviews (n-19) and professionals working on climate concerns in the region (n=5). The research was designed using community-based research approaches including having older adults as members of the research team from instrument design to dissemination. One emergent theme, the importance of legacy as motivation in addressing environmental concerns, will be highlighted. This presentation will conclude with a discussion of next steps for this work.
MAPPING SIDEWALK FALL RISKS USING BIG DATA AND MACHINE LEARNING
Authors: Miranda Fabio , Hosseini Maryam
Published: December 2022

Outdoor falls are a leading cause of fatal and non-fatal injuries in the US. These falls are more likely to occur due to environmental hazards, inclement weather, unsafe construction zones, or poor sidewalk condition. Fall prevention programs targeted at older adults must therefore be informed by the interplay between weather condition, urban development, and built environment. Current practices, however, are limited by the lack of comprehensive data describing the condition of pedestrian facilities at fine, human scale, limiting the effectiveness of these programs. To address these shortcomings, we propose a multi-pronged approach leveraging urban data and machine learning techniques to create city-scale inventories describing sidewalk features that can inform safe strategies and programs for community mobility. We will cover the creation of multiple data sets, including computing shadow / shade from building geometries, detection of sidewalk surface material from street-level images, and creation of sidewalk networks from satellite images.
PRESIDENTIAL SYMPOSIUM: THE INTERSECTION OF AGE AND RACE: IMPACT ON REIMAGINING AGING
Authors: Jarrott Shannon , Lincoln Karen , Levy Becca
Published: December 2022

In this BSS Presidential Symposium, we address the conference theme of “Embracing our diversity; enriching our discipline; reimagining aging” by attending to the intersection of age and race. In our panel, speakers will address the intersection of age and race as it relates to experience of ageism and its effects on individuals’ opportunities to live meaningful lives. Researchers who apply an intersectional lens to their study of aging, ageism, and productive aging among diverse populations will share relevant theoretical concepts, methodological approaches, and associated findings. Links between racism, ageism, and health hold practice implications across health care, work, leisure, and other community settings. Researchers link life course influences, including discrimination, and cognitive health (Muñoz) and productive aging (Gonzales); Robinson-Lane presents a health care model of Culturally and Linguistically Appropriate Services Standards designed to reduce racism and improve care; and, Muramatsu offers practice and policy recommendations to reduce structural racism experienced by older persons and those paid to care for them. Presenters will address the following as we discuss how to reimagine aging from an anti-ageist, anti-racist perspective: 1. Evidence of the intersection of age and race in the experience of ageism. 2. Research models that attend to the intersection of age and race.3. Efforts to reduce ageism as it intersects with race in order to reimagine aging through practice and policy.