bluuebunny/crossref_metadata_2025 huggingface dataset:
THE INFLUENCE OF NURSING HOME CHAMPIONS ON THE IMPLEMENTATION OF A PERSON-CENTERED QUALITY IMPROVEMENT PROJECT
Authors: Kunkel Miranda , Kasler Kamryn , Heppner Alexandra , VanHaitsma Kimberly , Abbott Katherine
Published: December 2022

Preferences for Activity and Leisure (PAL) Cards are a communication tool designed to alert nursing home staff to important resident preferences. This study explored the role of nursing home provider champions implementing (PAL) Cards in their community. Champions (n=35) created PAL Cards for 15-20 residents. A total of 88 monthly interviews were audio-recorded, transcribed, checked for accuracy, and coded using the domain “Characteristics of the Individual” from the Consolidated Framework for Implementation Research. Each construct was assigned a general valence rating based on consensus. Four constructs received the highest positive valence ratings and were identified as important facilitators to implementation success, and one construct received a neutral valence. Champions who anticipated the benefits of PAL Cards for their community and recruited a supportive team exhibited high implementation success. Additionally, the champion’s perception of help from staff seemed to increase their own self-efficacy to achieve their goals.
TEMPORARY ADDITIONS TO TEMPORARY HOUSING: LESSONS FROM HEALTH EXPERIENCES OF COVID AVOIDANCE HOTEL RESIDENTS
Authors: Johnson Ian , Light Michael , Perry Tam , Lewinson Terri
Published: December 2022

COVID-19 amplified system burdens and health risks within the housing care continuum, in which older adults with chronic serious illness are disproportionately represented. We present retrospective chart review data about the health experiences of older adults with serious illness living in and moving through temporary avoidance hotels during the COVID-19 pandemic. Through narratives of fourteen residents, we illustrate trends across two nine-month phases. Trends illustrate how avoidance hotels created opportunities for continuity of care, connection to services, and health-affirming relationships with place. We also identified challenges in catering to diverse medical, behavioral, and psychosocial-spiritual needs of older and seriously ill residents, as well as negative consequences to the geographic dispersion caused by de-congregating homeless shelters. Avoidance hotels present important lessons in considering future housing and healthcare intervention and implementation for older people facing homelessness while seriously ill.
BRIDGING THE GAP: SERVICE COORDINATION IN HUD HOUSING DURING COVID-19
Authors: Scheckler Samara , Molinsky Jennifer
Published: December 2022

Older HUD residents were vulnerable to COVID-19 due to their age, health, income, race, ethnicity, and resources. In combination, these factors increased risk to health and housing stability. While many HUD properties employ a service coordinator, this role is not universally adopted and impacts of these services are not well understood. This research surveyed service coordinators in mid-2020 and late-2021 to characterize older adult experiences living in public housing during the pandemic and ways service coordinators helped manage disruptions. Surveys were disseminated to 3,500 service coordinators. Findings identified needs in transportation, personal care, sociality, mental and physical healthcare, and food. Interventions included resource procurement, benefits management, technology access improvement, and linking residents to services. Tools included information dissemination, needs assessments, and partnership development. This work offers insight into the role of a service coordinator to mitigate health and housing risk. It becomes increasingly salient as HUD residents trend demographically older.
GSA R13 DIVERSITY WORKSHOP: THE CAREER JOURNEY OF A THOUSAND EXPERIENCES BEGINS WITH ONE STEP
Authors: Heyn Patricia , Whitfield Keith
Published: December 2022

After 23 years, since the NIH recognized the need to increase the contribution of underrepresented minority (URM) scientists in the biomedical sciences, modest gains have been made to address the significant under-representation in biomedical sciences. By the time URM scholars have gained the necessary research skills to succeed as scientists, they have overcome many social and professional barriers, yet they still experience the social burdens of disadvantage and discrimination. In an effort to increase representation, the GSA has been successfully delivering Diversity Mentoring and Career Development Technical Assistance Workshops (GSA DMCDTAW) since 2018 with support from grants from the NIH/NIA. Many trainees and faculty from diverse backgrounds participated in DMCDTAW. The program promoted peer mentoring opportunities, professional training, and networking engagements and underwent a series of evaluations and focus group discussions. The program framework, curriculum, and evaluation will be presented. Recommendations for future mentoring development and evaluation will be discussed.
UPDATE IN GEROSCIENCE FOR NONBIOLOGISTS
Authors: Kuchel George , Austad Steven
Published: December 2022

Geroscience began as a result of discoveries made by biologists in aging cells, simple organisms and animal models. Such advances, the discovery of strategies for modifying rate of aging, and appreciation of aging as a shared risk factor for chronic diseases led to the Geroscience Hypothesis. It states that interventions modifying aging biology can slow its progression, resulting in the prevention or delay of onset of multiple diseases. However, for these discoveries to truly impact human health, nonbiologists – scientists in other disciplines and clinicians, must also engage in geroscience. An obstacle to a wider engagement by disciplines and GSA members other than basic biologists in geroscience has been the fact that varied fields engaged in aging issues tend to use language (jargon), methods and scientific approach that can make their work less accessible and understandable to other disciplines. To that end, speakers have been selected not only for their scientific contributions, but also for their ability to overcome such barriers. Steve Austad (UAB) will discuss the range of animal models and experimental approaches that led to the Geroscience Hypothesis. Anne Newman (U Pittsburgh) will review evidence that these findings are relevant to and might be translatable to humans. John Newman (UCSF/Buck) will seek to frame these considerations in terms of broader societal discussions regarding aging while providing a framework by which nonbiologists may critically evaluate discoveries and actual products claiming benefits in terms of aging. (Sponsored by Nathan Shock Coordinating Center U24AG056053; Geroscience Education and Training Network R25AG073119).
WHAT WAS IMPORTANT TO OLDER VOTERS IN THE 2020 ELECTION? A LOOK AT COVID-19, MISINFORMATION, AND POLICY
Authors: Rickenbach Elizabeth , Fassi Janelle , Doran Kevin
Published: December 2022

High older voter turnout rates, a growing aging population, and organizations that serve the interests of older adults have historically contributed to the importance of older adults for elections. Since 2010 older voters have tended to vote Republican, with White older adults typically preferring Republican candidates, and Black and Hispanic older voters typically preferring Democratic candidates. In the 2020 election, the 65+ group of voters showed the same Republican candidate favorability but followed a slow downward trend from recent elections. Grounded in a demographic, economic, and generational context, and considering theory and research from gerontology, political science, psychology, and sociology, this presentation will explore older voter turnout and candidate choice in the 2020 presidential election. The focus will be on considering past trends and public polling data to examine three key issues in relation to the behavior of older voters in 2020: COVID-19, presidential candidate platforms, and misinformation and the media.
RACIAL/ETHNIC DISPARITIES IN RISK AND PROTECTIVE FACTORS OF DEMENTIA: A LIFESPAN APPROACH
Authors: Ferdows Nasim B , Aranda Maria
Published: December 2022

We examined risk and protective factors associated with dementia and decomposed racial/ethnic disparities in factors associated with dementia. We performed a retrospective analysis of 3,495 individuals 65+ who participated in the 2016 Harmonized Cognitive Assessment Protocol, linked to Health and Retirement Study. Using the MMSE score, individuals were classified as having dementia vs cognitively normal. Risk factors included cardiovascular factors and hearing loss in midlife, current smoking, depression, and physical inactivity. Protective factors included educational attainment and wealth. Using Oaxaca-Blinder decomposition we quantified the relative contribution of individual variables in explaining racial/ethnic disparities. We found that Blacks and Hispanics have higher dementia risk compared to Whites. Accounting for demographics, mid-and later-life risk and protective factors explained one-third of the difference in Blacks and Whites’ cognitive functioning, and two-thirds of the difference in Hispanics and Whites. The findings highlight disparate dementia rates, and the need to elucidate other factors beyond race/ethnicity.
MEDICARE AND THE DYNAMICS OF US HEALTH REFORM POLITICS
Authors: Gusmano Michael , Monheit Alan
Published: December 2022

Since the 2020 election, President Biden and Congressional Democrats have largely abandoned proposals for creating a “Medicare for All” system or adding a “public option” to the Affordable Care Act (ACA) marketplaces. This reflects a lack of sufficient enthusiasm, within the Congress or the public, for either option. These options are viewed by many current Medicare beneficiaries as a potential threat to their existing benefits. Indeed, framing the ACA and other efforts to expand insurance coverage as a threat to Medicare has become something that health reform opponents have done routinely since the 2010 midterm election. We will apply behavioral economics principles including loss aversion, hyperbolic discounting, and status quo bias, to explain why it has been easy to demonize reform options such as these. In addition to presenting data from public opinion polls, we will examine how Congressional and other party leaders have framed these choices for the public.
AGING IN COMMUNITY MODELS IN THE US: FRAMEWORKS FOR COMMUNITY SUPPORTIVE NETWORK DIALOGS BETWEEN WEST AND EAST
Authors: Hou Su-I
Published: December 2022

Aging in Community (AIC) is the preferred way to age. This session shares promising AIC models in the U.S. and analyzed model characteristics. Four models were identified with the potential to achieve person-environment (P-E) fit, including village, naturally occurring retirement community (NORC), cohousing, and university-based retirement community (UBRC). Empirical studies show these AIC models enhance social support and improving older adult's well-being, remain independence at homes, and community social and civic participation. Each model has a unique way to help community-dwelling older adults with their aging needs. This session aims to stimulate dialogs on opportunities and challenges of forming AIC supportive networks considering Eastern versus Western cultural and societal differences. Promising U.S. AIC models shared will serve as conceptual frameworks to facilitate discussions on various model’s strengths and weakness and how they might be adapted in Taiwan’s society considering eastern cultural values, societal norms, and healthcare system. Examples of Taiwan versions of these similar promising U.S. AIC models will be shared. Continued research is needed to address the challenges of engaging older adults with lower socio-economic status, meeting older adults' diverse and dynamic needs, and conducting comparative studies to share lessons learned across the globe.
LINGUISTIC STRATEGIES FOR AGE-INCLUSIVITY: ANALYSIS OF HAIKU-BASED INTERGENERATIONAL INTERACTION
Authors: Maeda Harumi , Wan Emily , Matsumoto Yoshiko
Published: December 2022

Many studies have examined communicative and linguistic strategies helpful to the interactional inclusion of persons living with dementia (PLwD) and the promotion of an age-inclusive society (e.g., Wray, 2020; Stickle, 2020). Building on this existing body of research, our study examines question-answer sequences in conversations (Schegloff & Sacks, 1973) among younger adults and PLwD using discourse analysis methodology to illuminate effective communicative practices for facilitating more inclusive and meaningful interactions between these individuals. Findings from this methodology are complemented by analysis of post-interaction interviews. The data set for this study consists of audio-video recordings of (1) intergenerational conversations around haiku poetry in English between older adults with mild cognitive impairments (MCI) and college students, and (2) post-interaction interviews that assess participants’ feelings about the experience. The data was collected as part of a larger study designed to promote social inclusion of individuals of all ages and cognitive conditions, particularly during the pandemic, via an online intergenerational haiku-making activity. The audio-video recordings were transcribed for qualitative analysis. Findings from the analysis demonstrate the effectiveness of open and emotion-focused questions (Matsumoto, Liao, Xue, 2020; Worley, 2005) in encouraging persons with MCI to express themselves on their own terms and promoting their interactional participation. By presenting the benefits of this type of question and related linguistic strategies, this study hopes to provide a basis for developing more inclusive communicative environments for people of all ages and PLwD to help improve quality of life and well-being across all stages of life.
PLACE OF DEATH AMONG MEDICARE BENEFICIARIES: VARIATIONS BY DEMENTIA DIAGNOSIS AND RACE/ETHNICITY
Authors: Jarrín Olga , Lin Haiqun , Wu Bei , Zafar Anum , Lopez Maria , Duberstein Paul
Published: December 2022

Death at home is preferred by most people and has become a key indicator of the end-of-life care quality; however cultural attitudes about death and dying may vary by race and ethnicity. This study describes racial and ethnic variation in place of death among Medicare beneficiaries aged 50 years and older who died in 2018 with a dementia diagnosis (n=902,208) and without a dementia diagnosis (n=1,096,074). Among those with dementia, 60% died at home, with the highest percentage for non-Hispanic white (62%) beneficiaries, followed by Black/African American (55%), Hispanic (61%), Asian American/Pacific Islander (58%), and American Indian/Alaska Native (58%) beneficiaries. Among those without dementia 61% died at home, with the highest percentage for non-Hispanic white (60%) beneficiaries, followed by Black (57%), Hispanic (65%), Asian American (65%), and American Indian (60%) beneficiaries. Among those who died at home, about half without dementia received hospice care compared to the majority with dementia.
EVOLVING AGE-FRIENDLY UNIVERSITIES: ENHANCING STUDENT SUPPORT SERVICES AND PROMOTING SKILL DEVELOPMENT
Authors: Graf Allyson , Terhune Katherina , Ewen Heidi
Published: December 2022

Students in higher education face numerous challenges, many of which have been exacerbated by the pandemic. Globally, universities have capitalized on age-friendly programs and practices to respond to rapid changes in age demographics, build more age-inclusive and intergenerational programming, and create new forms of support campus-wide. This symposium features campus leaders representing universities that have drawn on the Age-Friendly University (AFU) principles to generate new and creative forms of support and skill-building for students of all ages. These initiatives represent the diverse ways that AFU-based programs and practices can be utilized to respond to opportunities and challenges in higher education. Graf et al. will discuss how age and age-related bias impact adult learners’ experiences in the classroom, and ways to inform training programs for students, faculty, and staff. Felsted and Eaton will describe a GSA/AARP-funded grant initiative aimed at increasing access, inclusion, and support for older adult learning at the university, resulting in a partnership with Emeritus faculty to pursue the AFU designation. Hancock and Kutcher will describe how service-learning and intergenerational learning opportunities provide a meaningful space for students to develop realistic notions of their own aging experiences. Newsham et al. will discuss a virtual intergenerational mentoring project designed to improve social connectedness and well-being, to improve expectations regarding aging, and to decrease ageism. Terhune et al. will discuss campus-wide data used to assess the prevalence and impact of unpaid caregiving on students and will explore community and campus connections to better support students in caregiving roles.
IMPLEMENTING A VIRTUAL, AGE-FRIENDLY INTERGENERATIONAL PROGRAM
Authors: Newsham Tina , Fugate-Whitlock Elizabeth , Quinn Natalie , Bergman Sky
Published: December 2022

As the University of North Carolina Wilmington (UNCW) seeks to become more age-friendly and stakeholders pursue endorsement of the Age-Friendly University principles, a virtual intergenerational mentoring project was implemented. The aim was to connect the community’s older adults, including retired faculty, with current students. Older adults and students were paired and asked to engage in a series of conversations, watch a documentary, and attend a Q&A with the filmmaker. The goals were to improve social connectedness and well-being, improve expectations regarding aging for members of both groups, and to decrease ageism. Impacts of the project were assessed through the Expectations Regarding Aging scale prior to any interactions between partners and again at the end of the project along with an open-ended questionnaire about their experiences. Expectations regarding aging improved on 75% of the items, and participants indicated qualitatively that their experiences with the intergenerational interactions were positive.
LINKING LIVES: DISRUPTING THE CYCLE OF SOCIAL ISOLATION
Authors: Goldsen Karen Fredriksen , Kim Hyun-Jun , Hoy-Ellis Charles , Nelson Christi
Published: December 2022

Loneliness has been found to be associated with increased risk for early mortality and dementia, with sexual and gender diverse older adults at elevated risk of both social isolation and loneliness. Based on the Health Equity Promotion Model and Iridescent Life Course, we examine factors associated with increased risk of loneliness over time, utilizing 2014 to 2016 data from the Aging with Pride: National Health, Aging, Sexuality/Gender Study, a longitudinal national study of LGBTQ+ midlife and older adults. The findings illustrate that sexual and gender diverse older adults had nearly double rates of loneliness compared to the general population, with those living alone and having cognitive decline at increased risk. We found that higher mastery, LGBTQ+ community engagement, larger network size, and being partnered/married were associated with less loneliness over time. Loneliness is ripe for the development of interventions; additional longitudinal data is needed to further assess trajectories in loneliness.
FAMILIAR CONTEXTS, FAMILIAR EMOTIONS? A NEW PERSPECTIVE ON CONTEXT-SPECIFIC EMOTION PROCESSES IN OLDER ADULTHOOD
Authors: Springstein Tabea , English Tammy
Published: December 2022

As people age, their emotional well-being tends to be maintained or improves. Theories of adult development suggest that features of the context (e.g., more familiar environments) and successful management of emotions contribute to this effect. This talk focuses on how familiarity may promote emotional differentiation (e.g., knowing whether one feels angry or sad) in daily life, an important predecessor to emotion regulation success. A sample (N=290) of community participants between the ages of 25 and 85 years old completed an experience sampling study (6x/10days). When people were more familiar with their current situation, they differentiated more between emotions. The relationship between familiarity and differentiation was stronger for older adults than younger adults. These results support the perspective that emotional well-being benefits from wisdom accrued over the lifespan, such that older adults are at more of an advantage when their daily contexts afford for them to draw on their prior experiences.
CHARACTERISTICS OF OLDER ADULTS WHO DIED FROM OPIOIDS AS A CAUSE OF DEATH DURING THE COVID-19 PANDEMIC
Authors: Suriaga Armiel , Tappen Ruth
Published: December 2022

There was a 1,886% increase in opioid overdose deaths among people 55 years and above, from 518 in 1999 to 10,292 in 2019 in the U.S. The National Institute on Drug Abuse reported a 30% increase in drug overdose deaths in 2020, where it claimed nearly 100000 American lives. However, few studies focused on the individual opioids that caused more deaths in the aging population and their death circumstances. This retrospective study aims to describe the sociodemographic characteristics of older adults who died from opioids as a cause of death (COD) in Florida during the COVID-19 pandemic in 2020, using descriptive statistics in SPSS 28. De-identified data from the Florida Department of Law Enforcement in 2020 were used in this study. A total of 1656 cases of decedents (ages > 65 years) were analyzed; 348 out of 1656 cases had opioids as a COD. Age ranged from 65 to 103, mean age of 73.31 (SD= 7.690). Majority of decedents were males (67.3%), non-Hispanic whites (86.5%). Nearly 80% died from accidents, suicide at 18.1%; 99.1% of cases happened in urban counties. Fentanyl caused more deaths (n=135), then morphine (n=48), oxycodone (n=42), and hydrocodone (n=29).The study results have direct clinical practice implications to patient safety, particularly the opioid deaths that resulted from accidents. Opioid harm reduction interventions should be tailored to older adults’ specific needs, specifically in urban counties. Healthcare providers should pay extra attention to opioids that cause more deaths, i.e., fentanyl, morphine, oxycodone, and hydrocodone to safeguard public safety.
MULTISTAGE SAMPLING FOR TRANSLATIONAL COMMUNITY RESEARCH: ZOOMING OUT TO HONE IN ON PLACE-BASED HEALTH DISPARITIES
Authors: Gan Daniel Rong Yao
Published: December 2022

​​Whereas researchers strive for generalizability, community-engaged research (CEnR) typically involves only a few specific communities. Drawing on Weberian ideal type, I outline the use of an innovative blended-methods approach to sample the communities in which CEnR practitioners would collect in-depth data. To complement typical practices of entering a community without preconceived ideas, understanding how communities in the sampling frame relate to one another is important for equigenic (place-based health equity) implementations. The selection of neighborhood communities from quadrants in 2x2 matrices allows pertinent concepts to emerge and relevant solutions to be drawn from thriving communities to aid program co-creation and implementation in other communities. For example, this has led to the identification of communities in British Columbia with differing socioeconomic status, social capital, and coping during COVID-19. This methodological innovation is congruent with asset-based community development (ABCD) to minimize arbitrariness in sampling decisions and advance health equity in our cities.
THE ART, WELLNESS, AND VITAL INVOLVEMENT IN AGING PROGRAM: MY WORK WITH HELEN KIVNICK
Authors: Davis Linda
Published: December 2022

Linda Davis will discuss her partnership with Helen Kivnick on The Art, Wellness and Vital Involvement in Aging (AWVIA) Program. AWVIA began in 2009 as an innovative approach to health programming in HUD Affordable Senior Housing, employing engaging creative activities to attempt to address the despair and loneliness often found in older adults who have low social engagement, due to health, mobility, or economic circumstances. In 2013, Davis teamed up with Helen Kivnick to develop the Vital Involvement Model, which employs creative activities to increase meaningful engagement with the world. Over 6 years, AWVIA was employed by 84 HUD Senior Housing communities across the U.S. Kivnick and Davis received funding from NEA for a quasi-experimental study on the participants. Information from more than 2,000 qualitative narratives suggests the program decreased isolation, increased self-reliance, generativity, and a sense of mastery in participants. Examples of the narratives will be shared.
CAPTURING OLDER ADULT PEER MENTORS' EXPERIENCE WITH COMMUNITY-DELIVERED HEARING CARE THROUGH PHOTOVOICE
Authors: Nieman Carrie , Mossman Audrey , Yi Julie , Suen Jonathan , Lin Frank , Szanton Sarah , Han Hae-Ra
Published: December 2022

While age-related hearing loss is common, disparities in care exist by race, ethnicity, and socioeconomic position. HEARS is a hearing care intervention that incorporates over-the-counter hearing technology, partnering older adults with peer mentors via a community health worker (CHW) model to address disparities. Through a randomized controlled trial, 8 older adult peer mentors delivered the HEARS intervention. We aimed to understand the CHWs’ perspectives on their role through photovoice. Participants took photos illustrating the intervention, their role, and hearing health. Semi-structured interviews (n=4) and a focus group were conducted. CHWs responded positively to the intervention and were satisfied with their role. A notable theme was the value of serving as a peer mentor. Participants valued the opportunity for generativity, learning as older adults, and associated social benefits. Our findings demonstrate an opportunity to engage older adults in the evaluation process, expanding access to hearing care, and in peer mentorship.
AGING IN CROSS-NATIONAL CONTEXTS
Authors: Ailshire Jennifer , Choi Eunyoung
Published: December 2022

Cross-national comparative research is a useful tool for identifying common aspects of, and risk factors for, healthy and unhealthy aging across populations and sociocultural contexts. The papers in this symposium use harmonized data from the Gateway to Global Aging to examine a range of topics in aging and provide new insights into long-standing and emerging questions in aging research. Using data on 31 countries, Ehrlich estimates the population attributable fraction of dementia due to vision impairment, a treatable and thus potentially viable target for interventions to slow progression to dementia. Seligman et al., use a frailty index validated in multiple countries to provide new evidence for which aspects of socioeconomic status (SES) – education, income, rural residence – are most strongly linked to frailty in Brazil, China, and India, three highly populated and rapidly aging countries. Using recent harmonized data on stress, Chen et al. examine the association between cumulative social stressors and cognitive function trajectories in the US and UK, finding interesting patterns in the relationship with status and change over time. Finally, several harmonized aging studies collected data throughout the COVID-19 pandemic, and Mair et al., take advantage of this to gain insights into how family structure impacted experiences of loneliness among older adults during the pandemic in the U.S. and across Europe. The papers in this symposium demonstrate the tremendous potential for using cross-national comparisons to deepen our understanding of health and well-being among older adults.
EXAMINING EXCLUSION FOR GUIDANCE TO INCLUSION: A GOOD IDEA?
Authors: Holley Lyn
Published: December 2022

This paper is based on a literature review that informed writing of a chapter for a new edited book, Moving beyond the rhetoric - research with older service users – why ethics and integrity matter. (Emerald, in review). This literature review was undertaken to ground guidance for the chapter in the book that addresses ethics in research with American Indians of all tribes on lands currently part of the USA. A theme that emerged uninvited was the many ways in which inquiry that was unintentionally or deliberately unethical also operated to reduce inclusion of American Indians in research – often the very research needed to discern or demonstrate value of various clinical, social, or other types of interventions needed to improve policies or practices. This paper explores that theme and its implications for research with American Indians.
ELEMENTS OF AN INTERPROFESSIONAL LEARNING CULTURE IN NURSING HOMES
Authors: Meijers Judith , Van Lierop Merel (E A ) , Verbeek Frank , Laurant Miranda , van Rossum Erik , Zwakhalen Sandra , Van Vught Anneke
Published: December 2022

Healthcare professionals in nursing homes need to be able to keep up with changes at work, deal with a growing complexity in healthcare demands and have to keep developing themselves within a team to be able to plan and deliver high quality of care. To keep up with these changes and demands, an interprofessional learning culture must be stimulated. Insight about developing such a culture in nursing homes is lacking. A scoping review was performed. Articles were examined on actions that positively influence the development of an interprofessional learning culture. 51 Actions were identified. The influencing factors were divided in eight main themes i.e. (1) communication, (2) shared goals, (3) tasks and responsibilities, (4) learning and knowledge, (5) work approaches, (6) attitude, (7) leadership, and (8) safety, respect and transparency. These actions form a basis for an interprofessional learning culture but should be operationalized and tailored to practice use.
DEATH AND GRIEF IN INTERGENERATIONAL SERVICE LEARNING: EXPLORATIONS FROM THE FIELD
Authors: Bartlett Sara , Solomon Phyllis
Published: December 2022

Intergenerational service-learning has been established as an effective pedagogical strategy for undergraduate gerontology education but can challenge students and instructors alike if an older adult participant dies during such a program. Currently, there is a lack of literature to provide guidance to instructors about how to address such an event. Examination of a case study of such an occurrence during the Lives Well Lived intergenerational service-learning program seeks to advance the field by describing an example of such an event and how an instructor might seek to address it. Grief literature, including theories such as Kübler-Ross’ stage model, Worden’s TEAR model, and Wortman and Silver’s approach, as well as Doka’s concept of disenfranchised grief are examined and applied to this challenging situation. Applying these theories as a framework, recommendations are given for addressing death and grief in service-learning including: (1) assessment of the course, instructor, student, and situation; (2) creating opportunities for grief processing and (3) resources for on and off campus grief and instructor support. Providing education on death, grief and grieving as integral course content and allowing student choice in how to proceed with the project should a death occur are key recommendations to consider. Implications call for more research related to this topic.
RACIAL DISPARITY IN THE START OF HOME HEALTHCARE IN HIGH-RISK ADRD PATIENTS BY THE QUALITY OF HOME HEALTH
Authors: Roy Indrakshi
Published: December 2022

Improving the quality and timely access of home health care is a new quality measure and particularly crucial in high-risk ADRD adults following hospitalization. However, a significant portion of older patients waits longer than 2 days to receive home healthcare. In this study, we examine how the quality of home health agency and race are associated with the delay in care among ADRD patients receiving home healthcare and how this delay mitigates the risk of rehospitalization. We find that Black patients in low rated home health agencies have 28% higher odds of delay in care compared to White patients in high rated home health agencies (Odds ratio (95% CI) =1.28 (1.21 - 1.36)). Timely initiation of home health care also reduces the risk of rehospitalization in minority older adults with ADRD.
THE READYR PROGRAM'S INTERIM FEASIBILITY, ACCEPTABILITY, AND EFFECTS ON VALUES-BASED CARE AND RELATIONSHIP QUALITY
Authors: Hiatt Shirin , Steele Joel , Wu Chao-Yi , Miller Lyndsey
Published: December 2022

This study evaluated preliminary feasibility, acceptability and efficacy of the READyR program, a remote intervention for early stage dementia dyads designed to assess and address values-based care and relationship quality. Measures of program acceptability, preparation for future care, and relationship quality were examined pre- and post-intervention. Feasibility was high among the first 10 enrolled dyads who completed phase 1: 39 out of 40 sessions were completed with 100% retention. Acceptability was also high with nearly 95% reporting that participation was easy and that they would recommend it to others. Insufficient time was the only critique reported by 17%. Medium/large effects were found in improvements to positive interactions (d=-0.71 95%CI [-1.34-.00]), relationship strain (d=0.53 95%CI [.-.15-1.18]), and awareness (d=-0.91 95%CI [-1.64- -0.15]) and avoidance (d=-0.53 95%CI [-1.18-.15]) of preparation for future care needs. The READyR program shows preliminary feasibility, acceptability, and efficacy in improving values-based care and relationship quality remotely.
WHAT DO 'BEHAVIORS" COST? UNDERSTANDING COSTS IN DEMENTIA CARE PARTNER-BASED RESEARCH
Authors: Dawson Walter , Gothard Sarah , Mattek Nora , Kaye Jeffrey , Lindauer Allison
Published: December 2022

The out-of-pocket costs to care for individuals living with dementia are high, and is exacerbated by the expense of managing behavioral and psychological symptoms of dementia (BPSD) (e.g., depression, irritability). STELLA (Support via TEchnology: Living and Learning with Advancing AD) is a telehealth-based intervention that provides a personalized approach to teach care partners (CPs) strategies to manage BPSD. To understand the relationship between BPSDs and costs, weekly surveys were administered to CPs (n=12). Surveys asked about out-of-pocket costs incurred from: hospitalizations and emergency department (ED) utilization, primary care visits, use of paid in-home care, prescription drugs, and over-the-counter medications. The most frequent cost reported by CPs was prescription drug related (11 CPs), while costs associated with hospitalizations and ED were the least frequently reported (4 CPs). A longitudinal weekly survey-based approach to quantify CP costs is a novel approach examine an intervention outcome (cost) that matters to families and policymakers.
END-OF-LIFE EVENTS AND CAUSES OF DEATH IN DANISH LONG-LIVED FEMALE SIBLINGS
Authors: Galvin Angeline , Ukraintseva Svetlana , Arbeev Konstantin , Feitosa Mary , Newman Anne , Christensen Kaare
Published: December 2022

Long-lived siblings have better health and survival compared to “sporadic” long-lived individuals, but it is unknown whether they also differ in end-of-life events and causes of death. Deceased Danish long-lived female siblings (n=833, mean age at death=95.6) were identified through national health registers compared to controls matched on sex, year-of-birth, and year-of-death. End-of-life events (hospitalizations, emergency room visits, medication within the five years before death) and causes of death were analyzed using linear models with fixed effects and multinomial logistic models, respectively. End-of-life events and causes of death were not statistically significantly different between long-lived female siblings and “sporadic” long-lived individuals. However, long-lived female siblings presented non-significant higher risk of ischemic heart disease and cancer – and lower risk of mental diseases and accidents. The analyses will be extended to include men, a longer follow-up, and focus on dementia in the last years of life.
GENOME-WIDE ASSOCIATION STUDY OF EXTREME LONGEVITY USING WHOLE-GENOME SEQUENCING DATA
Authors: Gurinovich Anastasia , Bae Harold , Song Zeyuan , Leshchyk Anastasia , Li Mengze , Andersen Stacy , Perls Thomas , Sebastiani Paola
Published: December 2022

Extreme longevity (EL) runs in families which supports the hypothesis that this is a genetically regulated trait. However, with the exception of APOE, genome-wide association studies (GWAS) of EL have not identified many genetic variants that replicate in independent studies. The majority of GWAS of EL have used imputed genotype data. Recently, the Long Life Family Study has generated the largest whole-genome sequencing data of centenarians and matched controls. We perform single-variant and gene-based tests of EL in these data using the nf-gwas-pipeline with the saddle point approximation adjustment of the p-values. These analyses suggest that, in addition to the APOE/TOMM40 region, some uncommon variants of GRM7 (chr3), AUTS2 (chr7), KIF13B (chr8), SLC2A14 (chr12), and ADCY9 (chr16) genes, and other intergenic SNPs in chromosomes 5, 10, and 20 may be implicated with EL.
THE IMPACT OF SOCIAL DEPRIVATION ON COVID-19 INFECTIONS IN NURSING HOMES
Authors: Weech-Maldonado Robert , Lord Justin , Davlyatov Ganisher , Ghiasi Akbar , Orewa Gregory
Published: December 2022

Health inequities vary along social and economic gradients. The COVID-19 pandemic and nursing home infections have highlighted this fact. Using the Centers for Medicare and Medicaid Services’ Nursing Home COVID-19 Public File, Brown University’s LTCFocus, Robert Graham Center’s Social Deprivation Index, and CMS Nursing Home Payroll Based Journal Staffing Data. We examined the relationship between community resource scarcity, as conceptualized by the Social Deprivation Index (SD) and COVID-19 incidence rates in nursing homes. After controlling for interstate differences, organizational enabling factors, as well as, facility-level resident and community-level characteristics, nursing homes located in communities with medium levels of social deprivation had 4.4% more COVID-19 infection rates (Incidence Rate Ratio [IRR] = 1.04; p < 0.05) and communities with high levels of social deprivation had 7.5% higher COVID-19 infection rates (Incidence Rate Ratio [IRR] = 1.07; p < 0.01) as compared to nursing facilities located in areas of low social deprivation. From a policy perspective, nursing homes, that are located in socially deprived communities, may need additional resources, such as, funding for staffing and personal protective equipment in the face of the pandemic. The COVID-19 pandemic has sharpened the focus on healthcare disparities and societal inequalities in the delivery of long-term care.
EMOTION REGULATION AND POSITIVE AFFECT IN SPOUSAL DEMENTIA CARE DYADS
Authors: Piechota Amanda , Novak Joshua , Vu Thi , Monin Joan
Published: December 2022

The early stages of dementia can be a time of stress and uncertainty for spouses, yet little attention is paid to positive experiences. It is important to understand whether there are individual differences in emotion regulation that impact the positive affect of the individual and the partner. Drawing from interdependence theory, we hypothesized that one spouse’s greater difficulty regulating emotions would be associated with their spouses lower positive emotions over time. We used self-report data from an intervention study with three assessment points (baseline, two weeks, and three months) of 45 older adult married couples (N=90) where one spouse has early-stage dementia. Both partners completed the Difficulties in Emotion Regulation Scale and the Positive and Negative Affect Scale. Results from the longitudinal actor partner interdependence model showed that when care partners were high in difficulty regulating emotions, their partner’s positive affect decreased (β = -0.343, p <.01), controlling for intervention arm and covariates.
INFORMAL DEMENTIA CAREGIVERS' EMOTIONAL EXPERIENCES DURING CONFLICT AND DEPRESSIVE SYMPTOMS
Authors: Brown Casey , Chen Yuxuan , Levenson Robert
Published: December 2022

Emotional interactions may change as a result of dementia and negatively impact caregivers’ mental health. We examined 62 dementia caregivers’ emotional experiences during conflict with their partners, including 22 individuals with behavioral variant frontotemporal dementia (bvFTD), 20 with Alzheimer’s disease (AD), and 20 with a language variant of frontotemporal dementia (language variant). Dyads engaged in a 10-minute conversation involving conflict. Caregivers watched recordings of their conversation while rating their emotional valence using a rating dial. Caregivers of individuals with bvFTD reported greater decreases in positive emotion across the conversation relative to caregivers of individuals with AD and language variants. Caregivers who reported greater decreases in positive emotion across the conversation had higher levels of depressive symptoms, even after accounting for their partner’s diagnosis and level of cognitive impairment. Findings suggest bvFTD caregivers experience the greatest declines in positive emotion during conflict, with potential implications for depression.
KINLESSNESS AND COGNITIVE FUNCTION AMONG EUROPEAN OLDER ADULTS
Authors: Mair Christine , Ornstein Katherine
Published: December 2022

So-called “kinless” older adults (unpartnered and childless) are a growing population across the globe who may be at higher risk for social isolation and cognitive decline. Yet, this group of older adults is understudied in dementia-related research and their risk of cognitive decline likely varies by country context. We analyze data from the Survey of Health, Ageing & Retirement in Europe (SHARE) to explore cognitive decline by family structure and country. We assess cognitive decline along a gradient of “kinlessness” by comparing older adults with a) partner and child, b) partner and no child, c) no partner and child, and d) no partner and no child across 20 European countries. Results of this study will outline the dementia risks faced by the growing population of older adults with non-traditional family structures and highlight characteristics of country context that might enhance or reduce risk of cognitive decline for “kinless” older adults.
I-CONECT RESULTS: ENHANCING SOCIAL INTERACTIONS IMPROVES COGNITIVE FUNCTION IN SOCIALLY ISOLATED PARTICIPANTS
Authors: Dodge Hiroko , Wu Chao-Yi , Yu Kexin , Lichtenberg Peter , Struble Laura , Potempa Kathleen , Silbert Lisa
Published: December 2022

Epidemiological studies suggest that social isolation is a risk factor of dementia although the underlying mechanisms are not well known. A core component of social isolation is a lack of conversational interactions. We recently completed a NIH-funded multi-center randomized controlled trial called Internet-Based Conversational Engagement Clinical Trial (I-CONECT, ClinicalTrials.gov: NCT02871921), which aimed to examine whether social engagement, specifically conversational interactions through webcam and internet, could improve cognitive function in socially isolated older adults with mild cognitive impairment (MCI) or normal cognition. The data was un-blinded in August, 2021. We found strong evidence of efficacy in the primary (global cognitive function, Cohen’s d = 0.73, p=0.03) and secondary (memory function, Cohen’s d=0.67, p=0.03) outcomes at Month 6 (high-dose post-trial endpoint) and Month 12 (maintenance-dose post-trial-endpoint), respectively, using the mixed model for repeated measures. We will present the background, COVID-19 pandemic related protocol modifications and the primary results of this intervention project.
RISK FACTORS AND IMPACT OF FINANCIAL FRAUD ON OLDER ADULTS AND DISADVANTAGED COMMUNITIES
Authors: DeLiema Marguerite , Witt Paul
Published: December 2022

In 2021, Americans age 80 and older reported median fraud losses of $1,300 per incident, substantially higher than younger age groups (Federal Trade Commission, 2022). Using data from the Federal Trade Commission’s Sentinel Fraud Complaint Database and the Area Deprivation Index, this study assesses the demographic and contextual correlates of consumer fraud victimization in the United States. Models show a positive association between living in a disadvantaged community and reporting victimization (versus reporting no losses after being targeted). Black and Hispanic consumers are significantly more likely report victimization, although non-Hispanic White victims report higher average fraud losses. Results also show that older adults are significantly less likely to report fraud victimization relative to people age 30 and younger, but older victims lose hundreds of dollars more, on average. Applying a sentiment analysis to the consumer complaint narratives, we find that compared to emotionally neutral complaints, emotionally positive and emotionally negative complaints are positively associated with reporting victimization versus reporting no losses. Gift cards are the most common method of payment demanded by fraud criminals overall, but victims who pay using cash, wire transfer, or cryptocurrency lose significantly more money, on average. To limit the impact of fraud on the aging population, consumer protection agencies need to focus their efforts on educating older adults and members of socially and economically disadvantaged communities about scams, as well as enforce greater controls on cryptocurrency exchanges and retail gift card sales.
BODY WEIGHT INFLUENCES MUSCULOSKELETAL ADAPTATION TO LONG-TERM VOLUNTARY WHEEL RUNNING DURING AGING
Authors: Kitase Yukiko , Julian Vallejo , Xie Yixia , Dallas Mark , Dallas Sarah , Johnson Mark , Wacker Michael , Bonewald Lynda
Published: December 2022

Frailty is a key hallmark of aging and exercise has been shown to delay aging effects. This study was initiated based on the hypothesis that voluntary wheel running (VWR) starting at 12 mo until 18 or 22 mo of age would benefit the female murine musculoskeletal system. Based on the final body weight, the mice were separated into high (HBW) and low body weight (LBW) subgroups. Beneficial effects of VWR were observed on soleus muscle mass and contractile force at both ages, although HBW led to greater increases at 22 mo. VWR increased fiber cross-sectional area by 20%, leading to more type I and fewer IIA fibers in soleus. HBW mice were resistant to age-related decline in Extensor digitorum longus (EDL) mass and contractile force. EDL in 18 mo HBW also showed 15% higher contractile force following VWR while muscle from 18 & 22 mo LBW responded to VWR with greater osteocyte protective factor secretion. Skeletal adaptation to VWR was also dependent on body weight, with HBW showing higher femoral cortical thickness and area under sedentary conditions. VWR maintained osteocyte dendrite number in HBW. VWR increased periosteal and endosteal circumferences in HBW, suggesting compensation for loss of material strength. Consistent with this, VWR maintained higher bone mechanical properties in 18mo LBW. In summary, VWR alters musculoskeletal parameters depending on body weight with HBW contributing to more muscle mass and strength to prevent sarcopenia while bone retains better mechanical properties in LBW but HBW contributes structural modification to prevent osteopenia.