bluuebunny/crossref_metadata_2025 huggingface dataset:
CRITICAL SOCIAL GERONTOLOGY AND RURAL AGING
Authors: Burholt Vanessa , Scharf thomas
Published: November 2019

This paper examines the extent to which critical gerontology has raised awareness of the heterogeneity of rural ageing in High Income Countries (HICs) and compare this to our knowledge of the issues that are associated with rural ageing in Low to Middle Income Countries (LMICS). We will draw on Nancy Fraser’s social justice framework to summarize key issues around: (1) Demography (such as globalization, urbanization, counter-urbanization and rural population ageing); (2) Resources (individual material and social resources; community resources such as access to services); (3) Recognition (social status, cultural visibility through social participation and cultural worth through valued social roles); (4) Representation (in social, health and rural development policies; and in private sector and NGO approaches). We argue that an intersectional approach that takes into account location and context (structural/economic/political) alongside other dimensions of oppression and/or privilege can provide a better understanding of the experience of ageing in rural areas.
RETHINKING RURAL GERONTOLOGY THROUGH A DEWEYAN PRAGMATIST PERSPECTIVE
Authors: Cutchin Malcolm , Cutchin Malcolm P , Rowles Graham D
Published: November 2019

Rural aging as we have conceived of it in the gerontological literature of the past 50 years no longer exists, if it ever did. In this presentation, we contribute toward a reframing of the discourse on rural aging through a critique of established views of rural aging as an ecological, cultural, and phenomenological experience. We argue that each view is limited in its ability to encapsulate the essence of rural living and community. Our critique provides a context for a dynamic perspective on rural aging that embraces the situational uniqueness of each rural environment. We introduce that perspective, based in John Dewey’s philosophy, and grounded in the idea of situationally defined manifestations of place integration within an ever-changing milieu. We conclude with a discussion of key implications, including how this perspective reshapes the roles of researchers and older rural residents in the process of ongoing rural gerontological inquiry.
PRE-REGISTERING QUALITATIVE RESEARCH: BENEFITS, UNINTENDED CONSEQUENCES, AND UNANSWERED QUESTIONS
Authors: Bowers Barbara
Published: November 2019

While preregistration has gained increasing acceptance for quantitative, particularly experimental, studies, its relevance and implementation for qualitative research has only recently been proposed. This presentation provides an overview of the very recent and ongoing debate on the potential benefits and costs of implementing preregistration for qualitative research. The presentation summarizes the debates about whether and how preregistration will lead to greater transparency in qualitative research, explores the implications of preregistration for qualitative research, identifies some of the costs incurred in preregistering qualitative studies, describes the inaccurate assumptions about qualitative research that are repeatedly embedded in calls for preregistration, and identifies some likely, unintended consequences of adopting the same approaches employed or proposed for quantitative studies. Acknowledging the importance of greater transparency and reduced publication bias for all research, including qualitative studies, questions about transparency that qualitative researchers must urgently address are also suggested.
MEASUREMENT OF GERIATRIC SURGERY OUTCOMES IN A NATIONAL REGISTRY
Authors: Finlayson Emily
Published: November 2019

The American College of Surgeons National Quality Improvement Program started a “Geriatric Pilot” in January 2014. This project has already collected 19 additional older adult specialty variables in more than 60,000 patients undergoing operations. Twenty-six medical centers participate from across North America. The variables collect information in the domains of cognition, function, mobility and decision-making. Variables are collected in both the pre- and post-operative settings. It is clear that the quality of surgical care cannot be limited to the immediate hospitalization. The pilot has recently expanded its use of longer-term outcomes and has begun collecting 30-day outcomes of functional status and living location.
EFFECTIVENESS VS. EFFICACY: CREATING EVIDENCE FROM GERIATRIC SURGERY QUALITY PROGRAMS
Authors: Ma Meixi
Published: November 2019

The American College of Surgeons National Quality Improvement Program started a “Geriatric Pilot” in January 2014. This initiative has collecting specialty variable related to older adults in more than 60,000 patients 65 years and older undergoing operations. Multiple research publications have been generated from this pioneering national quality program focused on surgical quality in older adults. The purpose of this presentation will be to review the major findings of this new body of research. Studies have focused on functional trajectory following operations, postoperative delirium, and peri-operative decision-making.
MEDICAL MANAGEMENT OF PAIN IN GERIATRIC PATIENTS
Authors: Sehgal Sonia
Published: November 2019

Pain and pain management is a growing concern for older adult patients and their health care providers. Upwards of 50% of older adults report having bothersome pain and 75% of these individuals report having pain in more than one location. Persistent pain is associated with decreased physical function, depression, isolation, and a decreased quality of life. Managing chronic pain in the setting of an opioid crisis requires special knowledge about the aging body so that medications can be used safely and effectively; and adjuvant therapies such as PT or acupuncture can be maximized. This segment of the symposium will review common challenges faced by primary care providers when managing chronic pain in older adults: the natural physiologic changes that occur in the aging body, co-morbid chronic diseases which can complicate pain syndromes, and assessing pain in cognitively impaired patients.
INTEGRATIVE APPROACHES TO MANAGING PAIN IN GERIATRIC PATIENTS
Authors: Kilgore David
Published: November 2019

In the United States, over 100 million people have chronic pain, which is associated not only with high care costs, disability and suffering, but more recently, with growing concerns about potential side effects and complications from medications commonly used to treat pain, in particular NSAIDs and opioid therapies. Pain is a multifaceted issue involving nutritional, psychosocial, biochemical, neurological and physical components. Our current medical model typically addresses pain in a unidimensional mode that often only focuses on medications. The last decade has seen advancement in the evidence base behind a number of Integrative therapies used to treat pain, most of which offer a safe side effect profile and can help expand the toolkit of available options to treat this challenging problem in the older patient. This session will briefly review several examples of Integrative therapies for pain, including Acupuncture, Mind Body treatments, Nutrition and selected supplements.
EXERCISE THERAPY: AN ALTERNATIVE APPROACH TO MANAGING PAIN IN GERIATRIC PATIENTS
Authors: In Lydia
Published: November 2019

Physical therapy improves the physical function and strength of older adults. Exercise decreases pain associated with osteoarthritis of the knee and hip, while improving well-being and physical function in patients with fibromyalgia. Current CDC guidelines for chronic pain management recommend exercise therapy as one of the non-pharmacologic strategies to employ. Based on a patient’s personal goals, physical therapists, experts in human movement, design individualized care plans, provide appropriate interventions, and modify treatment as necessary to optimize or maintain function, improve quality of life, and delay dependency and need of care. When PTs work with patients in pain, they focus on the movement patterns that may contribute to the pain. PTs also evaluate risk factors for pain to help prevent future pain issues. Strategies employed by physical therapists will be discussed, and well as ways to integrate exercise into a holistic and multi-disciplinary pain management approach.
INTEREST GROUP SESSION—SLEEP, CIRCADIAN RHYTHMS AND AGING INTEREST GROUP: SLEEP, PHYSICAL ACTIVITY, AND BRAIN AGING
Authors: Kaufmann Christopher N , Stone Katie L
Published: November 2019

As the US population ages, the prevalence of Alzheimer’s Disease (AD) and related dementias is expected to increase, making dementia prevention efforts a major public health priority. Impaired sleep and circadian rhythms, along with other lifestyle factors, have emerged as important modifiable disease risk factors—recent studies demonstrate the importance of sleep in preventing the development of key biomarkers for AD/dementia pathology. In this symposium, we will highlight findings on the associations of sleep, circadian rhythm disruptions, and daytime activity patterns on development of cognitive decline and dementia, exploring not only the mechanisms driving these associations, but the potential impact of sleep and lifestyle interventions in promoting healthy brain aging. The symposium consists of four presentations which use data from large national cohort studies. First, we will present analyses on patterns of 24-hour (circadian) activity rhythms (e.g., usual time of day for peak activity, regularity of circadian patterns) and incident dementia risk. The second presentation will present findings pertaining to understanding the link between sleep disturbance and inflammation (a substantial contributor to cognitive aging). The third will examine whether detailed daytime activity patterns associate with imaging-based brain volumes, independent of sleep disturbance. The final presentation will explore whether initiation of sleep disorder treatments may have the potential to change trajectories of cognitive performance as individuals age. Overall, the symposium will highlight the importance of sleep and activity patterns to brain health and stimulate discussion about improving sleep and circadian disruption as a target for dementia prevention efforts.
CROSS-SECTIONAL AND LONGITUDINAL RELATIONSHIPS BETWEEN REST-ACTIVITY RHYTHMS AND INFLAMMATION IN OLDER MEN
Authors: Qian Xiao , Xiao Qian , Evans Daniel S , Redline Susan , Lane Nancy , Ancoli-Israel Sonia , Stone Katie S
Published: November 2019

Sleep disturbances and physical inactivity have been associated with chronic inflammation, an important risk factor for cognitive decline in the aging population. However most previous studies focused on the cross-sectional relationships between sleep and physical activity and inflammation. In the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study, we studied both the cross-sectional and prospective associations between characteristics of 24-hour rest-activity rhythms measured by actigraphy and inflammation index measured by multiple circulating markers. In cross-sectional analysis, a lower amplitude is associated with elevated inflammation (Odds ratio Q4 vs Q1 (95% Confidence interval): 1.65 (1.22, 2.24)). In prospective analysis, an earlier acrophase (<12:30) is associated with a two-fold increase in the risk of developing elevated inflammation over four years of follow up (2.08 (1.02, 4.23)). No individual inflammatory markers are associated with rest-activity rhythms. Our findings suggest that rest-activity rhythm characteristics predicts elevated inflammation.
COGNITIVE TRAJECTORIES BEFORE AND AFTER SLEEP TREATMENT INITIATION IN U.S. OLDER ADULTS WITH SLEEP DISTURBANCE
Authors: Kaufmann Christopher N , Bondi Mark W , Murphy James D , Tu Xin , Moore Alison A
Published: November 2019

Sleep disturbances are associated with cognitive decline but it is not clear if initiation of sleep treatments mitigates decline. We used the 2006-2014 Health and Retirement Study. At each wave, participants were administered cognitive assessments and scores were summed (values=0-35; higher=better cognition). All participants also reported if, in the past two weeks, they had taken medications or used other treatments to improve sleep. Our sample (N=4,650) included individuals who at baseline were cognitively normal and untreated for sleep, and at any wave reported some sleep disturbance. We characterized cognitive performance over study period with comparisons before and after sleep treatment initiation. Between 2006-2014, participants exhibited declines in cognitive performance (B=-2.40; 95% CI=-2.73, -2.06; p<0.001) after controlling for confounders. Following sleep treatment, cognitive decline became less pronounced (interaction B=0.94; 95% CI=0.21, 1.67; p=0.013). Results suggest that in older adults with sleep disturbance, initiation of sleep treatment may slow cognitive decline.
EVALUATING THE ENGAGING OLDER ADULT LEARNERS AS HEALTH RESEARCHERS PROJECT I
Authors: Kondolf Kate , Duckles Joyce , Seshadri sandhya , Jackson Phyllis , Sellers Craig , Young Doreen , Moses George , Sörensen Silvia
Published: November 2019

We discuss the evaluation of the Engaging Older Adult Learners as Health Researchers (ENGOAL), a program designed to educate older adults from underserved and underresourced communities about geriatric health and research methods, enabling them to become Research Partners. Quantitative and qualitative data were collected for evaluation from 21 participants aged 53-79. We used All Aspects of Health Literacy Scale (AAHLS, King’s College, London) and an adaptation of Stanford Patient Education Research Center Chronic Disease Self-Efficacy Scale to assess pre-post and follow-up changes, using repeated measures analyses. Results suggest notable increases in self-efficacy, but only small improvements in subjective health literacy. Themes identified through qualitative analysis of interviews with participants included: (1) Finding our Voices (2) Race and Health (3) Faith and Health (4) Communicating with Providers and (5) Sharing and Advocacy. Emerging community leadership of participants are further evidence of confidence gains in our participants.
HOW TO GET AN NIA GRANT
Authors: Barr Robin A
Published: November 2019

Dr. Barr will provide an overview of the various funding mechanisms supported by NIA, with emphasis on mechanisms that are most appropriate for early career scientists.
THE ROLE OF HEALTH LITERACY ON PROCESS AND OUTCOMES OF A DIABETES SELF-HELP INTERVENTION WITH KOREAN AMERICANS
Authors: Kim Miyong T
Published: November 2019

The purpose of this study was to explicate the underlying mechanisms of the role of health literacy (HL) in diabetes management process involving a group of Korean Americans with type 2 diabetes mellitus (DM). We used data from a randomized clinical trial of an HL-focused diabetes self-management intervention (n = 250). A series of path analyses identified the level of self-efficacy and self-care skills as a significant mediator between HL and glucose control (HbA1C) and quality of life for the target population. In addition, education and acculturation were revealed as the most significant correlates of HL for this new immigrant group. Despite inconsistent empirical findings regarding the statistically significant effect of HL on glucose control, this study confirmed the apriority hypothesis that HL indirectly influences health outcome through mediators such self-care skills as self-efficacy. This study highlighted the importance of HL in chronic disease management for people with limited HL.
MOBILE APP INTERVENTION TO PROMOTE BREAST CANCER SCREENING IN OLDER KOREAN AMERICAN WOMEN
Authors: Lee Hee Y
Published: November 2019

To promote breast cancer screening behavior in older Korean American women, a mobile phone multimedia messaging intervention (mMammogram) was developed. The current study explored how the mMammogram intervention can be applied and improved for wide dissemination and implementation in other older racial/ethnic immigrant populations. Three focus groups were conducted with 14 older Korean American women who completed the mMammogram. Three themes emerged: (1) emphasis on knowledge improvement (understanding of breast cancer screening); (2) assistance of bilingual health navigators to promote mammography (e.g., setting up appointment and transportation); and (3) consideration of technology literacy (e.g., training for use of smartphone and connectivity issues). Mobile app intervention combined with bilingual health navigation services can be an acceptable and effective intervention medium to promote mammogram, which will bring about a positive change in women’s health screening behavior, especially for newly arrived immigrant populations.
ATTITUDES TOWARD AND PREFERENCE FOR ADVANCE CARE PLANNING AMONG OLDER KOREAN AMERICANS
Authors: Hong Michin , Noh Hyunjun , Kim Kyeongmo
Published: November 2019

Advance care planning (ACP), referring to a decision-making process for end-of-life (EOL) care in advance, is critical in ensuring satisfaction with care and quality of life among patients and caregivers at the EOL. However, Korean Americans consistently report lower levels of ACP engagement compared to whites, indicating their potential vulnerability at the EOL. To gain insight into strategies to address the disparity, this qualitative study explored attitudes toward and preference for ACP among older Korean Americans. We conducted three focus group interviews with 31 older Korean Americans. Through iterative data analysis process, four themes emerged: 1) moderate levels of awareness of and prior experiences with ACP: 2) favorable attitudes toward ACP, while concerned about non-compliance by children: 3) preference for natural dying without life prolonging treatments and pain: and 4) preference for physician-initiated ACP. Our findings suggest the necessity of culturally tailored approaches to promote ACP for this population.
WHAT STORIES DO FILMS TELL ABOUT AGING?
Authors: Kivnick Helen Q , Vandenbosch Jim
Published: November 2019

With the aging of the worldwide population, films inevitably include an increasing number of stories about aging and its vicissitudes. Gerontologists acknowledge that aging (a process that is at once biological, social, and psychological) includes elements of decline, loss, and fear– along with opportunities for new learning and creativity, contributions, love, and satisfactions. However given mainstream society’s predominant demand for the status quo, we should not be surprised that films made for popular, commercial audiences tend to reflect self-reinforcing, negative stereotypes and defenses against them (e.g., denial; fantasy; melodrama). This symposium seeks to: 1) Name and illustrate this filmic process of reinforcing negative stereotypes and misconceptions; 2) Describe and illustrate two existing theories that. explain positive processes associated with healthy aging; 3) Identify and illustrate films that constitute positive alternatives to the status quo and, in so doing, open the door to films presenting realistic stories of the positive balancing of later-life Integrity with Despair. The first presenter will articulate and illustrate this filmic process of reinforcing negative stereotypes and misconceptions. Presenters #2 and 3 will describe and illustrate two existing theories that explain positive processes associated with healthy aging (Baltes & Baltes’ Selective Optimization and Compensation; Erikson’s Integrity & Despair). Presenter #1 will return to identify and illustrate films that constitute positive alternatives to the status quo and, in so doing, open the door to discussing films that present realistic stories of older adulthood’s complexities.
THE COURAGE TO EMBRACE OLD AGE
Authors: Vandenbosch Jim
Published: November 2019

Most popular films and television programs reflect, and thereby reinforce, the common and entrenched cultural perception of aging as the “enemy” of vital living. Aging used to be kept at bay in popular films and TV programs through a stereotyping that allowed ridicule and avoidance. Today, such overt negative portrayals have begun to fall out of favor but are being replaced by a subtler form of ageism—that of “super-aging” where older adults who are seen as successfully holding onto their youthful ways are celebrated and held up as models of “successful” aging. This presentation will give an overview of how most popular films and television programs frame the experience of older adulthood, and will illustrate this with clips from such films. Then, in contrast, clips will be presented from films that present a more holistic and balanced view of elderhood.
THE S.O.C. MODEL OF AGING IN DOCUMENTARY FILMS: POSITIVE ADAPTATION TO AGE-RELATED LOSS IN THEORY AND EVERYDAY LIFE
Authors: Scheidt Rick
Published: November 2019

There is overwhelming evidence that “pop culture” depictions of age-related losses are primarily negative, ignoring positive adaptive experiences associated with the second half of life. Unfortunately, film as an entertainment medium often creates and reinforces this negative status quo. This presentation describes the usefulness of the Baltes and Baltes S.O.C. Model for offsetting losses – via narrowing and revision of goal priorities (Selection), locating and enhancing resources to achieve positive outcomes (Optimization), and using these to increase one’s personal limits and reserve capacities (Compensation). In addition, positive “S.O.C. Solutions” (Spiehs, 2018) are illustrated for everyday loss scenarios within four new documentary films. These include positive adaptations to four loss domains – personal autonomy (driving), physical capacity (sexual responsiveness), psychological well-being (loneliness and belonging), and environmental destruction (place dependency). Annotated sources will be made available.
THE DO IT MYSELF VILLAGE: BUILDING A VILLAGE-LIKE SUPPORT SYSTEM WITHOUT A VILLAGE
Authors: Glicksman Allen , Ring Lauren , Graham Carrie
Published: November 2019

Villages provide members with a wide range of support including socialization, vetted vendors and other services that assist the elder to age in place. While not every Village offers the same types of support many older adults join Villages to gain benefits they may have lost (such as an informal support network) or ones they cannot find (such as identifying reliable providers of home repair). However, Villages are not available everywhere and there are barriers to Village membership, especially cost. Do older adults without access to a Village simply “do without” or do some of them create the same type of support system on their own? This presentation, using data collected in focus groups and individual interviews for a study of aging in community will describe the ways in which older adults have fashioned their own set of services and socialization opportunities to achieve the same goals as Village membership.
RACIAL-ETHNIC DIFFERENCES IN NURSING HOME QUALITY OF LIFE FOR ALZHEIMER’S DISEASE AND DEMENTIA RESIDENTS
Authors: Shippee Tetyana P , Jarosek Stephanie , Qin Xuanzi , Woodhouse Mark
Published: November 2019

Nursing homes (NHs) are often racially segregated, and minority residents admitted to NHs usually have more advanced stages of dementia at the time of admission than their white counterparts, with different care needs. Previous work has shown that racial disparities in NH quality of life (QoL) were partially due to different case mix of white and minority residents; it is unclear if disparities persist when comparing residents with similar ADRD diagnoses. The 2011-2015 Minnesota Resident Quality of Life and Satisfaction with Care Survey data contain in-person resident responses from a random sample of residents of all Medicare/Medicaid certified NHs in the state, about 40% of whom have AD/ADRD. These data were linked to the Minimum Data Set (MDS) and facility characteristics data. The population consists of 25,039 White, 580 Black, 94 Hispanic, 229 Native Americans, and 99 Asian/Pacific Islander NH residents with ADRD residing in 376 NHs. Racial/ethnic minority residents reported significantly lower QoL scores compared to their white counterparts, with the largest disparities in the food and relationships domains. We adjusted for resident (age, marital status, education, sex, length of stay, anxiety/mood disorder, activities of daily living scores) and facility characteristics (proportion of minority residents, ownership, urban vs rural, size, and occupancy ratio) using a multivariate random intercept model. After adjustment, significant differences remained in total QoL score and several QoL domains for Black, Asian and Hispanic residents (no significant differences for Native American residents). Practice guidelines should consider different care needs of racial/ethnic minority NH residents with ADRD.
APPLYING MIXED-METHODS APPROACHES TO THE STUDY OF SOCIAL TIES IN LATER LIFE
Authors: Suitor J Jill , Gilligan Megan
Published: November 2019

This symposium brings together a diverse set of studies applying mixed-methods approaches, with an emphasis on illustrating the ways in which such designs can provide greater understanding of interpersonal processes in the middle and later years. The papers span a wide range of relational contexts, including ties between parents and adult children, grandparents and grandchildren, and couples in gay, lesbian, heterosexual partnerships. They illustrate a variety of ways to combine quantitative and qualitative data collecting using surveys, in-depth interviews, timeline data, and technological devices. In the first paper, Silverstein and Bengtson present a study of continuity, change, and conflict across the generations regarding religion. The next two papers explore the impact of social relations on well-being. Fingerman and colleagues report findings from a study of social engagement and sedentary activities; and Suitor and colleagues investigate gender differences in the effects of mothers’ favoritism on adult children’s depressive symptoms. The final two papers focus on couples’ experiences when facing potentially demanding and/or challenging life circumstances. Thomeer and colleagues present findings from a study of same-sex couples in the context of marriage and parenthood; and Umberson and colleagues shed light on marital dynamics in same-sex and different-sex couples when one partner experiences psychological distress. This diverse set of studies provides a rich overview of the ways in which mixed-methods approaches can shed more light on patterns and consequences of relationships in adulthood than could be learned using single-method designs.
CHANGES IN THE PSYCHOLOGICAL COSTS OF MATERNAL FAVORITISM FOR DAUGHTERS AND SONS AS MOTHERS AGE
Authors: Suitor J Jill , Gilligan Megan , Rurka Marissa , Hou Yifei , Stepniak Catherine
Published: November 2019

Life course perspectives suggest that the consequences of being mothers’ favorite children will vary, depending on the expectations associated with that status at different points in mothers’ lives. We propose that maternal favoritism predicts depressive symptoms only when mothers are older and at greater risk of facing losses for which favored children perceive they should provide additional emotional support. To address this question we used mixed-methods panel data collected from 479 adult children as part of the Within-Family Differences Study. Multi-level regression analyses revealed that perceiving oneself as the child most emotionally close to the mother did not predict depressive symptoms for daughters or sons at T1, but was a predictor of daughters’ depressive symptoms at T2. Qualitative analyses revealed that by T2, favored daughters had begun perceiving themselves as emotional caregivers when mothers faced age-related losses, whereas favored sons did not hold these role perceptions at either wave.
PARENTHOOD AND MARRIAGE WITHIN SAME-SEX COUPLES: AN ANALYSIS USING SURVEY, TIMELINE, AND IN-DEPTH INTERVIEW DATA
Authors: Thomeer Mieke , LeBlanc Allen J , Frost David M
Published: November 2019

In this study, the authors analyze data from Project SHARe, a mixed-methods study of same-sex couples in two cities, Atlanta and San Francisco. This study considers both past experiences of parenthood and marriage among same-sex couples, as well as what same-sex couples anticipate will occur regarding their own future experiences of parenthood and marriage, based on analysis of survey responses, timeline data, and in-depth interviews.
HOW LONELY AND ISOLATED ARE OLDER PEOPLE WITH DEMENTIA AND THEIR CARERS: A DYADIC ANALYSIS
Authors: Victor Christina , Rippon Isla , Martyr Anthony , Mathews Fiona , Clare Linda
Published: November 2019

Studies of loneliness and isolation have rarely explored is how these experiences are reported within couples or the wider households. The IDEAL study has collected details of loneliness, as measured by the de Jong Gierveld (DJG) scale (range 0-6) and a single-item self-report measure, and isolation, using the six-item Lubben social network scale (range 0-30) from both people with dementia and carers. Loneliness is classified into three groups: not lonely (score 0-2), moderately lonely (3-4) and severely lonely (5+) and isolation into two: not isolated (score of 13+) or isolated (12 or less). Of the 1547 people with dementia and 1283 carers interviewed at baseline we have 1089 dyads who provided complete data on loneliness and 1204 for social isolation. Loneliness ratings are congruent between 43.1% of dyads and for 67.8% for isolation highlighting the subjective evaluative nature of loneliness as compared with more objectively measured isolation.
COGNITIVE DECLINE ENHANCES VULNERABILITY TO ENVIRONMENTAL DETERMINANTS OF MOBILITY
Authors: Rosso Andrea , Clarke Philippa , Studenski Stephanie L , Rosano Caterina L
Published: November 2019

Neighborhood and residential characteristics can potentially influence mobility of older adults but associations may differ based on cognitive function. We tested whether neighborhood and residential characteristics derived from audits of Google Streetview images were related to 4-year incident mobility disability and whether these associations differed by cognitive trajectories (maintainer vs decliner over 14 years). In 260 participants from the Health ABC (mean age=81.8 years, 57% female, 39% black), Cox proportional hazard models tested associations stratified by cognitive trajectory, adjusted for demographics. Mixed compared to residential land use was associated with greater risk of mobility disability among cognitive decliners (HR=1.27, 95% CI: 1.05-1.54) but not cognitive maintainers (HR=1.07, 95% CI: 0.90-1.28). Presence of slopes near the home and having a ramp at the home entrance were associated with lower mobility disability risk, again in decliners only. Lower cognitive function may increase vulnerability to poorer neighborhood and residential characteristics for mobility outcomes.
NEIGHBORHOOD SOCIOECONOMIC STATUS AND GRAY MATTER VOLUME IN OLDER ADULTS
Authors: Godina Sara L , Rosano Caterina , Gianaros Peter J , Aizenstein Howard J , Carlson Michelle C , Clarke Philippa , Rosso Andrea L
Published: November 2019

Lower neighborhood socioeconomic status (nSES) is associated with poorer cognitive function; underlying neural correlates are unknown. Cross-sectional associations of nSES (six census-derived measures of income, education, and occupation) and gray matter volume (GMV) of eight memory-related regions (hippocampus, middle frontal gyrus, amygdala, insula, parahippocampal gyrus, anterior, middle, and posterior cingulum) were examined in 264 community-dwelling older adults (mean age=83, 56.82% female, 39.02% black). In linear mixed effects models adjusted for total brain atrophy and accounting for geographic clustering, higher nSES was associated with greater GMV of the left hippocampus, left posterior cingulum, and bilateral insula, middle frontal, and parahippocampal gyri. nSES remained associated with GMV of the right insula (β= -32.26, p=0.026, 95%CI: -60.66, -3.86) after adjusting for individual level age, gender, race, income, and education. The nSES and cognitive function association may not be due to gray matter volume differences; other behavioral and biological mediators should be explored.
ESPO/SOCIAL RESEARCH, POLICY, AND PRACTICE: CHOT: AN INDUSTRY-ACADEMIC MODEL TO IMPROVE HEALTH
Authors: Lord Justin C , Waldron Danielle
Published: November 2019

This proposed symposium will bring together a diverse panel of emerging and established academics, as well as, industry leaders to speak about the power of collaboration. As the delivery of health care in the field of gerontology becomes increasingly complex – researchers and practitioners will have to find new ways to address these challenges. One potential solution is to become more interdisciplinary and collaborative in our approach. This symposium will bring together academic and industry leaders from the National Science Foundation’s Centers for Health Organization Transformation (CHOT) to share with our membership an industry-academic partnership model that has benefited industry-focused research across more than 50 disciplines. As the ESPO representatives for the SRPP division, we believe that our membership would benefit from a symposium of this nature. This symposium would also reflect this year’s conference is “Harnessing the Power of Networks.” The SRPP section has the strongest commitment to practice and research on practice such as ways to improve the delivery of services to an increasingly diverse older population. A model of industry partnership holds tremendous value for all those involved; however, it is incredibly valuable for junior researchers who are just beginning their careers. The CHOT model provides opportunities and funding for researchers to develop collaborative relationships; engage in research; access new sources of data; disseminate findings directly to a broader audience, and have the ability to address some of health care’s wicked problems.
CHOT INDUSTRY PARTNER
Authors: Cochran Kenneth
Published: November 2019

The third speaker will be the industry partner representative, Kenneth Cochran, President and CEO of Opelousas General Health System. Here we will hear from industry partners about what drew them to this program of inter-collaboration; the benefits they have received, and what was required of them to participate. This will be helpful as it will provide an opportunity to have a first-hand account about the value that practitioners find in this program as it relates to testing interventions, developing new systems, and improving financial performance and/or quality. Kenneth will speak to a particular project at Opelousas and describe entire process. Kenneth will highlight the challenges and opportunities that come from partnering with an academic institution. Also, how CHOT brings together industry partners who are facing the same challenges and how they learn and adopt best practices from each other. This should further illustrate the value that academic/industry collaboration can bring.
LIVING ALONE WITH DEMENTIA: FINDINGS FROM THE IDEAL COHORT
Authors: Clare Linda , Clare Linda , Martyr Anthony , Quinn Catherine , Victor Christina , Matthews Fiona
Published: November 2019

We aimed to better understand the profile of people living alone with mild-to-moderate dementia in the UK and to identify any systematic differences between those living alone and those living with others. We analysed cross-sectional data from 1541 people with mild-to-moderate dementia participating in the IDEAL cohort at the first wave of assessment. There were 285 participants (18.5%) living alone and 1256 (81.5%) living with others, usually a spouse/partner. Among those living alone, 145 (50.9%) had no care partner participating in the study, and 56 (19%) had received no help from a relative or friend in the past week. People living alone were older on average than those living with others, reported fewer functional difficulties, had slightly smaller social networks, engaged in fewer cultural activities, and experienced slightly more loneliness. People living alone had lower satisfaction with life scores, but quality of life scores did not differ between the groups.
CORRECTING GLUTATHIONE DEFICIENCY AND MITOCHONDRIAL DYSFUNCTION IN OLDER HUMANS: A RANDOMIZED CLINICAL TRIAL
Authors: Sekhar Rajagopal V , Kumar Premranjan , Hsu Jean W , Suliburk James , Taffet George E , Minard Charles G , Jahoor Farook , Liu Chun
Published: November 2019

Aging is associated with impaired mitochondrial fatty-acid oxidation (MFO) due to unknown mechanisms, and interventions are lacking. We hypothesized that impaired MFO in aging occurs due to Glutathione-deficiency and tested this in a randomized, placebo-controlled double-blind clinical-trial in 24 older-humans (71.1y) and 12 young-controls (25.5y) using calorimetry, muscle-biopsy and tracer-protocols. Older-humans received either GlyNAC (Glycine 1.33mmol/kg/d and N-acetylcysteine 0.83mmol/kg/d as Glutathione precursors) or isonitrogenous-placebo for 16-weeks; young-controls received GlyNAC for 2-weeks. Compared to young-controls, older humans had significantly lower Glutathione, impaired MFO, lower gait-speed and physical-function, and higher oxidative-stress, inflammation and insulin-resistance. GlyNAC supplementation in older-humans significantly improved and restored MFO; increased gait-speed (19%,) and physical-function; and decreased oxidative-stress (TBARS 80%), inflammation (IL-6 83%; TNF-alpha 58%), and insulin-resistance (HOMA-IR 68%), but young-controls were unaffected. These data provide proof-of-concept that GlyNAC supplementation could improve the health of older-humans by correcting Glutathione-deficiency and mitochondrial-defects to improve gait-speed, oxidative-stress, inflammation and insulin-resistance.
THE SOCIOCULTURAL MODEL OF CREATIVITY: HOW IT CAN EXPLAIN THE SIGNIFICANCE OF MULTIPLE FORMS OF LATE-LIFE CREATIVITY
Authors: Adams-Price Carolyn E
Published: November 2019

Creativity in later life comes in many forms, ranging from everyday creativity to genius-level creativity, and including both newly learned creative activities and life-long creative hobbies. Previous psychosocial models of creativity have had limited utility in explaining the significance of late life creativity. Glaveanu’s sociocultural model has not been previously applied to older adults, but its inclusiveness makes it supremely useful for describing the range of creative activities and products in context. Creativity, according to Glaveanu, involves five interconnected components: actors, actions, artifacts, audiences, and affordances, which can be used to describe many different points along continuum of creative activities. The sociocultural model recognizes the value of different levels of creativity, including culturally-specific crafts, practice and learning new skills, the role of large and small audiences for creativity, and the connection of creativity and community. Glaveanu’s model will be discussed in the context of Erikson’s theory of late life development.
PREVALENCE OF LONELINESS AND ISOLATION AMONG PEOPLE WITH DEMENTIA AND THEIR CARERS
Authors: Rippon Isla , Quinn Catherine , Martyr Anthony , Victor Christina , Mathews Fiona , Clare Linda
Published: November 2019

People with dementia and carers may be vulnerable to loneliness and isolation. The IDEAL study includes two loneliness measures: 6 item de Jong Gierveld (DJG) scale (range 0-6) and a single-item self-report measure and the six-item Lubben social network scale (range 0-30). Full data are available for 1533 people with dementia for self-rated loneliness and for 1455 for the DJG scale and 1232 and 1195 carers respectively. For isolation complete data are available for 1489 people with dementia and 1252 carers. The prevalence of severe loneliness for people with dementia were 10% (self-rated) and 5% (DJG score 5+), approximately the population norm, and 15% and 18% respectively for carers. Most people with dementia or carers did not rate themselves as lonely ((79% and 71%) compared with 65% and 39% using the DJG scale. One third, 35%, of people with dementia were at risk of isolation compared with 18% of carers.
CUMULATIVE DIS/ADVANTAGE IN HEALTH AS AN INTERGENERATIONAL PROCESS
Authors: Shuey Kim
Published: November 2019

Empirical applications of cumulative dis/advantage primarily focus on accumulative processes within an individual life course as a mechanism generating growing intracohort inequality with age. However, adult health reflects the accumulation of exposures to advantages and disadvantages across the individual life course as well as the transmission of resources and practices across generations within one’s family of origin, which forms the foundation from which children are launched and inequality is reproduced. In analyses using two panel studies (PSID and Add Health), we integrate literature on the early-life origins of health with the concept of linked lives and the intergenerational transmission of resources to examine the relationship between parents’ health and the health of their children in adulthood. Results indicate an intergenerational persistence in health and demonstrate the importance of looking beyond the individual life course to better understand cumulative dis/advantage in health as a process operating across generations within families.
CURRENT EFFORTS TO UNDERSTAND AND IMPROVE OLDER ADULTS’ FUNCTIONAL RECOVERY AFTER HIP FRACTURE
Authors: Fortinsky Richard H , Latham Nancy
Published: November 2019

The annual number of hip fractures in the US is projected to increase from 258,000 in 2010 to 458,000 by 2050. Globally, annual hip fractures are projected to reach 4.5 million by 2050. Yet the majority of older adults experience long-term mobility disability following hip fracture and do not return to pre-fracture functional capacity. Published reviews have concluded there is insufficient evidence regarding effectiveness of interventions designed to reduce residual disability and enhance mobility post-hip fracture. This Symposium features current efforts to understand and improve functional recovery post-hip fracture. Dr. Magaziner will present results from the recently-completed Community Ambulation Project (CAP), a multi-site randomized trial in which two in-home physical therapy interventions were compared: PUSH, which included aerobic conditioning, strengthening, balance and functional training; and PULSE, which included transcutaneous electrical nerve stimulation, flexibility and active range of motion exercises. Dr. Fortinsky will present CAP data examining the role of psychological resilience, optimism, depression, and balance confidence on mobility measures. Dr. Gruber-Baldini will present CAP data examining differences between PUSH and PULSE on study participants’ cognition and the impact of cognition on community ambulation. Dr. Binder will present the study design and early results from the STEP-HI study, a multi-site randomized trial evaluating whether structured exercise and topical testosterone therapy can improve function post-hip fracture among older women. Discussant Dr. Latham will comment on design, results, and implications of these two studies for research, policy, and practice intended to improve older adults’ recovery after hip fracture.
PSYCHOLOGICAL FACTORS ASSOCIATED WITH AMBULATION PERFORMANCE AFTER HIP FRACTURE AMONG HOME-DWELLING OLDER ADULTS
Authors: Fortinsky Richard H
Published: November 2019

Many older adults fail to resume optimal community living after hip fracture due to sustained limitations in ambulation capacity, yet reasons remain poorly understood. Roles of psychological factors in affecting ambulation performance post-hip fracture remain particularly understudied; depression has been associated with poorer self-reported functional status, and little is known about self-perceived balance confidence, resilience, and optimism. This presentation reports associations between each psychological factor, measured at CAP baseline, and gait speed and walking endurance, measured at baseline and 16 weeks later. In the CAP cohort (N=210), baseline mean/sd 4-meter gait speed (gs), 50-foot walk gs, and 6-minute walk distance were: 0.60/0.19 meters per second (mps); 0.67/0.20 mps; and 186.9/55.4 meters, respectively. In multivariate models, balance confidence was positively associated with all baseline ambulation measures (p<0.001 in all models), and resilience was positively associated with all 16-week follow-up ambulation measures (p>0.05 in all models). Implications of results will be discussed.
EVENT-SPECIFIC EMOTIONAL EXPRESSION OF PERSONS WITH DEMENTIA IN LONG-TERM CARE: PRELIMINARY RESULTS
Authors: Lee Kyung Hee , Lee Ji Yeon , Kim Bora , Boltz Marie
Published: November 2019

Although dementia-related language, comprehension, and memory deficits occur fairly early stage in dementia, persons with dementia retain the ability to express their emotion even in the late stage of disease. However, health care providers do not know how to interpret emotional expressions that could be utilized as important signals of underlying needs and care preferences in persons with dementia. The purpose of this study was to explore the event-specific emotional expressions of persons with dementia in long-term care over a 6-month period. This was a longitudinal study using repeated observations. Emotional expressions were videotaped when three specific events (personal care, meal time, and activity) occurred at baseline, month 3 and month 6. A total of nine observations was made for each participant. We enrolled 13 participants so far; ten participants were completed 6 month follow up. The mean score of MMSE at baseline was 4.38; that of ADL was 16.62. On average, persons with dementia showed 9.93 episodes of positive emotional expression (PEE) per minute and 1.81 episodes of negative emotional expression (NEE) per minute. We found between person variations for both PEE and NEE. PEE and NEE were different by three types of events. Specifically, persons with dementia showed more PEE with activity than personal care and meal time and more NEE with personal care than the other two events. This study will provide better understanding of event-specific emotional expressions, and inform the development of emotion-oriented interventions programs to improve the psychological well-being of persons with dementia.
RESILIENCE THROUGH CONNECTION: SOCIAL SUPPORT AND ELDER ABUSE, DISASTER, BEREAVEMENT, AND COMBAT
Authors: Acierno Ron , Muzzy Wendy
Published: November 2019

Elder abuse prevalence among community residing adults is 10%, but this prevalence is cut by more than half among those who report high levels of social connection. Relatedly, elder abuse outcomes are significant, producing increased prevalence of anxiety and depressive disorders, the prevalences of which are, again, halved when one experiences abuse in the context of high social support. Similarly, mental health effects of natural disaster on older adults are virtually eliminated in the presence of high social support. Moreover, treatment for anxiety and depressive disorders is improved when high social support is present. We will present findings from five of our major studies in the aforementioned areas that underscore this point.