bluuebunny/crossref_metadata_2025 huggingface dataset:
THE EXPERIENCE OF AGING IN DAILY LIFE IN CROSS-CULTURAL CONTEXTS
Authors: Neupert Shevaun , Palgi Yuval
Published: December 2023

Subjective views of aging capture the many ways that people acknowledge, contemplate, and reflect on aging. These views are related to a wide range of health and well-being indicators including emotional well-being, mental health, chronic health conditions, memory functioning, and even life expectancy. However, most of what we know about subjective views of aging and health is based on W.E.I.R.D. (Western, Educated, Industrialized, Rich, Democratic) samples. The Subjective Aging within Global Everyday ecological Studies (Subjective AGES) consortium was built to address this problem by collecting parallel daily diary data from the United States, Turkey, Germany, United Kingdom, and Israel. Neupert will provide an overview of the consortium and present findings from the U.S. data, focusing on the interaction of daily stressors and uplifts for subjective aging. Can will demonstrate the deleterious effects of daily stressors on subjective aging within the Turkish data. Kornadt will show the beneficial effects of daily uplifts on subjective aging within the German data. Tse will demonstrate that doing personally meaningful and flow-conducive activities predicts feeling younger in the United Kingdom data. Shrira, Palgi, and Neupert will show cultural differences and similarities between Israeli Jews and Arabs and then present cross-country differences comparing the Israeli sample to the American sample. The talk will end by synthesizing the findings from each talk and pointing to future directions for the consortium. Collectively, these findings point to the importance of taking a cultural perspective in the daily relationships between subjective aging and well-being.
IMPLICIT AND EXPLICIT SPIRITUALITY IN THE LIVES OF TRANSGENDER AND GENDER-EXPANSIVE OLDER ADULTS
Authors: Fabbre Vanessa , Taylor Courtney , Sloan Stef , Gaveras Eleni
Published: December 2023

Religion and spirituality for transgender and gender expansive people (whom we refer to collectively as trans) are complicated by mainstream religions’ history of stigmatizing and marginalizing sexual and gender minorities. We conducted an interpretive content analysis of biographical interviews with 88 trans older adults from across the United States, applying six tenets of spiritual psychotherapy to their life narratives. Our findings suggest that some trans older adults’ spirituality is experienced both implicitly and explicitly. Implicit spirituality reflects the ways in which meaning, purpose, and connection in one’s life are nurtured with respect to one’s gender identity. Explicit spirituality reflects the process of consciously renegotiating one’s spiritual beliefs and religious practices to validate one’s gender identity and place in society. This knowledge is potentially helpful for gerontological practitioners who seek to nurture trans people’s spirituality and well-being as they age.
FINDINGS FROM NSHAP: SOCIAL CONNECTEDNESS, HEALTH INDICATORS, MEDICATION EFFECTS, AND PREDICTING MORTALITY
Authors: Piedra Lissette , Karraker Amelia
Published: December 2023

The National Social Life, Health, and Aging Project’s broad range of both social measures, and objective and self-reported health measures enable detailed analysis of the intersections between these fundamental aspects of older adults’ lives. The papers in this symposium explore various aspects of these topics from different angles. The first explores employment as an important form of social participation, establishing that full-time employment among respondents is associated with better cognitive function, and less ADL and IADL difficulties. The second examines how social isolation affects men and women differently. Social Networks are the focus of the third paper and compare family to friendship ties. Using NSHAP’s unique medication log, Wilder examines sleep disturbances and the prevalence of respondents taking medications with somnolence as an adverse event, demonstrating the need for more research into how this might affect older adults’ health and well-being. Li uses NSHAP data to develop machine learning models to predict 10-year mortality of older adults in the US which perform with better accuracy than logistic regression.
FEASIBILITY AND ACCEPTABILITY OF USING PLASMA BIOMARKERS FOR DIAGNOSING ALZHEIMER’S DISEASE IN PRIMARY CARE
Authors: Fowler Nicole , Swartzell Kristen , Hammers Dustin , Brosch Jared , Murray James , Willis Deanna
Published: December 2023

Blood-based biomarkers (Aβ, P-tau, neurofilament light) are clinically available to aid in the diagnosis of Alzheimer’s disease and related dementias (ADRD). However, no research has examined the use of blood biomarkers to aid in the diagnosis of ADRD in primary care (PC). Our study will test feasibility and acceptability of implementing blood-based biomarkers for ADRD in PC. Participants include: all PC patients ≥65 years presenting to one of six PC clinics between 6/1/22 and 5/31/23 who score cognitively impaired on the Linus Health Digital Clock and Recall (DCR™), and PC providers (PCPs) of these patients. Patients will view a decision guide about biomarkers and complete the Concerns about Alzheimer’s Disease Dementia Scale, and the Future Time Perspective Scale and the Impact of Events Scale. These measures and the PHQ-9 and GAD-7 will be repeated within 2 weeks of results disclosure. PCPs will receive training on biomarker disclosure techniques and best practices. To date 9 PCPs have consented to provide the biomarker results disclosure and 11 have declined. Following completion of PCP consent (n=100), a total of 200 patients who failed the DCR are eligible to be approached for consent. By November 2023, we anticipate that 150 patients will have completed biomarker testing, and we will have examined the biomarker results in the context of patient neuropsychological and clinical data, comorbidities, and sociodemographic information. This study will provide information regarding feasibility and utility of ADRD biomarkers in PC and a preliminary analysis of biomarker results compared with the patients’ clinical profiles.
ENHANCING COLLABORATION FROM ADULT PROTECTIVE SERVICES TO PROVIDERS WORKING WITH MISTREATMENT VICTIMS/SURVIVORS
Authors: Liu Pi-Ju , Xue Wei- Lin , Hass Zachary
Published: December 2023

Adult Protective Services (APS) is the frontline agency that receives, investigates, and provides services and/or referrals to victims/survivors of adult abuse, neglect, and exploitation. However, APS cannot resolve adult mistreatment alone, and must collaborate with healthcare, social, legal, and other community-based providers to address the needs of victims/survivors. Partnering with Montana APS and healthcare, legal, social and aging services providers, AARP, American Indian Health, local law enforcement, judge, attorneys, Medicaid Fraud Control Unit, ombudsman, and Certification and Licensing Bureaus, our goal is to examine how state agencies can work together to reduce mistreatment and systems burden. Twenty-two interviews were conducted with state agencies to inquire about collaboration challenges and strategies, what has worked well with APS, and what can be improved. Thematic analysis was used to characterize barriers and solutions for collaboration, and social network analysis was used to map out the collaboration network. We found that information sharing is a boon for collaboration among agencies using integrated information systems, but becomes a barrier when information sharing is limited by statute. State agencies also identified other agencies they have worked with to address mistreatment and reflected on challenges and strategies in working with these other professionals. Challenges for state agencies to work together center around lack of funding and service shortages, especially during the pandemic. Strategies to improve collaboration involve agency cross-training to remove silos. These interviews offer rich insight to guide practitioners across agencies to work together at the state-level to reduce mistreatment and its recurrence.
NEW OPPORTUNITIES FOR ADVANCING DYADIC HEALTH SCIENCE IN GERONTOLOGY
Authors: Wilson Stephanie , Novak Joshua , Yorgason Jeremy , Martire Lynn
Published: December 2023

As dyadic health science enters a golden age, important conceptual, theoretical, and technical challenges remain. Based on a forum review published in The Gerontologist by a group of dyadic scholars, this presentation will provide an overarching framework for understanding the essential components of robust dyadic health research, and the wide array of approaches used within the field. Each component of the framework will be discussed in relation to supporting empirical examples. The presentation will close by identifying crucial challenges and considerations that coincide with important future directions for the field.
VOLUNTEERING AND CHANGES IN CARDIOVASCULAR BIOMARKERS: LONGITUDINAL EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: Kim Seoyoun , Halvorsen Cal , Han Sae Hwang
Published: December 2023

A growing body of research shows that volunteering is beneficial for those served, the volunteers, and the larger communities. However, major challenges remain that hinder the practical implications for volunteer activity as a public health intervention, including potential selection effects, lack of longitudinal studies that adjust for baseline characteristics, and a paucity of studies that consider multiple physical health outcomes in a single model. Using data from the 2006-2016 waves of the Health and Retirement Study (N=18,847) and an outcome-wide approach, the current paper evaluated if changes in volunteering between 2006/2008 (t0) and 2010/2012 (t1) were associated with seven cardiovascular disease biomarkers four years later (2014/2016, t2). Further, these models were adjusted for demographic factors, socioeconomic status, health behaviors, chronic conditions, baseline biomarkers, and baseline volunteering. Inverse probability treatment weights (IPTW) were included for the selection into volunteering and multiple imputation was conducted for missing data. Compared to non-volunteers, volunteering more than 200 hours a year was associated with a lower risk for clinically high diastolic blood pressure. Increased volunteering effort (change from 1-99 hours at t0 to >100 hours at t1) was associated with a lower likelihood of clinically high systolic and diastolic blood pressure levels. Sustained high volunteering (>100 hours at both t0 and t1) was associated with lower diastolic blood pressure. The current study adds to the evidence of the health benefits of volunteering for adults 50 and older by inferring a potential causal link between high-intensity volunteering and reduced blood pressure.
THE M. POWELL LAWTON AWARD LECTURE AND PRESENTATION
Authors: Washington Tiffany
Published: December 2023

The M. Powell Lawton Award Lecture will feature an address by the 2022 recipient Jon Pynoos, PhD, FGSA, FAGHE, of the University of Southern California. This session will also include the presentation of the 2023 M. Powell Lawton Award to recipient. The M. Powell Lawton Award is presented annually to an individual who has made outstanding contributions from applied research that has benefited older people and their care. The Lawton Award is generously funded by the Polisher Research Institute of Abramson Senior Care.
CAREGIVER INVOLVEMENT AND CONCERNS WITH RESIDENT CARE IN ASSISTED LIVING BEFORE AND DURING COVID-19
Authors: Hoben Matthias , Dampf Hana , Hogan David , Corbett Kyle , McGrail Kim , Griffith Lauren , Gruneir Andrea , Maxwell Colleen
Published: December 2023

Family/friend caregivers are essential in promoting assisted living (AL) residents’ health/well-being, but their involvement was restricted during the COVID-19 pandemic. Care needs in AL are similarly complex as in nursing homes, but fewer staffing resources and services are available. Caregiver involvement and concerns with care of AL residents before and during the COVID-19 pandemic is a critical knowledge gap. This prospective cohort study collected online surveys from caregivers to AL residents in Western Canada. Surveys assessed socio-demographics, ways of visiting or communicating with residents, involvement in care tasks, concerns with resident physical/mental health, perceived lack of resident access to care services, and whether caregivers felt well informed/involved with resident care. Our first survey assessed outcomes in the three months before and after pandemic wave 1 (03/2020), our second survey assessed outcomes in pandemic wave 2 (11/2020 -02/2021). Based on 386 responses, in-person visits dropped significantly in wave 1 (91.5% to 30.6%) and so did caregiver involvement in nearly all care tasks (e.g., toileting: 7.5% to 2.6%, social/recreational activities: 73.6% to 25.7%). While these rates increased in wave 2, most did not return to pre-pandemic levels. Caregiver concerns increased in wave 1 (e.g., concerns about residents’ depressed mood: from 21.3% to 50.3%) and stayed high in wave 2. Concerns were particularly high (e.g., >20% higher for depressed mood) among caregivers who did not feel well informed/involved with resident care. Continued caregiver involvement in resident care and communication with caregivers is key to mitigating caregiver concerns and supporting caregiver and resident well-being.
COVID-19 AND PSYCHOTROPIC DRUG USE IN ASSISTED LIVING RESIDENTS: VARIATION BY WAVE AND SETTING TYPE
Authors: Maxwell Colleen , Dampf Hana , Alkabbani Wajd , Cotton Cecilia , Gamble Jean-Michael , Hogan David , Gruneir Andrea , Hoben Matthias
Published: December 2023

The onset of COVID-19 was associated with significant, albeit modest, increases in the use of psychotropics and opioids in nursing home residents. Little research exists on whether similar trends occurred among older residents of publicly funded assisted living (AL) homes, a growing and poorly investigated setting. We examined the impact of pandemic wave (1 to 4) and setting type (dementia designated spaces [AL-D] vs other [AL-O]) on prevalent antipsychotic, antidepressant, benzodiazepine, opioid and anticonvulsant use in AL residents from Alberta, Canada. Using linked population-based clinical and health administrative databases, we conducted a repeated cross-sectional study of quarterly medication prevalence from January 2018 to December 2021. Log-binomial GEE models estimated prevalence ratios (PR) for 4 waves (vs 2018-19 historical months) and setting (AL-D vs AL-O) and period-setting interactions. On March 1, 2020, there were 2,874 AL-D and 6,611 AL-O residents in our cohorts (mean age 82.4 vs 79.9 years and 93.5% vs 42.6% with dementia, respectively). Antipsychotic prevalence increased during waves 2-4 for both settings but this increase was significantly greater for AL-D than AL-O in later waves (e.g., AL-D: PR 1.21, 95%CI 1.14-1.27; AL-O: 1.12 (1.07-1.17) for March-May 2021 vs 2018-19). For both settings, there was a significant but modest increase in antidepressants but a decrease in benzodiazepines during several waves. No pandemic effect was observed for opioids in either setting. The AL resident and home characteristics associated with these medication trends, concerns about medication risks (particularly for dementia care settings), and consequent health outcomes for residents require further study.
ETHNICITY IN RESEARCH ON OLDER MIGRANTS: HOW THE SCHOLARSHIP CONCEPTUALIZES IT AND WHERE WE NEED TO HEAD
Authors: Torres Sandra
Published: December 2023

A recently completed scoping review of peer-reviewed articles on older ethno-racialized minorities has shown that although conceptual and theoretical advancements have been made in the field of ethnicity and race, the social gerontological literature on these minorities continues to regard ethnicity in essentialist ways, conflates ethnicity with race and seldom operationalizes what these social positions mean to aging and old age. The impact of ethnicity is, in other words, almost always inferred in this research, which is why the field has been deemed to be characterized by data-richness and theory-poorness. Over the past three years, researchers working on the nexus of aging and migration have surveyed the current state of knowledge on older migrants (focusing on migrancy, rather than ethnicity and/ or race). One of these inventories is a meta-analysis of how research on older migrants conceptualizes ethnicity, and the manner in which this social position is presumed to impact on migrants’ old age- and aging-related experiences. At stake has also been the assessment of whether this literature differs from the scholarship on older ethno-racialized minorities, and the ways in which that scholarship conceptualizes ethnicity. This presentation offers insight into what this inventory has found out. In focus are the current state of affairs about how ethnicity is approached in research on older migrants, and the launching of a theoretically-informed and empirically-astute research agenda for the study of ethnicity in gerontology.
PRAGMATIC CLINICAL TRIALS TO IMPROVE DEMENTIA CARE: IMPLEMENTATION, ADAPTATION, AND OUTCOMES
Authors: Thomas Kali , Gaugler Joseph
Published: December 2023

Pragmatic clinical trials test the effectiveness of interventions in “real-world” settings. One challenge with conducting such research in non-controlled environments is exposure to unpredictable events: in the case of the studies here, the COVID-19 pandemic. This session shares the implementation experiences and findings from four pragmatic clinical trials designed to improve dementia care and describes how the studies were impacted by and adapted to respond to the pandemic. The first speaker discusses a successful, team-based approach for adapting and implementing an intervention to improve sleep for nursing home residents with dementia. The second speaker presents the modifications made to implementation strategies between two trials of a personalized music intervention delivered to nursing home residents with dementia. The third speaker discusses findings from a mixed-methods evaluation with frontline staff at VA Community Living Centers enrolled in a stepped-wedge cluster randomized trial of Montessori-based approaches to improve dementia care. The fourth speaker shares findings from a pilot trial comparing two modes of meal delivery to homebound older adults with dementia. The discussant situates these adaptations and findings in the context of lessons learned by other trialists working to improve care provided to people living with dementia.
PRAGMATIC IMPLEMENTATION OF A BEHAVIORAL INTERVENTION PRE- AND POSTPANDEMIC: A TALE OF TWO TRIALS
Authors: McCreedy Ellen , Dewji Aleena , Dionne Laura , Mor Vincent , Rudolph James
Published: December 2023

We describe two embedded pragmatic trials (ePCTs) of a personalized music intervention for nursing home (NH) residents with ADRD conducted pre-COVID (2019) and 2021 (COVID). Between trials, the implementation strategy was modified to incorporate learnings from the first trial and to address COVID-related restrictions. 54 intervention NHs (27 from Trial 1, 27 from Trial 2) comprised the sample. We compare the trials using the Framework for Implementation Fidelity (FIF) criteria: coverage (number of residents who received the intervention); duration (dose of music received); and frequency (how often nursing staff used the music with the residents). Adherence was worse in Trial 2 (post-COVID) versus Trial 1 (pre-COVID). On average, 12.7 (SD: 3.6) residents were exposed per NH in Trial 1 and 7.5 (SD: 5.5) in Trial 2. Median minutes of music per day was 27.1 (SD: 23.9) minutes in Trial 1 and 2.5 (SD: 5.2) minutes in Trial 2. A greater proportion of exposed residents had nursing staff administer music in Trial 1 (frequency; 0.4 (SD:0.3)) than Trial 2 (0.2 (0.3)). Despite changes to increase nursing engagement and clinical targeting, adherence to intervention was dramatically lower in Trial 2 than in Trial 1. While it is impossible to completely disentangle changes to the implementation strategy from the lingering effects of COVID, it is clear that the NH environment fundamentally changed during the pandemic. With that change comes the need to re-evaluate strategies for implementation and incentivizing participation
POLICY SERIES: ARE WE THERE YET? MEASURING PROGRESS IN ACHIEVING POLICY GOALS FOR FAMILY CAREGIVERS
Authors: Nadash Pamela , Snyder Rani
Published: December 2023

The RAISE Family Caregiving Advisory Council, created under the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (2018) has been tasked to support the Secretary of Health and Human Services in developing a national family caregiving strategy, published in 2022 as its National Strategy to Support Family Caregivers. One key concern identified by advocates and others is the accountability question: how can we hold policymakers at all levels of government accountable for achieving the policy goals articulated in the National Strategy? This symposium discusses that issue by first providing an overview of a key mechanism for state accountability, AARP’s State Scorecard on Long-Term Services and Supports, which identifies support for family caregivers as one of its four dimensions. Susan Reinhard, PhD, Senior Vice President at AARP and Director of its Public Policy Institute, will describe the history, goals, and future of the Scorecard’s family caregiver component. Salom Teshale, PhD, from the National Academy for State Health Policy will describe how states are focusing their energies in current actions supporting family caregivers, while Mike Wittke, MPA, of the National Alliance for Caregiving will discuss how federal actions might be tracked and assessed. Drawing on research supporting the RAISE Advisory Council, Eileen J. Tell, MPH will suggest additional dimensions that could be integrated into the assessment of progress. Rani Snyder, MPA, of the John A. Hartford Foundation will act as discussant.
PREVALENCE AND DISPARITIES OF VERY LOW-INCOME OLDER ADULT RENTERS IN US METROPOLITAN AREAS
Authors: Traver Anthony , Dabelko-Schoeny Holly
Published: December 2023

Income eligibility for federal housing subsidies is based on HUD calculations of area median income (AMI) and family size. Frequently used measures of poverty and income do not reflect the geographic economic variations on which HUD eligibility is based. By integrating Current Population Survey (CPS) data for metropolitan-dwelling people in 2000, 2010, and 2020 with HUD yearly 50% AMI thresholds (very low-income (VLI)), this study aims to provide a novel estimate of the number of metropolitan older adult (OA) (62+) VLI renters and to compare their growth rate, rental assistance use, race, and health with other population groups. Sample weights are used to produce national estimates of four metropolitan OA subgroups: VLI renters, VLI owners, non-VLI renters, and non-VLI owners. Results show that between 2000 and 2020, the total number of metropolitan OAs increased by an estimated 84%, OA VLI renters increased by an estimated 74%, and OA VLI renters without rental assistance increased by an estimated 71%. Across all years, metropolitan VLI OA renters were more likely to be non-white, disabled, report poorer health, and receive rental and utility assistance. Approximately two-thirds of metropolitan VLI OA renters did not receive any form of rental assistance across time points. VLI OA renters without rental assistance face significant affordability challenges as metropolitan rental prices rise faster than most retirement incomes. Communities should proactively link their growing OA VLI renter populations with financial assistance and supportive services to reduce their risk of housing precarity in late life.
LIVING WITH DEMENTIA: AN INTERDISCIPLINARY COMMUNITY-BASED EDUCATION SERIES TO EMPOWER CARE PARTNERS
Authors: Husser Erica , Boltz Marie
Published: December 2023

Approximately 75% of persons living with dementia receive essential day-to-day direct care and support from informal, unpaid care partners who receive little education or guidance from health care professionals on how to negotiate day-to-day challenges associated with living with dementia. This symposium describes the development, implementation, and impact of a comprehensive, four-part Living with Dementia community education program focused on dementia care featuring an optional Memory Café, developed collaboratively by the Penn State College of Medicine and College of Nursing for the purpose of empowering care partners. The first presentation will describe the educational content and instructional strategies, designed by an interdisciplinary team (physician, nurse, and long-term care dementia specialist), and based on the Medicare Cognitive Assessment and Care Plan Services visit and using evidence-based curricula. The second presentation describes the concurrent and collocated intergenerational respite program (Memory Café) for persons living with dementia (PLWD) that enabled care partners to attend the education. Health care students were paired with a PLWD and during the two-hour session each pair engaged in Opening Minds though Art™ (OMA), reminiscence, and music therapy; outcome data includes PLWD pre- and post-mood assessments. The third presentation provides overall evaluation data from the 4-part education series. Respondents were asked about the overall impacts of the program, the skills they learned, the usefulness of the education now and into the future, and what additional support would be most helpful. Our discussant will address the implications of our findings for practice, policy, and future program development.
MEMORY CAFÉ PROVIDES INTERGENERATIONAL ENGAGEMENT OPPORTUNITIES FOR LWD CARE-PARTNERS’ LOVED ONES
Authors: Whitaker Janice , Berish Diane , Rank Jenny , McGraw Meghan , Husser Erica
Published: December 2023

To facilitate attendance by care partners attending the Living with Dementia (LWD) education sessions, an optional Memory Café was available at the same location. We describe the design and implementation of the Memory Café, which included evidence-based programming to engage and provide socialization for the older adults. Basic health, safety, person-centered, and care preference information was collected at registration to ensure quality supervision and support during the Memory Café. The Café was facilitated by interprofessional staff and included Opening Minds through Art (OMA), an intergenerational no-fail art-making experience for persons with neurocognitive disorders (“artists”) that fosters creative self-expression and engagement for persons living with dementia (PLWD). Facilitators also integrated reminiscence, music, and movement therapies during the two-hour LWD education session. Nineteen community dwelling PLWD attended an average of two of the four Memory Café sessions, 26 participants were recruited from a care home at one location, and 124 volunteers were paired with PLWD for OMA and attended at least one Memory Café (volunteers included undergraduate nursing students, graduate students, Penn State faculty and staff, and community members). Fifty-one pre- and post-mood assessments were completed by the 19 community dwelling OMA artists (using a 5-point Likert scale of faces, from frowning to smiling, to indicate how they felt in the moment) and data showed mood improved by an average of .67 points (standard deviation = .95). Care partner evaluation data was positive; 8 (22%) reported that having the Memory Café option made it possible for them to attend LWD.
MINORITY STRESS AND LONELINESS IN A LIFESPAN SAMPLE OF SEXUAL MINORITIES
Authors: Vale Michael
Published: December 2023

Marginalized individuals often experience social isolation (i.e., loneliness), which is a risk factor for diminished health, especially for older sexual minorities (i.e., LGB+) who were socialized in a period with less social recognition and overt stigmatization (i.e., minority stress). Although it is known that minority stressors contribute to loneliness, little is known about the contextual factors that predict this relationship, such as age/cohort. First, we examined cross-sectional baseline data from a lifespan sample of sexual minorities (N=333, ages 18-90) to investigate the relationship between seven different minority stressors and loneliness. Compared to their younger peers, older sexual minorities reported lower levels of loneliness and minority stress; however, age moderated the links between internalized homonegtaivity (B=.01, p<.01), anticipated stigma (B=.02, p<.01), and family-directed stigma (B=.01, p<.05) on loneliness, respectively. Secondly, daily experiences of minority stress and levels of loneliness were examined across a 21-day period (N=1,878 days) from a subsample of the baseline study (N=112, ages 19-79). There was higher daily loneliness on days when participants concealed their identity and had higher internalized homonegativity. Conversely, loneliness was lower when participants disclosed their identity. We further explored lagged-effects and found that loneliness was significantly higher following high internalized homonegativity (B=-.02, p<.001) from the prior day and that this change was moderated by age. These findings underscore the importance of considering age and cohort when examining minority stress. They also highlight the need for interventions that address minority stressors in this population to prevent poorer well-being and higher levels of loneliness.
IT’S GRATEFULNESS: THE ROLE OF GRATITUDE ON ADVERSE OUTCOMES AMONG BEREAVED BLACK ADULTS
Authors: McDuffie Danielle
Published: December 2023

The Black population has been found to experience more bereavement than other racial/ethnic groups. Accompanying loss for Black populations is often other stressful factors such as racial trauma, childhood trauma, and comorbid depression. However, despite these hardships, one of the most prevalent strengths in the Black population is their engagement in religious faith as a means of coping. Gratitude, a major factor in Positive Psychology, shares many tenets with religious beliefs; however, the utility of gratitude has yet to be fully investigated within a Black bereaved population. This study sought to identify whether gratitude moderated the relationship between experienced negative life events (i.e., racial trauma; RT, adverse childhood experiences; ACEs) and depression in a sample of bereaved Black middle to older adults. 103 Black adults aged 45+ (33% female) were administered items assessing depression, gratitude, RT, and ACEs as part of a larger bereavement study. ACEs and RT both significantly predicted depression (p=.009, p=.008, respectively), and there was a significant conditional effect of gratitude on depression, reflecting differences in the endorsement of depression across levels of ACEs and RT. Accordingly, with the significant role of gratitude amongst the present sample, there is evidence for utilizing a strengths-based, Positive Psychology informed approach in the clinical care of Black adults experiencing bereavement, particularly in the context of impactful and racially traumatic events. Additionally, a fruitful direction for future research and policy is addressing the role of adverse traumatic events on Black bereavement.
LONGITUDINAL CHANGES IN WELL-BEING ASSOCIATED WITH AGING ATTITUDE, COGNITIVE STATUS, AND WIDOWHOOD TRANSITION
Authors: Li Lydia
Published: December 2023

This symposium brings together four studies that employ national data collected from older Americans to examine longitudinal changes in older adults’ cognitive, social, and psychological health. The first study focuses on the role of self-perception of aging in memory decline and social mechanisms linking aging perception and memory. It found that negative perceptions of aging predicted memory decline 8 years later and that loneliness and social isolation were pathways. The second study is concerned with neuropsychological changes before the onset of dementia. Using latent growth modeling, it found that the trajectory of depression increased over time in a quadratic fashion before the onset of incident dementia. Further, there were racial/ethnic group differences in levels of depression. Using fixed-effect linear regression, the third study reports that changes in cognitive status were associated with changes in social isolation in older adults. Specifically, it found that transitioning from cognitive intact to cognitive impairment status was associated with increased social isolation. The fourth and final paper examines changes in psychological well-being related to the transition to widowhood. It found that during the year right after the spouse died, older adults experienced increased depressive symptoms and reduced positive well-being. But adaptation is evident—the surviving spouse returned to pre-loss levels of psychological well-being around two years after the death. Together, the four studies show that attitude, cognitive status, and life course transition shape the dynamics of cognitive, social, and psychological health in later life.
EXCLUSION FROM CIVIC ENGAGEMENT IN TWO DISADVANTAGED NEIGHBORHOODS IN BRUSSELS, BELGIUM: A LIFE COURSE PERSPECTIVE
Authors: Dikmans Bas , De Donder Liesbeth , Sarah Dury , Serrat Rodrigo
Published: December 2023

Although research into older people’s civic engagement has come a long way in the last decades, there are still some blind spots on this scholarship. Notably, the influence of neighbourhood features on in- or exclusion from civic activities, as well as the multifaceted nature of civic engagement and the dynamics of such processes across the life course have been scarcely addressed. Therefore, this research focuses on the life course trajectories of older people in two socioeconomically disadvantaged neighborhoods in Brussels, Belgium, in order to understand their inclusion and exclusion from multidimensional forms of civic engagement, including formal volunteering, informal helping behaviours, memberships in associations, political participation and digital civic engagement. We conducted forty semi-structured interviews supported by life diagrams that focused on the changes of in- and exclusion from multidimensional civic engagement throughout the life course. The life stories of these older residents are thematically and narratively analyzed. The outcome of this study underlines the importance of a life course perspective in understanding older people’s experiences of inclusion and exclusion from multidimensional civic engagement. The findings will be used for informing policy recommendations to foster multidimensional civic engagement for older people living in disadvantaged communities.
IMPACTS OF COVID-19 ON TRAINING HEALTH CARE WORKERS AT EAST LOS ANGELES COMMUNITY COLLEGE
Authors: Velazquez Janice
Published: December 2023

The Pandemic changed how community colleges prepare the next generation of healthcare workers, and they are slowly adjusting to remain relevant in the current environment. How community colleges train their students will determine how well their communities will be cared for, which is why this topic is important. Some of the strategies implemented to fulfill the East Los Angeles’ College (ELAC) workforce demands following COVID are: aligning basics skills with some of the courses; providing career counseling, including mock interviews; opportunities to branch out and transfer in two years; connecting students with services to address their basic needs including mental health. Faculty are also required to stay current, and they need support from their local Districts and national collaborators. Some completed specialized training in humanizing curriculum and transforming faculty learning programs to improve undergraduate STEM faculty’s instructional practice. Moreover, the ELAC faculty felt that developing a humanities course tailored to Health and Human Services could be a great start to connect current needs with our academic programming. Faculty are revising and collecting content to address recent changes impacting our society and how we operate in the fast-changing work environment. After the Pandemic, the use of technology is more common and accepted. This change facilitates interactions, and this is a contributing factor to the program development process. For example, the advisory questionnaire is now available electronically, and therefore expecting more participation. Faculty have more variety and options for training to improve content development and delivery strategies.
LONG-TERM ASSOCIATION OF AN INTENSIVE LIFESTYLE INTERVENTION ON GLOBAL COGNITIVE FUNCTION
Authors: Espeland Mark , Hayden Kathleen , Rapp Stephen , Sachs Bonnie , Pleasants Debbie , Booth Debbie , Wing Rena , Neiberg Rebecca
Published: December 2023

The long-term effects of mid-life changes in lifestyle on later life cognitive function have not been rigorously assessed among individuals with type 2 diabetes. The Look AHEAD Aging study examined differences in standardized composite cognitive function scores in 1367 individuals, currently aged 64 to 95 years, who had enrolled an average of 20 years previously in a randomized controlled trial to compare a 10-year multidomain intensive lifestyle intervention (ILI) to a condition of diabetes support and education (DSE). The composite averaged standardized scores from the telephone administration of tests chosen to capture the individual cognitive domains of memory, attention/processing speed, executive function, and global cognitive function. At enrollment into the Look AHEAD Aging study there was no overall difference between intervention groups in cognitive test scores: mean [SE]: -0.01 [0.03] ILI versus 0.00 [0.04] DSE (p=0.76). However, among participants with overweight at Look AHEAD enrollment, those assigned to ILI had mean [95%CI] of 0.33 [0.08, 0.57] better global cognitive function scores than those assigned to DSE. For those initially with obesity, there was no relative intervention benefit: mean [95%CI] -0.08 [-0.18, 0.03] (interaction p=0.003). Benefits for those with overweight appeared to be strongest for tests of memory. ILI should be recommended to individuals with type 2 diabetes and overweight to provide long-term resilience against cognitive aging. The cognitive benefits we have reported earlier for individuals with overweight during intervention delivery endure for a decade following the cessation of the intervention.
CROSSING THE DIGITAL DIVIDE: ASSESSING DIGITAL READINESS AMONG UNDERSERVED OLDER ADULTS
Authors: Navarro Sheila Salinas , Yan Mengzhao , Lomeli Sindy , Wilber Kathleen
Published: December 2023

The California Department of Aging launched the “Connecting, Health, Aging, & Technology (CHAT) Program, “aimed at bridging the digital divide and mitigating social isolation among older adults by providing an iPad device and technology training. Because providing a device does not guarantee uptake, we examined factors associated with technology adoption among research participants (n=1,219). We used a global “digital readiness” scale, and two open-ended questions to examine potential device uptake. We ran multivariate regressions with explanatory independent variables including demographic characteristics (age, gender, race/ethnicity, living arrangement, and education), health indicators (self-rated health and mental health status) and the intention to adopt technology against the global readiness question. The analysis showed that digital readiness was associated with age and education, and Asian or Pacific Islander older adults were more ready than non-Hispanic Whites. Further, digital readiness was negatively associated with mental health but positively associated with self-rated health. Digital readiness was also associated with an increased intention to adopt technology. A content analysis of the open-ended questions in Atlas.ti informed the regression analyses and revealed participants’ strong desire for digital self-efficacy, informed citizenship, lifelong learning, a proactive desire to improve quality of life, and the desire to foster connection to family and friends. Our research highlights the personal and multifaceted nature of technology adoption among older adults, and the complexity of fostering digital inclusion on a large scale.
CHANGES IN TECH USE PREDICTING SOCIAL WELL-BEING FOR INTERGENERATIONAL PROGRAM PARTICIPANTS
Authors: Tsotsoros Cindy , Leedahl Skye , Brasher Melanie , Capolino Alexandria , Santilli Josie
Published: December 2023

Previous research has shown that technology-based interventions show promise for reducing social isolation and loneliness. Less research has examined quality of life outcomes for these programs or interconnectedness of these outcomes when examining pre/post-change. This study examined the connections between technology use and knowledge with loneliness, social isolation, and quality of life before and after participation in the program. The final sample (N=324) was rather diverse regarding work and living status (for example, 67.5% retired; 67.8% lived alone; 70.1% had less than $30,000 income; 40.2% had a high school education or less). Using structural equation modeling, this study examined pre- and post-data to identify to what extent technology usage and knowledge (frequency of iPad use, digital competence) predicted an individual’s change in loneliness, social isolation, and quality of life. This final model showed excellent model fit (𝜒2(148, N=324)=247.01 p<.05 with CFI = .95, TLI = .93, RMSEA = .05, CMIN/df = 1.67). Within this model, findings showed that digital competence improvements predicted quality of life, social isolation, and loneliness (Ad. R. Square = 0.17); the frequency of iPad use influenced social isolation and quality of life (Adj. R Square = 0.29); and loneliness influenced quality of life and social isolation (Adj. R Square = 0.81). There are multiple possible mechanisms through which older participants’ lives can be impacted by intergenerational technology programs. Understanding the complex interplay of factors helps us understand the potential benefits of these programs on quality of life.
DID STRONGER STATE AGE DISCRIMINATION LAWS REDUCE THE ADVERSE IMPACTS OF COVID-19 ON LABOR OUTCOMES OF OLDER WORKERS?
Authors: Bui Truc
Published: December 2023

Covid-19 caused tremendous impacts on the health and employment status of older workers, while current literature shows that age discrimination increased during recessions. In this context, I examine whether stronger state age discrimination laws reduced the adverse impacts of Covid-19 on the labor outcomes of older workers. State age discrimination laws are stronger than federal law because they protect workers in smaller firms or require firms to pay harsher penalties if violating the laws. I use these two classifications to identify the strength of state protections and employ the difference-in-difference-in-difference method. Using CPS and QWI data, I compare the labor outcomes of older and younger workers, in states with stronger and weaker laws, before and after the Covid-19 recession. There is very little evidence that stronger state laws protected older workers from the adverse impacts of the Covid-19 recession. I even found that stronger state protections were associated with more negative effects on older workers. Although stronger state laws were associated with higher hiring and separation rates right after the Covid-19 pandemic started, the increases in hiring rates were high enough to offset the growth in separation rates, and those effects were more pronounced among older men. The findings were consistent with the effectiveness of stronger state laws during the Great Recession, implying that severe labor market conditions weakened the effectiveness of stronger state age discrimination laws. The results also question the protection of discrimination laws on intersectional discrimination against age and gender.
RESOLUTION OR WORK STRESS? WHY DOES RETIREMENT CHANGE HEALTH BEHAVIOR?
Authors: McKenzie Colin , Kajitani Shinya , Sakata Kei
Published: December 2023

The purpose of this paper is to examine the impact of retirement on actual health outcomes and intentions relating to these outcomes for Japanese men and women. The health outcomes investigated relate to alcohol and tobacco consumption, physical exercise, and psychological distress. This paper uses data from the first 14 waves of the Longitudinal Survey of Middle-aged and Elderly Persons (LSMEP) to estimate regression models explaining these health outcomes. An instrumental variable estimator using instruments constructed from the eligibility ages for various aspects of the Japanese pension is used to account for the endogeneity of retirement and income. Individual heterogeneity is dealt with by using a fixed effects estimator. For both men and women, it is found that there is no significant impact of retirement on the extent to which individuals report that they will take care not to drink too much, nor smoke too much, and to engage in a sufficient amount of exercise. While psychological distress declines for both men and women as they retire, the proportion of men drinking alcohol falls while there is no change for women. For both men and women, the proportion who are smoking falls after retirement. The proportion of males and females engaging in moderate amounts of exercise increases following their retirement. Taken together, the results suggest that reductions in stress following retirement are driving the results. Falls in income associated with retirement explain little of the behaviour observed.
THE BURDEN OF COGNITIVE IMPAIRMENT
Authors: Chaturvedi Ritika , Gracner Tadeja , Heun-Johnson Hanke , Tysinger Bryan , Goldman Dana
Published: December 2023

Over 10% of American seniors (age≥65) experience cognitive impairment (CI) related to Alzheimer’s disease and related dementias (ADRD). An additional 15-22% experience mild cognitive impartment (MCI), which often precedes ADRD and occurs earlier in life. However, CI burden estimates inclusive of MCI and early CI onset (age< 65) are limited. Using microsimulation, we estimated the burden of CI (ADRD and/or MCI) over remaining life years above 50 overall and by disease progression, age of onset, and sociodemographic subgroups for a nationally representative sample of Americans (age≥50) with cognitive status information in the Health and Retirement Study (2000-2016). The per capita lifetime CI burden was $124K (95%CI:$101K-$148K) due to $162K (95%CI:$139K-$185K) and $6.40K (95%CI:$5.03K-$7.77K) in lost Quality Adjusted Life Years (QALYs) and earnings, respectively, and $4.07K (95%CI:$1.82K-$6.33K) in informal care costs, offset by $48.6K (95%CI: $42.4K-$54.8K) in lower medical expenditures. The aggregate CI burden was $627B (95%CI: $511B–$743B): 59% due to ADRD and 41% to MCI. Individuals with MCI without progression to ADRD lost healthy life years valued at $119K (95%CI:$99K-$139K). Those with early CI onset were more likely to be from disadvantaged populations and carried the largest per capita burden [$376K (95% CI: $315K-$436K)] cumulating to 60% on aggregate, nearly half of which experienced during MCI. Individuals with lower education, progression to ADRD, or racial/ethnic minorities also carried disproportionate burden. MCI represents 41% of the overall CI burden and disproportionately affects individuals with early CI onset. Characterizing CI-related health and economic disparities at milder stages and younger ages should be prioritized.