bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSOCIATION OF PHYSICAL ACTIVITY WITH NEUROFILAMENT LIGHT IN NONDEMENTIA OLDER ADULTS AND THE MEDIATION OF FRAILTY
Authors: Liu Sofia , Li Mengchi , McPhillips Miranda , Calderon Russell , Li Junxin
Published: January 2025

Neurofilament light (NfL) is a biomarker for neuronal health, indicative of neural damage and decline in older adults. Physical activity (PA) is known to promote healthy aging and prevent frailty. However, the interplay between PA, physical frailty, and NfL remains underexplored. This study examines the associations between PA and NfL and the mediating role of frailty using baseline data of 95 community-dwelling non-dementia older adults in a randomized controlled trial. PA was measured using ActiGraph Link and Physical Activity Scale for the Elderly (PASE). Frailty was assessed using the Fried frailty phenotype, and NfL levels were determined from plasma samples. Multiple linear regressions, adjusting for sociodemographic and health factors, tested the association, and Baron and Kenny’s approach was used to examine frailty’s mediation effect. Participants were aged 70.0 ± 6.0 years, 80% female, 28.6% Black, had 2.8 ± 1.9 chronic conditions, and 28% had mild cognitive impairment (MCI). In the adjusted models, a higher level of Actigraph-measured PA was associated with lower NfL (β= -7.4, 95% confidence interval (CI) = [-13.4 to -1.3]). The frail group showed increased NfL compared to the robust (β = 26.3, 95% CI = [11.8 to 40.8]) and pre-frail (β = 25.5, 95% CI = [39.9 to 11.1]) groups. Further, frailty status significantly mediated the PA-NfL relationship. In summary, increased PA level was associated with reduced NfL, and frailty status mediated the associations in our sample of older adults with normal cognition or MCI. PA interventions may reduce frailty-related neuronal damage; further study is needed.
OPTIMIZING PHYSICAL AND MENTAL FUNCTION ACROSS THE AGING CONTINUUM: PCORI’S FUNDING PORTFOLIO AND RESEARCH PRIORITIES
Authors: Akinbami Yewande , Majid Tabassum , Audley John , Arora Neeraj
Published: January 2025

In 2021, the National Academy of Medicine identified “Actualizing better health and healthcare for older adults” as one of five vital directions in healthcare. In response, PCORI launched a $50 million, targeted PCORI funding announcement (PFA) on Healthy Aging in 2021 that called for CER to optimize the physical and mental functioning of older adults. This funding announcement coincided with PCORI’s Board identifying 12 focused topic themes, including “Promoting the Health of Older Adults”. This project synthesizes PCORI’s portfolio of funded work aimed at promoting the health of older adults and presents the Healthy Aging continuum, a conceptual framework informed by stakeholders to guide future PCORI research investments. The conceptual framework encompasses four domains: (1) healthy older adults with 1-2 well-managed chronic conditions (2), individuals with sub-optimally managed multiple chronic conditions (3), individuals with significant functional impairment and (4), seriously ill older adults who may need end-of-life care. Caregivers who support older adults as they age throughout the continuum undercut all four of these domains. To date, PCORI has funded 63 CER projects, totaling $323 million, focused on promoting the health of older adults. PCORI’s targeted initiatives have called for CER on palliative care, hearing loss, visual impairment, osteoporotic fractures, delirium, and hypertension. This presentation will provide an overview of PCORI’s portfolio of older adult studies and implications for future research priorities. During the symposium discussion, PCORI will solicit further insights on evidence gaps and implications for future research focused on real-world decisional dilemmas in older adult health.
ENGAGING VILLAGES AS KEY PARTNERS IN PATIENT-CENTERED HEALTHY AGING RESEARCH
Authors: Greenfield Emily , Shih Regina , Kincaid William , Palimaru Alina , Pope Natalie , Sullivan Barbara
Published: January 2025

Villages are a grassroots-led community-based movement to facilitate aging in place through social connection, sense of belonging, and services from neighbors and other local resources. With over 270 villages across the nation, villages present a unique opportunity to deliver patient-centered interventions for health aging. This presentation will provide an overview of a Patient-Centered Outcomes Research Institute-funded engagement project to promote the meaningful involvement of Villages in all phases of patient-centered comparative clinical effectiveness research (CER). This project serves as an early step toward the collaborative design of future research on how Villages promote healthy aging. First, we will describe the strategic value of establishing digital communications for the project as an early project goal. Second, we will discuss how the themes that arose during five focus groups (n=49) on villagers’ perspectives onhealthy aging, intersections with the health care system, and their involvement in research informed subsequent project activities. Third, we will provide an overview of the formation of the Villages Healthy Aging Ambassadors group for peer-to-peer engagement and collaborative research design. Fourth, we will summarize the planning and implementation of regionally-based virtual summits with Villages across the United States to gain further insights for future research projects and to strengthen the position of research as part of the national Village movement. We will conclude by reflecting on the value of collaboratively designing and implementing this project for optimizing the success of longer-term patient-centered CER with Villages and amplifying the efforts of Villages to advance healthy aging.
THE VALUE OF ENGAGEMENT: IMPROVING ORAL HEALTH THROUGH COMMUNITY-BASED INTERVENTIONS
Authors: Nelson Suchitra , Curtan Shelley , Ejaz Farida
Published: January 2025

Many older adults accept oral health problems as an inevitable consequence of aging and do not seek dental care. Further, with limited dental insurance options alternative care models are needed. Our project investigated the most effective and efficient means of addressing oral health disparities and access to dental care among community-dwelling older adults. This clinical trial tested the comparative effectiveness of two non-surgical evidence based cavity treatments (Silver Diamine Fluoride vs. Atraumatic Restorative Treatment) in arresting tooth decay for adults 62+. Treatments required no needles or drills and were done using portable equipment in the independent housing sites where the adults lived. The project enrolled and screened 952 older adults, treated 568 with active decay, living in 34 housing sites (17 sites randomized to each treatment intervention). Follow-up visits at 26 and 52 weeks assessed caries arrest and participant report of oral pain and hypersensitivity. Focus groups were conducted to capture qualitative data related to participant’s treatment satisfaction. A stakeholder group comprised of individuals representing payers, policy makers, advocacy organizations, housing administrators, and patients have been active throughout each study phase, offering guidance and assistance with the project. We will outline experiences of participants and perspectives of stakeholders that enabled positive oral health outcomes for older adult participants. Challenges and successes will be shared, along with next steps for dissemination and ideas for health system change to support continuation of treatment based on project clinical outcomes.
ADAPTING A DISASTER PREPAREDNESS PROGRAM USING AN INDIGENOUS IMPLEMENTATION FRAMEWORK
Authors: Thompson Lena , Lewis Jordan , Ashida Sato
Published: January 2025

Implementation frameworks can help increase the relevance and sustainability of intervention research with Indigenous populations. The He Pikinga Waiora (HPW) framework centers around Māori self-determination and has four elements: community engagement, cultural centeredness, integrated knowledge translation, and systems thinking. This study applied the HPW framework to inform adaptation of a disaster preparedness program for older adults with a Midwestern tribe in the United States. Tribal organization leaders, including a member from the Tribal Government, Senior Center, Emergency Preparedness Department, Police Department, and one older adult from the community, read through the program with the researcher while considering the four elements of HPW throughout the process. Five experts in Indigenous aging research and practice listened to the recordings of these sessions and evaluated the researcher’s fidelity to the framework and the extent to which the HPW framework fit the community context and project. Additionally, research assistants conducted qualitative interviews with Tribal organizational leaders about the fit and relevancy of the framework. Data from expert evaluators and interviews with tribal organizational leaders and the community member suggest that the HPW framework was a good fit for the community and program. Both groups made recommendations to improve the framework, including integrating sustainability into the model and making language simpler. The HPW framework appears to facilitate healthy partnerships and provide guidance to adapt, implement, and eventually disseminate a tailored intervention to a Midwestern Tribal community. This study demonstrated beginning processes of conducting cultural adaptations using an implementation model created and tested with Indigenous populations.
EAST MEETS WEST: PERSPECTIVES ON CAREGIVING, FRAILTY, AND BASIC RESEARCH ON AGING IN CHINA AND THE UNITED STATES
Authors: Nelson James , Wang Jianye
Published: January 2025

This interdisciplinary symposium brings together scholars from China and the United States to share recent discoveries from the health and biological sciences, as well as public policy initiatives designed to increase accessibility to established means of promoting health and well being of older individuals. Included will be discussions of novel therapeutics that may alleviate the pathophysiological burdens of senescence. An overarching premise of this cross-cultural symposium is that the unique cultural and experiential perspectives of scientists and practitioners from these two countries can enrich the approaches to research, education, and practice of geroscience and gerontology in both countries. Another goal is to build new bridges of communication between the two countries to promote collaboration, thereby synergizing research and practice everywhere. To this end, presentations on frailty and novel approaches to increase access to known behavioral interventions bring together different methodological perspectives, as will presentations on basic biology of vascular aging and pre-clinical pharmacologic interventions informing clinical trials aimed at restoring physiological functions in older individuals.
BASIC AND CLINICAL ASPECTS OF VASCULAR AGING
Authors: Zhang Cuntai
Published: January 2025

Vascular aging (VA) is an important pathophysiological contributor to the aging process. In response to China’s aging population, a hierarchical “Standardized Vascular Aging Management Center (VMC)” network, with Tongji Hospital in Wuhan as the central hub, was established in 2023 to offer comprehensive vascular aging (VA) management nationwide. This initiative encompasses assessment, stratification, and intervention strategies for VA, a key factor in the aging of human organs and systems and a common denominator in the chronic diseases of aging. Our research delves into the cellular and molecular dynamics of VA, examining the effectiveness of pharmaceutical interventions against vascular stiffness and investigating cellular aging mechanisms such as metabolic changes, ferroptosis, mitochondrial dysfunction, and senescence-associated secretory phenotype (SASP), alongside key factors like SOX9, Nrf2, and FGF21. Furthermore, we are launching a national cohort study and conducting randomized trials on novel drugs to bridge clinical and basic research findings. This integrated approach aims to detect early VA signs, enabling timely interventions to mitigate chronic elderly diseases, foster healthy aging, and effectively tackle the implications of an aging demographic. By developing an integrated VA research and application platform that facilitates seamless translation between basic and clinical settings, we aim to identify early signs of VA and implement appropriate interventions to delay and manage this process. Ultimately, our efforts aim to reduce chronic disease in the elderly, promote healthy aging and more effectively address the challenges of an aging society.
FRAILTY AND INTRINSIC CAPACITY IN OLDER ADULTS IN CHINA: FROM RESEARCH TO PRACTICE
Authors: Ma Lina
Published: January 2025

Older adults with frailty have a reduced ability to cope with stresses, such as that associated with acute diseases, and these adults also have an increased risk of falls, disability, and death. The prevention and treatment of frailty in this group of people are very important. In China, as the general population has aged, the demand for medical care services for older adults has increased. China has given high priority to healthy aging and established a national strategy “Healthy China 2030” blueprint and is progressing rapidly in geriatric medicine. Although frailty research in China started late, it has developed very rapidly, especially on assessment tools, epidemiology, and management. Furthermore, several guidelines have been established to help physicians make clinical decisions while treating frail older persons. In recent years, clinicians and researchers have shown increasing interest in intrinsic capacity, a new positive approach to health aging. However, much effort should be made to integrate frailty into clinical practice. This talk focuses on the research advances on frailty from biological mechanisms to therapeutic opportunities as well as individual-centered integrated care for optimizing intrinsic capacity to prevent frailty and disability in older adults in clinical practice in China.
A CLOSER LOOK AT EMOTIONAL ACCEPTANCE IN LATE LIFE
Authors: Haase Claudia , Li Yu , Yu Chen-Wei , Fu Lillian , Rompilla David
Published: January 2025

When older adults regulate emotions, they tend to prefer emotional acceptance (i.e., embracing emotions without judging them) over other strategies, such as reappraisal (i.e., reframing an emotional situation to view it in a more positive light) or detachment (i.e., mental distancing from an emotional situation). While regulation strategies, such as reappraisal, have been widely studied, interest in emotional acceptance is just starting to take off. Here, we present findings from two studies on emotional acceptance with older adults. In a laboratory-based study, we examined habitual emotional regulation (using questionnaires) and instructed emotion regulation (instructing participants to use different emotion regulation strategies when watching loss-themed film clips vs. “just watch” them while monitoring their autonomic physiology) in a sample of 129 older adults (age 64-83). We examined emotional acceptance and (to determine specificity) detachment and reappraisal. Findings showed that habitual emotional acceptance (but not detachment or reappraisal) was associated with (1) greater vagal reactivity during instructed emotion regulation and (2) lower levels of anxiety and depressive symptoms. In an online study, we probed a novel measure of emotional acceptance in a sample of 241 older adults (age 65-88). A confirmatory factor analysis supported a 2-factor solution with acceptance of negative emotions and acceptance of positive emotions as two distinct factors. Together, these findings highlight the physical and mental health benefits of emotional acceptance in late life, underscore differences between different cognitive change strategies, and suggest further probing of accepting not just negative but also positive emotions in future research.
AMPLIFYING THE POSITIVE: RECIPROCAL ASSOCIATIONS BETWEEN SAVORING AND POSITIVE AFFECT
Authors: Stephens Jacquelyn , Smith Jennifer
Published: January 2025

Savoring and positive affect are closely related, yet little work has disentangled the bi-directional relationship between them, as they have primarily been examined cross-sectionally. Further, more empirical work is needed to show that savoring is longitudinally associated with increased positive affect even when accounting for baseline positive affect. We examined year-to-year associations between savoring and positive affect using three annual waves of data from the Age Well study. Participants consisted of 2945 older adults (Mage = 82.08, SD = 6.38; 66% female) recruited from Life Plan Communities across the United States. Positive affect was modeled on savoring ability using random-intercept cross-lagged panel models. Our results revealed significant bi-directional relationships, such that savoring predicted later positive affect (B =.15, p >.001) and positive affect predicted later savoring (B =.34, p >.001). Our results show evidence that changes in savoring sequentially predict greater positive affect, as well as the reverse. In line with views of upward spirals of positive emotion, increasing positive emotion regulation indeed contributes to greater emotional well-being in older adults, independent of initial levels of positive emotion.
EXAMINING CUSTODIAL GRANDMOTHER’S PARENTING PRACTICES BY MEANS OF A THREE-STEP LATENT PROFILE ANALYSIS
Authors: Ye Minzhi , Smith Gregory
Published: January 2025

Although parenting is the central responsibility of custodial grandparents, research on the parenting practices of these family caregivers remains scarce. With various measures of parental nurturance and discipline as objective indicators, we used Three-Step Latent Profile Analysis (Mplus 8.1) to (1) identify distinct custodial grandmother (CGM) parenting profiles among a nationwide sample of 733 individuals and (2) examine how these profiles were related to grandchildren’s (GC) psychological difficulties, CGM mental health, CGM coping behaviors, and key contextual factors. Four parenting profiles emerged: Permissive (35%; n = 259), Authoritative (7%; n= 53), Optimal (49%; n = 357), and Inconsistent (9%, n=64). These profiles differed considerably in terms of how each was related to CGM depressive and anxiety symptoms as well as to GC internalizing and externalizing difficulties. For example, in Permissive CGM, both their anxiety and depression symptoms were positively related to GC internalizing and externalizing difficulties. On the other hand, among Authoritative CGM, their depressive symptoms were negatively related to GC internalizing, while their anxiety symptoms were positively related to CG internalizing. In addition, multinomial contrasts with Optimal CGM as the referent showed that “Permissive” CGM reported less problem-focused coping, more family conflict, and younger CGM with older GC. “Authoritative” CGM reported higher depressive symptoms, less support, and increased family conflict. Finally, Inconsistent CGM reported less problem-focused coping, heightened family conflict, and older GC. These findings shed light on the relationships between CGM parenting profiles, well-being, coping behaviors, and GC outcomes which informs future interventions. [Funded by NIH R01- MH-66851-02]
WHO IS “OLD” IN AN AFFLUENT RETIREMENT COMMUNITY: QUALIFYING STIGMA THROUGH OUTLIER DATA
Authors: Crampton Alexandra
Published: January 2025

The purpose of this study has been to compare and potentially reconcile professional constructs defining who is an older adult with lived experience of aging into 80+ decades. In this anthropological field research project, the study site is an affluent, Midwestern retirement community in which the average age is 85. Data were primarily collected through participant observation and semi-structured interviews during several data collection periods from 1 week to 2 months between July 2021 and December 2023. Despite optimal access to resources and identities of privilege, findings show how residents confronted “deep old age” as a highly stigmatized experience and social identity. Demographic and other quantitative data were collected from administrative data. These data helped qualify normative responses from research participants, such as a perceived “rash of deaths,” during the Covid-19 pandemic. In addition, qualitative data provided richness of detail and contextualization that numbers could not. In the objective concerns of a facility caring for older adults and the subjective experiences of residents confronting fears of aging, outlier data included examples of coping and social interactions that did not fit professional nor peer expectations of aging as stigmatizing or debilitating. Such examples inspired hope of alternative constructs that transformed ageist fears of age-related change. Residents who inspired included those who were unusually able to accept frailty, falls, and disability without resignation. In dialogue with research participants, “old” age was redefined as risk at any age of “giving up.”
HOUSING MODELS TO PREVENT AND INTERVENE IN HOMELESSNESS AMONG LGBTQIA+ OLDER ADULTS
Authors: Perone Angela , Zhou Leyi
Published: January 2025

LGBTQIA+ older adults have heightened risks for homelessness, given structural and systemic barriers and inequities across the life course. Little is known about housing prevention and intervention models for LGBTQ+ older adults at risk of homelessness. This study uses a novel multi-method approach to answer the following community-driven research questions: What housing models aim to prevent or intervene in homelessness among LGBTQIA+ older adults? How do these models respond to the diverse needs of LGBTQIA+ older adults? The research team first conducted a scoping review using Arksey and O’Malley’s five-step framework. In collaboration with a national community partner, the team next identified and reviewed grey literature. The team supplemented review findings with secondary qualitative data from community leaders. Data revealed five core housing models used as prevention and intervention homelessness tools among LGBTQIA+ older adults: affordable housing developments, homeshare spaces, tiny homes, community land trusts, and mobile communities. Affordable housing developments tended to be located in spaces that were more heavily populated by white residents. Transgender and LGBTQIA+ older adults of color led projects that invoked the other four nontraditional housing models. While affordable housing developments for LGBTQIA+ older adults are growing, they may not be meeting the diverse needs of this community. Intersecting experiences of trauma, discrimination, and exclusion (e.g., racism, ableism, sexism, heterosexism, transphobia) may be driving the need and desire among transgender older adults and LGBTQIA+ older adults of color to develop alternative housing models to prevent homelessness.
CHARACTERISTICS OF MIDLIFE WOMEN FAMILY CAREGIVERS ASSOCIATED WITH THEIR NEGATIVE ATTITUDES TO DEMENTIA AND CARE
Authors: Kim Dongmi , Im Eun-Ok , Chee Wonshik , Yang You Lee
Published: January 2025

Racial/ethnic minority family caregivers, especially midlife women who are family caregivers of persons living with Alzheimer’s Disease (MWPLAD), tend to suffer quietly without necessary support and care partially due to their cultural attitudes related to Alzheimer’s Disease (AD) and dementia care (e.g., filial piety, fatalism). Yet, little is still known about the women’s characteristics that are associated with their negative attitudes toward AD and dementia care. This information could provide important directions for future intervention development for this specific population of family caregivers. The purpose of this secondary analysis study was to determine the characteristics of MWPLAD that were significantly associated with their negative attitudes toward AD and family Caregiving. This analysis included the data from 172 MWPLAD who were recruited through online and offline communities/groups for midlife women. The instruments included: the Attitude toward AD and Related Dementias Scale (DAS), the Questions on Attitudes toward AD Caregiving, the Social Readjustment Rating Scale, the EQ-5D-5L and the Midlife Women’s Symptom Index. The data analysis was conducted with descriptive and inferential statistics including Independent t-tests, Mann Whitney U tests, one-way ANOVA, and multiple regression analyses. The total DAS scores were significantly associated with employment, race/ethnicity (being Hispanic), and instrumental activities for daily living (p <.05). Those who were unemployed, Hispanic, and with low instrumental activities for daily living tended to have negative attitudes toward Alzheimer’s Disease and dementia care. More interventions need to be developed for racial/ethnic minority MWPLAD while considering these characteristics.
EXAMINING THE ROLE OF SOUTHERN CONTEXT FOR DEMENTIA, DISABILITY, AND MORTALITY AMONG OLDER US BLACKS AND WHITES
Authors: Kim Jaein , Cha Hyungmin , Farina Mateo , Hayward Mark D
Published: January 2025

Racial inequalities in older adult health are well-documented. Compared to Whites, Blacks have greater risks of disability, dementia, multimorbidity and mortality. These differences in age-related health are paralleled by race differences in context. In particular, approximately 80% of older Blacks were born in Jim Crow South no matter where they currently live compared to 30% percent of older Whites. In the United States, the U.S. South has historically structured the life course experiences of Black and White older adults differently through legalized racial segregation. As a result, the role of association of Southern context with later life health risks is expected to differ substantially across the groups. We focus on three critical dimensions of population health to better understand the role of context for race difference in health – cognitive and physical functioning as well as mortality. Drawing on the Health and Retirement study from 2000-2016, we estimate a series of hazard models for each of the health outcomes separately for each race group. This approach promises new insights into the role of context for within-group variation in the health outcomes as well as for potential between-group differences for each specific outcome. Whereas for Whites Southern birth regardless of residence was associated with increased risk across all three conditions, for Black older adults we found more heterogeneity. Those who were born and lived in the South had the highest risk of dementia. Southern residence was associated with an increased risk of mortality, but its effect was ambiguous for risk of disability.
MULTILEVEL FACTORS ASSOCIATED WITH RACIAL AND ETHNIC DISPARITIES IN TIMELY DIAGNOSIS OF DEMENTIA IN US OLDER ADULTS
Authors: Qian Yuting , Li Fan , Chen Xi
Published: January 2025

In the U.S., non-Hispanic Black and Hispanic older adults are disproportionately more likely to develop dementia but less likely to receive a timely diagnosis than White older adults. Quality care for people with dementia starts with an early diagnosis, a key goal of the national plan to address dementia. This study examines individual-level and neighborhood-level factors associated with racial and ethnic differences in timely dementia diagnosis. We used 1998-2020 Health and Retirement Study (HRS) data, which contains detailed information on cognitive assessments and provider diagnoses for a representative sample of U.S. older adults. This was then linked to the National Neighborhood Data Archive (NaNDA) for neighborhood contexts. We find that racial and ethnic disparities in timely dementia diagnosis were substantially attenuated after adjusting for individual-level and neighborhood-level factors. The adjusted odds ratio of having a timely dementia diagnosis increased from 0.60 (95% CI: 0.48-0.76) to 0.76 (95% CI: 0.58-1.00) for non-Hispanic Black older adults compared to their White counterparts. A mediation analysis revealed that household income and education explained the largest proportion of the disparity between non-Hispanic Black and White older adults (17.9% and 12.7%, respectively), followed by neighborhood affluence (10.9%), neighborhood disadvantage (9.9%), and health care access (measured by physician density and other health practitioner density). These patterns were similar for Hispanic compared to White older adults. Our findings may inform targeted interventions and policies that emphasize socioeconomic risk factors and health service availability to reduce racial and ethnic disparities in timely dementia diagnosis and promote health equity.
BRAIN FOG AND A SHRINKING WORLD: GRIEF AND LOSS IN THE CONTEXT OF DEMENTIA
Authors: Hirsch Jen , Gibson Allison
Published: January 2025

To date, little is known about people living with dementia’s experience of relating to and coping with their disease. Most studies about dementia have focused on their experience from the perspective of a care partner(s), professional care provider(s), or through observation of rather than engaging those living with dementia directly to reflect on their experiences. This qualitative study engaged 20 people living with dementia in focus groups to explore their lived experiences of grief and loss in the context of dementia, such as needing to constantly adapt to changes in disease symptoms, brain fog, and having their environment shrink as they disengage from life roles. Reflexive thematic analysis was used to describe and interpret the rich data. Participants discussed numerous strategies to cope with their diagnosis including engaging in new activities such as hobbies or advocacy efforts around dementia. Others discussed leaning on support systems and peer support groups using social engagement and technology as their most effective coping mechanisms. The themes from this study offer a richer understanding of the experience of dementia as a serious illness. Grief responds well to social support, and yet this population who are dealing with compounding loss also face isolation due to their treatment by others. Understanding this population’s experience and what strategies they use to cope could be used to improve quality of life and psychosocial support for people with dementia and their families.
NEIGHBORHOOD ENVIRONMENTS AND COGNITIVE HEALTH: ADVANCEMENTS IN CONCEPTS AND METHODS
Authors: Rosso Andrea , Hirsch Jana
Published: January 2025

Evidence for the importance of residential neighborhood environments for cognitive health in older adults has grown substantially in the past decade. It is important to understand details of these relations, including timing and mechanisms, as interventions at the neighborhood level could have broad public health importance. Here, we present a series of five talks from four studies that aim to advance the field of environmental influences on cognitive health through several conceptual and methodological advancements: inclusion of lifecourse exposures (Cheng, Finlay), consideration of the role of race as a social construct and a modifier of neighborhood exposures (Cheng), incorporation of blood-based biomarkers of Alzheimer’s disease as an outcome (Fan), consideration of spatial and historical context in interpreting results (Moored, Desjardins), use of qualitative interviews to gain insight from people’s lived experiences (Finlay), and use of novel exposures such as cognability (Finlay) and blue space (Moored, Desjardins) as well as upstream factors indicative of structural disadvantage (Cheng, Fan, Desjardin). Together, these talks will challenge the audience to consider the complex ways in which neighborhoods could influence cognitive outcomes and how to best approach analysis and interpretation of such data. Advancing our conceptual understanding of the influence of neighborhoods on cognitive aging over the lifecourse will allow for informed public health interventions. A discussion of next steps will be led by Jana Hirsch. Environmental Gerontology Interest Group Sponsored Symposium
LIFE COURSE “COGNABILITY”: INVESTIGATING NEIGHBORHOODS AND COGNITIVE HEALTH RISKS ACROSS THE LIFESPAN
Authors: Finlay Jessica , Savard Grace , Alvarez-McNelis Desiree , Sagehorn Mallory , Esposito Michael
Published: January 2025

A growing body of evidence identifies potentially modifiable individual risk factors for Alzheimer’s Disease and Related Dementias (ADRD) such as physical inactivity, hypertension, and social isolation. However, the neighborhood built and social environments in which people develop and navigate these risk factors are often overlooked. This knowledge gap is particularly acute for longitudinal neighborhood contexts that may differentially structure opportunities and barriers to individual ADRD risk across the lifespan. The Neighborhoods and Health at All Ages Study employed seated and mobile interviews from August 2023-March 2024 to investigate which neighborhood amenities and hazards are perceived as most relevant to cognitive health-promoting activities at different life course stages. Fifty-six study participants living across the Minneapolis-St. Paul (MN) metropolitan area were on average 42 years old (range: 18-75). 52% identified as female, 40% male, 8% non-binary; and 29% identified as Asian, 24% Hispanic, 19% Black/African American, 17% non-Hispanic White, and 11% American Indian/Alaska Native. Reflexive thematic analysis identified that greater access to affordable amenities, online social infrastructure, and robust public and active transit in young adulthood; safe transportation, online neighborhood swaps, and educational sites (e.g., daycares, schools) in mid-life; and civic/social organizations, arts/cultural amenities, and accessible outdoor recreation in later life can support cognitively healthy lifestyle behaviors. The interviews captured nuanced perspectives and varying personal experiences of how individuals uniquely engage with their neighborhood environments, including navigating structural racism, classism, and ageism. Results may inform upstream community-level interventions to help create more equitable neighborhoods with opportunities to support lifelong cognitive health.
LAUNCHING A NEW UNIVERSITY-BASED OPENING MINDS THROUGH ARTS PROGRAM
Authors: Carr Dawn , Monroe Suzanne Smith
Published: January 2025

Florida State University launched the Opening Minds through Arts program in Fall of 2023 within the college of Social Sciences and Public Policy. The current model is based in a student internship program, in which students are able to earn up to three credit hours. The internship course includes one face-to-face, hour-long class per week with an instructor in which they complete course readings, watch videos, and listen to podcasts to learn about Alzheimer’s and Dementia related subjects, as well as research associated with art-based therapies and person-centered care models. Students are paired with one older adult for the semester at one of our two partnership residential care homes, in which students facilitate art making and, in the process, get to know their older adult artist. Since the program’s launch, FSU has trained 18 student interns and 13 volunteers from varying disciplines, such as the FSU College of Law. The program has also served 19 older adults in Tallahassee and continues its plan to expand the number of OMA sessions, with the Spring semester currently holding three OMA sessions per week (5 older adults per session). Although FSU’s program is in early stages of development, we will provide internal program evaluation results which includes institutional partnership characteristics that promote long-term success, student training and preparation, and qualitative feedback from student interns. We will also provide information about expansion of the program for clinical settings at FSU to expand geriatric training and person-centered care.
IMPACT OF OMA ON HEALTH CARE TRAINEE ATTITUDES AND PERCEPTIONS TOWARD PEOPLE LIVING WITH DEMENTIA
Authors: Berish Diane , Rank Jennifer , Whitaker Janice , George Daniel
Published: January 2025

To meet the complex needs of the growing population of people living with dementia (PLwD), the healthcare workforce must have not only the necessary clinical knowledge, but also the interpersonal skills. Experiences in the arts and humanities, such as OMA, can provide opportunities to acquire best-practice approaches. At present, no evaluation of OMA has been conducted on health trainees. We implemented OMA at Penn State University in both the Nese College of Nursing (NCON) and the College of Medicine (COM). In the NCON, OMA was implemented into nursing clinicals and as part of a memory cafe. N=10 clinical and N=15 memory café students completed pre and post assessments (Allophilia, Dementia Attitudes) of their perceptions and attitudes towards PLwD. Results showed that clinical students reported higher levels of comfort with PLWD on both scales (Allophilia, p=.0039; Dementia Attitudes, p=.002). Memory café students reported higher Allophilia scores (affection, p=.02; comfort, p=.04; engagement, p=.02) and Dementia Attitudes knowledge (p=.02). The COM was one of 6 medical schools to implement OMA in 2019-2020. Overall, 52 first- or second-year medical students were trained in OMA and participated with residents at partner assisted living facilities. Students’ scores showed significantly larger pre-post improvement than controls with respect to Dementia Attitudes scores (p=.001) and all Allophilia-scale factors (p=.001). Our work suggests that arts-based learning experiences such as OMA, which enable playful, creative, humanizing interactions between health trainees and PLwD, may foster more positive attitudes. Experiences like OMA might improve attitudes and encourage students to pursue geriatric specialties.
RELATIONSHIP BETWEEN STRESS AND PREDEATH GRIEF IN FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Elliott Lauren , Sparks Sarah , Schneider Sydnie , McLean Elisabeth , Fadalla Carol , Neugebauer Volker , Singer Jonathan
Published: January 2025

Being a family caregiver of a person with Alzheimer’s Disease or Alzheimer’s Disease Related Dementias (AD/ADRD) has been associated with chronic stress. Family caregivers likely experience increased rates of pre-death grief (PDG; grief symptoms that develop while an individual with a life-limiting illness is still living), given the trajectory and terminal nature associated with an AD/ADRD diagnosis. Higher levels of PDG in family caregivers is a robust predictor of depressive symptoms and prolonged grief disorder following the loss. Stress has been extensively studied within this population, but previous studies have failed to link stress to pre-death grief. Data from 65 family caregivers of individuals with AD/ADRD were analyzed (Mage = 68.68, SDage = 11.89). Participants completed questionnaires regarding pre-death grief symptoms (Prolonged Grief—12; PG-12) and subjective stress (Perceived Stress Scale; PSS). Consistent with previous research, family caregivers reported moderate levels of stress (PSS; M = 17.88, SD = 6.42) and pre-death grief (PG-12; M = 27.68, SD = 7.89). A bivariate correlation revealed a significant, positive relationship between stress and pre-death grief (r =.603, p <.001). Thus, family caregivers reporting higher levels of stress were experiencing heightened pre-death grief symptoms. Evaluating subjective stress in family caregivers is a time-efficient, non-invasive way to identify individuals at increased risk for psychosocial dysfunction. Interventions targeting stress in family caregivers may have beneficial downstream effects on pre-death grief before the loss, which may decrease the risk of developing prolonged grief disorder following the loss.
INCREASING CONNECTIONS BETWEEN PERSONS WITH DEMENTIA AND CARE TEAMS: MY LIFE, MY STORY
Authors: Gately Megan , McLaren Jaye
Published: January 2025

My Life, My Story (MLMS) was developed by the Veterans Health Administration (VHA) Office of Patient-Centered Care and Cultural Transformation as an opportunity for patients to share life stories with their care teams. Participating in MLMS interviews increases connection with clinicians, thereby facilitating patient-centered care. This study examines remote delivery of MLMS by occupational therapy students to patients of outpatient dementia clinics and their caregivers. Interviews were conducted using either videoconferencing, phone, or a combination. Post-interview questionnaires gathered Veteran-caregiver technological experience, including the need for technical support, comfort with technology, and how well they could see and hear. Questionnaires also gathered overall interview experience, including the belief that having care teams read stories would assist them in providing better care. In this session, we describe the MLMS program and objectives and present findings such as visit details (e.g., devices utilized, technological challenges, and caregiver role), and Veteran experience. We will also discuss strategies for conducting virtual interviews in the presence of cognitive concerns, such as interviewer flexibility and adaptability around technology, and communication strategies like simplifying questions and allowing extra time to accommodate for technology lag. Virtual narrative interviews using a structured approach like My Life, My Story allow for increased connection between individuals living with dementia and the care team, thereby facilitating patient-centered care. By providing an opportunity for social engagement, MLMS interviews may also address the growing scourge of older adult loneliness and social isolation, which is exacerbated for persons living with dementia.
SERVICE LEARNING TO PREPARE OCCUPATIONAL THERAPY STUDENTS TO MEET THE NEEDS OF VETERANS WITH LATE-STAGE DEMENTIA
Authors: Trudeau Scott
Published: January 2025

One of the challenges to providing activity programs in dementia units is meeting a wide range of residents’ needs. Programs are typically directed to the more moderately functional, often not meeting the needs of the least and most functional. The recognition that a significant cohort (approximately 20%) of residents on a dementia unit at Veterans Health Administration were typically excluded from group activities was of concern. This cohort came to be referred to as “VIPs” (Very Isolated Patients). The reason for their isolation was difficulty tailoring activities to their limited function within a group context. While more individualized approaches would be ideal, limited staffing precluded this approach. Developing a structured intervention that could be deployed by students to this vulnerable population seemed advantageous. The Reading Buddies Program was developed in which students were paired with a VIP resident with the assignment to meet with them weekly to engage in reading for a 45-minute session. Students read to residents in pairs, with one student facilitating and another student observing and gathering data. Data was collected in the form of qualitative student reflections and the Observed Measure of Engagement (OME). Students reported many opportunities for growth and mastery. The OME data reflected continued capacity for resident engagement in reading activities. Findings support the conclusion that by providing cognitive stimulation and social interaction for residents with later stage dementia, The Reading Buddies Program provided hands-on experience for occupational therapy graduate students to address the challenging functional and interpersonal needs of this cohort.
PRESIDENTIAL SYMPOSIUM: BUILDING FORTITUDE FOR THE JOB MARKET
Authors: Hu Rita , Kim Sohyun , Bernard Marie
Published: January 2025

The journey to establish a robust career in the gerontological research field is often marked by navigating through a maze of challenges, strategic decision-making, and the forging of vital professional relationships. The ESPO Presidential Symposium will feature early-career scholars from each scientific section to share their diverse pathways to landing a job and achieving research independence. Dr. Marissa Schafer from Mayo Clinic will discuss transitioning from PhD to Principal Investigator (PI), underlining the necessity of a comprehensive research portfolio, nurturing mentor-mentee relationships, and strategic career moves. Dr. Ketlyne Sol from the University of Michigan will share insights from her clinical psychology path, stressing the importance of dedicated research training and building a supportive network. Dr. Allyn M Bove from the University of Pittsburgh will compare physical therapy principles to career building in research, suggesting a balanced development of strength and endurance. Dr. Sara Bybee from the University of Utah will explore job market strategies through the lens of posttraumatic growth, highlighting personal strength and professional growth opportunities. The symposium concludes with a panel discussion led by Dr. Marie Bernard, the Chief Officer for Scientific Workforce Diversity at NIH, synthesizing the presentations and facilitating a dialogue among the speakers. This symposium serves as a crucial platform for aspiring gerontologists, offering guidance, strategies, and encouragement to navigate the complexities of the job market and achieve a successful and fulfilling career in aging research.
UNDERSTANDING MEDICARE-RELATED DECISION-MAKING BY OLDER ADULTS: ROLE OF TECHNOLOGY SUPPORT
Authors: Lee Hye Soo , Mudar Raksha , Rogers Wendy
Published: January 2025

Decisions related to Medicare carry significant implications for public health, given older adults’ reliance on this federal program. Our literature review on Medicare decision-making and technology utilization aimed to investigate how technology could be enhanced to better support older adults. We identified pertinent studies by using combinations of search keywords such as “Medicare”, “decision”, and “older adults”, and by using the information from the collected studies. The findings revealed varying levels of Medicare knowledge among older adults, predominantly acquired through human assistance. Government-provided technology for Medicare was either underutilized or perceived as challenging. The evidence indicated that training in decision-making and technology use could prove advantageous. Factors like stress avoidance and the need for reassurance played roles in the decision-making process and plan selections. Considering older adults’ characteristics and preferences in decision-making and technology utilization is crucial for future technological developments, supported by policy and research initiatives.
END USER FEEDBACK TO IMPROVE PATIENT-FOCUSED TELEHEALTH TRAINING
Authors: Freddolino Paul
Published: January 2025

After older-adult home-delivered meal recipients in a predominantly white, rural Midwest community received tutoring on basic digital skills including safety and security, email, internet browsing, videoconferencing, and photo tools, they were presented with a five-part patient-focused Telehealth 101 mini-course. Content included types of telehealth (real time encounters, remote patient monitoring, and patient portals), what to expect from providers, how to prepare for telehealth encounters, and a live simulation of a telehealth visit. The telehealth mini course was also offered virtually on Zoom to predominantly black groups at five urban senior centers. While participants rated the sessions positively, and patient engagement in healthcare (Patient Activation Measure scores) increased significantly after the training, critical feedback provided insights into how to improve the training. During 2023 the project team worked with six ‘co-producers’ to get their suggestions and assessments of revisions under consideration for the training materials. Concurrently, revised resources – including two new topics in the telehealth content – were piloted with two predominantly white senior centers and two predominantly black senior centers. Feedback has again been positive and included insights for continuous quality improvement. Our experience shows the contributions and challenges encountered in seeking and engaging end users as co-producers of health-related content.