bluuebunny/crossref_metadata_2025 huggingface dataset:
BETWEEN-PERSON AND DAILY WITHIN-PERSON VARIATION PATTERNS IN MEASURES OF VIEWS OF AGING
Authors: O’Brien Erica , Smyth Joshua
Published: December 2023

Despite increasing evidence of daily associations between individuals’ health and their age-related thoughts, beliefs, feelings and experiences (collectively referred to as views of aging, VOA), we know little about daily variation in VOA more generally. We used data from an online sample of 122 adults (aged 26 to 78 years) who completed multiple measures of VOA (subjective age, age group identity, aging attitudes, implicit theories of aging, awareness of age-related change) on each of 7 consecutive days, partitioning variance in responses to each measure at the person and day levels to assess between- and within-person variability, respectively. Results showed that, in all measures, between-person variability accounted for most of the total observed variation (62% to 92%) whereas within-person variability accounted for a significant but smaller amount (8% to 38%). The ratio of between- to within-person variation, however, depended on the specific measure and age group assessed, with the highest ratios observed for subjective age (versus other measures) and older adults (versus young adults). Findings suggest that VOA are relatively stable in daily life and may become more stable with advanced age. Further study of measures and age groups that exhibit the most within-person variability can yield insights that help increase understanding about the dynamics of VOA (i.e., which VOA constructs are most sensitive to fluctuating contexts and for whom?) and therefore inform future work linking VOA to other phenomenon in daily life.
CHANGES AMONG COLLEGE STUDENTS’ ATTITUDES, KNOWLEDGE, AND INTENTION TO WORK WITH OLDER ADULTS
Authors: O’Brien Christopher , Strong Jessica
Published: December 2023

Curricular intervention studies have examined if instruction in aging and gerontology affects undergraduates’ attitudes, knowledge, and perceptions toward older adults. However, less is known about the curricular impact on undergraduates’ intentions to work with older adults and attitudes and knowledge about sexuality and aging. The current longitudinal study examined the impact of an upper-level adult development psychology course on student attitudes, knowledge, and intentions toward working with older adults. Participants were 8 undergraduate students enrolled in upper-level undergraduate psychology courses. Participants completed validated, self-report questionnaires at the beginning of the semester and at the end of the semester related to their attitudes towards working with older adults, ageism attitudes, aging sexual knowledge and attitudes, and attitudes and knowledge about aging. Paired samples t-tests were used to examine changes in main outcome variables. Students endorsed significantly greater attitudes toward working with older adults at the end of the semester (t = -2.57, p = .037). Additionally, knowledge about sexual aging significantly increased (t = 2.62, p = 0.34). These findings suggest curricular interventions may positively impact attitudes toward working with older adults and sexual aging knowledge. Future work will evaluate predictors of change in attitudes, knowledge, and intentions. By identifying factors that increase undergraduates’ intentions to work with older adults and improve attitudes and knowledge regarding sexual aging, we may elucidate meaningful points of intervention to enhance the pursuit of careers in the geriatric workforce.
CONTROL BELIEFS MEDIATE THE WITHIN-PERSON RELATIONSHIP BETWEEN EVERYDAY CONTEXT AND SUBJECTIVE AGE
Authors: Zhang Shenghao , Neupert Shevaun
Published: December 2023

Appraisal and interpretation of personal experiences resulting from interaction with situational contexts might play an important role in shaping subjective age at within-person level, but it is unclear how this process unfolds. We propose that older adults evaluate situational contexts and reflect on their general psychological resources when determining their subjective age, and tested this proposal with volition of daily activities as proxy for appraisal of situational contexts and control beliefs as proxy for psychological resources. We hypothesize that appraising daily activities one engaged in as obligatory would deplete one’s perceived control and concomitantly make one feel older. Older adults (n=116) ranging in age from 60 to 90 (M=64.71) completed a nine-day daily diary study online, resulting in 743 total days. Participants reported their sociodemographic characteristics on Day 1 and major daily activities, volition of every reported activity, felt age, and control beliefs on Days 2-9. Results showed that on days when older adults felt that activities they engaged in were more of their own volition, they also felt more in control. Lower-level mediation result suggests that within-person control beliefs mediated the relationship between volition of daily activities and subjective age. Our findings suggest that older adults evaluate situational contexts and reflect on their control beliefs as a general psychological resource when determining their subjective age. These findings show the important role psychological resources play in determining subjective age from a within-person perspective and extended the within-person process proposed in previous theoretical models.
DOES INTERNET USE PROMOTE OLDER ADULTS’ SELF-PERCEPTION OF AGING: SEPARATING WITHIN- AND BETWEEN-PERSON EFFECTS
Authors: Wang Kun , Gu Danan
Published: December 2023

Previous longitudinal studies indicate a positive causal association between older adults’ Internet use and self-perception of aging (SPA). However, it is unclear whether this positive effect is truly due to the lagged within-person changes in Internet use or due to some stable, trait-like between-person differences. Thus, with between-person differences controlled, this study aimed to 1) examine reciprocal associations of within-person SPA and Internet use and 2) investigate the potential age, gender, race/ethnicity, and education group differences. Data used in this study were from the Health and Retirement Study (T1: 2008; T2: 2012; T3: 2016). Older adults aged 65 and older with normal cognition were included in the analysis (n = 6,666). Random-intercept cross-lagged panel models (RI-CLPM) were applied to separate the within- and between-person effects regarding the associations between SPA and Internet use. Multiple-group analyses were used for testing group differences. Results showed positive carry-over stability of both Internet use and SPA across time. At the within-person level, only one cross-lagged path, Internet use (T1) ♢ SPA (T2), was significant (b = .08, p < .05), indicating that the within-person Internet use change was predictive of within-person SPA change at T2. At the between-person level, SPA and ICT use were positively correlated (r = .16, p < .001). No group differences were identified. This study indicates that the positive effects of Internet use on SPA may be largely due to between-person differences. Internet use may promote SPA to some extent, but effects may plateau after a certain period of time.
DOES THE FACTS ON AGING QUIZ ASSESS AGING STEREOTYPES?
Authors: Schultz Savannah , Francis Sarah , Shelley Mack , Vincent Aaron , Hyde Cori , Bauman Alexandra
Published: December 2023

The World Health Organization (WHO) Global Report on Ageism urges researchers to develop and validate assessment tools, thus enabling the field to better address ageism. This study assesses the internal consistency and construct validity of a short Facts on Aging Quiz (SFAQ, 10-items). We hypothesize that the SFAQ is a valid and reliable tool for assessing aging stereotypes. Data from the National Resource Center on Nutrition and Aging 2022 Needs Assessment were utilized. Data were collected via an online survey through a convenience sample of the National Aging Network (n=1,910). Three aging perspective tools were included: SFAQ, Expectations Regarding Aging (ERA, 12-items), and the WHO Ageism Quiz (AQ, 8-items). An exploratory factor analysis assessed whether negative (NEG) and positive (POS)-stereotype SFAQ items emerged as constructs. The factor analysis showed that NEG and POS-SFAQ accounted for 31.39% and 19.63% of the total variance, respectively. Cronbach alpha evaluated the internal consistency of the tools. Internal consistency for ERA (α=.81) and AQ (α=.57) were acceptable but low for total SFAQ (α=.28); reliability was acceptable for NEG-SFAQ (α=.71) and lower for POS-SFAQ (α=.40). Pearson correlation assessed convergent validity, with a significance level of p<.0001 (df=1,908) for all correlations. A negative correlation was detected between POS-SFAQ and ERA (r=-.31) and positive correlations between NEG-SFAQ and both ERA (r=.55) and AQ (r=.65), confirming convergent validity. POS-SFAQ was negatively correlated with NEG-SFAQ (r=-.19), suggesting the SFAQ may contain conflicting items. In conclusion, versions of the FAQ may perform better as a tool to assess aging stereotypes.
GRAY FOR A DAY: A SIMULATION ACTIVITY IMPACTS PARTICIPANTS IN COMMUNITY-BASED HEALTH EDUCATION
Authors: Buys David , Harris-Speight Jasmine , Redwine Pamela , Sansing Ann , Yelland Erin
Published: December 2023

Nearly 80% of older adults own their own homes; approximately two-thirds live within 25 miles of relatives; and most prefer to age-in-place, without access to geriatric-specific care. They rely on primary care clinics and family, friends, and other local support to meet their health needs. The healthcare workforce and lay public need to better understand age-related functional decline. Simulation activities can increase one’s understanding of new concepts or perspectives. One such activity, “Gray for a Day,” offers a didactic presentation and simulations of functional decline. In 2022, 10 Mississippi State University Cooperative Extension agents offered the “Gray for a Day” training to 550 individuals across 35 sessions in community colleges, high school career and technical education classes, and hospitals and nursing home food service departments. Participant evaluations were collected to assess learning outcomes and empathy development. Process evaluation data and descriptive statistics are reported. Nearly all (98%) of the participants reported increases in knowledge of age-related sensory and functional decline and increases in understanding how age-related sensory and functional decline can impact one’s daily life; and 95% reported an increase in considering how they can better interact with older adults experiencing functional decline. Understanding challenges facing older adults is essential to empathy and important both in a home environment and in the workplace. The “Gray for a Day” simulation activity is feasible for implementation in multiple settings and has the potential to increase knowledge, understanding, and possibly empathy for older adults experiencing functional decline.
HOW DO PEOPLE PERCEIVE THEIR OWN AGE?—SELF-REFLECTION ON HEALTH STATUS
Authors: Choi Hyojin , Litzelman Kristin
Published: December 2023

Subjective age -- how old you feel -- is a simple, but inclusive indicator of how people experience their own aging. This hypothesis-generating study sought to assess how objective and subjective indicators of well-being differ by subjective age, in order to progress our understanding of how this metric internalizes physical and psychological information. Data were drawn from the Midlife in the United States in 2004-2006 (MIDUS 2). The sample represented adults aged 50 years and over (n=612) and was divided into two groups: 1) felt younger than chronological age, and 2) felt the same or older than chronological age. Nearly four in five older adults reported feeling younger than their chronological age. Chi-square statistics showed that subjective indicators differ by subjective age. Specifically, those that felt the same/older than their chronological age were more likely to have depression or functional limitations, and report poor health status than were feeling younger group. Interestingly, bio-marker (i.e., C-reactive protein), physical and cognitive ability (i.e., gaits and episodic memory), and chronic conditions did not differ by subjective age. The findings indicate that reports of subjective age correlate with perceived rather than objective health status. Subjective age may therefore function as an indicator that health problems or life stressors are becoming internalized and overcoming an individual’s capacity to cope. Future research is needed to understand how subjective age can act as a bellweather of subjective and objective health decline.
SELF-DIRECTED AGEISM OUTCOMES ASSOCIATED WITH AGEISM-REDUCTION INTERVENTIONS: A SCOPING REVIEW
Authors: Scrivano Rachel , Jarrott Shannon
Published: December 2023

Self-directed ageism refers to stereotyping, prejudice, and discrimination toward oneself based on age or perceived age. Self-directed ageism research is limited but growing as the conceptualization of ageism evolves and the implementation of ageism-reduction interventions increases. A scoping review was conducted to explore self-directed ageism outcomes associated with ageism-reduction interventions among populations measured. The PRISMA-ScR checklist guided study methods. A systematic search for relevant peer-reviewed journal articles was conducted in 2022 using eight EBSCOhost databases. Fifty-two studies were included after screening was completed on 19,309 articles. Ageism-reduction interventions that assessed self-directed ageism outcomes were primarily implemented among college students (k = 20), older adults (k = 18), and children (k = 8). Despite methodological variation among included studies, such as measured domains of self-directed ageism, measures used, duration, dosage, and specific intervention characteristics, results suggest that purposeful in person intergenerational contact across age groups and in person intergenerational contact with aging education among college students and children are commonly effective in reducing self-directed ageism. Other interventions were found to be effective for certain age groups. Results provide initial support to suggest that intergenerational contact and aging education interventions can be similarly effective at reducing self-directed ageism as they are at reducing other-directed ageism. This scoping review also highlights several gaps in the literature. Notably, a universal definition for self-directed ageism is needed, a lifespan perspective of self-directed ageism should be taken, and research is needed to identify mechanisms of change responsible for significant outcomes achieved, especially within multifaceted interventions.
THE RELATIONSHIP BETWEEN MEDIA PORTRAYALS OF OLDER PEOPLE AND PERCEPTIONS OF INTERGENERATIONAL CONFLICT
Authors: Chung Soondool , Lee Ahyoung , Kim Ju-Hyun
Published: December 2023

As South Korea experienced rapid social change in several decades, there are lots of gaps in historical and cultural experiences of younger people and older people. In addition, with rapid population aging, generational tension became stronger due to limited resources and opportunities. This study examined the relationship between media portrayals of older people and intergenerational conflict and the mediating role of prejudice against older people in the relationship in South Korea. Also, the relationship between trust and intergenerational conflict was examined. Finally, the buffering effect of trust in the relationship between media portrayals of older adults and intergenerational conflict was examined. Secondary data analyses were conducted using Age Integration and Intergenerational Solidarity survey data of Korean adults aged 20 and over with a total of 1,000 cases. The findings revealed that prejudice against older people mediated the relationship between the media’s portrayal of older people and perceptions of intergenerational conflict. Trust showed a significant negative relationship with intergenerational conflict. Finally, trust had a buffering effect on the media’s negative portrayal of older adults and intergenerational conflict. For people with lower levels of trust, there was a significant positive relationship between negative media portrayals of older adults and intergenerational conflict. Further implications for practice to reduce intergenerational conflict were discussed.
FOOD TALK AS AGING TALK: LISTENING TO OLDER ITALIANS
Authors: Barrett Anne , Consolandi Monica , Fattorini Eliana
Published: December 2023

An extensive literature in gerontology examines older adults’ diets and their effects on health and longevity. Much less research examines how food, including experiences of its scarcity and plentitude across the life course, shape older adults’ constructions of their own aging. Our study addressed this topic using semi-structured interviews conducted in a mid-sized northern Italian city in 2018-2019 (n=28) and 2022 (n=23). Analyses revealed that participants used vivid references to food – a topic that was not the focus of any interview questions – to illustrate their experiences of aging. Participants’ food talk referenced different tenses of time, including durable food memories from the distant past and more ephemeral food activities and concerns of the present. Participants also referred to food when making different comparisons that shaped assessments of their own aging experiences, including comparisons with older family members in the past and age peers in the present. Food figured into participants’ discussions of aging in four ways: food as anchors for childhood memories, intergenerational comparisons of food’s plentitude versus scarcity in later life, food choices to support aging well, and food sharing to sustain social relationships. Our study illustrates the use of food a lens for understanding individuals’ aging experiences, as embedded in historical times that give them meaning.
GAMBLING AND PSYCHOLOGICAL WELL-BEING AMONG OLDER CHINESE ADULTS IN THE US
Authors: Zhu Yuyang , Ma Yiming , Tang Fengyan , Jiang Yanping
Published: December 2023

Gambling is a common but not harm-free social practice. Few studies have investigated the long-term impact of gambling activities on psychological well-being among racial/ethnic minority groups in the U.S. This study aimed to close this gap by examining the associations between gambling, problem gambling, and psychological well-being among older Chinese immigrants. We drew data from 2,811 (58% female) participants aged 60 years or older in the Population Study of Chinese Elderly in Chicago Study who completed the baseline assessment and at least one of the three follow-ups that were conducted every two years. Gambling participation was assessed using Modified South Oaks Gambling Screen and Problem Gambling Severity Index. The responses were used to categorize participants: never gambled (the reference group), participated in gambling, and problem gambling. Psychological well-being was assessed using Patient Health Questionnaire-9 and Hospital Anxiety and Depression Scale. Of all participants, 761 reported ever participating in gambling activities, and 52 reported problem gambling experiences. Participants who participated in gambling reported the lowest baseline scores of depression and anxiety compared to the other two groups. However, gambling participation predicted faster increases in depression (β=0.076, p=0.01) and anxiety (β=0.103, p=0.02) over time. Also, problem gambling was associated with a faster increase in anxiety (β=0.083, p=0.02). These results show a faster increase in psychological distress related to gambling participation over time. Culturally responsive interventions to reduce gambling activities and their impacts on psychological well-being are needed to promote health among this population.
THE JOINT EFFECTS OF PAIN AND ELEVATED DEPRESSIVE SYMPTOMS AMONG MEXICAN AMERICANS AGED 80 AND OLDER
Authors: Sanchez Claudia , Cantu Phillip , Markides Kyriakos , Milani Sadaf
Published: December 2023

Pain and depression are common among older Hispanic adults and their combined effects may increase mortality. We examined the joint effects of pain and depressive symptoms on mortality. We used data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2010-2016), which included Mexican Americans aged 80 and older in the Southwestern US. Participants were categorized into four groups based on self-reported pain on weight-bearing and depressive symptoms: no pain or elevated depressive symptoms, pain only, elevated depressive symptoms only, or both pain and elevated depressive symptoms. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression scale. A score of 16 or more was considered elevated depressive symptoms. Cox proportional hazards models were used to estimate the joint relationship of pain and depressive symptoms with mortality. We examined social support as a potential effect modifier. At baseline, 35.9% reported pain only, 8.6% of participants reported elevated depressive symptoms only, and 16.9% reported pain and elevated depressive symptoms (n=836). Over 6 years of follow-up, 46.2% of the sample died. Those with pain and elevated depressive symptoms had 1.41 times the risk of mortality compared to those without pain or elevated depressive symptoms (95% confidence interval: 1.05, 1.09). Having pain or elevated depressive symptoms only was not significantly associated with mortality. Social support was not a significant effect modifier. Our findings highlight the importance of screening for pain and elevated depressive symptoms among older Mexican Americans.
ASSOCIATION OF EVERYDAY LIFE INFORMATION ACQUISITION METHODS AND DEPRESSION AMONG US OLDER ADULTS
Authors: Dong Wuyi , Su Yan-Jhu , Alberth Andrew
Published: December 2023

Everyday life information acquisition refers to the incidental ways people obtain information through daily activities such as reading, watching television, or communicating with friends rather than through intentional or purposive information seeking behaviors. It has been identified as a fundamental way to obtain informational resources and is a potential means to promote social connections and engagement among older adults. Research has shown that social engagement and connections are protective factors of depression for older adults. However, little research has explored how information seeking behaviors effect risks of depression among older adults. To fill this gap in the literature and provide insights into the mechanism of information access impacts the mental health of older adults, this study examines the relationships between different ways for obtaining daily information (reading, using computer, and watching television) and depression among older adults in United States. The data retrieved from 2018’s Health and Retirement Study (HRS). We multiple linear regression analyses on HRS data including adults age 50 years and older (n=3,179). After adjusting for age, gender, race, marital status, education, and chronic diseases, all three different ways to obtaining daily information (reading, using computer, and watching television) were negatively associated with depression (β=-0.19, p< 0.001; β=-0.15, p=0.002; β=-0.15, p< 0.001, respectively). Findings suggest that the association between everyday life information acquisition and depression among older adults varies depending on the specific information acquisition methods used. These findings highlight the importance of implementing targeted interventions to promote effective information access and enhance social inclusion among older adults.
EMOTIONAL CLOSENESS, SOCIAL NETWORK, NEGATIVE AND POSITIVE AFFECTS, AND AGITATION IN OLDER ADULTS WITH DEMENTIA
Authors: Rababa Mohammad
Published: December 2023

Background

If given a choice, people with dementia (PWD) would prefer to live in their homes instead of nursing homes. Living in older adults’ own houses would positively impact their quality of life and be associated with more privacy, security, and social support. In addition, living in a nursing home is not culturally and religiously accepted, especially in a religious and conservative country like Jordan. However, with increased financial obligations and hardships in Jordan, women are forced to work outsides their houses. Therefore, PWD stay alone in their homes without care or attention. This neglect would put PWD at significant risk for adverse physical and psychosocial health consequences. Method: This descriptive cross-sectional study was conducted on a convenience sample of 102 Jordanian PWD (51 Community-dwelling older adults and 51 NH residents) to examine the association of their emotional closeness and social networks with agitation and positive and negative affects. Result: The finding of this study based on an independent samples t-test showed that NH residents were significantly more likely to have physically non-aggressive behaviors than community-dwelling older adults. The study showed that the PWD’s sex (male), higher educational levels, and patients with a family member in the healthcare field are associated significantly with their mean positive affects score.

Conclusion

Future research would consider exploring potential factors associated with agitation and affect in PWD. Experimental studies that intend to increase the levels of social support and emotional closeness, thus alleviating negative affect and levels of agitation, are recommended in the future.
SOCIAL ISOLATION AND COGNITIVE FUNCTION: FOCUSING ON RACE/ETHNIC DIFFERENCES FROM THE NHATS STUDY
Authors: Taani Murad , Lee Yura , Ellis Julie , Cho Chi , Hammouri Ammar
Published: December 2023

Social isolation has negative associations with various health outcomes including cognitive function. However, limited research exists delineating the effect of social isolation on cognition using population-based longitudinal data. Moreover, little is known whether there are any race/ethnic differences in this social isolation-cognition relationship. We examined the effects of social isolation on cognitive function and explored the moderating role of race/ethnicity using longitudinal data of 4381 older adults from two waves of NHATS (2015 and 2018). Social isolation was measured by addressing four domains of network and integration: (a) marriage or partnership, (b) family and friends, (c) church participation, and (d) club participation (score range: 0 - 6). A higher score indicates more social isolation. Cognitive function was measured using the composite score of three domains: memory, orientation, and executive function (range: 0 - 33), with higher scores indicating better cognitive function. Repeated-measures ANOVA showed a significant relationship between social isolation and cognitive function. Specifically, the greater the social isolation, the lower the cognitive function. We found significant differences in cognitive function scores across race/ethnic groups. Non-Hispanic White showed higher cognitive function than non-Hispanic black, Hispanics, and other races. Non-Hispanic black and other races also showed significantly higher scores than Hispanics. The findings also showed that the cognitive function score significantly decreased over a 4- year period. There was no moderating effect of race/ethnicity found between social isolation and cognitive function. Interventions are needed to reduce social isolation by facilitating social participation in community activities, thereby protecting against cognitive decline.
THE MODERATING ROLE OF SOCIAL SUPPORT IN THE RELATION BETWEEN FUNCTIONAL LIMITATIONS AND DEPRESSIVE SYMPTOMS
Authors: Lim Junyub , Kim Giyeon
Published: December 2023

Background and Objectives

Prior research has demonstrated that social support from friends and neighbors can effectively reduce depressive symptoms. However, few studies have investigated how the characteristics of these relationships can alleviate depressive symptoms among older adults with functional limitations. Therefore, the present study aims to investigate the moderating effects of characteristics of friends and neighbors relationships on the link between functional limitations and depressive symptoms among Korean older adults.

Methods

The data used for analyses were obtained from the 2020 Survey of Living Conditions and Welfare Needs of Korean Older Persons, a nationally representative survey. The sample included a total of 9,985 individuals who were 65 years of age or older residing in Korea.

Results

Results from the moderator analyses revealed that the link between functional limitations and depressive symptoms was influenced by both the number of close friends and neighbors (b = -0.085, p < .01) and the level of satisfaction with relationships with friends and communities (b = 2.052, p < .05).

Discussion

Satisfaction with relationships with friends and communities may act as a protective factor that mitigates the impact of functional limitations on depressive symptoms. In particular, for older adults with functional limitations, having a larger network of friends and neighbors network is expected to help reduce the risk of depressive symptoms.
ANALYSIS OF CONVERSATIONAL ENTRAINMENT AMONG OLDER PERSONS WITH ADRD AND UNIMPAIRED ADULTS
Authors: Williams Christine , McKinley Joseph , Cooper Charles , Erdol Nurgun , Beetle Christopher
Published: December 2023

Social isolation threatens the health of older adults, particularly those with Alzheimer’s disease and related dementias (ADRD). Our research uses measures of behavioral coordination to quantify the entrainment of an individual’s behavior to the collective dynamics of a group to which they belong, aiming to identify useful strategies to reduce social isolation for persons with ADRD in therapeutic group contexts. The present study is based on data collected during 27, 30-minute group therapy sessions conducted biweekly via WebEx by staff facilitators at a university-affiliated Memory and Wellness Center (MWC) in 2021, when CoViD-19 restrictions limited patients’ access to existing, in-person day programs. We study conversational entrainment among facilitators and participants in the recorded sessions using previously identified measures such as speech duration; voiced and voiceless interval durations; variations in pitch, intensity, and syllabic rate; and turn breaks. We present preliminary results identifying dynamical characteristics of sessions showing greater and lesser degrees of group social engagement before discussing possible strategies facilitators could use to enhance social coordination within therapy groups. The mental health benefits of professionally facilitated supportive group discussions for older adults with ADRD are well-accepted. Measuring conversational entrainment has the potential to provide quantitative evidence of cognitive benefits for persons with ADRD, and to help shape a therapeutic environment tailored to the needs of this vulnerable population.
NURSES’ PAIN ASSESSMENT AND TREATMENT OUTCOMES IN NURSING HOME RESIDENTS WITH DEMENTIA AND APATHY
Authors: Liao Yo-Jen , Jao Ying-Ling , Berish Diane , Boltz Marie
Published: December 2023

Pain is often undermanaged in nursing home (NH) residents with dementia-related apathy; an understanding of related nursing practices is warranted. This descriptive study examined nurses’ pain assessment and treatment outcomes in NH residents with dementia and apathy. A two-week chart review of nursing progress notes was extracted. Residents’ apathy measured by the Apathy Evaluation Scale (AES) of at least 40 was required. Descriptive and correlation statistical analyses were performed. Seventeen residents were recruited from three NHs; only one NH required daily pain assessment. All residents had pain-related diagnoses (mean=3), with Gastro-esophageal reflux disease and arthritis being the two most common diagnoses. Thirty-four pain-related documentations were identified in progress notes, with 19 pain-related events (e.g., falls, tooth extraction). Among the 19 events, 4 had follow-up documentation of pain management, while the other 15 did not. Among the 34 pain-related documentations, only six described residents’ behaviors, and three used a pain assessment tool (Numeric Rating Scale). More frequent as-needed analgesic administration was associated with lower agitation (-0.56, p< 0.05), yet this association was not found in scheduled analgesic use. Residents who reported pain more frequently received more as-needed analgesics (0.63, p< 0.01). Resident apathy levels were not correlated with analgesic prescriptions. Altogether, nurses recognized residents’ pain reports. As-needed analgesic use correlated with better pain management outcomes; however, pain-related events were not adequately followed up and/or documented. More research is needed to examine the association between nursing pain management practices and resident outcomes in this population.
ASSOCIATIONS THAT FITNESS AND BODY MASS INDEX HAVE WITH DEFICIT ACCUMULATION FRAILTY
Authors: Espeland Mark , Houston Denise , Wing Rena , Simpson Felicia , Olson KayLoni
Published: December 2023

Lower cardiorespiratory fitness and obesity may accelerate aging processes. The degree to which changes in fitness and body mass index (BMI) may alter the rate of aging may be important for promoting lifestyle changes. We assessed cross-sectional and longitudinal associations that cardiorespiratory fitness and BMI had with a deficit accumulation frailty index (FI). Fitness (based on standardized graded exercise tests) and weight (to calculate BMI) were collected at baseline and year 4 from 3,944 participants, ages 45-76 years, in the Action for Health in Diabetes (Look AHEAD) randomized controlled clinical trial. A validated 38-item FI was used as a marker of aging. Associations between baseline levels and changes in fitness and BMI with changes in FI were assessed using linear models. Both baseline and 4-year changes in fitness and BMI were independently associated with 4-year changes in frailty (all p< 0.001). Participants with the greatest fitness increase and BMI loss tended to have improvements (i.e., decreases) in FI: mean [95% confidence interval] changes -0.019 [-0.024,-0.013]. Those with the greatest fitness loss and increases in BMI tended to have worsening (increased) FI: 0.029 [0.024,0.034]. Associations of 4-year changes in fitness and BMI with FI changes were similar across subgroups based on age, gender, baseline BMI, diabetes duration, and cardiovascular disease history. Increased fitness across 4 years was associated with less FI accumulation independent of baseline fitness. Adults with type 2 diabetes and overweight or obesity may slow aging processes by increasing their cardiorespiratory fitness and losing weight.
METABOLOMIC SIGNATURES PREDICT HEALTHY AGING IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Yao Shanshan , Marron Megan , Boudreau Robert , Newman Anne , Shah Ravi , Murthy Venkatesh
Published: December 2023

This study sought to identify metabolomic signatures of multi-system aging by relating comprehensive mass-spectrometry-based metabolomic profiles with the aging phenome. We studied 2469 Black and White older adults (mean age, 75 years; 38% Black) in the Health, Aging, and Body Composition Study (Health ABC) with detailed characterization of the aging phenome across 20 aging-related phenotypes spanning 7 domains (physical function, neurocognitive/executive function, adiposity/sarcopenia, vascular aging, dietary pattern, psychosocial stress, and physical activity). Regression was used to identify metabolites associated with the aging phenome for pathway analytics. Penalized regression and principal components analysis were used to generate parsimonious, metabolomic scores, which were entered into Cox models for the endpoint of exceptional healthy aging, defined as surviving free of cardiovascular disease, cancer, dementia, or major disability over 9 years. We identified 4 distinct metabolomic scores independently linked to body composition, physical performance/mental health, muscle strength, and physical activity. The body composition score (hazard ratio (HR)=0.80 per SD [95% Confidence Interval: 0.70–0.90]), mental/physical performance score (0.77 [0.69–0.87]), and muscle strength score (0.82 [0.73–0.93]) were associated with failure to achieve “exceptionally healthy aging” after adjusting for age, race, gender, and lifestyle and traditional risk factors. Metabolomic signatures of different aspects of the aging phenome are associated with long-term healthy aging processes independent of lifestyle and traditional risk factors. Efforts to include precision measures of metabolomic health in risk stratification to achieve healthy aging are warranted. External validation in a diverse cohort of younger adults is underway.
METHYLATION RISK SCORES ARE ASSOCIATED WITH CARDIOVASCULAR RISK FACTORS IN OLDER US ADULTS
Authors: Lin Lisha , Zhao Wei , Birditt Kira , Smith Jennifer
Published: December 2023

DNA methylation risk scores (MRS) are biomarkers that may prove clinically useful by enabling earlier prevention and individualized treatment of cardiovascular diseases (CVD). However, it is unclear whether relationships between methylation and CVD risk factors differ by demographics or health behaviors. Using existing epigenome-wide association studies, we created MRSs for eight CVD risk factors: systolic and diastolic blood pressure, body mass index (BMI), C-reactive protein (CRP), low- and high-density lipoprotein cholesterols (LDL-C, HDL-C), triglycerides (TG), and fasting glucose. Methylation was measured in whole blood samples from Health and Retirement Study participants (N=3,996, mean age=69.5 years). In linear regression, each MRS was positively associated with its corresponding CVD risk factor after controlling for demographics and health behaviors (all p< 0.001). Adding interaction terms between each MRS and age, gender, or alcohol use revealed differences in MRS associations with their corresponding CVD risk factors across groups: higher MRSs were associated with greater increases in BMI, HDL-C, and TG in younger participants than older participants, greater increases in BMI and HDL-C in females than males, and a greater increase in CRP in non-drinkers than heavy drinkers (≤65 years old: >2 per day for males and >1 per day for females; >65 years old: >1 per day for both genders). In conclusion, some MRSs for CVD risk factors have stronger associations in younger adults, women, and non-drinkers. Additional research is needed to better understand the potential clinical utility of MRSs for early CVD prevention and intervention.
PREDICTION OF SARCOPENIA USING A MULTIPLE BIOMARKER RISK SCORE OVER TWO-YEAR FOLLOW-UP
Authors: Shin Hyung Eun , Kim Miji , Won Chang Won
Published: December 2023

It is necessary to consider multiple biomarkers simultaneously to detect sarcopenia due to its multifactorial etiology. This study is to compare the AUC of multiple biomarker risk score (MBS) that combines multiple biomarkers with that of individual biomarkers and to examine the association of MBS with incidence of sarcopenia in older adults. A total of 1,021 older adults were selected from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 criteria. The MBS was calculated from eight biomarkers (Growth differentiation factor-15, Cystatin-C, Dehydroepiandrosterone, Hemoglobin, Myostatin, Aspartate aminotransferase/Alanine aminotransferase, Estimated glomerular filtration rate, and Blood urea nitrogen) using ridge regression. Receiver operating characteristic (ROC) analysis was conducted to identify an utility of MBS to discriminate sarcopenia. The association of MBS with incidence of sarcopenia were examined by multivariate logistic regression. MBS has an area under the ROC curve (AUC) of 0.71 with an optimal cutoff of 1.76, which is higher than all other individual biomarkers (all, p< 0.01). In prospective study, continuous MBS was positively associated with incidence of sarcopenia after adjusting for confounders (odds ratio[OR]=1.63; 95% CI=1.23–2.17). Participants with high risk (>1.76 score) had a higher odds of sarcopenia than those with low risk (≤ 1.76) (OR=1.82; 95% CI=1.04–3.19). In conclusion, MBS better discriminated the presence of sarcopenia than did individual biomarkers, which can further predict sarcopenia after 2 years in older adults. Thus, combination of multiple biomarkers into single risk score can be helpful for earlier detection of sarcopenia.
AGING-RELATED IMMUNE CELLS PHENOTYPES AND ALL-CAUSE MORTALITY IN THE FRAMINGHAM HEART STUDY
Authors: Ragab Ahmed A Y , Doyle Margaret , Chen Jiachen , Fang Yuan , Lunetta Kathryn , Murabito Joanne
Published: December 2023

Almost 2 billion people will likely be above the age of 60 by 2050. Aging is a process that is intrinsically complicated. One of the measures for immune system senescence is aging related immune cells phenotypes (ARIP)s. Besides CD8/CD4 ratio, new immunosenescence phenotypes have been proposed. The associations between ARIPs and all-cause mortality during long-term follow up is understudied. We profiled immune cells using flow cytometry and prospectively investigated ten different ARIPs, namely, CD4+CD27-, CD4+CD28-CD27-, CD8+CD27-, CD8+CD28-CD27-, CD4+/CD8+ ratio, CD4+(Tnaive/(T Central Memory (Tcm)+T Effector Memory (Tem)+T Effector (Teff)), CD8+ (Tnaive/(Tcm+Tem+Teff)), Granzyme B+CD8/Granzyme B+CD4 ratio, CD8+ Tc17/Treg ratio and CD4+ Th17/Treg ratio in relation to survival outcome among 990 dementia-free Framingham Heart Study (FHS) Offspring cohort participants who attended the seventh exam (1998-2001, mean age 62 years, range 40-88, 52% female). Cox proportional hazards regression models adjusting for age and sex with robust variance to account for family correlation were used to test for association between the ARIPs and hazard of death. During up to 20 years of follow up, the survival rate was 66%. Higher CD8+ Tc17/Treg ratio was significantly associated with better survival (HR:0.82 [0.7-0.94], p< 0.001). Higher CD4+ Th17/Treg ratio and CD4/CD8 ratio were also nominally associated with lower risk of death (HR:0.87, [0.75-0.97], p=0.01 and HR 0.9, [0.79-0.99], p=0.04, respectively). Other ARIPs were unassociated with all-cause mortality. We conclude that further investigation of the CD8+Tc17/Treg and CD4+ Th17/Treg ratios as ARIP biomarkers for risk of all-cause mortality is justified.
COMMUNITY–CLINICAL LINKAGE MODELS FOR COMMUNITY-DWELLING OLDER ADULTS: A RAPID SCOPING REVIEW
Authors: Gofine Miriam , Laynor Gregory , Massar Rachel , Schoenthaler Antoinette
Published: December 2023

About 10% of older adults (OA) have unmet healthcare needs. Community-clinic linkage models (CCLM) aim to facilitate healthcare access by linking the community and health sectors. However, research on community-based linkages for community-dwelling OA into the healthcare sector is nascent. CCLM implemented for the general adult population are not necessarily age-friendly. This scoping review aims to characterize programs that are designed to facilitate community-dwelling OA’s access to healthcare through community sector-based linkages. In order to comprehensively survey CCLM designed for community-dwelling OA, the AgeLine (EBSCO) database was searched to review the academic and grey literature regarding programs that link community-dwelling OA from community to clinical sectors. AgeLine focuses on OA, indexing academic and grey literature from disciplines including health sciences, social work, and public policy. 470 publications were included for title/abstract screening; 24 were assessed for full-text eligibility by two independent reviewers. Data were extracted from two publications; exclusions were due to ineligible intervention (n=9) or setting (n=2); insufficient detail (n=6); full text unavailable (n=5). The sole empirical publication (2021) found that pilot implementation of a pilot linkage program between OA and clinicians was significantly associated with improved medication self-management. A final report (1993) on implementation of a supportive service pilot program in New Hampshire public housing found that OA residents and managers benefitted from the program. Results suggest the benefits of age-friendly CCLM for OA but highlight an existing gap in the literature. The results of this review underscore the need for age-friendly CCLM research, practice and innovation.
HOME BUT HOMEBOUND AFTER TBI: PREVALENCE AND CORRELATES OF HOMEBOUNDNESS AFTER TBI
Authors: Kumar Raj , Ornstein Katherine , Juengst Shannon , Reckrey Jennifer , Wagner Amy , Dreer Laura , Lercher Kirk , Dams-O’Connor Kristen
Published: December 2023

Discharge home following post-acute care for traumatic brain injury (TBI) has historically been viewed as an unequivocally positive post-treatment outcome. Payors incentivize hospitals to discharge patients home and minimize readmissions. A historically overlooked topic in post-acute TBI care is homeboundness, which is the state where an individual rarely or never leaves home. Homeboundness is associated with premature mortality and poor physical and mental health. Our study investigates the prevalence and correlates of homeboundness among 6,595 non-institutionalized adults (mean age=42, range 16-99) who received inpatient rehabilitation for TBI in the TBI Model Systems National Database, a multicenter prospective cohort study. Our definition of homebound was based on self-reported number of days participants get out of the house in a typical week. We found that 14.2% of participants were completely homebound (never left the home) or partially homebound (left the home 1-2 times/week) 1-year after TBI. Using multivariable regression, we found the following variables were significantly associated with being completely/partially homebound at 1-year post-injury: older age, < college degree, Medicaid insurance, living alone and rural settings, not driving independently, and having functional needs for walking, upper body dressing, bowel and bladder, problem solving, and social interactions. These variables together had an area-under-the-curve of 0.81 distinguishing homeboundness. Our study elucidates an invisible subgroup of non-institutionalized adults living with TBI in the community who require ongoing support services or other follow-up care to improve functional status and participation. Implications for community integration will be discussed.
PAIN INTENSITY AND INTERFERENCE PREDICT STAGE OF ENGAGEMENT IN SELF-MANAGEMENT IN OLDER AFRICAN AMERICAN ADULTS
Authors: Booker Staja , Horgas Ann , Wu Jianli
Published: December 2023

Osteoarthritis in African American older adults often causes a disproportionate burden of severe chronic joint pain that interferes with physical and emotional/cognitive activities. One tool commonly used in clinical research studies to evaluate patterns in pain intensity and pain interference is the Brief Pain Inventory-SF (BPI-SF). Confirmatory factor analysis validated a three-factor structure of the BPI-SF comprising pain intensity, activity-related pain interference, and affective pain interference. However, what is unclear and novel, is whether these three factors predict stage of readiness to engage in osteoarthritis self-management. Stage of readiness to engage (pre-contemplation, preparation, action) were assessed for seven recommended osteoarthritis self-management strategies: land-based exercise, water exercise, strength training/stretching, assistive devices, warm/cool compresses, medications, and self-management education. Using secondary data from 110 African American men and women (Mean Age 68.4, SD= 12.4), we performed ANOVA and ordinal logistic regression in SPSS. Pain intensity, activity-related pain interference, and affective pain interference were not significantly different between stages of engagement in pain self-management strategies except for medication use and assistive devices (p<.05). After controlling for age and employment, higher pain intensity was significantly associated with 27% reduction in the odds of being in preparation phase for water exercise, and higher levels of activity interference was associated with a 42% increase in the odds of being in the action phase for assistive devices. These results help us understand the relationship between behaviors and pain, particularly the impact of pain intensity and interference with physical activities on which strategies African Americans select to manage pain.