bluuebunny/crossref_metadata_2025 huggingface dataset:
IMPROVING AGING IN PLACE FOR OLDER VETERANS LIVING IN PERMANENT SUPPORTIVE HOUSING
Authors: Su Kelly , Maitra Medha Romee , Peeples Amanda , Goodman Octavia , Brown Rebecca
Published: December 2023

The average age of formerly-homeless Veterans living in HUD-VASH (Housing and Urban Development-Veterans Affairs Supported Housing) aged 50 and older is increasing. Homeless-experienced people experience accelerated aging, with premature onset of geriatric conditions and mortality. However, current supportive services at HUD-VASH do not address these conditions and enhance “aging in place,” i.e., the ability to live comfortably and safely in one’s own home and community. We conducted qualitative interviews and focus groups to determine barriers, facilitators, and adaptations needed to successfully implement interventions in HUD-VASH. We then used a modified Delphi process to reduce a list of 66 intervention elements based on perceived feasibility and importance. In total, 9 Veteran Affairs HUD-VASH staff members and 1 Veteran participated in 3 conference calls and surveys. The top-rated intervention elements were organized by: who should be involved in delivering the intervention (social workers, physicians, nurse practitioners, physician assistants, nurses), what types of goals/needs they will focus on (geriatrics, mental health needs, general health goals, dementia care, medication management), where and how should the intervention be delivered (in the home, at the VA), how long should the intervention be (when veterans are experiencing functional impairment, memory impairment, mental health problems, trouble caring for themselves, and when they are new to HUD-VASH) and when should the intervention be delivered (regularly scheduled and ongoing as needed). With feedback from expert stakeholders, our findings will be used to develop and implement interventions to improve aging in place for older Veterans living in HUD-VASH.
INFLUENCE OF COGNITION AND FUNCTIONAL LIMITATIONS ON HOSPITALIZATIONS AMONG OLDER ADULTS IN THE UNITED STATES
Authors: Boateng Augustine , Friedman Ari
Published: December 2023

Background

Older adults frequently seek emergency department care, with 45 visits for every 100 older adults. Many health events in later stages of life can be attributed to health conditions and behaviors during middle-age. Yet, while qualitative and quantitative analyses exist, documenting the reasons for emergency department visits among all comers, no study focuses specifically on the determinants of hospitalization among middle-aged and older adults using the emergency department. Additionally, the impact on longer-term outcomes starting in mid-life remains unknown.

Objectives

To determine whether impaired cognition, functional limitations, and multimorbidity in midlife predict subsequent hospitalizations in older age among older adults in the United States using core gerontology concepts such as functional limitations, multimorbidity, and cognitive impairment.

Methods

We performed secondary analysis of 2,221 participants from the Midlife in the United States (MIDUS) Series, a longitudinal study involving US adults aged 45 to 75 years using a balanced Generalized Estimation Equation (GEE) approach. Covariates such as as gender, education, marital status, income, race/ethnicity, social stressors, and social connectedness were adjusted for.

Results

Findings suggests that impaired cognition (p< 0.05), having two or more health conditions (p< 0.001) and functional limitations (p< 0.05) in midlife increases the number of hospitalizations in old age a decade later.

Conclusions and Implications

Health behaviors and conditions in midlife can significantly impact the number of hospitalizations among older adults and increase costs associated with hospitalizations. The promotion of preventive care, targeted interventions, and the adoption of healthier lifestyle habits in midlife may reduce hospital admissions in old age.
ISOFORM-SPECIFIC FUNCTION OF C. ELEGANS TAU, PTL-1
Authors: Sconiers Charlie , Ko Su-Hyuk , Chen Lizhen
Published: December 2023

As life expectancy increases with technological advancements, age-related dementia disorders, such as tauopathies, have become more rampant, impacting over 50 million people worldwide. Tauopathies are neurodegenerative diseases catalyzed by the dysregulation of tau protein in the brain. Alzheimer’s disease, the most common tauopathy, has impacted more than 6 million Americans in 2023. It has been speculated that within tauopathies, dysregulation only occurs in specific tau isoforms. After alternative splicing, two types of tau isoforms (one with three microtubule-binding repeats and one with four microtubule-binding repeats) may cause functional differences within the brain. A protein in C. elegans called PTL-1 was discovered to have similar microtubule-binding repeats in its isoforms. In this project, worms with two types of PTL-1 isoforms (PTL-1A and PTL-1B) and wild type worms were aged and consistently tested for their touch sensitivity and speed to document whether certain microtubule-binding repeats negatively impact function. It was found that PTL-1A worms lost speed and touch sensitivity at an expedited rate compared to the other two samples of worms. It was also found that some PTL-1A worms developed abnormal branches throughout their exons. These findings suggest that PTL-1A overexpression might cause morphological defects. These study results will assist in the development of tauopathy research and can be applied in evaluating how isoforms impact the genetic spread of neurodegenerative diseases.
RELATIONS BETWEEN MOOD AND DAILY ACTIVITIES: AN ECOLOGICAL MOMENTARY ASSESSMENT
Authors: Pichardo Abel , Mausbach Brent
Published: December 2023

Behavioral activation (BA) is an evidence-based therapy for depression that has recently been applied for informal caregivers. Investigating the mechanisms of BA could lead to enhanced quality of care by optimizing guidance to patients. We examined concomitant and lagged associations between mood and daily activities in 50 informal caregivers using an Ecological Momentary Assessment approach via smartphone technology. Participants recorded the number and types of activities they did each day in a 14-day period. Activities were rated for enjoyment on a scale of 1 to 5 (5 being most pleasant). Mood for the day was rated on a scale of 1 to 5, (5 being the most positive). Linear mixed-model analyses examined concomitant and lagged (+/- 1 day) associations between activities and moods. Results indicated concomitant associations between mood and both frequency (t = 2.36, p = .019) and enjoyment of activities (t = 4.11, p < .001). Previous day’s mood was not associated with either frequency or enjoyment of activities the following day. Previous day’s enjoyment of activities was associated with mood the following day (t = 2.34, p = .02). There was no association between frequency of activities the previous day and mood the following day. These findings support BA theory by suggesting that increasing engagement in enjoyable activities may have positive impacts on mood not only in the moment but also have a lasting impact on future mood. Future research should expand this model by including covariates important to the population such as age and activity restriction.
25 YEARS AFTER THE PASSING OF THE NPO LAW: EXAMINING THE ORGANIZATIONAL CAPACITY OF OLDER VOLUNTEER ORGANIZATIONS
Authors: Chen Li-Mei
Published: December 2023

Japan has experienced a growth in non-profit organizations since the enactment of the NPO Law in 1998. In 2022, there were 175,046 volunteer organizations with approximately 6.7 million volunteers. Many of these non-profits providing community-based social services are disproportionately represented by older volunteers. Tbe benefits of older volunteerism have been well-documented stating that society gains from the older adults’ contributions as well as older adults’ lives are improved and enhanced through volunteerism. However, evidence is lacking as to how older volunteer organizations have evolved in the past 25 years. This study investigates the types and characteristics of non-profit organizations which recruit older volunteers based on their organizational capacity. Surveys were mailed to 500 volunteer organizations which provide social services in Japan. 155 (Findings from cluster analysis showed that there are types of organizations ranging from “Achiever” which excelled in all dimensions of organizational capacity to “Challenged” which lacked in all dimensions. Other volunteer types include “Government dependent” type which are non-profit organizations which depend on government programs, “Autonomous” type which excel in offering role flexibility to volunteers but lack capacity in all other dimensions, and “Bonding” type which is formed by a tight-knit group of persons and are no longer seeking new volunteers. Bivariate analysis was conducted to examine the relationship between the organization types and volunteer outcomes . “Achiever” type found an increase in volunteers and rarely experienced lack of volunteers while the “Challenged” type seldomly experienced an increase and frequently experienced lack of volunteers.
A KEY DENDRITE DEVELOPMENT REGULATOR PLEXIN-A4 IS ASSOCIATED WITH DENDRITE MAINTENANCE IN AGED MICE
Authors: Baek Jiyeon , Naveed Haniya , Muyingo Laura , Romero Angélica Jimenez , Eisenberg Carol , DeLucia Jack , Tran Tracy
Published: December 2023

There is significant loss of dendritic complexity with age, which may account for synaptic loss and cognitive decline in mammals. However, molecular mechanisms underlying these changes are unclear. Key molecular players in dendritic morphogenesis include the guidance cue semaphorin 3A (Sema3A). In developing cortical neurons, Sema3A signals through the Plexin-A4 receptor to induce basal dendritic arborization, while another closely related member, Sema3F, induces apical dendritic spine pruning. Interestingly, both ligands are expressed in adulthood, but their roles in age-associated dendritic remodeling are unknown. To address this, we established a model of aging mouse primary cortical neurons: 5, 15, and 30 days-in-vitro (DIV) representing young, mature, and aged timepoints. Treating with either ligand increases branching at 5-15DIV, but not 30DIV, suggesting age-associated changes in cellular responses to Sema3A/3F. Next, we examined mouse cortices in vivo and found both Plexin-A4 expression and dendritic elaboration decrease with age, suggesting a need for Plexin-A4 to maintain dendritic complexity at older ages. In 6-month-olds, mutant Plexin-A4 mice have less branching than wildtypes, but we found no further decline in 18-month-olds, likely because there can be no age-associated downregulation of Plexin-A4 signaling if the receptor is not present. Finally, we found increased levels of active-RhoA GTPase (a downstream cytoskeleton regulator) in Plexin-A4-/- 6-month-old cortices versus controls. Additionally, our preliminary data trends towards increased active-RhoA in 18-month-olds versus 6-month-olds. Collectively, our study provides novel insights into the diverse cellular functions of semaphorin-plexin, a signaling pathway important for nervous system development, in age-associated dendritic loss and cognitive decline.
A LONGITUDINAL STUDY ON SNAP PARTICIPATION AND SELF-REPORTED HEALTH AMONG DIABETIC AND NON-DIABETIC INDIVIDUALS
Authors: Duran Danielle , Ferdows Nasim
Published: December 2023

Self-reported health is a strong predictor of future health status, new morbidity, mobility decline, illness recovery, and healthcare utilization. Because self-reported health is rooted in social position and social comparison, it dually reflects individual health perceptions and health inequities, especially among those who experience a social struggle for resources. Food insecurity is associated with higher risk of chronic diseases and higher mortality rates. Interventions such as the supplemental nutrition assistance program (SNAP) were created to help address food insecurity. Although morbidity and mortality risks caused by food insecurity is exacerbated for those with nutrition-centered chronic disease, such as diabetes, limited research has assessed the impact of food insecurity and SNAP participation on health among diabetics. Using Health and Retirement Study data, we explore the effect of SNAP participation and food insecurity on the likelihood of reporting fair or poor health comparing 24,446 diabetes to 69,260 non-diabetics individuals aged 65 and above (2004-2020). Our analysis controls for key socioeconomic factors, including age, gender, race/ethnicity, and wealth, accounting for the complex design of HRS. Our key findings reveal that food insecure diabetics have significantly higher odds of reporting fair/poor health, and diabetic SNAP participants also had significantly higher odds of reporting fair/poor health. Our study demonstrates how food insecurity and diabetes concurrently influence health and how, despite the presence of resources, such as SNAP, there was no improvement in self-reported health. This study is important as it highlights the need for future research on the effects of SNAP participation and self-reported health.
A NEW METHOD TO IDENTIFY MEDICARE CLAIMS-BASED FACTORS ASSOCIATED WITH POST-ACUTE RECOVERY IN OLDER ADULTS WITH ADRD
Authors: Chen Chixiang , Shen Biyi , Falvey Jason , Shardell Michelle , Ren Haoyu
Published: December 2023

Nearly 300,000 older adults experience a hip fracture every year, the majority of which occur following a fall. Unfortunately, recovery from hip fracture is poor, where older adults diagnosed with Alzheimer’s Disease and Related Dementia (ADRD) spend a particularly long time in hospitals or rehabilitation facilities during the post-operative recuperation period. Because older adults value functional recovery and spending time at home versus facilities as key outcomes after hospitalization, identifying factors that influence days spent at home after hospitalization is imperative. However, few rigorous analytical approaches are available to help overcome potential sources of analysis bias such as hospital-level unmeasured confounders, informative hospital size, and loss to follow-up due to death. To overcome these challenges, we developed a new data science approach equipped with unsupervised learning to simultaneously handle statistical complexities that are often encountered in research using large administrative claims databases. The proposed approach is accessible and performs well in simulation studies. Analysis of 16562 Medicare beneficiaries diagnosed with ADRD who were aged 65 or older and experienced a hip fracture between 2017 and 2019 demonstrated that older age, longer length of stay in the hospital, more chronic health conditions, and less days at home before fracture are significantly associated less days spent at home in the 12-month period after hip fracture (p<.05), while existing methods fail to detect some effects. Findings demonstrate that the proposed method can overcome bias in health services research using Medicare data and can lead to findings that may inform care and resource allocation.
A REVIEW OF PAIN MANAGEMENT FOR PEOPLE WITH DEMENTIA: A GENERAL SURGICAL PERSPECTIVE
Authors: Neville Emily , Wagstaff Ruth , Stolic Snezana , Neville Christine
Published: December 2023

As the global population ages and the prevalence of dementia increases, more people with dementia will present for surgery. Perioperative pain management, particularly for people who are not able to communicate effectively, is challenging for clinicians. Poor surgical outcomes may result if pain is not managed appropriately. The objective of this review was to synthesize the existing research about how pain is managed for people with dementia in the perioperative setting, discuss the implications for general surgery so clinical practice and surgical outcomes are improved. After an extensive database search, the themes identified were pain assessment including commonly used rating scales, the types and amount of pain relief, that people with dementia received less analgesia than people without dementia and the challenges for effective pain management. Findings determined that pain management needs a stronger evidence base, challenges are due to the impaired ability of the person with dementia to communicate pain and that clinicians have difficulty understanding pain behavior in people with dementia. Adequate pain management for people with dementia in the perioperative setting is important for a faster and better recovery and this matter will only become a bigger issue as the ageing population increases.
A SCOPING REVIEW ON BARRIERS AND FACILITATORS OF COMMUNITY ENGAGEMENT IN LEARNING HEALTH SYSTEMS
Authors: Hung Lillian , Wong Karen Lok Yi , Berndt Annette , Windsor Tracy , Vasarhelyi Krisztina
Published: December 2023

This scoping review identifies the challenges and enablers of community engagement in Learning Health Systems (LHS), an area where elder and health care have growing interests on. LHS aims to improve healthcare delivery, translate knowledge into clinical practice, and emphasize patient-centred outcomes. We followed the Joanna Briggs Institute’s (JBI) scoping review methodology. First, keywords and index terms were identified from MEDLINE and CINAHL databases. Second, using the keywords and index terms identified in the first step, other databases like Web of Science, PsycINFO, and Google were searched. Third, the reference lists of the chosen literature were searched. The results include 25 papers. The Assessing Community Engagement (ACE) Conceptual Model by Aguilar-Gaxiola et al. was utilized to inform the analysis. Active community engagement enhances the relevancy and applicability of health research and fosters trust and rapport between healthcare providers and their communities. It is essential to have appropriate support, mutual respect, culturally sensitive and locally relevant processes with common-ground language. We identified several barriers to engagement: 1) meaningful motivations, 2) logistical challenges in processes, 3) disparities in power dynamics, 4) cultural misunderstanding, and 5) lack of knowledge and skills. The review underscores the need to move beyond tokenistic engagement towards genuine community collaborations. Future research should investigate the facilitators that enhance such meaningful partnerships.
A SYSTEMS APPROACH TO PRACTICE TRANSFORMATION FOR BRAIN HEALTH INTEGRATION INTO COMMUNITY HEALTH CENTER SERVICES
Authors: Lindholm Cassie , Modica Cheryl
Published: December 2023

Community Health Centers are America’s largest and most successful primary care system, providing access to quality healthcare services to more than 30 million Americans through more than 14,000 service delivery locations regardless of patients’ ability to pay. The National Association of Community Health Centers (NACHC) provides the training and education that health centers need to advance practice transformation and improve care delivery models to succeed in value-based care and meet the needs of patient populations. Through the Value Transformation Framework (VTF), NACHC provides an approach to support health center systems change, organizes and distills evidence-based interventions, provides knowledge, tools and resources, and links performance to the Quintuple Aim – improved health outcomes, patient and staff experience, reduced costs, and equity. NACHC guides health centers in the application of the VTF through a nation-wide learning community, Elevate. Health center participation in Elevate is linked to improved performance on clinical quality measures, improved patient and staff experiences, and reduced costs. Within the Elevate, NACHC successfully implemented a learning track focused on brain health, offering health center-specific guidance on a clinical introduction to Dementia early detection/risk reduction; incorporating Dementia early detection/risk reduction into care management workflows and leveraging reimbursement opportunities; and strengthening community linkages and partnerships to support Dementia early detection/risk reduction. Evaluation data from this learning track indicates health center interest in continuing education related to brain health integration into health center services. This topic is especially relevant considering the increasing population segment of older adult patients that health centers serve.
ADVANCING GERONTOLOGY THROUGH EXCEPTIONAL SCHOLARSHIP (AGES): FIRST INSIGHTS FROM A NEW MENTORSHIP MODEL
Authors: Bacsu Juanita-Dawne , Baker Zachary , Petrovsky Darina , Rahemi Zahra , Sefcik Justine , Ma Kris Pui Kwan , Smith Matthew
Published: December 2023

Mentorship is vital to supporting professional growth among early career faculty members. Working with the Gerontological Society of America, the Advancing Gerontology through Exceptional Scholarship (AGES) Program was created as a mentorship model to promote productivity and peer support for early career faculty members. This presentation will: 1) describe the AGES Program as a prototype to facilitate peer support, collective learning, productivity, and co-authorship opportunities to advance early career faculty members; and 2) identify effective strategies to facilitate other groups looking to develop high-quality mentorship and training programs to support early career faculty members. After a competitive process, a cohort of 7 AGES members (including 2 program co-leads and 5 participants who all studied dementia) partook in monthly workshops from November 2022 to June 2023. Drawing on our experience with the AGES Program, we identified four strategies that cultivated our AGES Program: 1) being adaptable to address mentorship needs; 2) establishing accountability measures to enhance productivity; 3) fostering collective learning and peer support; and 4) delivering inspirational and educational activities. Following on the completion of the AGES Program, an open discussion was held with the cohort to assess and critically reflect on the program. Discussion results indicate the AGES Program was valuable in supporting early career faculty members. Specifically, findings demonstrate that the program was perceived as successfully supporting team science, collaborative opportunities, and enhancing productivity. Next steps are to conduct an anonymous evaluation survey to identify specific areas to strengthen and enhance the program for future cohorts.
AGE AS A FACTOR IN DIVERSITY, EQUITY, AND INCLUSION INITIATIVES IN HIGHER EDUCATION
Authors: Galucia Natalie , Morrow-Howell Nancy
Published: December 2023

At institutions of higher education, demographic shifts in the population and the growth of diversity, equity, and inclusion (DEI) initiatives are occurring simultaneously. This study seeks to understand their intersection by focusing on age as a diversity factor in DEI initiatives on college campuses. Six focus groups with a total of 42 DEI staff members were convened, including 36 colleges/universities across the country. Thematic data analysis was conducted by three members of the research team who reached consensus on themes, subthemes, and representative quotes. Focus group participants suggest that age as an identity factor is not given much attention in DEI initiatives. Participants acknowledge the issue of age; but in general, they strive to keep other identities, like race and gender, in the forefront, especially in the face of low resources. These findings can be understood in the context of the current political environment around social justice issues and the pervasive ageism at the society level, especially in age-segregated institutions of higher education. While it may be difficult to elevate age in DEI initiatives on campuses, interventions were identified; and advocacy efforts may move us toward advancing age diversity, equity, and inclusion in higher education as well as other organizations.
AGING AND WELL-BEING: TESTING MINDFULNESS AS A MEDIATOR AND RESILIENCE AS A MODERATOR IN A NIGERIAN SAMPLE
Authors: Amanambu Peace , Chukwuorji JohnBosco , Allard Eric
Published: December 2023

The mediating role of mindfulness on the relationship between age and affect (both positive and negative) has been established in Western samples. However, these associations have not been well considered within additional cultural contexts. The present study examined whether mindfulness mediates the relationship between increased age and both positive (PA) and negative (NA) affect. We also took an exploratory approach to assess the strength and direction of the age-affect relationship as a function of resilience. Participants were 242 (95 women, age range = 18-75 years, Mage = 41.79; SDage = 13.58) adults, affiliated with the University of Nigeria-Nsukka, who completed the Positive and Negative Affect Scale, Brief Resilience Scale, and the Mindful Attention Awareness Scale through Qualtrics. Separate moderated-mediation analyses were conducted for PA and NA. For the PA model, the only significant association was between age and mindfulness, with higher age predicting increased self-reported mindfulness. For the NA model, higher self-reported mindfulness predicted lower levels of NA. When NA was simultaneously regressed on age and mindfulness, the direct effect between age and NA was non-significant, but the indirect effect of age on NA through mindfulness was significant, suggesting that the association between age and negative affect was mediated by mindfulness. Resilience did not provide a significant moderating influence in the PA and NA models. The present findings suggest that older adults may experience diminished levels of negative affect due to an increased capacity for mindfulness. Hence, mindfulness-based interventions may be helpful in improving the well-being of older populations.
AGING MODULATION WITH EXERCISE AND MIMETICS
Authors: Lox Dennis
Published: December 2023

Understanding the molecular and cellular processes of the Longevity Pathway AMPK-SIRT1, and its activation by exercise and mimetics, plays a vital role in a series of molecular and cellular processes which stimulates optimal healthy cellular efficiency and functioning, ending with improved exercise tolerance. Knowledge of the role of exercise induced activation of the AMPK-SIRT1 pathway, and altering it towards dysfunctional processes and drivers of aging and disease propagation is important to understand to also understand. Cellular dysfunction unfortunately is the norm. This leads to molecular increase of P53 in a binding state not of DNA repair, but upregulation of gene transcription of NF-kB, which increases inflammatory cytokines, over activation of MTOR, and cellular senescence with secretion of the SASP. All these dysfunctions create feedback loops, which makes the process self propagating, resulting in progressive aging, and disease states. The most optimal state is regulation of the optimal molecular and cellular environment, via exercise or a mimetic stimulator of AMPK-SIRT1. Knowledge of the optimal body state for health, and enhancing this AMPK-SIRT process, is low body fat releasing beneficial adiponectin, and no inflammatory cytokines or adipokines. Training muscle releases positive myokines. Various mimetics can stimulate AMPK-SIRT1, such as Metformin, the mitochondrial derived peptide MOTS-C, AICAR, and other compounds intended for people with medical issues that prevents exercise. Some display a synergistic effect with exercise. Understanding, the benefits of exercise and modulation of aging, by encouraging healthy processes, and reducing the deleterious patterns is important to understand.
AGING SUSTAINABLY: A PILOT STUDY OF OLDER MIDWESTERN ADULT PERSPECTIVES ON ENVIRONMENTAL BEHAVIOR
Authors: Pedersen Megan , Walden Justin , O’Connor Melissa
Published: December 2023

Given their life experience and significant political power, the perspectives of older adults on environmental issues are crucial to addressing the climate crisis. Although unsupported by research, the general public tends to believe that older adults do not care about climate change. In seeking to overturn this belief, a qualitative responsive interview study was conducted. With a sample of 5 adults between 50 and 70 from North Dakota and Minnesota, this study is small, but can serve as a pilot study for more intensive research. Interview questions focused on older adults’ attitudes, personal behavior, and motivations for engaging (or not) in sustainable behavior. Although the sample size was small, findings showed that most older adults understand the need for sustainability and try to care for the climate in their own ways. Religion, financial incentive, and generativity can be strong motivators for sustainable behavior, but misinformation and distrust can act as de-motivators. Investigating older adults’ motivation to engage in sustainable behavior is a necessary step to involving more older adults in environmental advocacy. These interviews demonstrate that many older adults are willing to act on behalf of our shared planet, and future research may uncover more motivations and bring us closer to that goal.
ALLEVIATING WORRIES OF DEMENTIA AMONG OLDER ADULTS WHO ATTEND AN AGING BRAIN SEMINAR
Authors: Simonson Grace , Wehry Susan
Published: December 2023

Dementia worry is prevalent among older adults, and these concerns are often not addressed. Research demonstrates the public lacks accurate knowledge of dementia, which contributes to its negative perception. We hypothesized participation in an aging brain seminar would significantly alleviate dementia worry in older adults. The 45-minute in-person talk covered normal and abnormal aging brain changes, and research-based strategies for healthy brain aging. Attendees completed surveys immediately before and after the seminar. Both surveys included the 12-item Dementia Worry Scale (DWS), which uses Likert scales to assess dementia worry. Two additional Likert questions in the post-survey determined the immediate effect on dementia worry and intent to adopt new strategies. 7 sessions garnered 61 viable pre-post surveys from 160 attendees. 69% reported their dementia worry was somewhat or significantly improved; 68% reported they were very likely or definitely going to take action. Collectively, the Dementia Worry scale was reduced (median pre=19, median post=16, range= 12 - 41), but results were insignificant (p=0.058) likely due to the long-term nature of the questions. The aging brain seminar was successful. It resulted in an immediate reduction of dementia worry and intent to change behavior, and it can be effectively delivered by a medical student. Further research is warranted to determine if the seminar has a long-term effect on dementia worry and sustained adoption of healthy behaviors.
ASSOCIATION BETWEEN FRAILTY AND FIVE-YEAR MORTALITY AFTER HIP FRACTURE SURGERY IN OLDER PATIENTS
Authors: Choi Jung-Yeon , Kim Kwang-il
Published: December 2023

We aimed to identify the association between frailty and 5-year mortality after hip fracture surgery. The Hip-Multidimensional Frailty Score (Hip-MFS) was calculated using the Comprehensive Geriatric Assessment (CGA). The primary outcome was 5-year mortality. Among 1,363 patients who underwent HF surgery, 598 (44%) patients underwent CGA, and 536 patients were included in the final analysis. The mean age was 80.5 years and 71.3% were females. A total of 223 (41.6%) patients experienced postoperative complications. The median observation time was 1999.5 days, and the overall mortality rate was 60.4% (n = 324), whereas the 1-year mortality and the 5-year mortality rate after HF surgery were 13.8% (n = 74) and 42.8% (n = 235), respectively. In the multivariate regression analysis, after accounting for clinical and demographic factors, the high-risk Hip-MFS group and the group with postoperative complications had hazard ratios of 1.49 (95% confidence interval [CI] 1.090–2.037, p = 0.012) and 1.498 (95% CI 1.139–1.970, p = 0.004), respectively. Patients with postoperative complications with low Hip-MFS showed better 5-year survival than those without postoperative complications with high hip-MFS in the Kaplan-Meier curve (p = 0.013). Compared with the occurrence of postoperative complications, the frailty status evaluated with the Hip-MFS had a more significant impact on long-term mortality after hip fracture surgery.
ASSOCIATION BETWEEN LATE LIFE EDUCATION AND COGNITIVE FUNCTION AMONG U.S. OLDER ADULTS
Authors: Wang Nan , Dupre Matthew , Xu Hanzhang
Published: December 2023

This study assessed whether late-life education (LLE) was associated with better cognitive function and whether the benefits of LLE on cognitive decline differed by gender, race/ethnicity, and education level in a nationally-representative sample of U.S. older adults. We conducted a retrospective cohort study using six waves of data from the Health and Retirement Study ([HRS] 2008-2018) that included adults aged ≥ 65 with no baseline diagnosis of Alzheimer’s disease and related dementias (ADRD). Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7’s test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range=0-35). LLE was measured at every wave and was categorized as “once a month or more,” and “not in the last month [or never].” Covariates included participants’ demographic background, socioeconomic status, psychosocial and behavioral factors, and health-related factors. Of 12,099 participants (median age 71 [IQR=10]), engaging in LLE at least once a month or more was associated with better cognitive function and was equivalent to a 2-4 year delay in cognitive decline than non-participation in LLE. The association was only partially attenuated after adjusting for a wide range of covariates. In addition, the benefits of LLE on cognitive function did not significantly differ by gender, race/ethnicity, or prior educational attainment. This study provides new insights into the protective role of LLE on cognitive function and underscores the importance of continued learning among older adults.
ASSOCIATION BETWEEN SCHOOL DESEGREGATION AND THE COGNITION OF OLDER BLACK MEN: A CITY-LEVEL ANALYSIS
Authors: Perryman Collin , Anderson Taharka , Thorpe Roland J , Whitfield Keith
Published: December 2023

Objective

We sought to understand the relationship between school setting attendance (desegregated or segregated) and the cognition among older Black men.

Methods

Data from older Black men (n=153; age range: 50 to 89 years) from the Baltimore Study of Black Aging—Patterns of Cognitive Aging (BSBA-PCA) was used to explore the relationship between type of schooling and cognitive functioning. We conducted ANOVA and OLS regression analyses to find associations between schooling and various cognitive domains. The independent variable, school type, was measured using a variable assessing if participants attended a racially-mixed school in their youth. The outcome variable, cognition, was measured using global cognition, reasoning, memory, immediate recall, working memory, language, and perceptual speed.

Results

ANOVA analyses found that Black men who attended desegregated schools reported significantly better reasoning and global cognition. OLS regression analyses found that global cognition, reasoning, language, and working memory were significantly better performance in the OLS regression results. The multivariate analysis found that global cognition and reasoning yielded statistically better performance.

Conclusion

Our study provides insights to how cognition varies in Black men depending on the school settings in which they were educated. Additionally, our study finds evidence that past educational policies represent risk for poor cognitive health of older Black men populations.
ASSOCIATION OF RAPID EYE MOVEMENT SLEEP AND APOE PROTEOTYPE TO COGNITIVE PERFORMANCE IN OLDER ADULTS
Authors: Hammel Edward , Roberts Mitchell , Sappington Erica , Dagum Paul , Iliff Jeffrey , Levendovszky Swati Rane , Lowenkron Jeff , VandeWeerd Carla
Published: December 2023

Exploring the multifaceted interaction of sleep, disease-related biomarkers and cognitive decline is of particular importance for aging populations. Sleep quality and the APOE E3/E4 allele has been linked to Alzheimer’s Disease (AD). This study aims to examine relationships between older adults’ level of cognitive performance, proportion of rapid eye movement (REM) sleep, and APOE proteotype. Analysis of sleep study data collected in an active lifestyle retirement community - The Villages, Florida was conducted using a subset of markers collected as part of a larger cognitive health study. Polysomnography, cognitive battery (Montreal Cognitive Assessment(MoCA), Trail Making Tests(TMT), Symbol Digit Modalities Test(SDMT), Psychomotor Vigilance Test(PVT)), and APOE blood-biomarker (E2/E3,E3/E3,E3/E4) data were obtained from healthy participants (n=33) aged 55-65. Descriptive statistics, multilinear regression, and ANOVA were used. Participants’ mean age was 61.9 years, with 55% being male. Cognitive test scores did not show a significant relationship with REM sleep percentage (p=0.3096). No consistent dispersion or skew was shown in box plot analysis of APOE proteotype across cognitive performance measures. Unexpectedly, although not statistically significant (p=0.396), average REM sleep percentage was higher in the APOE E3/E4 group (20.04%, Mean:75.44 minutes) as compared to the E3/E3 group (15.99%,Mean: 59.07 minutes). Proteotype E3/E4 was examined specifically due to its potential association with Alzheimer’s disease. The REM sleep proportion was lower than the average experienced on a typical night at home, possibly due to study conditions. Further research is needed examining the relationship between older adults with REM sleep insufficiency and cognitive impairment.
AVENUES OF SOCIAL ISOLATION AND HEALTH AMONG OLDER CHINESE MIGRANTS: A STRUCTURAL EQUATION MODELING APPROACH
Authors: DeJohn Amber , Widener Michael , Liu Bochu , Ma Xinlin , Liu Zhilin
Published: December 2023

Social isolation and loneliness have detrimental impacts on health. During the COVID-19 pandemic, access to third places (e.g., coffee shops, libraries) decreased due to the closure of non-essential destinations for fear of serious illness. With reported rises in anti-Asian hate crimes, which primarily impacted older Asian adults, community mobility might have been additionally affected. Older adults reported adopting ICT during pandemic lockdowns, which may have sufficiently replaced previous activities that would require trips out of the home. Understanding different avenues of social connection and their distinct relationships to health for a vulnerable migrant population is critical to supporting equitable, healthy aging in a post-COVID world. Using a survey of older Chinese migrants in the Greater Toronto Area (GTA) during the extended COVID-19 lockdown, we investigate both community mobility and ICT use to understand how either avenue of socializing is related to the built environment and what the impact of community mobility and ICT use has on loneliness (De Jong Gierveld 6-item scale), mental and physical health (SF-12). Specifically, we use a structural equation model to test a theoretical framework of older adult social isolation. Ultimately, our model demonstrates the importance of community mobility in reducing feelings of loneliness, while ICT use is significantly related to better physical health. Both community mobility and ICT use have significant, although opposite, relationships to transit density. Results indicate that ICT use might have a limited ability to reduce loneliness and support mental health when mobility is limited.
BARRIERS AND SOCIETAL FACTORS SURROUNDING LONG-STAY RESIDENT DISCHARGE TO THE COMMUNITY IN LOUISIANA
Authors: Williams Valerie
Published: December 2023

The focus of this study is to determine the resident characteristics and societal factors that prevent long-stay residents (LSR) from discharging to the community based on the LSR in Louisiana (LA) compared to the United States (US). This study will also explore solutions that can assist LSR in successfully discharging to the community. Discharge to the community from a skilled nursing facility is influenced by functional status, health of the resident, and the availability of community-based services. About 20% of LSR (>100 days) discharge to the community from skilled nursing facilities (SNF), while that number is more than doubled for short-stay residents. Current data provides little information about the odds of a LSR returning to the community. CMS data shows that LSR in LA have higher rates of Activities of Daily Living Decline (ADL) (LA-18.83%/US-14.68%), Antipsychotic Use (LA-16.9%/US-14.58%), and Pressure Ulcers (LA-9.4%/US-2.4%) than the national average. LSR exhibiting these characteristics are less likely to be discharged to the community. Additional characteristics of this population include high levels of comorbid chronic conditions that are difficult to manage outside of the facility, and having Medicaid (LA-71.5%/US-61.1%) as their payer status, a known barrier to community discharge. States should increase the availability of home health and community-based services that cater to the Medicaid population. Assisted living facilities are a great alternative to living “at home”. Additional research should be conducted to examine affordable assisted living options in more states for long-stay Medicaid residents who desire to live independently in the community.
BEING A CAREGIVER DOES NOT INCREASE MORTALITY RISK AT 10-YEAR FOLLOW-UP IN A NATIONAL US SAMPLE
Authors: Cheung Dominique , Manvelian Atina , Bouldin Erin , Wielgosz Joseph , Trivedi Ranak
Published: December 2023

An increasing number of people are expected to become caregivers of relatives with medical or mental health conditions. The chronic stress of family caregiving has been shown to worsen one’s health, leading to concerns that it may also increase mortality risk. Seminal work showed associations between caregiving and increased mortality risk, but recent population-based studies have disputed this. Our objective was to use longitudinal, nationally representative data to rigorously examine whether caregiver status was associated with 10-year mortality. We used data from the National Social Life Health and Aging Project (NSHAP), a nationally representative study of 2,367 older adults (57-85 y) that combines interviews, surveys, and mortality data. We compared 10-year mortality risk between self-reported caregivers and non-caregivers with and without propensity score matching. Baseline sample included 401 caregivers (68.6±7.6 y) and 1,966 non-caregivers (69.2±7.7 y). Among caregivers, 25.0% had 2+ chronic health conditions, compared to 41.1% of non-caregivers. At the 10-year follow-up, 20.6% of caregivers had died versus 29.6% of non-caregivers (p<.0001). After propensity score matching on demographics, health, and limitations in? activities of daily living, there were no differences in mortality between the groups (p>0.05). Our study suggests no difference in mortality risk based on caregiver status. While family caregivers frequently experience negative impacts on well-being because of their role, it is heartening to know that caregiving may not confer an additional risk of death.
BOTH COGNITIVE IMPAIRMENT AND DEPRESSION MAY INCREASE THE RISK OF POOR MUSCLE FUNCTION IN OLDER PEOPLE
Authors: Liu I-Ting
Published: December 2023

Muscle loss might occur in aging, target organ failure, metabolic and endocrine disorders, etc. The aim of this study was to identify the high-risk group of low grip strength, a key component of sarcopenia. 100 subjects aged 65 or older who received Comprehensive Geriatric Assessment (CGA) and grip strength measurement were enrolled at EDA Hospital, Taiwan, form January 2022 to February, 2023 (IRB: EMRP-110-108). Exclusion criteria: unclear consciousness or unable to cooperate 、advanced disease. CGA and grip strength measurement were performed by well-trained nurses and geriatrician. Depressive mood was defined as Geriatric Depression Scale-5 ≧2 or with diagnosed depression. Cognitive impairment was defined as Short Portable Mental State Questionnaire (SPMSQ) < 8 (SPMSQ < 6 in those without education) or with diagnosed dementia. Multiple linear regression was constructed to assess the independent associated factors on increased average grip strength of bilateral hands. Univariate analysis showed male, weight, ADL significantly associated with greater grip strength. Multiple linear regression revealed CKD(ß= -7.70, 95%CI -13.35~-2.05, p=0.011), COPD(ß= -9.15, 95%CI -17.15~-1.17, p=0.027 ), cognitive impairment(ß= -7.67, 95%CI -12.66~-2.65, p=0.005) and depressive mood(ß= -8.39, 95%CI -13.46~-3.32, p=0.003) have detrimental effect on grip strength even after adjustment of age, sex, BMI, socioeconomics, chronic comorbidities, and other geriatric syndromes. Our results resemble another sarcopenia study in which poor muscle function, but not reduced lean muscle mass, was associated with late-life cognitive impairment. Therefore, early screening, education, and intervention of sarcopenia should be applied on high-risk population such as those with CKD, COPD, cognitive impairment, and depressive mood.
CAN YOU HEAR ME? IMPLICATIONS OF HEARING LOSS FOR SOCIAL TIES AMONG OLDER ADULTS
Authors: Birditt Kira , Turkelson Angela , Noyer Emily , Stephenson Jane , Fingerman Karen , McKee Michael
Published: December 2023

Hearing loss is a leading source of disability among older adults; over 65% of those aged 71 and older have hearing loss. Hearing loss may be associated with reduced relationship quality due to greater communication challenges, conflict, and avoidance of social interactions. This study examined links between hearing loss and social ties among older people. Participants included 11,161 respondents from the 2016 and 2018 waves of the Health and Retirement Study (ages 50+) who completed a hearing test and reported on their social ties (contact, quality), social activities (e.g., charity work), and loneliness. Multilevel models controlling for age, gender, and education revealed that having hearing loss was associated with having lower positive quality and higher negative quality relationships with spouse and friends, higher negative relationship quality with children, having fewer close friends, meeting up less with friends, greater loneliness, doing less charity work, and less attendance at social and community events. Older age was associated with more detrimental outcomes. Older aged individuals with hearing loss met up with friends less often, talked on the phone less with friends, did fewer activities with grandchildren/extended children and neighborhood children, did less charity work, and attended fewer social events compared to younger individuals with hearing loss. Overall, older adults with hearing loss are at high risk for relationship problems and social isolation; especially as they grow older. Hearing loss and social ties are important targets for future interventions for older adults with hearing loss as they may be particularly vulnerable.