bluuebunny/crossref_metadata_2025 huggingface dataset:
EMBOLDEN: CATALYZING RESEARCH FOR OLDER ADULTS THROUGH CO-DESIGNED MOBILITY-PROMOTING INTERVENTION RESEARCH
Authors: Ganann Rebecca , Moore Caroline , Phillips Stuart , Alvarez Elizabeth , Newbold Bruce , Neil-Sztramko Sarah , MacNeil Maggie , Fisher Kathryn
Published: December 2023

Mobility and social participation are requisites for optimizing health, independence, and quality of life in older populations. Most mobility-enhancing interventions for older adults have been designed by researchers alone, which often experience implementation challenges and limited effectiveness when translated to real-world contexts. The EMBOLDEN research program aims to i) partner with older adults and service providers to co-design, implement, and evaluate a mobility-promoting intervention and ii) enhance physical and mental health, foster social connections, and support system navigation among older adults living in neighbourhoods with health inequities. EMBOLDEN has completed two phases: (1) intervention co-design based on evidence reviews, environmental scan, qualitative study, and strategic guiding council expertise; (2) a mixed-methods pilot randomized controlled trial. Twenty-seven local older adults (≥55y) and 34 service providers contributed to Phase 1, co-designing an integrated health and social care intervention delivered through collaboration with primary care, public health, and recreation. The three-month community-based program includes a weekly interactive group program of physical activity, healthy eating, socialization, and individual system navigation support. The co-design determined priority intervention features (e.g., addressing social determinants of health, assets-based approaches) and implementation strategies. The pilot study evaluated quantitative and qualitative participant outcomes and experiences and intervention team experiences. The pilot study demonstrated intervention feasibility and acceptability to participants and interventionists, informing a larger pragmatic hybrid implementation-effectiveness trial that is currently underway. EMBOLDEN’s partnership engagement was critical to successfully co-designing intervention research to address identified health, mobility, and social needs of older adults living in neighbourhoods with significant health inequities.
MUSCULOSKELETAL PAIN CHARACTERISTICS AND OBJECTIVELY MEASURED PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Cai Yurun , Liu Fangyu , Wanigatunga Amal , Simonsick Eleanor , Ferrucci Luigi , Schrack Jennifer
Published: December 2023

Pain is associated with reports of restricted physical activity (PA), yet the associations between multiple musculoskeletal pain characteristics and objectively measured PA quantities and patterns in late life are not well understood. A total of 553 adults (mean age 75.8±8.4 years, 54.4% women) in the Baltimore Longitudinal Study of Aging (BLSA) completed pain assessments and subsequent 7-day wrist-worn accelerometry in the free-living environment between 2015 and 2020. Pain characteristics included pain presence in the shoulders, hands/wrists, low back, hip, knees, and feet, pain laterality in each site (no pain, unilateral pain, and bilateral pain), and pain distribution (no pain, single site pain, and multisite pain). PA metrics were summarized into total daily activity counts (TAC), activity fragmentation, active minutes/day, and diurnal patterns of activity. Linear regression models adjusted for demographics and comorbidities suggested that unilateral knee pain was associated with 184,070 fewer TAC/day (p=0.04) and 36.2 fewer active minutes/day (p=0.03) while hand/wrist pain was associated with 24.8 more active minutes/day compared to those without pain (p=0.04). By time-of-day, participants with hip pain had less activity during the morning (6:00am to 11:59am) while those with unilateral knee pain had fewer activity counts during the afternoon (12:00pm to 5:59pm). Analyses stratified by sex showed that these associations were only significant among women. Our study highlights the importance of assessing pain laterality in addition to traditional pain measures (e.g., pain presence) and suggest that pain interferes with multiple aspects of daily activity. Longitudinal studies are needed to assess the temporality of these findings.
SUCCESSFUL COMPLIANCE OF FAMILY CAREGIVERS IN DEMENTIA RESEARCH
Authors: Armah Henrietta , Winstead Vicki , Yildiz Mustafa , Vickers Jasmine , Pickering Carolyn
Published: December 2023

Attrition is an issue for all longitudinal studies. One concern with intensive protocols with many repeated measures is that participants will drop out before completing the protocol, or will not complete enough of the surveys to provide meaningful data. Features of the study design can be important in increasing compliance with study participations. These features include incentives, survey windows, clear direction, ease of use of the data collection platform, and reminder protocols. This presentation examines compliance, defined as completion of >50% of all surveys, among 3 different micro-longitudinal daily diary studies. Compliance was high for all three studies (78%, 88%, 89%). The lowest compliance rate of 78% was an 8-day protocol with four diaries each day; three diaries were sent out randomly each of the eight days and the one nightly recap was sent at the same time each night. This suggests having multiple surveys in a single day reduce compliance with the study protocol. Compliance did not vary by other study features such as incentives, reminder method or length of the study. For daily diary studies, findings suggest that by doing once-a-day surveys, data collection protocols can be longer and total incentives ranging from $82-$91 are acceptable for maintaining high compliance.
DEMENTIA FAMILY CAREGIVERS’ REASONS FOR PARTICIPATION IN RESEARCH
Authors: Vickers Jasmine , Winstead Vicki , Armah Henrietta , Pickering Carolyn
Published: December 2023

Recruitment of participants with Alzheimer’s and Related Dementias (ADRD) and their family caregivers can pose significant challenges to the successful completion of research, particularly for intensive protocols like daily diary research. Understanding the reasons ADRD family caregivers are willing to participate in research can provide researchers with the tools for successful recruitment efforts. In this study, we assessed the reasons ADRD family caregivers (N=123) participated in a 21-day diary study and the translatability of the findings for informing the development of recruitment materials to address recruitment challenges. We conducted a thematic analysis of responses to the question “Tell us in a few words why you are interested in participating in this study” as an addendum to the consent form. Thematic analysis was conducted by two independent coders. Participants were mainly women (86%) and biological children of the care recipient (46%). Findings revealed four predominate motivations for participation in the research project: 1) finding meaning for their caregiving experiences by sharing them through the study, 2) altruistic motivations for helping others, 3) personal benefits including helping their care recipient or learning more about caregiving, 4) and the meaningfulness of the study’s focus. Caregivers were motivated to participate in this intensive protocol for a variety of meaning-making reasons. Recruitment materials should focus on language that emphasizes opportunities for caregivers to share their experiences and practical relevance of potential study findings.
VIGOROUS PHYSICAL ACTIVITY, DEPRESSION, PRO-INFLAMMATORY CYTOKINE AND RACIAL/ETHNIC VARIATIONS IN FALLS
Authors: Malatyali Ayse , Cidav Tom , Xie Rui , Thiamwong Ladda
Published: December 2023

Physical activity plays a key role in preventing falls among older adults as it supports muscle strength and improves balance and postural control. Recent studies have revealed that physical activity modulates Interleukin-6 (IL-6) levels and reduces the incidence of falls among older adults. This study describes the relationships between vigorous physical activity, IL-6 plasma levels, depression, and falls among older adults. We conducted a cross-sectional study on Health and Retirement Study participants aged 65 and above (n= 9,942) using datasets from the 2016 interviews. Of the sample, 37.7% reported falling in the last 24 months. Mean ages were: 77.4 (8.14) years in participants who had a fall and 75 (7.31) years in participants without a fall. Participants engaging in regular vigorous physical activity were 24% less likely to have a fall than those not engaging in vigorous activity. We quartiled the IL-6 levels and presented quartile-4 as the most elevated IL-6 levels. Compared to quartile-1 (lowest), participants in quartile-3 were 24%, and those in quartile-4 were 45% more likely to fall. The effect of IL-6 was insignificant in quartile-2. Having depression was also significantly associated with falls (OR=2.40). We observed a significant inverse relationship between ethnic/racial minorities and odds of falling: Hispanics were 16%, and African Americans were 36% less likely to fall than non-Hispanic whites. The likelihood of falling among people living in rural was significantly higher than among those living in urban (OR= 1.15). Interleukin-6 may be incorporated to fall prevention interventions as an indicator of fall risk.
VIRTUAL GERAS DANCING FOR COGNITION EXERCISE (DANCE) FOR OLDER ADULTS: A FEASIBILITY RANDOMIZED CONTROL TRIAL
Authors: Hewston Patricia , Ioannidis George , Kennedy Courtney , Papaioannou Alexandra
Published: December 2023

Background

GERAS DANcing for Cognition and Exercise (DANCE) was developed with rehabilitation and geriatric medicine expertise for older adults (age 60+) looking to improve brain health or mobility. Our primary aim of this study was to assess the feasibility of virtual GERAS DANCE.

Methods

This study utilized a single-center, prospective, parallel-group randomized controlled trial (RCT) feasibility approach. We recruited 50 older adults. Participants were randomized to receive 6-weeks (1-hour class twice weekly) of virtual GERAS DANCE or usual care. Feasibility was assessed using pre-defined criteria for process, outcomes, and acceptability, and the effect of GERAS DANCE on mood, balance confidence, and fear of falling.

Results

Our study recruitment period occurred over 8 weeks to recruit 50 older adults (mean age = 75.02(5.89) years, range: 63-92, 92% female). The enrollment-to-screening ratio was calculated as 25:103 and the retention rate of participants was 84%. The average class attendance of the study cohort was 77%. One adverse event was reported unrelated to the study intervention. The program had a high-fidelity score and adhered to the standardized curriculum. Both the intervention and usual care groups improved mood (Depression, Anxiety and Stress Scale – 21). The intervention-group had higher balance confidence and lower fear of falling.

Discussion

Pre-determined thresholds for feasibility were met for all outcomes providing evidence that virtual GERAS DANCE is feasible, well-accepted, and safe for older adults. Improved balance confidence and reduced fear of falling through dance can have significant implications for fall prevention, healthcare costs, and overall quality of life.
OLDER ADULTS’ UNDERSTANDING OF SIGNALS COMMUNICATED BY ROBOT COMPANIONS FOR CAREGIVING
Authors: Malle Bertram , Chi Vivienne , Rebola Claudia B
Published: December 2023

Robotic animal-like companions for older adults are promising technologies to address companionship and new models of care. Our project, Affordable Robotic Intelligence for Elderly Support, aims to design smart communication capabilities in an Ageless Innovation Joy for All™ robotic cat. The cat robot with enhanced capabilities uses intuitive digital cues, including display screen, sound, and LED to create affordances to communicate various interaction intents to engage users into desirable actions. We conducted a study with 315 participants to understand the efficacy of designed affordances. A total of 8 affordances for 8 task scenarios, each with 3 variations of complete or incomplete information, simulating possible experiences were tested with users. Participants were randomly assigned to the conditions “full” (=display+sound+LED), “no_display” (=sound+LED), and “no_sound” (=display+LED) and were asked to provide a response interpretation of the experience signals and rank a list of potential interpretations in order of possibility. Results indicate that participants in the full experience group liked the robot the most (M=6.95 on a scale of 1-10) and gave the highest probability of the robot being a pleasant companion to older adults (M=7.17), compared to the no_display group (M_likability=6.01; M_companionship=6.58) and the no_sound group (M_likability=6.35; M_companionship=6.96). Participants in “no_display” had the greatest difficulty at inferring the robot’s intent. However, the no_sound group had less difficulty understanding the robot than the “full” experience group. Sound (e.g., meowing) appeared to be ambiguous, and removing it improved the communicability of the designed interface of this robot companion.
USER EXPERIENCES OF OLDER ADULTS NAVIGATING AN ONLINE DATABASE OF COMMUNITY-BASED PHYSICAL ACTIVITY PROGRAMS
Authors: Connelly Denise , Lowndes Ashley
Published: December 2023

As cataloguing health care services becomes more internet-based, older adults are increasingly expected to navigate services online. Previous studies have outlined the needs, barriers, and facilitators of older adults using eHealth, however, none included user experiences in navigating websites. Connecting community-living older adults with local, high quality, community-based physical activity programs is a gap in efforts to promote physical activity by older adults. This study aimed to: 1) explore older adult user experiences navigating an online health database of local physical activity programs; 2) compare navigational feedback with age-friendly website design guidelines; and 3) assess online database completeness. Focus groups, including guided navigation tasks and a semi-structured interview script, gathered user experiences of fifteen older adults (≥65). A literature review produced three age-friendly best practice website design guidelines. A website search for local physical activity programs was completed. The design of the online database website was challenging for older adult participants to navigate and was not ’intuitive’. In navigating the online database, the older adults identified multiple discrepancies with established guidelines for designing age-friendly websites. A total of 187 local physical activity programs were missing from the database. Findings provide novel insight into user experiences of older adults navigating online health and physical activity program websites. Redesign following age-friendly website recommendations would empower older adults in use of online databases and promote awareness of local physical activity programs. Health care providers need reliable and age-friendly online resources to link their patients with local physical activity programs to promote healthy aging.
BIAS AND GENERALIZABILITY IN MEDICARE-BASED ANALYSES ACROSS THREE POLICY PERIODS
Authors: Gorbunova Galina , Yashkin Arseniy , Kravchenko Julia , Yashin Anatoliy , Akushevich Igor , Stallard Eric
Published: December 2023

Administrative Big Health data such as that drawn from the Medicare program is an invaluable resource for the study of population health. Although the Medicare program provides near universal health coverage for older U.S. adults age 65+, for most types of care data is collected only for individuals enrolled in traditional Medicare (TM) plans, with those enrolled in private Medicare Advantage (MA) plans being effectively censored in terms of the extent of available data. This presents two potential problems for health outcomes research: bias and generalizability. In this study we use Health and Retirement Study data (1998-2015) to assess the presence and magnitude of group-specific differences between MA and TM beneficiaries as well as plan switchers across three policy-specific periods (Balanced Budget Act; Medicare Modernization Act; Affordable Care Act). We found that the MA population was characterized by higher diversity, adverse behavioral habits, lower education, and economic disadvantage. Initially, lower morbidity levels converged with the TM average over time. Individuals, switching into MA after TM had much larger morbidity levels and mortality risk than any other Medicare group. We found significant loss of generalizability with respect to the Hispanic population; such estimates could be further biased to the extent that MA Hispanics differ from TM Hispanics. Of great concern is the combination of low education and low economic status in MA beneficiaries – a combination also found in many disadvantaged minorities. Care is needed in the design of TM-based studies, especially those focused on ethnic differences.
NEIGHBORHOOD QUALITY AND WEEKLY PATTERNS OF PHYSICAL ACTIVITY AMONG BLACK AND WHITE ADULTS
Authors: Surachman Agus , Jenkins August , Armendariz Marina
Published: December 2023

Engaging in regular moderate to vigorous physical activity across the week is recommended for maintaining health. This analysis examined whether objective and subjective neighborhood quality was associated with different patterns of weekly physical activity across the week among middle and older Black and white adults. We leveraged data from the National Study of Daily Experiences (NSDE), in which 833 Black and white American adults (Mage = 62.65; n Black = 167) reported their daily moderate to vigorous physical activity across eight consecutive days. The objective and subjective measures of neighborhood quality were the area deprivation index (ADI) and personal belief in the neighborhood, respectively. Hypotheses were tested using the latent class analysis (LCA) framework. Weekly patterns of daily physical activity were classified into four different groups: Active Every Day (group size = 35.75%), Active on Weekdays (26.63%), Active on the Weekend (11.76%), and Less Active (15.85%). Lower ADI rankings, but not personal beliefs about one’s neighborhood, were associated with a higher probability of being in the three more active relative to the Less Active group, an association stronger among white adults. Finally, the three more active groups showed higher self-rated physical health than the Less Active group. Within-race analyses showed that this association was only evident among white adults. Neighborhood deprivation is an important structural context that may strongly limit adults’ engagement in daily physical health.
SELF-COMPASSION, DAILY STRESS APPRAISALS, AND ODDS OF ELDER ABUSE AND NEGLECT IN DEMENTIA FAMILY CAREGIVING
Authors: Pickering Carolyn , Yildiz Mustafa , Yefimova Maria
Published: December 2023

Stress related to behavioral symptoms is often found to be a risk factor for elder abuse and neglect in dementia family caregiving. The stress-process model suggests that stressful events alone do not determine caregiving outcomes, rather, they are impacted by personal factors which influence the response to stress. Self-compassion represents how one responds to themselves in moments of distress, with compassionate self-responding consisting of treating oneself with self-kindness (vs. judgement), feelings of common humanity (vs. isolation), and mindful awareness (vs. overidentification). Self-compassion is a modifiable intervention target with efficacious interventions available. We hypothesize that self-compassion can buffer the effects of daily stress on a caregiver’s likelihood of using abusive and neglectful behaviors. To test this hypothesis, a generalized linear mixed model with days (n=9513) nested in dementia family caregivers (N=453) was used. Self-compassion was measured at baseline with the Self-Compassion Scale – Short Form, and daily stress appraisal of behavioral symptoms and occurrences of elder abuse and neglect were measured on 21 sequential daily diary surveys. Having higher self-compassion reduced the likelihood of a caregiver using abusive and neglectful behaviors on a given day by 40% (p=0.001, CI 0.45-0.80). Daily stress appraisal of behavioral symptoms significantly increased the odds of abuse and neglect (OR 1.05, CI 1.02-1.09, p=0.002), while the interaction term showed self-compassion significantly lowered the effect of daily stress (OR 1.01, CI 1-1.02, p=0.029). Given the large effect size, self-compassion should be a priority area for future interventions to reduce elder abuse and neglect in dementia family caregiving.
FROM CRISIS TO CONTROL THROUGH COVID-19: NURSING HOME LEADERSHIP PERSPECTIVES ON DELIVERING QUALITY CARE
Authors: Behrens Liza , Heilbrunn Emily , Van Scoy Laruen , Grewal Ashmita , Osevala Nicole , Whitaker Janice , Calo William , Kraschnewski Jennifer
Published: December 2023

A year after the US Government announced that the COVID-19 pandemic has transitioned to an endemic phase, nursing home (NH) leaders are still challenged to deliver quality care. This study aimed to describe NH leadership perspectives on preparing and maintaining quality care during times of diminishing resources as experienced through the COVID-19 pandemic to gain a perspective on how best to support NHs moving forward. We used convergent mixed methods to explore experiences of NH leaders (N=15) participating in the Project ECHO (Extension for Community Health Outcomes) study. Data were collected through publicly reported survey data and individual interviews conducted at 12-month follow-up. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using verbatim transcripts and inductive thematic coding subsequently organized by a guiding framework. Convergent analysis indicates that participating NHs (N=136) align with national trends in infection rates of residents, staff, access to resources such as personal protective equipment and testing supplies. Leadership from a sub-sample of these homes (N=14; 43% rural; 71% not-for-profit) perceived their NH to be in varied states of operations needed so support quality infection control at the transition to endemic COVID-19 phase. Leadership reported continued challenges in addressing resident & staff vaccinations, securing testing supplies, obtaining financial resources to maintain acceptable levels of personal protective equipment, and isolation practices. Leadership valued providing person-centered care even in times of crisis. These results indicate socio-cultural reasons behind why NHs continue to struggle delivering quality care post-pandemic and offers areas to focus support efforts.
WELL-BEING IN NURSING HOME RESIDENTS THROUGH THE COVID-19 PANDEMIC
Authors: Heilbrunn Emily , Behrens Liza , Felix Laura , Lehman Erik , Osevala Nicole , Whitaker Janice , Calo William , Kraschnewski Jennifer
Published: December 2023

The SARS-CoV-2 (COVID-19) pandemic has disproportionately impacted residents in nursing homes. As a result of the vulnerable nature of congregate living, and to reduce resident morbidity and mortality, the Centers for Medicare and Medicaid Services (CMS) published Quality, Safety, and Oversight (QSO) guidance. Unfortunately, these restrictions may have had unintended negative consequences on the well-being of residents. Significant evidence illustrates that social isolation and loneliness have serious adverse health implications for older adults. We used GEE ordinal logistic regression modeling to examine the trends of depressive symptoms in nursing homes through the COVID-19 pandemic using the CMS Minimum Data Set (MDS). The PHQ-9 was leveraged to measure depressive symptoms, which was then transformed into a categorical variable (no depression = scores 0-4, mild depression = scores 5-9, moderate-severe depression = 10-27). We compared this with the 4-week incidence of COVID-19, transformed into a categorical variable (0 cases, 1-10 cases, 11-40 cases, >40 cases). The odds of depressive symptoms were elevated when comparing some cases to none (1-10 cases vs. 0 cases, OR 1.33 (1.31, 1.36), p-value < 0.001), 11-40 cases vs. 0 cases, OR 1.16 (1.14, 1.18), p-value < 0.001, >40 cases vs. 0 cases, OR 1.19 (1.18, 1.21), p-value < 0.001). While it is important to acknowledge that isolation-based practices are an effective means to reduce disease transmission, it is vital to recognize that they are in conflict with many quality-of-life goals. With this being said, nursing homes worked dutifully to protect residents’ health and well-being.
ASSESSING THE IMPLEMENTATION OF COVID-19 INFECTION CONTROL BEST PRACTICES IN NURSING HOMES
Authors: Heilbrunn Emily , D’Souza Gail , Francis Erica , Kraschnewski Jennifer , Behrens Liza , Calo William
Published: December 2023

The COVID-19 pandemic has claimed over a million lives in the United States, with nursing homes suffering over 158,000 deaths through 2022. In a cluster randomized controlled trial (RCT) with 136 nursing homes, we delivered best-practice training to improve COVID-19 infection control practices. We sought to assess the implementation of infection control practices in participating nursing homes using Project ECHO (Extension for Community Health Outcomes) as an implementation strategy. We delivered a 16-week infectious disease and quality improvement training via real-time, interactive videoconferencing. We surveyed nursing home administrators (NHAs) and nursing staff at baseline and 6-month follow-up. Using validated items from the Centers for Disease Control and Prevention (CDC), the surveys inquired about 80 infection control best-practice activities (yes/no) related to preparedness, visitation policies, communication, protocols, management of deceased residents, education, staffing, personal protective equipment (PPE), and hygiene practices. We also assessed readiness for change and implementation climate in nursing homes with validated scales. We assessed changes in infection control practices and implementation scale scores between baseline and 6-month follow-up. A total of 197 unique participants from 126 nursing homes responded to our surveys. We found that visitation decisions were less likely made on a case-by-case basis by the end of 6 months (91% vs.76%, p=0.025) and an increase in informational materials developed for residents and families at the appropriate reading level (88% vs. 100%, p=0.021) was observed. We also saw changes in some individual items, e.g., an increase in delegating to non-physician staff
EMANCIPATORY PEDAGOGY IN GERONTOLOGICAL SPACES
Authors: Pond Brittney , DiCarlo Nicholas , Pond Brittney
Published: December 2023

Awareness of the field of gerontology has been bolstered by increased training and education programs and other critical pedagogies in several disciplines in higher education. Public and philanthropic initiatives have also supported the development of scholars and researchers in this field (Gross & Eshbaugh, 2011; Merz et al., 2017; Snyder, Wesley, Lin & May, 2008; Wesley, 2005). Furthermore, research notes that incorporating experiences of LGBTQ+ older adults in gerontological spaces can help to address a lack of representation in higher education and provide critical training to support LGBTQ+ older adults (Lipinski, Wilson, Kortes-Miller & Stinchcombe, 2022; Smith, Altman, Meeks & Hinrichs, 2019). This symposium aims to discuss critical pedagogies and emancipatory gerontology in higher education through an intersectional lens. We aim to address the question, where do critical pedagogies flourish, where are they needed, and in what ways? Presenters discuss multiple aspects of this question, describing the ways in which access is a critical component of emancipatory pedagogies, including 1) how we learn and teach abolitionist gerontology in interdisciplinary spaces 2) confronting ableism and ageism in gerontological spaces as part of intergenerational pedagogical praxis and 3) highlighting the need for LGBTQ+ aging education in curricula by discussing a student-led “queering gerontology” campaign with tangible outcomes.
CRONE PEDAGOGIES: EMANCIPATORY PRAXIS
Authors: DiCarlo Nicholas
Published: December 2023

Confronting ableism and ageism in gerontological spaces promotes an intergenerational praxis rooted in an ethics of care. “Crone pedagogies” signal teaching and learning that raises consciousness collectively across generations by confronting the coloniality of everyday life and challenging the ways in which people are forced to cope with unjust systems (Philips, Adams, & Salter, 2015). This framework extends from the critical gerontological work and mentorship of Carroll Estes. The emancipatory potential flourishes from the restoration of historical memory (Martín-Baró, 1994) and the futurity that intergenerational work embodies. This presentation features examples from teaching practice and scholarship, within and outside the academy, while encouraging real-time experiential learning through reflective awareness about intergenerational access within the conference space.
TEACHING ABOLITIONIST GERONTOLOGY IN INTERDISCIPLINARY LEARNING SPACES
Authors: Johnson Ian
Published: December 2023

The discourse surrounding population aging has now infiltrated prisons, jails, and the ‘institutional circuit’ of homeless services, mental health systems, substance abuse treatment, and safety-net healthcare. Students of gerontology must be prepared to consider the experiences of people most affected by the criminal-legal apparatus. Conversely, those training to be social service and healthcare professionals within and in opposition to these systems must be prepared to. Through a conceptual review of the literature and experiential knowledge gathered through curriculum design and implementation, this presentation will outline a pedagogical framework for understanding the effects of transcarceration across the life course and in later life. This framework will be presented in conjunction with tools and strategies for guiding and enhancing interdisciplinary dialogue about the intersections of eldercare and punishment. This presentation will prompt discussion on the responsibilities of aging care providers and gerontological researchers in realizing an abolitionist future.
OPPORTUNITIES FOR USING HIGH-FREQUENCY ASSESSMENT METHODS TO ADVANCE THE STUDY OF COGNITIVE CHANGE
Authors: Sliwinski Martin
Published: December 2023

Embedding mobile cognitive assessments into high frequency assessment (HFA) designs, such as ecological momentary assessments or measurement bursts, affords novel opportunities for the study of both short-term and long-term change. By collecting frequent measurements across short periods of time, it is possible to model short-term within-person trends and fluctuations in cognitive performance, and to relate those features to changes over longer time periods, clinical phenotypes, and neurodegenerative processes. In this presentation, we will review contemporary approaches for HFA of cognitive function and evaluate prior studies utilizing these approaches to examine the short-term coupling among naturally occurring variations in psychosocial variables such as social activity and stress with cognitive function. The challenges and potential for using high frequency mobile cognitive assessments to discover and characterize proximal contextual influences on cognitive functioning and performance will be discussed.
USING HIGH-FREQUENCY ASSESSMENTS TO EXPLORE WITHIN-PERSON COUPLING OF PSYCHOLOGICAL STATES AND COGNITION
Authors: Felt John , Slayday Riki , Scott Stacey , Sliwinski Martin , Harrington Karra
Published: December 2023

From the perspective of traditional assessment approaches, variation in cognitive performance due to participant factors (e.g. mood, fatigue) are treated as part of measurement error. This talk will discuss how high-frequency assessment methods, such as ecological momentary assessment (EMA), can be leveraged to capture meaningful signal from variation in cognitive performance. This approach will be used to explore fluctuations in thought valence and levels of arousal as short-term mechanisms for change in working memory and processing speed performance. Participants (n = 265, aged 25-65, 64.9% female) completed a 14-day measurement burst that included five EMAs per day. Each EMA included self-report measures of current thought valence (pleasant-unpleasant) and level of arousal (sleepy/tired-alert/active), as well as two brief cognitive tasks. We use multi-level modelling to disaggregate between- and within-person effects of thought valence and arousal, and to examine within-person coupling with performance on each of the cognitive tasks. Models also include demographic and contextual covariates (e.g. current location), as well as linear and quadratic functions of time and session number to account for time of day and retest effects. We found that at moments when individuals were experiencing more unpleasant thoughts than usual for them, they also made more errors on the working memory task. Additionally, at moments where individuals were feeling more sleepy/tired than usual for them, they performed more slowly on the processing speed task. These results will be discussed from the perspective of using models of within-person coupling to understand short-term mechanisms for cognitive change.
LEADERSHIP IN LONG-TERM CARE LEADERSHIP: THE NURSING HOME ADMINISTRATOR’S JOURNEY DURING THE COVID-19 PANDEMIC
Authors: Manning Lydia , Peerman Carey
Published: December 2023

The COVID-19 pandemic has impacted long-term care (LTC) leadership and has made us all aware of the preciousness of life and the resilience it takes to keep moving forward during challenging times. This study aimed to understand how long-term care administrators have experienced changes in their leadership abilities and explore what resources they have drawn on to manage the COVID-19 pandemic. A qualitative research design included individual interviews (n = 20) conducted with LTC Administrators serving in leadership roles during the COVID-19 pandemic. The data were subjected to thematic analysis. Three categories related to long-term care administrators’ experiences of leading during the COVID-19 pandemic were identified: (1) changes in leadership behavior and decision-making styles, (2) transformational experiences of leadership during COVID-19, and (c) important lessons learned during a pandemic. We found that LTC leaders have responded to the COVID-19 pandemic by adapting, navigating, and creating new ways to be leaders in an environment of rapidly changing regulations. Findings illustrate how LTC leadership has experienced nursing home and assisted living administrators during the COVID-19 pandemic. There have been innovative changes in care processes, workflows, and responses to regulation. Long-term care leaders have been forced to create new ways to lead, resulting in new leadership styles emerging.
SOCIAL WORKERS’ AND NURSES’ VIEWS ON COLLABORATIVE WORK IN A SETTING WITH SKILLED NURSING CARE
Authors: Kilaberia Tina , Apgar Dawn , Padgett Deborah , Wu Bei , Kennedy Teri
Published: December 2023

This study compares social workers’ and nurses’ views on collaborative work using descriptive and thematic analysis of semi-structured in-depth interviews conducted at an urban retirement and assisted living community including independent living, assisted living, and skilled nursing care in a United States Midwestern city. Social workers (N=11) and nurses (N=12) responded to questions about how they spent their time, with whom (job category) they worked most and least closely, and what constrained collaborative work. Descriptive analysis showed that social workers exercised greater collaborative awareness than nurses and viewed nurses as partners with whom they worked most closely, whereas nurses did not view social workers and non-clinical peers as such. Qualitative analysis showed that social workers were more focused on resident self-determination, advocacy, and requisite care whereas nurses’ orientation was directed toward safety, tasks, and clinical outcomes. In terms of collaborative work, the devalued professional identity of social workers was a threat to collaborative work whereas nurses portrayed failures in collaborative work as stemming from individual actions and attributes. Different approaches to collaborative work between social workers and nurses can impede teamwork. Interprofessional training focused on long-term services and supports may help to reconcile disparate approaches and strengthen collaborative work between social workers and nurses.
LONG COVID: IT’S A BIG DEAL
Authors: Mehegan Laura , Khillan Rohini , Tan Erwin , Dean Olivia , Keenan Teresa , Choi-Allum Lona , Palmieri Jim
Published: December 2023

AARP fielded two nationally representative surveys of adults aged 50 and older to explore their experiences with COVID and long COVID (lingering symptoms for ≥ 4-weeks). The October 2022 survey (N=1,795) was a re-fielding of the May 2022 survey (N=1,018). Survey results showed that 40% of participants were infected with COVID at least once and, among those, 27% experienced long COVID. Among those who experienced long COVID, 33% said it impacted their job. To explore long COVID in greater depth and to understand the financial, health, and social impacts, seven virtual focus groups were held with either long COVID patients (N=27) or partners of long COVID patients (N=20). Focus group participants reported extensive suffering due to debilitating symptoms, most notably brain fog, severe fatigue, depression, and anxiety. Partners reported caregiving duties that impacted their jobs and patients often altered their work schedule or quit their jobs completely. Social isolation was reported in all focus groups. Most participants reported adapting to the loss of income and increased medical expenses; however, the extent of financial consequences is yet to be observed. When queried on the support they needed, most patients and caregivers said they needed more reliable information, and they needed their healthcare providers to share their medical information. It was difficult for patients to understand their symptoms or to get a diagnosis or symptom relief. This research suggests the need to develop and disseminate consistent information on long COVID symptoms and remedies, and to encourage information sharing within the healthcare community.
BIOLOGICAL AGING AND APOE STATUS REWIRE INTER-OMIC ASSOCIATIONS RELATED TO BIOENERGETICS IN HUMANS
Authors: Rappaport Noa , Ellis Dylan , Watanabe Kengo , Wilmanski Tomasz , Hood Leroy , Price Nathan , Funk Cory , Baloni Priyanka
Published: December 2023

Apolipoprotein E (APOE) modifies human aging, with the ε2 and ε4 alleles being among the strongest genetic predictors of longevity and Alzheimer’s disease, respectively. However, the mechanisms of APOE’s impact on aging and cognition remain largely uncharacterized. In this study, we analyzed inter-omic context-dependent association patterns across APOE genotype, sex, and health in an undiagnosed cohort of 1950 individuals. We hypothesized that APOE genotypes would show variation in energy metabolites tied to previously-validated metrics of ’biological aging’, a modifiable health metric based on blood biomarkers. Our analysis identified top APOE-associated metabolites as diacylglycerols, including oleoyl- and linoleoyl-arachidonoyl-glycerols, similarly increased in APOE ε2- and ε4- carriers compared to ε3-homozygotes. Male ε2-carriers and biologically-older males displayed a similar increase in associations between insulin resistance and bioenergetic metabolites including pyruvate, glucose, gluconate, and lactate, a trend which was validated in an independent cohort of TwinsUK females. These results provide an atlas of APOE allele-rewired associations and support the involvement of bioenergetic pathways in mediating APOE impact on longevity and AD risk, suggesting targets for enhancing healthspan via lifestyle-modifications or drug-repurposing.
SERUM METABOLOMICS SIGNATURES OF EXTREME OLD AGE AND LONGEVITY
Authors: Monti Stefano , Sebastiani Paola , Song Zeyuan , Huang Ziwei , Andersen Stacy , Perls Thomas
Published: December 2023

A total of 1,495 chemicals including 1,213 compounds of known identity and 282 compounds of unknown structural identity were profiled in serum samples collected at enrollment at Metabolon, Inc. from the blood serum of 213 subjects, including centenarians (n=80), offspring (n=70), and controls (n=63), mean ages of 105, 70, and 70, respectively, enrolled in the New England Centenarian Study (NECS). We performed metabolite- and metabolite module-based regression analyses on age, differential analyses comparing centenarian to offspring and control, and Cox proportional hazard-based survival analyses. We annotated the derived signatures by enrichment analysis using metabolite sets curated by Metabolon, RefMet, and Pathbank, among others. We identified 323 (436) metabolites that change with age at an FDR-corrected q-value of 0.01 (0.05), and 298 (407) metabolites differentially abundant between centenarians, their younger offspring, and controls. Our results confirm and expand upon previous metabolomics-based studies of aging, including decreased abundance with age of Tryptophan, DHEA-S, Pregnenolone, Glutathione, and Androgen, among others, and increased abundance of Amino acids (Tyrosines), Phenylacetylglutamine, Ornithine, Urea, Kynurenine, and Creatine, among others. To distinguish metabolites associated with longevity from those associated with extreme old age, we performed age-adjusted survival analysis, and rank-based enrichment analysis identified several metabolites significantly associated with survival independent of age, including secondary and primary (C 24) bile acids, and multiple classes of steroids (androgens, pregnenolone, progestin), among others. Additional analyses are ongoing to further annotate and characterize these findings. If validated, these results could contribute to the identification of novel healthy aging therapeutics.
LIGHTS! CAMERA! REPRESENTATION!: EXAMINING AN INTERGENERATIONAL FILM COURSE FOCUSED ON MEDIA REPRESENTATION
Authors: Van Vleet Samuel
Published: December 2023

This paper explores the humanities-based approach to an intergenerational course focused on providing older adults with a guided course in filmmaking. The goals for this course were to provide opportunities for intergenerational lifelong learning, insight into older adult led media representation, and intergenerational community engagement. This course was hosted through an Institute for Learning in Retirement. Throughout the course, students were taught the fundamentals of filmmaking and storytelling. The class worked together to create an original short film screenplay that focused on topics related to their perspectives as older adults. After the script was completed, older adult students were introduced to undergraduate students from a local university that assisted in the creation of their short film. The film equipment and resources were provided to the students which allowed the students to focus on working together to create an original short film. After the film was completed, it was premiered to the community which included a post-film Q&A session that allowed the students to describe their experience working on this intergenerational project. The Q&A session also focused on how important it was to the older adult students to have a role in creating media representation of an older population. This paper highlights the impact of providing opportunities for older adult representation through a creative process while also promoting opportunities for intergenerational learning related to narrative work.
SUCCESSFUL LEARNING EXPERIENCES OF OT AND PT STUDENTS: ENGAGING OLDER ADULTS IN THE USE OF ASSISTIVE DEVICES
Authors: Zeiner Tracey , Moore Jennifer , Traywick LaVona , Cox Krista , McAtee Robin
Published: December 2023

The Arkansas Colleges of Health Education and the Arkansas Geriatric Education Collaborative collaborated on a project to use an authentic teaching/learning approach with occupational and physical therapy students about the use of assistive technologies (AT) through educating older adults. Twenty occupational and physical therapy students were mentored by faculty/staff to collaborate with community-dwelling older adults to research, develop, and disseminate 27 video vignettes shared via Facebook. The vignettes included demonstrations using AT for self-care, home management, community engagement, and leisure participation to help older adults live safely and independently. Through this authentic learning approach, the students learned about the use and benefits of AT, interprofessional practice, and the importance of collaborating with older adults. Viewers of the videos were encouraged to seek further information, providing yet another opportunity for students to acquire additional information about how to secure AT and engage with older adults. Focus groups of faculty & staff involved in the project were held to determine student learning themes arising from this project. Through these focus groups, faculty/staff expressed that students • conveyed AT recommendations without prompts for clients served in the ACHE on-campus clinic; • demonstrated a greater understanding of available non-medical AT; • revealed greater comfort levels working with older adults; • gained an appreciation and understanding of each other’s disciplines; • attained professional development goals. It was also noted that faculty involved in the project appreciated the authentic nature of the teaching approach as opposed to more traditional teaching styles such as lectures.
OPPORTUNITIES AND CONSIDERATIONS WHEN WORKING WITH AGING PET OWNERS: THE DEVELOPMENT OF GUIDES FOR PROFESSIONALS
Authors: Bibbo Jessica , Nicolay Sarah , Johnson Justin
Published: December 2023

Pets can be an important relationship in the lives of older adults and are often a factor in older adults’ behaviors and decisions. Guided by the stress process model, the aim of this study was to understand the benefits, challenges, and resources of pet ownership geriatric professionals encountered in their work. An interdisciplinary sample (N=462, 89.13% female, Mage=53.02, SDage=12.18) of geriatric professionals (i.e., people working with older adults [OA], persons with dementia [PWD], and/or caregivers [CG]) working in healthcare, social services, and private and community-based services (e.g., long-term care, housing) completed an online survey on pet ownership issues they had encountered in their work. A convergent parallel approach was used in data analysis. Quantitative data were analyzed with descriptive statistics, t-tests, and repeated measures ANOVAs. Qualitative data were analyzed using a directed content analysis to create codes and themes. The benefits of pet ownership were wellbeing (e.g., positive mental and physical health) and connections. Pet care was the most common challenge (e.g., basic care, financial), caregiver strain was unique to CGs. Other challenges were planning, safety (e.g., falls, pet behavior), and the pet being a barrier to care. The companionship directly experienced by OA and PWD was the central resource of pet ownership. The results were synthesized to develop guides for professionals on the benefits, challenges, opportunities, and considerations when working with older adult pet owners (including PWD) and another was created for professionals working with caregivers aging pet owners (living with and without dementia).