bluuebunny/crossref_metadata_2025 huggingface dataset:
ANALYSIS OF SOCIAL PARTICIPATION, ELDER ABUSE, AND CORRESPONDING BEHAVIOR OF THE ELDERLY IN CHINA
Authors: Feng Guanggang , Jiang Shumin
Published: December 2022

Introduction

Ancient Chinese wisdom under the Confucian culture show that “Parents raise children who in turn support them in old age” and "Don't wash one's dirty linen in public". The elderly in China brings up children with the aim to guard against troubles in their late years, but many older people with sons also suffer from various forms of elder abuse, and often choose to submit to humiliation when facing abuse from family members. Data: The Survey on the living conditions of the elderly in urban and rural China（SSAPUR）, four waves: 2015, 2016, 2017 and 2018 followed samples(N=224360)

Methods

The hierarchical Logit model was used to analyze the influence of social participation on elder abuse in China, and the risk of the elderly's choice to submit to humiliation. Results and

conclusion

The results showed that the annual incidence of elderly abuse (include physical abuse, emotional abuse, financial abuse, and neglect of care) among the elderly in China was 5.36%, and 35.77% of them chose to submit to humiliation. The more the elder participate in society involvement outside the home, the less likely they are to be abused from family members, the less likely they submit to humiliation. The more sons, the higher the risk of elder abuse. Therefore，the relevant government and the grass-roots social organizations should strengthen the construction of social organizations for the elderly.
AGING, DISPLACEMENT, AND COPING WITH COVID-19 IN PRECARIOUS SPACES IN NORTHEAST NIGERIA
Authors: Adeyombo Adewale , Oyebode Abiodun
Published: December 2022

Nigeria is witnessing internal displacements due to terrorism and kidnapping across many communities with more of these evitable challenges in the North Eastern region. These challenges are impacting on older people amongst other social categories that have been displaced, killed or kidnapped across different communities. The outbreak of covid-19 and the poor social support for older persons and other vulnerable groups in Nigeria imply that survivors in such precarious spaces are likely to face challenges with implications on their well-being and meanings attached to life. This paper explores ageing in precarious spaces that have been ravaged by terrorism and banditry and the outbreak of covid-19. The narratives of the 15 older persons aged 57 to 82 years living in Internally Displaced Camps revealed some dimensions of hopelessness, despair and the acceptance of present challenges as fate and structural defects. Awareness and adherence to covid-19 protocol was poor. Moving away from communities of residence represent diverse forms of loss that transcends material things. Sharing of experiences, prayers and relief materials from non-governmental agencies were considered as instrumental in coping with their daily challenges. The hope of returning to their communities of residence was doubted and considered risky. The belief that their seeds would have a better future was expressed by all the participants, with the females affirming such expectation than the men. Integrating displaced older persons would require more than existing efforts being taken by Nigerian government across levels.
CHANGES IN INTERGENERATIONAL RELATIONSHIPS DURING THE COVID-19 PANDEMIC: THE IMPACT ON WELL-BEING
Authors: Stepniak Catherine , Suitor J Jill , Gilligan Megan , Ogle Destiny , Hou Yifei
Published: December 2022

A burgeoning body of research has revealed the COVID-19 pandemic’s dramatic impact on the lives of family members in the U.S., including increasing caregiving burden and reducing in-person contact. However, the preponderance of this work has focused on how COVID-19 has reshaped a single role, rather than the set of role relationships individuals hold. In the present paper, we used mixed-methods data collected from 543 adults in later midlife (mean age=60) collected as part of the Within-Family Differences Study-III to explore the impact of the pandemic on intergenerational and intragenerational family relationships. Using a combination of quantitative and qualitative analyses, we classified which relationships were affected (e.g., parents, adult children, grandchildren, siblings, etc.), identified social structural characteristics that predicted pandemic related relational changes (e.g., gender, race, age, SES), provided a detailed picture of how family members experienced these changes, and studied the impact of these changes on respondents’ depressive symptoms. Findings suggested that respondents were most likely to report changes in their relationships with their parents and adult children, with reduced in-person contact and direct care to parents, and increased coresidence with adult children. White women were most likely to report changes in in-person contact and care to parents, and they were also more likely to develop higher depressive symptoms due to these changes. Black respondents reported fewer changes in contact with parents or children due to greater coresidence compared to White respondents, and no association was found between changes and depressive symptoms in this group.
PASSING ON THE SILVER SPOON: THE ROLE OF EARLY LIFE CIRCUMSTANCES ON DOWNWARD INTERGENERATIONAL FINANCIAL TRANSFERS
Authors: Cheng Kent Jason
Published: December 2022

Childhood circumstances are known to etch an indelible influence on individual outcomes across the life course such as education, income, and health. Yet relatively little is known about how early life exposures influence family outcomes. This study aims to determine how childhood exposures are associated with inter vivos downward intergenerational financial transfers among older adults aged 51-85 with at least one surviving adult child. Using cumulative (dis)advantage theory, I hypothesized that experiences in childhood shape intergenerational transfers patterns – with early-life advantage being able to provide more transfers than their disadvantaged counterparts. I used data from the US Health and Retirement Study waves 1998 to 2018 (n=32,095 individuals, 169,316 person-years) and estimated random effects models. The index of childhood socioeconomic status was constructed by adding the following dichotomized indicators: poor to fair family socioeconomic status, mother / father having less than HS education, father working for service sector, and moved due to financial difficulty. Downward transfers were defined as whether the respondent gave money, helped pay bills, or covered certain costs to children or grandchildren worth ≥US$ 500. The unadjusted model revealed that the probability of providing downward transfers among those with 1 and 2+ childhood socioeconomic status disadvantage was 5.4% and 3.8% less than those without disadvantage. The inverse association of early life disadvantage and downward transfers were preserved when basic demographic controls and household income and wealth were controlled for, although the magnitude slightly declined (4.0% and 3.1% lower probability for those with 1 and 2+ misfortunes, respectively).
DYADIC COPING AND WELL-BEING AMONG COUPLES TAKING CARE OF EACH OTHER
Authors: Lou Vivian Wei Qun , Liu Huiying , Wu Wenmiao
Published: December 2022

Background

In the context of population aging, more and more couples would have the chance to taking care of each other when one or both of them experience functioning decline. Objective: Taking a dyadic perspective, the objective of this study is to examine collaborative dynamics in mastering daily stressors, and the relationship between couples’ practice of dyadic coping and individual well-being. Method: A total of 77 dyads were recruited from community elderly centres located in four different geographic locations of Hong Kong. Potential participants who met the following inclusion criteria: (1) both partners aged 60 or above; (2) both partners living alone in the same household; (3) one or both partners reporting at least one limitation in performing ADLs and/or IADLs, were invited to complete a survey questionnaire interviewed by trained researchers. Standardized measures by Dyadic Coping Inventory (DCI), Centre for Epidemiological Studies-Depression Scale (CES-D), EQ-5D, and Relationship Assessment Scale (RAS), respectively. The Actor-Partner Interdependence Model (APIM) framework was used for data analysis. Findings: The most adopted collaborative coping strategies were non-negative dyadic coping of oneself, non-negative dyadic coping of the partner, and common dyadic coping. Supportive and delegated dyadic coping strategies were strongly associated with marital satisfaction and health-related quality of life.

Conclusion

Collaborative dynamics among couples when one or both experience functional impairment is associated with quality of relationship. The findings advocate a shift from individual-based stress process on caregiving to a dyadic-based process that address joint needs of both spouses in super-aging societies globally.Funding: RGC 17605119
CARING FOR THOSE WHO CARE: EVALUATION OF A COMPREHENSIVE CULTURAL COMPETENCY TRAINING CURRICULUM
Authors: Powers Sara , Cannon Rachel , Bass David , Pongan Lauren , Le Ocean , Darby Nina
Published: December 2022

By 2030, nearly 3 in 10 older Americans will identify as a member of a diverse or underrepresented group. To better support diverse, aging communities and help professionals meet the growing needs of family and friend caregivers, the Diverse Elders Coalition developed a comprehensive cultural competency training curriculum that, in the first year of development, engaged over 2,500 healthcare and social service providers. To evaluate the short and long-term impact of the training curriculum, this paper focuses on two types of anonymous evaluations that were electronically distributed to training attendees: 1) Subjective knowledge post-tests (n=162), and 2) 3-month post-training follow-ups (n=232). Majority of participants identified as female, White/Caucasian, and earned at least a college degree. Upon completion of the trainings, participants reported improved subjective knowledge about diverse communities, more confidence and preparedness to meet diverse caregivers’ needs, and also indicated that because of the training they would engage in a variety of diversity related actions (e.g., use more inclusive language, share training resources with colleagues, attend additional diversity trainings). At the 3-month follow-up, 91.8% of respondents reported they engaged in two or more diversity related actions since attending the training. Respondents (73.8%) also indicated that their organization engaged in one or more diversity-related actions since attending the training (e.g., provided staff additional diversity-related trainings, translated materials). Discussion will focus on ways to improve healthcare and social service providers’ advocacy efforts and awareness surrounding the needs of older adults and caregivers from diverse communities.
NOWHERE ELSE TO GO: EFFECTIVENESS OF THE PASRR PROGRAM TO MEET THE NEEDS OF RESIDENTS WITH SMI ADMITTED TO NURSING HOMES
Authors: Bucy Taylor , Shippee Tetyana , Woodhouse Mark , Bowblis John , Fashaw-Walters Shekinah , Shippee Nathan
Published: December 2022

The number of adults with serious mental illness (SMI) who receive care in nursing homes (NHs) continues to rise. The Preadmission Screening and Resident Review (PASRR) program requires screening for SMI prior to NH placement, in order to avoid inappropriate admission and unnecessary institutional care. We interviewed staff responsible for the processing of PASRR documentation at four NHs in Minnesota (n=15), and obtained and analyzed all completed PASRR-II assessments in Minnesota from 2019 (N=532). PASRR assessments overwhelmingly recommended 24-hour NH care (94.7%) with 94% of assessments indicating a need for mental health services while at the NH. Most NH staff interviewed noted that PASRR is not used in the care planning process and described PASRR as a regulatory hoop. Staff shared that PASRR assessments could provide insight into an individual’s mental health history, current and future needs, and can be helpful in assessing NH capacity to provide such services. Although mental health services provided while at the NH are supposed to be facilitated in partnership with the county, there is a lack of follow-up and NH staff are largely left to deal with SMI in isolation. PASRR assessments are supposed to be a tool for care coordination, but leave the NH as the sole responsible point of contact for residents with SMI. A more integrated PASRR program that better focuses on incorporating PASRR into care planning and mental health service delivery in NHs and the broader community is necessary to improve the lives of individuals with SMI.
ROLE OF ACTIVITY PROFESSIONALS IN APPLYING APIE MODEL TO ENHANCE RESIDENTS’ ACTIVITY IN LONG-TERM CARE SETTINGS
Authors: Li Xiaoli
Published: December 2022

Background

Residents’ activity is a strong contributor to quality of life in long-term care facility. Hence, activity professionals (AP) have an essential role to play in enhancing resident activity and engagement. The service process of AP includes Assessment, Planning, Implementation, and Evaluation (APIE model). Although AP have made significant advances in demonstrating its value, few studies have focused on the APIE model for activity professionals. Method: A survey was conducted to help define the role of AP in using APIE in long-term care. Questionnaires were completed by 195 AP working as activity directors and activity staff in long-term care settings. The major factors studied were job background and certification, and performance of AP using the APIE model.

Results

Findings showed that 11.8% of AP only had a high school education, while 12.3% of participants had no certification and 9.2% of activity professionals had invalid certifications. When examining the APIE model, the activity professionals used person-centered approaches when they assessed residents` needs and wants, planned and implemented the activities, but lacked evaluation when measuring the outcomes, 79.5% of the participants were not tracking the number of minutes residents spent on activities, and 72.8% did not measure the impact of resident engagement on clinical outcomes such as falls, depression, cognition, and medication use.

Conclusion

Lack of professional training and meaningful evaluation could lead administrators to underestimate the value and role of activity professionals. The study advocates for applying APIE mode and increased evidence-based research on the benefits of residents` activity and engagement.
THE TIES THAT RECRUIT, RETAIN, AND BIND: ENGAGING HISPANIC IMMIGRANT FAMILIES IN THE TIME OF CRISIS
Authors: Lin Jielu , Wilkinson Anna , Koehly Laura
Published: December 2022

In 2008, we launched Project RAMA (Risk Assessments for Mexican Americans) in Houston, Texas, seeking to understand how multigenerational Mexican immigrant families communicate about familial risk for complex disease. Several lessons were learned. First, our community advisory committee endorsed research goals. Second, we listened to the community with regards to immigration concerns and structural racism. Finally, in the summer and fall of 2008, Hurricane Ike struck the region. Because our team provided support and resources to families in need, we had a higher participation rate post-disaster. Pausing recruitment and postponing assessments led us to unexpectedly discover a long-term intervention effect that was not originally hypothesized. These lessons guide a new initiative focused on Hispanic immigrant families affected by rheumatoid arthritis in Washington DC. We discuss how we address challenges in the on-going project during the Covid pandemic, including recruiting through embedded community clinics and integrating community needs into study design.
IN THE SHADOW OF THE GREAT RECESSION: THE ASSOCIATION BETWEEN RECESSION EXPERIENCES AND DAILY INDICES OF WELL-BEING
Authors: Rush Jonathan , Bhat Aarti , Thomas Duncan , Karlamangla Arun , Almeida David , Seeman Teresa
Published: December 2022

The current study examined the associations of positive and negative experiences during the Great Recession (GR) with levels of daily well-being. In 2012, participants from the Midlife in the United States Refresher survey reported on their positive or negative GR experiences related to job, housing, or finances. A subsample, selected into the National Study of Daily Experiences (N=782), also reported on their daily levels of health and well-being across eight consecutive days and provided saliva samples, from which cortisol was assayed. The number of negative GR experiences reported related to poorer daily well-being (negative and positive affect, physical symptoms, stress severity, and cortisol daily peak-to-nadir ratio), whereas, the number of positive GR experiences was only related to lower severity of daily stressors (β=–0.03, p=.03). Examining specific GR experiences revealed that individuals who reported bad housing experience during the GR reported higher daily levels of negative affect (β=0.14, p<.001), physical symptoms (β=0.90, p<.001), and frequency of stressor days (β=0.01, p<.001), and lower daily levels of positive affect (β=–0.19, p=.02). Bad financial experience was related to more physical symptoms (β=0.62, p<.001) and greater severity of daily stressors (β=0.14, p=.03). Conversely, positive financial experiences were related to greater cortisol daily peak-to-nadir ratio (β=1.98, p=.03), but also greater frequency of stressor days (β=0.05, p=.01). Results highlight the potential influence of major economic strains on our ongoing daily experiences. This work has implications for policy and interventions around supporting midlife and older adults facing economic strains, in order to improve daily well-being.
USING AGILE METHODOLOGY AND NUDGE STRATEGIES TO IMPROVE ENROLLMENT IN CLINICAL TRIALS
Authors: Bylund Peggy , Mehta Jade , Mathavan Nandini , Trowbridge Kimberly , Taylor Britain , El Sharu Husam , Campbell Noll
Published: December 2022

The enrollment of human subjects is crucial for the success of clinical trials. In the ongoing “Reducing the Risk of Dementia through Deprescribing” trial, the initial approach for enrolling subjects did not meet expected goals in the first 6 months, creating the need for innovative nudge strategies. We used an Agile methodology as the framework to understand the problem, then find and implement a solution. Our study aimed to examine the effectiveness of utilizing a texting nudge to enhance post-agreement recruitment of subjects with cognitive impairments. Prior to enrollment, eligible potential participants were contacted using a texting nudge. Potential participants received a second contact call to remind subjects of the enrollment appointment, introduce the person and the phone number that would call them, and the option of confirming or rescheduling. During the 1-week text-message experiment, 8 out of 9 subjects who agreed to participate in the study and received the text message enrolled, yielding an 89% post-agreement enrollment rate compared to a baseline rate of 44% prior to introducing this nudge. After implementing into the standard operating procedures, the 6-month average rate of enrollment among those that agreed rose to 80%, nearly doubling the rate from the first 6 months of the study and quadrupling the number enrolled each month. Inadequate recruitment has necessitated the use of innovative recruitment methods. Using the Agile problem-solving mindset, the texting nudge was developed to leverage the behavioral influences of the messenger, social commitments, priming and affect to increase subject enrollment.
DO AGE-FRIENDLY COMMUNITIES PROMOTE OLDER ADULTS’ HEALTH?
Authors: Kim Kyeongmo , Burnette Denise , Buckley Thomas , Kim Seon
Published: December 2022

The WHO developed the concept of age-friendly environments that contribute to older adults' better health and well-being. However, research on the effects of age-friendly communities (AFCs) on their health is limited. As AFC initiatives grow, it will be essential to examine whether older adults who live in an AFC have better health than those in other environments. This study uses data from the 2017 AARP AFC Surveys and the AARP Livability Index to assess whether AFCs promote the health of older adults. We analyze data for 3,027 adults aged 65 and older who reside in 262 zip code areas. Following AARP guidelines, we allocated the sample into two groups: the AFC group (livability score of 51+; n=2,364) and the non-AFC group (score≤50, n=663). The outcome variable was self-rated health (M=3.47; SD=1.09; range: 1-5). Findings employing an inverse probability weighting approach showed that older adults who lived in an AFC had better self-rated health than those in a non-AFC (b=0.08, p=.027). Compared to non-Hispanic whites, Black and Hispanic older adults reported worse self-rated health. Oldest old individuals had better health status than young-old adults. Consistent with previous literature, higher education, and frequent social interaction were associated with better self-rated health. The study adds to the growing literature on the role of age-friendly environments in older adults’ health and suggests directions for future research. Since living in an AFC can promote the well-being of older adults, policymakers and practitioners should continue to build high-quality, accessible built and social environments.
HOUSING CONDITIONS, SOCIAL CAPITAL, AND SUBJECTIVE WELL-BEING AMONG MIGRANT OLDER ADULTS IN INDIA
Authors: Hemalatha Sruthi Anilkumar , Sarif Nawaj
Published: December 2022

Aging and migration are complex multidimensional processes affected by various factors at different levels. According to the most recent Census of India (2011), more than half of the older adults in India are migrants. Migration at an older age is considered risky and vulnerable because it may lead to many problems. Changes in the environment and living place at an older age may disconnect their social network and affect their health. Therefore, this study examines the housing conditions, social networks, and subjective well-being of older adult migrants in India using data from Longitudinal Aging Study in India, Wave 1 (2017-18). The bivariate and multivariate analyses show significant socio-economic differences in living arrangements and access to better housing facilities among older adult migrants. Additionally, there exist state-wide differences in the social capital of older migrant adults. The likelihood of having poor social capital is higher among migrant older adults than non-migrant older adults. It also reveals that the subjective well-being of older adult migrants is strongly associated with their housing conditions, social networks, and other socio-economic factors. Thus, the paper finds environmental factors and social support essential for better health and well-being, especially for older adults, especially those in new surroundings. Therefore, extensive research is needed to understand the situation of migrant older adults in India to formulate appropriate policies for the same.
EXPLORING AGEISM WITHIN THE FAMILY
Authors: Gordon Stacey , Gonzales Ernest
Published: December 2022

It is well documented that ageism negatively affects older people's opportunities for productive aging, and access to the workplace and healthcare. Ageism as it manifests within families, however, has not yet been well studied despite significant implications for the wellbeing of older adults and families. This study presents the problem of ageism in the family through the lens of larger social structural factors shaping meso- and micro-level behaviors. Negative implicit ageism and stereotype embodiment theory underscore the unconscious perpetuation of negative age stereotypes and attitudes in families. To illustrate this concept, we describe three evidence-based case examples involving interactions among family members observed by a geriatric care manager. The first describes how ageism expressed by an adult child undermines choice, opportunity, and power of the parent when an older adult enlists the help of her adult children in downsizing from the family home to a smaller apartment. The second explores ageism when adult children attempt to persuade their older father to leave his home, pointing out dangers living alone at his age. The third describes a relatively healthy newly widowed woman who is coerced by her adult children to move to an assisted living facility by threatening social and emotional abandonment. These examples demonstrate how macro and meso-level factors combine with the implicit ageism of both adult children and older adults converge, influencing pathways to create healthy, tolerable and toxic living conditions within the family.
ELDER MISTREATMENT AND RELATIONSHIP QUALITY: SECONDARY DATA ANALYSIS USING DATA FROM THE NSHAP
Authors: Xue Wei-Lin , Hass Zach , Liu Pi Ju
Published: December 2022

As social networks shrink with age, older adults value the importance of interpersonal relationships with close others, such as partners, family and friends. Previous studies focused on perpetrators' and victims' characteristics; however, few studies examined the relationships with close others and the incidence of elder mistreatment. This study used the National Social Life, Health, and Aging Project Wave 1 data (2005-06) to examine the correlations between relationship quality with close others and the occurrence of mistreatment among older adults (N = 3005). Based on spousal relationship literature using the NSHAP data, factor analysis was used to estimate factor scores conceptualizing two domains of relationship quality: relationship support (positive dimensions of relationship), and relationship strain (negative dimensions of the relationship). Logistic regression models were used to test the relationship between the relationship quality factor scores and the likelihood of each mistreatment type while controlling for gender, education, age, and race. Psychological abuse was more likely for older adults experiencing relationship strain with spouse (OR=1.82, p<.001), family (OR=1.75, p<.001), and/or friends (OR=1.67, p< 0.001). Financial abuse was more likely for those experiencing poor relationship support with family (OR=1.34, p<.05) and those experiencing relationship strain with friends (OR=1.47, p<.01). However, relationship quality was not correlated with likelihood of physical abuse. Interpersonal relationships with close others could provide stronger support and care, but relationship strain might contribute to mistreatment. When determining safeguarding gatekeepers to protect older adults from potential mistreatment, interventions should consider the quality and composition of interpersonal relationships with close others.
THE RELATIONSHIP OF AGEISM, INTENTION TO WORK WITH OLDER ADULTS, AND SOCIAL DESIRABILITY
Authors: MacLean Maria , Strong Jessica
Published: December 2022

Previous research demonstrates: 1) men and younger adults have higher negative ageism scores than women and older adults 2) higher scores of negative ageism are associated with lower intention to work with older adults and 3) women and older adults have higher scores for social desirability. It remains unclear how these factors interact. University students (N=547) aged 16 - 59 (Mean = 20.6) completed a survey measuring positive and negative attitudes towards older adults, intention to work with older adults, and social desirability. ANOVAs found a significant effects in negative ageism based on age, F(1, 3) = 6.69, p = 0.01, ω2 = 0.01, and gender, F(1, 3) = 11.43, p = 0.001, ω2 = 0.02, with a small effect size, but no significant interaction between age and gender. Young adults (M = 22.3) and males (M = 21.5) demonstrated more negative ageism than middle aged adults (M = 23.1) and females (M = 22.7) (lower scores indicate negative attitudes). An ANOVA of gender x age x social desirability was also significant for negative ageism, F(11) = 2.00, p = 0.03. However, there were no significant effects or interactions for gender or age on positive ageism and intention to work with older adults, or when social desirability was added. Although there were differences between demographic and social desirability groups for negative ageism, this relationship was not found for positive ageism. We expected social desirability to play a role in ageism, but this was not the case in the current sample.
THE ROLE OF PLATELET ENERGY METABOLISM IN PAIN AFTER WALKING IN BLACK ADULTS WITH KNEE OSTEOARTHRITIS
Authors: Klinedinst Jennifer , Huang Weiliang , Kane Maureen , Fiskum Gary , Borcar Apruva , Rangghran Parisa , Dorsey Susan
Published: December 2022

Nearly 30% of adults aged 60 or older suffer from knee osteoarthritis (KOA) that causes significant pain and disability. Walking is considered a “gold standard” treatment option for reducing KOA pain and maintaining joint mobility. However, pragmatic trials have shown that walking increases pain for some and relieves pain for others. The mechanism by which walking is helpful for KOA pain is unclear. The purpose of this study was to gain a better understanding of the mechanisms underlying walking for knee pain. We conducted a pre-test/post-test study using quantitative sensory testing to measure pressure pain sensitivity at the knee and examined protein signatures and measured energy metabolism in platelets in six adults with KOA before and after six weeks of walking three days/week at 100 steps/minute. All participants identified as Black/African American, five were female, average age 57±5.8. Pressure pain sensitivity increased for three participants and decreased for three participants. Protein signatures among KOA participants indicated differences in immune and energy metabolism pathways. Proteins in the energy metabolism pathways were significantly downregulated after walking in participants whose pain increased compared to participants whose pain decreased. Platelet energy metabolism was also lower among participants whose pain increased as compared to participants whose pain decreased. One goal of developing individualized interventions for KOA pain is to elucidate the mechanisms by which self-management interventions impact pain. The addition of therapies that target cellular energy metabolism may lower pain with walking among Black adults with KOA.
REDUCED LEVELS OF NAD IN SKELETAL MUSCLE IN PEOPLE AGING WITH HIV INFECTION ON TREATMENT
Authors: Montano Monty , Pencina Karol , Schultz Michael , Tran Thanh , Li Zhuoying , Ghattas Catherine , Lau Jackson , Sinclair David
Published: December 2022

People living with HIV (PLWH) are disproportionately burdened with multimorbidity and decline in physiologic function compared to their uninfected counterparts, but biological mechanisms that differentially contribute to the decline in muscle function in PLWH compared to uninfected people remains understudied. The study site was Brigham and Women’s Hospital, Harvard Medical School, Boston MA. We evaluated skeletal muscle tissue for levels of total NAD, NAD+ and NADH in middle-aged asymptomatic PLWH, coinfected with hepatitis C virus (HCV) and/or cytomegalovirus (CMV) and compared them to uninfected control participants. Of the 54 persons with muscle biopsy data, the mean age 57 years with 33% women. Total NAD levels declined in skeletal muscle in association with HIV infection, and was exacerbated by HCV and CMV coinfection, with lowest levels of total NAD, NAD+ and NADH among persons that were coinfected with all three viruses (P=0.015, P=0.014, P=0.076; respectively). Levels of total NAD, NAD+ and NADH in skeletal muscle were inversely associated with inflammation (P=0.014, P=0.013, P=0.055; respectively). Coinfections were also associated with measures of inflammation (CD4/CD8 ratio: P< 0.001 and sCD163: P< 0.001), immune activation (CD38 and HLA-DR expression on CD8 T cells: P< 0.001). Additionally, coinfection was associated with increased physiologic frailty, based on the VACS Index 1.0 assessment (P=0.001). Further research is warranted to determine the clinical relevance of preclinical deficits in NAD metabolites in skeletal muscle in association with viral coinfection and inflammation, as well as the observed association between viral coinfection and physiologic frailty.
CHRONIC CONDITION DISCORDANCE AND ALCOHOL USE AMONG OLDER COUPLES: THE MODERATING EFFECTS OF MARITAL QUALITY
Authors: Polenick Courtney , Turkelson Angela , Cranford James , Blow Frederic , Birditt Kira
Published: December 2022

Chronic condition discordance (i.e., the extent that two or more conditions have non-overlapping self-management requirements that heighten self-management complexity) may be stressful and contribute to increased alcohol use over time among older adults, especially for those with greater marital stress. In this study, we examined how chronic condition discordance at the individual level (i.e., within individuals) and the couple level (i.e., between spouses) predicted alcohol use across an 8-year period, and whether these links varied by negative marital quality. The U.S. sample included 1,116 wives (M = 54 years) and husbands (M = 57 years) from five waves (2006-2014) of the Health and Retirement Study. Dyadic growth curve models controlled for age, minority status, education, and own and partner time-varying number of chronic health conditions and depressive symptoms. Wives with greater individual-level discordance reported fewer initial drinks per week. Marital quality moderated the links between chronic condition discordance and alcohol use over time. Notably, when husbands reported lower negative marital quality and had greater individual-level chronic condition discordance, they had faster decreases in their own drinks per week over time. By contrast, when husbands reported higher negative marital quality and had greater individual-level discordance, their wives had faster increases in drinks per week over time. Overall, these findings indicate that better quality marriages may protect against increased alcohol use for both wives and husbands in the context of greater chronic condition discordance among husbands.
CHRONIC BACK PAIN, LIMITATIONS ON USUAL ACTIVITIES, AND TREATMENT AMONG OLDER BRAZILIANS
Authors: Andrade Flavia , Chen Xiayu
Published: December 2022

Chronic back pain is prevalent among Brazilian older adults, leading to substantial social and healthcare costs. It also disproportionately affects low-income and less-healthy people. Using the latest Brazil’s National Health Survey (PNS-2019), multivariate logistic regressions were conducted to examine how biopsychosocial factors correlate with chronic back pain, limitations on usual activities, and pain treatment (N=17,184). PNS-2019 data showed that 31.3% (95% CI 30.1-32.5) of older adults ages 65 to 112 reported back pain. Chronic back pain was positively associated with being female, having more chronic conditions, depressive symptoms, and lower education. Among those who reported having back pain, 19.2% reported that pain limited their usual activities. Higher odds of having limitations were found among older adults with three or more chronic conditions, obesity, and depressive symptoms. However, it was lower among those with higher levels of alcohol consumption. Among older adults with back pain, 69.2% received some treatment for their pain - 24.1% exercised regularly, 14.3% received physical therapy, 48.1% medications/injections, 6.1% alternative methods, and 30.7% regularly visited health professionals. Treatment was higher among women and those with higher education. The results show significant disparities in the prevalence, limitations, and treatment of chronic back pain among older adults in Brazil. The findings point to the need for prevention and treatment programs for older Brazilians with lower socioeconomic and worse health conditions.
INTEGRATING TELEHEALTH AND COMMUNITY HEALTH WORKERS TO ENHANCE QUALITY CARE ACCESS: A NARRATIVE REVIEW
Authors: Engel Ilana , Zhang Alice , Stiles Robert , Nelson Eve-Lynn , Watts Amber
Published: December 2022

Community Health Workers (CHWs) often share cultural, geographic, or other lived experiences with patients and provide health education and support. Use of CHWs and telehealth approaches are promising strategies for addressing the needs of patients with metabolic syndrome (MetS). This narrative review analyzed how these approaches were integrated into programs expanding care access for patients with MetS. Searching PubMed, PSYCInfo, Embase, Web of Science, and Google Scholar resulted in 1,630+ abstracts screened and 12 articles meeting inclusion criteria. These studies examined implementation of tele-mentoring approaches (n=4), patient group classes via videoconferencing (n=2), or individual telehealth consultations facilitated by CHWs (n=7), with some programs including multiple intervention types. This review included adults ranging from 37-79 years old. Most studies focused on late mid-life (ages 50-64). Because health behaviors in midlife have important implications for MetS and related health concerns in later life, it is important to consider midlife interventions. Using the RE-AIM framework, we evaluated studies on five dimensions: reach, effectiveness, adoption, implementation, and maintenance. Reach and implementation indicators suggest reducing barriers to engagement (e.g., home visits) allows for higher participation and program completion rates. Measures of MetS-related behavioral outcomes were heterogeneous across study designs, making overall effectiveness difficult to determine. Adjusting time spent with patients according to health literacy and clinical needs is a strategy CHW programs use to provide equitable, cost-effective care. Programmatic considerations for implementing programs that include both CHWs and telehealth are discussed, with special consideration for what works in late middle age and in older adulthood.
EXPOSURE TO GENERATIVE MESSAGES BOOSTS COGNITIVE PERFORMANCE IN OLDER ADULTS
Authors: Gruenewald Tara , Standridge Natalie , Tadros Clarissa
Published: December 2022

Both self-perceived and primed generativity has been found to be linked to better cognitive and physical functioning, psychological well-being, and longevity in older adulthood. A prior experiment also found that priming older individuals with messages regarding the generative, or contributory value of their social group (older adults) boosted cognitive performance compared to exposure to a message about the societal burden of one’s group (Hagood & Gruenewald, 2018) . A key limitation of this earlier work was the lack of a neutral prime condition to determine whether being exposed to messages regarding the generativity of older adults enhanced their cognitive performance or being exposed to negative messages regarding the social burdens of one’s age group suppressed performance. This limitation was addressed in the current online experiment of 300 U.S. adults age 55 and older who were randomly exposed to either a social generativity, social burden, or neutral prime presented as a test of reading comprehension and recall. Participants completed other measures of cognitive ability before and after the priming task, including an assessment of verbal memory. An ANCOVA model including age as a covariate indicated a significant effect of priming condition (F(2,296) = 3.30, p = .038). Mean verbal memory performance did not vary between the neutral and social burden priming conditions, while performance was significantly higher in the generativity prime condition (d=.29). Experimental findings provide support for the hypothesis that exposure to generative messages about one’s social group can boost cognitive performance in a national sample of older adults.
LIVED EXPERIENCES OF OLDER CHINESE IMMIGRANTS IN AFFORDABLE HOUSING DURING THE PANDEMIC: STRESS AND RESILIENCE
Authors: Yu Kexin , Chi Iris , Sun Fei
Published: December 2022

Older immigrants in affordable housing have unique sets of challenges during the COVID-19 pandemic posed by limited English proficiency and resources. The aggregated living condition could increase their risk of being exposed to the contagious disease. This symposium reports empirical findings of the social Network of Immigrant Chinese older adults in affordable Housing Environment (NICHE) project, which focused on the influence of COVID-19 on underprivileged Chinese older immigrants. We conducted 27 semi-structured interviews with foreign-born older Chinese immigrants (mean age 78.1, 69.23% female) in an affordable housing in Los Angeles to learn about their lived experiences and coping strategies during the COVID-19 pandemic. The first presentation focused on the changes in older Chinese immigrants’ social life after the onset of the pandemic and aimed to understand the pandemic’s impact on their depressive symptoms and loneliness. The second presentation describes older Chinese immigrants’ perceived pandemic-related stressors and resilience across phases of the pandemic, including at the beginning, after they got vaccinated, and the rising of delta variant. The participants explained what supportive services had been helpful and what support they wished they could have over the past two years in the pandemic. The third presentation reports the experience of being discriminated against during the pandemic, the Chinese older adults’ attitudes towards these discriminatory events, and coping strategies. Together, these three presentations will depict the lived experience of Chinese immigrants over two years during the pandemic and discuss intervention strategies and policy considerations for preparing for future crisis like the COVID-19 pandemic.
CHILDHOOD SOCIOECONOMIC POSITIONING AND LATE-LIFE COGNITIVE FUNCTIONING: A CRITICAL REVIEW
Authors: Skoblow Hanamori , Proulx Christine
Published: December 2022

The predictors of cognitive functioning are varied and complex. Gerontologists are increasingly interested in the long arm of childhood, suggesting that late-life cognitive functioning may be partly the result of influences across the life span. Research shows that childhood economic hardship is associated with disparities in cognitive functioning in older adulthood. Framed by the life course perspective, we reviewed 27 articles that examine associations between childhood socioeconomic positioning (SEP), commonly assessed via parents’ educational attainment, and late-life cognitive functioning in 11 different US datasets. The influence of childhood SEP on cognitive functioning is stronger when cognitive functioning is assessed at a single time point rather than as change over time, suggesting that childhood SEP might not affect the rate at which cognition declines in later life, but does impact where decline begins. The majority of research supported the pathway hypothesis, suggesting that childhood SEP’s influence on adult cognitive functioning works primarily through the mechanism of adults’ own educational attainment and SEP. Several studies support the accumulation of (dis)advantage hypothesis and point to the compensatory potential of upwards social mobility. Support for the latency model, which posits that early-life economic hardship results in enduring outcomes that influence cognitive functioning in older adulthood, above and beyond one’s adult SEP, is present, although weaker than the other hypotheses. Implications include strengthening policies that relieve economic strain and promote educational access among families with young children and also among young adults, as addressing the precursors of cognitive functioning in tomorrow’s older adults is paramount.
RELATIONSHIP BETWEEN PHYSICAL AND MENTAL HEALTH WITH SUBJECTIVE COGNITIVE DECLINE AMONG OLDER ADULTS IN PUERTO RICO
Authors: Buckley Thomas
Published: December 2022

Worse physical and mental health are risk factors for cognitive decline in older adults. In Puerto Rico, existing healthcare services are lacking, further exacerbating this risk. This study examines how mental and physical health factors affect subjective cognitive decline for older adults in Puerto Rico. Data comes from the 2020 Behavioral Risk Factor Surveillance System, restricted to adults age 60+ residing in Puerto Rico (n = 1603). Subjective cognitive decline was measured with two dichotomous variables (no/yes): increases in confusion or memory loss and difficulty making decisions in the past year. Multivariate logistic regression models were run for each outcome variables. Predictor variables were number of days in past month with poor mental health, diagnosis of depression or mood disorder, self-rated health, and access to healthcare services, along with covariates. Higher number of days with poor mental health (B = 2.44, p < .001), diagnosis of depression or mood disorder (B = 3.76, p < .001), and cost barriers to accessing healthcare (B = 2.90, p = .002) were associated with increased odds of increased confusion or memory loss. Significant predictors of increased odds of decision-making difficulty included higher number of days of poor mental health (B = 1.88, p < .001), diagnosis of depression or mood disorder (B = 3.80, p < .001), and worse self-rated health (B = 2.13, p < .001). To promote better cognitive health, intervention efforts should focus on those with poor mental and physical health, including identify strategies to improve access to healthcare services.
PHYSICAL FRAILTY AS A PREDICTOR OF INCIDENT DISABILITY IN SPECIFIC-IADL ITEMS AMONG OLDER ADULTS
Authors: Lee Jane , Kim Miji , Won Chang Won
Published: December 2022

This study investigated the 2-year impact of physical frailty on disability (activities of daily living [ADL], instrumental ADL [IADL], and mobility) and mortality among community-dwelling older adults in Korea. We used data from 2,905 older adults aged 70–84 years who participated in the Korean Frailty and Aging Cohort Study (KFACS) at baseline (2016–2017) and Wave 2 (2018–2019) with all five components of Fried’s physical frailty phenotype. Of these,277 (7.8 %) were frail and 1,312 (45.2 %) were robust. In the 2-year follow-up, multivariate analysis showed significant differences in frailty status for all disabilities (ADL, IADL, mobility) and mortality incidence. Both pre-frail (odds ratio [OR]=1.48, 95% confidence interval [CI]= 1.06–2.05) and frail (OR = 5.11, 95% CI=2.78–9.39) statuses showed increased risks of mobility disability. The incidence of ADL disability was significant only in frail older adults (OR =10.26, 95% CI=3.16–33.31). Both pre-frailty (OR =1.55, 95% CI=1.03–2.32) and frailty (OR =4.11, 95% CI=2.35–7.18) status were significantly associated with the incidence of IADL limitations. Frailty status was associated with disability in mobility-related items of IADL (going out, using transportation, and shopping) among men, and was associated with most IADL items among women after 2 years. The results of this study emphasize the need for sex-specific policies and frailty prevention programs, with a focus on detecting frailty before it leads to irreversible disability or other negative health outcomes. These findings may provide a framework for frailty prevention in community-dwelling older adults.