bluuebunny/crossref_metadata_2025 huggingface dataset:
Dog Park Membership and Life Satisfaction Among Older Adults
Authors: King Betz , Duberstein Adam , Maureen McGlinn
Published: December 2021

Dog park members initially join and attend dog parks for the wellbeing of their dogs, but often experience their own biopsychosocial benefits. This mixed methodology (Quantitative n=44, Qualitative n=11) ) pilot study utilized qualitative heuristic interviewing (Moustakas, C., 1990) and the Satisfaction with Life Survey (Pavot, W., & Diener, E. 2013). Data gathered from interviews and surveys administered to participants of a members-only dog-park indicate a high satisfaction with life. Members 60 years and older reported feelings of life satisfaction almost 7 points over the total respondent average, placing them in the “highly satisfied” range. All members experience the dog-park as a supportive social environment that benefits their physical health, mental health and the well-being of their canine companions. Five qualitative themes were identified: Canine Well-being, Community, Mental Health Benefits, Physical Health Benefits and Fights, Falls & Frustrations. These findings demonstrate the need for more research into the impact and importance of pet ownership, community dog parks and outdoor green spaces on older adults and life satisfaction.
Fostering Intergenerational Connections in the time of Covid-19: A Friendly Caller Program
Authors: Claver Maria , Clark Tatia , Wilkinson Alexandra , Park Chan
Published: December 2021

Social isolation affects one in five older adults, significantly increases the risk of premature death from all causes and is associated with higher rates of depression, anxiety and suicide. Covid-19 has exacerbated social isolation, including among older adults that reside in senior apartments. In response, a Friendly Caller Program was developed to foster intergenerational social connections among university students and residents in a large housing community that serves older adults aged 62 and older who have limited income and have mobility impairments. This study aimed to evaluate the Friendly Caller Program from the perspective of the older adult. An online survey includes questions about the participants’ demographic characteristics, physical and mental health self-assessment, social support, and ways in which the Friendly Caller Program has affected these areas of their life. An open-ended question assesses older adult participant expectations of the Friendly Caller Program. Results describe the population currently being served by this program and indicate that the program has a positive influence on participants’ feelings of safety, support and ability to function. Suggestions for future research include assessing university student perceptions about the benefits of participation as callers in the program and creating a toolkit that can guide other universities to create similar programs in partnership with housing communities that serve older adults.
The Impact Of Oral Health On Psychological Distress Among Older Adults In California
Authors: Melgoza Esmeralda , Archuleta Jennifer , Tran Emma , Abarca Gabino , Fiastro Anna
Published: December 2021

In California, the population of adults ages 65 and older is projected to increase from 11% in 2010 to 19% in 2030. The aging of the population requires modifications in public health to ensure that people are not only living longer, but also healthier lives. Oral health is an important, but often overlooked factor that affects the overall health of older adults. Poor oral health increases the risk of physical comorbidities, decreases chewing performance, limits food choices, and exacerbates weight loss. Furthermore, poor oral health disrupts social health via decreases in verbal communication and facial expressions, such as smiling. This study examines the effects of oral health, assessed by tooth condition, on psychological distress among adults ages 65 and older in California. The study uses the 2019 California Health Interview Survey (CHIS), an annual survey of a representative sample of the state’s residential, noninstitutionalized population. Logistic regression models are used to determine the association between tooth condition on psychological distress controlling for gender, race, and elderly poverty index. Worsening tooth condition increases the odds of having psychological distress with lower odds among individuals 85+, and higher odds among women, and non-Hispanic whites compared to Hispanics. Public health programs and interventions are required in California to prevent and mitigate the impacts of poor oral health on psychological distress among the increasing and diverse older adult population.
Caring for the Stonewall Generation: Assessment of Staff Training for Transgender Persons Living in Long Term Care
Authors: English Sara
Published: December 2021

Transgender persons who came of age in the late 1960s are considered LGBTQ+ elders - The Stonewall Generation. These persons experience unique bio-psychosocial challenges, often complicated by a history of a lack of access to good medical care and social supports. Discrimination and bias can influence the provision of care and the protection of privacy for transgender or gender non-conforming persons. Staff training is essential to provide ethical care for aging trans persons who require residential care. This presentation examines current staff training modules of 100 Long Term Care (LTC) facilities, assessing training needs to provide affirming, culturally competent, and ethical care for sexual and gender minorities.

Keywords: cultural competence; Long Term Care; staff training; transgender
Keep on Keepin’ On: Investigating ACES and Positivity among Bereaved Black Middle Aged and Older Adults
Authors: McDuffie Danielle
Published: December 2021

Many of the most damaging life events are more prevalent among Black older adults. Black people have been found to have higher amounts of adverse childhood experiences (ACEs), which are linked to detrimental life impacts. Additionally, bereavement occurs at a higher rate among Black people and older adults. Despite these challenges, Black older adults have been repeatedly cited overcoming these challenges. Accordingly, the present study sought to investigate whether Black middle to older aged adults who encountered two of life’s most difficult challenges (i.e. bereavement and ACEs) would still maintain positivity. 103 middle to older Black adults (M=44.72, SD=5.48, 67% male) from a larger online grief study were probed about factors including time since loss, positive outlook, and ACES. A linear regression and mediation analysis were used to analyze the data. ACES were found to significantly predict positive outlook among bereaved middle to older Black adults (F=11.46, p=.001), such that as the number of ACES increased, so did positivity in spite of bereavement. Notably, this association was not mediated by time since loss. Results from this study provide evidence that even when faced with some of life’s most difficult events, Black middle to older adults were still able to reframe their situation with a positive focus. The ability for Black middle to older aged adults to reframe their tragedies into positivity could provide a basis for the use of Positive Psychological techniques specifically within this population. Additionally, this study provides further evidence that Black people exhibit exceeding resilience.
Minority Stress in the Context of the Disablement Process Model
Authors: Lentz Jeffrey
Published: December 2021

The changing demographics and growing diversity in the United States pose significant challenges for researchers, particularly scholarship involving sexual minority adults’ health and aging processes. Not much is known about how all minority stressors could lead to a disability. Sexual minority adults are at a greater risk of developing a disability later in life than their heterosexual counterparts (Fredriksen-Goldsen, Kim, & Barkan, 2012). Drawing from critical components of the disablement process model (Verbrugge & Jette, 1994), this dissertation sought to understand the relationship between minority stress and disability status among sexual minority adults 50 years and older. Minority stress in the context of the disablement process model is a social condition. While exploring the relationship between minority stress and disability status, intra-individual factors and extra-individual factors were assessed to see if they mediated the relationship between minority stress and disability status among sexual minorities 50 years and older. Discrimination is significantly associated with having a disability. None of the intra-individual factors and extra-individual factors mediated the relationship between minority stress and disability; however, several intra- and extra-individual were associated with greater or lesser odds of experiencing a disability. This dissertation concluded that discrimination is associated with disability status among sexual minority adults 50 years and older. On the other hand, the disablement process model does not support minority stress as a social condition leading to a disability. On the other hand, this dissertation's results support the ideology that experiencing discrimination is associated with a disability.
Racial/Ethnic Differences in the Longitudinal Effects of Fear of Falling on Falls
Authors: Chen Tuo Yu , Kim Giyeon
Published: December 2021

Research suggests that the effects of fear of falling on falls may differ by race/ethnicity. We investigated whether race/ethnicity (White, Black, and Hispanic) moderated the longitudinal effects of fear of falling on the incidence of falling and having a repeated fall among community-dwelling older adults. We used data from 2011-2018 of the National Health and Aging Trends Study (NHATS). These included a total of 19,516 person-intervals from 5,113 respondents. Self-reported any fall in the past year was the outcome variable with baseline fear of falling as the predictor and race/ethnicity as the moderator. Known risk factors for falls were included as covariates. Results showed that among respondents without the experience of falling at baseline, baseline fear of falling significantly increased the odds of a new-onset of fall at 1-year follow-up among Blacks, compared to Whites. Among respondents who already fell at baseline, baseline fear of falling significantly increased the odds of having a repeated fall later on among Hispanics, compared to Whites. Clear evidence of racial/ethnic differences was found in the relationship between fear of falling and falls among community-dwelling older adults in the U.S. Special attention should be paid to Black older adults with a fear of falling but have not fallen down recently and Hispanics with fear of falling and have fallen in the past year. Readily available educational programs should be actively advertised to older adults to reduce the fear of falling and culturally tailored educational programs should be developed for older adults from racial/ethnic minority backgrounds.
Relationship Between Meaningful Activity Engagement and Well-Being Moderated by Race
Authors: O'Connor Dugan , Smith Jennifer
Published: December 2021

Engaging in meaningful activities has benefits for health and well-being in older adults; however, racial differences in meaning from activities have been observed. The current study examined how the relationship between engagement in a variety of meaningful activities and well-being differs for Black and White older adults. Participants (130 White and 101 Black older adults), ages 53 to 90 (M=69), completed an online survey that measured the extent to which engaging in various activities provided meaning or fulfillment as well as measures of purpose in life, positive affect, negative affect, and loneliness. Overall, the most meaningful activities included “spending time with family,” “reading,” and “being outdoors/experiencing nature.” The least meaningful activities included “job/career,” “caring for pets/animals,” and “supporting a social or political cause.” Black older adults reported greater meaning from “religious faith,” “spiritual practices/meditation,” “spending time with family,” and “listening to music,” and less meaning from “caring for pets/animals,” compared to White older adults. A series of multiple regression analyses (with age, gender, education, and income as covariates) revealed that greater meaning across activities was associated with lower loneliness, regardless of race. Significant Meaning x Race interactions revealed meaning was positively associated with sense of purpose and positive affect for Black but not White older adults. These findings suggest that finding meaning in leisure activities is a psychological resource that may contribute to Black older adults’ well-being. The racial differences in sources of meaning further support the importance of considering the target population when designing activity programs for older adults.
The Utility of Social Media Recruitment to Achieve a More Diverse Participant Sample
Authors: Washington Faith-Christina , Su Tai-Te , Griffin Aileen , Sosnoff Jacob , Meija Shannon
Published: December 2021

The COVID-19 pandemic created an immediate, lasting impact on recruitment methods in academic research, most notably in the field of gerontology. To protect older adult participants' health during the COVID-19 crisis, the Daily Balance Project, a 30-day micro-longitudinal study of older adults' awareness of balance in daily life, shifted to complete remote administration. Our new remote protocol included developing new methodologies to recruit participants with varying degrees of fall risk and educational attainment. In this study, we present our approach to remote online recruitment and compare educational attainment, objective and subjective fall risk, and alignment of objective/subjective fall risk across three samples recruited via a) Fall Clinic registry (16 participants); b) University e-newsletter to faculty and staff (5 participants); c) social media recruitment (7 participants). Eligibility included being 65+ and wireless internet at home. For samples a and b, screening assessments were conducted via phone while baseline assessments were conducted in-person. For sample c, screener and baseline assessment were virtual. Analysis of recruitment methods aims to determine whether recruitment via social media platforms may provide a sample of participants with more variation in fall risk or alignment of subjective versus objective balance. Results demonstrate no significant differences in educational attainment (p=0.7949) or balance confidence (p=0.213), despite significant differences in the alignment of objective and subjective fall risk (p=0.031). Participants from samples a and b proved more able to accurately assess fall risk, while sample c had the most misalignment between subjective and objective fall risk assessments.
Are Age Differences Between Partners Related To Gender and Generations Among Middle-Aged And Older Asian Americans?
Authors: Ye Minzhi , Mei Di
Published: December 2021

Previous research has shown that women who immigrate to the United States tend to partner with much older spouses. However, most studies have focused on young people and first-generations. Spousal age differences among older Asian Americans with different generations have not been well studied. Using data from the Annual Social and Economic Supplement survey (2013-2019), we employed the segmented assimilation theory to test 7,064 married middle-aged and older (50+) Asian Americans. Logistic regression analyses were conducted to understand the association between spousal age differences and individual background, including gender, ethnicity, socioeconomic status, generation, and marriage types. Of the 3,342 men, 20% were married to wives at least 6 years younger and 2% were married to wives at least 6 years older. Men who were Japanese or had inter-ethnical marriages were more likely to marry women at least 6 years older. Men who were Indian, Vietnamese, or having an interracial marriage were more likely to marry women at least 6 years younger. Of the 3,722 women, 3% were married to husbands at least six years younger and 19% were married to husbands at least six years older. Women who were Indian or Vietnamese were more likely to marry men at least six years older. Women who had a high school diploma or were third-plus generation were more likely to marry men at least 6 years younger. The findings reflect the complexity of Asian senior marriage and provide insight for policymakers to design new or improved social integration programs for senior immigrants.
Adults Aging With Spinal Cord Injury: Prevalence and Associated Risk Factors for Diagnosis of Diabetes Mellitus
Authors: Park Seeun , Bratzke Lisa
Published: December 2021

With the increased life expectancy, people aging with spinal cord injury (SCI) are more likely to experience chronic conditions, including diabetes mellitus (DM). The results of previous literature related to the prevalence of DM are mixed and risk factors associated with diagnosis of DM after SCI are not well defined. This study aims to investigate the prevalence of DM and explore associated risk factors for diagnosis of DM among adults aging with long-standing spinal cord injury in the United States. This is a secondary data analysis using the National Spinal Cord Injury Model Systems Database. Participants included 516 people age 45 and older who have been living with SCI for more than 10 years. The prevalence of DM in this sample was 13.2%. Multivariate logistic regression, controlling for confounding variables, was conducted to identify risk factors associated with DM diagnosis in this sample. The multivariate logistic regression model found that the participants who responded with less severe SCI measured by the ASIA impairment scale were less likely to be diagnosed with DM (OR=0.332, p=.017). Also, DM was found to be significantly associated with BMI (OR=1.043, p=.010) and age (OR=1.038, p= .010) respectively. Duration of disability was not significantly associated with DM. Future research is needed to validate these findings and identify other common risk factors for DM such as diet/nutrition. Further, exploration of the effect size of risk factors is also warranted. Such findings will inform interventions to aid prevention and early detection of DM.
Brain Magnetic Susceptibility is Associated With Slower Gait in Community-Dwelling Older Adults
Authors: Poole Victoria , Dawe Robert , Luergans Sue , Bennett David , Buchman Aron , Arfanakis Konstantinos
Published: December 2021

Age-related slowing of gait is exceedingly common and a robust predictor of various adverse health outcomes in older age. Prior neuroimaging studies have documented diverse non-specific structural brain abnormalities which are related to slow gait; however, the extent to which quantitative susceptibility mapping (QSM), which measures regional magnetic susceptibility in the brain, associates with gait speed remains unexplored. In the current study, 415 non-demented community-dwelling older adults (91 males; 81+/- 7 years) underwent an MRI (Siemens 3T TIM Trio) and in-home motor assessment. Gait speed was measured and averaged across 2 timed 8-ft walks. MR-acquired QSM data were pre-processed, registered to ICBM template, and spatially smoothed with a 5mm FWHM Gaussian kernel. When these maps entered group-level GLMs, voxel-wise associations with gait speed were of interest, after adjusting for demographics. We observed very strong negative associations between gait speed and magnetic susceptibility, such that those with slower gait had higher susceptibility in bilateral inferior frontal, superior temporal, and angular gyri (corrected p<.0005). Robust associations were also observed in the middle frontal, precentral, and postcentral gyri of the right hemisphere. These novel findings suggest that reduced myelination or increased iron accumulation in these brain regions may contribute to impaired gait. Future work will need to determine to what extent these cross-sectional QSM metrics are independent predictors of incident adverse health outcomes when controlling for other common brain imaging abnormalities observed in older adults.
Dual-task gait speed and mobility are positively associated with declarative memory
Authors: Gray Michelle , Paulson Sally , Gills Joshua , Madero Erica , Myers Jennifer , Campitelli Anthony , Jones Megan , Glenn Jordan
Published: December 2021

In the US, it is not recommended to perform routine screening assessments for cognitive function or impairment among older adults, due to the lack of effective pharmacological treatments. These common practices result in delayed identification and treatments for slowing cognitive decline progression. Thus, the purpose of the present investigation was to determine the ability to predict cognition from common measures of physical function. Seventy-five community-dwelling older adults (80.7±5.4 years) completed physical function and cognitive assessments. Physical function was assessed using the Short Physical Performance Battery (SPPB), peak velocity during a power sit-to-stand task, and dual-task walking test. Cognition (declarative memory) was assessed using a validated Visual Paired Comparison test. 38% of the variance in cognition was accounted for by the predictor variables (age, sex, education, SPPB, dual-task, peak velocity). Significant predictors included dual-task walking (p = .03), SPPB (p = .02), and education (p = .02). For each 1 second faster during the dual-task performance, cognition increased by 4 percentile units. Likewise, each 1 unit increase in SPPB resulted in an increase of 4 percentile points in cognition. The results indicate more than a third of the variance in declarative memory can be predicted by commonly assessed measures of physical function. This information is useful when identifying older adults that may have cognitive impairment before overt signs are realized. With the lack of recommended cognitive testing, using physical function declines to identify possible cognitive decline is promising. These results are preliminary in nature and longitudinal determination is warranted.
Exploring the Intersection of Chronic Disease, Function, and Social Care in Adult Day Care Clients With Dementia
Authors: Sadarangani Tina , Boafo Jonelle , Wu Bei , Brody Abraham , Yu Gary
Published: December 2021

The interrelationships among dementia, concomitant disease, and social determinants of health are poorly understood and have critical implications for disease course, treatments, and caregiving needs. The aim of this study was to identify patterns of co-occurring chronic conditions among persons with dementia and the relationship of these patterns with clinical characteristics, demographic predictors and functional status. A latent class analysis (LCA) was conducted using data from 53 California adult day centers (n=3,053). Four distinct groups emerged: “dementia only”; “dementia +: > 2; + > 3; + >5 chronic conditions. Having dementia + >5 was associated (p <.001) with greater risk of falls, isolation, medication mismanagement, and reduced likelihood of using an adaptive device. Dementia in day center clients is complicated by clinical conditions, functional decline, and a need for supports that may be lacking. Center staff must be trained and resourced to manage the complex needs of persons with dementia.
Age and Gender Demographics Predict Compliance with COVID-19 Public Health Measures: Data from a Global Sample
Authors: Heemskerk Amber , Lin Tian , Harris Elizabeth , Van Bavel Jay , Ebner Natalie
Published: December 2021

The COVID-19 global pandemic has brought far-reaching consequences on individual and societal levels. Social distancing and physical hygiene constitute effective public health measures to limit the spread of the virus. The current study investigates individual age and gender demographics, in interaction with a country’s human development index (HDI), as crucial factors influencing compliance with public health measures in a large multi-national adult lifespan sample. This report leverages data from a large-scale international collaboration (Van Bavel et al., 2020; https://psyarxiv.com/ydt95/) comprising 45,576 individuals from 66 countries/territories. Participants provided self-reports of their compliance/agreement with three public health measures (i.e., spatial distancing, physical hygiene, policy support). Older age, female gender, and lower HDI were independently associated with greater compliance with public health measures. In addition, a significant three-way interaction between participant age, participant gender, and a country’s HDI revealed that compliance was lowest in younger adults from well-developed countries, while compliance was highest among females across all ages from less-developed countries. Compliance with public health measures is crucial in effectively reducing coronavirus spread. Our findings suggest that age and gender as individual-level demographics, in tandem with HDI as a country-level predictor, affect individuals’ willingness to comply with public health measures. These results highlight the potential of data-driven, tailored (i.e., towards specific demographics) health campaigns and public policies in the fight against a global pandemic.
Exploring older adults’ lived experiences of COVID-19: A narrative inquiry study
Authors: Rogers-Jarrell Tia , Meisner Brad
Published: December 2021

COVID-19 dramatically changed daily life for older adults in numerous and complex ways. Research is calling for an understanding on how COVID-19 has and will impact aging, and older adults’ lived experiences with aging, within the context of the pandemic. Social and physical distancing guidelines have put older adults at an increased risk for social isolation. Intergenerational tensions have also intensified during the pandemic, and early research states the labeling of older adults as a homogenous and “vulnerable” group can lead to an increased risk of ageism in their communities. Therefore, the purpose of this study is to explore how community-dwelling older adults (ages 65 and greater) experience daily life amid the COVID-19 pandemic using a biopsychosocial approach. This study employs a critical qualitative narrative inquiry design. Data will be collected through solicited diaries and semi-structured individual interviews (via telephone and video conferencing software). Data will be analyzed thematically and involve a re-storying of the findings. Preliminary results will be presented and discussed. This study aims to inform new and critical perspectives that broaden our understanding of how the overall health, wellness, and quality of life of older adults can be supported. Findings contribute to the current and developing knowledge of older adults’ first-person accounts of their experiences within the COVID-19 pandemic.
Framing the COVID-19 Pandemic Through a Family Lens: Results of a Qualitative Thematic Analysis
Authors: Gilbert Lauren , Adepoju Omolola , woodard LeChauncy , Howard Daniel
Published: December 2021

Background: The growing proportion of older adults in the U.S. population tends to be most vulnerable to the effects of natural disasters such as pandemics. To date, little has been done to counteract the impacts of public health emergencies and disasters on the aging populations, particularly in African American and Latinx communities. Methods: We administered a survey to community-dwelling minority older adults, 55+, in the Houston metroplex, between 11/2020 and 01/2021. The survey assessed how the COVID-19 pandemic has impacted minority older adults. This thematic analysis focused on open-ended questions regarding daily health management, biggest health concerns, and personal experiences with COVID-19. Results: A total of 575 older adults completed the survey. The mean age was 69 years, 74% were female, 71% reported English as their primary language and 27% were college educated. Three main themes of COVID-19 related concerns emerged from the thematic data analysis: 1) Fear of contracting COVID-19 from family members and fear of passing COVID-19 on to family members. 2) Social needs, including prolonged isolation from family/friends to stay safe, obtaining basic necessitates such as food, medications, and transportation . (3) Personal experiences focused on COVID-19 cases, hospitalizations, and deaths of family/community members. Conclusions: These older minority adults framed their experiences and concerns regarding the COVID-19 pandemic through the lens of family and their community. Their personal relationships permeated their responses and demonstrate the importance of integrating a family lens into future disaster planning, response and recovery efforts for minority older adults.
Missed Opportunities for Compassion: A Call to Action for Incarcerated Individuals Denied Compassionate Release
Authors: Morton Claire , Nathan Rachel , Chacko Anjana , Kheirbek Raya
Published: December 2021

In 2016, a total of 4,117 state and federal prisoners died in publicly or privately operated prisons. Each year from 2001 to 2016, an average of 88% of deaths in state prisons were due to natural causes, with more than half of those due to cancer, heart disease or liver disease, conditions for which non-incarcerated citizens often benefit from palliative care and hospice. Prisoners age 55 and older are the fastest-growing segment of the population residing in prisons, as well as those with the highest mortality rate. Compassionate release of seriously ill prisoners became a matter of federal statute in 1984 and has currently been adopted by the majority of U.S. prison jurisdictions. The spirit of the mandate is based on the idea that catastrophic health conditions ie terminal illness affect the four principles of incarceration: retribution, rehabilitation, deterrence, and incapacitation. Concerned about an aging prison population, overcrowded facilities, and soaring costs, many policy makers are calling for a wider use of compassionate release for persons with terminal illness as well as broader prison reform. The prognosticating criteria of compassionate release guidelines are clinically flawed, and the application and procedural barriers are prohibitive. In this paper we review cases of patients who qualified for compassionate release but had their applications denied. We will discuss the urgent need for access to quality palliative medicine for incarcerated persons with advanced illness and call healthcare providers to action with the aim of reducing suffering and promoting social justice for those in need.
Prevalence of Musculoskeletal Pain and Analgesic Treatment Among Home-Dwelling Older Adults: Changes 1999–2019
Authors: Lehti Tuuli , Pitkälä Kaisu
Published: December 2021

Pain has been shown to be undertreated in the older population. At the same time, the increased opioid use is of concern in the Western world. This study analyzes temporal trends in pain management among home-dwelling people aged 75 to 95 using cross-sectional cohort data spanning 20 years. The Helsinki Aging Study recruited random samples aged 75, 80, 85, 90, and 95 in 1999, 2009, and 2019. In total, 5,707 community-dwelling people participated in the questionnaire survey. Participants reported their medical diagnoses, regular prescription medications, and the presence of back pain or joint pain within the last 2 weeks (never, sometimes, or daily). We compared analgesics use in people reporting musculoskeletal pain and in people not reporting pain in 1999, 2009, and 2019. Of participants, 57–61% reported intermittent or daily musculoskeletal pain. The percentage of people taking a daily analgesic increased from 9% in 1999 to 16% in 2019. The use of NSAIDs decreased from 1999 to 2019, while the use of paracetamol increased from 2% to 11%. Of participants, 3% took daily opioids in 2019. Of those reporting daily musculoskeletal pain, 20% in 1999, 35% in 2009 and 32% in 2019 took regular pain medication. Pain remains undertreated in the older population, although the use of regular prescribed analgesics increased from 1999. The use of NSAIDs diminished, while the use of paracetamol increased. Daily opioid use remained modest from 1999 to 2019.
Reliabilities of mean and variability of ambulatory pain among community dwelling older adults
Authors: Hyun Jinshil , Qin Jiyue , Wang Cuiling , Katz Mindy , Pavlovic Jelena , Derby Carol , Lipton Richard
Published: December 2021

Individual’s pain experiences vary substantially over time periods, and the variability in pain may be an important metric to predict health consequences. However, research on its reliability is lacking among older adults. We aimed to examine the reliabilities of both intra-individual mean (IIM) and intra-individual variability (IIV) of subjective pain reports assessed using ecological momentary assessments (EMA) among racially diverse, community dwelling older adults. Participants were from the Einstein Aging Study (N=311, age=70-91) and completed a 14-day EMA protocol which included self-reports of pain intensity 6 times a day. Pain IIV was quantified using intraindividual standard deviation (iSD). We followed Wang and Grimm(2012)’s approach to calculate the reliability of IIM and IIV. Over a 2-week period, we found excellent reliabilities for both pain IIM (.99) and pain IIV (.91), showing that these measures are reliable and can be used to link with various health outcomes among community dwelling older adults. We also estimated the average number of assessments that produce acceptable levels of reliability. The average of 2 assessments for pain IIM and 23 assessments for pain IIV produced values that exceeded reliability score of .80, suggesting that a briefer study design may be used to reduce participants’ burden with reliable pain metrics. Future studies need to examine whether pain IIV is associated with cognitive, emotional, and physical health among older adults and whether intervention studies that target to reduce pain IIV improve health consequences.
Associations of pain severity and mobility with age in chronic low back pain: does the type of assessment matter?
Authors: Buchanan Taylor , Rumble Deanna , Allen-Watts Kristen , O'Neal Katie , Quinn Tammie , Buford Thomas , Goodin Burel
Published: December 2021

Chronic low back pain (cLBP) can lead to severe pain symptoms as well as disability in adults. As individuals age, pain symptoms and mobility outcomes can become increasingly debilitating. However, current findings regarding the influence of age on symptoms and outcomes are mixed and may be attributed to the assessment methodologies for pain and mobility. Therefore, we sought to examine the association of age with broad and specific assessments of pain severity and mobility commonly implemented in adults with cLBP. cLBP participants (n = 158) completed questionnaires regarding pain intensity and disability including demographics, Clinical Pain Assessment (CPA) and the Oswestry Low Back Pain questionnaire (OLBP). Participants also completed assessments of movement-evoked pain and difficulty by performing the Short Physical Performance Battery (SPPB). Pearson’s chi-square tests and regression-based analyses were conducted using SPSS version 26.0. Among cLBP participants, age was associated with pain-related disability indexed by section one of the OLBPS regarding pain intensity (F= 5.0, p<.05), and mobility via total SPPB score (F= 11.7, p<.05). Interestingly, age predicted greater self-reported difficulty climbing stairs (F= 21.7, p<.05), performing chores (F= 17.0, p<.05), walking (F= 14.0, p<.05), and running errands (F= 13.4, p<.05) from the CPA. Further, age predicted total balance (F= 3.2, p<.05), gait speed (F= 7.8, p<.05), and chair stand (F= 6.5, p<.05) scores of SPPB. Age is associated with questionnaires assessing cLBP pain severity and is also associated with mobility outcomes. Future research should seek to understand the influence of age on movement-evoked pain in cLBP.
Challenges with Pain Treatment for Rural Older Adults: Family Caregivers' Views
Authors: Noh Hyunjin , Won Cho Rong , Suntai Zainab
Published: December 2021

Family caregivers face various challenges in assisting older adults experiencing pain and difficult symptoms. Living in rural areas poses additional obstacles to their caregiving. The purpose of this study was to explore family caregivers’ lived experiences in caring for older adults with pain and discomfort in rural communities. A qualitative research design was adopted to capture the common essence of participants’ experiences through a phenomenological method. Purposeful sampling was used, and the participant criteria was: age 18+, have good thinking skills, resident of Alabama, provide unpaid assistance to a family/relative who has chronic/serious health conditions and experienced pain/discomfort in the last 3 months. Ten participants were recruited from rural counties of Alabama. Individual semi-structured interviews were conducted via phone and were recorded and transcribed verbatim. Inductive, thematic analysis of the data revealed themes in five categories: 1) impact of pain (physical and psychological/emotional toll), 2) coping strategies (faith/contentment with life/logistical adaptation), 3) impact of Covid-19 (physical health/social interaction/mental health/added caregiving), 4) challenges in pain treatment (transportation (time/distance/driver/cost) and non-transportation related problems (healthcare provider issues/health insurance/financial burden)), and 5) suggestions (transportation-related (more transportation options/tailored services) and non-transportation-related support (home-based services/better health insurance coverage)). Findings of this study highlight rural family caregivers’ unique experiences in assisting older adults’ access to pain treatment, particularly during the Covid-19 pandemic. Policy- and program-level intervention is called for to increase individualized transportation options, improve health insurance coverage, and expand financial support for rural older adults experiencing pain and their caregivers.
Connecting the Dots: Pain Mental Models of Spousal Caregivers of Veterans with Dementia and Pain
Authors: Block Phoebe , Shrestha Srijana , Evans Tracy , Hilgeman Michelle , Loup Julia , Kunik Mark , Snow A Lynn
Published: December 2021

Pain is prevalent among persons with dementia (PWDs), yet often goes underrecognized and undertreated. Exploring caregivers’ pain mental models may provide valuable insight into how they conceptualize pain, and how such conceptualizations affect their identification of and response to PWDs’ pain. We identified and described the pain mental model(s) of spousal caregivers of community-dwelling veterans with dementia and pain through a secondary qualitative thematic analysis of recordings of a psychosocial intervention aimed at preventing aggression in PWDs with pain. Thirty female spousal caregivers (11 Black, 10 non-Hispanic White, and 9 Hispanic) comprised the present sample. Two themes were identified: Pain Assessment Beliefs and Knowledge (PA) and Pain Management Beliefs and Knowledge (PM). In our proposed mental model framework, PA and PM affect the ways caregivers answer two PA-related questions (Is there a problem?, Is this problem pain?) and three PM-related questions (Is the pain treatable?, Is it worth treating?, How do I prefer to treat it?). Caregivers are moved to action when they “connect the dots” by identifying a problem in PWDs’ behavior, labeling the problem as pain, and identifying a response (i.e., a treatment approach) they consider worth trying. Disconnects in caregiver understanding of PWDs’ behavior are common in this sample, and predictably lead to inaction. The proposed mental model provides further explanation about how caregivers do or do not synthesize and apply pain knowledge and experience, allowing for the identification of potential areas of intervention (e.g., pain psychoeducation) to improve pain treatment for the PWDs under their care.
Pain Interference and Conscientiousness in Older Adults
Authors: Judge Stephanie , Meyr Kaitlyn , Segerstrom Suzanne
Published: December 2021

Pain interference increases with age and occurs when pain interrupts daily activities. Individuals vary in their amount of interference at a given level of pain. Conscientiousness is a personality trait characterized by diligence, perseverance, and goal-directedness, and is associated with fewer unhealthy behaviors and better health, including less pain and fewer functional limitations. This study tested three hypotheses on the relationships between pain, Conscientiousness, and pain interference among community-dwelling older adults (N=210) in a longitudinal study. At semi-annual interviews, participants reported their pain and interference. Conscientiousness was measured at baseline and follow-up. Multilevel models tested the between- and within-person relationships among study variables. Greater pain predicted more interference (person: γ01=.541, SE=.042, p<.0001; visit: γ10 =.495, SE=.014, p<.0001) but higher Conscientiousness decreased interference (γ02=-.156, SE=.064, p<.025). There was an interaction between Conscientiousness and pain: At higher levels of pain, older adults higher in Conscientiousness experienced much less interference than their less conscientious peers (γ11=-.199, SE=.089, p<.025). Older age at baseline predicted a greater decrease in Conscientiousness over the study period (b=-0.013, t(91)=-2.07, p<.05). Conscientiousness reduces the negative impact of pain on daily function. This protective effect may reflect perseverance and commitment to valued activities, consistency with proactive health behaviors, or other attitudes and behaviors that reduce the likelihood of psychosocial sequelae of pain. Overall, the sample decreased in Conscientiousness over time; however, the direction and amount of change varied considerably. These results refine existing knowledge of personality in old age and implicate personality factors as a potential target for pain management.
Pathological Traits and Interpersonal Difficulties in Depressed Older Adults: Clinical versus Community Sampling
Authors: Lederer George , Freedman David , Atlas Lauren , Kafker Shira , Yenko Ira , Mak Angel , Francois Dimitry , Zweig Richard
Published: December 2021

Personality pathology, represented by high neuroticism and low agreeableness in the Five Factor Model of Personality, has been identified as a predictor of depression in mixed-age samples and preliminary studies of older adults. Research on older people, however, has not examined the differential impact of pathological personality traits and processes on depression or examined them across treatment settings. This secondary analysis examined personality traits and processes as predictors of depression, evaluated the moderating effect of interpersonal problems, and assessed stratification of these personality variables across community and clinical settings. Older adults (N=395) ranging in age from 55 to 99 (M = 72.06; SD = 10.10) from inpatient psychiatric, outpatient medical, and community settings completed self-report measures of personality traits (NEO-FFI Agreeableness and Neuroticism), processes (Inventory of Interpersonal Problems), and depression (GDS-30). Higher neuroticism predicted worsened depressive symptoms (β = .765, p < .001), as did lower agreeableness (β = -.163, p = .002) and more interpersonal problems (β = .459, p < .001). Findings partially supported the stratification of personality traits and processes by setting. Interpersonal problems moderated neither the neuroticism-depression or agreeableness-depression relationships. Personality traits and processes predict depression in older adults across care settings but do not significantly interact. Levels of pathological traits and processes vary across community and clinical settings.
The Interpersonal Circumplex and the Alternative Model of Personality Disorders: Relationships among Older Adults
Authors: Stone Lisa , Segal Daniel
Published: December 2021

Introduction: The interpersonal circumplex model measures interpersonal dysfunction along two axes (communion and agency), resulting in eight unhealthy patterns: Domineering, Vindictive, Cold, Socially Avoidant, Nonassertive, Exploitable, Overly Nurturant, and Intrusive. It is unclear how the circumplex model applies to older adults and their unique biopsychosocial contexts. This study examined relationships between the circumplex and personality disorder features, using the Alternative Model of Personality Disorder’s (AMPD) personality functioning and pathological personality trait constructs. Method: Older adults (N = 202) completed the Inventory of Interpersonal Problems-Short Circumplex (IIP-SC), the Levels of Personality Functioning Scale-Self-Report (LPFS-SR), and the Personality Inventory for DSM-5 (PID-5) to measure pathological personality traits. Results: Correlations were computed between the IIP-SC’s eight circumplex scales with the LPFS-SR’s four personality functioning domains and with the PID-5’s five domains. All circumplex scales significantly (p < .001) and positively correlated with all LPFS-SR and PID-5 domains, with large effect sizes (> .45). Next, regressions were conducted, with the LPFS-SR and PID-5 domains predicting each IIP-SC scale. Across the eight regressions, the AMPD constructs accounted for significant variance in the IIP-SC scales, ranging from 38% (Nonassertive) to 64% (Domineering and Cold). Discussion: Significant overlap between the interpersonal circumplex and the AMPD was demonstrated, but patterns are distinct from previous research among younger adults. The circumplex was limited in its relation to the AMPD’s personality functioning, but the pathological personality trait model was well represented through the circumplex. Results indicate that the circumplex may have some validity among older adults and warrants further investigation.
Actigraphy Measured Physical Activity on Cognitive Functioning in Older Adults
Authors: Thangwaritorn Pilar , Watts Amber
Published: December 2021

Physical activity may preserve cognitive functioning in older adults. This study examined associations between objectively measured physical activity and cognitive functioning. We recruited participants (Mage = 75.38 years, SD = 5.99) with (N=26) and without (N=181) cognitive impairment from the University of Kansas Alzheimer’s Disease Center (KU-ADC). We collected cognitive data representing verbal memory, attention, and executive function. Accelerometers (Actigraph GT9X) were used to measure physical activity 24 hours a day for 7 days in a free-living environment. Physical activity was categorized as moderate to vigorous physical activity (MVPA) based on the Freedson (2011) Adult Vector Magnitude cut points. The association between cognitive functioning and total MVPA was evaluated by using multiple regression. We used factor analysis to create three composite scores (verbal memory, attention, executive function) from 11 individual cognitive tests. Compared to verbal memory and attention, results indicate that total MVPA was more strongly associated with executive function (β = 0.001, p = .024). These findings are consistent with the literature suggesting that executive function in older adults may benefit from physical activity. Future research should investigate the physiological mechanisms by which MVPA benefits executive function in contrast to types of activity that might benefit verbal memory and attention.