bluuebunny/crossref_metadata_2025 huggingface dataset:
Family and Aging in Cross-National Contexts
Authors: Ailshire Jennifer , Ailshire Jennifer
Published: December 2021

The global aging of the population, combined with shifts in the structure and composition of families, has led to increased attention to the role of family and social relationships in the aging experience. The importance of family in determining healthy aging, however, may largely depend on the social, political, and economic context in which individuals are embedded. Cross-national investigations offer a unique opportunity to understand how family relationships and family caregiving influence health and well-being among older adults by comparing family dynamics across different sociocultural contexts. The HRS-family of surveys, which have been harmonized within the Gateway to Global Aging, provides remarkable opportunities for cross-national comparative analysis. The papers in this session use harmonized data from the Gateway to compare the influence of family on health across different social dimensions in multiple countries from around the world, including examinations of: 1) the impact of grandparenting on health of older adults in Europe and China; 2) psychological well-being among European older adults whose partners receive formal care; 3) the influence of parent-child relationships on health and well-being of older adults in China and the U.S.; and 4) how loneliness among older adults is patterned according to their living arrangements and relationship quality. The discussion will highlight the promises and challenges of cross-national research on families and aging and how harmonized aging data facilitates international comparisons.
Partner Care Arrangements and Older Europeans' Well-Being: Variations by Gender and Context
Authors: Floridi Ginevra , Quashie Nekehia , Glaser Karen , Brandt Martina
Published: December 2021

Across Europe, partners are often primary caregivers to older adults with care needs. Yet, a variety of partner care arrangements may arise. Little is known about the interrelations between partners’ care arrangements, (potential) caregivers’ gender, and the context in which care is embedded. We use 2015 SHARE data from 17 countries on 3,465 couples aged 50+ where one partner receives care. We examine how life satisfaction and depressive symptoms of (potential) caregivers vary across five care arrangements: solo-care; shared formal; shared informal; outsourced formal; and outsourced informal. We explore heterogeneity by gender and across four contexts: Northern, Western, Southern, and Eastern Europe. Outsourcing partners’ care to formal or informal providers is linked with higher well-being among Northern and Western European women, but with lower well-being among women in Southern Europe, where traditional female caregiving responsibilities are stronger. Among men, outsourcing partner care is linked to higher well-being regardless of context.
Child-Parent Relation and Older Adults' Health: A Cross-Cultural Comparison Between China and the United States
Authors: Lu Peiyi , Kong Dexia , Shelley Mack
Published: December 2021

Western culture emphasizes independence in the child-parent relationship while Chinese culture values interdependence between adult children and older parents. This study compared the association of child-parent relationships with older adults’ multidimensional health over time in the U.S. and China. Two waves of data (2012-2015) from HRS and CHARLS were used (n=6,641, aged ≥65). Linear regression models were estimated. Results showed that, compared to Chinese older adults, fewer older Americans co-resided with or lived nearby their children, had less weekly contact, and fewer financial transfers from/to their children. Most child-parent relationship variables were nonsignificant predictors of older Americans’ health. However, a closer child-parent relationship was linked to fewer depressive symptoms and better cognition among older Chinese. Co-residence was associated with poorer health among Chinese parents. The associations of child-parent relationships with older adults’ health exhibited cross-cultural differences. A cultural perspective is recommended in understanding how family relations affect older adults’ health.
Mutual Recognition: Empathy as the Foundation of Community in Dementia
Authors: Costello Peter
Published: December 2021

This paper explores the challenges of developing a healthy, genuine community as some of its members experience cognitive decline or dementia. I draw upon philosophical discussions on community (Stein, 2000) and Husserlian empathy (1931;1939) to identify these challenges. First, community is organic; it relies on the differentiated roles of individual members to remain healthy. The ability to recognize the contribution of each member is essential for its health. Second, dyadic relationships may similarly be healthy or waning depending on the presence or absence of mutual empathy. Empathy is embodied. Persons living with dementia (PLWD) need to experience being recognized as persons, in person, in order for dyadic relationships and communities to thrive. As such, some communities may become unhealthy in the absence of mutual recognition. In these instances, careful interventions, e.g., through shared experiences and embedded memories, may be required to promote the well-being of the community and its members.
Self-Management of Diabetes in Black Men: The Flint MANUP Intervention Study
Authors: Carthron Dana , McCullough Wayne , Chatterjee Samir , Key Kent , Lemke Kelsey , Gordon David , Piatt Gretchen , Neighbors Harold
Published: December 2021

The story of John Henry, the “steel-drivin’ man”, is well known to Black men in the United States. John Henry is considered a hero because he demonstrated tremendous strength and self-determination. The MANUP diabetes program used the John Henryism, defined as high-effort active coping in the face of adversity, as the basis of a diabetes intervention for Black men. MANUP conducted four community-based focus groups identifying topics of concern to Black men with type 2 diabetes (T2D). Interestingly, the men reported that high-effort active coping was crucial for successful diabetes self-management. MANUP then developed and implemented a longitudinal culturally targeted self-management program for 33 Black men with T2D in Flint, Michigan. MANUP included discussion groups, physical activity, and an app incorporating text-messaging, group-chat, and a blood glucose monitoring dashboard to improve glycemic control (A1c). This single-group, repeated measures intervention assessed A1c three times over a six-month period. Improvements in A1c were observed at: baseline – time 2: 8.9% vs 8.6%, p=0.14; time 2 – time 3: 8.6% vs 8.1%, p=0.21; and baseline – time 3: 8.9% vs 8.1%, p=0.005. After controlling for age and insulin use, the significant reduction in A1c over 6 months remained (p=0.01). These findings demonstrate that combining mobile health technology and moderate physical activity with culturally targeted discussion topics can improve T2D self-management and reduce A1c in Black men. More community-driven longitudinal intervention studies that improve diabetes self-management among Black men are needed to achieve gender and racial health equity..
Motor Behavior Changes Are Predictive of Acute Events in Skilled Nursing
Authors: Bowen Mary (Libbey) , Rowe Meredeth , Cacchione Pamela , Ji Ming
Published: December 2021

Background: Common acute medical conditions among older adults with dementia in skilled nursing include falls, delirium, and pneumonia. This study utilized a sensor technology to examine how motor behaviors may predict these acute events. Methods: Radio frequency identification (RFID) technology continuously measured time and distance travelled, gait speed, and continuous walking with little/no breaks (paths) across 3 long-term facilities for up to 1 year (N=51). Change point analysis estimates the probability of whether a sudden change occurred and provides the location of the change point (in days prior to the event) in a time series model. Results: Gait speed had very low probability to detect a change point across all events (22 falls, 10 delirium and 8 pneumonia). Sensitivity estimates ranged from 63% (number of paths) to 90% (distance travelled) for a fall; 37.5% (number of paths) to 100% (rest of the motor behaviors) for pneumonia. Except for gait speed, all other motor behaviors had high probability (100%) to detect a delirium change point. There was intra-individual variability in the location of the change points (mean of 10 days). Linear regression models for time and distance travelled using baseline predictors of age, ethnicity, gait and balance explained 89% and 90% of the variance in change point locations. Conclusions: Prior to an acute event there is a significant change in motor behavior, suggesting these are an early signal that may be used to prevent a fall or provide for the earlier recognition and treatment of delirium and pneumonia.
Generational Views of Life Challenges and the Aging Process: Influence of Relationship Type, Frequency, Experience
Authors: Pagan Mary
Published: December 2021

This study, conducted within a higher education setting, examines and compares views of younger adults (age 20-24) and older adults (age 65-97) in two major areas; life challenges and aging processes. Are they complimentary, neutral, or opposing? We investigate views and the potential association to relationship type (family relation, close contact, casual), frequency (times interacting per month) including mode of communication (face-to-face, phone, visual technology), and narrative of overall experience. A mixed-method approach incorporated convenience survey data and extensive in-depth interviews. Data collection instruments were designed and conducted by students in an upper-division wellness and aging course at SUNY Oswego. Students partnered with older adult study participants. Participant (n=80) inquiries centered on life challenges (COVID, adversity, loss, discrimination/bias, regrets) and aging processes (views on aging, life expectancy, changes in health). The study also examines the impact of the 3-credit course on aging views; specifically did they change their life expectancy choice (years) from the week one by the end of the course.
The Photography and Memory Project: Adapting an Intergenerational Program During a Global Pandemic
Authors: De Fries Carson , MacInnes Roddy , Walker Anne , DelPo Amy , Hasche Leslie , Steward Andrew , Schilz Matthew
Published: December 2021

Since 2019, a university-community partnership has connected undergraduate students with older adults from independent living and community-based settings (i.e., library, art museum) for a photography-based intergenerational program. This study compares the implementation and impacts of this photography-based intergenerational program both in an in-person format before the COVID-19 pandemic (n=34) and an online format during the COVID-19 pandemic (n=25). Pre- and post- results from older adult and undergraduate student participants regarding social connection and evaluation comments from program participants and staff were compared between the pre-pandemic, in-person format, and the same program’s offering the next year in a virtual format. Results indicate that the benefits of this intergenerational photography program were experienced at a similar level during and before COVID-19. Findings demonstrate that intergenerational programs could effectively continue in remote formats, while also identifying potential challenges in implementation for staff regarding managing logistics and maintaining engagement among participants.
Intervention Design With Cognitively Impaired Populations: The Optimize Deprescribing Intervention
Authors: Sheehan Orla , Bayliss Elizabeth , Green Ariel , Drace Melanie , Norton Jonathan , Reeve Emily , Gleason Kathy , Boyd Cynthia
Published: December 2021

Older adults with cognitive impairment and multiple other chronic conditions often have polypharmacy which increases their risks of medication related cognitive effects, adverse drug events, hospitalization and death and leads to higher health care costs. Deprescribing, the process of reducing or stopping potentially inappropriate medications may improve outcomes for those older adults with cognitive impairment and multiple chronic conditions. The OPTIMIZE trial examined whether a primary care-based, patient- and family-centered intervention educating and activating patients, family members, and clinicians about deprescribing reduces numbers of chronic medications and potentially inappropriate medications for older adults with dementia or mild cognitive impairment and multiple chronic conditions. We explored the mechanisms of intervention effectiveness through post hoc qualitative stakeholder interviews and surveys with 15 patients, 7 family caregivers, and 28 clinicians. All stakeholder groups endorsed the acceptability of the intervention. Success of the intervention was affected by contextual factors including prior knowledge and openness to deprescribing, cognition and prognosis. Positive outcomes included patients and care partners scheduling specific appointments to discuss deprescribing and providers remembering to consider deprescribing in cognitively impaired older adults. Recollection of intervention materials was inconsistent over time but highest shortly after intervention delivery. The time required to mail intervention materials to patients prior to a scheduled appointment limited the reach of the intervention by excluding persons with rapidly scheduled appointments. Our work identifies key learnings in intervention roll out which can guide future translation of our intervention to other settings and other pragmatic intervention studies in this vulnerable population.
Preliminary Efficacy of an mHealth Mindfulness Intervention With Caregivers of Older Adults With MCI or Dementia
Authors: Kozlov Elissa , Llaneza Danielle , Dong XinQi , Duberstein Paul
Published: December 2021

Decades of research have documented the negative effects of caregiving on unpaid caregivers. Caregivers are more likely to suffer from high levels of stress and anxiety, and caregivers of older adults with dementia are at especially high risk. Mindfulness Therapy (MT) is a promising, non-pharmacological technique with proven efficacy and effectiveness in managing stress and anxiety in diverse populations. Mindfulness Coach is an m-health delivered mindfulness therapy intervention developed by the Veterans Affairs National Center for PTSD. The objective of this paper is to report the preliminary efficacy of an 8-week pilot trial of mHealth-delivered mindfulness therapy to alleviate anxiety and caregiver stress in caregivers of persons with dementia. Sixty caregivers of patients with mild cognitive impairment or dementia were recruited to participate in this single group pre-post design study. After receiving an orientation to using the app, participants were instructed to use the app daily to learn about and practice mindfulness skills. At the end of the 8 weeks, there was a significant reduction between baseline anxiety on the Hospital Anxiety and Depression Scale Anxiety subscale (mean = 14.45, SD = 3.36) 15.42, SD = 3.12) and 8 weeks (mean = (t(55)=2.6, p=.012) and perceived stress measured by the perceived stress scale at baseline (mean = 23.59, SD = 3.99) and 8 weeks (mean = 21.12, SD = 3.09), (t(56)=5.94, p<.001). This study offers preliminary evidence that mHealth Mindfulness Therapy strategies may help caregivers manage the stress and anxiety associated with caregiving.
Margret M. and Paul B. Baltes Award Lecture: Optimism and Health: Resource or Delusion?
Authors: Crimmins Eileen
Published: December 2021

The lecture will be given by the 2020 Baltes Award recipient, William Chopik, PhD, of Michigan State University. The recipient of the 2021 Baltes Award is Laura B. Zahodne, PhD, of the University of Michigan. The Margret M. and Paul B. Baltes Foundation Award in Behavioral and Social Gerontology recognizes outstanding early-career contributions in behavioral and social gerontology. The award is generously funded by the Margret M. and Paul B. Baltes Foundation.
Validation Study of the Spanish Version of the Marital Satisfaction Questionnaire for Older Persons
Authors: Fernandes-Pires José Adrián , Losada-Baltar Andrés , Pedroso-Chaparro María del Sequeros , Gallego-Alberto Laura , Cabrera Isabel , Jiménez-Gonzalo Lucía , Márquez-González María , Guardia Jorge González
Published: December 2021

Interpersonal relationship quality is relevant for older adults′ well-being and mental health. Studies focused on methods to evaluate marital satisfaction in older adults and the relationship of this variable with psychological correlates are scarce. This study examined the psychometric properties of the Spanish version (Castro-Díaz et al., 2012) of the Marital Satisfaction Questionnaire For Older Persons (MSQFOP; Haynes et al., 1992) in a sample of middle-aged and older adults from Spain. Participants were 130 individuals (60.8% women) 40 years or older (M= 60.31, SD=11) involved in a marital/partner relationship. The assessed variables were marital satisfaction (MSQFOP), marital warmth, positive emotions, frequency of arguments, perceived stress associated with the COVID-19 pandemic, and anxiety and depressive symptoms. The results from the exploratory factor analysis yielded a three factor structure (compatibility, communication, and sex) explaining 77.8% of the variance. Even though the factor structure was the same as that of the original version, some items loaded on other factors. The internal consistency (Cronbach’s alpha) was 0.97. The results revealed significant (p < .001) positive associations between marital satisfaction, marital warmth, and positive emotions. In addition, significant negative associations were found between marital satisfaction and frequency of arguments, stress associated with the COVID-19 pandemic, and anxious and depressive symptomatology (p < .05). The findings suggest that Spanish version MSQFOP has good psychometric properties that recommend its use with middle-aged and older adults. Marital satisfaction seems to be a relevant construct for understanding stress, well-being, and mental health in middle-aged and older adults.
Mental Health Consequences of SARS-CoV-2 Pandemic on Long-Term Care Facility Social Care Provider in Poland
Authors: Szcześniak Dorota , Senczyszyn Adrianna , Maćkowiak Maria , Ciułkowicz Marta , Lion Katarzyna , Rymaszewska Joanna
Published: December 2021

During the pandemic long-term care facilities (LTCF) social health providers constantly remain in a dilemma between loyalty to people with dementia and concerns for their own families. All of these factors could contribute to the mental burden, burnout, and increased chance of depression, anxiety and post-traumatic symptoms. In our study we aimed to provide a window on psychopathological consequences (somatic symptoms, anxiety and insomnia, social dysfunction, and depression) associated with the exposure of LTCF employees to the risk of the SARS-CoV-2 contagion in Poland. Moreover, we investigated if institutional factors, such as personal protection equipment availability, safety guidelines or access to psychiatric and psychological support at the workplace, contribute to the decrease of psychological distress of the LTCF personnel. The results can serve as ready-made guidelines for mitigating the SARS-CoV-2 impact on dementia care and constitute the basis for further analysis of long-term consequences of this precedential situation.
International Evidence on the COVID-19 Deaths of People Who Live in Long-Term Care Facilities
Authors: Zalakain Joseba , Lemmon Elizabeth , Henderson David , Hsu Amy , Scmidt Andrea , Arling Greg , Kruse Florien , Comas-Herrera Adelina
Published: December 2021

The COVID-19 pandemic has had a disproportionate impact, in terms of mortality, on people who live in Long-Term Care Facilities (LTCFs). This study involved compiling data on number of deaths of people who live in LTCFs and analyzing the extent to which differences between countries could be attributed to measures taken to control the spread of COVID-19 to LTCFs or to other factors. The study found that differences in how the data is collected make international comparisons difficult but that there is a clear correlation between number of COVID-19 deaths of residents in LTCFs and number of COVID-19 deaths of people living in the community. The study also found that countries that experienced a particularly high number of deaths in LTCFs during the first COVID-19 wave tended to have lower relative mortality in LTCFs in the subsequent waves, which potentially could be attributed to learning from the initial shock.
Predictors of Mental Health During the COVID Pandemic
Authors: Lach Helen , Stallings Devita , Lorenz Rebecca , Taylor John , Palmer Janice
Published: December 2021

Health professionals have been concerned about mental health of older adults during the COVID pandemic. To explore their experiences, we conducted an online survey of community-dwelling older people to examine their mental health related to stress, based on Pearlin’s Stress Process Model. A snowball approach was used; we sent recruitment e-mails through senior organizations and contacts with e-mail lists of potential participants; there were 504 respondents. We used regression analysis to explore predictors of mental health based on Pearlin’s model. Background characteristics included age (m = 75.7, SD 4.95), gender (77.4% female) and race (White = 93.4%). The CESD-10 provided a measure of mental health. Scores indicated 62.3% of the sample scored in the low range for depressive symptoms and 37.7% in the moderate to high range. Stressors were measured using the Perceived Stress Scale that includes subscales of perceived helplessness and perceived self-efficacy. We also measured perceived social Isolation, and current life space as predictor variables. Results of regressing the CESD-10 onto the set of theoretical predictors revealed that the inclusion both subscales of the Perceived Stress Scale, social isolation, and current life space jointly accounted for approximately 63.0% of the variability in the outcome beyond the baseline model (FChange[4, 449] = 211.15, p < .01), which included age, race, and gender. The model overall, accounted for approximately 66.5% (R2adjusted = 66.0%) of the variability in CESD-10 scores, (F[7, 449] = 127.473, p < .01). Addressing stress among older adults is important to help them maintain positive mental health.
If You Build It, Will They Come?: Getting the Word out About Gerontology Accreditation
Authors: Guest M Aaron , Randall Phillip
Published: December 2021

The development of AGEC introduced a new facet to gerontological education: accreditation. The presence of such a new organization requires continuing marketing and education. Throughout its first three years, AGEC has continually worked to provide information and to differentiate between accreditation and credentialing for the broader community. Through informal and formal feedback processes, including focus groups and interviews, AGEC has refined its message and delivery. While schools and departments of Gerontology remain the decision-makers behind seeking accreditation, students have become one of the largest drivers and constituencies AGEC engages as they seek clarification on and the availability of accredited programs of Gerontology. Prospective students, many coming from the health sciences, see the value of accreditation. Furthermore, emerging and international programs see accreditation as an opportunity to engage the field. There is an opportunity to further refine the messages around accreditation and differentiate among the organizations active in gerontological education.
Trends in Informal and Formal Long-Term Care Use Among Older Adults With Disabilities in Japan
Authors: Sugisawa Hidehiro , Sugihara Yoko , Kobayashi Erika , Fukaya Taro , Liang Jersey
Published: December 2021

Whether increased formal long-term care (LTC) reduces informal LTC use by serving as a substitute or has a complementary role that boosts both informal and formal LTC use has been an important issue for evaluating LTC policy effectiveness. We described trends in in-home LTC use among older adults and LTC availability in relation to changes in LTC policy in Japan. In addition, we examined whether these trends differ by living arrangements, gender, income, and disability levels. We used five waves of repeated cross-sectional data starting in 1999 to 2017. The use of both informal and formal LTC types combined increased until 2006 and then gradually decreased while remaining higher than in 1999. Although implementing the LTC program may have temporarily contributed to the complementary use of both LTC types, eligibility limitations brought about by LTC reform potentially reduced the effects of formal LTC’s complementary role.
Race Differences in Allostatic Load Among Black and White Men: Does Age Matter?
Authors: Archibald Paul , Hill Sarah , Zare Hossein , Bruce Marino , Norris Keith , Whitfield Keith , Thorpe Roland
Published: December 2021

Although Black-White disparities in health and mortality among men persist, there has been a paucity of work focusing on race differences in physiological dysregulation of biological processes resulting from the cumulative impact of stressors among men. The purpose of this study was to assess potential race differences in Allostatic Load (AL) among adult men and if such differences varied by age. Data were drawn from the 1999-2016 NHANES and the study population included 21,529 non-Hispanic Black (NHB) and 34,282 Non-Hispanic White (NHW) born in US. Adjusting for potential confounders, NHB men 25-44 and 45-64 had a higher AL score (OR = 1.19, 95% confidence interval (CI) 1.00, 1.42) and (OR = 1.14, 95% confidence interval (CI) 1.02, 1.28) NHW men. No race differences with respect to AL score were observed among the other age groups. The results suggest that age plays a role in race differences in AL
Social Determinates of Health Among Older Adults Living With HIV/AIDS
Authors: Robinson Erin , Taylor Tonya , Emlet Charles
Published: December 2021

In the United States (U.S.), people aged 55 years and older make up 36% of people living with HIV/AIDS (PLWHA). Nearly 20% of new HIV infections occur among people aged 50+. While medical breakthroughs in HIV treatment have allowed PLWHA to live longer, healthier lives, structural conditions still exist that affect health outcomes of older adults living with HIV/AIDS (OALWHA). These conditions continue to disproportionately burden OALWHA, particularly older adults of color. Therefore, a greater understanding of the social determinates of health (SDH) is essential to continue making progress in HIV treatment, maintenance, and prevention. The U.S. Centers for Disease Control and Prevention (CDC) has highlighted several SDH among OALWHA, including: poverty, education, income, employment status, health insurance coverage, and housing. This symposium will highlight emerging research that examines several of these indicators among OALWHA. Using a variety of research methodologies, the five abstracts included in this symposium aim to address: 1) psychosocial risk factors of quality of life; 2) life instability and mental health; 3) institutional barriers and facilitators of successful aging; 4) determinants of engaging in advance care planning; and 5) a needs assessment of OALWHA, with particular emphasis on SDH. Results from this research identify several priority areas (such as housing instability, mental health, food insecurity, and isolation) for healthcare leaders to consider in targeting future policy, programming, and funding. Future initiatives are essential to help continue the progress in HIV/AIDS treatment and prevention, including addressing SDH among the aging population living with HIV/AIDS.
Delivering a Tai Chi Intervention to Adults Aging with Mobility Disabilities Using Zoom
Authors: Mitzner Tracy , Remillard Elena , Cohen Kara , Cochran Lelah
Published: December 2021

Many individuals aging with mobility disabilities experience barriers to participating in physical activity, including transportation challenges and the need for specialized instruction. Since the COVID-19 pandemic began, these participation barriers have been amplified due to lockdowns and restrictions. Tele-technologies, including videoconferencing platforms like Zoom, can facilitate access to exercise classes from one’s home. Virtual group exercise classes that incorporate social interaction have particular potential to support the physical and mental health of this population. This session will highlight lessons learned from launching the ‘Tele Tai Chi’ study, in which we are delivering an evidence-based Tai Chi program (Tai Chi for Arthritis) via Zoom to small group classes of older adults with long-term mobility disabilities. We will describe adaptations made in translating the in-person program to an interactive, online class, and provide an overview of a ‘Telewellness’ Tool that provides guidelines for using Zoom to deliver exercise classes to older adults.
Defining Poverty as an Eligibility Requirement for Supportive Services
Authors: Glicksman Allen , Ring Lauren
Published: December 2021

Deciding which individuals qualify as “poor” often depends on how each country or municipality defines the term ‘poverty’. In the United States, program eligibility is often tied to the Federal Poverty Level (FPL), using 100% of the FPL as a cut-off for receipt of services. However, research has shown that incomes of 200% of the FPL and higher are often needed to establish even minimum levels of economic security. Using data from an omnibus health study conducted in 2018 that included 1,581 persons ages 60+ who were asked about their health and service needs, we compared persons making 100% of the FPL or less to persons making 101%-199% and 200%+, respectively. Results show that poor health status and need for services among persons in the 101%-199% are similar to those with incomes less than 100% FPL, and significantly higher than persons with incomes at 200%+ of the FPL.
Anti-Ageism Interventions: An Ecological Approach
Authors: Gendron Tracey , Van Aartjik Alexa , Carpenter Kyrie , Backer Ryan , Applewhite Ashton
Published: December 2021

Ageism, discrimination based on age, is a systemic problem that occurs at multiple levels of the ecological system – meaning that ageism manifests at the individual, dyadic, institutional and societal levels. The expression of ageism within the levels of the ecological system makes ageism a continually shifting and dynamic force of oppression. Although ageism is a well-documented phenomenon with wide-reaching negative impacts, interventions to mitigate ageism’s effects remain understudied. Little is known about the taxonomy of interventions available addressing ageism at the individual, dyadic, subcultural, institutional and societal levels. The current study conducted a deductive content analysis of an anti-ageism resource clearinghouse, OldSchool.info, to evaluate ageism interventions using an ecological framework. Results indicate the majority of ageism interventions are passive-oriented societal-level macrosystem approaches. A gap analysis will be discussed that indicated more active-oriented interventions with engageable content to address ageism at the personal and relational levels are needed.
A New Type of COP: The Role of Circulating Osteoprogenitor (COP) Cells in Health and Disease
Authors: Duque Gustavo
Published: December 2021

Circulating osteogenic progenitor (COP) cells are a population of cells in the peripheral blood with the capacity for bone formation and broader differentiation into mesoderm-like cells in vitro. While some of their biological characteristics are documented in vitro, their role in the aging process and the pathogenesis of musculoskeletal diseases remains yet to be thoroughly evaluated. This translational session will go from bench to bedside, reviewing the current evidence on COP cells. In this session, we will provide an overview of the role of COP cells in the aging process and a number of physiological and pathological conditions and identify areas for future research. In addition, we will suggest possible areas for clinical utilization in the management of musculoskeletal diseases, which include novel diagnostic and therapeutic uses.
Alzheimer's Alphabet Soup: ADRD research in NHATS and NSOC
Authors: Anderson Loretta , Wennberg Alexandra , Lin Frank
Published: December 2021

There are 5.8 million Americans living with Alzheimer’s disease, but currently there is no cure or effective treatment. Alzheimer’s disease and related dementias (ADRD) are characterized by cognitive decline, but patients also have behavioral symptoms and functional decline. Understanding the gamut of risk and prognostic factors for ADRD and those associated with the task of caring for these patients is layered. The National Health and Aging Trends Study (NHATS) and the sister National Study of Caregiving (NSOC) are excellent resources to investigate layers of ADRD incidence, progression, and caregiving in the population. NHATS is a nationally representative sample of Medicare beneficiaries aged 65 and older. Since 2011, annual in-person interviews have collected data in many areas, including health, environment, wellbeing, cognition, and function. NSOC has been conducted at three timepoints corresponding with NHATS rounds and collects detailed data on caregivers, including information on care activities, caregiver burden, and caregiver wellbeing. This symposium illustrates the broad range of ADRD research questions that can be probed using NHATS/NSOC data. The session begins with a presentation the association between caregiver burden and ADRD patient cognitive outcomes. The second presentation examines the role of physical performance as a predictor of developing ADRD. The third presentation investigates the role of dual sensory impairment – both hearing and vision impairment – on dementia incidence. The session concludes with an examination of whether hearing impairment among dementia patients is associated with different caregiving needs.
Association of Hearing Impairment With Higher Level Physical Functioning and Walking Endurance
Authors: Amezcua Pablo Martinez , Kuo Pei-Lun , Reed Nicholas , Simonsick Eleanor , Agrawal Yuri , Lin Frank , Deal Jennifer , Schrack Jennifer
Published: December 2021

The longitudinal associations between hearing impairment and higher-level functional measures and the potential confounding role of vestibular function have not been assessed. We investigated these associations in 831 participants of the Baltimore Longitudinal Study of Aging (2012–2019). Hearing was measured using pure-tone audiometry and categorized using WHO standards. Physical function was assessed with the Health Aging and Body Composition Physical Performance Battery (HABCPPB, higher=better) and walking endurance with time to walk 400 meters. Multivariable regression models tested the hypotheses that participants with hearing impairment have poorer physical outomes. In a subset, we further adjusted for vestibular function. Hearing impairment was associated with decrements in higher-level physical performance and walking endurance, and faster decline over time, regardless of vestibular function. Among participants with any hearing impairment, hearing aid users were faster in the 400-m walk. Early screening for higher-level functional loss among older adults with hearing loss is warranted.
Weather, Built Environment, or Personal Factors: Predictors of Walking by Independent Living Residents With Frailty
Authors: Danilovich Margaret , Espinoza Aura , Norrick Christie
Published: December 2021

Environmental factors influence older adult physical activity. However, the evidence about which factors lead to increased physical activity is mixed and few have studied how these factors affect those with frailty or living in retirement communities. This study investigated how environmental and weather factors influence physical activity among pre-frail and frail older adults residing in independent living retirement communities. We used ActivPal accelerometers to measure 7-day step counts among (n=108) pre-frail and frail residents in 9 independent living residences in metropolitan Chicago. We conducted environmental audits using the MAPS Abbreviated tool and collected National Weather Service Station data (temperature, precipitation, and daylight minutes) during the ActivPal periods. Participants were on average 80.0 years, 74% female, and average daily step count was 3,450 (range 151 - 11,663). Four buildings were in suburban areas and 5 in urban areas and four were private-pay residences while 5 offered subsidized rent. ANOVA results showed private-pay buildings had higher total MAPS scores than subsidized buildings (p=0.001), and urban buildings had higher total MAPS scores than suburban buildings (p < 0.000). Mean step differences were non-significant between different building types: (mean steps = 3,317 private-pay, 3,629 subsidized, 3,536 urban, 3,350 suburban). Pearson product-moment correlations showed a positive association between steps and MAPS positive streetscape features (p=0.011). Multiple regression analysis showed higher temperature days, precipitation, and more minutes of daylight were associated with higher step counts (p=.04). Given the dramatic variation in individual step counts, future research should investigate personal factors that contribute to activity among independent living residents.
The Behavioral Recovery Outreach (BRO) Team: A Transitional Care Model for Veterans With Complex Care Needs
Authors: Matthews Kathleen , Bauste Grant , Luitjens Emily
Published: December 2021

In 2012, VA Central Iowa developed a novel program known as the Behavioral Recovery Outreach (BRO) Team to address unmet needs of our aging Veteran population with complex medical, psychological, neurocognitive and behavioral concerns. BRO Teams provide evidence-informed treatments in inpatient VA settings, and transitional care/support post-discharge to ensure successful placement and stability in the community. We will discuss how implementation science informed the expansion of this model from a local pilot to a nationally disseminated program. We will explore the challenges of ensuring program fidelity while fostering innovation and adaptation. Given the challenges of national dissemination, we will highlight the predicted and unforeseen aspects of program evaluation and policy implications. Finally, we will discuss the impacts of the COVID-19 pandemic on delivery of care methods and community-based interactions, as well as how this program has improved the lives and quality of care for this high-risk Veteran population.
Perceived Discrimination, Social Environment, and Older Adults’ Psychological Well-Being
Authors: Park Min-Kyoung , Mair Christine
Published: December 2021

Experiencing discrimination can have detrimental effects on psychological well-being. For older adults in the U.S., discrimination on the basis of country of origin may be a particularly alienating experience. A positive social environment, however, has been shown to buffer associations between discrimination and poorer psychological well-being. However, this hypothesis has not been tested in a sample of older Americans who perceive discrimination because of country of origin. As the United States continues to diversify and politically polarize, understanding older adults’ experiences with discrimination and identifying potential buffers to these negative effects is increasingly important. We analyze 942 older Americans (aged 50+) from the Psychosocial Module of the most recent wave of the Health and Retirement Study (HRS, 2020). Specifically, we analyze associations between perceived discrimination on the basis of country of origin and three psychological well-being outcomes: loneliness, anxiety, and life satisfaction. We further test if the social environment buffers negative effects by examining interactions between discrimination and social support as well as discrimination and neighborhood environment. Our results reveal clear and consistent associations between older adults’ perceived discrimination and increased loneliness and decreased life satisfaction. These negative associations, however, appear to be buffered by social support and positive neighborhood environment, respectively. The potential buffering effect of positive social environments on psychological well-being is particularly pronounced for older adults under the age of 65. We discuss these findings in light of the prevalence of discrimination in the U.S. and consider potential mechanisms for improving the social environment of older adults.
Characterizing Episodes of Lucidity in Dementia: Observational and Applied Computational Linguistics Approaches
Authors: Bykovskyi Andrea Gilmore , Mueller Kim , Werner Nicole , Smith Erica , Block Laura , Benson Clark
Published: December 2021

Though episodes of lucidity (EL) in Alzheimer’s disease and related dementia (ADRD), reportedly more common near end of life, have significant implications for care, they are poorly understood due to underdeveloped methodological approaches for capturing and measuring these events. This prospective observational study addresses these gaps through audiovisual observation among persons with ADRD surrounding end of life to inform data-driven definitions for EL and distinguish EL from routine fluctuations in ADRD. Audiovisual observation is well-suited to addressing gaps in operationalization of EL, providing an objective data source to assess verbal and nonverbal communication, the primary means through which EL are evidenced. Our study is designed to establish optimal procedures for capturing audiovisual data of targeted populations and timeframes to maximize opportunities for detecting EL. Operationalization of EL will be informed by computational linguistic and behavioral-event coding of linguistic and non-linguistic communication features of EL and associated temporal qualities.
Neighborhood Environment, Intrinsic Capacity and 4-Year Late-Life Functional Ability Trajectories
Authors: Lu Shiyu , Liu Yuqi , Guo Yingqi , Ho Hung Chak , Chui Hiu Kwan , Webster Chris , Chiu Lai Har , Lum Terry Y S
Published: December 2021

Knowledge on how intrinsic capacity (IC) and neighbourhood physical environment shape functional ability (FA) trajectories in later life remains understudied. We investigated the 4-year trajectories of IC and their impact on FA trajectories, and the associations between neighbourhood physical environments and FA trajectories over time among older adults. We conducted a four-wave longitudinal study from 2014-2017 in Hong Kong with 2,081 adults aged 65 and above. FA was assessed by The Chinese Lawton Instrumental Activities of Daily Living. We used cognition, affect, locomotion, sensory capacity, and vitality to capture multi-domains of IC. Neighbourhood physical environment attributes included green space, land use diversity, and facilities availability, assessed within 200- and 500-meter buffers of respondents' homes. IC and FA each decreased significantly over time. Individuals with declines in IC experienced faster declines in FA over time. Green space, the number of leisure facilities and public transport slowed the decreasing FA rate.
Community Engagement and Human-Centered Design: Lessons From HEARS in Inclusive Recruitment of Older Adults
Authors: Nieman Carrie , Han Hae-Ra , Marrone Nicole , Suen Jonathan , Szanton Sarah , Trumbo Jami , Lin Frank
Published: December 2021

Within hearing care, significant disparities persist despite the highly prevalent nature of age-related hearing loss and relatively few trials include representation of racial/ethnic minorities. HEARS is an affordable, accessible hearing care intervention delivered by older adult peer mentors. The HEARS randomized controlled trial (NCT03442296) is a community-engaged RCT with an embedded human-centered design practitioner. Recruitment efforts occurred over 18 months in partnership with 13 affordable housing and social centers. The cohort (n=151) includes 43% (n=65) who self-identify as African American and 63.6% (n=96) with <$25,000 annual household income. The cohort represents the largest to-date of African American and low-income older adults with hearing loss. Recruitment efforts entailed 470.5 staff hours and $4,917.26 in supplies, equating to 1.4 hours and $14.13 per 1 individual screened and 3.1 hours and $32.56 for 1 participant randomized. Community-engaged research, partnered with human-centered design, may offer critical approaches to increasing representation within behavioral intervention trials.
Aging as Readiness and Wariness
Authors: Ekerdt David
Published: December 2021

Gerontology concerns itself with events in time, either things that have happened or things that may happen. In the former, our work is to describe and explain. In the latter, the occurrence of events is unknowable, but we can nonetheless study people’s imagination of them (how it arises) and how that imagination shapes behavior and attitudes in the present (how it matters). The subjective experience of aging, thus, is one of looking ever forward—welcoming, waiting for, or hoping to avoid what the future may hold. This personal experience of aging toggles between readiness and wariness of the time ahead, one stance incurring or else eclipsing the other. Transitions are fruitful opportunities to study people’s readiness and wariness toward the time ahead, for example, widowhood, the prospect of retirement, and residential relocation. This is when people are more likely to conjure, in their minds, whom they may become. Arguably, the fundamental transition that looms and occupies aging minds (and the minds of loved ones) is not death but rather the potential passage into the “fourth age” of frailty and vulnerability. This prospect hovers above all else: its occurrence increasingly likely but its timing uncertain. About this prospect, gerontology has the capacity, nay the obligation, to promote narratives about later life that shape wariness and readiness for the practical future (e.g., financial matters, bodily care, living arrangements) as well as for the emotional reception of an old age coming ever closer.
Adaptive Care and Remote Training: Models of Resilience for GWEPs During a Pandemic
Authors: Zubatsky Max
Published: December 2021

Service and training are interconnected for GWEP’s, whose dual missions are to advance training as well as service delivery to improve the care of older adults. The COVID-19 pandemic has necessitated a pivoting from in-person to remote delivery of program content and services. As a result, older adults and their families require the continuity of services with their providers due to the barriers that the pandemic has created. Additionally, universities and organizations have adapted virtually to teach learners how to work with older adults around different health initiatives. The pandemic required these programs to develop immediate services that provided an alternative to remote delivery services. This collection of GWEP programs utilized students and trainees in their older adult services and initiatives. The goal of this symposium is to demonstrate new models of educational and program delivery to enhance and extend training and service to new audiences. The symposium centers on best practices including technological tools to promote GWEP aims and will allow a discussion of challenges and outcomes faced. The session will be comprised of presentations from five university-based, Geriatric Workforce Enhancement Programs (approximately 12 minutes each), a 20 minute discussion and sharing of best practices, and a 10 minute question/answer session. Individual presentations will address areas that include: 1.) group interventions for dementia and caregivers, 2.) teaching interdisciplinary interns in conducting telehealth visits, 3.) adapting geriatrics regional conferences to reach older adults virtually, and 4.) Developing new programs and services for underserved and underrepresented older adult populations.