bluuebunny/crossref_metadata_2025 huggingface dataset:
Religion and Spirituality Measures in Dementia: An Integrative Review of the Literature
Authors: Britt Katherine , Acton Gayle , Kwak Jung
Published: December 2021

Literature documents positive effects of religion and spirituality on health including improved cognitive function, quality of life, and well-being. Extant research suggests that persons living with dementia (PWD) are more likely to have spiritual needs and rely on others to support their spiritual well-being than those without dementia. However, spiritual care is absent or minimally present in dementia care. To effectively address spiritual needs of PWDs, accurate screening and assessment is critical. We conducted an integrative review of the current literature on measures of religion and spiritualty for PWDs by searching five databases (ATLA Religion, CINAHL, PsychInfo, PubMed, and SocIndex) and identified 14 studies that were peer-reviewed original research articles focusing on assessment of religion/spirituality among PWDs and published between 2000-2020 in English. Most were conducted in Europe (n=7), included PWD in mild stage (n=68) from various settings, and were cross-sectional in design (n=8). Of a total of 17 measures identified, 6 were originally developed for the general population and then adapted for PWD, and only 3 were validated for PWD. A majority of the studies were limited in sample size, generalizability, methodological rigor, and measure validation. More research is needed using diverse samples and rigorous study designs to develop valid screening and assessment tools for this population. Improving religious and spiritual measures could greatly impact public health by improving quality of life for millions of individuals suffering from dementia and their caregivers who carry a heavy burden.
Racial/Ethnic Differences in Trajectories of Dementia Onset
Authors: Rote Sunshine , Moon Heehyul
Published: December 2021

Racial and ethnic minority older adults—especially non-Latino Black and Latino older adults—continue to have a higher prevalence of dementia with longer delays in formal diagnosis compared to non-Latino Whites. Few studies have estimated racial/ethnic differences in trajectories of dementia onset using nationally representative data with representation from the three largest racial/ethnic groups in the U.S.: non-Latino White, non-Latino Black, and Latino older adults. Additionally, given the delays in formal diagnosis we rely on a measure of probable dementia that takes into account both formal diagnosis and cognitive function. Data from the National Health and Aging Trend Study (NHATS, 2011–2019) reveals three trajectories of dementia onset (early, late, and dementia-free) and we find that Latino and Black older adults are at greater risk for early dementia onset compared to non-Latino Whites. Our next step is to explore the role of social function for dementia disparities.
Recognizing and Intervening on Elder Abuse, Neglect, and Exploitation in the Age of COVID-19
Authors: Liu Pi-Ju , Teaster Pamela
Published: December 2021

The rapid outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic. Public health measures to prevent the spread of COVID-19, such as social distancing and self-quarantine, have drastically altered people’s lives and led to social isolation, financial instability, and disrupted access to healthcare and social services. Older adults have not only borne the brunt of the highest COVID-19 mortality rates, but recent studies also describe growing reports of elder mistreatment. It is necessary to attend to these age-related disparities during the remainder of the COVID-19 pandemic and future health crises. This symposium includes four presentations on researchers’ findings in elder mistreatment during the COVID-19 pandemic. Dr. E-Shien Chang will compare prevalence of elder mistreatment before and since the pandemic, and highlight associated risk and protective factors during the pandemic. Dr. Lena Makaroun will examine changes in elder mistreatment risk factors among caregivers during the pandemic. Dr. Pamela Teaster will present Adult Protective Services’ (APS) policy and practice changes in response to the pandemic to demonstrate the pandemic’s impact on service providers. Lastly, Dr. Pi-Ju (Marian) Liu will appraise elder mistreatment victims’ awareness of COVID-19 and their unmet needs during the pandemic. Following the four presentations, Dr. Pamela Teaster will moderate a discussion on how elder mistreatment is a growing concern, especially during the pandemic, and what service providers are doing to protect older adults.
Relationship Functioning and Gut Microbiota Composition Among Older Adult Couples: Feasibility of Data Collection
Authors: Langer Shelby , Guest M Aaron , Tolson Melissa , Ortiz Juan Maldonado , DiBaise John , Labonte Helene , Krajmalnik-Brown Rosa
Published: December 2021

An emerging area of research extends work on couple functioning and physical health to gut health, a critical marker of general health and known to diminish with age. As a foray into this area, we conducted a pilot study to determine feasibility of data collection (questionnaires and a stool sample) among older adult couples. Participants were recruited from the community using a variety of methods including social media. Among 41 persons responding with interest across recruitment sources, 32 were contacted for screening. Inclusion criteria were: age 60+, marriage or cohabiting partnership, and English speaking/understanding. Exclusion criteria were a gastrointestinal disorder, receiving enteric nutrition, use of antibiotics (past month), cancer treatment (past 6 months), and a +COVID-19 diagnosis (past 2 months). Among 31 eligible couples, 30 consented. All 60 participants completed questionnaires and provided a stool sample using DNAgenotek’s OMR-200 collection kit, chosen for its ease and because samples can be stored at room temperature for 60 days. Sample characteristics were: M (SD) age = 66.57 (4.78); 53.3% female; 91.7% White; 1.7% Latinx; and 78.3% college-educated. 2 couples were same-sex. 43% reported at least one health condition and 25% reported use of a proton pump inhibitor (which can affect the gut microbiome), though none daily. Relational well-being was moderate-high on average per measures of dyadic adjustment and intimacy. Despite original plans to recruit couples in-person from a retirement community, remote operations were feasible via online assessment and study-coordinated shipping, a necessary yet fruitful shift due to the SARS-CoV-2 pandemic.
Teaching in Geriatrics: Is structured written feedback effective for lectures
Authors: Pohlmann Theresa , Hager Klaus , Paulmann Volker , Steffens Sandra
Published: December 2021

Background: Although there have been discussions about traditional lecturing, lectures are still largely a widespread concept of knowledge transfer. Therefore, it is important to constantly review and evaluate this format. The aims of this study were to analyze which effect a criteria-based written feedback has on the lecture course in geriatrics as an alternative to the conventional student evaluation. Furthermore, we wanted to investigate what kind of impact structured feedback has on lecturers in terms of content, organization and quality. Methods: The study was a prospective longitudinal analysis. The 34 lectures on the subject of geriatrics were analyzed over two cohorts using a standardized evaluation sheet. The assessment was carried out on a 5-point-scale using a 22-item feedback instrument. After the first evaluation, each lecturer received an individual evaluation with strengths and suggestions for improvement. In the second cohort the lecture series was evaluated again, and individual feedback was sent. Results: In six of 22 sub-categories the improvement was significant. The most significant improvement was made in terms of content/structure with an increase from 3.4 to 4.3 points. Conclusion: This study shows that significant improvement in teaching is possible by means of individualized written feedback for the lecturers and that students perceive the resulting improvements positively. Our results suggest that the implementation of these feedback instruments in other modules might improve their teaching as well.
Alternative Pathways: The Use Of Field-Specific Micro-Credentials in Aging Services
Authors: Guest M Aaron , Clark-Shirley Leanne , Hancock Cynthia , Newsham Tina K , Alvarado Katherine , DuMont Kristina Amirchian Renee , Hackett Lauren , Patton Kaylah Jenkins J R , Weaver Caylee
Published: December 2021

The rise of formal academic programs in gerontology at colleges and universities has been well documented over the last fifty years. Organizations such as AGHE and AGEC have been established to provide guidance, foster consistency, and advance formal gerontology education programs. Broadly, the purpose of these programs has been to develop a pipeline of trained gerontologists for the aging services workforce. What has been less documented is the rise of alternative pathways to gerontology and gerontological competence, including micro-credentialing. Micro-credentials are intended to provide quick-to-complete competency-based education around specific topics to demonstrate relevant skills to employers. To date, little is known about the prevalence of micro-credentialing in gerontology. Still, it may be that micro-credentials are sought in place of formal academic preparation due to their reduced cost, ease of completion, recognizability, and opportunity to quickly train employees in specific skills. To address this gap, we conducted a review of existing gerontological micro-credentialing opportunities. We identified a total of 51 micro-credentials with an explicit aging-focus and searched for associated competencies for these micro-credentials. In this poster, we describe findings on the emphases of micro-credentials, including dementia and care coordination, and review the programs' scope and nature of competencies. We argue that micro-credentialing can offer value for employees unable or unwilling to pursue formal academic training but should be differentiated from such training. Moving forward, it is critical to ensure alignment between gerontological micro-credentials and established gerontological competencies and standards and to differentiate micro-credentials from formal academic programs.
Art and Aging: Use of Social Media for Geriatric Education
Authors: Manocha Gunjan , Morton Casey , Derenne Nicole , Bau Heidi , Jurivich Donald
Published: December 2021

Social media as an educational tool for health care learning has untapped potential. Benefits of social media include peer-to-peer engagement, active learning and interprofessional training. Here we explored social media platforms as a vehicle to deliver short, pithy clinical pearls from evidence-based, peer-reviewed manuscripts. Key points from recent medical publications are paired with pre-existing artwork to provide visual reinforcement of the clinical pearl. Dubbed “Art and Aging”, the clinical pearl and artwork combination is posted on different social media platforms such as Instagram, Twitter and Facebook, thus allowing for an expansive audience. Different hashtags and tags are used to increase followers and engagement on each platform. Over a 9 months period learner engagement increased by 150% and includes a diverse learner profile. These curated social media platforms show considerable promise for disseminating Geriatrics best practices. As yet, we do not know subject matter retention or whether it changes clinical practices - both questions which are future research objectives.
GeriPOP: Older Adults Population Health Serious Game
Authors: Manocha Gunjan , Morton Casey , Holloway Jeremy , Brewster Scott , Wood Joseph , Van Eck Richard , Jurivich Donald
Published: December 2021

Health professionals have limited opportunities to learn about population health in their curriculum. With a shortage of geriatricians nationwide, health care systems need different ways to provide evidence-based geriatric care. To address both these shortcomings, a serious game, called GeriPOP has been developed to allow trainees to explore the impact of assessment and management of principles of geriatric care (the 4Ms+) on quality of life, health, longevity, and health care costs by applying them to a virtual older adult population. Trainees assume the role of a system manager who is asked to explore ways to optimize health outcomes and lower costs. They develop their population health plan around a framework of Geriatric 4Ms+ and apply it in a virtual panel of older adult patients that move longitudinally into different age bands (65-74; 75-84; 85+). As the game progresses, a dashboard helps trainees track the impact of their treatment decisions across the population. Several levels of play allow trainees to explore various issues intersecting with aging such as gender, diversity, social determinants, and multiple chronic conditions. Periodic debriefings and explanatory pop ups during the game allow trainees to further explore evidence–based Geriatrics. The game engages health care trainees to strengthen their knowledge of Geriatrics through exploration of systems change. Future study is needed on whether Geri POP changes learner attitudes, future clinical practice or healthcare outcomes.
Impact of Virtual Reality on Healthcare Provider Empathy for Older Adults with Sensory Impairment
Authors: Dutton Suzanne , Cimino Andrea
Published: December 2021

Virtual reality (VR) is an innovative technology that can simulate dual sensory impairment so that healthcare providers can experience this affliction common in older adults. The current study investigated whether VR simulation could increase empathy among healthcare workers. Empathetic care is linked with improved patient satisfaction, compliance, and outcomes. The study used a one-group pre/posttest study design implemented with healthcare providers at a hospital in the Mid-Atlantic region. All participants experienced a 7-minute VR scenario from the viewpoint of “Alfred”, a 74-year-old with macular degeneration and high frequency hearing loss on a commercial VR headset (Oculus Rift). A survey assessed participants’ self-reported knowledge, empathy, and behavior change. Empathy was measured using the validated tool Kiersma-Chen Empathy Scale (KCES). Analyses included descriptive statistics and paired t-tests. Survey results showed that participants increased their knowledge of macular degeneration and hearing loss, and that 9 of 14 empathy items had statistically significant increases (average absolute change = .41 points). Additionally, 97% of participants agreed or strongly agreed that they would utilize the information learned in their work with patients. Evidence suggests VR is an effective intervention to increase empathy and positively change behavior to support persons with sensory impairment.
Strategies for Developing an Inclusive Geriatric Physician Workforce for Older Adults in the U.S.
Authors: Wallace Brandy , Clark-Shirley Leanne , Podapati Pallavi
Published: December 2021

The “geriatric imperative” has been part of the aging discourse for more than 30 years but neither geriatric practice nor older adults are homogenous. As the U.S. population ages, elders will become more racially and ethnically diverse; and, their health outcomes will be shaped by lifetime experiences with systemic discrimination and racism. Already, COVID-19 has made clear that older adults and non-Whites, particularly African Americans and Hispanics, disproportionately bear the burden of disease and illness. Research suggests health disparities will continue unless there is change within the health care system. The Institute of Medicine (2001) reported on the problematic nature of the stark contrast between the diversity of patients and the physicians caring for them, including issues with patient trust and communication, yet no significant movement has been made to diversify the physician workforce. Despite being 13% and 16% of the U.S. population, respectively, African Americans and Hispanics make up just 5% and 6% of the practicing physician workforce. Further, practicing geriatricians represent less than 1% of physicians with very few physicians of color. There is a need for more African American and Hispanic geriatricians. In this systematic review, we examine recruitment and retention efforts targeting students of color, and curricula of geriatric medical programs in the U.S. We offer recommendations toward incentivizing physicians of color to enter geriatrics, strategies to support decolonization of geriatric medical curricula in undergraduate medical education programs, and the development of mentorship and pipeline programs to increase diversity in the geriatric physician workforce.
Training Clinic Providers on Advance Care Planning Improves Provider Self-Efficacy
Authors: Graupner Jeffrey , Tun Sandy , Read Carolyn , Qureshi Amena , Lee Cassie , Thompson Katherine
Published: December 2021

Advance care planning (ACP) is a vital step to ensure patients receive and prioritize the care that best aligns with their end-of-life wishes, including discussion and documentation of an advance directive. Significant gaps in ACP among underserved populations have been well documented. Research suggests a successful strategy for increasing the communication between provider and patient about ACP is to educate clinicians on this important issue. Three, 2.5 hour training sessions were provided to healthcare staff of a large chain of older adult primary care clinics across three states. Lecture materials were created and presented by a palliative care (PC) physician and PC nurse practitioner. Presentations were held both in person and virtually. Participants were asked to complete a pre/post-training survey online which included a validated 17-item ACP Self-Efficacy Scale (Baughman, 2017), perceived barriers checklist, and additional quality improvement measures. A total of 131 providers attended one of three training sessions. 76 providers (58.0%) and 47 providers (35.9%) completed pre- and post-training surveys respectively. Scores on a 17-item validated ACP Self-Efficacy Scale were significantly higher after training (Wilcoxon signed rank test, Z= 4.42, p <.001). Participants ranked “lack of time” as the number one barrier to having ACP conversations both before and after the training, whereas “lack of training” ranked 2nd and fell to 7th after the training. These initial results suggest ACP self-efficacy among providers can be increased through a one-time training session. Previous literature has highlighted the importance of provider self-efficacy as factor in increasing ACP conversations with patients.
Explaining Online Fraud Victimization of Older Adults via Cyber Routines and Lifestyles
Authors: Parti Katalin
Published: December 2021

The paper compares victim group characteristics: the differences between individuals under 55 and 55 and older, victimized by online fraud committed by a stranger. We test Cyber-Routine Activities Theory (cyber-RAT; Choi, 2008). In addition to active online lifestyle and computer familiarity, we include in the analysis independent variables such as living arrangements, occupation, and the willingness to report and ask for help. A representative sample of US citizens 18 or older was collected using a Dynata research panel in October 2020. We utilized one-way ANOVA on ranks for testing whether older and younger victims’ characteristics can be derived from the same independent variables. We find that older victims differ in characteristics from younger victims. Those who live alone or in a marriage with no children, and retired are significantly less victimized by online fraud than those who live with a partner and children and having full-time jobs. Besides, they are less likely to report their victimization, and their online activities and computer familiarity make them more vulnerable to online fraud than younger adults. Our findings suggest that older victims need prevention and intervention solutions designed especially for them. In an aging society, individuals will be increasingly active online and in the job market. Employers must provide internet security training for employees on manipulative online scams. Crime prevention programs must include awareness-raising on the role of reporting and how to ask for help. Relatives, friends, and caretakers need to be trained in preventing and early recognizing online fraud impacting older adults.
Nostalgia for a Purpose? A Comparison of Three Theoretical Frameworks in a Lifespan Sample
Authors: Turner Jennifer , Kerin Jessica , Delposen Kenzie , Stanley Jennifer
Published: December 2021

Nostalgia is a common experience for most people, but the functions or motivations for nostalgia are unclear. Several theoretical arguments for the purpose of nostalgia have been offered: nostalgia may reduce anxiety or fear of mortality (i.e., Terror Management Theory), resolve developmental conflicts (i.e., ego-integrity vs. despair), or provide a touchstone to the past (i.e., self-continuity). The goal of this study was to compare these theoretical frameworks among young (YA), middle-aged (MA), and older adults’(OA) descriptions of nostalgia and explore whether content of nostalgia differs by age. We hypothesized that YA would report greater amounts of nostalgia related to self-continuity, MA would report more integrity-related nostalgia, and OA would report more Terror Management. Nostalgia recordings (N=593) were collected during a two-week daily diary study in 108 participants (ages 18-78 years; 60.2% women). Recordings were transcribed and then coded by two trained coders (Magreement=87.4%; κ=.66, p<.001) using a rubric containing three typologies of nostalgia: Terror Management, Integrity v. Despair, Self-Continuity. Only n=255 transcripts could be coded within these typologies. Supporting our hypotheses, YA reported more self-continuity (51.5%) than Integrity (39.4%) or Terror Management (9.1%), and MA reported more Integrity (42.0%), than self-continuity (39.5%) or Terror Management (18.5%). Our third hypothesis was not supported: OA reported self-continuity most frequently (47.5%), followed by Integrity (31.9%) and Terror Management (20.6%). Nostalgia may provide a vehicle for self-reflection as people compare the past to the present, and future research should examine whether emphasis on different types of nostalgia has implications for psychological outcomes like wellbeing.
Knowledge of Hospice Care among Korean American Immigrants in Deep South
Authors: Choi Eunyoung , Lee Hee , Noh Hyunjin , Lee Lewis
Published: December 2021

Despite the benefits of hospice care in end-of-life care, there is a dearth of research on the knowledge or perceptions of hospice care, particularly among immigrants. A handful number of existing studies with this population have mainly used qualitative research methods. The purpose of the current study was to investigate the knowledge about hospice care and identify its predictors. We used cross-sectional data from 256 Korean American immigrants living in Alabama (Mean age = 44.78, range 23–70, 50.4% female). The outcome variable was measured by whether the respondents had heard of hospice care. Independent variables included sociodemographic (age, gender, education, and income), health (functional limitation and chronic conditions), health care access (health literacy, health insurance, unmet medical needs due to the cost, and social isolation). Logistic regression analyses were performed. About 78% of the respondents reported that they had heard of hospice care. Older age (OR=1.05, 95% CI=1.01-1.09, p <.05), being female (OR=7.13, 95% CI=3.18-15.98, p <.001), and higher levels of education (OR=1.68, 95% CI=1.15-2.45) were significantly related to increased odds of knowledge about hospice care. There were no significant roles of health and health care access factors. Our findings suggest sociodemographic gradients present in immigrants’ knowledge about hospice care, emphasizing the need for a targeted intervention to increase the hospice care knowledge.
Palliative Care Knowledge and Planning in U.S. Adults
Authors: Albright Amy , Allen Rebecca
Published: December 2021

Palliative care knowledge and health literacy are frequently underestimated in American adults; for example, as measured by the Newest Vital Sign (Weiss et al., 2005), 79.2% (n = 247) of participants within a Geriatrics Clinic sample displayed “adequate” functional health literacy, while 11.8% (n = 37) scored within the “possibly limited” range, and 9.0% (n = 28) scored within the “highly limited” range. There was additionally a significant association between health literacy and age (r = .15, p < .01) within this sample. The Palliative Care Knowledge Scale (PaCKS; Kozlov et al., 2018) was administered to participants, and higher scores indicated a greater knowledge of palliative care. This construct is particularly important to measure, as racial/ethnic disparities exist within this domain; for example, African Americans may have lower overall knowledge of palliative care services and advance care planning than non-Hispanic Whites (Noh et al., 2018). In the current study, knowledge of palliative care was measured using the PaCKS (Kozlov et al., 2018), and scores represented the widest possible range of 0 to 13 (M = 7.68, SD = 4.08). There was a significant correlation between age and PaCKS score (r = .12, p < .05), as palliative care knowledge increased with age. Females scored significantly higher (M = 8.29, SD = 3.91) than males (M = 6.81, SD = 4.18), t(309) = 3.18, p < .001. There was no main effect of race on palliative care knowledge, and post-hoc analysis using Tukey HSD did not demonstrate significant differences between groups.
Disaster Preparedness Among Middle-Aged and Older Adults: Who is the Least Prepared?
Authors: Connelly Caitlin , Boerner Kathrin , Bryant Natasha , Stone Robyn
Published: December 2021

Adverse impacts of natural disasters are viewed as particularly concerning for older adults. Disaster preparedness is an important step towards offsetting potential harm. Research comparing different age groups with respect to their disaster preparedness has produced inconclusive evidence. Some studies found older adults more prepared than younger age groups, whereas others found them to be equally or less prepared. To shed light on this issue, we examined disaster preparedness among N = 16,409 adults age 40 and older from the American Housing Survey. Using logistic regression analyses, we compared preparedness levels of four groups – households of middle-aged adults (age 40-64), older adults (age 65-84), oldest old adults (age 85+), and mixed households comprised of both middle-aged and older adults. Findings showed that households of older adults and the oldest old had significantly higher preparedness levels compared to middle-aged and mixed households, accounting for demographics, living alone, and disability. However, the oldest old group appeared less prepared compared to the older adult group. Thus, while our findings suggest that older adults aged 65-84 may be better prepared for disasters than middle-aged adults, the oldest old group, who are likely at a higher risk of adverse impacts from natural disasters, may be less prepared than their relatively younger counterparts. Therefore, older adults should not be treated as a homogenous group when considering disaster preparedness. Rather, policies and interventions to improve disaster preparedness may benefit from focusing on specific high vulnerability groups.
National Estimates of Climate-Related Disasters among Older Adults with Dementia
Authors: Ferreira Katelyn , Ornstein Katherine , Bell Sue Anne , Husain Mohammed , Yee Cynthia , Kelley Amy
Published: December 2021

Climate-related disasters can have devastating consequences, particularly for the growing population of older adults with dementia. Increasingly, older adults with dementia are aging in place at home, where they often receive assistance for mobility or self-care activities from family and/or paid caregivers. Understanding this population’s experience with climate-related disasters is integral to mitigation, preparedness, and emergency response outside of institutional (e.g., nursing home) settings. We aimed to estimate the population of community-dwelling older adults—including those with dementia—who live in counties that experienced climate-related disasters. We used 2000-2016 data from the Health and Retirement Study (HRS), linked 2000-2018 with Federal Emergency Management Agency (FEMA) disaster data. We flagged each occurrence of climate-related disaster (e.g., hurricane, flood) and then identified HRS participants living in counties with a disaster declaration. Using survey weights, we obtained population-level estimates by disaster frequency and sample characteristics. In each two-year HRS period, we found that 14.26-20.50 million community-dwelling adults over age 65 in the contiguous US (32.2%-53.7%) resided in a county with at least one disaster. This includes 0.62 -1.12 million persons with dementia, 67.2%-76.8% of whom are reliant on caregivers. On average (per two-year period), more than one-third (36.3%) of community-dwelling older adults living with dementia lived in a county with a least one disaster. Policy makers and emergency planners should strongly consider the needs of older adults at the intersection of dementia and risk of climate-related disasters, with an eye towards ensuring access to mobility and self-care assistance.
New Solutions for “Old” Problems: Implications and Opportunities of Intergenerational HomeSharing
Authors: Mirza Raza , Tanner Jacalyn , Hull James , Hocking Taylor , Liu Anna , Hsieh Jessica , Klinger Christopher
Published: December 2021

Across North America, many older adults have expressed their preference to live in their own homes and communities for as long as possible — and to 'age in place'. To address challenges faced by older adults living in the community, home-sharing - an exchange-based intergenerational housing approach, has empowered older adults to ‘thrive in place’ by providing additional income, companionship, and support with household tasks. In 2018, Toronto HomeShare was launched as an intergenerational home-sharing pilot program (n=22), matching older adults (55+) with postsecondary students intending to simultaneously address social isolation and the affordable housing crisis. In 2019, the pilot was adopted as a funded program in the City of Toronto with over 200 participants. Program results highlight unique benefits and challenges for older adults participating in home-sharing: (1) the capacity for intergenerational engagement to fulfill social needs, and (2) the importance of agency facilitation as a determinant of the experience for older adults. Survey findings indicate 88% of participants reported that participation in HomeShare positively impacted their general well-being, 88% reported improved financial security, 94% reported a delay in the need to move out of their community, and 72% felt that participation in HomeShare prevented the need for institutional care. These findings were used to transition Toronto HomeShare into a fully funded program as well as in the development of a national program. Beginning in January 2021 Toronto HomeShare transitioned to Canada HomeShare and will be scaling the program to Vancouver, Winnipeg, Halifax, Calgary, Montreal and other Canadian cities.
Older Adult Behavioral Health Issues in New England: Findings from the Healthy Aging Data Reports
Authors: Jansen Taylor , Lee Chae Man , Xu Shu , Karakida Maki , Porell Frank , Silverstein Nina , Dugan Beth
Published: December 2021

Behavioral health issues in older adults are prevalent and have negative consequences on quality of life and overall health, yet are often untreated. The present study compares state and local community rates of behavioral health indicators of older adults age 60+ in Massachusetts (MA), New Hampshire (NH), Rhode Island (RI), and Connecticut (CT). For this study rates were calculated from the following data sources: Medicare Current Beneficiary Summary File 2014-2018 (2014-2015 MA, NH, and 2016-2017 RI, CT) and the Behavioral Risk Factor Surveillance System (2013-2015 MA, 2014-2016 NH, 2015-2017 RI, CT). Small area estimation techniques were used to calculate age-sex adjusted community rates for more than 170 health indicators (https://healthyagingdatareports.org/). This research examines disparities in rates across the 4 states for 4 behavioral health indicators: substance use disorder (SUD), tobacco use disorder (TUD), opioid use disorder (OUD), and excessive drinking. Results varied across states with RI reporting the highest rates of substance (7.0%) and tobacco use (10.8%) disorders, CT had the highest rate of opioid use disorder (2.2%), and MA and RI reporting the highest rates of excessive drinking (9.3%). Overall, MA had the greatest disparities in rates for all indicators (SUD: 6.6% (5.35-15.99%); TUD: 10.2% (2.67-24.20%); excessive drinking: 9.3% (5.63-19.98%)), indicating behavioral health disparities by community are most pronounced in MA. This study found behavioral health issues are prevalent among New England older adults and should no longer be overlooked. Furthermore, visualizing the community rates makes disparities evident and may guide resources and services to areas of highest need.
Role of community centers in promoting sustainable regional life of community-dwelling older adults with frailty
Authors: Nishino Akiko , Ogino Ryogo , Miura Takahiro , YABU Ken-ichiro , TSUTSUMI Kanako , OKATA Junichiro , Nishide Kazuhiko , IFUKUBE Tohru
Published: December 2021

Japan’s long-term care insurance system, which is a formal service, focuses only on older adults requiring care and support. Therefore, to create supportive communities for frail older adults, appropriate measures have been taken to establish community centers within their walking distance. However, the specific functions of these centers largely remain unknown. Accordingly, this study is aimed at clarifying the role of community centers by analyzing their services and management systems. In February 2020, we conducted a questionnaire survey (36% response rate) and four semi-structured interviews in O city, which has 36 community centers (81.45㎢, 36.4% elderly population). Results from the questionnaires revealed that the most frequent users of the community center were in their 70s (61.5%); such centers tended to provide informal services, such as exercises and cafes. Meanwhile, 57.2% of community centers collaborate with formal service providers. Community centers tend to be operated together with parent facilities, such as hospitals and nursing homes(61.2%). The results of the onsite survey showed that, in three cases, the community centers were situated within 200 meters of the parent facility. The findings show that these community centers facilitated creation of a supportive community that provides informal services to the frail elderly. Furthermore, they are operated in cooperation with formal service providers, hospitals, and nursing care facilities and are located in close proximity to one another. To summarize, the community centers continue to play a role in providing seamless services to the frail elderly even as their physical functions evolve.
Physical Activity and Aging: Exploring Motivations of Masters Swimmers
Authors: Brilliant Susan , Claver Maria , LaPlace Patti , Schlesinger Cynthia
Published: December 2021

Physical activity has many benefits for the optimal health of older adults (e.g., lowering risk of cardiovascular disease, depression, dementia and falls). However, less than one in four Americans meets guidelines for physical activity and evidence suggests inactivity increases with age. A growing number of unhealthy older adults will strain resources. Masters athletes are one segment of the population that some promote as exemplary because of their remarkable physical functioning. Swimming is a global, fast-growing sport in Masters athletics. This qualitative study explored the motivations and barriers of older adult (60+ years of age) members of a Masters swim club in Southern California. The researcher used purposive sampling to diversify the sample by selecting male and female participants (N=18) from multiple geographical areas. Guided by a primary research question: Why do Masters swimmers choose swim late in life, when most of their age cohort are becoming less physically active, the researcher conducted semi-structured interviews to delve into the lived experiences of the participants, solicited peer feedback and employed Interpretive Phenomenological Analysis. Four main themes emerged: Masters swimming provided an enjoyable way to slow physical decline; participants felt camaraderie; working out with a group provided challenge and achievement that reinforced their identity as swimmers; and their practice greatly reduced stress. A formidable barrier was revealed when most of the participants expressed longing and regret that they could not swim due to COVID risk and safety guidelines. These findings can be used to design community programs to promote lifelong physical activity participation.
Disparities in Cognition Among U.S. and Foreign-Born Minority Populations With and Without Diabetes
Authors: Kindratt Tiffany , Dallo Florence , Zahodne Laura , Ajrouch Kristine
Published: December 2021

Adults with cognitive limitations and diabetes may be less able to adhere to treatment recommendations. Our aims were to: 1) estimate and compare the prevalence of cognitive limitations and diabetes among foreign-born non-Hispanic whites, blacks, Hispanics, Asians, and Arab Americans to US-born non-Hispanic whites; and 2) examine associations after controlling for covariates. We linked 2002-2016 National Health Interview Survey and 2003-2017 Medical Expenditure Panel Survey data (ages >=45 years, n=122,898). The prevalence of cognitive limitations was highest among foreign-born non-Hispanic whites (9.71%) and Arab Americans (9.40%) and lowest among foreign-born blacks (5.19%). Foreign-born non-Hispanic whites had higher odds (OR=1.36; 95% CI=1.05-1.49) of cognitive limitations than their US-born counterparts. Foreign-born Hispanics with diabetes had greater odds of cognitive limitations (OR=1.91; 95% CI=1.63, 2.24) compared to US-born non-Hispanic whites. Additional findings will be discussed focused on stressors that may contribute to cognition disparities using the immigrant health paradox framework.
Immigration-Related Trauma Associated With Metabolic Risk and Cognition in Hispanic and Latino Immigrant Populations
Authors: Diminich Erica , Ajrouch Kristine , Antonucci Toni , Clouston Sean , Vega Irving , Zahodne Laura , Webster Noah , Gonzalez Richard
Published: December 2021

Recent immigrant and undocumented Hispanic/Latino adults in the United States (U.S.) are an underserved segment of the aging population. In this cross-sectional pilot study, we examined associations between self-reported stressors metabolic syndrome, emotional reactivity, and cognitive functioning in a heterogenous sample (N=80) of Hispanic/Latino adults (43.8% Central America; 43.8% South America; 7.5% Caribbean; mean years in the U.S.=18.1, SD=12.8). Participants (Meducation=10.2 years, SD=5.34; Mage=48.6 years, SD=12.3) underwent blood draw, anthropometrics and NIH-toolbox cognitive and behavioral measures. Linear regressions indicated that, elevated glucose was inversely associated with working memory (r=-.30), whereas higher HDL and controlled glucose were associated with better episodic memory (r=.27) and executive functioning (r=.32). Results further revealed associations between immigration-related trauma and elevated posttraumatic stress symptomatology. Implications for mental health and early detection of modifiable risk factors to promote healthy aging in vulnerable Hispanic/Latino immigrant populations are discussed.
Caregiving Across the Life Course: Life History Findings from the Health and Retirement Study (HRS)
Authors: Larkina Marina , Smith Jacqui
Published: December 2021

Informal caregiving, defined as unpaid care provided to a relative or friend with some sort of special need, is a topic of research across different disciplines. Previous research highlights the prevalence and heterogeneity of caregivers in terms of their age, gender, relationship with the care recipient, and the duration of care provision. However, most research focuses on a specific episode of caregiving. Little is known about the people who provide care to multiple recipients throughout their own life. To fill this gap, we examined data from the HRS Spring 2017 Life History Mail Survey (N = 3520; age range 50-101 yrs). Participants reported their relationship with people to whom they had provided unpaid care for ≥ 6 months (max 5) and listed the start and end years of care. Compared with people who had not provided care, caregivers (N = 1000, 28%) were more likely to be women, white, and currently widowed. They cared for their parents (67%), spouses (22%), children (11%), or other relatives (16%) and 30% reported providing care two or more times (M = 1.44, SD = 0.81). Respondents, who reported multiple episodes of caregiving were more likely to be women, widowed, aged between 25 and 50 at the time of first providing care. People who first cared for their spouse were less likely to report multiple caregiving episodes comparing with those who cared for parents or children. Future research will examine the health and well-being consequences associated with caregivers’ histories of providing unpaid care to others.
Psychosocial Stress Profiles and Cognitive Function in a Racially and Ethnically Diverse Sample of Adults
Authors: Munoz Elizabeth , Zahodne Laura , Gonzalez Richard , Webster Noah , Sliwinski Martin , Scott Stacey
Published: December 2021

We developed comprehensive multi-domain profiles of psychosocial stress in urban-dwelling, racially and ethnically diverse adults (age range: 25-65; N=256; 63% Non-Hispanic Black; 25% Hispanic; 9% Non-Hispanic White) and evaluated associations with cognitive function. Participants completed psychosocial stress measures tapping into ten domains and tasks of processing speed, working memory, and episodic memory. Latent profile analyses controlling for age yielded four-profiles: high neighborhood stress, moderate versus high work stress and daily discrimination, and high health and relationship stress. Profiles significantly differed in income, age, and employment status. The profile with moderate work stress and daily discrimination and the profile with high neighborhood stress each had significantly lower working memory than the other profiles. The finding of lower working memory among individuals in the moderate work stress and daily discrimination profile was not due to sociodemographic variables. Results highlight the potentially cumulative influence of different contextual stressors on cognition.
Older Latinos’ Perceptions of the Caregiving Experience
Authors: Jaldin Michelle , Balbim Guilherme , Marques Isabela , Marquez David
Published: December 2021

There has been a rapid growth of Latinos age 65 and older in the United States and the population is projected to grow to 21.5 million by 2060. Latinos with Alzheimer’s disease is expected to increase 832% by 2060. Caregiving for adults with Alzheimer’s Disease and Related Dementias (ADRD) is physically, emotionally, and financially demanding, and has significant implications for caregivers’ health, personal and social life, and overall well-being. This study aimed to describe the perceived experiences of middle-aged and older Latino who were primary caregivers of relatives with ADRD. We conducted semi-structured interviews with Latino caregivers to examine their perceived experiences of providing care for a relative with ADRD. Interviews were conducted in English and Spanish and were transcribed, translated into English when needed, and coded. We conducted direct content analysis. Participants were aged 50 to 75 years (n = 16), the majority were female (n = 12), and majority were caring for either their parent or spouse. We identified six reoccurring themes in the Latino caregiving experiences: (1) caregiver burden; (2) dealing with care recipient; (3) coping strategies; (4) social support; (5) cultural values; and (6) knowledge about services. The identified themes showed that Latino caregivers need support from their family and friends for caregiving. Latino family’s structure plays an important role in caregiving experience. These themes are important to consider in future interventions that aim to reduce caregiver burden in Latinos as they influence the overall well-being of the caregiver.
The Life Satisfaction of Informal Caregivers in Europe: Regime Type, Intersectionality, and Stress Process Factors
Authors: Browning Sean
Published: December 2021

This research assessed the role of welfare state/family care regimes, intersecting social locations and stress process factors in influencing the life satisfaction of informal caregivers of care recipients with age-related needs or disabilities within a European international context. Empirical analyses were conducted with a sample of informal caregivers residing in Denmark, Sweden, France, Germany, Italy, Greece and the United Kingdom (n=6,007). Ordinary least squares and ordered logit regression models revealed that welfare state/family care regime, intersecting social locations, and stress process factors were independently associated with the life satisfaction of informal caregivers. Furthermore, there was some evidence to suggest that social location and stress process factors intervened in some of the relationships between regime type and life satisfaction. There was also some evidence that stress process factors intervened in the relationships between social location factors and life satisfaction. Overall, the results provide support for integrating welfare state/family care regime type and intersectionality factors into the stress process model as applied to the context of informal caregiving. The results also have policy and practice implications with regards to which social location and stress process factors explain specific disparities in life satisfaction between informal caregivers residing in different welfare state/family care regimes.
The Other Caregivers: Informal Non-Spousal Male Caregivers for Persons With Dementia
Authors: Tucker Gretchen
Published: December 2021

Informal caregivers for persons with Alzheimer's disease and related dementias (ADRD) have become an integral part of the long-term health care system. They are relied on to provided day-to-day care that is challenging, complex, and often spans several years. Most of the research on informal caregivers for persons with ADRD have focused on spousal caregiving, mother-daughter dyads, and daughters. There is sparse literature on informal non-spousal male caregivers for persons with ADRD. The objective of this research was to obtain an understanding of the experiences of informal non-spousal male caregivers for persons with ADRD. This descriptive qualitative pilot study consisted of in-depth one-on-one interviews with three informal non-spousal male caregivers for persons with ADRD. Four themes emerged through data analysis: 1) the male perspective and experience of caregiving, 2) relationship dynamics, 3) caregiving challenges, and 4) finding meaning within caregiving. Conclusion: Similar to other caregivers, informal non-spousal male caregivers assisted with transportation, managing medical appointments, as well as bathing and personal care. Differences with other caregivers, specifically female caregivers, emerged in terms of descriptions of traditional versus non-traditional gender roles. The implications of this study are that public policies, support services and medical professionals need to understand and be able to address the different experiences and needs of informal non-spousal male caregivers.