bluuebunny/crossref_metadata_2025 huggingface dataset:
EVALUATION OF A COMMUNITY-BASED CURRICULUM ON WELLNESS AND SAFE PAIN MANAGEMENT: A PRELIMINARY ANALYSIS
Authors: Tanbonliong Gretchen , Vafiadis Dorothea , Plunkett Laura , Silberman Susan , Hou Erin , Hatch Maddy , Guidry John
Published: January 2025

The body of recent evidence-based interventions for pain self-management targeted at community-dwelling older adults is limited. The aim of this ongoing pilot study is to determine the efficacy of a six-week curriculum in promoting knowledge, attitudes, and behaviors related to wellness and safe pain management among older adults who were recruited via community-based organizations. Interim results from a sample survey analysis of 6 out of 8 cohorts (n=87) in a quasi-experimental crossover design showed that majority of the participants (91%) were White (63%) and Black (28%) women between the ages of 60 to 79. On a scale of 1 to 5 where “4” indicates that the knowledge or behavior is being implemented, 100% of the pain prevention strategies (i.e., maintaining a healthy weight or losing weight; engaging in physical activity; getting adequate sleep; and avoiding/limiting caffeine, tobacco, or alcohol) and two pain management strategies (“using topical therapies such as gels and creams” and “cleaning out old and expired medicines”) met this threshold post-curriculum. There were statistically significant differences observed in participants’ individual acceptance and commitment to cognitive behavior therapy (p=0.0015); adoption of meditation and/or mindfulness techniques to manage pain (p=0.0118); and reported more effective pain management (p=0.0109) between the post-curriculum and 6-week follow-up period. These preliminary findings suggest that the curriculum was an effective intervention for safe pain management among community-dwelling older adults. It has potential to be replicated across multiple community-based organizations and to target other underrepresented groups in the older adult population.
A NEW LOOK AT NEUROTICISM: FINDINGS FROM THE IOWA UNMARRIED SURVIVORS STUDY
Authors: Hensley Robert , Martin Peter , Bishop Alex
Published: January 2025

The purpose of this study was to analyze the association between personality traits and other variables relative to Neuroticism reported by N = 227 (M = 78.2, SD = 8.1) participants from the Iowa Unmarried Survivors Study. Using the development adaptation model as a conceptual framework (and Neuroticism as the dependent variable), a series of blocked multiple regression analyses were conducted. In the first block, age, gender, ethnicity, total years of education, and current marital status were included. The second block contained selected childhood variables, whereas the third block contained the personality variables, and the fourth block included the Venting subscale of the Brief COPE, social support, depression, stress, and loneliness. Recalled childhood abuse emerged as a significant predictor of Neuroticism, β =.118, p <.05. If one was abused in childhood, one would show higher levels of Neuroticism. In addition, both venting and loneliness were significant predictors of Neuroticism, β =.120, p <.05, β =.191, p <.05 respectively. Moreover, stress and depression served as significant predictors of Neuroticism, β =.208, p <.01, β =.432, p <.01 respectively. This model explained 64% of the variance in Neuroticism scores. Although a causal relationship cannot be established via this model, the mulitdirectional nature of Neuroticism is noteworhy. Results from this study have implications relative to how geriatric social workers and aging service providers develop interventions and programming to improve mental health and quality of life for persons who remain unmarried throughout later life.
TRANSITIONS OF ASSET POVERTY AND DEPRESSIVE SYMPTOMS: A COMPARISON BETWEEN URBAN AND RURAL CHINESE OLDER ADULTS
Authors: Hu Ting , Chen Yu-Chih
Published: January 2025

Urban-rural disparities and asset poverty are being examined individually as critical socioeconomic factors influencing depression among older adults. However, while asset poverty, a dynamic condition evolving over the life span, is significantly influenced by urban-rural residency and household registration (hukou) status in China, the extent of their contribution to the relationship between asset poverty transitions and depressive symptoms in later life remains largely unexplored. Using four waves of the China Health and Retirement Longitudinal Study, we examined how asset poverty affects depressive symptoms among 7,982 adults aged 60 and older and the interaction effects by rural/urban areas. The fixed effect regression models revealed that older adults who transitioned from a non-asset-poor status to an asset-poor status reported elevated levels of depression compared to those who maintained a non-asset-poor status. Furthermore, significant interaction effects were found in the relationship between asset poverty and depressive symptoms. The simple slope analyses revealed that the effect of transitioning to asset poverty on depression was only significant for older adults living in rural areas or with rural hukou. The findings highlight the necessity of prioritizing policies to build a financial support system for older adults and promoting asset building to mitigate the negative impacts of asset poverty on mental well-being in later life, particularly for those in rural areas or with rural hukou. Additionally, efforts at reducing urban-rural disparities in social and family support and within the social welfare system should be advocated.
TARGETED SCREENING FOR LIVER FIBROSIS: IDENTIFYING HIGH-RISK ADULTS FOR TRANSIENT ELASTOGRAPHY EVALUATION
Authors: Namrouti Amina , Chaves Paulo
Published: January 2025

Non-alcoholic fatty liver disease (NAFLD) poses a significant clinical concern, impacting over 30% of the general population and leading to potentially reversible liver fibrosis, cirrhosis, and physical frailty. Transient elastography (TE) offers a non-invasive screening tool, measuring liver stiffness as an indicator of hepatic fibrosis, guiding subsequent biopsy decisions. However, TE’s availability and cost hinders its widespread use. Clinical practice relies on individual indicators like obesity for TE testing referrals. We aim to assess the accuracy of traditional indicators and explore whether combining readily available indicators in primary care settings could enhance screening accuracy. We conducted a cross-sectional analysis using National Health and Nutrition Examination Survey (NHANES) 2017-2020 data, involving adults aged ≥ 40 years without excessive alcohol consumption, cirrhosis, or hepatitis B/C. We evaluated liver stiffness measurements (LSM) >7pKa by TE as the outcome. Various predictors, including systemic diseases, examination findings, and laboratory tests, were assessed using stepwise logistic regression with sampling weights. Area under the receiver operating curve (AUC-ROC) was utilized to compare predictive accuracy across models. Results showed modest accuracy of individual indicators with AUC-ROC of 52%. The final model, incorporating diabetes, BMI>30 kg/m2, HR, A1c, FIB-4>3.25, APRI>0.5, and AST>40 IU/l, yielded an improved AUC-ROC of 74%. Combining primary care indicators enhanced identification of at-risk adults for abnormal LSM, compared to relying solely on individual indicators. Further research is necessary to determine the optimal combination of indicators for identifying individuals at risk of liver fibrosis who may benefit from TE screening.
RESOLUTION OR WORK STRESS? WHY DOES RETIREMENT CHANGE HEALTH BEHAVIOR?
Authors: McKenzie Colin , Kajitani Shinya , Sakata Kei
Published: January 2025

The purpose of this paper is to examine the impact of retirement on actual health outcomes and intentions relating to these outcomes for Japanese men. The health outcomes investigated relate to alcohol and tobacco consumption, physical exercise, and psychological distress. This paper uses data from the first 15 waves of the Longitudinal Survey of Middle-aged and Elderly Persons (LSMEP) to estimate regression models explaining these health outcomes. An instrumental variable estimator using instruments constructed from the eligibility ages for various aspects of the Japanese pension is used to account for the endogeneity of retirement and income. Individual heterogeneity is dealt with by using a fixed effects estimator. It is found that there is no significant impact of retirement on the extent to which individuals report that they will take care not to drink too much, nor smoke too much, and to engage in a sufficient amount of exercise. Retirement leads to psychological distress declining, the proportion of men drinking alcohol to fall and the proportion who are smoking falls after retirement. The proportion of respondents engaging in moderate amounts of exercise increases following their retirement. Taken together, the results suggest that reductions in stress following retirement are driving the results. Falls in income associated with retirement explain little of the behaviour observed.
DISPARITIES IN HEARING LOSS AMONG OLDER ADULTS: HEALTH AND RETIREMENT STUDY, 2016–2018
Authors: Tan Nasya , Pike James , Kobayashi Lindsay , Clarke Philippa
Published: January 2025

As hearing loss becomes more prevalent in middle and older ages, more research is needed to identify factors associated with hearing loss among this population using nationally representative data. This study aimed to examine associations between sociodemographic factors and hearing loss using 2016-18 data from the Health and Retirement Study, a population-based cohort of US adults aged 51+ (n=17,468). Respondents self-reported hearing loss, age at assessment, gender, race/ethnicity, and education. We ran weighted logistic regression models that accounted for the complex survey design, stratified by gender and race/ethnicity. Covariates included year of assessment and birth cohort. Results showed that for every 5-year increase in age, the odds of hearing loss increased by 40% (95%CI=1.26, 1.55). Compared to White males, Black males were 42% less likely to have hearing loss (95%CI=0.44, 0.77). Compared to White females, Black females were 46% less likely to have hearing loss (95%CI=0.42, 0.70). Among men, those with less than a high school education were 23% less likely to have hearing loss (95%CI=0.63, 0.94)than college graduates. However, men with an associate’s degree or some college education were 34% more likely to have hearing loss (95%CI=1.14, 1.58). Education was not associated with hearing loss among women. This study highlights disparities in hearing loss in later life by race/ethnicity, gender, and education. It adds to the current literature by identifying disparities in hearing loss, and is the first study to examine hearing loss disparities using nationally representative data on middle-aged and older adults in the Health and Retirement Study.
EFFECT OF AWARENESS OF HEARING LOSS AMONG CARE RECIPIENTS ON ATTRIBUTES OF CARE PROVIDED: A NATIONAL STUDY
Authors: Powell Danielle , Zhang Wuyang , Reed Nicholas
Published: January 2025

Hearing loss (HL) is prevalent among older adults and may result in caregiving challenges due to communication barriers. This study aims to investigate whether care recipients’ awareness of HL is associated with attributes of care. Using data from Round 12 (2022) of the linked National Health and Aging Trends Study (NHATS) and National Study on Caregiving (NSOC), a sample of 1,133 (Mean age: 62±15 years; Female: 68%) caregivers assisting 713 older adults (Mean age: 83±8 years; Female: 63%; White: 63%) with audiometric HL was derived. From care recipients’ self-reported hearing difficulty and hearing aid use, HL awareness was defined as (1) unrecognized HL (no hearing difficulty or hearing aid use reported), (2) recognized HL (only hearing difficulty reported), and (3) managed HL (hearing aid use reported). Caregiving outcomes, including ADL/IADL-related care needs and past month hours of caregiving, were measured through self-report. Of all caregivers, 628 (55%) assisted older adults with unrecognized HL, while 162 (15%) and 343 (30%) assisted older adults with recognized and managed HL, respectively. Relative to unrecognized or managed HL, care recipients with recognized HL reported greater needs on ADL/IADL-related activities (≥3 ADL needs: 65.4% vs. 47.8%/45.0%; IADL needs: 55.1% vs 48.3%/40.0%). Results from models adjusted for multiple caregiver-recipient characteristics suggest time spent on care activities by caregivers of those with recognized HL and managed HL were 0.66 (95%CI:0.43-1.03) and 0.84 (95%CI:0.56-1.27) times lower than those with unrecognized HL. Supporting HL awareness and management as aligned with care needs may contribute to effective provision of care.
HOW HEARING DIFFICULTIES AND SOCIAL ACTIVITIES SHAPE TRAJECTORIES OF COGNITIVE FUNCTION AMONG OLDER MEXICANS
Authors: Han Chengming , Wong Rebeca
Published: January 2025

Objective. This paper aims to explore the role of social activities in the pathway between hearing difficulties and cognitive function among Mexicans □ 50 years over a longitudinal period. Method. Data were drawn from the Mexican Health and Aging Study (MHAS) 2015 to 2021. MHAS is a national longitudinal study of adults □ 50 years in Mexico, with baseline in 2001, and six waves completed by 2021. The analytical sample includes 8,049 Mexicans at wave 4 (2015). Cognition was operationalized as verbal memory and visual scanning scores. Multilevel ordinary least squares regression models were used to estimate the mediating effects of social activities on the association between hearing difficulties and cognition over 2015 to 2021. Results. There are 2766 (34.36%) respondents who reported having a poor or fair hearing in 2015, among whom only 9% used hearing aids. Poor or fair hearing was associated with reduced social activities, which in turn related to decreased visual scanning scores in 2021. Poor/fair hearing showed both indirect and direct effects on visual scanning scores. Reporting more social activities was associated with better cognition independently. Using a hearing aid was associated with lower verbal memory scores. Conclusion. There are few studies on sensory limitations and cognitive function that include populations in middle-income countries like Mexico. Although the results displayed on the similar mechanism on hearing difficulties and cognition in MHAS, the lower percentage of using a hearing aid suggested that Mexico has experienced rapid population aging with inadequate institutional social support for health care.
TRENDS IN PREVALENCE OF HEARING LOSS AMONG OLDER ADULTS AND UNPAID FAMILY CAREGIVERS IN THE UNITED STATES: 2011–2022
Authors: Zhang Wuyang , Powell Danielle , Reed Nicholas
Published: January 2025

Hearing loss (HL) prevalence rises with age and is a potential barrier to communication, a key component of caregiving relationships. With a rapidly aging population, the United States faces a surge in age-related HL prevalence in tandem with demand for disability-related care needs. We aim to estimate the trends in national prevalence of HL among (1) older adults receiving unpaid family care and (2) their caregivers. The National Health and Aging Trends Study (NHATS) and linked National Study of Caregiving (NSOC) provide nationally representative samples of Medicare beneficiaries and their family caregivers between 2011-2022. HL was measured through self-reported functional hearing ability (subjective) in both NHATS and NSOC until 2021, when NHATS introduced objective measures of hearing. In 2011, the prevalence of self-report HL was 31.7% (95% CI: 28.3%-35.4%) among care recipients and 7.9% (95% CI: 6.7%-9.3%) among caregivers. By 2022, the prevalence reached 34.9% (95% CI: 31.5%-38.4%) and 9.7% (95% CI: 8.1%-11.6%), respectively. Notably, prevalence of objective HL among care recipients more than doubled its subjective counterpart (73.5%; 95% CI: 69.2%-77.3%). Among caregiving dyads, 3.6% (95% CI: 3.5%-5.0%) had both parties reporting subjective HL and 5.7% (95% CI: 4.4%-7.3%) had caregivers with subjective HL assisting older adults with objective HL. Stratified analyses by sociodemographic characteristics suggested the prevalence of HL was higher among male, non-Hispanic White, or Hispanic care recipients along with spousal caregivers. Our findings suggest that HL is highly prevalent among both older care recipients and caregivers, and further investigation is needed to understand its caregiving consequences.
FORGIVENESS AS A RESOURCE FOR COUNTERING FEELINGS OF LONELINESS AMONG WOMEN AGING IN CORRECTIONAL CUSTODY
Authors: Thompson Anya , Bishop Alex , Randall Kevin
Published: January 2025

Analyzing cross-sectional data from 232 women in custody ages 40-years and older (M = 49.06; SD = 7.22), we examined a conceptual path analytic model based on the developmental adaptation model consisting of distal and proximal influences on Loneliness, controlling for age, race, education, marital status, and crime type. The tested model linked participant recall of adverse childhood experiences (ACES) to loneliness (LONE) through religious doubt (RD) and three assessments of dispositional forgiveness, Self, Others, and Situation. The model fit the data well, X2 = 2.09 (3 df); p =.55; RMSEA = 0.00; CFI = 1.00; and SRMR =.008. Standardized results revealed that RD was related to ACES (.13, one-tailed p =.028). In addition, significant paths were found linking all three disposition assessments of forgiveness to RD: Self, β = -.42, p <.001; Others, β = -.32, p <.001; and Situation, β = -.47, p <.001. However, only Self was significantly associated with LONE: β = -.19, p =.017; however, there was a significant total indirect effect on LONE from ACES through RD and the three measures of forgiveness;.019, one-tailed p =.045. The model explained 22% of the variance in LONE. Results have implications for how clinical counselors, social workers, cases managers, and pastoral care ministers administer rehabilitative programming. Discussion will highlight forgiveness as a rehabilitative resource for addressing childhood trauma and religious doubt, as well as reducing feelings of loneliness reported by middle aged women in correctional custody.
INCLUSION OF SPIRITUAL CARE AT THE INDIVIDUAL LEVEL FOR PERSONS LIVING WITH DEMENTIA
Authors: Park Sooyoung , Kim Eunkung , Park Soobin
Published: January 2025

Spirituality is known to remain for a long time until the advanced stages of dementia and is associated with positive health outcomes. Initiatives such as dementia-friendly church services and spiritual programs in institutional settings aim to recognize and enhance the emotional, social, spiritual, and artistic facets of person living with dementia (PLWD). However, the application of spirituality in the day-to-day lives of PLWD at home remains a research gap and poses practical challenges. Thus, we draw from our personal insights as a family caregiver of an older adult with severe dementia and collaborated with a social worker specialized in this area to integrate spirituality into PLWD’s daily routines. Based on the Spiritual Dimension of Ageing model, we designed a range of practices aimed at fostering sustainable spirituality at home for PLWD. These practices encompassed four themes: relationships with others, creating an environment conducive to engaging in meaningful activities, incorporating favorite art/music, and exploring religious beliefs. This approach allowed for the customization and diversification of spirituality practices, catering to the unique interpretations and needs of each PLWD. As part of the practice, it enabled PLWD to reunite with a family member after 12 years. Utilizing photographs and written narratives from community-dwelling PLWD and caregivers, we highlighted specific qualitative benefits of this approach (e.g., positive emotions, experience moments “beyond dementia”), particularly for individuals in the advanced stages of dementia. Discussing opportunities to nurture the whole person and their soul may offer comfort and hope to those facing a disease with no cure.
RELATIONAL RELIGIOSITY, FORGIVENESS, AND FAMILY FUNCTIONING IN OLDER AFRICAN AMERICAN COUPLES
Authors: Skipper Antonius , Rose Andrew , Cho Seungjong
Published: January 2025

Despite recent advances in studies on positive psychology, relatively little is known about the factors that influence the romantic relationships of older African Americans. Existing literature does note that older African Americans are among the most religious racial/ethnic groups in the United States. In addition, forgiveness is recognized as a common mediator between relational religiosity and other positive outcomes, such as psychological well-being and successful aging. Given the need for more strength-focused studies on minority-based romantic relationships, this study examined forgiveness as a potential mediator between relational religiosity and family functioning among older, romantically involved African American couples. This study utilized the dyadic data of 194 African American couples with partners between the ages of 50 and 86 years. Data were captured with the Revised Sanctification of Marriage scale, six items assessing interpersonal forgiveness, and the McMaster Family Assessment Device. Indirect effects were verified with 95% confidence intervals within 10,000 bias-corrected bootstrap iterations. The relations between men’s relational religiosity and men’s reports of family functioning were partially mediated by men’s self-reported ability to forgive their partner (B =.053 (95% CI [.001,.187])), as well as the sum of all men’s and women’s reported abilities to forgive and perceive forgiveness (B =.132 (95% CI [.012,.260])). These findings highlight the growing, yet underrecognized, need to understand the religiosity of older African American men relative to positive relational outcomes. Further, this data helps to counter the deficit-narratives that often paint African American family functioning as poor and flawed.
DIGITAL LITERACY CHANGES OVER TIME: IMPLICATIONS FOR LIFE SATISFACTION IN OLDER ADULTS
Authors: Kang Miseon , Lee Seolah , Jung Inhye , Lee Hyo Jung
Published: January 2025

Rapid digitalization of society requires people to utilize digital technology in daily lives, and the COVID-19 pandemic accelerated this situation. Although older adults are known to be unfamiliar with using digital technology, their digital literacy can vary according to their life experiences. This study aimed to identify patterns of digital literacy changes in older adults before and after the COVID-19 pandemic and examined how life satisfaction differs based on subtypes of digital literacy changes over time. Data were drawn from the ‘Media Panel’ by the Korea Information Society Development Institute. The final sample was 1,924 individuals over 65 who responded from 2019 to 2021 and maintained their living arrangements (Living alone, Couples only, Couples with children, and Couples with their parents and children). Latent Class Growth Analysis and multiple regression analyses were employed. The patterns of older adults’ digital literacy changes were classified into four subtypes: ‘Low-level increase group (60.9%),’ ‘Medium-level increase group (29.8%),’ ‘High-level maintenance group (5.0%),’ and ‘Rapid increase group (4.2%). The other three groups had higher life satisfaction than the low-level increase group. Findings imply that the majority of older adults saw a rise in their digital literacy skills during the COVID-19 pandemic. The heterogeneity in digital literacy levels among older adults offers valuable insight into the need for interventions that cater to different digital skill levels, potentially impacting their quality of life. Particularly, in order to enhance their overall well-being, it is important to better understand the key features of individuals in each identified group.
PATTERNS AND ASSOCIATED FACTORS OF TECHNOLOGY USE IN US COMMUNITY-DWELLING OLDER ADULTS
Authors: Peng Wenting , Luo Yuqian , Liu Minhui
Published: January 2025

Technology, especially digital health technology, has been increasingly used to deliver healthcare services. The COVID-19 pandemic accelerated the rapid adoption of medical technology. However, how many and how older people currently use technology remain unknown. Using the cross-sectional data from the National Health and Aging Trends Study collected in 2022, we examined the prevalence, characteristics, and associated factors of technology use (including technology device use, everyday/digital health technology use) among 5,512 community Medicare beneficiaries aged 65 years and older with analytical sample weights and design-based logistic regression models. Results showed that over 1.3 million (2.7%) older people did not use any information and communication technology devices (i.e., computers, cell phones, and tablets). The weighted prevalence of everyday technology use and digital health technology use were 83.3% (95% CI, 82.1%-84.5%) and 52.1% (95% CI, 49.5%-54.7%), respectively. Compared to individuals who never used digital health technology, older adults who used digital health technology were more likely to be younger, white, not living alone, self-rated as having good health, non-homebound, and possessed higher education, income, and cognitive function, with fewer ADL/IADL impairments, and were less likely to experience hospitalization and depressive symptoms (All P< 0.05). Age, education, income and a diagnosis of dementia were independently associated with technology device use, everyday technology use, and digital health technology use (All P< 0.05). The prevalence of technology use in US older adults differed significantly by demographic and health-related characteristics. Future technology-based services or interventional studies should consider the devices and modalities of technologies in the older population.
TECHNOLOGY-ASSISTED TOILETING BY OLDER ADULTS: A SCOPING REVIEW OF BIDET USE
Authors: Van Son Catherine , Cerruti Minyoung
Published: January 2025

Objective

With aging, toileting can become difficult, given changes in mobility, agility, and cognition. Interventions are needed to support toileting privacy and independence. A technology-assistive device for toileting, referred to as a bidet (washlet), uses one’s existing toilet and plumbing to provide a cleansing mechanism by spraying water on the perineum after toileting. Using a remote-controlled device, water temperature, and pressure can be individualized, and the seat warmed. This review focused on the following question: What are the benefits and challenges older adults (OA) and their caregivers experience in using a bidet?

Methods

A scoping review was conducted using the five stages of Arksey and O’Malley’s framework and the PRISMA-ScR checklist. Our search focused on literature published after 2000 and included five databases.

Results

Fourteen articles were identified and analyzed. Seven papers focused on OAs, two on caregivers for OAs, and five included OAs as part of their sample. Findings described bidet technology facilitators and barriers for OAs and their caregivers. Older adults described apprehension about using the technology while appreciating increased privacy and independence. Caregivers reported less time toileting and could focus more on other ADL activities. Research gaps were identified, and recommendations were proposed to change the culture of toileting and promote bidet use. Randomized controlled studies with larger samples are needed to determine the feasibility and effectiveness of bidet use by older adults.

Conclusion

Bidet technology can support OAs’ toileting privacy and independence, reduce caregiver burden, and decrease the environmental impact by using fewer paper products.
THE ART OF GRIEVING AMONG OLDER ADULTS ON TIKTOK
Authors: Ng Reuben , Indran Nicole
Published: January 2025

Although TikTok is dominated largely by younger persons, the platform has since gained traction among older adults, a number of whom have used it to cope with bereavement and grief. Presently, little is known about the therapeutic effects of creating TikTok content in the context of bereavement. However, there have been suggestions that the platform has the potential to serve as an accessible form of art therapy. This study explores how older adults mobilize audio-visual functions to communicate their experience of bereavement on TikTok. We compiled the most viewed videos of users aged 60 and above with at least 100,000 followers, generating 1,382 videos with over 3.5 billion views. Videos which did not feature older adults engaging in discourses on bereavement were excluded. This left us with 22 videos. Both inductive and deductive approaches guided the qualitative analysis. Three themes emerged: ‘Emotional Expression’ (Theme 1; 59%), ‘Maintaining a Relationship with the Deceased’ (Theme 2; 23%) and ‘Channelling Grief into Positive Emotions’ (Theme 3; 18%). This study represents a first step towards understanding the use of TikTok among older bereaved individuals. As findings from this study paint a rather optimistic portrait of the experience of uploading bereavement-related content on TikTok, future inquiry could dive into the potential harms of uploading such content on the application. In view of the enduring presence of TikTok, it is crucial to investigate the clinical effectiveness of using the platform as an art form to cope with bereavement.
TRENDS IN DIGITAL DEVICE ACCESS AMONG HISPANIC OLDER ADULTS IN THE US (2011–2021)
Authors: Chen Xiayu , Dong Yanjun , Véaz Karla Sanabria , Gu Danan , Wang Kun
Published: January 2025

Despite the general increase in digital technology use among U.S. older adults within the past decade, Hispanic older adults may still face a notable digital gap due to socioeconomic disparities. Guided by the intersectionality lens, the study aims to examine (1) the trends of digital device access between Hispanic and non-Hispanic White older adults in the U.S. from 2011 to 2021 and (2) the effect of gender, education and income factors on the digital access disparity. We used 11 waves of National Health and Aging Trend data, and identified 38,253 observations from 8,503 community-dwelling older adults aged 70 and above for the analysis. Applying weighted multilevel logistic regressions, we found that compared to non-Hispanic White older adults, those who were Hispanic had significantly lower odds of having digital device access (OR = 0.42, 95% CI = 0.25 - 0.70). However, the gap in digital device access has narrowed over time. Meanwhile, specific factor-stratified models revealed that the digital access between Hispanic and non-Hispanic White older adults was significantly reduced with time among both men and women, those with low education, and those with low income, but not among those with higher education and medium-to-high income. Our findings highlight notable progress in narrowing the digital access gap for Hispanic older adults in 2011 to 2021. Nevertheless, disparities persist, necessitating continued efforts in tailored policies and community programs to address the complex factors contributing to digital inequalities.
VIRTUAL REALITY IN RESPITE: USING IMPLEMENTATION SCIENCE TO ASSESS ADOPTION OF VR WITH PLWD
Authors: Milnamow Mary , Agyemang Lillian , Bakk Louanne , Dauenhauer Jason
Published: January 2025

In the U.S., 6.7 million older adults are living with dementia (PLwD); this number is estimated to double by 2040. Community-based volunteer respite programs are vital for PLwD to receive social connections and engagement. Virtual Reality (VR) programming for PLwD is typically used in nursing homes, residential care, and rehabilitation settings. Few studies have examined using VR with PLwD and caregiver dyads receiving community- and home-based services. This study applied Implementation Science to identify facilitators and barriers in adopting a VR intervention within a respite program and to develop evidence-based strategies to guide successful implementation. The RE-AIM framework evaluated changes in VR skills, confidence, comfort, and buy-in from respite staff and volunteers. Electronic surveys were completed anonymously before VR training and after completing one VR session. The IAM and FIM were also used to assess the intervention’s acceptability, appropriateness, and feasibility. After training and practicing VR, a paired samples t-test revealed that participants significantly improved across all areas, with the most significant improvement in VR skills from pre to post (16.36 (1.31) vs. (28.00 (1.26), t= -4.44, p=.0001, respectively). The strongest facilitator was the practical and financial support provided by leadership. A persistent challenge was the cost of VR technology. Implementation strategies contributing to successful VR programming included identifying and training champions and developing a trauma-informed quick guide. Findings demonstrate effective utilization of Implementation Science to address the strengths and weaknesses of incorporating a novel intervention that prepares staff, volunteers, and families to experience VR adventures.
NEIGHBORHOOD TRANSPORTATION OPTIONS AND TRANSITIONS TO NONDRIVING
Authors: Hansmann Kellia , McAndrews Carolyn , Gangnon Ronald , Robert Stephanie
Published: January 2025

Many older drivers rely on their social networks for transportation support as they transition to non-driving, but still experience barriers to maintaining the mobility they had when driving independently. In the transition to non-driving, older adults also need transportation options in their neighborhoods to maintain mobility. We examined whether neighborhood transportation options were associated with changes in driving behaviors among U.S. older drivers. We analyzed National Health and Aging Trends Study data from community-dwelling drivers (n = 5,102; 2015 cohort). We used weighted logistic regression models to estimate whether walking or taking public transit was associated with the number of driving behaviors they avoided (avoided driving at night, in bad weather, on highways, or alone) at the three-year follow up. We also estimated the association between the National Walkability Index (NWI) and driving reduction at the three-year follow up. In 2015, 52% of older drivers reported walking to get places outside their homes, but few reported taking public transit (6%). In adjusted models, we found no associations between walking or taking public transit to get places in 2015 and driving reduction over a three-year period. However, older drivers living in very walkable neighborhoods in 2015 had greater odds of driving avoidance behaviors compared to those living in very unwalkable neighborhoods (NWI of 18 vs. 2 out of 20: adjusted odds ratio = 1.73; 95% Confidence Interval: 1.14-2.63). Future research should examine what modifiable aspects of neighborhood transportation options might play a role in supporting transitions to non-driving for older drivers.
BARRIERS AND BENEFITS TO TECHNOLOGY ADOPTION BY DEMENTIA CAREGIVERS
Authors: Simone Patti , Scott Julia , Yueter Sheila , Cepukenas Emma , Himes McKenzie , Anderson Kennedy , Mai An , Grewal Kiren
Published: January 2025

Technology can support caregivers of people with dementia but to date, they are not adopted at scale. We surveyed a range of caregivers regarding their use of technology they use to assist in caregiving tasks to better understand the relationship between technological tool use and satisfaction with caregiving. An anonymous online survey was distributed to the local community and dementia care networks in California and Washington (N = 69) and a subset of the respondents were invited to engage in a didactic interview (N = 19). Respondents identified the most important unmet need for caregivers was access to resources (53%), such as healthcare navigation, mental health support, and financial planning, all of which could be improved with technological tools. Furthermore, the majority of caregivers (64%) reported significant emotional struggle and conflict associated with their role. Similarly, interviews with professionals and caregivers illustrated concerns about caregiver well-being. Even though three-quarters of survey respondents reported using some technological tools to assist caregiving (e.g., medication and routine tracking applications, mobility assistive devices, sensors and monitors), the study showed that caregivers felt inadequately supported and they relied minimally on technology to address their pain points (e.g., mental health). Instead they noted barriers of access and usability of products as limiting features of adopting additional technology. Effective use of digital technologies can reduce caregiver stress by simplifying care tasks and delivering more convenient access to support. Strategies in product design and user communication that engage dementia care partners would likely accelerate adoption of technologies.
CAREGIVERS’ PERCEPTIONS OF ADVANCE CARE PLANNING–RELATED DISCUSSIONS FOR PEOPLE LIVING WITH DEMENTIA
Authors: Zhang Yuchen , Sereika Susan , Lingler Jennifer , Seaman Jennifer , Pettigrew Corinne , Albert Marilyn
Published: January 2025

People living with dementia (PwD) experience progressive decline in functional abilities, including the execution of real-time medical decisions. Nevertheless, advance care planning (ACP) has the potential to mitigate healthcare overutilization and prevent ethical dilemmas at the end-of-life. We aimed to characterize caregivers’ understandings of ACP-related discussions between PwD and their healthcare clinicians. This secondary analysis leveraged data (n=431) from the cross-sectional, interviewer-administered survey, “Care Planning for Individuals with Dementia”, at Alzheimer’s Disease Centers nationwide. Statistical analysis utilized descriptive statistics and multinomial logistic regression. Surveyed caregivers had a mean age of 78.3 years, were predominantly white (88.5%), and were highly educated (mean=15.9 years). Most (95.1%) were the care recipient’s designated healthcare proxy and 30.9% of caregivers were aware of discussions between PwD and clinicians about medical treatment preferences. Caregivers (23.2%) who did not co-reside with PwD were 2.71 times more likely to report knowing such discussions occurred (p< 0.001). Caregivers who had higher dementia knowledge scores were more likely to indicate the need for further discussion between the proxy and clinicians regarding treatment preferences (OR=1.27, p=0.02); however, caregivers who endorsed knowing a lot about severe stage dementia were less inclined (OR=0.31, p=0.003). Lastly, caregivers of those in earlier stages were more likely to acknowledge the necessity for additional discussions about treatment preferences between PwD and clinicians (no impairment & MCI: OR=7.38, p=0.002; mild: OR=5.32, p=0.005). Overall, our results highlight the need for healthcare clinicians to conduct ACP-related discussions proactively and explicitly include likely proxies, especially during prodromal and earlier stages of dementia.
DEVELOPMENT AND VALIDATION OF THE CLINICAL PHYSICAL RESILIENCE ASSESSMENT SCALE (CHEES) IN OLDER ADULTS
Authors: Ma Lina
Published: January 2025

Objective

Physical resilience is an emerging concept that describes an individual’s capacity to recover from stressors. However, few instruments are currently available for assessing physical resilience. We aimed to develop and validate an easy-to-use physical resilience scale, Clinical pHysical rEsilience assEssment Scale (CHEES), in Chinese older adults.

Methods

Delphi method was used to establish an initial scale. Psychometric evaluation of the scale was then tested on 172 older adults. The reliability and validity of CHEES was tested in 1982 community-dwelling and 362 hospitalized older adults. Cronbach’s α coefficient, Spearman-Brown coefficient and Guttman coefficient were used for reliability test. Validity was assessed by content validity and construct validity based on exploratory factor analysis.

Results

After two rounds of expert consultations, three primary and 16 secondary items were determined. Two items were removed after the psychometric evaluation. The final CHEES containing three primary (“intrinsic capacity”, “adapt to change”, and “external support”) and 14 secondary items showed promising properties both in community-dwelling and hospitalized older adults. The acceptance rate of the CHEES was 90.88%, and the qualified rate of the scale was 100%. The Cronbach’s α coefficient of the total scale was 0.826, Spearman-Brown coefficient was 0.737, and Guttman coefficient was 0.731. Exploratory factor analysis extracted three common factors. The factor load of each item was 0.446-0.656, and the cumulative variance contribution rate was 57.49%. Conclusions: CHEES has good reliability and validity, and is suitable for the evaluation of physical resilience of the older adults in both hospital and community.
EXPLORING DIGITAL LITERACY, HEALTH LITERACY, AND SELF-MANAGEMENT IN YOUNGER AND OLDER LIVER TRANSPLANT RECIPIENTS
Authors: Lee Hanna , Choi JiYeon , Choi Seongmi , Chu Sang Hui
Published: January 2025

Liver transplant recipients (LTRs) face challenges in self-management, including adhering to immunosuppressant therapy and navigating healthcare systems. Adequate health literacy enables LTRs to manage daily tasks, while digital proficiency enhances self-management. Understanding health and digital literacy among older LTRs is crucial for targeted self-management strategies amidst increasing digitalization and liver transplantation in older adults. This descriptive study compared health literacy, digital literacy, and self-management between younger LTRs (< 60 years; n=97, 50.88±7.19 years, 27 male, 20.57±17.42 months since LT) and older LTRs (≥ 60 years; n=58, 64.52±3.48 years, 21 male, 27.33±16.21 months since LT) and explored associations among these variables. LTRs responded to a cross-sectional survey on digital literacy (Everyday Digital Literacy Questionnaire, 22 items), health literacy (European Health Literacy Survey, 16 items), and self-management (modified Transplant Self-Management Scale, 16 items). Younger and older LTRs differed in self-management (56.95±9.43 vs 61.83±7.73, p< 0.001) and digital literacy (85.58±16.99 vs 71.17±22.98, p< 0.001), but not health literacy (13.62±3.43 vs 13.50±3.30, p=0.833). When exploring the role of health literacy and digital literacy in predicting self-management in the entire sample after controlling for age, sex, education level, household income, and time since LT, health literacy had a significant association with self-management (B=0.479, p=0.04) whereas digital literacy did not (B=0.007, p=0.87). In our sample, older LTRs reported better self-management and similar health literacy levels but poorer digital literacy compared to younger LTRs. Supporting digital literacy in older LTRs may enhance their self-management. Further studies are needed to understand digital literacy and self-management in older LTRs.
QUADRICEPS MUSCLE THICKNESS MEASURED BY POINT-OF-CARE ULTRASOUND AND HOSPITAL LENGTH OF STAY
Authors: Ganbat Uyanga , Byambaa Altan-Ochir , Meneilly Graydon
Published: January 2025

Background

Accurate prediction of hospital length of stay (LOS) and readmission rates could help improve effective healthcare resource allocation. Recent evidence suggests point-of-care ultrasound for muscle assessment, specifically muscle thickness, as a promising tool in this regard. This study explores the hypothesis that ultrasound measurements of quadriceps muscle thickness (MT) and echointensity (EI) can serve as predictors for these crucial patient outcomes.

Methods

The study measured quadriceps MT and EI using point-of-care ultrasound for patients in a supine position in the emergency department of Vancouver General Hospital. Predictor variables included age, sex, muscle thickness, and echo intensity. Outcome variables were hospital LOS, readmission rate, and discharge destination. Follow-up was conducted after one month to assess hospital readmissions and mortality.

Results

A total of 120 participants were included (average age 76.9 ± 7.5, with 64 women and 56 men). Mean LOS was 27.4 ± 31.4 days, and mean MT was 20 ± 6 mm. Sex-based differences in MT were statistically significant (P = 0.032). MT correlated significantly with LOS (Standardized β = -0.152 ± 0.016, R² = 0.290, P = 0.001). In the multivariate regression model, MT remained a significant predictor (Standardized β = -0.152 ± 0.563, P = 0.008).

Conclusion

Muscle thickness is a significant predictor of hospital stay duration. The findings of this study indicate the potential of point-of-care ultrasound in measuring skeletal muscle as an effective predictor of discharge outcomes.
INDUCIBLE SKELETAL MUSCLE SOD2 KNOCKDOWN MIMICS AGE-RELATED MITOCHONDRIAL DYSFUNCTION IN MOUSE SKELETAL MUSCLE
Authors: Ostrom Ethan , Sandhu Sahir , Marcinek David
Published: January 2025

Aging causes declines in mitochondrial energetic efficiency and increased reactive oxygen species (ROS) production in skeletal muscle, leading to declines in muscle function and impaired stress resilience. While perturbations in redox homeostasis have been associated with declines in muscle and mitochondrial function, the mechanisms and time course of this decay have not been established. Here we use a new model of inducible skeletal muscle specific knockdown of SOD2 (KD) to produce an oxidative stress and compare the functional declines to those seen in aging muscle mitochondria. We demonstrate the model induces skeletal muscle specific SOD2 protein KD by 50% at 3 weeks and 90% decrease by 8 weeks. KD showed a significant decline in in vivo muscle force in female KD mice (p=0.0249), but not male KD mice compared to controls at eight weeks. KD resulted in significant reductions in aconitase 2 (ACON2) activity an enzyme sensitive to oxidative stress. Similar to aged skeletal muscle, KD showed significant deficits of complex I-driven respiration (p< 0.0001), max oxphos capacity (p=0.0001), and maximal ROS production rate (p< 0.05) in permeabilized muscle fibers. Interestingly, the CI impairment in SOD2 KD was dependent the order of substrate addition indicating that SOD2 KD affects metabolic flexibility of the mitochondria. These results show that short term redox stress reproduces some aspects of aged skeletal muscle mitochondria. Ongoing experiments are testing the metabolic and molecular mechanisms underlying impaired metabolic flexibility related to elevated redox stress in the SOD2 KD and their relevance to aging muscle.