bluuebunny/crossref_metadata_2025 huggingface dataset:
ADULT CHILDREN‘S SINGLEHOOD AND AGING PARENTS’ PSYCHOLOGICAL WELL-BEING IN SOUTH KOREA
Authors: Lim Mihye , Lee Hyo Jung
Published: January 2025

Guided by a life course perspective, this study aims to examine the linkages between the marital status of adult children as an indicator of the transition to adulthood and their parents’ psychological well-being, considering how parental socioeconomic resources play a role in this association. We conducted a series of regression models using data from the 2018 Korean Longitudinal Study of Ageing (KLOSA, n=3112 aging parents who had at least one child over 35 years old). Consistent with the exposure model, having an unmarried son was associated with poorer parental psychological well-being, irrespective of parental income and education. However, parental education partially explained the association between daughter’s marital status and parental psychological well-being, suggesting that parental well-being regarding adult children’s marital status may depend on child’s gender and parental education level. This study has implications for the intergenerational relationships in collectivist and patrilineal Eastern cultural context. Aging parents’ psychological well-being ties to their adult children’s marital status based on the social norm regarding the transition to adulthood, and particularly sons’ marital status than that of daughters’. Also, aging parents may have different views on daughter’s marital status depending on their educational attainment. In sum, based on the concept of ‘linked-lives’ and stress process model, this study provides an extended understanding of intergenerational relations in later life in Korea. Clinicians and family professionals should consider well-being in old age associated with adult children’s life transitions and gender in the cultural context.
BURDEN AMONG INFORMAL CAREGIVERS OF OLDER ADULTS IN GHANA: A SCOPING REVIEW
Authors: Okine Joana , Ruggiano Nicole
Published: January 2025

The aging population in Ghana has experienced a significant increase, expanding tenfold from 213,477 in 1960 to 1,991,736 in 2021 during the last population census. Projections indicate that by 2030, the population of persons aged 60 and above will hit 2.8 million (Mba, 2010). In Ghana, as in many African countries, kinship-based system of care is predominant as caregiving is viewed as a filial responsibility and an expression of love. There are empirical studies done in advanced countries like the USA that have documented the burden associated with caregiving for older adults. However, literature on burden among informal caregivers of older adults in Ghana in sparse. This study aimed to review available studies exploring caregiver burden experienced by informal caregivers in Ghana. We searched for studies published since 2013 across various databases, including Ebscohost (APA PsychInfo, CINAHL, Abstract in Social Gerontology, SocIndex, APA PsychArticles, Eric Ebscohost), Web of Science, Social Services Abstracts, Sociological Abstracts, Taylor and Francis, PubMed, and Google Scholar. Out of 505 identified studies, 9 met the inclusion criteria for this review. Findings suggest that caregivers of older adults in Ghana, irrespective of the care-recipient’s condition, face various burdens, including economic, physical, and psychological challenges. However, there is a noticeable gap in research addressing the burdens faced by informal Ghanian caregivers. It is crucial to focus on understanding and mitigating the burden on this group of caregivers to inform the development of culturally relevant interventions tailored to the needs of older adults and their caregivers.
COGNITIVE FRAILTY IN RURAL KOREAN OLDER ADULTS: A GENDER-BASED EXAMINATION
Authors: Jang Ah Ram , Sagong Hae
Published: January 2025

Cognitive frailty, characterized by the simultaneous presence of physical frailty and cognitive impairment, is strongly associated with dementia and mortality, with prevalence among community-dwelling older adults ranging from 0.9% to 12.0%. Rural residents exhibit a higher risk, underlining vulnerability to health issues. However, there is a significant research gap regarding factors influencing cognitive frailty, especially in rural areas. Our cross-sectional survey conducted from May to September 2020 in rural areas of South Korea aimed to address this gap. Participants (n=376) aged 65 or older were recruited from 60 primary health care posts. Incomplete data excluded 32 participants from analysis. Cardiovascular Health Study frailty index and Korean Mini-Mental State Examination were used to categorize cognitive frailty.T-tests, Chi-squared tests, and logistic regression analysis were employed for statistical analysis. The results indicate that among males, higher nutritional scores were associated with a reduced likelihood of cognitive frailty. Conversely, in females, older age heightened the risk. Further, factors such as education, higher nutritional scores, and active social participation were linked to a decreased likelihood of cognitive frailty in females. Recognizing these gender-specific influences, tailored interventions are paramount. Strategies should aim at enhancing nutritional status for both genders while placing a specific emphasis on promoting increased social participation among females. This study enhances our understanding of cognitive frailty in rural older adults and provides valuable insights for the development of targeted interventions.
EXPLORING CURRENT CHARACTERISTICS OF GEROTRANSCENDENCE: A QUALITATIVE STUDY OF OLD PERSONS LIVING IN TOKYO SUBURBS
Authors: Kitayama Jun , Igawa Hitoshi
Published: January 2025

Tornstam (2005) proposed the concept of “gerotranscendence.” He identifies the phenomenon that the boundary between the self and the outer world is loosened in old age as gerotranscendence. The purpose of this study is to explore the experience of gerotranscendence among older people today living in the suburbs of central Tokyo. The participants, three men and five women who averaged 73.9 years old, attended a community association for older adults. The WHO-5-J scale was used to measure the participant’s mental health, and the overall score (21.4 out of 25 points) indicates that the eight participants were in good health. A semi-structured interview based on Tornstam’s gerotranscendence interview guide was conducted individually. The authors reviewed the collected narrative data and analyzed its individual and universal features. Unlike Tornstam’s idea, the results demonstrated that the participants are mainly living in actual life, in a preliminary state of gerotranscendence. The realization of psychological changes associated with aging were not often experienced. Most of them had not yet considered their views on death. They did not experience changes in their personality traits or personality integration. Interestingly, some participants mentioned that they reminisced about family members who had passed away or tried not to purchase new goods. It seemed that these usual expressions contained faint but significant indications of transformation in their views of life. This may suggest that clear phenomena of gerotranscendence seldom occur in healthy older adults. Therefore a better understanding of psychological transcendence may be achieved by focusing on individual small stories.
ADVERSE CHILDHOOD EXPERIENCES AND ALZHEIMER’S DISEASE/DEMENTIA RISK FACTORS AMONG TRANSGENDER ADULTS
Authors: Cicero Ethan , Chiow Jobina , Flatt Jason
Published: January 2025

Adverse childhood experiences(ACEs) are associated with an increased risk of developing Alzheimer’s disease and related dementias(ADRD). Compared to the general population, transgender, nonbinary, and other gender expansive people(TNGE) report a higher prevalence of ACEs and ADRD. The relationship between ACEs and ADRD risk factors among TNGE adults has not been explored. 2019-2021 Behavioral Risk Factor Surveillance System(BRFSS) data, representing 16 U.S. states that assessed ACEs, subjective cognitive decline(SCD), and gender identity were used to determine the association between ACEs and ADRD risk factors(coronary heart disease[CHD], depression, diabetes, hearing loss, high cholesterol, hypertension, obesity, SCD, smoking, stroke) among TNGE adults aged 45+(N=206). Chi-squared and adjusted odds ratios(aOR) along with 95% confidence intervals(CI) were calculated, adjusting for BRFSS year, age, race, education, and employment. Obesity(70%), hypertension(56%), high cholesterol(47%) and depression(29%) were the most prevalent risk factors among the sample. Experiencing any ACE was associated with depression and SCD; >4 ACEs was associated with CHD, depression, SCD, and stroke. As the number of ACEs increased, the odds of CHD, depression, SCD, and stroke increased by 29–41%. The odds of depression and SCD were higher with childhood abuse (aOR=3.1, 95%CI:1.7-5.9, p< 0.01; aOR=3.8, 95%CI:1.7-8.3, p< 0.01) or household dysfunction (aOR=5.1, 95%CI:2.4-10.6, p< 0.0001; aOR=4.7, 95%CI:2.0-11.1, p< 0.01). Compared with no ACEs, experiencing 2,3, and >4ACEs were associated with 1.3–5.6x higher odds of depression and SCD. A lifecourse perspective is needed when examining the brain health of TNGE adults. ACE screening/interventions for TNGE youth are needed to help reduce the risk of ADRD later in life.
PSYCHOSOCIAL WELL-BEING, RELATIONSHIP STATUS, SEXUALITY, AND GENDER IN THE CANADIAN LONGITUDINAL STUDY ON AGING
Authors: Stinchcombe Arne , Hanes Douglas
Published: January 2025

Social connection and support are vital components of later-life health; for many older people, much of this support comes from a spouse or partner. Existing research has shown that gender and sexuality are central to the effects of partnership, and thus the later-life psychosocial and mental health benefits of partnership also likely differ by these factors. Canadian Longitudinal Study of Aging (CLSA) participants were categorized according to gender and sexuality; we analyzed how the effects of relationship status differed across these categories. Several psychosocial and mental health outcome variables were tested, including depression symptoms, mood disorder, anxiety, self-rated health, social support, and social standing. Linear and ordered logistic regressions were conducted, adjusting for age and education. Married persons had lower depression scores (B=-2.20, p<.001), higher social support (B=21.49, p<.001), and subjective status (B=.61, p<.001) than other relationship categories. The differences themselves differed by gender and sexuality: lesbian/bisexual women were better overall and experienced less adverse impact (B=23.37, p<.001), while these had greater effects on gay/bisexual men (B=21.10, p<.001). Lesbian/bisexual women have greater social supports across relationship statuses, while gay/bisexual men have less social support if not partnered. Findings highlighted variable and gendered effects of relationship status and sexual orientation on psychosocial outcomes. Examining differential effects for gender and sexual minority groups is essential to inclusive gerontological research.
ORAL HEALTH IN LONG-TERM CARE FACILITIES: A SYSTEMATIC REVIEW
Authors: Wang Xiaochuan , Zaman Eman
Published: January 2025

Oral health in long-term care facilities (LTCFs) is becoming an increasing concern as the aging population grows bigger. Recent research indicates that less than 20% of older adults living in LTCFs receive proper dental care. This gap is expected to continue to expand due to various reasons such as oral health being deemed less important in healthcare culture, especially for LTCF residents who may already have multiple other medical conditions. Inadequate oral care can adversely affect one’s mental, physical, and social well-being, causing disproportionate impacts on the vulnerable LTCF resident population. Thus, it is pivotal to understand the current status of oral health care in LTCFs, and LTCF workforce’s roles, competency, and preparedness in providing such care. To address this gap, a systematic review of existing literature was conducted using PRISMA guidelines. We searched electronic databases (e.g., PubMed, ProQuest) to identify peer-reviewed articles published in English between 2013 and 2023. A total of 1101 unduplicated publications emerged in the search. After screening articles for relevance based on titles and abstracts, 22 were reviewed in full text. Sixteen articles were included in this review. Findings demonstrate that residents in LTCFs suffer from poor oral care as its significance is overlooked. The articles suggest solutions such as integrated care, expanded insurance access, and further research on oral hygiene in LTCFs. Findings underscore the importance of oral health education programs. Proper training and increased awareness is needed to prevent further health issues beyond mouth to improve oral and overall health of LTCF residents.
RELATIONSHIP BETWEEN SWALLOWING FUNCTION, NUTRITION, AND QUALITY OF LIFE DURING THE CORONAVIRUS DISEASE PANDEMIC
Authors: Morisaki Naoko , Numata Keizo
Published: January 2025

This study aimed to determine the relationship between swallowing function, nutrition, and quality of life (QOL) in older adults in Japan who stayed at home during this period of the COVID-19 pandemic. The participants of this study were adults aged 65 years or higher who were staying at home during the COVID-19 pandemic. A questionnaire-based survey was conducted from 2021 to 2022. The participants’ age, sex, swallowing function, nutrition, and QOL were surveyed. Swallowing function was assessed using the 12-item Dysphagia Risk Assessment for the Community-dwelling Elderly (DRACE) tool. Nutritional status was assessed using the Mini-Nutritional Assessment Short-Form (MNA-SF). QOL was assessed using the Short Form-8 (SF-8™) scale. Physical component summary (PCS) and mental component summary (MCS) scores were calculated based on the SF-8™ scale. Associations among swallowing function, nutrition, and QOL were analyzed using stepwise multiple regression analysis. The statistical software IBM SPSS Ver. 28.0 was used for the statistical analyses. The participants included 330 (70.1%) women and 141 (29.9%) men and their mean age was 81.5 ± 7.1 years. The participants’ average DRACE, MNA, PCS, and MCS scores were 3.65 ± 3.78, 10.25 ± 2.64, 46.31 ± 6.36, and 47.61 ± 6.31, respectively. The analysis was conducted with DRACE scores as the dependent variables and the age, sex, MNA, PCS, and MCS scores as the independent variables. A significant association was observed among swallowing function, nutritional status, and QOL (P < 0.01). The findings suggested an association among swallowing function, nutritional status, and QOL even during the pandemic.
CHANGES IN PERSONALITY TRAITS PREDICT ALLOSTATIC LOAD
Authors: Alderson Jacob , Miller Sarah , Turiano Nicholas
Published: January 2025

Understanding the influences personality change has on physical health has been identified as a key direction for personality research (Leszko et al., 2016). One key indicator of health and aging process is allostatic load, an objective index capturing physiological regulation (or dysregulation) across a variety of biological systems (e.g., inflammation, cardiovascular health). While some evidence suggests cross sectional associations between personality traits and allostatic load in older adult populations (Yoneda et al., 2023), little research at present has assessed if changes in personality are also associated with allostatic load. The present study utilizes the Midlife Development in the United States (MIDUS) data set (N = 998; Mean age = 46.14; range = 25-74), to analyze change scores in personality traits at two time points (1994-1995 to 2004-2005) as predictors of allostatic load at a subsequent time point (2004-2009). Age, race, gender, education level (at 1994-1995) and baseline level of personality traits were used as covariates. Regression analyses revealed that increases in openness (b = -.20, p =.034) and decreases in agreeableness (b =.27, p =.004) were associated with a lower allostatic load. These findings have implications for considering the role personality development has on healthy aging. Given that naturalistic change in personality does associate with important markers of physical health and physiological processes, future studies could attempt to intervene at the level of personality (e.g., attempt to increase openness) in order to promote more optimal physical health and aging processes.
THE ALTERNATIVE MODEL OF PERSONALITY DISORDERS: LONGITUDINAL PSYCHOMETRIC PROPERTIES IN OLDER ADULTS
Authors: Stone-Bury Lisa , Segal Daniel L
Published: January 2025

The Alternative Model of Personality Disorders (AMPD) is a dimensional model of personality disorders that contains two main diagnostic constructs: personality functioning and five pathological personality traits domains. This study examined the temporal stability and predictive validity of the AMPD’s two diagnostic constructs among older adults. It was hypothesized that (1) the AMPD will show high levels of both differential and absolute stability and (2) the AMPD domains measured at baseline will be significantly predictive of various salient aspects of psychosocial functioning at Time 2, including interpersonal, intrapersonal, health, and social functioning. Community-dwelling older adults (n = 200) were recruited online and completed self-report questionnaires of the AMPD and aspects of psychosocial functioning. A subsample of the original group (n = 172) completed the same questionnaires three months later. Correlations and paired samples t-tests partially supported the temporal stability of the AMPD: personality functioning demonstrated good temporal stability, whereas pathological personality traits were mixed (good differential stability and poor absolute stability). Hierarchical regressions supported the pathological personality trait model’s predictivity validity among older adults, with Time 1 scores significantly predicting personality, interpersonal, intrapersonal, health, and social functioning scores at Time 2. Overall, hypotheses were partially supported. Differential stability (relative positioning of a participant within the sample) of the AMPD’s pathological personality trait model appears questionable in older adults, which is notable given the brief period of time examined in the study. However, the AMPD showed good predictive validity, with the trait model predicting several clinically meaningful outcomes in later life.
DOES ASSET POVERTY INFLUENCE HEALTH AND WELL-BEING IN LATER LIFE? AN 8-YEAR PROSPECTIVE STUDY IN CHINA
Authors: Chen Yu-Chih , Hu Ting
Published: January 2025

Wealth serves as a financial cushion for older adults that can be consumed to generate economic, psychological, and social benefits in later life. Asset poverty, defined as inadequate wealth to cover basic needs for three months, can lead to financial instability and diminished well-being. However, research on its impact on the health and well-being of older adults, particularly in developing countries like China, is scarce. Using data from 7,982 adults aged 60 and older from the 2011-2018 China Health and Retirement Longitudinal Study, this study investigates the effects of asset poverty on cognition, self-rated health, depressive symptoms, and life satisfaction. Four types of asset poverty across time (i.e., persistent asset poverty, transitioning into asset poverty, transitioning from asset poverty, and persistent asset non-poverty) were constructed using three varied wealth measures: total assets, financial assets, and non-housing assets. Findings from the two-way fixed effect model showed that, compared to those consistently above the asset poverty line, households falling into asset poverty or experiencing prolonged asset poverty reported lower self-rated health and life satisfaction, along with higher depressive symptoms. Even transitioning out of asset poverty correlated with lower self-rated health and life satisfaction. However, asset poverty was not associated with cognition. This study underscores the significance of maintaining adequate assets to guard against financial insecurity and diminished mental health. Policies aimed at fostering lifelong asset accumulation and development should be advocated to bolster health and well-being in later life.
GETTING OLDER AND GETTING BY WITH SSI
Authors: Freitag Callie
Published: January 2025

For decades, qualitative researchers have asked low-income younger adults how they make ends meet in light of a shifting safety net. Yet, we know comparatively little about the daily economic lives of an increasingly policy-relevant group: low-income older adults who receive Supplemental Security Income (SSI). SSI provides a monthly backstop of cash assistance, a maximum of $943 per month in 2024, but its strict income and asset limits may mitigate its poverty-reducing potential. Additional disability-based eligibility requirements for people under age 65 may create administrative burden and perpetuate economic and health disparities. This project uses nationally representative, secondary qualitative interview data from the American Voices Project to examine the life events that led older adults to take up SSI and describe how they make sense of their economic circumstances in light of SSI’s benefits and constraints. From a stratified subsample of low-income adults ages 50 years older (N=28), I take an abductive approach to analyze interviews and compare findings across respondents who entered SSI through the disability and retirement pathways. I find that a wide array of life experiences lead older adults to SSI, but nearly all are underscored by a lifetime of precarious employment and persistent poverty. Most respondents say they are able to “get by” between their monthly SSI check and other resources like subsidized housing, but are unable to cope with large, unexpected expenses without turning to family or debt.
LABOR FORCE TRANSITIONS, INCOME CHANGES, AND POVERTY ENTRIES AMONG OLDER WORKERS: 2018–2023
Authors: Freitag Callie , Hill Heather
Published: January 2025

Economic downturns and recoveries, like the one caused by the COVID-19 pandemic, can change retirement plans by prompting early retirement or inducing workers to remain in the labor force longer. These changes in the timing and circumstances of later-life labor force transitions can have significant impacts on the income sources available to those making the transition—and thus the likelihood of experiencing poverty—but prior studies do not examine these outcomes. Using the Current Population Survey March ASEC from 2018-2023, this study examines older adults’ (age 50 or over) labor force transitions during the COVID-19 pandemic. We contribute to prior literature by focusing specifically on trends, and the economic consequences of two types of labor force exits: retirement or non-retirement. Our main analysis estimates associations between labor force transitions and entries into poverty and describes changes in income during labor force transition years. We find that transitioning out of the labor force for any reason is significantly associated with substantial reductions in total income and a higher likelihood of entering poverty. However, these associations did not change much throughout the pandemic or recovery period. We also find that COVID-19 Economic Impact Payments and Unemployment Insurance were important protections against earnings losses and poverty entries in 2021, but especially for those who transitioned out of the labor force. This study also sheds light on the fluidity of retirement and labor force participation in later life.
GENERATING VIDEO VISITS FOR RURAL OLDER VETERANS IN TELE-GERIATRIC MENTAL HEALTH SERVICES
Authors: Gould Christine , Carlson Chalise , Humber Marika , Peeples Amanda , Burningham Zachary , Trivedi Ranak
Published: January 2025

Telehealth services increase access to specialty mental health services for rural older adults. Within the Veterans Health Administration (VHA), older Veterans are more likely to receive audio-only mental telehealth services compared with younger Veterans. Using a mixed methods approach, we examined the use of video telehealth services by geriatric mental health (GMH) providers in four regional VHA telehealth hubs. Between October 2022 and September 2023, 351 rural Veterans with a mean age of 75.1 years (SD = 8.8) received services from one or more GMH provider. Patients were mostly white (88.6%), males (95.4%) with high care needs (CAN = 81.6 out of 100, indicating highest need). Of the 1,440 encounters delivered, 49% were video to home, 27% were video to clinic, 19% were telephone, and 5% were e-consultation services. Through interviews with GMH providers, we identified technology-related barriers and solutions used to help rural Veterans be seen via video. Findings suggested that barriers to video services included lack of home internet and/or devices, poor connection, and audio or video issues. Solutions included using VHA resources to obtain iPads for patients who lacked connectivity/devices and prioritizing getting patients into local clinic when needed for video visits. Providers described utilizing the telehealth clinical technician to help overcome patient barriers and discomfort with digital technology through teaching patients and caregivers to use home telehealth software. With troubleshooting, use of resources and training, high quality video telehealth services can be delivered successfully to older rural Veterans and increase access to GMH care.
THE CARE NAVIGATOR ROLE IN RURAL PRIMARY CARE MEMORY CLINICS
Authors: Morgan Debra , Bayly Melanie , Kosteniuk Julie
Published: January 2025

Collaborative dementia care models that include a navigator role achieve better outcomes but little is known about impacts in rural settings. Rural primary healthcare memory clinic teams in Saskatchewan include Coordinators from the Alzheimer Society of Saskatchewan (ASOS) First Link Program, which aims to connect persons living with dementia (PLWD) and families with supports at diagnosis. We examined perceptions of First Link Coordinators (FLC) and memory clinic team members about the FLC role, and evaluated impact of the role within the memory clinic (compared to self- and direct-referrals from other healthcare providers) on timeliness, number of completed FLC-client contacts, topics discussed, duration, and contact method. The QUAL+QUAN design included: (1) semi-structured interviews with three FLC and six team members in four rural memory clinics, (2) routinely collected ASOS client data. Separate inductive thematic analyses with FLC and team interviews (Jan 2021-Apr 2023) identified two common themes: benefits for PLWD and families (eg, early and ongoing connection to emotional support) and benefits for team members (eg, can focus on their unique role). Face-to-face contact established a FLC-family relationship and facilitated follow-up contact. Longitudinal retrospective analysis of ASOS data found that between Dec 2017-Dec 2021, 139 clients (predominantly spouses, children) were referred. Compared to other referrals, statistically significant differences (p<.05) included: memory clinic clients contacted sooner after referral, longer duration of first contact, more completed contacts, more topics discussed. Findings demonstrate the added value of FLC in rural memory clinics. Future research should explore long-term outcomes for PLWD and families.
CAREGIVING FOR OLDER ADULTS LIVING WITH DEMENTIA AND CONCURRENT HEARING LOSS
Authors: Lewis Charity , Zhang Wuyang , Reed Nicholas , Sanchez Victoria , Arnold Michelle , Haley William
Published: January 2025

While hearing loss and dementia are highly concurrent conditions, there is a lack of studies examining its impact on dementia caregiving. Hearing loss has been identified as an unmet need among older adults living with dementia, as it contributes to communication challenges. Using Round 12 (2022) of the linked National Health and Aging Trends Study (NHATS) and National Study on Caregiving (NSOC), we aim to investigate the association of concurrent hearing loss and dementia with caregiving stressors and appraisals. Our study population consisted of 1,445 (Mean age: 61±15 years; Female: 68%) caregivers assisting 942 older adults (Mean age: 82±8 years; Female: 66%; non-Hispanic White: 59%). Hearing loss was measured using pure-tone audiometry and dementia was ascertained using a pre-established algorithm in NHATS. Caregiving stressors, including hours of care in the past month and caregivers’ appraisals of difficulties in physical, emotional, and financial domains, were self-reported. In the analytic sample, the prevalence of hearing loss among care recipients with dementia was high (274/314: 87%). Moreover, 431 (30%) of caregivers provided care to an older adult with concurrent hearing loss and dementia. After adjusting for caregiver-recipient characteristics, results from linear regression models suggest among caregivers assisting older adults with dementia, per 10-dB increment in care recipients’ hearing was associated with a 35% increase in caregiving time (95% CI: 9%-68%). No statistically significant associations were observed regarding caregivers’ perceived difficulties. Our findings suggest that caregivers of older adults with concurrent hearing loss and dementia may be more susceptible to facing greater caregiving intensity.
IMPROVING DETECTION OF UNTREATED HEARING LOSS IN A COMPREHENSIVE CARE SETTING USING A SINGLE-QUESTION SCREENER
Authors: Mamo Sara , Krysko Alyssa , Garrity Katherine , Wallhagen Margaret
Published: January 2025

A majority of older adults have untreated hearing loss, which poses care and communication challenges for healthcare providers. Routine identification of hearing loss would help providers and individuals recognize hearing as a possible contributor to communication difficulties. The objective of the study was to implement a single-question hearing screening administered by medical assistants (MAs) in a health clinic. The study took place in a Day Health Clinic at a Program for All-Inclusive Care for the Elderly (PACE). Participants included anyone seen in the clinic during the study. Participants were screened by the MA, and the researchers collected hearing thresholds after their appointment. We performed behavioral hearing threshold testing and used a 4-frequency pure-tone average to estimate the individual’s hearing status and measure the sensitivity/specificity of the screening method. With a sample of 49 participants (age range = 56-90 years), we calculated a sensitivity of 71.4% and a specificity of 42.9%. Categorically, our behavioral hearing tests resulted in 14 individuals with clinically normal hearing, 24 with mild hearing loss, and 11 with moderate or worse hearing thresholds. There were no current hearing aid users in the sample, and three who reported having used hearing aids previously. The findings suggest that a single-question screener can be used as a simple method of identifying individuals who may benefit from a hearing evaluation and/or hearing loss treatment. Future studies should integrate ‘hearing status’ prominently in the individual’s medical record and establish protocols for using personal amplifiers to support adults with untreated hearing loss.
VISUAL DIFFICULTY AND VALUED ACTIVITY AMONG OLDER ADULTS: FINDINGS FROM THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Xu Shu , Wang Haowei
Published: January 2025

Vision loss is common among older adults and is associated with reduced activity. However, few studies have examined the value of various activities for older adults with visual difficulty. Using nationally representative data from the National Health and Aging Trends Study 2022, we examined activity preferences and participation among older adults with and without visual difficulty (N=5,807). We explored potential barriers (e.g., transportation, health, and COVID-19) limiting participation in valued activities. Visual difficulty was measured by self-reported vision status and impairments. Valued activities were assessed by four items: visiting friends and family who lived separately, attending religious services, participating in clubs, classes, or other organized activities, and going out for enjoyment. Activities rated as “very important” were considered to be of personal value to the individuals. Weighted sample characteristics showed that 56.3% of participants aged between 65 and 74 years old, and 8.6% experienced visual difficulty: 6.5% near or distance visual difficulty, 1.9% near and distance visual difficulty, and 0.3% blindness. Overall, most older adults (58.7%) rated visiting friends/family as important. Logistic regression results showed that older adults with near and distance visual difficulty were less likely to engage in valued activities (OR = 0.36) and more likely to report health-related (OR = 2.75) or COVID-19 restrictions (OR = 2.04) for ceasing participation in any valued activity, compared to those with no visual difficulty. Findings underscore the significance of developing interventions that bridge the gap between activity preferences and participation for older adults with visual difficulty.
EFFECTIVENESS OF A COMMUNITY NAVIGATOR PROGRAM TO IMPROVE SOCIAL CONNECTEDNESS IN CLINICAL SETTINGS
Authors: Smith Matthew
Published: January 2025

While healthcare professionals are uniquely positioned to identify social disconnectedness among older patients, coordinated linkages to community-based organizations are essential to provide social engagement opportunities. The Reduce Social Isolation and Lift Outcome for Seniors (SILOS) program was created to screen older adults for social disconnectedness risk and link them to community services, resources, and programs. Patients ages 50 years and older were screened in the healthcare setting or by community health workers (CHW) using the Upstream Social Interaction Risk Scale (U-SIRS-13) and Duke Social Support Index (DSSI). Participants completed baseline assessments, and data were collected again at 3, 6, and 12 months. Data were analyzed from 119 participants enrolled in the SILOS program. On average, these individuals were age 67 years. Sixty-six percent of participants were female, 15.3% were Hispanic, 70% were Caucasian, and 36% were Black or African American. At baseline, 92% of participants reported social disconnectedness risk. On average, participants reported significantly lower social disconnectedness from baseline to 3-month follow-up (t=6.15, P< 0.001), 6-month follow-up (t=7.65, P< 0.001), and 12-month follow-up (t=5.01, P< 0.001), respectively. On average, participants reported significantly higher social support from baseline to 3-month follow-up (t=-3.28, P< 0.001), 6-month follow-up (t=-3.67, P< 0.001), and 12-month follow-up (t=-3.81, P< 0.001), respectively. Findings from this initiative highlight the benefits of navigated clinical-community linkages to identify and address social disconnectedness among older adults. Including CHW in SILOS was essential to build trust and create rapport with the older adults, facilitating an in-depth understanding of social deficits, risk, and need for clinical and community services.
GEOGRAPHY AND LIVING ARRANGEMENT AS LONELINESS FACTORS FOR OAA NUTRITION CLIENTS DURING COVID-19
Authors: Menne Heather , Osborne Jason , Pendergrast Claire
Published: January 2025

Loneliness is increasingly understood as a public health crisis. Multiple risk factors for increased loneliness in older adults have been identified in previous studies, including age, gender, race, geographic location, and living alone. Social distancing efforts during the COVID-19 pandemic may have increased loneliness among older adults. This study uses two cross-sectional waves of the National Survey of Older Americans Act Participants (NSOAAP) from 2019 and 2021 to expand understanding and identify possible points of intervention to increase social support for vulnerable older adults. Results reveal that while home-delivered meal participants have higher overall levels of loneliness than congregate meal participants. Those receiving home-delivered meals did not experience changes in loneliness during the COVID-19 pandemic, and did not differ significantly by age, geographic location, or living arrangement. Congregate meal participants’ loneliness was lower before the pandemic but increased during the first year of the pandemic, particularly for participants aged 65-74, those living in suburban or rural areas, and those living alone. The significant differences based on geography and living arrangement for congregate meal clients (but not home-delivered meal clients) suggest the need for further investigation as to whether living arrangement has a buffering effect on loneliness or whether the closing and less access to congregate meals sites impacted loneliness. These findings suggest opportunities for policymakers and aging services providers who seek to increase social engagement among older adults who participate in Older Americans Act (OAA) nutrition programs.
LONELINESS AMONG PERSONS WITH LONGSTANDING MULTIPLE SCLEROSIS (MS)
Authors: Stuifbergen Alexa , Grimes Darla , Becker Heather , Kim Nani
Published: January 2025

The isolation induced by the global COVID pandemic highlighted the negative health and quality of life impact of loneliness and loss of social connections, especially among those who are aging with chronic disabling conditions with associated mobility and sensory impairments that make community participation more difficult. The purpose of this study was to explore the relationship between loneliness and depressive symptoms and health behaviors and quality of life outcomes for persons with MS using data collected in 2023 as part of an ongoing longitudinal survey study. The survey included measures of loneliness, depressive symptoms, self-rated health, health behaviors and quality of life outcomes. The sample (N=157) of community-residing persons with MS had a mean age of 70.70 (SD=7.80) and had been diagnosed with MS for an average of 35.16 years (SD=6.16). The majority were married (61%) and female (90%). Fifty-five percent of participants rated their overall health as good or excellent. Reports of loneliness were strongly positively correlated with reports of depressive symptoms (r=.63, p<.001), negatively correlated with economic adequacy (r= -.64, p<.001) and had a small negative correlation with age (-.23, p< 01). Greater functional limitations were associated with greater loneliness (r=.27, p<.001) and depressive symptoms (r=.37, p<.001). Loneliness and depressive symptoms had a similar pattern of moderate to strong negative correlations with reports of health behaviors and quality of life outcomes. Novel interventions to identify and treat loneliness and depression among older adults with chronic disabling conditions may improve important health and quality of life outcomes.
PERCEPTIONS AND ATTITUDES TOWARD LONELINESS DETECTION USING PASSIVE SENSING TECHNOLOGIES IN OLDER ADULTS
Authors: Cho Emma , Demiris George , Cho Hannah , Lee Insup , Yuh Ahhyun , Ji Xiayan , Harrison Sean Lee , Sokolsky Oleg
Published: January 2025

While passive sensing has been examined in terms of older adults’ acceptance for the purpose of tracking activity levels or daily routines, less attention has been paid to how older adults perceive monitoring technologies that specifically capture levels of loneliness and social isolation. Therefore, the purpose of this study is to explore the perceptions and attitudes of older adults toward passive sensing technologies installed in their homes to assess loneliness. Structured interviews were conducted to assess older adults’ perceptions and attitudes toward passive sensing technologies to assess their loneliness after six months of having seven types of sensors (e.g, motion, temperature, bed and door sensors) installed in their homes. Audio recordings were transcribed and content analysis was conducted. A total of 15 older adults participated in the interview sessions. Themes included participants’ adaptation and adjustment, privacy and trust in data sharing, and perceived benefits and concerns of the installed sensors. Benefits included detecting and reducing loneliness, monitoring physiological parameters, improving healthier behaviors, etc. Concerns were raised about privacy, such as potential misuse by authorities or third parties, lack of accuracy of functions or feasibility of sensors, and lack of human response. All participants had an overall positive attitude towards sensors that could be installed in their homes to assess their loneliness.
RISK AND PROTECTIVE FACTORS FOR INCREASING ISOLATION AND LONELINESS AMONG OLDER ADULTS
Authors: Hughes Tiffany , Fang Fang , Wang Yueting , Jacobsen Erin
Published: January 2025

Social isolation and loneliness are associated with poor health and quality of life as well as decreased longevity. This study examines patterns of change in self-reported isolation and loneliness, and factors associated with these patterns, using data from 1,474 cognitively normal participants followed annually for up to 12 years in a population-based cohort study of older adults. Composite measures of isolation and loneliness were created, and trajectory analyses were conducted to detect patterns of change in these composites over time. Multinomial logistic regression tested associations of baseline demographic, health, and lifestyle factors with patterns of change in isolation and loneliness. Trajectory analyses revealed three patterns of change in isolation - slowly decreasing, slowly increasing, and quickly increasing; and three patterns of change in loneliness - stable, increasing, and decreasing. Participants who had ever smoked, currently drank alcohol, were physically active, had hypertension, used the computer, and were not obese at baseline were less likely to be in the quickly increasing isolation pattern. Those with greater isolation and loneliness at baseline, who lived alone, were obese, did not have daytime sleepiness, and rated health as very good or excellent were more likely to be in the increasing loneliness pattern. Distinct patterns of change in isolation and loneliness were found over 12 years with different factors associated with risk for changing isolation and loneliness over time. Understanding characteristics of participants associated with change in isolation and loneliness over time may help to identify older adults for interventions.
SOCIAL ISOLATION AND WELL-BEING IN OLDER ADULTS: EXAMINING THE POTENTIAL PROTECTIVE EFFECT OF PHYSICAL ACTIVITY
Authors: Ogunjesa Babatope , Ashrafi Sadia Anjum , Alam Rifat , Dubure Emmanuel , Schwingel Andiara
Published: January 2025

As individuals age, the issue of loneliness and social isolation becomes a growing concern for public health. These can have significant health consequences for older adults, including an elevated risk of heart disease, high blood pressure, depression, and dementia. To explore the association between social isolation and self-reported general health as well as the interaction of physical activity, we conducted a study analyzing a sample of 2,203 older adults (aged 65 and above) from the Health Information National Trends Survey 6 (HINTS 6). We used a logistic regression model while controlling for socio-demographic factors. Our study found that older adults with high levels of social isolation are less likely to report high self-reported general health (OR=0.958, 95%CI=0.931 – 0.987). However, those who met the recommended guideline of 150 minutes or more per week of moderate-vigorous physical activity are more likely to experience better self-reported general health (OR=3.37, 95%CI=1.878 – 6.050) than those who don’t meet the guideline. In our interaction effect analysis, we observed that for both physical activity groups, the predicted general health outcome decreases over time with an increased isolation score, but it decreases faster for those getting less than 150 minutes of moderate exercise per week. These findings suggest that social isolation has negative impact on health in later life and that regular moderate physical activity and meeting recommended guidelines may help protect older adults against the adverse health consequences of isolation. Interventions targeting social connectivity and promoting physical activity may improve isolated older adults’ health outcomes.
SOCIAL RELATIONSHIPS OF OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Kilaberia Tina , Hu Yuanyuan , Bell Janice
Published: January 2025

This study examined the impact of the COVID-19 pandemic on social relationships of older adults in two groups: eleven who were part of a caregiving dyad and seven who were not (mean age=79; 12 White, 5 Black, 1 More Than One Race). Semi-structured qualitative interviews were combined with the Lubben Social Network Scale (six-item version, LSNS-6). Those in dyads and not in dyads reported comparable extent of social connections on average with family (9 monthly social engagements vs. 9.5 on LSNS-6, respectively). Those in dyads reported greater social engagement on average with non-family individuals than those not in dyads (8.5 vs. 7 on LSNS-6). Older adults in both groups had greater social connections with family than non-family members. Qualitative themes such as seeking, losing and keeping ties represent the range of social connection experiences: all in dyads (vs. five not in dyads) referred to family members as key persons during the pandemic, five (vs. one) reported social isolation from family members specifically, zero (vs. three) identified a spouse or partner as most protective, five (vs. three) described supportive relationships, and four (vs. one) described relationships needing adjustments as a result of the pandemic’s impact. Six older adults in dyads (vs. two not in dyads) described non-family contacts as key, eight (vs. three) described the loss of connection with friends, and three (vs. zero) identified friends or hobbies as most protective. Type of dyadic relationships (spouses vs. parent-child vs. friends) and relationship quality may influence older adults’ social connections differently.
THE INNER DYNAMICS OF THE OLD AND SOCIALLY WITHDRAWN IN JAPAN: INSIGHTS FOR INTERVENTIONS FROM CASE STUDY ANALYSES
Authors: Ikeuchi Tomoko , Hayashida Cullen
Published: January 2025

An increasing number of older adults in Japan are refusing social support even when offered. This lack of support elevates their risk of health deterioration, delays evacuation in disaster scenarios, and increases the likelihood of premature and lonely deaths with inadequate closures. This study examines the psychological factors contributing to the lack of motivation among socially isolated older adults in Japan to seek help. We conducted semi-structured one-on-one interviews with nine individuals aged 60 years or older who reside in the community identified as socially isolated by community-based healthcare personnel. Using a narrative case study approach, the study revealed a prevalent concern among these socially isolated individuals about causing inconvenience to others by seeking help. The findings suggest that their reluctance to ask for help may be driven not by a desire to maintain independence but rather by a concern about inconveniencing others. In the context of Japanese culture, maintaining harmony with others is considered important. Asking for help might inconvenience others and potentially disrupt this harmony. To effectively assist those who refuse necessary support, social and community health workers should develop ways of minimizing the perceived burden of the recipients. However, further research is necessary to establish whether these findings are unique to the Japanese cultural context. Examples of innovative strategies to address this challenge will be discussed.