bluuebunny/crossref_metadata_2025 huggingface dataset:
THE EFFECTS OF NEIGHBORHOOD, NETWORK, AND INDIVIDUAL EDUCATION LEVELS ON COGNITIVE HEALTH
Authors: Webster Noah , Zahodne Laura , Antonucci Toni , Ajrouch Kristine
Published: January 2025

It is well established that greater education is associated with better cognitive health. Less is known about the cognitive effects of education across levels of influence, including neighborhood, interpersonal, and individual levels. In this study we compare the effects of individuals’ education, their social network members’ education, and their neighborhood’s education on cognitive health five years later. Respondents age 60 and older who participated in Wave 3 (2015) of the longitudinal Social Relations Study based in Metro Detroit and also completed interviews in 2021 for the Detroit Area Wellness Network COVID-19 Supplement project were selected for analysis (n=161). In 2015, respondents were asked to report completed years of education and the education level of up to 10 social network members. Household addresses were geocoded and census tract educational attainment was obtained from the American Community Survey. In 2021, cognitive assessments were administered via telephone, and a latent variable measuring global cognition was derived from episodic memory, language, attention, and working memory tests. In separate models controlling for age and gender, respondents’ own education and the proportion of social network members with a bachelor’s degree, but not the proportion of people in the census tract with a bachelor’s degree, were associated with better cognitive health. In a combined model, only having a greater proportion of social network members with a bachelor’s degree remained associated with better cognitive health. Findings highlight the salience of educational resources embedded within social networks for cognitive health and point to the need for meso-level interventions.
FOSTERING MULTIDISCIPLINARY SOLUTIONS IN AGING: THE RESEARCH CENTERS COLLABORATIVE NETWORK
Authors: Kritchevsky Stephen , van der Willik Odette
Published: January 2025

The NIA supports the Research Centers Collaborative Network (RCCN) to bridge scientists from the 7 NIA-sponsored center programs: Alzheimer’s Disease Research Centers, Artificial Intelligence and Technology Collaboratories for Aging Research, Centers on the Demography and Economics of Aging, Claude D. Pepper Older Americans Independence Centers, Nathan Shock Centers of Excellence in the Basic Biology of Aging, Resource Centers for Minority Aging Research, and Roybal Centers for Translational Research on Aging. To provide a forum for collaborative exchange, RCCN has convened workshops on crosscutting concerns relevant to multiple NIA center programs ranging from sustaining behavior change in older adults to measuring biologic age. RCCN also awards pilots that address topics spanning the missions of multiple NIA Center Programs. This symposium will present key learnings from the work of five RCCN pilot teams. Dr. King will discuss a novel analysis of proteomic and cellular senescence biomarkers in kidney using a non-human primate model. Dr. Nguyen will discuss the relationship between social disconnection and changes in cognitive health over time among older Black adults. Dr. Quiñones-Cordero will discuss culturally congruent interventions to improve Latino ADRD caregivers’ psychological well-being. Dr. Christensen will discuss the development and implementation of older adult community engagement studios (OA-CES) to promote the inclusivity of older adults in research and to increase the number of research studies on older adults. Dr. Landauer will discuss the development of Age Friendly training webinars and research tools. Dr. Kritchevsky will also summarize lessons learned across the workshops.
ADAPTING COMMUNITY ENGAGEMENT STUDIOS FOR AN OLDER ADULT COMMUNITY EXPERTS
Authors: Christensen Janelle , Kerper Shaye , Albert Steven , Ragavan Maya , Scheunemann Leslie , Massart Mylynda
Published: January 2025

The development and implementation of older adult community engagement studios (OA-CES) to promote the inclusivity of older adults in the research process and to increase the number of research studies on (and inclusive of) older adults. This project utilized University of Pittsburgh Clinical and Translational Science Institute’s (CTSI, the required CTSA Hub) success using Community Engagement Studios (CES) to connect researchers with other populations historically underrepresented in biomedical research and bring it to older adult (OA) populations. This collaboration between the Pittsburgh Pepper Center (Pitt Pepper, NIA Center Program) and CTSI created a training and orientation process for older adults to: 1. Help researchers learn about how to more effectively include older adults in the research process and overcome barriers to the inclusion of older adults in their research; 2. Select and tailor implementation strategies to counter these barriers to inclusion, ultimately creating a toolkit that can be shared with other NIA Center Programs/ CTSA Hubs. The Community Engagement Studios themselves were tailored to address needs for inclusion of older adults during recruitment and implementation of the studios: 1) sending snail mail before calling and emailing potential participants; 2) providing a two hour orientation to research ethics and expectations for Community Engagement Studios; 3) providing multiple options for transportation to and from the in-person events; 4) providing increased tech support and training for remote events (via zoom). These best practices allow for the Pepper Center and CTSI to better consult with researchers seeking to increase the inclusion of older adults.
PET ATTACHMENT AND RETAINED PHYSICAL FUNCTION IN COMMUNITY RESIDING OLDER ADULT PET OWNERS
Authors: Friedmann Erika , Gee Nancy , Simonsick Eleanor , Resnick Barbara , Gurlu Merve , Shim Soyeon
Published: January 2025

Pet ownership has been associated with slower deterioration in cardiorespiratory fitness (400-M walk time), gait speed, overall functional performance and physical well-being independent of age and comorbidities in older adults with increasing age. As level of pet attachment, an aspect of social support, may impact physical function, we evaluated this association using data from the Baltimore Longitudinal Study of Aging (BLSA). In this longitudinal observational study of 214 pet-owning, generally healthy community-dwelling adults aged 50-100 years (M=68.0, SD=7.8), pet attachment and physical function were assessed during regularly scheduled visits every 1-4 years over 1-13 years (M=7.5,SD=3.6). Linear mixed models with pet attachment, time, and pet attachment by time interaction controlling for age and comorbidities were used to examine the relationship of pet attachment to deterioration in several physical function outcomes. Higher pet attachment was associated with slower deterioration in usual (p< 0.001) and rapid gait speed (p=0.002) and overall physical performance (p=0.009) not cardiorespiratory fitness or physical well-being. Among dog owners only (N=121) attachment did not moderate deterioration in physical function. Among cat owners (N=100), higher attachment was associated with slower decline in physical well-being (p=0.035). We provide important longitudinal evidence that pet attachment is differentially associated with rates of decline in physical function that older adults experience as they age and that attachment to different types of pets may have different relationships to the decline process. Potential explanations for these differences are proposed.
PROMOTING ACTIVE AGING THROUGH TAEKWONDO AMONG OLDER ADULTS
Authors: Seo Minhwa , Im Sua , Heo Jinmoo
Published: January 2025

With increasing longevity, the older adult’s population is growing, highlighting the importance of addressing issues related to active aging. In Korea, older adults actively participate in various leisure activities, including a specialized group practicing Taekwondo, a traditional Korean martial art, to promote active aging. This study aims to explore the role of Taekwondo engagement in active aging. Utilizing a phenomenological method design with semi-structured interviews, we explored how Taekwondo influences active aging. Participants aged 73 to 95, and each participant was diagnosed with at least one disease such as arthritis, stroke, or facial paralysis (n =12). Through in-depth interviews, three main themes and seven sub-themes emerged, all aligned with the WHO’s Active Aging model. The first theme highlights the promotion of diverse social participation through Taekwondo involvement, encompassing leisure, cultural engagement, community integration, and participation in competitions and performances. The second theme focuses on the positive impact on physical and mental health. Participants reported enhanced well-being, including reduced knee pain and improved cognitive function, following Taekwondo engagement and social interaction. The third theme emphasizes the security benefits associated with health promotion and participation in Taekwondo. Older adults were able to mitigate isolation through social connections and enhance their mobility and independence through physical activity. Overall, our findings underscore the potential of Taekwondo as a promising avenue for fostering active aging among older adults. This study contributes valuable insights for promoting health and well-being in aging populations.
DEVICE-MEASURED MOVEMENT BEHAVIORS IN A NATIONALLY REPRESENTATIVE COHORT OF OLDER ENGLISH ADULTS
Authors: Brocklebank Laura , Doherty Aiden , Steptoe Andrew
Published: January 2025

Movement behaviours impact various health outcomes. However, they have rarely been objectively measured in large nationally representative cohorts of older adults. We aim to describe the collection and analysis of device-measured movement behaviours in the English Longitudinal Study of Ageing (ELSA), and report variation by key participant characteristics. ELSA is a nationally representative cohort of English adults aged ≥50 years. In 2021-23, a random subset of 5,429 individuals were invited to wear a wrist-worn triaxial accelerometer for eight consecutive days. 4,400 agreed (81.0%) and of them 3,308 (75.2%; 55.6% men; aged 68.5 ± 9.0 years) had sufficient wear time (median [IQR] 8.0 days [7.4-8.4]). We used a machine-learning model to infer time spent in four movement behaviours (sleep, sedentary behaviour, light physical activity [LPA], and moderate-vigorous physical activity [MVPA]). Average acceleration, or overall physical activity, was 22.9 mg/day. On average, participants spent 9.4 hours/day (39.0%) sleeping, 9.8 hours/day (40.8%) being sedentary, 4.4 hours/day (18.1%) in LPA, and 30.4 minutes/day (2.1%) in MVPA. Despite men accumulating more MVPA than women, women had higher overall physical activity (23.2 vs. 22.5 mg/day) by accumulating more LPA and less sedentary time. Adults aged ≥65 years had lower overall physical activity than those aged 50-64 years (21.1 vs. 26.5 mg/day) by spending less time being active and more time being sedentary and sleeping. These data will shortly be deposited in national archives for use by other research teams and will enhance our knowledge about the potential relevance of different movement behaviours for healthy aging.
INCORPORATING EXERCISE TO BUFFER AVERSIVE HEALTH EFFECTS OF LONELINESS AMONG OLDER ADULTS IN THE LIFE TRIAL
Authors: Kaushal Navin , Pemmasani Deepishka , de la Colina Adrian Noriega , Nemati Donya
Published: January 2025

Introduction

In 2023 the US Surgeon General announced an epidemic of loneliness and isolation. Prolonged loneliness among older adults has been shown to predict dementia and cardiovascular disease (CVD). However, exercise has been demonstrated to have preventive effects on CVD and cognitive health, but its effects on buffering these outcomes manifested from loneliness, or gender effects have not been investigated. This study aimed to test two moderated-mediation models to investigate if exercise moderates the relationship between loneliness and health outcomes.

Methods

The Lifestyle Interventions and Independence for Elders (LIFE) Study is a randomized controlled trial (n=1,600) that assigned older adults (aged 65+) to either an intervention or control group. The present observational study analyzed participants in the control group. Measures included: exercise (accelerometry), loneliness (Center for Epidemiologic Studies Depression Scale [CES-D]), CVD risk (handgrip test), and cognitive health (global cognitive function). Model #14 from Hayes PROCESS Macro 4.0 in SPSS was used to analyze the data.

Results

In both models, females experienced greater loneliness compared to males(β=.25, p<.001). The CVD risk model found Moderate-to-Vigorous Physical Activity (MVPA) to independently predicted handgrip strength(β=.11, p<.001), and interacted with loneliness to predict handgrip strength(β=.05, p=.03). The cognition model also found MVPA to independently predict cognition(β=.14, p<.001), and interacts with loneliness to predict cognition(β=.07, p=.03), and also demonstrate total moderated-mediation effects(β=.02, 95%CI.003 to.367).

Conclusion

Exercise can buffer aversive cardiovascular risk and cognition from loneliness. Lonely older adults are a high-risk demographic that should be sought for enrolling in exercise programs.
STATE-BASED ESTIMATES OF COGNITIVE DIFFICULTY AMONG MIDDLE EASTERN AND NORTH AFRICAN AMERICANS
Authors: Kindratt Tiffany , Smith Alexandra
Published: January 2025

Research on cognitive difficulty in the US focuses on racial/ethnic groups that comprise federal minimum reporting guidelines, including White, Black, Hispanic/Latino, Asian, American Indian/Alaskan Native (AI/AN), and Native Hawaiian/Other Pacific Islanders (NH/OPI). Research on Middle Eastern and North African (MENA) adults is limited, and no state-based estimates have been reported. Our objective was to estimate the prevalence of cognitive difficulty among MENA adults compared to other racial/ethnic groups in four states (California, New York, Michigan, and Texas) after adjusting for age and sex. We calculated MENA populations by state using race, ethnicity, ancestry and birthplace responses from the 2017-2021 American Community Survey. The four largest MENA populations were found in California (n=912,787), New York (n=341,361), Michigan (n=262,918) and Texas (n=258,395). Cognitive difficulty among MENA adults (yes/no; age>=45years) was compared to other racial/ethnic groups (e.g., White, Hispanic/Latino, Black). In California, the prevalence of cognitive difficulty was higher among MENA adults (6.96%) compared to White (4.80%), Hispanic/Latino (5.44%), and Asian (4.35%) adults. In New York, the prevalence was lower among MENA adults (3.96%) compared to Black (4.82%), Hispanic/Latino (7.96%), and AI/AN (8.94%) adults. In Michigan, the prevalence was lower among MENA (8.30%) compared to Black (11.32%) adults, but higher than White (6.25%) and Asian (3.28%) adults. In Texas, the prevalence was lower among MENA (4.44%) adults compared to Black (8.41%), Hispanic/Latino (6.28%), and Asian (8.41%) adults (all p’s<.05). This study provides an important first look at state-based estimates of cognitive difficulties among MENA adults living in California, New York, Michigan, and Texas.
SLEEP QUALITY, DURATION, AND EFFICIENCY IN LOW-INCOME OLDER ADULTS WITH AND WITHOUT DISABILITIES
Authors: Brightman James , Lafontant Kworweinski , Suarez Jethro Raphael , Crook Jennifer , Thiamwong Ladda
Published: January 2025

Seventy million Americans experience chronic sleep disorders and older adults are more likely than younger ones to have problems sleeping. Sleep is a critical part to the circadian rhythm, and getting adequate sleep can help prevent falls and increase physical functioning. Even though sleep quality declines as a function of normal aging, the presence of a physical disability may exacerbate that natural decline. Income status can also impact sleep quality and the prevalence of dysregulated sleep may lead to an increased use of medicinal sleep aids to alleviate the issue. The chronic use of sleep aids, however, may not be beneficial for alleviating sleep complaints. In this study, we assessed the sleep quality and sleep aid use of 87 low-income community-dwelling older adults with (n = 24) and without (n = 63) a physical disability. Sleep quality, duration, and efficiency were assessed subjectively with the Pittsburgh Sleep Quality Index. Sleep duration and efficiency were objectively measured with actigraphy. Participants self-reported medicinal sleep aid usage. Significant group differences were observed in sleep duration measured objectively (p = 0.02). No group differences were identified in subjective sleep quality factors (p = 0.21) or medicinal sleep aid use (p = 0.41). Our findings show physical disability may be a factor in sleep duration, though neither associated with worsened sleep perception nor greater reliance on medicinal sleep aids. Implications of our research highlight the importance of using subjective and objective measures when assessing sleep quality and carefully considering the use of medicinal sleep aids.
LONGITUDINAL DYADIC ASSOCIATIONS BETWEEN LONELINESS AND COGNITION AMONG OLDER COUPLES IN THE UNITED STATES
Authors: Stokes Jeffrey , Prasad Anyah , Barooah Adrita , Stam Elisabeth
Published: January 2025

Objectives

Loneliness is associated with diminished health and cognition for older individuals. However, little research has examined dyadic loneliness – i.e., loneliness of both partners in a relationship – and its potential consequences for cognitive functioning among both spouses, nor whether one partner’s cognition may impact both partners’ loneliness over time.

Methods

We analyze 3-wave dyadic Health and Retirement Study data (2010-2020; N=1,061 dyads) to determine (a) whether loneliness predicts participants’ own and/or their partners’ episodic memory and verbal fluency over 8 years, and (b) whether cognitive functioning predicts older spouses’ own or their partners’ loneliness over the same period.

Results

Loneliness predicted participants’ own and their partners’ loneliness at follow-up, at both timepoints. Loneliness was also associated with own episodic memory at follow-up, but not with verbal fluency. Episodic memory and verbal fluency predicted one another over time. Neither episodic memory nor verbal fluency predicted loneliness at follow-up. Significant dyadic mediation was established such that Time 1 loneliness was linked with partner’s Time 3 episodic memory via that partner’s Time 2 loneliness.

Discussion

Lonelier older adults displayed worse trajectories of episodic memory over time, yet poor memory did not precede changes to loneliness. Further, having a lonely partner was linked with poorer episodic memory 8 years later, indicating that both one’s own and – to a lesser extent – a partner’s emotional well-being may be consequential for maintaining cognitive functioning with age. Associations were more clearly established with episodic memory than with verbal fluency, suggesting domain-specific effects of loneliness.
AGING WITH INCARCERATION HISTORIES: AN INTERSECTIONAL EXAMINATION OF INCARCERATION AND HEALTH AMONG OLDER ADULTS
Authors: Latham-Mintus Kenzie , Deck Monica , Nelson Elizabeth
Published: January 2025

Objectives

Experiences with incarceration are linked to poor mental and physical health across the life course. The pur- pose of this research is to examine whether incarceration histories are associated with worse physical and mental health among older adults. We apply an intersectionality framework and consider how the intersection of sexism and racism leads to unequal health outcomes following incarceration among women and people of color.

Methods

We employ 2 measures of health (i.e., number of depressive symptoms and physical limitations) to broadly cap- ture mental and physical health. Using data from Waves 11 and 12 of the Health and Retirement Study, we estimated a series of general linear models to analyze differences in health by incarceration history, gender/sex, and race/ethnicity.

Results

Findings suggest that experiences with incarceration are associated with a greater number of physical limitations and more depressive symptoms among older men and women, net of sociodemographic characteristics, early-life condi- tions, and lifetime stressful events. Formerly incarcerated women, particularly women of color, had more physical limita- tions and depressive symptoms relative to other groups.

Discussion

These findings suggest that incarceration histories have far-reaching health implications. Older women of color with incarceration histories experience markedly high levels of physical limitations and depressive symptoms in later life.
MIGRATION AND COGNITIVE HEALTH DISPARITIES: THE ARAB AMERICAN AND REFUGEE CASE
Authors: Al-Rousan Tala , Moore Alison , Sideman Alissa Bernstein , Ajrouch Kristine , Kamalyan Lily
Published: January 2025

This study investigates whether the year of arrival to the United States (U.S.) and birthplace relate to postmigration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life. We analyzed 19 years (2000-2019) of data from the American Community Survey Public Use Microdata Samples (weighted N = 393,501; ages ≥ 50 years). The cognitive difficulty was based on self-reported data and weighted means, percentages, adjusted prevalence estimates, and adjusted odds ratios were calculated. Controlling only for demographics, foreign-born Arabs reported higher odds of cognitive difficulty compared to U.S.-born Arabs across all arrival cohorts (p <.001). After accounting for economic and integration factors, those who arrived between 1991 and 2000 had higher odds (odds ratio [OR] = 1.06, 95% confidence interval [CI] =1.00, 1.19, p <.01), while those who arrived after 2001 had lower odds (OR = 0.87, 95% CI = 0.78, 0.97, p <.001) of cognitive difficulty. Lacking English proficiency (OR = 1.90, 95% CI = 1.82, 1.98, p <.001) was related to higher odds, whereas not being a U.S. citizen was significantly associated with lower odds (OR = 0.89, 95% CI = 0.52, 0.94, p <.001) of cognitive difficulty. Yet, results varied by birthplace. Migrants born in Iraq consistently reported the highest odds of cognitive difficulty across all arrival cohorts. Migration history and birthplace are essential factors explaining cognitive disparities among the diverse group of Arab migrants and Arab Americans. Reasons for migration such as displacement due to war may explain these disparities.
POPULATION PREVALENCE OF MOTOR FUNCTION IMPAIRMENTS IN US OLDER ADULTS: THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Davoudi Anis , Wang Hang , Dougherty Ryan , Wanigatunga Amal , Gross Alden , Schrack Jennifer
Published: January 2025

Motor function impairments reflect physical health status for older adults, which has profound implications for quality of life. However, there is a significant research gap concerning comprehensive, nationally representative data on the prevalence of these impairments, including diminished gait speed, chair stand ability, standing balance, and grip strength, especially among those aged □80 years. We used data from Round 12 of the National Health and Aging Trends Study (NHATS), a nationally representative panel study of U.S. Medicare beneficiaries aged ≥65 years who completed objective physical function testing. Motor function was assessed using gait speed, chair stand speed, standing balance, and grip strength and impairment(s) were defined using standard clinical thresholds or previously published norms. Age was categorized in 5-year intervals [65-69, 70-74, 75-79, 80-84, 85-89, and 90+]. In this US-representative sample of 5055 older adults (mean age: 78.7 years old (78.3-79.1), 54.4% women), weighted prevalence of impairments in gait speed, chair stand speed, standing balance, and grip strength were higher with advancing age. Among those aged 65-69 years, chair stand impairment was the most prevalent (42.4% (37.0%-47.8%)), while gait speed impairment was the most prevalent among those ≥90 years (90.4% (86.0%-94.9%)). Prevalence of being impaired in all four motor function domains was 11.8% (8.5%-15.2%) at ages 65-69 years and 64.0% (58.0%-69.9%) among those ≥90 years. These findings indicate a higher prevalence of impairments in motor function with older age, underscoring the importance of addressing these impairments earlier in life to enhance the quality of life in the aging population.
ALGORITHMICALLY DEFINED SENSORIMOTOR FUNCTION AND RISK OF MILD COGNITIVE IMPAIRMENT
Authors: Wanigatunga Amal , Wang Hang , Davoudi Anis , Dougherty Ryan , Tian Qu , Simonsick Eleanor , Gross Alden , Schrack Jennifer
Published: January 2025

Early detection of persons at risk for, or living with, mild cognitive impairment (MCI) is a public health priority. Sensorimotor functioning—the integration of sensory information with motor function signaling to perform tasks and interact with the environment—may be a specific domain intertwined with movement planning and mental ability. However, a gap remains as to the optimal approach to operationalize sensorimotor function. This study assessed sensorimotor functioning using common clinical and research measures and evaluated its cross-sectional association with MCI. A unidimensional sensorimotor functioning factor was developed using confirmatory factor analysis based on six binary sensory and motor function impairment indicators including hearing, vision, olfaction, standing balance, usual gait speed, and grip strength. Using structural equation modeling, we examined whether higher sensorimotor functioning (greater factor score indicating less impairment) was related to lower odds of MCI using two independent cohort studies: The Atherosclerosis Risk and Communities Study (ARIC) (N=932), and the Baltimore Longitudinal Study of Aging (BLSA) (N=681) of participants who had complete sensory and motor function tests. After covariate adjustment, for each additional SD higher in sensorimotor factor score, there was a 56% (95%CI: 40%-68%) and 45% (95%CI: 24%-60%) lower odds of MCI in ARIC and BLSA, respectively. Findings suggest that leveraging a sensorimotor functioning score derived from common assessments is feasible and associated with MCI. Longitudinal studies are needed to determine whether degrading sensorimotor function can predict early cognitive decline indicative of elevated dementia risk.
PHYSICAL ACTIVITY ATTENUATES THE INFLUENCE OF ALZHEIMER’S BIOMARKERS ON COGNITIVE FUNCTION
Authors: Dougherty Ryan , Soldan Anja , Pettigrew Corinne , Greenberg Barry , Spira Adam , Moghekar Abhay , Albert Marilyn
Published: January 2025

Alzheimer’s disease (AD) is characterized by the abnormal accumulation of amyloid-β (plaques), and tau (neurofibrillary tangles) that can be quantified in vivo through cerebrospinal fluid (CSF) sampling. Physical activity has emerged as a possible modifier of AD risk; however, the influence of physical activity on CSF biomarkers and cognitive function remains unclear. We examined whether higher levels of physical activity favorably modify associations between AD CSF biomarkers and cognitive function. One hundred and seventeen adults free of dementia from the BIOCARD study (mean age 72.2±8.0 years, 70% women) wore a wrist accelerometer for one week, underwent lumbar puncture to collect CSF, and completed a comprehensive neuropsychological exam. Covariate-adjusted linear regression analyses were used to examine whether physical activity (total activity counts over the 10 most active hours of the day) moderates the association between AD CSF biomarkers [amyloid-β (Aβ42/40), total tau, phosphorylated tau (p-tau181)] and cognitive composite scores (episodic memory, executive function). There were significant interactions between physical activity and total tau (p=.004) as well as physical activity and p-tau181 (p=.016) for the executive function composite score. Among those with elevated total tau or p-tau181, participants with greater levels of physical activity exhibited significantly higher executive function composite scores compared to participants with lower levels of physical activity. In contrast, there were no significant interactions for episodic memory, and physical activity did not interact with Aβ42/40 (all interactions p>.05). These findings suggest that a physically active lifestyle may play a protective role against cognitive decline through tau pathways.
UNDERSTANDING CHANGES IN PUBLIC TRANSIT BEHAVIOR AND ITS LINKS TO PHYSICAL ACTIVITY: FINDINGS FROM THE NHATS
Authors: Twardzik Erica , Schrack Jennifer
Published: January 2025

Public transit use is beneficial to human health. With a growing older adult population, a better understanding of older adult’s use of public transit and physical activity among public transit users is needed. We aim to describe public transit use among older adults from 2015 to 2022 within a nationally representative sample. Using the 2015-2022 National Health and Aging Trends Study (n = 38,970), we examined the prevalence of public transit use among adults aged 72 years and older. We found that 8.0% of older adults use public transit to get to places outside of their home. However, the prevalence of public transit use varied by gender, age group, and year of observation. Women (6.3%) used public transit less than men (8.5%), and public transit use prevalence was lower at older ages (ages 72-74, 7.8%; ages 90+, 3.6%. Public transit use was consistent across years 2015 to 2019 (8.5%), before it decreased drastically in 2020 (3.3%) and remained low in 2021 (5.2%) and 2022 (4.7%). In 2021 and 2022 public transit users averaged 48.8 more daily minutes of physical activity than non-users. These results suggest demographic and temporal trends in public transit use among older adults. Given that older adults report 7-10 non-driving years at the end-of-life, public transit could be an attractive option for this growing population. The pandemic reshaped the transportation landscape, and many public transit systems have not recovered pre-pandemic ridership. Future efforts should integrate age friendly policies to increase older adult ridership.
“WE TREAT EVERYONE THE SAME”: PROVIDER PERSPECTIVES ON LGBT+ AGING IN EAST TENNESSEE
Authors: Winberry Joseph
Published: January 2025

Aging Services providers in East Tennessee were asked to report barriers and solutions they saw to 5 aging-related needs raised by local Lesbian, Gay, Bisexual, and Transgender plus (LGBT+) people fifty years and older. The 5 needs included services for caregivers, social support, culturally competent care, LGBT+ Specific Services, and Planning. Fourteen providers working in settings such as offices on aging and long-term care facilities shared 248 responses via a qualitative survey. Thematic analysis of those responses revealed 6 barrier themes (ageism and elder abuse, discrimination, fewer personal resources, identity concealment, staff limitations, and stigma) and 4 solution themes (direct affirmation, creating and sharing information in partnership, inclusive written messages and images, and training participation). Review of the data also indicated a third category of response which was denial of needs raised. The findings indicate that providers have a varied understanding of barriers and potential solutions for meeting the aging services needs of LGBT+ older adults. They also demonstrate a lack of awareness among at least some providers of how LGBT+ older adults feel about their ability to access aging services in comparison to non-LGBT+ older adults. These findings are part of a larger, multidisciplinary community-engaged participatory research project that is ongoing in East Tennessee. Its purpose is to address information and social barriers that LGBT+ older adults see as obstructing their ability to age with dignity and respect in the community they call home. The findings raised from provider survey responses are useful for designing future interventions for providers.
MAKING THE MOST: UNDERSTANDING COMMUNITY IN SEXUAL- AND GENDER-DIVERSE COMMUNITIES
Authors: Guest M Aaron , Happel Christine , Burk-Leaver Erin
Published: January 2025

In program service and delivery, community significantly impacts the health and well-being of older adults, providing essential social support, fostering belonging, and ensuring access to vital resources and services. Beyond mere geographic proximity, communities embody shared traits, interests, values, and goals, aiding members in accessing various services and activities crucial for healthy aging. This includes fostering engagement, inclusivity, and support. Importantly, individuals often belong to multiple communities, enhancing their resource access as they age. A notable example is the sexual and gender-diverse community, comprising individuals identifying as gay, lesbian, bisexual, and transgender, among other identities. These individuals, especially older ones, face considerable barriers in accessing care, support, and resources, often lacking the opportunities available to their heterosexual counterparts. This symposium delves into how older individuals from these diverse backgrounds form and participate in communities. Happel et al.‘s work explores the unique experiences of loneliness, isolation, and service use among older LGBTQ adults. Guest et al. identify how community connection can affect self-perceptions of aging, resulting in accelerated social aging and adverse health outcomes. Mccoyy et al. then share a community-based participatory action approach to identifying and addressing the needs of sexual and gender-diverse older adults through alliance building. The shared theme of community and how SGD individuals create and use community will be highlighted through exemplars leading to a discussion of how we can create health-promoting communities for SGD individuals as they age.
IN THEIR OWN WORDS: EXPERIENCES OF LONELINESS, ISOLATION, AND SERVICE UTILIZATION AMONG LGBTQ+ OLDER ADULTS
Authors: Happel Christine , Dabelko-Schoeny Holly , Sheldon Marisa , Cho Al
Published: January 2025

Research has dismantled the stereotype of older LGBT people as lonely, depressed, and unattached to significant relationships. Yet, social isolation and loneliness are increasingly common experiences, especially when compounded by health and economic disparities. These experiences have substantial implications for our health and longevity. This study aimed to gain a better understanding of LGBTQ+ older adults’ experiences of loneliness and isolation and where and how they are connecting to community and social services to inform strategies rooted in community strengths. Through community partnerships in one Midwestern US city, semi-structured interviews were completed with 12 LGBTQ+ older adults and three service providers supporting LGBTQ+ populations. 58% of older adult participants were between 65-69. 16% were trans, and 16% were gender non-conforming. 41% were Black / African American. 92% were gay or lesbian, and 8% were bisexual. 83% had college degrees. 41% were married or living with a significant other. Interviews were analyzed using the team-based flexible coding method. Results indicated that being partnered does not necessarily relieve experiences of loneliness, and coming out later in life was associated with smaller, less satisfying support networks. Health challenges acted as both a source of positive and negative impact, as participants discussed connection to others experiencing similar challenges through support groups and social networks but also recognized limitations created by chronic conditions. Limited access to inclusive gathering spaces beyond bars, as well as the evolving queer community, were identified barriers to social connection. Intergenerational relationships were referenced as supportive and protective factors.
A COMMUNITY-BASED PARTICIPATORY APPROACH TO BUILDING ALLIANCE WITH LGBTQ2S+ OLDER ADULTS
Authors: McCoy Megan
Published: January 2025

The intersection of homophobia, transphobia, and heterosexism with ageism perpetuates health equity challenges for LGBTQ+ older adults. Many LGBTQ+ older adults fear having to “go back into the closet” to access healthcare, housing, and social support in later life and intentionally seek out identity-affirming settings. Yet, the availability of inclusive community spaces and services varies geographically. Understanding the experiences of LGBTQ+ older adults can inform research, advocacy, and programmatic efforts locally and regionally. Community-based participatory research (CBPR) is one framework for engaging historically silenced communities to drive research questions generated by and with the community. CBPR involves equitable community-academic partnerships, from development through dissemination. The first phase of successful CBPR involves forming a partnership and assessing community strengths, challenges, and dynamics— before we can even think about implementing a research project. This presentation will highlight how a CBPR model is used to engage key stakeholders to support LGBTQ2S+ older adults in Arizona better. Initially conceived as an advisory committee to inform research to build inclusion within one residential living community, the AZALEA Project (Arizona Alliance for LGBTQ2S+ Equity in Aging) continues to evolve as a broader statewide LGBTQ2S+ aging equity alliance. We will share emerging successes and lessons learned from an inaugural LGBTQ2S+ Aging Equity Forum and how these are informing future research development and design.
EFFECT OF COCHLEAR IMPLANT ON GAIT AMONG ADULTS WITH AGE-RELATED HEARING LOSS: A SYSTEMATIC REVIEW
Authors: Rafoul Bahaa , Agmon Maayan , Karawani Hanin
Published: January 2025

Research shows a link between hearing loss, gait impairment, and an increased fall risk. A number of reviews on the effect of hearing interventions on balance have been published; however, whether Cochlear Implant (CI) can improve gait impairment and reduce fall risk remains unclear. This systematic review evaluates the impact of CIs on the walking abilities of adults with hearing loss. It contributes to the theoretical understanding of the link between hearing loss and gait, as well as to the clinical understanding of the combined effect of treatment on gain improvement. Utilizing PRISMA guidelines, we extracted seven relevant studies from PubMed, Web of Science, and Scopus. Five studies included CI users, while two included CI and hearing aid users. Inconsistency in measurement methodologies and follow-up durations were noted, contributing to incongruent findings. We found that a short follow-up (up to two months) after the activation of the CI was associated with non-improved and even worsening gait, and a longer follow-up (at least three months) was associated with a partially improved gait. However, due to various methodological inconsistencies in the seven articles available, it remains challenging to fully understand the effects of hearing treatment by the CI on gait. We suggest that future research should consider underlying mechanisms such as cognition and function in dual-task walking with longer follow-up to better understand the link between hearing and gait, especially after hearing intervention.
DISEASE-SPECIFIC CONTRIBUTIONS TO GEOGRAPHICAL DISPARITIES IN MORTALITY AMONG MEDICARE BENEFICIARIES
Authors: Ouyang Meishuo , Akushevich Igor , Kravchenko Julia
Published: January 2025

Improving Life expectancy (LE) in the LE-lagging states could significantly improve overall LE and eliminate health inequalities in the United States. We analyzed the disparity in mortality rates between eight states with high and low LE at 65 using individual morbidity trajectories in Medicare administrative claims data from 2000-2020. Disease-specific contributions were identified using the Powers-Yun decomposition technique for hazard functions (the Blinder-Oaxaca algorithm extended for time-to-event data). This approach identifies two effects per disease: exposure (the disparity is generated because of the difference in the prevalence of a disease in two compared populations) and vulnerability (the disparity is generated because of the difference in mortality in the subpopulation with the disease). Two population groups (80-) and (80+) separated by age 80 were analyzed. Disease-specific contributions explained 44% and 63% of the disparities in all-cause mortality in the 80- and 80+ age groups, respectively. Exposure effects dominated in the 80- group (47.8% vs. 3.5% of vulnerability effect), while vulnerability was the main contributor (40.1% vs. 23.3% of exposure effect) in the 80+ group. Heart failure, influenza, and pneumonia explained 21.3% of the disparity in the 80- group, while the other circulatory system diseases, especially the vulnerability of cardiac dysrhythmias (5%), dominated the 80+ group. Additionally, cerebrovascular diseases (10.7%) and blood diseases (14.1%) are the other two major contributors to vulnerability in 80+. Reducing disparities in LE demands multiple fronts, such as tobacco control, heightened preventive measures against influenza and pneumonia, and enhanced access to arrhythmia treatments.
MOVING FORWARD TOWARD DEPLOYING HEALTH INFORMATION TECHNOLOGY IN ALL US NURSING HOMES
Authors: Alexander Gregory , Caraballo Christina , Moen Maria , Morton Cynthia , O’Malley Terrance
Published: January 2025

The Moving Forward Coalition Health Information Technology (HIT) Committee has refined two action plans designed to promote HIT adoption in all U.S. nursing homes (NH). In this work, Moving Forward is responding to two recommendations in the (National Academies of Sciences, Engineering, Medicine Report of 2022 (The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff) to deploy HIT in all NHs and to ensure that care is consistent with the individual’s goals, preferences, and priorities (GPPS). The first plan includes a HIT Readiness Guide to inform the adoption of the essential HIT capabilities required for survival in Value Based Payment models (VBP) mandated by the Centers for Medicare & Medicaid Services (CMS) to begin in 2030. The second provides an HIT enabled tool to facilitate the collection of an individual’s GPPs to facilitate goal concordant care consistent with an individual’s GPPs and to enable measurement of the degree to which the care provided is concordant with those GPPS. In this presentation, members of the HIT Committee will discuss the “what, why, and how” of these plans and the progress to date. Additionally, panel members will discuss plans for testing and evaluating tools developed from our initial work. Included will be a discussion of the challenges of sustainability and feasibility in the face of little federal support for these efforts. Although the Moving Forward Coalition and the NASEM report focus on NHs, the HIT tools being developed here will benefit all sites of care.
BIOMARKERS HELP US UNDERSTAND HOW CELLULAR AND SYSTEMIC AGING CONTRIBUTE TO MORTALITY
Authors: Klopack Eric , Crimmins Eileen
Published: January 2025

Research suggests aging is a coordinated decline occurring in multiple systems and at multiple biological levels. However, it is largely unknown how general biological aging and specific systemic aging co-occur and influence one another to affect health outcomes like mortality, multimorbidity, and functional limitations. There is also emerging interest in understanding how social exposures may differentially accelerate decline in individual physiological systems. We utilize data from the Health and Retirement Study, a nationally representative sample of about 4000 US adults over age 55. We used eXtreme Gradient Boosting (xgboost) in a training subsample to create estimates of health risk based on mortality, multimorbidity, and functional limitations using sets of biomarkers representing biological systems (e.g., nervous, immune, cardiovascular, and renal systems) as well as cellular aging (e.g., epigenetic clocks). These models generated risk scores for each outcome based on each system (e.g., renal functioning using BUN, creatinine, and cystatin C). Outcomes were regressed on these scores in a testing subsample to assess the relative impact of each system on health. Results suggest cellular aging, respiratory aging, and metabolic dysfunction contribute most to these health outcomes. Aging of these systems also partially mediates the risk associated with age, race/ethnicity, sex, and education. These results suggest aging of specific systems may be differentially affected by sociodemographic exposures and may differentially contribute to health risks. This research may help guide interventions focused on reducing inequalities in mortality risk by identifying health risks that would have the greatest impact on health at the population level.
USING BIOLOGICAL AGING TO BETTER UNDERSTAND THE DIFFERENTIAL RETURNS TO EDUCATION AMONG BLACK AND WHITE OLDER ADULTS
Authors: Farina Mateo
Published: January 2025

Numerous studies have documented “differential health returns” for education among older Black and White adults in the United States. Despite being a more select group, Black older adults with higher levels of education see a smaller return in health risk declines than White older adults. This pattern has been observed for cardiovascular and metabolic conditions, disability, and mortality. Underlying several of these age-related health conditions may be accelerated biological aging, which may provide further insight into why education returns differ across many health outcomes. In this study, we use the Health and Retirement 2016 Venous Blood Study to examine the differences in the education gradient for Black and White older adults for accelerated aging as defined by the newly developed Expanded Biological Age measure. We use a series of linear regression models to examine the association of education with accelerated biological aging and we examine whether the differences can be partly explained by health behaviors, experiences of discrimination, or psychosocial stress. Preliminary findings show that, compared to Black older adults White older adults have a larger gradient (greater returns) to education when evaluating accelerated biological aging: 3.2-year difference between those without a high school diploma and a bachelor’s degree for Blacks, and a 5.3-year difference for Whites. Health behaviors had no impact on the differences across groups, but we find some indication that stress and discrimination may have a role in mitigating the health benefits for well-educated older black adults.
MAINE REACHING FOR THE SUMMIT: ADDRESSING ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Holland John , May, Jr Alfred , Frohmberg Eric , Gordon Dawn
Published: January 2025

Maine is one of the most rural states in the country with 61.4% of its population living in rural areas and thirteen of sixteen counties categorized as rural. Maine is also the oldest state in the country based on a median age of 44.8 years. Maine’s BOLD Program strategized to treat the whole state as rural and determine various means to build the infrastructure for dementia education and services. One of these strategies is to develop a working relationship with primary care through our federally qualified health centers, who serve our target low-income population and are located in our most rural areas of the state. Because federally qualified health centers are established to provide primary care services as well as oral and behavioral health, they are open to partnerships with the Area Agencies on Aging for providing specialized umbrella services to patients with Alzheimer’s disease and related dementias (ADRD) and respite services to families and caregivers of patients with ADRD. This approach builds on the Healthy Brain Initiative Road Map strategies as well as working toward clinical to community best practices in preventing ADRD. A key resource for our work with the lead federally qualified health center has been the New York University Medical School, one of the Public Health Centers of Excellence. This collaboration has resulted in the creation of a dialogue type webinar that utilizes research to practice for early detection, diagnosis, and care planning.