bluuebunny/crossref_metadata_2025 huggingface dataset:
INTEGRATED PERSON-CENTERED INTERVENTIONS FOR OLDER PEOPLE’S CARE IN SWEDEN: SCOPING REVIEW AND EXPERT OPINION
Authors: Kirvalidze Mariam , Boström Anne-Marie , Liljas Anne , Doheny Megan , Hendry Anne , McCormack Brendan , Agerholm Janne , Calderón-Larrañaga Amaia
Published: January 2025

The recent shift towards a holistic, person-centered approach to older people’s care that considers a person’s overall well-being requires collaboration within and between medical and social healthcare organizations. To map and contextualize the scientific literature on the effectiveness of integrated person-centered care interventions, including implementation experiences in Sweden. Publications were identified by searching MEDLINE and contacting experts. Workshop discussions in Stockholm (Sweden), on 21/03/2023, were recorded and transcribed. Original peer-reviewed articles published in Swedish or English from 01/01/2000 to 10/03/2023, were screened. Evidence from included studies was narratively synthesized and interventions were categorized using two frameworks: (1) Integrated Care for Older People (ICOPE) and (2) Integrated People Centered Health Services (IPCHS). Workshop discussions were thematically summarized. We included 73 publications analyzing 31 unique and heterogeneous interventions pertaining, mainly, to the micro and meso levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability in 48%, and service utilization in 58%. Experts emphasized the need for participatory designs and shared ownership for adoption and scalability of interventions, and transitions from person- to people-centered integrated care. In conclusion, integrated person-centered care interventions demonstrated the strongest evidence for the optimization of service utilization. Unexpectedly, evidence for health outcomes was less consistent. This could be due to several issues mentioned by the experts, such as poor evaluation practices, lack of participatory research approaches, and scarcity of macro-level initiatives. Our findings offer internationally transferable perspectives on the real-world challenges in delivering integrated care.
PATIENT PORTAL USE, PATIENT TRUST, SOCIAL DETERMINANTS OF HEALTH, AND SHARED DECISION-MAKING AMONG US OLDER ADULTS
Authors: Chen Yuling
Published: January 2025

Background

Shared decision-making (SDM) and patient portals are increasingly embraced in health care and recommended in cardiovascular disease (CVD) guidelines. This study investigated the associations between patient portal use, patient trust in the healthcare system, social determinants of health (SDOH), and patient involvement in SDM among adults 65 years or older with or at risk of CVD.

Methods

We conducted a cross-sectional study of US adults from the 2022 Health Information National Trends Survey. CVD risk was defined as reporting a heart condition, diabetes, hypertension, and/or current smoking. SDM was measured by asking how often patients’ providers involved them in health decisions over the past year. A weighted multivariable logistic regression model was employed, adjusting for sociodemographic and clinical characteristics.

Results

The study included 1,139 older adults with or at risk of CVD, with a mean age of 73.5 (SD 6.7) years. The sample included 54.0% females; 66.4% identified as white. Older adults who accessed the patient portal 6 to 9 times in the past year were 1.98 times more likely to engage in SDM (95% CI 1.13-3.48) compared to those without access. Older adults with high trust in the health system were 3.15 times more likely to engage in SDM (95% CI 1.89-5.23) than those with low trust. However, SDOH (inability to afford meals, being forced to move, and lack of transportation) was not significantly associated with SDM.

Conclusion

These findings underscore the vital role of utilizing patient portals and fostering trust in enhancing older adults’ engagement in SDM.
A CRISIS LEADERSHIP FOR NURSE MANAGERS IN CRISIS SITUATIONS: DEVELOPMENT AND PSYCHOMETRIC EVALUATION
Authors: Kim Sun Ju
Published: January 2025

Crisis situations such as COVID-19 have a negative impact on society and the economy, with increased mental health issues, medical crises, and mortality among nurses. The inadequate leadership of nurse managers during crisis situations can negatively impact the quality of patient care and infection transmission. Consequently, the aims of this study were to develop a crisis leadership scale for nurse managers and to evaluate its psychometric properties. For the development of the initial items, the literature was reviewed along with the existing measuring tools. This study was conducted from August to October 2023. A total of 443 nurse managers in 34 hospitals in Korea participated in the study to verify the validity and reliability of the instrument. The exploratory and confirmatory factor analyses yielded a five-factor solution, while the confirmatory factor analysis showed a good fit (RMSEA =.07, SRMR =.02, CFI =.92, TLI =.91). Therefore, the final instrument was derived, containing 28 items on “crisis management competency” (12), “decision-making” (6), “collaboration” (4), “communication” (3), and “building trust” (3), as well as 5 factors, scored on a 5-point Likert scale. The Cronbach’s α for this instrument was.96. In conclusion, the crisis leadership scale showed good psychometric properties for four validity metrics (content, construct, convergent, discriminant and criterion validity) and internal reliability. These findings indicate that the instrument can be applied in both research and clinical practice, being capable of quantitatively measuring the degree of crisis leadership skills of nurse managers.
ANTI-AMYLOID THERAPIES FOR ALZHEIMER’S DISEASE: PATIENTS’ AND FAMILIES’ PERCEPTIONS
Authors: Lucca Kaitlyn , Lapins Allison , Morhardt Darby
Published: January 2025

With new drug therapies available aimed to slow the progression of Alzheimer’s Disease (AD), this study hopes to gain insight into the perceptions, concerns and perceived barriers from patients and families who are impacted by AD. Drug consultations for these therapies are currently taking place at the Northwestern Neurobehavior and Memory Clinic with potentially eligible patients and their families. Study aims are to: 1) measure patient and family perception, barriers and concerns of the drug therapy following a formal consultation or informal discussion with a neurologist, and 2) gather data on the patient and family experience with the drug consultation as a method for making an informed decision. After consultation with their behavioral neurologist, participants are asked to complete the survey with a study team member. To date, 10 participants have completed the survey following consultation with a neurologist. Preliminary results found the highest reported concerns with starting anti-amyloid therapies to be medical complications [larger brain bleeds, brain swelling, micro-hemorrhages] and financial burden. The majority of participants’ interest levels remained the same or were increased following the consultation. Those who reported a decrease in interest level were concerned that the therapy would not be impactful on their daily life. Families will continue to be surveyed following consultation with a neurologist with additional results reported in the coming months.
INTEGRATED PRIMARY CARE MODEL FOR PEOPLE LIVING WITH DEMENTIA REDUCES HIGH-RISK MEDICATIONS AND HOSPITALIZATIONS
Authors: Clevenger Carolyn , Khakharia Anjali , Medders Laura , Moore Miranda
Published: January 2025

Harmful care including the prescribing of high-risk and potentially inappropriate medications for older people is widespread among older adults, including people living with dementia (PLWD). Integrated Memory Care (IMC) is a comprehensive dementia care model where patients and their family caregivers access dementia-sensitive geriatric primary care. The IMC conducted a retrospective observational study of patients of IMC, Cognitive Neurology (CN), and Primary Care (PC) clinics aged 65 and older with a diagnosis of dementia in 2019-2021. We matched patients by age, gender and race and measured the hospitalization, rate of deprescribing and inappropriate screening test referrals using logistic regressions controlling for clinic. Additionally, we conducted a regression adjusted for state of illness (proxied by activities of daily living (ADL)) for the IMC and CN clinics. IMC patients had higher odds of deprescribing high dose antipsychotics, benzodiazepines, and opiates when compared to CN patients. IMC also had higher odds of deprescribing high dose antipsychotics, benzodiazepines, and opiates when compared to PC patients. For hospitalizations, CN had 10% [2 times] higher odds, when compared to IMC patients in unadjusted models. After adjusting for ADL scores, CN patients had 66% higher odds of having a hospital admission during the study period. Dementia-sensitive primary care reduces the rate of total and ambulatory-sensitive hospitalizations reducing healthcare costs and causing less disruption to care as well as reduces inappropriately prescribed medications among PLWD.
TRANSFORMATIVE CARE: LIFESTYLE INTERVENTIONS IN UNDERSERVED AGING
Authors: Neises Kristen
Published: January 2025

In response to the escalating challenges posed by an increasingly aging population in the United States, particularly in rural areas, an urgent demand arises for innovative healthcare solutions. This presentation illuminates the formidable hurdles faced by older adults with multiple chronic conditions, most of which result from lifestyle. The Optimal Aging Lifestyle Medicine (OALM) program emerges as a catalyst for transformative change in older adult care. Focused on medically underserved regions, this program empowers healthcare professionals through education in age and dementia-friendly lifestyle medicine, emphasizing evidence-based lifestyle interventions for preventing, managing, and reversing chronic diseases. The OALM program forges a collaborative care approach, uniting professionals across disciplines using the Flourish Model and extending outreach via Project ECHO to remote rural areas. Its mission encompasses filling training gaps by educating healthcare workers across Kentucky and evolving a traditional geriatric clinic into an innovative lifestyle medicine center for older adults. This presentation delves into the integration of lifestyle medicine into geriatric clinics, explores older adults’ perspectives on care through focus group discussions, and the development of an interdisciplinary lifestyle medicine curriculum. Case studies will spotlight a resilient patient care approach, highlighting successes and addressing challenges in groundbreaking initiatives navigating the intricacies of geriatric care, ultimately optimizing aging outcomes and reshaping narratives in rural communities.
ADHERENCE TO INTERVENTIONS AND COGNITIVE CHANGES IN FALLEN OLDER PEOPLE: RANDOMIZED CLINICAL TRIAL
Authors: Ansai Juliana , Pereira Graziele Norberto , de Melo Mariana Luiz , Sossai Mariana Ignácio , Maciel Leticia Teodoro , Silva de sá Mel , Dias Ana Laura Oliveira , Gramani-Say Karina
Published: January 2025

Falls are an important health challenge for older people and society. Understanding how to reduce cognitive risk factors for falls is essential to develop effective prevention strategies. The purpose of this work was to assess the impact of adherence to interventions on cognitive changes after 16 weeks in older people with a history of falls. A controlled, randomized, single-center clinical trial was conducted with brazilian community-dwelling older adults with a history of recurrent falls in the past 12 months. Participants were allocated to Intervention Group (IG) and Control Group (CG). The IG underwent case management, including multidimensional assessment, explanation of fall risk factors, proposal of intervention based on risks, development of an individual fall intervention plan, plan monitoring and review. The CG received monthly health-related guidance. The assessment included cognitive measures (Addenbrooke’s Cognitive Examination ACE-R, Mini-Mental State Examination, Verbal Fluency tests, Clock Drawing test CDT) at baseline and after 16 weeks, and adherence (frequency) to the intervention after 16 weeks. As results, the sample was composed by 55 participants (26 CG, 29 IG). The mean adherence to intervention was 80.27%. The IG improved the TDR performance, compared to the CG (p=0.034). Both groups presented a non-significant improvement in the ACE-R score over time. Adherence to the case management intervention did not influence changes in cognitive risk factors for falls (p>0.050). This findings point the need to understand better the factors related to improvement on risk factors for falls, to achieve personalized approaches in older people.
HARMONIZATION OF LATER-LIFE COGNITIVE FUNCTION ACROSS POPULATION-BASED COHORT STUDIES: RESULTS FROM HRS AND NHATS
Authors: Chen Diefei , Sekhon Vishaldeep , Roth David , Kaufmann Christopher , Gross Alden
Published: January 2025

Population-based cohort studies offer unique opportunities to study characteristics of people at greatest risk for cognitive decline. Harmonizing large, well-characterized cohorts powers investigations into subgroups or rare exposures/outcomes in their associations with cognitive decline. We derived a harmonized cognition score based on cognitive tests from the Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS), two of the largest nationally representative cohorts of older adults in the US. Using an item banking approach based on item response theory, we leveraged tests conducted in 2012-2018 Core interviews of two studies to leverage both common (i.e. anchors) and unique items to statistically harmonize a general cognition factor score. We evaluated concurrent and predictive criterion validity of the harmonized scores by 1) cross-sectionally comparing scores at baseline (year 2012) with algorithmically defined cognitive impairment status and demographics, and 2) longitudinally assessing associations between demographics and established risk factors for cognitive decline with cognitive trajectories using mixed effects models. Cross-sectionally, the harmonized score was lowest among dementia/probable dementia group (mean = -1.84, sd = 0.75). Longitudinally, cognitive decline was steeper for participants reporting hypertension (b = -0.04, se = 0.002), stroke (b = -0.06, se = 0.004), or diabetes (b = -0.04, se = 0.003) compared to those without. Inferences were similar in each study separately. This harmonized score using data from HRS and NHATS had strong criterion validity, and can be a resource for aging researchers to examine the rare factors associated with cognitive performance in diverse populations.
QUANTIFYING ASSOCIATIVE AND ATTENTIONAL INFLUENCES ON MEMORY FOR EVENTS
Authors: Kersten Alan , Darby Kevin , Smithwick Megan , Earles Julie
Published: January 2025

Aging is associated with declines in multiple aspects of the human memory system, including hippocampally-mediated associative abilities and frontally-mediated executive abilities. It is important to distinguish these different impacts of aging in order to identify possible causes of memory decline (e.g., Alzheimer’s disease vs. vascular dementia). In the present research, we used computational modeling to quantify the contributions of different cognitive processes to performance on a test of event memory, administered to 195 young adults and 195 healthy older adults. Participants viewed videos of actors performing simple actions and were later tested on memory for who did what. Participants in different conditions saw varying numbers of actors and experienced different levels of distraction, providing differential opportunities for executive involvement. A multinomial processing tree analysis was used to quantify different aspects of memory performance, including action memory, actor memory, and binding of actors with actions. Distraction impacted both actor memory and action memory, suggesting that distraction interfered with the deployment of attention to these event features. The largest impact of aging was on binding of actors with actions, especially when many different actors performed the actions. Distraction also impacted binding when only two actors performed all of the actions, suggesting that distraction interfered with strategic encoding of actor/action pairings in this condition. The large age differences and absence of an effect of distraction in the many actor condition suggest that this condition may be uniquely sensitive to hippocampally-mediated associative abilities, thus offering diagnostic potential for pathological conditions such as Alzheimer’s disease.
COMMUNITY RATES OF DEPRESSION AND DISABILITIES: FINDINGS FROM THE MS HEALTHY AGING DATA REPORTS
Authors: Su Yan-Jhu , Jansen Taylor , Lee Chae Man , Dugan Elizabeth , Silverstein Nina , White Kina
Published: January 2025

Depression in older adults is a significant public health issue, affecting all aspects of their well-being, independence, and quality of life. This cross-sectional study describes county rates of depression and daily life difficulties (ambulatory difficulty, self-care difficulty, and independent living difficulty) in Mississippi. We then explored if there was an association between county rates of depression and the disability measures in 82 counties in Mississippi. Small area estimation techniques were used to calculate rates using data from: the American Community Survey (2016-2020), the Behavioral Risk Factor Surveillance System (2013-2020), and the Centers for Medicare and Medicaid Services (2018). County rates varied: depression ranged from 6.30% to 24.9% (16.4% state average), ambulatory difficulties (7.14%-46.36%), self-care difficulties (2.53%-24.16%), and independent living difficulty (8.54%-33.0%). Multiple linear regression models after adjusting for age, gender, race, marital status, education, poverty, and physical health status, revealed that counties with higher rates of depression were significantly associated with higher rates of ambulatory difficulty and self-care difficulty (p = 0.003 and p < 0.001, respectively) but not independent living (p = 0.176). Bivariate mapping was conducted to overlay rates of depression and daily life difficulties, demonstrating counties that were high in depression and daily life difficulties in Mississippi. Identifying areas with high rates of 65+ depression and activities of daily living difficulties can help policymakers and service providers to prioritize communities most in need of interventions and services.
SELF-EFFICACY PARTIALLY MEDIATES PHYSICAL FUNCTIONING AND QUALITY OF LIFE IN MIDDLE-AGED ADULTS WITH DISABILITY
Authors: Singsank Katie , John Samantha , Molton Ivan
Published: January 2025

Middle-age is understudied. Adults living with long-term physical disability (LTPD) face added health conditions during middle-age, heightening psychosocial stress. The role of self-efficacy in managing these conditions and their impact on quality of life (QoL) remains unclear. Regression analyses were conducted using control participants from a health promotion trial, examining whether mid-intervention self-efficacy mediated the predictive relationship between baseline physical functioning (IV) and post-intervention QoL (DV). The sample (n = 159) was predominantly female (68.6%) and aged 45-64 (M = 55.99). Regression coefficients showed statistical significance for the models examining direct effects of physical functioning on QoL, Beta =.292, t(152) = 3.759, p <.001, physical functioning on self-efficacy, Beta =.208, t(152) = 2.638, p =.009, and self-efficacy on QoL, Beta =.579, t(151) = 8.731, p <.001. A regression model was conducted examining the indirect effect of self-efficacy as a mediator between physical functioning and QoL. Physical functioning significantly predicted QoL when the mediator was accounted for in the model, Beta =.187, t(150) = 2.819, p =.005. Self-efficacy as a mediator had a stronger predictive relationship on QoL than physical functioning, Beta =.542, t(150) = 8.190, p <.001. The statistically significant indirect effects show self-efficacy partially mediated physical functioning and QoL, demonstrating physical functioning’s influence on QoL is through self-efficacy. However, its effect may lack clinical significance due to minimal Beta change. Since LTPD often limits physical improvement, interventions should prioritize self-efficacy to enhance QoL for those aging with LTPD.
WE♡CARE: A CURRICULUM FOR CAREGIVERS WITH DEVELOPMENTAL DISABILITIES
Authors: Burkart Britney
Published: January 2025

Many adults with developmental disabilities (DD) live at home with their caregivers. However, there are limited resources available to individuals with DD living in mutual caregiving arrangements, a scenario in which adults with DD become more responsible for providing care to an aging loved one. This poster presentation will provide an opportunity to learn more about WE♡CARE, a curriculum developed for adults with DD living in a mutual caregiving arrangement. A mixed methods approach was employed to measure curriculum impact and identify lessons learned surrounding curriculum implementation. Observational data collected during the initial pilot program indicated that adults with DD can benefit from facilitated programs such as WE♡CARE. For example, participants of the pilot program not only learned to recognize when their loved one might need support, but also to develop confidence as a caregiver. Quantitative data measuring change in knowledge among participants showed improvement from pre-session to post-session. A confidence assessment administered before and after participation did show a statistically significant increase in confidence from pre to post (p < 0.05). While the curriculum offers great value to individuals with DD and their loved ones, the pilot program shed light on the need to modify protocols, considering physical and cognitive accessibility and adaptability of facilitators to individual needs. As the population ages, mutual caregiving relationships will become more common, and the knowledge and skill sets embedded in this curriculum can support the growing number of mutual caregivers throughout the country.
ASSOCIATION BETWEEN SELF-REALIZATION AND HEALTH OUTCOMES IN FAMILY CAREGIVING DYADS
Authors: de Rosa Cristina , Wang Weijun , Chang Yu-Ping
Published: January 2025

Self-realization, such as perceptions of life having meaning and purpose, can potentially influence health in older adults and their family caregivers, but how dyad members may contribute to each other’s outcomes is less well understood. This analysis examined whether self-realization in older adults and their family caregivers was associated with their own, and each other’s, mental health and perceived general health. Data for adults aged 65 and older were obtained from the National Health and Aging Trends Study (NHATS) (2022) linked with their respective family caregivers from the National Study of Caregiving (NSOC) IV (2022). A total of 1,571 dyads consisted of one older adult and their primary caregiver, defined as the family member or friend who provided the greatest number of hours of care. Actor-partner interdependence models (APIM) were used to examine associations between self-realization and mental health and perceived general health, controlling for dyad members’ own gender, age, and race/ethnicity, and dementia status of the care recipient. Results showed that self-realization significantly predicted caregivers’ and older adults’ own mental health and perceived general health. Furthermore, older adults’ self-realization significantly predicted their caregivers’ perceived general health (b = 0.043, S.E. = 0.014, 95% CI = [0.016, 0.070], p =.002). Findings suggest mental health and perceived general health are impacted by a person’s own self-realization even when accounting for partner effects. Caregivers are particularly influenced by older adults’ self-realization. Strategies supporting both dyad members may provide benefits for both older adults and their family caregivers.
BIOPSYCHOSOCIAL NATURAL HISTORY OF ALS: INTRODUCTION TO THE OPEN DATA, ACCESS, AND USE
Authors: Segerstrom Suzanne , Kasarskis Edward
Published: January 2025

The Seattle Amyotrophic Lateral Sclerosis (ALS) Patient Profile Database is a rich longitudinal dataset of ALS patients (n = 143; ages 26-83 years) and their partners (spouses, significant others, or caregivers; n = 123; ages 20-79 years) from clinics in Seattle, WA; San Francisco, CA; and Philadelphia, PA. The purpose of the study was to characterize the psychosocial and physical natural history of ALS and the interactions between them. Participants and partners (84% spouses) were separately interviewed in their homes every 3 months for up to 18 months between March 1987 and August 1989, with survival data collected up to 2008. Psychological measures include social cognition (e.g., self-perception and informant perception), psychological processes (e.g., coping, emotional expression), psychological health (e.g., anger, depression), social role activities (e.g., work, church attendance), and social support. Disease history, severity, progression, and survival data are available along with health behavior history, use of respirator and feeding tube, treatments (including psychotherapy or counseling), and medical and family history. This database is newly available and open on Mendeley Data, providing the opportunity for scientists to test biopsychosocial hypotheses in this hard-to-obtain patient population. Much of the data has never been analyzed or reported. In this presentation, the structure and contents of the dataset, the means of access, and the handful of previous findings will be introduced to the GSA meeting attendees.
EMOTION REGULATION IN PEOPLE LIVING WITH DEMENTIA AND THEIR SPOUSES: THE ROLE OF NEUROPSYCHIATRIC SYMPTOMS
Authors: Lou Yifan , Monin Joan , Vu Thi Hoang , Piechota Amanda
Published: January 2025

People with dementia (PwD) and their care partners (CP) may have difficulties in emotion regulation and individual differences in emotion regulation may be related to PwD’s neuropsychiatric symptoms. This study explores whether there is any self-awareness of the PwD’s emotional behaviors and whether CP’s emotion regulation relates to the PwD’s neuropsychiatric symptoms, potentially revealing bias or interpersonal effects. We used data from the Wish Outcome Obstacle Plan Study with a sample of 45 PwD and their spousal CP (n = 90 individuals). Multivariate linear regression models were used to investigate the associations between the CP-reported neuropsychiatric symptoms in PwD and self-reports of emotion regulation in both dyad members, net of sociodemographic and health factors. Separate analyses were conducted for each neuropsychiatric subsyndrome and each domain of difficulties in emotion regulation. Increasing numbers of neuropsychiatric symptoms were associated with higher difficulties in emotion regulation in PwD (ß = 2.78, p < 0.01), but not with CP’s perceived difficulties in emotion regulation. PwD reported particular difficulties in accepting emotions, controlling impulses, and accessing emotion regulation strategies, but not in emotion awareness and clarification, when CP reported more neuropsychiatric symptoms. Proxy-report hyperactivity and psychosis subsyndromes are most significantly related to PwD’s perceived difficulties in emotion regulation. PwD may be aware of their difficulties in emotion regulation at the early stage of dementia. Proxy-report neuropsychiatric symptoms may capture PwD’s emotion regulation capability and not be biased by CP’s emotion regulation difficulties.
AGING COURSES AS A MODEL FOR DEVELOPING PSYCHOLOGICAL LITERACY: INSIGHTS AND ACTIVITIES
Authors: Alea Nicole , Strickland-Hughes Carla
Published: January 2025

Psychological literacy refers to understanding psychological content and applying it to: the self, for adaptive self-understanding and management of effective socioemotional goals; local communities, so that students have, for example, the skills to fulfill employer’s needs; and international contexts, so that students have awareness of what is required to become a global citizen. Psychological literacy is relevant for students in all disciplines, as it prepares them for the world after graduation. In this presentation, we suggest that courses with an aging component, like gerontology and psychology of aging, can serve as model courses for developing psychological literacy among students, and should be earmarked as such in undergraduate curriculum. This suggestion will be grounded in three points: (i) aging is self-relevant but feels far-off for traditional-aged undergraduate students; (ii) this means that aging courses naturally tend to showcase the relevance of the material for individuals and society before content to engage students; and (iii) that aging courses tend to emphasize knowledge needed for success in professions and relationships. These three points mean that aging courses encourage psychological literacy. Example course activities, such as activities that create opportunities for intergenerational connections, activities that require exploration of aging careers, and activities that encourage students to propose innovations that will improve life for aging individuals and societies, will be provided to emphasize these points. We will conclude with strategies to include these activities in courses taught in different programs and institutional contexts.
MOMENTARY UNCONSTRUCTIVE REPETITIVE THINKING, WORKING MEMORY, AND AGE
Authors: Kircher Julie , Cerino Eric , Mogle Jacqueline , Charles Susan
Published: January 2025

Both trait and daily negative affect are often associated with lower performance on working memory tasks, perhaps because negative affect is often related to unconstructive repetitive thinking (URT) – negative ruminative thoughts about oneself or the environment. URT is posited to deplete attentional resources, resulting in downstream effects on cognition. Studies examining the effects of URT on cognitive performance often use laboratory-based study designs. This study aimed to investigate how reports of URT throughout the day are linked to scores on momentary cognitive tasks of verbal working memory. We hypothesized that reports of greater engagement in URT will be related to worse working memory, and that this association was related to age. Data from the Effects of Stress on Cognitive Aging, Physiology, and Emotion (ESCAPE) study included 263 community residents ranging from 25 to 65 years old (Mage = 46.5) completing five assessments throughout the day across 14 days. Contrary to our hypothesis, we found that greater URT was related to improved verbal working memory (γ =.005, SE =.001, p <.001). Higher momentary negative affect was related to poorer working memory, acting as a suppressor on the benefits of URT on working memory performance. This relationship between URT and verbal working memory remained significant across ages, but the relationship between levels of URT and working memory was strongest among younger adults.
STRATEGIES AND GOALS PREDICT DAILY EMOTION REGULATION EFFICACY BUT REAPPRAISAL USE IS LESS PREDICTIVE ACROSS AGE
Authors: Martins-Klein Bruna , Chen Ziyuan , Orlovsky Irina , Waite Elinor , Dixon-Gordon Katherine
Published: January 2025

Socioemotional goals shift with age, as older adults prioritize regulating emotion to maximize positive affect (hedonic goals) more so than to complete tasks (instrumental goals). Hedonic goals are associated with greater reappraisal use (aka positive reinterpretation), and instrumental goals predict suppression use in daily life, but age differences in the impact of strategies and goals on subjective daily emotion regulation effectiveness has not been previously explored. In this study, 113 participants aged 20-72 years old (M = 38.2; SD = 11.4) completed a 14-day MTurk daily diary on emotion regulation goals, reappraisal and suppression use, and subjective emotion regulation effectiveness in response to daily stressors. Multilevel models nested within day revealed positive effects of age (β=0.03, p<.05) and reappraisal use (β=0.11), and a negative effect of suppression use on subjective regulation effectiveness (β=-0.07, ps<.001). Interestingly, hedonic and instrumental goals positively predicted effectiveness even when controlling for strategy and age effects (ps<.001). In addition, a significant age x reappraisal interaction revealed positive associations of reappraisal use on effectiveness that were stronger for younger adults (β=0.18) than for middle aged adults (β=0.13, ps<.001), and not significant for older adults (p=.47). Thus, goals and strategies uniquely influence emotion regulation in daily life, but reappraisal use is unrelated to late-life regulatory efficacy. Future work should investigate whether increasing salience and awareness of emotion regulation goals may be a key interventional target, which could have important clinical implications for promoting emotion regulation efficacy in older adulthood.
THE MODERATING EFFECT OF AGE ON THE ASSOCIATION BETWEEN ANTICIPATORY APPRAISALS AND AFFECTIVE REACTIVITY
Authors: Kinnear Lana , Luong Gloria
Published: January 2025

Affective reactivity (changes in emotion in response to a stressor) has been linked to poorer health. Variability in affective reactivity may be due to individual differences in anticipatory appraisals (AAs; perceptions of threat associated with an upcoming stressor). More work is needed to understand how AA predicts affective reactivity to stressors, and adult age differences in these links. Theoretical frameworks suggest older adults may appraise upcoming stressors as more positive compared to younger adults, but it is unclear if anticipatory appraisals reduce affective reactivity differently across age groups. This research leveraged data from 159 younger and older adult participants in the Health and Daily Experiences (HEADE) study to examine how AA predicts affective reactivity to a well validated lab stressor (Trier Social Stress Test) involving spontaneous public speaking and mental arithmetic tasks. Participants completed ecological momentary assessments which included phone surveys assessing anticipatory appraisals of the upcoming lab session. It was hypothesized that more positive AAs would predict lower positive affective (PA) and negative affective (NA) reactivity, and that this effect will be more pronounced for older, relative to younger, adults. Multiple regression analyses revealed that contrary to the hypothesis, more positive AAs were associated with an overall increase in PA, but not NA, reactivity among older adults. This effect was not found for younger adults. These findings emphasize the importance of understanding how overly positive anticipatory appraisals may exacerbate stress responses in older adulthood.
CHANGE IN SOCIAL PARTICIPATION OVER TIME AMONG PERSONS AGES 45–64 AGING WITH LONG-TERM DISABILITY
Authors: Putnam Michelle , Stark Susan , Morgan Kerri , Hollingsworth Holly , Krauss Melissa
Published: January 2025

Change in social participation over time among mid-life adults with disabilities as they grow older is under-studied. Existing research indicates that social participation among persons with disabilities, younger and older, is positively associated with health and well-being outcomes including mental health and life satisfaction. Despite this knowledge, few studies have explored if and how social participation changes year to year, and how symptoms of aging with disability including pain, fatigue, and depression may influence those changes. We undertook a cohort survey (2019-2021) with a sample of adults aged 45-64 (N=323) with self-reported mobility disability, collecting data over three annual time points, in order to better understand if we could see annual change in social participation that could help inform early interventions to support and sustain social participation. Our results found that T-scores from PROMIS measures of physical function, depression, and pain changed little over time, but level of fatigue did significantly change. PROMIS T-scores of satisfaction with social roles and activities and did not change over time, but T-scores for ability to participate in social roles and activities increased over time. T-Scores for physical function, depression, fatigue, and pain were significantly associated with both participation outcomes. In qualitative data, most participants (63%) said their participation declined over the 3 years, attributing change to health, aging with disability symptoms, and the COVID-19 pandemic. Study limitations include potential effects of the COVID-19 pandemic on participation and disability/health. Findings suggest the need to consider aging with disability symptoms when evaluating participation interventions.
EXPERIENCE OF LOW-INCOME COGNITIVELY IMPAIRED COMMUNITY-DWELLING OLDER ADULTS WITH MINDFUL MOVEMENT
Authors: Ojo Eunice , Thiamwong Ladda
Published: January 2025

Falls are a common but avoidable problem among older adults. Older adults have a higher risk for falls and face many challenges to engaging in exercise-based fall prevention interventions. Practicing mindful movement contributes to gait improvement and fall prevention. However, there is limited information about the experience of older adults with mindful movement. This study aimed to explore the knowledge and experience of low-income cognitively impaired community-dwelling older adults with mindful movement. Participants aged 60 years and older with cognitive impairment were selected from a technology-based fall risk assessment study using BTracks Balance System, Fitbit, and Bioelectrical Impedance Analysis in low-income settings in Central Florida. Fourteen participants were individually interviewed, and a semi-structured interview guide was used to obtain participants’ experience with mindful movement. Individual interviews were audio-recorded, transcribed, coded, and analyzed using thematic analysis. Many codes emerged, and three major themes and sub-themes were developed including 1) knowledge of mindful movement 2) perceived benefits of mindful movement, and 3) linking mindful movement into physical activity. Most participants did not understand mindful movement but acknowledged regularly practicing careful movement to prevent falls. Participants identified fall prevention and stable mental health as benefits of mindful movement. They also described practicing mindful movement during performing physical activity including walking and dancing. There is a need to educate cognitively impaired older adults about mindful movement and encourage its practice as a vital part of daily physical activity. Future studies should focus on how to integrate mindful movement into fall prevention interventions.
GENDER DIFFERENCES IN THE ASSOCIATIONS OF RECREATIONAL WALKING WITH INDOOR AND OUTDOOR FALLS AMONG OLDER ADULTS
Authors: Chen Lingming , Procter-Gray Elizabeth , Le Qun , Churchill Linda , Aguirre Annabella , Cheng Jie , Li Wenjun
Published: January 2025

Indoor and outdoor falls are different among older adults. Women and men may have different patterns of recreational walking and types of falls. This study examined the gender differences in the associations of recreational walking with risk for indoor and outdoor falls. This prospective cohort study enrolled 359 community-dwelling older adults aged 65-95 years old in central Massachusetts (2018-2020). Recreational walking at baseline was measured by the frequency of walking for exercise for at least 10 min in participants’ neighborhoods. Falls were reported on monthly fall calendars, and when a fall was reported, the circumstances were collected via telephone interview. Negative binomial models were used to estimate the gender differences in the associations of recreational walking with rates of indoor and outdoor falls, separately. Models were adjusting for sociodemographic variables, physical health, functional status, lifestyle behaviors, mental health, and the fear of falling. The results showed that less than half of participants did recreational walking at least once per week. Women had lower rates of indoor falls and outdoor falls than men (women vs. men: 34 vs. 51, 37 vs. 57 per 100 person-years). Women engaging in recreational walking at least once per week had 86% lower indoor fall rates (IRR (95% CI): 0.14 (0.05, 0.44)) than those who did not. No significant associations were found between recreational walking and outdoor falls. In conclusion, for older women, but not men, higher frequency of recreational walking was associated with lower rates of indoor falls.
IDENTIFYING RISK PERCEPTION ON FALL OF COMMUNITY-DWELLING OLDER ADULTS USING PHOTOS
Authors: Lee Ji Yeon , Kim Gwang Suk , Park Min Kyung , Kim Layoung , Lee Jae Jun
Published: January 2025

Most falls in older adults occur within the home, especially in a bathroom. To prevent indoor falls, increasing fall risk perception is necessary; however, scarce research explored the risk perception of indoor falls in community-dwelling older adults. This study was an exploratory mixed-methods research using photos. We recruited 10 experts with extensive experience in home environmental assessment/modification and nine older adults with fall experience in home bathrooms within the last two years. All participants evaluated six-bathroom photos through one-to-one interviews with a structured questionnaire, which was based on the health belief model: individual perception, modifying factors, and likelihood of action. The mean age of the expert was 45.8 and 50% was female. The average years in home environment modification/assessment was 10.9 years. Regarding older adults, the mean age was 75.1 and 66.7% were female. The number of diagnosed diseases was 1.86 and many reported bad vision (66.7%) and hearing loss (44.5%). The expert group had a higher risk perception and found extensive risk factors including doorsill, door direction, slippery floor, improper toilet height, narrow space around the toilet, no washbasin, handrails in bathtub and entry, bathtub height, and not organized environment. Older adults showed lower-risk perception in all pictures and risk factors included doorsill, slippery floor, no washbasin, no handrail, and not organized environment. Our findings showed older adults with a fall history have a lower-risk perception regarding environmental hazards. Therefore, education is needed to increase risk perception, and assessment/intervention of the home environment is necessary to prevent further falls.
MUSCLE QUALITY AND REACTIVE BALANCE CONTROL IN OLDER ADULTS
Authors: Whitten Justin , O’Leary Bryant , Tarabochia Dawn , Graham David
Published: January 2025

Falls are a predominant cause of morbidity and mortality in older adults. Muscle quality is associated with mobility and fall risk in older adults. Echo intensity (EI), obtained via ultrasonography, offers a method to quantify muscular fat infiltration and has become increasingly popular as an objective measure of morphological muscle quality. This study aimed to determine the relationship between lower limb EI and reactive balance control (RBC) in community-dwelling older adults. We analyzed EI and muscle thickness in the biceps femoris (BF), vastus lateralis (VL), and medial gastrocnemius (MG) across 18 participants (12 older adults, age: 65 ± 4.1; 6 younger controls, age: 25 ± 3.4) before administering specific assessments of RBC including the Choice Stepping Reaction Test and the Lean and Release Test. BF and MG EI were associated with LRT performance (t=3.112, p<0.001; t=-3.597, p<0.01), and BF EI was associated with CSRT performance (t=-4.281, p<0.001). However, these associations were characterized by small effect sizes (d=-0.17, d=-0.19 and, d=0.12 respectively) and were not significant after controlling for age. Although muscle quality is important for functional mobility it was not associated with RBC in the present study. This is supported by previous research that balance recovery appears to depend on the ability to generate efficiently coordinated neuromotor responses rather than on general qualities such as muscle force or muscle quality and thickness alone and underscores the importance of specific training to improve balance recovery. Further research, with larger sample sizes, is needed to understand the influence of EI on RBC.
PERCEIVED BALANCE PREDICTS FALLS IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Dolan Hanne , Pohl Janet , Pituch Keenan , Coon David
Published: January 2025

Accidental falls are an increasing problem among older adults in the United States (US). Older adults’ self-report of falls is the primary method of fall risk identification. However, up to 72% of Medicare beneficiaries do not report falls and fall-related injuries to their healthcare providers. Limited research suggest that older adults prefer the term “balance problems” instead of “fall risk.” The aim of this study was to examine if perceived balance problem is a predictor of self-reported falls after controlling for known predictors of falls among older adults. The Health Belief Model and the concept of perceived susceptibility served as the theoretical framework. A longitudinal secondary analysis was conducted using data from a subsample of independently living participants (N = 5446) from the National Health and Aging Trends Study. Baseline data was from year 2015, and the outcome was self-reported falls in 2016, with 23.4% of the sample reporting a fall. Complex samples multiple logistic regression analyses revealed that perceived balance (OR = 1.69, p <.001) predicted falls in 2016, whereas, the balance performance measure, Short Physical Performance Battery, did not (OR = 0.98, p =.06). Also, non-Hispanic White participants were more likely to report falling compared to non-Hispanic Black and Hispanic participants, as were females compared to males. A stay in the hospital in 2015, co-morbidities, fear of falling, and reporting a fall in 2015 were also predictive of falls. Assessing older adults’ perceptions regarding their own balance is important to identify fall risk.
FAMILY INTERACTION, PSYCHOLOGICAL NEEDS, AND SELF-CARE IN KOREAN MIDAGE TO OLDER CANCER SURVIVORS
Authors: Lee Haerim , Shin Sun-ui , Park Eunyoung , Jung Mi Sook , Yeom Hyun-E
Published: January 2025

With medical advancements extending the lives of cancer survivors, active self-care becomes increasingly significant. Family interaction and psychological status are keys related to the engagement in self-care of individuals with long-term health issues. This study investigated how family interaction affects psychological needs—namely autonomy, competence, and relatedness—and self-care activities among Korean middle-aged to older cancer survivors. We also examined the variations with age in the roles of family dynamics on psychological needs and self-care behaviors. It is a cross-sectional study utilizing secondary data from two studies, encompassing 277 community-dwelling survivors. We performed descriptive statistics, Pearson’s correlation, and PROCESS macro analysis using SPSS to discern the influence of family interactions. Our results revealed that family interaction plays a crucial role in both satisfying and frustrating psychological needs, which, in turn, directly and indirectly influences self-care activities. Notably, the impact of family dynamics on self-care and the frustration experienced in meeting psychological needs, particularly autonomy and relatedness, was more pronounced in middle-aged survivors than in those over 60. The comprehensive findings highlight the need for healthcare interventions tailored to the age-specific needs of cancer survivors, emphasizing the importance of family engagement in supporting psychological well-being and self-care. The study advocates for strategies to foster active family involvement to enhance overall quality of life and encourage self-care among middle-aged to older survivors.