bluuebunny/crossref_metadata_2025 huggingface dataset:
EXAMINING TWO CONSECUTIVE YEARS OF OLDER ADULTS’ EVERYDAY PROSPECTIVE MEMORY LAPSES AND INFLAMMATION BY GENDER
Authors: Harrington Erin , Graham-Engeland Jennifer , Sliwinski Martin , Mogle Jacqueline , Lipton Richard , Katz Mindy , Engeland Christopher
Published: December 2023

Prospective memory (PM, i.e., memory for future intention) is vital to daily life. Although PM deficits can distinguish healthy older adults from those in early stages of dementia, limited work has examined PM and biological markers associated with memory decline. Extending past work, we examined self-reported PM lapses in daily life and systemic (circulating) inflammatory markers by gender across two years. Older dementia-free adults (n=90, Mage=76.84 years; 62%women) enrolled in the ongoing Einstein Aging Study completed two-waves of data collection (approximately one year apart), each including two-week measurement bursts of daily self-reported PM lapses which were summed across respective bursts. Averaged levels of systemic inflammatory cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-a) and C-reactive protein were derived from two blood samples per wave (pre/post burst). Among men, cross-sectional and cross-lagged correlations between PM and IL-8 were significant, such that reporting more PM lapses correlated with higher levels of IL-8 (ps<.009). Among women, wave-1 PM correlated with wave-2 TNF-a (p=.018), and wave-2 PM correlated with wave-2 IL-10 (p=.041). No other links emerged. Consistent with past research, these preliminary findings suggest that IL-8 may be an important correlate of poor daily PM in men. The neural substrate of this association could include accelerated aging or increases in Alzheimer’s or vascular pathology. Among women, lagged relationships between PM and inflammation may be indicative of pathology. Continued investigation into PM and inflammation that account for gender may reveal longitudinal links that could aid in early identification of persons at risk for cognitive decline.
EXPANDING CDC’S STILL GOING STRONG CAMPAIGN TO INCLUDE TRIBAL POPULATIONS AND PROMOTE SOCIAL CONNECTEDNESS
Authors: Haddad Yara , Bergen Gwen , Bruner Erin
Published: December 2023

The Centers for Disease Control and Prevention (CDC) launched the Still Going Strong (SGS) campaign in 2021 to promote ways older adults (65+) can age without injury. The goal was to encourage older adult participation in lifelong activities while taking steps to prevent injuries. Based on initial campaign evaluation, CDC plans to expand SGS to include social connectedness content and reflect greater diversity. To inform this expansion, CDC conducted spring 2023 focus groups with Tribal elders (n=8) and differently-abled older adults (n=9) and presented different concepts depicting older adults engaging in activities with others. Tribal elders were affiliated with five tribes: Navajo, Ojibwa, Citizen Potawatomi, Lumbee Indian, and Wailaki. Half were female (n=4), and majority were 63–70 years of age (n=5). This group tested two new radio concepts: (1) Walking and Talking and (2) Sharing Lessons. Themes across Tribal participants included the importance of connecting with loved ones, sharing culture and spirituality through service, and connecting with younger generations. The differently abled focus group was majority female (n=6), white, (n=5), 70–75 years of age (n=5) and reported using a mobility aid (n=6). This group tested two new video concepts: (1) Best Friends and (2) Health in Numbers. Participants identified social connection and being with others as important for their overall health. Using these data, we will create and refine campaign materials targeting both populations, which will be disseminated and further evaluated. By creating culturally relevant and respectful health promotion messages, we can better engage disproportionately affected persons and reduce injuries.
EXPERIENCES AND PERCEPTIONS OF FOREIGN NURSES WORKING IN A SUPER-AGED SOCIETY: A QUALITATIVE DESCRIPTIVE STUDY
Authors: Zeng Derong , Asakura Kyoko , Kinoshita Ayae , Qi Bingbing
Published: December 2023

This study delves into the experiences of foreign male nurses from China working within Japan’s super-aged society, a distinctive environment marked by unique healthcare and elderly care systems. We directed our focus on the Chinese perspective, aiming to gain a detailed understanding of their experiences, challenges, and perceptions within this context. This qualitative research explores experiences, challenges, and perceptions of 16 Chinese male nurses in Japan’s super-aged society. Focused on the Chinese perspective, it provides valuable insights via semi-structured interviews. The interviews were conducted in Chinese via Zoom, with each participant being interviewed once for an average duration of 90 minutes. Key findings include: 1) Job Responsibilities and Challenges: Participants reveal high work intensity and difficulties with disease management and scheduling in the Japanese healthcare system. 2) Aging Society Implications: While Japan’s eldercare and healthcare systems provide stability, they also result in increased demand and workloads. Some system aspects were criticized as unreasonable. 3) Cultural Adaptation: Challenges included language barriers, understanding Japanese etiquette, and lifestyle and work habits adjustment. 4) Interpersonal Relationships: Narratives about interactions within this new cultural environment highlighted communication issues and feelings of isolation. this study offers an in-depth understanding of the unique challenges faced by Chinese male nurses within Japan’s super-aged society. The findings serve to inform future healthcare policies and practices tailored towards foreign healthcare professionals in Japan. By focusing specifically on Chinese male nurses, this study contributes a fresh perspective to the ongoing discourse on cultural diversity within the international healthcare workforce.
EXPERIENCES OF RACISM IN HEALTH AND LIFE-COURSE RESEARCH: A MEASUREMENT BOOKLET AND RECOMMENDATIONS
Authors: Iveniuk James , Peek Monica
Published: December 2023

Numerous, interconnected fields of research study racism, and health inequities emerging from systemic racism. Researchers who are interested in strengthening this work may, however, find themselves at a loss as to where to begin. They may not have a conceptual framework that informs their choice of measures and approaches. They may also lack awareness of appropriate measures, that they can choose from to create impactful work. To meet this need, we create a research-community asset for the measurement of racial identity, intrapersonal/internalized racism, interpersonal racism, institutional racism, and structural racism, with an emphasis on measuring these experiences and their impact on health across the life course. Where applicable, we provide guidance on scoring. The asset is prescriptive in what measures it offers to readers, and in terms of the multi-level theoretical framework that we use to inform our selection. However it is also agnostic about health outcomes or research designs, and we provide measures that are applicable to self-report and administrative data sources, in order to be applicable to as many different researchers as possible, both in academic and community-engaged settings. We also provide some general guidance for translation into different languages, to be inclusive of respondents from diverse linguistic backgrounds.
EXPLORING INTERPROFESSIONAL HEALTH STUDENTS’ ATTITUDES AND PERCEPTIONS OF AGING AND CAREERS IN GERONTOLOGY
Authors: Garrison Brianna
Published: December 2023

ageism continues to impact healthcare professional’s attitudes toward older adults. Older adults are often assumed to be frail, weak, or a burden on society. Addressing ageist attitudes and myths about ageing, which often lead to discrimination, can impact policy decisions. Knowledge of opportunities available to older adults to increase healthy ageing is vital in any healthcare training program. Recognizing the growing needs to prepare health professionals to work with the increasing numbers of diverse older adults, this research survey conducted for the college of health and human sciences (CHHS) to examine the students’ attitudes and perceptions of ageing, interest in ageing careers, knowledge gaps in ageing, and ageing topics of interest. This survey resulted in 141 respondents who helped provide an informed baselines of CHHS student misconceptions about ageing, baseline of learning needs, and topics and practice opportunities of interest. This poster will share the unique results of this survey providing insight into students’ attitudes and perceptions on ageing. Additionally, this poster will provide a brief picture of the college’s response to the survey including curriculum development and systemic changes.
EXPLORING MULTIDIMENSIONAL RELATIONSHIPS OF OLDER ADULTS LIVING WITH CHRONIC PAIN
Authors: Munson Taylor , Curtis Megan , Brailsford Jennifer , Hendry Phyllis , Sheikh Sophia
Published: December 2023

Older adults who experience chronic pain (CP) face many challenges from their illness, which can affect their personal and healthcare relationships. Research indicates the importance of relationships on health and quality of life outcomes in older adults with CP. However, minimal research has explored their perspectives on the relationships they have with their healthcare providers, healthcare system, their CP, and family/friends/community. Objective: To understand how older adults’ CP impacts their relationship with the healthcare system; and how older adults’ CP impacts their personal relationships (i.e. self, family, community).

Methods: Adults >50 years of age with pain were eligible to enroll in virtual focus groups and/or interviews. Audio recordings were transcribed, coded, and analyzed via a mixed inductive-deductive framework approach using ATLAS.ti. Microsoft. Descriptive statistics were performed using Stata 16.

Results: Sixteen participants participated in a focus group (n=3) or an interview (n=13). Participants identified as White (n=12,75%), female (n=12,75%), and were between the ages of 55-64 years old (n=8,50%). Most participants held an associate’s degree or higher (n=15,93%) and reported private medical insurance coverage (n=11,70%). Sessions lasted between 30-90 minutes. Participants described complex relationships that could have positive or negative impacts on their ability to manage their CP and their overall quality of life. Relationships explored included the healthcare system, clinician(s), family, other patients, and CP.

Discussion: The relationships of older adults living with CP are multidimensional and can support or adversely affect pain management, mental health, and quality of life.
EXPLORING THE COMPLEXITY OF LUCID EPISODES IN DEMENTIA: PERSPECTIVES FROM MULTIDISCIPLINARY CLINICAL EXPERTS
Authors: Bangerter Lauren , Griffin Joan , Kim Kyungmin , Maria Lapid , Gaugler Joseph , Finnie Dawne , Frangiosa Theresa
Published: December 2023

Lucid episodes (LE) occur in people living with dementia who have seemingly lost cognitive capacity. Understanding LEs is a relatively new area of scientific inquiry. Most LE studies have utilized different conceptual and operational definitions. Reaching a definition of LE is critical foundation to facilitate more systematic investigation and new knowledge of LEs. The goal of this study was to convene a group of 13 clinical experts to brainstorm on the key components needed to understand LE among people living with dementia (PLWD). We aimed to reach consensus from the group on (1) potential medical or clinical explanations for LEs; (2) necessary medical and clinical questions to understand LE; (3) interpretation of the presence of LE. Thirteen experts from different disciplines (neurology, psychiatry, psychology, pharmacy, palliative care, hospice, nursing, social work, primary care, geriatrics, and professional home caregivers) participated in a virtual Delphi Method study. Experts provided a range of opinions on potential medical and clinical explanations for LE, necessary questions to understand LE, and did not reach consensus on the presence of LE when presented with clinical vignettes. Panelists highlighted key medical and contextual factors as well as a need to know more information about the general demeanor and typical behavior of the PLWD to make a definitive judgement about whether LE occurred. Clinical consensus on LEs is complex. There is great variability in how behaviors and cognitive fluctuations in PLWD are appraised by clinical experts.
EXPLORING THE EXPERIENCES OF PERCEIVED NEIGHBORHOOD SAFETY OF BLACK ADULTS: RESULTS FROM THE THINK PHRESH STUDY
Authors: Staben Omar , Palimaru Alina , Troxel Wendy , Dubowitz Tamara , Rosso Andrea
Published: December 2023

Racial residential segregation is a complex socio-economic phenomenon that affects many communities across the U.S. Such residential segregation is a result of historic policies in the United States including redlining and inequitable urban redevelopment. Black adults who live in segregated areas face challenges and experience psychosocial stressors, including poverty, crime, and feeling unsafe in one’s neighborhood which are risk factors for many negative health and cognitive outcomes. To date, few studies have explored perspectives on experiences of racial residential segregation, and specifically, neighborhood safety trajectories that may relate to healthy aging. This qualitative study used data from a sample of participants in adulthood and older adulthood (aged 35-89, Mage= 64 years) from two predominantly black, low-income neighborhoods that have had different histories with regard to disinvestment and systemic racist policies. We used 60 in-depth interviews to explore perceptions around neighborhood safety trajectories and their perceived impact on aging outcomes. The results highlight several dimensions of perceived changes in neighborhood safety over time and how these are perceived to relate to aging outcomes, e.g., psychological stress. The findings also show a few differences between the two neighborhoods concerning policing strategies, individual behaviors, and resource availability, all of which may contribute to perceptions of safety. Implications of this work highlight the importance of developing culturally relevant interventions that target upstream social determinants of healthy aging and health disparities.
EXPLORING THE STRESS-RELATED GROWTH AMONG ELDERLY KOREAN IMMIGRANTS IN THE CONTEXT OF COVID-19 PANDEMIC
Authors: Lee Jooah , Kim Yongseop , Park Hyejin , Kim Junhyoung
Published: December 2023

While some studies investigated stress-related growth (SRG) during the COVID-19 pandemic, little research has been pursued to explore positive psychological changes associated with COVID-19 among older Asian immigrants. Thus, we aimed to find positive changes resulting from the COVID-19 pandemic based on the SRG framework. Using a purposeful criterion sampling strategy, semi-structured in-depth interviews were conducted with 11 participants. Content mapping and content mining questions were used. Data were qualitatively analyzed using the constant comparative method. Challenges and stressors associated with the pandemic such as fears of physical or verbal attack, COVID-19 infection, strict COVID-19 regulations and mandates, and limited opportunities to interact with others were identified based on the statements of participants. We identified three salient themes that were characterized as components of SRG: (a) increasing leisure-time physical activity participation, (b) developing a closer relationship with others, and (c) improving resilience. The findings of the present study present qualitative evidence that older Korean immigrants experienced positive changes associated with the pandemic such as being physically active, developing closer relationships, and improving resilience. These changes are associated with the main elements of SRG, and it appears that the pandemic did lead to older Korean immigrants experiencing SRG.
EXTRACELLULAR VESICLES BIOMARKERS FOR PARKINSON’S DISEASE: A SYSTEMATIC REVIEW AND DIAGNOSTIC META-ANALYSIS
Authors: Taha Hash Brown , Bogoniewski Aleks
Published: December 2023

Parkinson’s disease (PD) and related disorders are frequently misdiagnosed due to shared symptoms and a lack of specific biomarkers, especially in early-stages. Moreover, the prediction of progression and conversion of prodromal conditions, such as RBD, is not possible. Extracellular vesicles (EVs) are tiny, lipid-bilayer bound vesicles released by all cells into the extracellular space and bodily fluids that contain cell-state-specific messages. As such, they have become potential diagnostic tools, but inconsistencies and poor reproducibility hinder their clinical translation. This meta-analysis aimed to clarify the diagnostic ability of EVs extracted from different bodily fluids, such as cerebrospinal fluid (CSF), plasma and serum, for distinguishing patients with parkinsonian disorders from one another or from healthy controls (HCs). Following PRISMA guidelines, we analyzed 21 studies using bivariate and HSROC models, focusing mainly on 1,265 patients with PD vs. 783 HCs due to limited research on other comparisons. The results showed a moderate diagnostic ability of the test (DOR = 21.6 and AUC = 0.852), but substantial heterogeneity and publication bias. The trim-and-fill method estimated two missing studies with null or low DOR. Sub-analysis of media showed that CSF-EVs performed the best (DOR = 42.4 and AUC = 0.924), while plasma-EVs showed the lowest effectiveness. Comparison of biomarkers from general EVs vs. central nervous system (CNS)-originating EVs (n = 13) showed that the former approach is more effective with less publication bias. Though promising, the emphasis should be on standardizing the field by rigorous validation to avoid making practical clinical application a reality.
FACIAL-TRUSTWORTHINESS AND BEHAVIORAL-EVALUATION FACILITATE DECISION MAKING AMONG YOUNG AND OLDER ADULTS
Authors: Liao Shuyao
Published: December 2023

Objectives. Older adults prefer non-diagnostic cues (e.g., facial-appearance) than diagnostic behaviors when making decision in trust games. However, previous research on decision-making heavily focused on memory, requiring older adults to remember multiple faces and corresponding behaviors. Due to cognitive deficits and the rarity of repetitive interactions with partners in real-life, older adults may experience limitations in their memory-based decision making. This study employs multi-trial one-shot trust game to investigate the reliance of younger and older adults on non-diagnostic (facial-trustworthiness) and diagnostic (behavioral-evaluation) cues, and whether older adults would learn the rule of basing decisions on diagnostic cue, when both cues are available. Method. 104 younger adults (Mage = 21.38, SD = 2.41) and 105 older adults (Mage = 65.5, SD = 4.15) completed 96-trial one-shot trust game, in which partner’s facial-trustworthiness and behavioral-evaluation were presented simultaneously. Regardless of facial-trustworthiness, decision outcomes were based on behavioral-evaluation. Results. A reinforcement learning model was established, including learning rate and different weights for facial-trustworthiness and behavioral-evaluation. Results reveled that older adults could indeed show rule-based learning, by exhibiting a non-zero learning rate, and an increase in their weights for behavioral-evaluation after learning, although they initially had higher weights for facial-trustworthiness and lower weights for behavioral-evaluation. Discussion. The present study indicated that older adults tended to rely more on facial-appearance initially. However, they could learn the right rule to adjust decision-making resembling those of younger adults. Keywords: decision-making, facial-trustworthiness, behavioral-evaluation, rule-based learning
FALL RISK AND FEAR OF FALLING IN LOW-INCOME COMMUNITY-DWELLING OLDER ADULTS USING A SIMPLE CHECKLIST
Authors: Uddeen Aleeyah , Komalasari Renata , Thiamwong Ladda
Published: December 2023

Fall risk is common among older adults and can seriously threaten their well-being and increase fear of falling (FOF). FOF can affect the ability of older adults to maintain daily activities and may cause depression. Using a simple checklist to assess the levels of fall risk and FOF can help tailor interventions to prevent falls and promote physical activity. The purpose of the study was to assess fall risk and FOF using simple checklists and examine the association between fall risk and FOF in community-dwelling older adults in low-income settings. A descriptive cross-sectional design was used to assess 103 older adults (men=16, women=87, mean age=75.70, SD±7.19). We used the CDC’s Stay Independent checklist with twelve items to measure fall risk and the Short Fall Efficacy Scale International (Short FES-I) with seven items to assess FOF. Scores equal to or greater than four on the Stay Independent and greater than ten on the Short FES-I indicate high fall risk and high FOF, respectively. The data was analyzed using SPSS version 28. Spearman correlation tests showed that fall risk was positively correlated with FOF (r=.606, p<.001). Our finding suggests that using simple checklists to assess both fall risk and FOF may be helpful for older adults in understanding their risk of falls, thus attenuating their FOF. It may be useful to increase accessibility to these two checklists in efforts to prevent falls and FOF among community-dwelling older adults in low-income settings.
FEASIBILITY OF AN ONLINE DEMENTIA CAREGIVER EDUCATION CURRICULUM FOR FAITH-COMMUNITY LEADERS
Authors: Graupner Jeffrey , Thompson Katherine , Long Monica , Smith Tiffany , Bennett Jenil , Williams Shellie
Published: December 2023

Dementia caregivers have well-documented needs including dementia education, resources, and emotional support. Our prior work demonstrated the efficacy of a novel dementia education program designed to transform urban faith-community leaders into “Dementia Resource Champions” equipped to start their own support groups. We adapted this program to be delivered virtually. A 6-week curriculum of presentations, resources, and video interviews with caregivers was created by an interprofessional team of geriatrics specialists. Recruitment for “DRC: Online” utilized email blasts and online sign-up forms. While registration for the course was open to all, recruitment emphasized that this program was originally developed for local faith-based communities. Each week, participants received an email with a pre-recorded video didactic presentation, a caregiver interview video, and a link for the weekly videoconference discussion. Fourteen participants completed the pre-training survey, and seven went on to complete the 6-week course and post-training survey. Participants’ reported self-confidence in dementia knowledge increased significantly from pre- to post-training (5-Likert Scale, Paired t-test: Pre (M = 2.1 , SD = 1.1); Post (M = 4, SD = 0.6), t(6) = 7.1, p < .001). Self-reported ability to use the internet to find dementia resources also increased significantly (Pre: (M = 3.9, SD = 1.1); Post: (M = 4.7, SD = 0.5), t(6) = 2.5, p = .045.) Participants’ average rating of the program was 4.7 (5-Point Likert, 5=Excellent). Results indicate that this relatively low-tech approach to virtual dementia education is a feasible way to train community leaders to become resources for dementia caregivers.
FEELING CLOSER WITH FUTURE-SELF PROMOTES RETIREMENT PREPARATION OF YOUNGER AND OLDER WORKERS
Authors: Yeung Dannii , Tang Esther Y K , Lin Gloria , Ho Alvin
Published: December 2023

Working adults’ preparation for retirement and later life remains low despite past research has revealed its benefits on the well-being of retirees. This study utilized an experimental method to test whether the positive effect of exposure to future-self on retirement planning would be retained two weeks after the manipulation. Younger and middle-aged Hong Kong Chinese workers were recruited and were randomly assigned to one of the four conditions: exposure to a future-self photo plus a 5-day writing task (FSW), exposure to a future-self photo only (FS), exposure to a current-self photo plus a 5-day writing task (CSW), and exposure to a current-self photo only (CS). Participants in the FSW and CSW conditions were further asked to do a 5-day writing task. Intention to make retirement plans was assessed after viewing the future- or current-self photo (Time 1), while actual preparatory activities for retirement were also assessed two weeks after the photo viewing (Time 2). Preliminary analyses on 91 participants [41 younger (M=31.01,SD=5.55) and 51 middle-aged (M=50.04,SD=6.59) workers] showed significant interaction effects between condition and age on T2 overall retirement planning (F=4.06, p=.01, ηp2=.13) and financial planning (F=4.42, p=.006, ηp2=.14). Specifically, younger participants in the two future-self conditions had more preparatory activities than those in the CSW condition. Middle-aged workers in the FSW condition also reported more retirement preparation than those in the FS condition. These findings suggest that exposure to future-self increases retirement preparation in the short run, and such effect was stronger on younger workers than on older workers.
FRAILTY AS A PREDICTOR OF MORTALITY: A COMPARATIVE COHORT STUDY IN COSTA RICA AND THE UNITED STATES
Authors: Santamaría-Ulloa Carolina , Lehning Amanda , Cortés-Ortiz Mónica , Méndez-Chacón Ericka
Published: December 2023

Geriatric frailty results from aging-related declines in multiple systems and leads to increased vulnerability for loss of mobility, falls, hospitalization, and mortality. The aim of this study is to compare the association between frailty and mortality in older adults from Costa Rica and the United States. This prospective cohort study uses secondary nationally representative data of community-dwelling older adults from the Costa Rican Longevity and Healthy Aging Study (CRELES, n = 2124) and the National Health & Aging Trends Study (NHATS, n = 6,680). Frailty status was assessed using Physical Frailty Phenotype, which includes shrinking, exhaustion, weakness, slowness, and low physical activity level. We estimated Cox proportional hazard models to examine the association between frailty and all-cause mortality at 8 years from the date at baseline. Survey weights were used. Sociodemographic characteristics and health behaviors were included as covariates. The death hazard for frail compared to non-frail older adults was three-fold in Costa Rica (HR = 3.14, p< 0.001) and four-fold in the white US (HR = 4.02, p< 0.001). Older age, being male, and smoking were death risk factors in both countries. High education was a protective factor in the US, whereas being married or in union was a protective factor in Costa Rica. Results indicate that frailty can have a differential impact on mortality depending on the context of different countries. The identification of behavioral, social, and policy determinants of frailty may serve as an essential component of population interventions that prevent the progression of frailty and its consequences.
FRAILTY-FOCUSED ENHANCEMENTS TO SENIORS’ HOSPITAL CARE (FRESH): DOES SPECIALIZED EDUCATION WORK?
Authors: Peterson Jennifer , Fowler Samantha , Faig Karla , Flanagan Kelly , Clancy Olivia , Robertson Caitlin , Yetman Linda , Feltmate Patrick
Published: December 2023

Research suggests that specialized education for nurses decreases frailty and improves functionality in hospitalized older adults. This study explored the impact of a specialized geriatric education program on care delivery for older adults in acute care in 5 hospitals across the province of New Brunswick. A mixed-methods approach with pre- and post- questionnaires was used to explore facilitators and challenges of caring for hospitalized older adults, the knowledge base and experiences of staff, and the impact of providing specialized education. Acute care staff (N=64) participated in a geriatric education intervention and completed pre and post questionnaires. A sub-set (n=26) participated in semi-structured interviews guided by Kirkpatrick’s theoretical framework. Data was collected on mobility, medications, and delirium from patients’ charts (N=99) to identify changes in outcomes pre- and post intervention. Findings revealed that staff had positive attitudes toward caring for older adults; however, their understanding and application of geriatric principles were limited and remained unchanged post-education. There was no significant change in the patient-level measures after the intervention. Interview participants shared that their work environment affects their mindset and workflow, limiting their capacity to deliver the type of care presented in the education sessions. Staff identified the need for specialized education; however, there was no impact on care after participation. Environmental constraints hindered staff from implementing best practices, leading to both practical and psychological challenges to care delivery. These results will inform changes to specialized education programming with the aim of improving care for older adults in hospital.
FROM FRONT TO BACK SEAT DRIVER: INVESTIGATING DRIVING RETIREMENT DECISION-MAKING WITH THE 85+
Authors: Ashebir Sophia , Patskanick Taylor , D’Ambrosio Lisa , Coughlin Joseph
Published: December 2023

It is impossible to consider personal transportation in the United States without engaging with the topic of driving. Over 90% of U.S. households own cars, while 83% of people report they drive several times a week. A critical but often overlooked component of the driving narrative particularly among older adults is the decision of when or if to forfeit the car keys, a topic which is both complex and, for many individuals and families, a source of stress and conflict. With a rapidly growing population of the oldest of older adults, the 85+ age demographic, it is crucial to understand the attitudes and behaviors of this diverse age group regarding the experience of driving retirement. Utilizing four semi-structured focus groups (n=17) and a 48-item survey of original and adapted measures (n=34) with a panel of the 85+, this study sought to understand people’s perspectives on driving, how current drivers think about and plan for driving retirement – or not, and participants’ general perceptions and attitudes toward the future of technology and driving. The data suggest four different vignettes or transportation paths with respect to driving among this age group that intersect with themes of autonomy, the experience of physical aging, the role of family, and key inflection points. Implications of this research highlight the need for targeted solutions and materials for people at varying levels of acceptance with their driving stage and underscore the need for more research and greater involvement of different stakeholders in conversations around transportation and aging.
GEROSCIENCE BLOOD-BASED BIOMARKER INDICES AND PHYSICAL PERFORMANCE IN OLDER ADULTS
Authors: Houston Denise , Pathak Deeya , Neiberg Rebecca , Justice Jamie , Nicklas Barb , Miller Michael
Published: December 2023

Dysregulation in cellular and molecular aging biomarkers are hypothesized to contribute to worse physical performance. We examined associations between blood-based geroscience biomarker indices and physical performance in 414 older adults (77.4±4.4 years; 69% female). Physical performance measures included the expanded SPPB, 4m and 400m walk, and grip strength. Serum IL-6, CRP, TNFr1, GDF15, and insulin were measured and three biomarker indices created: 1) a quintile index calculated by summing quintile scores for each of the biomarkers; 2) a composite z-score calculated using the standardized mean of individual biomarker z-scores; and 3) a principal component analysis (PCA) to identify biomarker factor(s). The quintile index and composite z-score were highly correlated (r=0.94, p< 0.0001). PCA identified two factors: TNFr1 and GDF-15 weighted heavily on Factor 1 and IL6 and CRP weighted heavily on Factor 2. The quintile index and composite z-score were correlated with PCA Factors 1 and 2 (r>0.61, p< 0.0001). Similar standardized beta coefficients were observed for the quintile index, composite z-score, and PCA Factor 1 with 4m and 400m gait speed (all p< 0.0001); every 1 SD higher biomarker index score was associated with ~0.25 SD slower gait speed. For expanded SPPB, higher standardized beta coefficients were observed for the quintile index and composite z-score (~-0.32) than PCA Factors 1 and 2 (~-0.24; all p< 0.0001). Weak associations between all indices and grip strength were observed (p≥0.05). Geroscience biomarker indices that capture inflammation and poor stress response appear to have similar associations with worse physical performance in older adults.
GRANDPARENTS RAISING GRANDCHILDREN IN NEW YORK STATE: UNDERSTANDING NEEDS OF A VULNERABLE POPULATION
Authors: Guastaferro Kate , Mozid Nusrat E , Kramsky Jayna , Melkonian Matilda , Young Kashyah , Spears Essence
Published: December 2023

Grandparents raising grandchildren are a rapidly growing population in the US – the 2020 census estimated 5.9million children < 18 were living with a grandparent and in 2023 this estimate exceeded 7.1million. The older adult was likely not anticipating raising a child and is subject to the same stressors as other adults of their age and similar socioeconomic status: financial insecurity, health problems, employment issues, and family conflict. The community-based interventions that exist for ‘grandfamilies’ address a small portion of their needs and there is no universal network of services for this family unit that can sufficiently address the grandparents’ need for support, resources, and training. A total of N = 58 grandparents (56% female; 70% White; 40% urban-dwelling; 63% married) raising grandchildren in New York State participated in the GRAND Study which sought to quantify the needs of grandparents raising grandchildren using mixed methods. Survey results, corroborated by qualitative interview and focus group data, suggest areas of need include: financial needs, legal needs (e.g., acquiring custody), social support and parenting. Additional needs were observed in grandparents’ self-reported level of depressive symptoms – 46% of responses indicated major depressive disorder – and in managing relationships with their adult child (i.e., parent of grandchild). Overwhelmingly, grandparents spoke about the ‘honor’ of raising their grandchildren despite the challenges, specifically how the public health systems with whom they interact are not responsive to their needs. Results can be used to inform a multicomponent behavioral intervention to improve the general health and well-being of grandfamilies.
HOME MODIFICATION ON FAVORITE ACTIVITY AND SELF-EFFICACY AMONG OLDER ADULTS WITH DEMENTIA
Authors: Park Soobin , Kwon Eunsun , Park Sojung , Shin Oejin , Baek Sehyun
Published: December 2023

Globally, most older people with dementia live at home and want to remain at home as long as possible with a sense of agency, and engagement in preferred everyday activities. To remain at home, a safe and supportive home environment is crucial as dementia progresses. Yet research on environmental modification among people with dementia is focused on neighborhood or urban built environment, and less on home modification. Guided by the ecological model of aging, this study aimed to explore the impact of home modification on both affective (e.g., self-efficacy) and adaptive behavioral (e.g., favorite activities) responses as a result of person-environmental fit among people living with dementia. Using two waves (2018-2019) data from the National Health and Aging Trends Study (NHATS), we examined the extent to which home modification is associated with self-efficacy and engagement in favorite activities. Multi-group structural equation modeling was conducted on 273 older adults living with dementia in the communities, comparing 145 with functional limitations and 129 without. Although home modification did not affect one’s self-efficacy in any group, a positive impact of home modification on engaging favorite activities, especially those that require more physical effort (e.g., active leisure), was significant among older people with dementia with functional difficulties (p< 0.01). Our finding points to the importance of home modification for the most vulnerable subgroup of older adults with dementia, not only ensuring physical safety at home but their continued engagement in the activities meaningful for them, thereby helping them age in place.
HOW DO EDUCATION AND SOCIAL MEDIA USE MATTER FOR ADVANCE CARE PLANNING AMONG CHINESE OLDER ADULTS?
Authors: Pei Yaolin , Qi Xiang , Zhu Zheng , Zhang Wei , Tsay Ruey-Ming , Wu Bei
Published: December 2023

In general, the rate of advance care planning (ACP) engagement is low in Chinese societies globally. Few studies have compared the ACP engagement among Chinese in different regions. This study aims to examine and compare the associations between education, social media use, and advance care planning (ACP) discussion among Chinese older adults in mainland China (Wuhan), Taiwan (Taichung), and United States (Honolulu). Community-dwelling older adults ≥ 55 were recruited from 2017 to 2018. The ACP discussion rate in Wuhan, Taichung, and Honolulu were 15.2%, 19.2%, and 31.3%, respectively. Logistic regression models reveal that education was positively associated with ACP discussion in Taichung and Honolulu. Social media use was positively associated with ACP discussions in Wuhan and Honolulu, and it attenuated the association between education and ACP discussion in Honolulu. The present study contributes to previous research by comparing the association between education, social media use, and ACP discussion in different settings within the same ethnicity. Practice interventions may need use a social media as a tool to promote advance care planning among Chinese older adults where the palliative care is in the initial stage. Form a policy standpoint, it is important to develop palliative care while promoting advance care planning.
HOW IS THE NURSING HOME QUALITY OF CARE ALIGNED WITH THE QUALITY OF LIFE?
Authors: Kwon Jenny , Bowblis John
Published: December 2023

The CMS Five-Star Quality Rating System does not currently incorporate nursing home (NH) consumers’ opinions. This study aims to investigate the association between star ratings and resident/family satisfaction. A unique, facility-level dataset of Ohio NHs that contains star ratings, consumer satisfaction scores, and NH characteristics was constructed (N=701). The key dependent variables were the overall, health inspection, and quality star ratings, categorized into two groups: 1-3 stars and 4-5 stars. Key independent variables were overall resident and family satisfaction scores, which ranged from 0 (low) to 100 (high). Bivariate and logistic regression analyses were conducted. Bivariate results showed consumer satisfaction and star ratings were correlated, but not perfectly related. Regression results found an increase in resident satisfaction was associated with an increased probability of being a 4-5 star rated facility across all star ratings (p<.05). An increase in family satisfaction was also associated with an increased probability of being a 4-5 star rated facility for the overall and health inspection ratings (p<.01). Early studies found little relationship between star ratings and consumer satisfaction. Due to improvements made to the star ratings, this study found consumer satisfaction is associated, though imperfectly, with star ratings, suggesting that a consumer-driven measure of quality still needs to be publicly reported.
HUMAN FACTORS ISSUES IN THE DESIGN OF VIRTUAL REALITY TO SUPPORT OLDER ADULTS’ SOCIAL AND COGNITIVE ENGAGEMENT
Authors: Borbolla Veronica Falcon , Boot Walter , Dilanchian Andrew , Torres Ana Sophia Garces , Hernandez Mario , Xu Bill Tong , Mostafavi Armin , Kim Benjamin
Published: December 2023

Emerging technologies such as virtual reality (VR) hold tremendous potential to improve the lives of older adults, including the opportunity to support social and cognitive engagement. However, this potential will only be realized if VR technologies and applications (apps) are well-designed, considering the needs, preferences, and abilities of older people. To explore and understand design barriers ahead of a randomized controlled trial testing the efficacy of a psychosocial VR intervention for older adults, a team of eight evaluators who underwent standardized and comprehensive training on how to perform a heuristic analysis assessed the design of 28 commercial VR apps. Apps were chosen for their potential to support social interactions, enhance cultural opportunities, facilitate new learning, or support leisure activities. Each app was evaluated based on the Nielsen Norman Group’s ten usability heuristics. For different VR components (hardware, app menus, VR environment), this analysis highlighted specific heuristic violations, examined the general human factors of these apps, and identified positive design elements while suggesting solutions for observed heuristic violations. The heuristic analysis revealed significant usability challenges, especially in areas like “System Status Visibility,” “User Control and Freedom,” and “Help and Documentation.” The primary system components exhibiting these heuristic violations were the “User Interface” and “Virtual Environment.” It was concluded that current virtual reality systems do not adequately address human factors issues, particularly considering the needs and abilities of older adult users. Based on this extensive evaluation, training and design solutions will be presented and VR guidelines for older adults will be introduced.
IDENTIFYING BRIDGE SYMPTOMS AMONG DEPRESSIVE SYMPTOMS IN CHINESE OLDER ADULTS: THE ROLE OF EATING CULTURE
Authors: Yang Zhongfang , Yu Junwen , Hu Tiantian , Zhu Zheng
Published: December 2023

Introduction

Identifying bridge symptoms among Chinese older adults with depressive symptoms is crucial for enhancing the precision and individualization of interventions.

Aim

The aim of this study was to identify the bridge symptoms and to explore the intercorrelation between depressive symptoms clusters in Chinese older adults.

Methods

Depressive symptoms were measured in 2014, 2016, and 2018 using the nine-item version of Center for Epidemiological Studies Depression Scale, and analyzed with cross-lagged panel dynamic network and centrality examination.

Results

Total of 3,438 participants were included. “D5: Had poor appetite” and “D9: Enjoy life” reported the highest value of outstrength (rnegative=0.063; rpositive=0.048) and the highest value of bridge strength (rnegative=0.029; rpositive=0.024) in negative and positive affects cluster. The strongest path is from D5 to D9 (β=-0.02).

Discussion

To explore the potential mechanism of depressive symptoms in Chinese older adults, identifying the bridging symptoms between the positive affect clusters and negative symptoms clusters of depressive symptoms may be needed.

Implications for Practice

More insights into the relationship between eating culture and the potential mechanisms could be provided to aid in the development of culturally sensitive interventions for Chinese older adults with depressive symptoms.
IDENTIFYING FACTORS THAT CONTRIBUTE TO THE FINANCIAL STRAIN OF HISPANIC CAREGIVERS OF OLDER ADULTS
Authors: Howard Margret , Mak Wingyun , Burack Orah
Published: December 2023

Informal caregiving has been shown to have negative effects on the caregiver’s physical, mental, and financial health. To date, studies have mainly focused on the physical and mental health of caregivers; however, finances too are an area of caregiver vulnerability. In this study we examined which types of financial hardships are the greatest predictors of financial strain in Hispanic caregivers (N=184) for persons 50 or older. Data were obtained from the American Association of Retired Persons (AARP) Caregiving in 2020 survey, which oversampled for Hispanic caregivers. A hierarchical regression analysis was conducted to predict caregiver financial strain. Independent variables were entered in three steps: (1) age and gender, (2) emotional strain, physical strain, length of expected caregiving, and attitude towards caregiving (3) taking on more debt, borrowing money, unable to afford basic expenses, late/unpaid bills, using short-term savings, using long-term savings, being unable to save, and moving to a less expensive home. Age and gender were not significant (ΔR2=.007, p=.531). Emotional (β=.309, t=3.512, p<.001), and physical strain (β=.229, t=2.627, p=.009) were both predictors of financial strain (ΔR2=.312, p<.001). Additionally, the specific financial hardships related to financial stress above and beyond steps one and two (ΔR2=.137, p<.001) were being unable to afford basic expenses (β=.356, t=4.161, p<.001), and using long term savings (β=-.308, t=-4.372, p<.001). These results have implications for education and interventions concerning financial hardships and options for Hispanic caregivers of older adults.
IDENTIFYING SOLUTIONS TO ADDRESS THE BEHAVIORAL HEALTH OF OLDER ADULTS: A QUALITATIVE ANALYSIS
Authors: Stodola Allyson , Elliott Sheryl , Parsons Nathan , Dys Sarah , Sotka Susan , Dawson Walter
Published: December 2023

The Oregon Older Adult Behavioral Health Initiative (OABHI), a program of the Oregon Health Authority, seeks to improve behavioral health (BH) services for older adults and people living with physical disabilities. Twenty-four OABHI Specialists work with BH and Aging services agencies, community-based organizations, and other key partners to strengthen the BH workforce, educate communities, provide complex care consultations, improve intra-agency collaborations, and foster timely access to coordinated, culturally-responsive services. Semi-structured, in-depth interviews with Aging and BH service agency managers and direct service providers (n=29) across Oregon were conducted over 12 weeks in 2023 to evaluate impacts of their involvement with the OABHI and improvements needed to better address the BH needs of these populations. Direct service staff and managers shared suggestions on programs, policies and inter-agency agreements that should be implemented to address the top BH-related challenges in their area. The first-hand experiences of direct service staff and managers who work with these populations provide unique insight into not only the most prevalent systemic issues, but what they perceive to be the key resources needed to help address these issues. Qualitative data were analyzed to develop systems-level recommendations to address gaps in BH resources for older adults, and were presented to policymakers and other decision makers in Oregon. Results indicate key resources and policy changes needed to support OABHI-delivered interventions, promote intra-agency collaboration, increase investment in BH services, and provide resources for an increasing population of older adults and people living with physical disabilities who have BH needs.