bluuebunny/crossref_metadata_2025 huggingface dataset:
CO-DESIGNING DATA COLLECTION AND USE PROTOCOLS FOR PROVIDING PERSON-CENTERED DEMENTIA CARE
Authors: Corazzini Kirsten , McConnell Eleanor , Kusmaul Nancy , Holmes Sarah , Wang Jing
Published: January 2025

Considerable gaps remain in delivering person-centered dementia care in residential long-term care (LTC) settings, despite gains in instrument development, and the addition of person-centered care-related items in the Minimum Data Set (MDS). The paucity of pragmatic measures and care processes to support person-centered dementia LTC has been identified as significantly contributing to this gap. Further, this gap is exacerbated in medically underserved and health professional shortage (MUHPS) communities, which are less likely to have the professional development and technical capacity to support robust data collection and use of person-centered care measures among front-line care staff. This multi-method, participatory research study aimed to address this gap by co-designing, with residential long-term care residents who are living with dementia, their families, and care staff in MUHPS communities, pragmatic data collection and use protocols. This paper describes the development of co-design workshops through the data analysis of qualitative interviews (N=68 residents, family members, and staff from 4 LTC communities), and results from co-design workshops of identified strategies following review of journey maps (N=8 workshops). Results provided low-resource strategies in multiple domains over time for staff members (onboarding, developing expertise, and becoming an expert); residents (moving into your new home, being who you are and living, and feeling like you are settled); and families (supporting a family member’s move, supporting good care, and overall assessment of care). Findings advance our methodological and substantive capacity for inclusive and low-resource strategies to improve person-centered dementia care practice in LTC.
LIFETIME ABUSE VICTIMIZATION AND PROSPECTIVE HEALTH OUTCOMES IN OLDER ADULTS
Authors: Kong Jooyoung , Moorman Sara , Qin Yue
Published: January 2025

Lifetime abuse victimization indicates cumulative violence exposures or repeated victimizations within and/or across different life stages. The current study aims to examine the patterns of lifetime abuse victimization that span childhood to older adulthood and evaluate the associations between lifetime abuse victimization and prospective health outcomes in late adulthood. Data were drawn from 4907 older adults (mean age = 80) from the Wisconsin Longitudinal Study. We assessed the exposure to interpersonal violence including childhood abuse and neglect, intimate partner violence, and elder abuse until the respondents’ age of early 70s. A series of multivariate analyses were conducted to examine the associations of a cumulative score of lifetime abuse victimization with depression, physical health status, and memory in respondents’ age of early 80s. On average, respondents experienced 1.1 exposure to lifetime abuse victimization (SD = 1.53). Greater exposure to lifetime abuse was associated with a significantly higher risk of depression and a greater number of limitations in physical functioning, but not with memory performance. When examined separately by abuse type, childhood abuse was associated with more health limitations and elder abuse was associated with a higher risk of depression and more health limitations. Our results support the interrelations of interpersonal violence across the life course and the lasting health effects of exposure to lifetime abuse, which can lead researchers and practitioners to adopt a more comprehensive conceptualization of interpersonal violence victimization. Findings also highlight the need for a life course-based, trauma-informed approach in prevention and intervention programs for older adults.
FINANCIAL EXPLOITATION AMONG HOLOCAUST SURVIVORS: EVIDENCE FOR VULNERABILITY AND RESILIENCE
Authors: Weissberger Gali , Bensimon Moshe , Shrira Amit
Published: January 2025

Late-life adverse events may be particularly impactful in Holocaust survivors (HS) as they may be reminiscent of certain conditions that existed during the Holocaust. Financial exploitation (FE) is one such adverse event that may lead to losses reminiscent of Holocaust conditions. Research has demonstrated that the experience of FE has devastating consequences on the mental health of older adults. However, few research studies have examined the consequences of FE in older adults with a traumatic past. In a quantitative study, we showed that anxiety and depressive symptoms associated with an FE experience were significantly greater in HS with posttraumatic stress disorder (PTSD) symptoms relative to comparisons (HS without PTSD symptoms who experienced FE and HS without an FE experience). However, research of HS has also shown that they exhibit certain resiliencies vis-à-vis stress. Accordingly, we used a qualitative approach to further examine vulnerability and resilience among HS who experience FE. The following questions guided our inquiry: What are the feelings and perceptions of HS following an experience of FE? How did they cope with FE? What are their perceptions of protective and risk factors for FE? Fifteen HS (10 females, M age = 84.66) living in Israel underwent semi-structured interviews. A four-stage content analysis revealed several core themes of meaning: 1) negative emotional reactions towards FE; 2) coping mechanisms; 3) positive life motto; 4) protective and risk factors for FE. Taken together, the qualitative analyses produced novel insights with regards to vulnerabilities and resiliencies amongst HS who have experienced FE.
SLEEP: A GEROSCIENCE TARGET
Authors: Carroll Judith
Published: January 2025

Obtaining healthy quantity and quality of sleep is important in maintaining good mental and physical health, and cumulative evidence points to a role of sleep loss and sleep disturbances as a factor increasing age-related disease risk and progression. Many older adults experience less sleep on average per night than they obtained in earlier decades. Despite convincing epidemiologic data linking poor sleep and diseases of aging, the molecular pathways accounting for these links are not well delineated. Our work has begun to tackle these questions by examining how poor sleep may accelerate the biological aging process, while intervening to improve sleep may slow aging. We have shown that insomnia is related to biomarkers of aging including shortened telomere length, older epigenetic age, and a pro-inflammatory signal. Experimentally restricting sleep in older adults led to acute changes in gene expression indicating increased DNA damage response and senescence related inflammatory activation. Treating insomnia in older adults led to lower transcripts for cellular senescence and slowing of the pace of aging (DunedinPACE). Healthy sleep may provide biological advantage for increasing restoration and repair, while poor sleep may reduce the time the system can dedicate energy to repair of insults experienced during waking hours. Parallel to clearance of waste from the brain, we hypothesize that sleep is also important for physiological restoration throughout the body. Many unknowns still exist and future research will be needed to disentangle the mechanisms through which sleep alters biological aging.
CAPABLE FAMILY FOR THE CAREGIVER–CARE RECIPIENT DYAD WITH DEMENTIA AND DISABILITY
Authors: Jenkins Emerald
Published: January 2025

Co-occurring physical and cognitive impairments in older adults with mild cognitive impairment (MCI)/early dementia lead to decreased functional independence and increased mortality. The purpose of this study is to address the needs of older adults with co-occurring physical disability and MCI/early dementia and their caregivers by adapting the Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program to become CAPABLE-Family. To adapt CAPABLE, we performed a two-part multi-method study, part included: (1) semi-structured interviews with clinicians (n= 15) and (2) photovoice/semi-structured interviews (n= 12) of persons with mild cognitive impairment (MCI)/early dementia and their care partners (dyads). The second part of the study was an open label pilot to (1) adapt CAPABLE for persons with co-occurring physical disabilities and mild cognitive impairment (MCI)/early dementia (n= 7) and their care partners (n= 6) (dyads), and (2) evaluate acceptability/feasibility of the CAPABLE-Family intervention. The pilot included both qualitative and quantitative descriptive analysis. Findings from clinician interviews include, for example: incorporate a greater emphasis on safety, memory, nutrition and advanced care planning. Findings from the photovoice were categorized into 3 major themes. From the pilot, difficulty with ADLs and IADLs improved in older adults. Depression and pain interference improved in care partners. Qualitative feedback from the dyads in the open label pilot included, for example: the importance of written/tangible items. There are multiple methods for mood mitigation, self-esteem, and memory. Evidence from this research points to the importance of individualized intervention/care elements for this population.
EFFECTS OF MINORITY AND CAREGIVING STRESS ON THE HEALTH OF BI+ INFORMAL DEMENTIA CAREGIVERS
Authors: Kittle Krystal , Cicero Ethan , Pelkmans Jordan , Flatt Jason , Anderson Joel
Published: January 2025

Bi+ people (e.g., bisexual, pansexual) are more likely to experience poor physical and mental health compared with monosexual minority (i.e., gay[G], lesbian[L]) people. These poor health outcomes stem from minority stress related to sexual minority status. Due to minority and caregiver stress, LGB+ people providing care to someone with Alzheimer’s disease and related dementias (ADRD) are more likely to have worse health than their straight counterparts. Little is known about how minority and caregiver stress affect the health of bi+ ADRD caregivers versus monosexual minority ADRD caregivers. Data from ADRD caregivers (bi+, n=125; gay/lesbian, n=161) were used to examine associations between minority stress, caregiver stress and overall health and if associations differed among bi+ and gay/lesbian ADRD caregivers. Multivariable regression, adjusting for demographics, was used to investigate if sexual orientation moderated the association between minority/caregiver stress variables and overall health. All minority stressors and two caregiving stressors (caring for spouse/care recipient’s level of independence) were associated with health. In our adjusted model, lifetime victimization, day-to-day discrimination, and caring for spouse/partner, moderated the association between sexual orientation and overall health. As lifetime victimization scores increased, bi+ health decreased while monosexual minority health increased. Caring for a spouse/partner, protective for both groups, had a greater effect on health for monosexual minorities. Higher day-to-day discrimination scores predicted worse health for both groups, but the magnitude was greater for monosexual minorities. Qualitative inquiries can illuminate underlying mechanisms for this phenomenon, informing interventions and policy aimed at supporting health and well-being of bi+ ADRD caregivers.
RACE AND GENDER DIFFERENCES IN UNMET NEEDS OF NONSPOUSAL CARE PARTNERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Tucker Gretchen , Gruber-Baldini Ann , Samus Quincy , Girling Laura , Orwig Denise
Published: January 2025

Research on unmet care needs of non-spousal informal care partners (ICPs) for persons living with Alzheimer’s disease and related dementias (P-ADRD) is limited. A secondary data analysis using linear and logistic regressions was employed to explore non-spousal ICPs’ unmet needs by gender and race using the Johns Hopkins Dementia Care Needs Assessment (JHDCNA 2.0©). The JHDCNA 2.0© includes six domains and 18 items assessing ICPs’ needs. Data included 413 ICPs of P-ADRD from two community-based studies: Maximizing Independence at Home Randomized Control Trial and Maximizing Independence at Home-Health Care Innovation Award, which enrolled dyads of P-ADRD and their ICPs. Of the 413 ICPs, 143 (34.6%) were White, 270 (65.4%) Black, with 343 (83.1%) female, and 70 (16.9%) male. Gender was not significantly associated with overall percentage of unmet dementia-related care needs. However, there was a race by sex interaction (p <.001); Black male non-spousal ICPs had the highest mean total percent unmet needs (33.48±13.87) while White female non-spousal ICPs had the lowest mean total percent of unmet needs (28.03±13.75). Being a Black non-spousal ICPs was associated with having higher odds of having unmet needs in specific categories such as behaviors 73% vs 61% (p =.015), substitute decision-making 29% vs 8% (p <.001), and decision-making documents 84% vs 71% (p =.002) compared to White non-spousal ICPs.This study highlights the importance of understanding the unique needs of non-spousal ICPs, particularly differences by race, to ensure access to resources and assistance for persons providing care to individuals living with ADRD.
EXPLORING CAREGIVING NETWORK CHARACTERISTICS FOR OLDER ADULTS LIVING WITH DEMENTIA ACROSS RACE/ETHNICITY
Authors: Lai Wen-Hua , Nemmers Natasha , Tsuker Sophia , Leggett Amanda
Published: January 2025

Black and Latinx older adults face a heightened risk of dementia or cognitive impairment. While minority communities often have family-focused supportive networks compared to White individuals, limited research has explored racial/ethnic disparities in caregiving networks (CGN) and contexts for people living with dementia (PLwD). This study investigates whether CGNs and caregiving contexts vary across racial/ethnic groups. Data from the 2015 National Health and Aging Trends Study (N=2,795) were used to analyze a subgroup of Black, Latinx, and White PLwD. Latent profile analysis identified dementia CGN profiles for each racial/ethnic group based on CGN size and composition (e.g., spouse, children, extended kin, non-kin). Multinomial logistic regression examined caregiving contexts associated with these CGN profiles for each race/ethnicity. Four CGN profiles were identified for each racial/ethnic group. The majority of Black PLwD (80%) were categorized into the “children and others (kin and non-kin)” group, with less spousal involvement. Latinx PLwD had smaller CGN profiles but a more balanced caregiver combination than Black peers. While some similarities in CGN configuration were observed across racial/ethnic groups, compositional differences were evident, influenced partly by sociodemographic and cultural contexts. These findings emphasize the importance of considering CGN disparities by race/ethnicity. Understanding these differences can inform the development of screening and intervention strategies to support caregivers within Black and Latinx families, who disproportionately bear caregiving responsibilities for PLwD.
CONTEXTUAL DETERMINANTS OF AGING AND HEALTH
Authors: Yu Jiao , Thorpe Roland
Published: January 2025

Addressing social determinants of health is crucial for promoting healthy aging. As this field grows, there is an increasing emphasis on understanding the upstream contextual factors of poor health and inequities. Contextual factors, operating at multiple societal levels, profoundly shape health and well-being among older adults. Guided by social disadvantage theory, this symposium aims to advance research on contextual determinants of aging and health through both innovative multilevel and life course perspectives as well as methodological advancements in novel statistical models and machine learning methods. This symposium will present four studies exploring how important contextual factors, ranging from education, neighborhoods, and childhood social-historical contexts are associated with health outcomes among older adults. Dr. Kim et al.’s interdisciplinary study delves into the micro-level, employing quantile regressions to investigate gender differences in the effects of education on brain pathology and cognitive decline. Dr. Yang et al. explore how meso-level neighborhood affluence and disadvantage influence older adults’ pain outcomes and medication choices. Focusing on minority aging, Dr. Qin et al. examine how neighborhood disadvantage moderates the association between disability and cognitive decline among older Mexican Americans. Finally, Huo and co-authors take a life course perspective, utilizing machine learning tree and forest models to examine a comprehensive set of 43 childhood micro- and meso-level family and residential characteristics contributing to later life frailty. Through these diverse investigations, this session will provide insights into the contextual determinants related to healthy aging, which will inform targeted interventions and policies to address health disparities among older populations.
THE ROLE OF NEIGHBORHOOD DISADVANTAGE IN PAIN AND MEDICATION AMONG OLDER ADULTS WITH OR WITHOUT COGNITIVE IMPAIRMENT
Authors: Yang Yulin , Kotwal Ashwin , Hunt Lauren , Gomez Scarlett , Torres Jacqueline
Published: January 2025

Neighborhoods are vital to older adults’ health and well-being, yet how they influence pain outcomes and medication use among older adults, with or without cognitive impairment, remains unknown. We evaluated the neighborhood effects on pain outcomes and medication use by cognitive impairment status. We use two distinct neighborhood socioeconomic status measures – disadvantage (including poverty, unemployment, female-headed families, households receiving public assistance income, and proportion of African Americans) and affluence (including adults with a college education, incomes>75K, and employed in managerial and professional occupations). We analyze data from 9,351 older respondents in the Health and Retirement Study from 4,611 census tracts. We fit multilevel logistic regression models with random intercepts to evaluate the neighborhood effects on the risk of reporting pain, pain-related disability, over-the-counter (OTC) pain medication, and opioid medication. In the overall sample, neighborhood affluence is associated with lower odds of pain and pain-related disability, and higher odds of using OTC medication. Among 6,675 cognitively normal respondents, neighborhood disadvantage is associated with greater pain-related disability, while neighborhood affluence is associated with lower odds of pain, pain-related disability, and higher odds of using OTC medication. Among 2,676 respondents with cognitive impairment, neither neighborhood disadvantage nor affluence is associated with any pain outcomes and medication. Neighborhood affluence predicted higher odds of pain-related disability; however, the 95% confidence interval crossed the null. These findings suggest that neighborhood factors are important social determinants of pain outcomes and management among older adults with and without cognitive impairment.
SPOUSAL HEALTH SHOCKS AND INDIVIDUALS’ LABOR PARTICIPATION AND RETIREMENT DECISION: CAUSAL EVIDENCE FROM THE US
Authors: Li Meiyi
Published: January 2025

Health decline is a dyadic process that elicits labor adjustments from both individuals and their intimate partners. Despite increasing attention to the spillover partner effects, empirical evidence is still mixed and the causal nature remains unclear. Drawing upon the nationally representative data from the Health and Retirement Study (1992-2018), the current study aims to investigate (a) What are the causal impacts of spousal health shocks (cancer diagnosis, strokes, and heart attacks) on individuals’ employment, retirement behaviors, and retirement expectations? (b) Are there any gender differences? Matching methods are combined with a difference-in-differences design to examine the causal impacts of spousal health shocks. Results suggest spousal health shocks reduce the probability of working for pay and increase the probability of retirement. As for retirement decisions, spousal health shocks reduce older adults’ expected probability of working after 65. Additionally, results do not show significant gender differences in labor outcomes. Overall, the current study provides important causal evidence on older adults’ labor responses to spousal health shocks. It also informs dyadic interventions to help both people with health decline and their partners maintain economic and social well-being in later life.
ESPO AND BEHAVIORAL AND SOCIAL SCIENCES SECTION SYMPOSIUM: DEFYING THE ODDS: HOW MINORITIZED OLDER ADULTS USE PSYCHOSOCIAL AND ENVIRONMENTAL FORTITUDE TO ENHANCE AGING HEALTH
Authors: Chang E-Shien , Walters Monica , Zahodne Laura
Published: January 2025

Minoritized older adults report worse health outcomes compared to their non-Hispanic White counterparts. However, existing research often focuses on the role of risk factors rather than sources of resilience among minoritized older adults. In this symposium, we will highlight ways in which racially and ethnically minoritized older adults use different facets of fortitude to ameliorate disparities and promote resilience. Our first two presentation will examine psychosocial fortitude in relation to cognitive health. Dr. Alexandra Clark will examine how belonging to a resilient psychosocial-behavioral phenotype buffers risk for Alzheimer’s disease and how bilingualism protects cognitive health variably among Latinx older adults. Dr. Ruijia Chen will address racial/ethnic disparities in Alzheimer’s disease and related dementias by focusing on the interplay of life course stressors, resilience factors, and sleep health across the life span. Our last two presentations will examine environmental factors in relation to cognitive and physical health. Dr. Talha Ali will provide insights on resilience mechanisms by exploring the moderating role of individual-level race/ethnicity in the relationship between structural racism and increased risk for subjective cognitive decline. Dr. Kyle Moored will explore ways in which neighborhood walkability buffers the negative impact of neighborhood socioeconomic disadvantage on step activity among Black older persons. Dr. Laura Zahodne, as discussant, will provide summative comments identifying synergies across presentations and promoting strategies for advancing the field of minority aging research.
ETHNICITY AND WELL-BEING AMONG OLDER IMMIGRANTS IN DIVERSE SOCIOCULTURAL CONTEXTS
Authors: Lai Daniel W L
Published: January 2025

The critical interaction between culture, ethnicity, and social determinants of health is a vital area of study, particularly regarding the unique experiences of ethnocultural minority older adults. The complex intersections of these factors across diverse social landscapes are ripe for investigation to uncover inequalities and inform targeted strategies to reduce the inequalities encountered by these groups. This symposium presents four key studies that examine the well-being, healthcare access, and civic participation of aging Asian immigrants, with a focus on South Asian populations in Hong Kong and Canada, as well as Chinese communities in Canada and the United States. These studies highlight the need for culturally congruent interventions. They emphasise the challenges faced in health and mental health service accessibility and the rich tapestry of cultural diversity within civic involvement. Critical factors such as the quality of intergenerational relationships, the breadth and depth of social capital, language skills, transportation availability, financial dependencies, and the impact of pre-migration histories are shown to significantly affect the lives and civic engagement of aging Asian immigrants. The research presented here strongly advocates for culturally attuned policies and practices. It underscores an imperative for health promotion, healthcare accessibility, and civic inclusion that are responsive to the cultural identities and preferences of diverse older populations. The findings of these studies are critical to the development of targeted interventions, public policies and supportive frameworks that address the unique needs and overcome the barriers faced by ageing migrants around the world.
BARRIERS TO ACCESS HEALTH AND MENTAL HEALTH SERVICES AMONG SOUTH ASIAN OLDER ADULTS
Authors: Shankar Janki , Das Papiya
Published: January 2025

Research on older immigrants in Canada is in its infancy despite their growing numbers. In 2019, Covenant Health, one of the largest healthcare providers in Canada, in partnership with the Indo-Canadian Women’s Association, a non-government service organization for new immigrants, in Edmonton, conducted a community consultation with South Asian older adults to understand their health and mental care needs and barriers to their access. The consultation was based on anecdotal evidence that South Asian older adults make poor use of health care services in general and mental health care services in particular. Focus groups and individual interviews with older adults were used to gather information, and the data were analyzed using thematic analysis. The results showed that a significant number of South Asian older adults lead marginalized and isolated lives within their community. Lack of language skills, transportation difficulties, poor knowledge of health care services, financial dependence on sponsors, and adherence to traditional beliefs about health and mental health services are some of the barriers to accessing services. Based on these findings, several recommendations are suggested to improve healthcare access for older adults.
RELIGION AND LONELINESS: OLDER PEOPLE IN IRELAND
Authors: Leavey Gerard
Published: January 2025

Background

Religious identity and adherence may confer health benefits, through increased social capital (eg, community belonging, and material resources) and mechanisms for coping with adversity and misfortune. Isolation and loneliness are associated with less engagement in religious practice and can influence mental health outcomes. Aims: To investigate comorbid depression (or subthreshold symptoms) in those with clinically relevant anxiety and their relationship with loneliness, social networks, religious practice and long-term illness.

Methods

Secondary data analysis of Wave 1 of the TILDA study (2009-2011), a nationally representative community-based sample.

Results

Compared to those with low/no symptoms of depression, those classed as comorbid were more likely to be male, had lower education levels, had spent more time abroad, lower religious attendance, a limited social network, were lonelier and had a long-term life-limiting illness. Those with subthreshold levels of depression reported a more restricted social network and more moderate levels of loneliness.
THE RELATIONSHIPS BETWEEN RELIGIOUS SERVICE ATTENDANCE, SPIRITUALITY, LONELINESS, AND SOCIAL ISOLATION
Authors: Taylor Harry , Nguyen Ann
Published: January 2025

The objective of our study is to determine if religious service attendance and spirituality had an association with loneliness and social isolation among older adults. We used the Health and Retirement Study to address our research objective. Religious service attendance was measured dichotomously (no religious service attendance vs. attending religious services at least once a year). Spirituality was measured by Fetzer Institute 4-item Brief Multidimensional Measure of Religiousness/Spirituality. Loneliness and social isolation were operationalized using the UCLA 3-item loneliness scale and by a social network index, respectively. Covariates included age, gender, race, income, employment status, and education. We used multivariable linear regression to examine the relationships between religious service attendance, spirituality, loneliness, and social isolation. We found respondents who did not attend religious services were more likely to be socially isolated. Additionally, spirituality did not have a significant association with social isolation. Respondents who did not attend religious services had significantly greater loneliness in comparison to those who did attend religious services. Furthermore, respondents with higher spirituality scores had lower loneliness scores. We found religious service attendance had an association with social isolation only, while both attendance and spirituality had an association with loneliness among older adults; therefore, improving access to religious institutions and enhancing one’s spirituality may serve as important factors for mitigating social isolation and loneliness among older adults.
THE EFFECT OF CAREGIVING ON ADULT CHILDREN’S SAVING: A MULTILEVEL, CROSS-NATIONAL ANALYSIS OF 11 EUROPEAN COUNTRIES
Authors: Wang Mengya
Published: January 2025

This research explores how caregiving impacts individuals’ retirement planning using Bronfenbrenner’s bioecological model. Focusing on retirement savings, it examines the association between caregiving and savings, considering gender, family support, and welfare regimes as moderators. Multi-level analysis of data from the Survey of Health and Retirement in Europe, with a sample of 3,555 individuals across 12 European countries participating in both wave one and two, reveals unexpected findings. Contrary to expectations, caregiving isn’t negatively correlated with savings, and female caregivers don’t face more financial challenges than males. Additionally, the impact of family support on savings varies by gender, with sons providing care having greater savings when they have at least one sister, while daughters engaged in caregiving tend to have fewer savings if they have at least one brother. Welfare regimes also impact savings differently based on caregiving duration; long-term caregivers in defamilialism regime (DF) experience significant savings changes between waves, while short-term caregivers in unsupported familialism regime (USF) undergo more changes. This suggests that in DF regimes, caregivers initially struggle with work and caregiving balance, but adapt successfully once arrangements are in place, possibly due to increased formal support. Conversely, in USF regimes, initial family support is strong, but over time, reliance on formal care services decreases, and family support dwindle, posing increasing long-term challenges for caregivers. This study offers insight into the implications for caregivers’ long-term financial well-being. Recognizing the financial strain they face, it’s imperative to explore effective policy options to alleviate economic burden linked to informal caregiving.
DEPENDS ON WHO YOU ASK: DISCORDANCE IN REPORTING SPOUSAL CARE BETWEEN WOMEN AND MEN ACROSS EUROPEAN WELFARE STATES
Authors: Vafaei Afshin , Rodrigues Ricardo , Simmons Cassandra , Zólyomi Eszter , Kadi Selma , Fors Stefan , Phillips Susan
Published: January 2025

Current research on determinants, prevalence, and effects of informal care on health assumes that survey instruments can appropriately identify informal care providers. We aimed to investigate systematic differences across Europe in reporting spousal care between caregivers and cared-for persons and their possible effects on associations between informal care and physical and mental health indicators. Using information on care provided/received from the Survey on Health, Ageing and Retirement in Europe (SHARE), we estimated prevalence rates of spousal care and discordance between caregivers and cared-for persons in the reporting of care among caregiving dyads. We used multinomial regressions to estimate differences in reporting spousal care across European countries and then constructed multivariate logistic regression models to evaluate the effect of discordance in reporting informal care on the correlation between care and poor self-rated health and depression. Results showed that only 53.9% of dyads report care confirmed by both spouses. Multinomial regressions showed that agreement on care provided/received was more common when women are caregivers, while men were more likely to underreport providing/receiving care. There was no effect on the association of care with SRH regardless of who is asked to identify the care providers, while the magnitude and direction of the association between depression symptoms and care varies according to the choice of respondent. Possible explanations for the discordance include social norms dictating gender roles and acceptability of men as care providers. Relying on self-identification of care providers as most surveys do has the potential to underestimate their numbers.
FAMILY CAREGIVING: TIME-VARYING CONTEXTS OF SOCIAL SUPPORT, FINANCES, BURDEN, AND BENEFITS
Authors: Malhotra Rahul , Lim-Soh Jeremy
Published: January 2025

Family caregiving is a crucial component of long-term care. Care provision provides opportunities for psychosocial gain but can also lead to burden among family caregivers in multiple domains – physical, psychological, social, and financial. Family caregiving is dynamic, with changes over time in the needs of care-recipients as well as care responsibilities and outcomes experienced by caregivers, yet longitudinal studies on caregiving contexts are scant. Longitudinal changes and trends in social support, financial well-being and service use, burden and benefits of caregiving, and spiritual resilience are essential to identify caregivers at-risk of detrimental changes over time. The four presentations in this symposium provide empirical findings from population-based longitudinal studies of family caregivers of older adults, most with three or more time points of data collection. The first investigates heterogeneity in perceived social support of family caregivers over time and explores the role of caregiver psychological resilience in reshaping the trajectories. The second examines longitudinal trends in financial difficulties and income among family caregivers and their impact on supportive care service utilization. The third discusses joint trajectories of the burden and benefits of caregiving over time and highlights modifiable factors in the process. The fourth unravels the paradox wherein family caregivers simultaneously experience both high burden and benefits of caregiving. Collectively, the presentations underscore the heterogeneous and dynamic nature of family caregiving and contexts over time. They also highlight the need to strengthen caregivers’ psychological resilience, financial capacity, preparedness for caregiving and spiritual beliefs to enhance their caregiving experience.
FROM NATIONAL DATA TO LOCAL APPLICATION: INNOVATIONS IN AGING NETWORK SERVICES AND RESEARCH PARTNERSHIPS
Authors: Wilson Traci , Sheldon Marisa , Menne Heather
Published: January 2025

As the local experts in planning, coordinating, and implementing aging services, Area Agencies on Aging (AAAs) address a broad range of social and health needs of an increasingly diverse older adult population. To live independently and with optimal health in their homes and communities, many older adults depend on Older Americans Act (OAA)-funded services such as nutrition and in-home supportive services, which they access through local AAAs. Increasingly, older adults look to AAAs for supports outside of core OAA services, such as housing and emergency preparedness and response. This symposium will provide data-driven insights on adaptive strategies to enhance aging services both within and beyond the OAA and how AAAs and researchers can collaborate to support innovations. Each presenter represents a different level and perspective within the Aging Network. The first speaker from USAging will use the National Survey of AAAs to describe organizational characteristics that support aging services innovations. The presenter from the Administration for Community Living will describe findings from recent National Surveys of OAA Participants including how they adapted during COVID and how prepared they are for future emergencies. The director of a university research center will demonstrate the continuum of community engaged research approaches, through a bi-directional relationship with an AAA. The symposium will conclude with a presentation from an AAA illustrating how her agency engages with a university-based research center to innovate, build evidence for program effectiveness, and strengthen services for at-risk older adults.
THINKING OUTSIDE THE BOX: THE ROLE OF FUNDING AND COMMUNITY-ENGAGED RESEARCH IN THE FUTURE OF AREA AGENCIES ON AGING
Authors: White Katie
Published: January 2025

As the older adult and disabled populations continue to grow, Area Agencies on Aging (AAAs) must develop new ways to meet the ever-diverse needs and ideas of individuals in their regions through innovative research partnerships. AAAs have served as the federally mandated, local leaders on aging and disability by planning, developing, funding, and implementing local systems of coordinated home and community-based services (HCBS). The Older Americans Act is the cornerstone of non-Medicaid HCBS, providing funding and requirements for nutrition, supportive, caregiver, and evidence-based services. By partnering with the Age-Friendly Innovation Center of The Ohio State University College of Social Work (AFIC), the Central Ohio Area Agency on Aging (COAAA) is supporting community-engaged participatory research with older adults and people with disabilities to inform future policy, program, service, and funding priorities. This presentation will outline how the COAAA prioritized funding community-engaged research, applied research findings to policy initiatives, and infused evidence-informed practice in new and emerging areas of focus. Practical steps for researchers to engage effectively with area agencies on aging will be discussed.
GLYNAC SUPPLEMENTATION IN OLDER ADULTS IMPROVES GLUTATHIONE, MITOCHONDRIA, AGING HALLMARKS, AND FUNCTION
Authors: Sekhar Rajagopal , Kumar Premranjan , Taffet George , Minard Charles , Suliburk James , Jahoor Farook , Liu Chun , Muthupillai Raja
Published: January 2025

Elevated oxidative stress (OxS), mitochondrial dysfunction, and aging hallmarks contribute to aging, but improving/reversing these defects in older adults (OA) has been challenging. We identified that deficiency of the intracellular antioxidant glutathione (GSH) could play a role and reported that supplementing GlyNAC (combination of glycine and N-acetylcysteine [NAC]) in aged mice improved GSH deficiency, OxS, mitochondrial fatty-acid oxidation (MFO), and insulin resistance (IR). To test whether GlyNAC supplementation in OA could improve GSH deficiency, OxS, mitochondrial dysfunction, IR, aging hallmarks and physical function, we conducted a placebo-controlled randomized clinical trial in 24 OA and 12 young adults (YA). The OA was randomized to receive either GlyNAC or placebo for 16-weeks, and the YA received GlyNAC for 2-weeks. Participants were studied before, after 2-weeks, and after 16-weeks of supplementation to assess changes in intracellular GSH concentrations, OxS, MFO, molecular regulators of energy metabolism, inflammation, endothelial function, IR, multiple aging hallmarks, gait speed, muscle strength, 6-minute walk test, body composition, and blood pressure. We found that compared to YA, the OA had GSH deficiency, elevated OxS, mitochondrial dysfunction (with multiple defects in molecular regulation), inflammation, endothelial dysfunction, IR, multiple aging hallmarks, impaired physical function, and increased waist circumference and systolic blood pressure. GlyNAC (and not placebo) supplementation in OA improved/corrected these defects. In conclusion, GlyNAC supplementation in OA for 16-weeks was found to be safe, well-tolerated, and effective in its ability to reverse multiple age-associated declines and age-related abnormalities. GlyNAC supplementation in older humans is an effective nutraceutical to promote healthy aging.
USE OF PATIENT PORTALS FOR MEDICATION-RELATED COMMUNICATION: IMPLICATIONS FOR DEPRESCRIBING INTERVENTIONS
Authors: Green Ariel , Wek Aleksandra , Gleason Kelly , Wu Mingche , Gamper Mary Jo , Wolff Jennifer
Published: January 2025

People living with dementia (PLWD) often use potentially inappropriate medications (PIM), in which the risks of medication use outweigh the benefits. Little is known about how PLWD and their care partners use patient portals in general, and specifically to communicate with healthcare providers about medications. Our objective was to characterize the content of patient portal messages relating to medications among PLWD, care partners, and clinicians in a single health system, to inform the development of a portal-based intervention to reduce the use of PIM. We examined secure message exchanges between 2/18/2017 and 10/2/2022 from patients 65 years and older with dementia or their care partners in an integrated, academic health system. A total of 399 message threads from 159 unique patients were analyzed. Patients were on average 78.4 years old (SD 8.0). The majority (65%) were female, white (76%), and non-Hispanic/Latinx (96%); 15% had at least one registered proxy portal user. The most common topic raised was logistics (42%), such as clarification of medication instructions. This was followed by messages about adverse effects/treatment burden (25%), asking for new medications (23%), and openness to stopping a medication (21%). Findings suggest that the patient portal is frequently used by PLWD and their care partners to discuss medication-related concerns and that it is a promising platform for delivering interventions to reduce the use of PIM in this population.
ANNUAL WELLNESS VISITS AND EARLY DEMENTIA DIAGNOSES AMONG MEDICARE BENEFICIARIES IN TEXAS
Authors: Kuo Yong-Fang , Raji Mukaila , Shan Yong , Cram Peter , Tzeng Huey-Ming
Published: January 2025

Early recognition of cognitive impairment (CI) and timely diagnoses of mild CI (MCI) and Alzheimer’s Disease and Related Dementia (ADRD) are key to optimal dementia care. No previous research has examined the effects of Medicare annual wellness visits (AWVs) on early CI recognition among Medicare beneficiaries. Here, we assessed the association between incident diagnosis at MCI, moderate or severe ADRD stages in 2017-2020, and having a Medicare AWV in the three years prior to diagnosis. This population-based, case-control study used 100% Texas fee-for-service Medicare data from 2014 to 2020; population: Medicare beneficiaries diagnosed with incident MCI or ADRD from 2017 to 2020. The exposure is Medicare AWVs. The primary outcome is MCI, moderate or severe ADRD status by ICD-9-CM and ICD-10-CM codes. We performed a multinomial logistic regression model to examine the association. Medicare beneficiaries (n=197,356) who had an AWV were 23–66% more likely to be diagnosed at the MCI stage and 8–30% more likely to be diagnosed at the moderate ADRD stage compared to diagnoses at the severe ADRD stage relative to those who did not have an AWV. There was a dose-response relationship; as the number of AWV visits in the three years increased, the magnitude of the likelihood of early diagnosis increased. This study suggests that receipt of a Medicare AWV is associated with increased identification of early CI.
PEOPLE LIVING WITH DEMENTIA AND THEIR FAMILY MEMBERS INFORM A PERSON-CENTERED MEASURE OF “HOME TIME”
Authors: Boucher Nathan , McKenna Kevin , Seidenfeld Justine , Vick Judith , Burke James , Plassman Brenda , Shepherd-Banigan Megan , Van Houtven Courtney
Published: January 2025

To build a person-centered “hometime” measure for use for persons living with dementia (PLWD, inclusive of mild cognitive impairment), we conducted in-depth interviews with PLWD and spouses who support PLWD to understand quality-of-life (QOL) at home versus health facility settings. We interviewed 32 PLWD (age 59-93) and 40 spouses with recent experience in these settings: PLWD in inpatient (12 PLWD; 15 spouses), emergency (8 PLWD; 12 spouses), post-acute skilled nursing (4 PLWD; 4 spouses), outpatient surgery (PLWD 8; spouse 6), and assisted living (3 spouses). Applied thematic analysis generated four themes: 1) Emotions: Participants were frustrated by limited control in health settings. Spouses described some relief, but guilt when the PLWD was in health facility settings. PLWD described being a burden to spouses. 2) Care Challenges: Tasks, including activities of daily living, exceeding spouses’ capabilities or worsening physical/cognitive status decreased QOL at home. Spouses had fewer care duties while PLWD were in health settings. 3) Activities: Time spent with spouse, pets, television, reading, and games provided satisfaction across settings. 4) Community Involvement: Spouses had low community involvement; little changed whether PLWD was in health settings or at home. Many spouses continued to check on PLWDs’ eating, bathing, or medication administration when in a facility. These data in concert with claims data provide insights on value/quality of time at home versus health settings. Our findings inform an emerging “hometime” measure and indicate enhanced task support and social support may raise caregivers’ QOL and help avoid visits to health facilities for PLWD.
A CRITICAL REVIEW OF DISCHARGE PLANNING AND DECISION-MAKING EXPERIENCE OF DEMENTIA FAMILY CAREGIVERS
Authors: Oppong Kwaku Duah , Kwak Jung
Published: January 2025

Persons living with dementia (PLWD) are significantly more likely to be hospitalized and experience poorer outcomes than their non-dementia peers. Despite available evidence-based care transition interventions, few are based on the experiences and perspectives of PLWDs and their family caregivers. To inform development of person-and family-centered care transition support for PLWDs and family caregivers, a systematic review focused on their decision-making roles and support received from hospital teams was conducted by retrieving studies published between 2000 and 2024 from PubMed, CINAHL, and Embase. Four papers were included for full review, and the rigor of each paper was assessed using the Mixed-Methods Assessment Tool. All four studies were qualitative, cross-sectional, and atheoretical, with only one study conducted in the United States. The sample size ranged from 15 to 30 and consisted of family caregivers and PLWDs recruited via chart reviews and hospital units. No study reported on the types of decisions that family caregivers were asked to make. Overall themes on information and support received were: lack of care coordination and inclusion in discharge planning, the discharge planning process often rushed, caregivers feeling unsupported by healthcare providers, and health providers’ inability to meet family caregivers’ informational needs and preferences. Surprisingly, few empirical studies are available, with no studies examining shared decision-making between PLWDs, caregivers, and providers. Existing studies suggest lack of information and support by the healthcare team as a major challenge for these families. Further studies that are theory-driven, with methodological rigor and racial/ethnically diverse PLWDs and caregivers are warranted.
MAXWELL A. POLLACK AWARD FOR CONTRIBUTIONS TO HEALTHY AGING PRESENTATION AND LECTURE
Authors: Dobbs Debra
Published: January 2025

The Maxwell A. Pollack Award for Contributions to Healthy Aging Lecture will feature an address by the 2023 Pollack Award recipient Bei Wu, PhD, FGSA, FAGHE of New York University. This session will also include the presentation of the 2024 Maxwell A. Pollack Award to recipient Edward Alan Miller, PhD, MPA, FGSA, of the University of Massachusetts Boston. The Maxwell A. Pollack Award for Contributions to Healthy Aging Award recognizes instances of practice informed by research and analysis, research that has directly improved policy or practice, and distinction in bridging the worlds of research and practice.