bluuebunny/crossref_metadata_2025 huggingface dataset:
THE MODERATING ROLE OF POSITIVE SOLITUDE IN THE RELATIONS BETWEEN LONELINESS AND DEPRESSIVE SYMPTOMS
Authors: Segel-Karpas Dikla , Palgi Yuval , Mor Sharon Ost , Raz Yaira Hamama , Shacham Mayan , Ben-Ezra Menachem , Kimron Lee Greenblatt
Published: December 2023

Positive solitude, the choice of being alone to engage in meaningful inner or physical, spiritual, mental, or cognitive activity/ experience, was recently suggested as a stand-alone phenomenon differentiated from loneliness and negative solitude. As loneliness was previously found to have adverse implications for mental health, the present study examined whether the ability to engage in positive solitude can moderate the harmful effect of loneliness on depressive symptoms. The sample consisted of 520 community dwelling older adults in Israel aged 68-87 (Mage=72.66). Participants answered an online questionnaire through a survey company (Ipanel) assessing their background characteristics, depressive symptoms, loneliness, and positive solitude. The results show that loneliness was positively associated with depressive symptoms, whereas positive solitude was negatively associated with depressive symptoms. Furthermore, positive solitude moderated the relationship between loneliness and depressive symptoms, such that higher levels of positive solitude weakened this association. The findings indicate that positive solitude may serve as a buffering factor for mental health among older adults by augmenting coping with the adverse outcomes of loneliness. The results provide insight for tailoring future treatment interventions focusing on positive solitude to enhance mental health among older adults.
SPECIAL FOCUS FACILITIES AND COVID-19: THE IMPACT ON STAFF AND RESIDENT HEALTH
Authors: Rhodes Ann , Caprio Thomas , Gendron Tracey , Waters Leland
Published: December 2023

The Special Focus Facility (SFF) program is an intensive, quality improvement intervention for 88 of the lowest-quality nursing facilities in 49 states. An additional 435 candidate facilities (SFFc) have similar quality problems but do not receive the SFF quality intervention. In the calendar year 2020, a total of 50 SFFs, and 197 SFFc were enrolled for all 12 months. These nursing facilities were compared on COVID-19 outcomes (Case Fatality Rate, staff cases, resident cases) to randomly selected 5-star nursing facilities in the same state for a total sample size of N=494. After controlling for case-mix hours per resident day resident (Case-Mix staffing) and size of nursing facility SFF and SFFc had significantly lower staff confirmed COVID-19 cases in 2020 as compared to 5-star facilities, adjusted R2 =.25, F (2, 4217)=358.2,p=<.005. Despite the lower staff COVID-19 rates, a higher resident Case Fatality Rate was observed, R2 =.013, F (4, 358) =15.42, p=<.005. Although both SFF and SFFc had lower total staff cases, there was a slightly higher rate of reported staff COVID-19 deaths in SFF and SFFc. However, this difference was not significant. R2 =.01, F (4, 4127)=12.32,p=.859. It is important to note that 2020 was the onset of the COVID-19 pandemic and, therefore, a time of extreme disruption from normalcy for residents and staff. However, these findings are a reminder that quality interventions should be designed to consider the linkages between staff and resident well-being and longevity in order to protect both residents and the workforce.
ESSENTIAL CAPABILITIES FOR MANAGING THE LONG-TERM CARE WORKFORCE: EVIDENCE FROM AN INTERNATIONAL SCOPING REVIEW
Authors: Taylor Philip
Published: December 2023

Amid ongoing concerns about meeting the staffing needs of long-term care providers, arguably exacerbated by the COVID-19 pandemic, there is a need to better understand the skills and capabilities required of managers in the sector. Internationally, the management of the long-term care workforce has been somewhat neglected by both the research literature and recent enquiries into the sector. There is fundamental agreement that well-managed staff provide better care. The sector’s leadership and its workforce have been under scrutiny for some time and the context of COVID-19 has shone further light on their limited ability to respond to crises. It is recognised that operational deficiencies in terms of the organization and characteristics of the sector’s workforce as well as its socio-cultural positioning have contributed to sub-optimal functioning. This project collated evidence and recommendations that could inform policymaking among long-term care providers as well as policy and decision makers. An evidence review of relevant international gray and academic literature was undertaken and examples of successful models of management practice across a range of dimensions were identified and written up as vignettes. The paper reports key information regarding the building of capabilities in long-term care workforce management, including: current and future workforce considerations, value proposition, onboarding of staff, career development and retention. Recommendations regarding essential management capabilities in the long-term care workforce are set out with the intention of providing a basis for developing innovative and novel methods for improving and monitoring the quality and impact of management on the workforce.
EXAMINING THE USE AND IMPACT OF CONTRACT CERTIFIED NURSING ASSISTANT STAFFING IN NURSING HOMES
Authors: Scales Kezia , Hailer-O’Keefe Laurie , Wagner Laura , Stepick Lina
Published: December 2023

Certified nursing assistants (CNAs) provide the majority of hands-on care in nursing homes, and adequate CNA staffing is associated with better resident and staff outcomes. However, low wages and overall poor job quality make adequate CNA staffing particularly challenging. There is evidence that nursing homes have increased reliance on contract staffing to fill staffing shortages, though the full scope of this trend for CNAs remains unclear and the impacts on care quality are still unknown. This study addresses this gap by examining staffing levels and patterns for fully employed versus contract CNAs in nursing homes over the past five years and assessing how these staffing trends are associated with quality outcomes for nursing home residents. Specifically, this session will present analysis of data from the Centers for Medicare and Medicaid Services (CMS) Payroll-Based Journal daily nurse staffing files, CMS nursing homes data archive, LTCFocus data, community transmission of COVID-19 data, and unemployment data to demonstrate how staffing patterns among fully employed versus contract CNAs varied from 2017 to 2022 according to facility-level characteristics, local market conditions, and pandemic-related factors. We also examine how CNA staffing levels and patterns affected care quality for nursing home residents. These findings will be presented with policy and practice recommendations for strengthening and stabilizing CNA nursing home staffing.
FINDING THE “SO WHAT?”: DEVELOPING A MEANINGFUL CAREER THAT MAKES AN IMPACT
Authors: Halvorsen Cal
Published: December 2023

As a foundation to my social work scholarship, I consistently ask myself a question that my advisor once posed to me: “So what?” In other words, why and to whom does your research matter, and what are you going to do with it? In this presentation, I will show how my scholarship is framed by my practice experience working in Washington, DC for a think tank and advocacy organization. I will describe my approach to merging traditional academic pursuits with public communication and dissemination activities, including publishing in open-access journals, writing op-eds and reports, and pursuing organizational and community collaborations. I will provide specific examples of my collaborative research with local, state, and national organizations, including how we discuss potential research projects and reach mutually beneficial agreements. Lastly, I will describe how I blend this exciting and personally meaningful approach with more established expectations for tenure-track professors.
PERSPECTIVES OF GERIATRIC FELLOWS TOWARD SCHOLARLY ACTIVITY
Authors: Milani Sadaf , Ahmed Adeeb , Rajagopal Shilpa , Raji Mukaila
Published: December 2023

Previous research conducted nearly two decades ago found that almost half of geriatricians published during their fellowships. About 17% of these geriatricians also indicated a need for further training in scholarly activity. However, it is unclear what barriers and facilitators to participating in scholarly activity geriatric fellows currently face. Our objective was to assess perceived barriers, facilitators, and attitudes toward scholarly activity among current geriatric fellows in ACGME-accredited programs. We conducted a survey of current geriatric fellows from September 2022 to November 2022. An online survey was emailed to geriatric fellows and geriatric program coordinators, when geriatric fellow emails were not publicly available, to assess fellows’ perceived barriers, facilitators, and attitudes toward scholarly activity. We used descriptive statistics to assess geriatric fellows’ perceptions of scholarly activity. Our sample (n=36) was mostly women (61.1%). The most common scholarly activities fellows planned to participate in during fellowship included quality improvement projects (80.6%), case report/series (44.4%), or original research studies (44.4%). The most common perceived major barriers reported were the short duration of fellowship (69.4%) and lack of training to conduct scholarly activity (58.3%). Lastly, about 44.4% of fellows reported being extremely or very enthusiastic and 50% reported being somewhat enthusiastic about participating in research during their fellowship. Most fellows reported plans for at least one type of scholarly activity and reported at least being somewhat enthusiastic about participating in research, however, barriers were identified. A follow-up email survey will be distributed at the completion of fellowship to assess changes in fellow perspectives.
EXPANDING EDUCATIONAL OPPORTUNITIES IN GERONTOLOGY IN JAPAN
Authors: Tsukada Noriko , Maeda Nobuhiro , Iijima Katsuya
Published: December 2023

There are two universities that offer Gerontology curriculum and confer Gerontology degrees in Japan, including J.F. Oberlin University and The University of Tokyo. J.F. Oberlin University started its Master’s program in 2002 and its doctoral program in 2004. The University of Tokyo endowed a Gerontology Research Division in 2006 and started its cross-departmental program in Gerontology in 2008. The endowed Gerontology Research Division was elevated to the Institute of Gerontology (IOG) in 2009. From April 2014 through March 2021, the Gerontology program, known as the Global Leadership Initiative for Age-Friendly Society (GLAFS) at The University of Tokyo, was funded by the Ministry of Education, Culture, Sports, Science and Technology. Today, The University of Tokyo now funds the program which was renamed World-leading Innovative Graduate Study Program in Gerontology: Global Leadership Initiative for Age-Friendly Society (WINGS-GLAFS). This paper first presents a brief history of Gerontology-related events in Japan, including foundational education proposals of The Science Council of Japan, then introduces Japan’s leading Gerontology education programs offered by J.F. Oberlin University and The University of Tokyo in detail. Finally, it presents other gerontology related activities including the Gerontology Literacy Test started by the IOG in 2013.
DEVELOPMENT OF AN INTERNATIONAL GERONTOLOGY EDUCATION COURSE BETWEEN THE US AND JAPAN
Authors: Yamashita Takashi , Lilly Flavius , Kamijo Mio
Published: December 2023

Sociocultural aspects of gerontology education have received growing attention in recent decades, as globalization and population aging resulted in more diverse older populations across global communities. Accordingly, gerontologists must equip with cultural and international competencies for their future careers, regardless of the fields, such as health care, long-term care, research, and education. This presentation outlines a development and case study (2023) of an international gerontology education course designed for graduate students in the U.S. After the preparation sessions, students take a faculty-led two-week trip to Japan, which is known as a super-aging society with nearly 30% of the population is age 65 years and older, and visit multiple aging-related sites including government agencies, research and education organizations, local communities, industries (e.g., robotics) and cutting-edge programs (e.g., health care research incubation program). The presentation offers three components. First, the academic objectives, such as the enhancement of cultural competencies and cross-national perspectives in gerontology, are described. Second, the practical course development process, including curriculum construction, planning trips, professional networking, student recruitment, funding source, coordination between two countries, and outcome assessment strategies, are illustrated. Finally, using the course evaluation data (n = 13 graduate students from 9 aging-related programs) and qualitative data (journals and field notes), positive outcomes (e.g., increased interest in working with socio-culturally diverse older adults) and challenges (e.g., funding international travel; scheduling difficulty; language barrier) are evaluated.
POLICY SERIES: GSA CONGRESSIONAL UPDATE
Authors: D’Antonio Patricia , Lindberg Brian
Published: December 2023

This popular annual session will provide cutting-edge information on what the 118th Congress has and has not accomplished to date, and what may be left for end of the First Session. Speakers will discuss key issues such as ending of public health emergency, Social Security, Medicare, Medicaid, and the Older Americans Act.
POLICIES TO OUTCOMES: MULTILEVEL CONSIDERATIONS FOR THE ASSISTED LIVING WORKFORCE
Authors: Dys Sarah , Hua Cassandra , Scales Kezia
Published: December 2023

Assisted living (AL) staff mix, levels, training requirements, regulatory enforcement, and career opportunities vary widely across license types, companies, and states. ALs represent the largest care providers for people living with dementia across the U.S. In most states, ALs must have enough qualified, trained staff to sufficiently meet the needs of their resident populations. While the use of interventions to address appropriate staffing levels and workforce retention is increasing, little is known about how the variation in the AL workforce relates to resident and staff experiences or manifests from policies governing these settings. This symposium uses a socioecological framework to examine AL-specific workforce variation. Presentations focus on national variation in staff training requirements, workforce recruitment and retention, trends in staffing levels, how staffing levels can relate to resident outcomes, and direct care staff experiences with stress and coping in long-term care communities. Findings emphasize similarities and differences in workforce composition and experience between states and across different types of facilities. From national comparison of state regulations to facility contexts to individual resident and staff experiences, this panel embraces multilevel contextual understanding of how policies, practices, and outcomes can intersect across AL and residential care environments. This is an Assisted Living Interest Group Sponsored Symposium.
TRENDS IN COMMUNITY-BASED CARE STAFFING LEVELS IN OREGON: DIFFERENCES BY FACILITY CHARACTERISTICS
Authors: Dys Sarah , Tunalilar Ozcan , Carder Paula
Published: December 2023

The COVID-19 pandemic re-centered the workforce crisis across long-term care settings in the U.S. Variation in regulatory requirements, industry practices, staff training, and lack of longitudinal data introduces complexity in understanding workforce trends specific to assisted living and residential care (AL/RC). Pooling five waves of the Oregon Community-Based Care study, we examine trends in AL/RC care staff levels and associations with facility characteristics: license type, Medicaid census, profit status, and rurality. From 2017-2022, 548 unique facilities participated in the study, 55% contributing to four to five waves. The estimated average care staff-to-resident ratio was 0.79 (median= 0.67), increasing between 2017 (0.74) and 2022 (0.87). The average staffing level (care hours per resident per day; hours:minutes) was 3:28 (median= 2:58). We estimated ordinary least squares regression models with robust standard errors, controlling for facility-level characteristics and year. On average, staffing levels were higher by 1:38 in memory care (MC) and 0:42 in nonprofit settings. Compared to non-Medicaid settings, overall staffing levels were about 1:00-1:30 lower in mixed-payer settings, and 2:00 higher in settings providing specialty care (e.g., behavioral health, bariatric) at increased Medicaid reimbursement rates. Licensed nursing staff levels were slightly higher in MC, nonprofit, and special contract Medicaid settings. Certified nursing/medication aide levels were 0:30 higher in nonprofit settings. There were no differences in caregiver levels by profit status or rurality, though mixed-payer setting levels were lower by 0:32-0:44. Reduced occupancy during the pandemic resulted in higher staffing levels, though findings suggest continued disparities in staff mix by facility characteristics.
THE ASSOCIATION OF COVID-19 OUTBREAKS AND OTHER FACTORS WITH NURSING HOME RESIDENTS’ QUALITY OF LIFE
Authors: Hoben Matthias , Dymchuk Emily , Banerjee Sube , Estabrooks Carole
Published: December 2023

Nursing home (NH) residents’ Quality of life (QoL) is an important goal of care. However, it is understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, care aide emotional exhaustion, and lack of resident access to geriatric professionals were associated with NH residents’ QoL. In this cross-sectional study (Jul-Dec 2021), we purposefully selected 9 NHs in Alberta, Canada based on their COVID-19 exposure (no or minor/short outbreaks vs repeated or extensive outbreaks). Using a validated questionnaire (DEMQOL-CH), we assessed dementia-specific QoL of 689 residents from 18 care units through video-based interviews with care aides. Independent variables included COVID-19 outbreak in the NH in the last 2 weeks (health authority records), proportion of care aides on a care unit with high emotional exhaustion scores (9-item short form Maslach Burnout Inventory), and resident access to geriatric professionals (validated facility survey). We ran mixed-effects regression models, adjusted for facility and care unit characteristics (validated facility and care unit surveys), and resident covariates (Resident Assessment Instrument – Minimum Data Set 2.0). COVID-19 outbreaks within two weeks of the data collection (β=0.189, 95% confidence interval [CI]: 0.058;0.320), higher proportions of emotionally exhausted care aides on a care unit (β=0.681, 95%CI: 0.246;1.115) and lack of access to geriatric professionals (β=0.216, 95%CI: 0.003;0.428) were significantly associated with poorer resident QoL. Policies aimed at reducing infection outbreaks, better supporting care staff, and increasing access to geriatric specialists, may help to mitigate negative effects of COVID-19 NH residents’ QoL.
AN INTERNATIONAL PERSPECTIVE ON OPTIMIZING FUNCTION AND ACTIVITY IN GERIATRIC CLIENTS ACROSS ALL SITES OF CARE
Authors: Zwakhalen Sandra , Metzelthin Silke , Resnick Barbara
Published: December 2023

With an increasing age, people are at risk for functional decline and care dependency. Frail older people in any site of care –at home, in nursing homes and in acute care– are supported by nursing staff to optimize their functioning, remain active, and maximize their independence. However, nursing staff often tend to work in a task-oriented manner and take over tasks unnecessarily which may deprive older people’s remaining abilities and adversely impact their life quality. Nursing staff require support to improve their activity supportive behavior in practice. This symposium presents the results of several international studies from primary care, home care, nursing home care and acute care, which aim to improve nursing staff behavior and –in turn– client outcomes. First, Prof. Galik will present the results of a randomized controlled theoretically-based trial testing the ‘Function-Focused Care’ approach in which over 350 patients participated. Dr. Vluggen will present the results of a cluster-randomized trial conducted in Dutch nursing home care in which the effectiveness of the ‘SELF-program’ is evaluated, including over 250 nursing staff and 200 patients. Dr. Metzelthin will discuss the feasibility of the SELF-program, which has been subjected to a thorough pilot-study in Dutch home care. Last, Prof. Graff will discuss the experiences of people with dementia and caregivers after following a coaching-based psychosocial program for primary care (SOCAV). The symposium is chaired by Dr. Vluggen and discussed by Prof. Resnick who has a considerable track record in intervention studies focusing on optimizing function and activity in geriatric clients.
EFFECTS OF COMPANION ROBOTS ON DEPRESSION AND SOCIAL ISOLATION AMONG KOREAN AMERICAN OLDER ADULTS
Authors: Lee Othelia
Published: December 2023

Objectives

During the COVID-19, older immigrants in low resource areas who are already excluded from much of social life, had to distance themselves even further, deepening their social isolation. Lack of stimulation can be particularly detrimental, as it influences mood and increases loneliness. Selected for cost-effectiveness and interactive features, we introduced the Companion Robot (CR) system. Preliminary studies conducted in South Korea found statistically significant improvement in quality of sleep and cognition among low-income older patients living alone with multiple chronic conditions and cognitive impairment. Method. Thirty CRs were deployed to solo-living Korean American older adults. We followed up with them after 3 months. In this Stage 1A clinical trial, we tested feasibility, usability and acceptability of CRs, investigating which features of CRs will help improve health behaviors such as medication adherence and daily exercises. Robotic Social Attitude (RoSAS) are assessed with a generic 18-items questionnaire (Krägeloh et al., 2019).

Results

The primary clinical outcomes measured at pre-and post-intervention were medication adherence and reduction of depression, social isolation and disabilities. The user-friendly doll-shaped design of CRs helped participants feel comfortable interacting with the CR on their own. Exposure to individualized CR-delivered content, including quizzes for brain training and inspirational messages, combined with consistent interaction with CR appeared to be beneficial for cognitive function.

Discussion

Since very few participants had reported diagnosis of dementia, we need to screen for undetected dementia using the Modified Mini-Mental Status Exam. The next stage is to implement further cultural adaptation for the U.S. participants.
BARRIERS AND FACILITATORS IN USING THE E-PAINSUPPORT INTERVENTION FOR ADRD PATIENTS AND CAREGIVERS
Authors: Mayahara Masako
Published: December 2023

Pain is one of the most common comorbidities of ADRD and is experienced by 45.8% of ADRD patients. The major barrier to effective pain management is poor adherence to pain management regimens, due in part to caregiver lack of knowledge and lack of self-efficacy in administering analgesics. Pain in ADRD patients is associated with depression, wandering, agitation, and aggression. Digital applications may facilitate pain management by: (1) delivering education to increase knowledge and self-efficacy, (2) expediting pain reporting to nurses, and (3) improving adherence to pain management protocols. e-PainSupport is a self-administered, digital pain management application. It has three elements: (a) Educational Module, (b) Patient Pain Record, and (c) Pain Summary for Nurses. The efficacy of the app is currently being tested in a randomized controlled trial funded by the National Institutes of Health. The preliminary findings support the efficacy of e-PainSupport in reducing patient pain intensity and increasing caregivers’ self-efficacy and knowledge. However, the current intervention relies on patients’ self-reporting of pain and thus is not appropriate for all ADRD patients. Therefore, the purpose of this study is to explore facilitators for and barriers to using e-PainSupport for ADRD patients and caregivers. The data will be collected through post-intervention, semi-structured interviews of nurses and caregivers with patients in the e-PainSupport condition. Findings will inform future adaptations of e-PainSuport for ADRD patients and caregivers.
AGING EDUCATION IN THE UNITED STATES: WHERE WE ARE AND HOW DID WE GET HERE?
Authors: Donorfio Laura
Published: December 2023

Aging education at the precollege level is relatively new in the United States, making its debut in the literature in the 1960s (Myers, 1977). The first White House Conference on Aging (WHCoA) in 1961, centered on the need for aging education and recommended it be integrated into curricula in public schools, higher education institutions, and libraries (McGuire, 2017). At the 1971 WHCoA it was noted that such educational efforts were indeed rare and again recommended that aging and life cycle education be mandatory at all levels of education, programs be developed to train teachers about aging, and older citizens be used as school volunteers (McGuire, 2017). Since then, aging curricula and intergenerational programming have made their way slowly and insufficiently into education at both the pk-12 and college levels. Interestingly, more recently, it seems more for-profit organizations are investing in aging education and training versus educational institutions to educate their workforce to better meet the needs of their older consumer base to increase their profit margins. Beyond profit margins, what is the heuristic value of aging education and why is it increasingly important and needed not only in the United States, but worldwide? This paper will kick off the symposium and set the stage with a retrospective account of what factors have propelled aging education in the United States and what we have learned to move aging education forward at both the pk-12 and higher education levels.
CELEBRATING CENTENARIANS IN ELEMENTARY SCHOOLS: PROMOTING POSITIVE VIEWS OF AGING AMONG YOUNG CHILDREN
Authors: Hancock Cynthia , Newsham Tina , Alston Daniel , Fugate-Whitlock Elizabeth , Nikzad-Terhune Katherina
Published: December 2023

Upon learning that some teachers celebrate the 100th day of school by asking young children to dress up “like a 100-year-old,” the presenters questioned what ideas about aging are reinforced by such an activity. Social media images reveal that many of these activities lead to stereotypical presentations of older people. Additionally, the “fun” activity of dressing like a centenarian teaches children that it is okay to have fun at the expense of another segment of the population and reinforces the belief that older people are frail, weak, confused, and out of touch. Partnering with experts in early childhood and elementary education, the presenters created a toolkit to offer accurate information about centenarians, aging, and ageism and to give teachers options for celebrating the 100th day of school that reinforce important academic content, address prekindergarten to second-grade learning standards/outcomes, and support age-inclusivity. The presenters will share data from a pilot study of the curriculum and suggest next steps for advancing aging education among very young learners.
INTER-ORGANELLE CROSSTALK IN THE REGULATION OF AGING AND LONGEVITY
Authors: Wang Meng
Published: December 2023

In eukaryotic cells, specific functions are compartmentalized into various organelles that are evolutionarily conserved across species. Many of these organelles play crucial roles in regulating cellular homeostasis and organismal health. Lysosomes, mitochondria, lipid droplets, and endoplasmic reticulum (ER) are highly metabolic active and support the metabolic balance of lipids, amino acids, carbohydrates, and nucleotides. These organelles also regulate signal transduction, transcriptional responses, and epigenetic dynamics, and contribute to the control of lifespan and healthspan in a variety of organisms. Importantly, these organelles do not act in isolation, instead exhibit complex intercommunication at structural, metabolic and signaling levels. The dysfunction of these organelles and their intercommunications have been associated with aging and age-related pathologies. This symposium aims to encourage innovative studies on the role of organelle interactions and communications in regulating aging and longevity. Speakers have been invited to share their new findings in this research topic. We will discuss how lysosomal metabolism couples with lysosomal signaling to regulate organelle crosstalk, tissue communication, and organism lifespan; how ER and mitochondria communicate through calcium signaling and promote longevity; how lipid droplets play a novel role in remodeling carbohydrate metabolism and define the metabolic balance in supporting organism health; and how lysosomal activity, mitochondrial function and cytosolic proteostasis orchestrate to support cellular homeostasis.
ER CALCIUM SIGNALING COORDINATES MITOCHONDRIAL DYNAMICS AND METABOLIC FUNCTION TO PROMOTE LONGEVITY
Authors: Burkewitz Kristopher
Published: December 2023

Inter-organelle communication is a critical determinant of cellular metabolic homeostasis, and defects in the interactions between organelles are increasingly correlated with age-dependent diseases. Despite these promising links, exploration of how inter-organelle signaling pathways can be targeted to promote healthy organismal aging is a nascent area of research. We have established a foundation in C. elegans to investigate how the communication between endoplasmic reticulum (ER) and mitochondria, two of the most central metabolic hubs in cells, controls the aging process. Combining electron microscopy, live-imaging and biochemical approaches, we provide evidence that C. elegans forms ER-mitochondrial contacts and that through molecular mechanisms conserved to mammals, ER calcium flux potently stimulates mitochondrial bioenergetics. Furthermore, genetic manipulation of the ER inositol triphosphate receptor (InsP3R) reveals that ER calcium signaling promotes mitochondrial homeostasis at multiple other levels, including mitochondrial gene expression and dynamics. Building on this foundation, we now reveal that ER calcium signaling is essential for longevity in contexts of mitochondrial reprogramming. Surprisingly, InsP3R-stimulated mitochondrial bioenergetics do not appear to be the key mechanism of longevity in these contexts, but rather the underappreciated roles of the ER in tuning mitochondrial gene expression and morphology. Our results thus highlight the InsP3R as a potent and central regulator of diverse mitochondrial properties and reveal that the connections between ER and mitochondria are deeper and more complex than current models suggest. Overall, we reveal that inter-organelle communication between ER and mitochondria is an essential mechanism of longevity in paradigms involving mitochondrial reprogramming.
POSTPENSIONABLE AGE AS A DISTINCT CAREER STAGE
Authors: Platts Loretta , Cahill Kevin
Published: December 2023

This paper presents a new, two-phase model of the late career. Drawing on life course theory, we assert the importance of age-norms for ordering the timing of people’s lives in countries with universal old-age pension systems. Three age boundaries may govern the transition to retirement: social security rules, employment rules and social norms. Upon reaching these boundaries: (1) old-age pension receipt provides a reliable income easing breadwinner pressures, (2) compulsory retirement may push older people out of the workforce, and (3) social expectations encourage participation in leisure rather than paid work. Once old-age pensions ease or eliminate bread-winning pressures, financial necessity no longer drives most of these oldest workers. Further, these working pensioners are defying social conventions calling on them to retire from paid work. Post-pensionable-age or “phase II” jobs tend to be more flexible and rewarding, and less stressful than those held by younger workers. Intriguingly, not only do these workers have quite distinctive motivations to work, they have unique ways of subduing the potential burdens of working. However, most research lumps together workers over pensionable age (in phase II) with workers still in their fifties (in phase I) who are fully exposed to labor market risks. This paper presents theoretical arguments and empirical evidence to support the idea that post-pensionable-age work is a discrete career phase economically, subjectively, and in terms of leverage with employers. It explores likely geographical and socio-economic limits to this two-phase model of the life course.
A QUALITATIVE EVALUATION OF RISE FROM THE PERSPECTIVE OF ADULT PROTECTIVE SERVICES CASEWORKERS
Authors: Rogers Geoff , MacNeil Andie , Connolly M T , Salvo Erin , Kimball Patricia , Lewis Stuart , Burnes David
Published: December 2023

Our understanding of effective elder abuse and self-neglect (EASN) response interventions is limited. Adult Protective Services (APS), the primary agency responsible for responding to EASN, lacks a coherent, conceptually driven, prolonged intervention phase. Informed by ecological-systems, client-centered, and relational perspectives and adapting evidence-based modalities from other fields, the RISE intervention addresses this systems gap and compliments and augments APS services. Based on a three-year pilot project involving a partnership between RISE and Maine APS, the current study conducted a qualitative evaluation of RISE, from the perspective of APS caseworkers (n=14) who worked with RISE. The purpose of this evaluation was to understand RISE strengths, areas for improvement, and qualities of the RISE/APS partnership. Findings suggest APS workers perceive that RISE benefits clients, complements the scope and nature of APS, enhances APS caseworker well-being, and reduces repeat APS cases. Further APS/RISE collaboration and clarification on RISE role responsibilities and referral eligibilities represent areas of growth. This study provides preliminary evidence for RISE as a community-based EASN intervention in partnership with APS
USING RISE IN CASES DIVERTING DEFENDANTS IN ELDER ABUSE SCENARIOS OUT OF THE CRIMINAL SYSTEM AND INTO TREATMENT
Authors: Connolly M T , Ulrey Page , Kimball Patricia , Rogers Geoff , Lewis Stuart , Burnes David
Published: December 2023

Criminal justice system interventions are a common response to elder abuse, neglect and exploitation (EA), but there is severely limited understanding of their efficacy in reducing EA or improving the well-being of older adults. A goal attainment scaling feasibility study revealed that APS clients’ goals often included getting help (like substance use or mental health treatment) for someone else, often family members harming them. Some APS and RISE clients reported reluctance to seek help or report harm, fearing that involvement of the criminal justice system might result in them losing control over their lives, losing a caregiver, being forced into a facility, or legal punishment of someone they care about. Given these findings, the RISE team engaged in a lengthy outreach and planning phase with state and local prosecutors, elder victim service providers, restorative justice experts, and researchers, to design a novel intervention, using RISE in conjunction with drug court, to divert cases involving substance using defendants alleged to have mistreated an older person. This session will describe the extensive planning and design process and provide a case study analysis, which suggests that a combination of drug court’s in-patient treatment for the defendant, services for the victim, and RISE’s focus on restorative justice approaches that repair breached relationships reduced harm and benefited the older person, the defendant, and their families. Implementation of RISE in partnership with the criminal justice system carries important implications for the integration of restorative justice practices in some EA cases.
NEIGHBORHOOD CONTEXT AND QUALITY OF LIFE OF OLDER ADULTS IN EASTERN NEPAL: A CROSS-SECTIONAL STUDY
Authors: Sapkota Krishna , Ghimire Saruna , Shrestha Aman
Published: December 2023

Introduction

Increased life expectancy has resulted in population aging and subsequently entails addressing the needs of older adults. Shifting family structures from multigenerational to nuclear have had a significant effect on the older adults’ livelihood and their ways of interaction with community members. This research aims to comprehend the relationship between neighborhood context and older adults’ quality of life (QoL) in Nepal.

Methods

A total of 847 non-institutionalized older adults (≥60 years) from eastern Nepal were interviewed in 2021. The QoL was measured by13-item version of the Older People’s Quality of Life questionnaire (OPQOL-brief), and each item was measured on a 5-point Likert scale. The OPQoL mean score < 3 was recoded as low, and ≥3 was high QoL. Ethnic diversity, monthly income, connection with family, friends, and neighbors, cultural connection, residential instability, and accessibility were measured to see the effect of neighborhood context. Multivariable logistic regression assessed the relationship between neighborhood context and QoL.

Results

More than 20% of older adults reported low QoL. Participants engaged in occupation [OR=2.63], not consuming tobacco [OR=1.78], living in communities with higher ethnic diversity [OR=1.03], frequently in contact with family [OR=4.77] and neighbor [OR=13.79], and stable residence [OR=5.43] had significant associations with better QoL.

Conclusion

In this study, neighborhood context was a determinant of better QoL in older adults. Therefore, engagement in income generation activities, and strengthening families and neighborhood ties bring good QoL among older adults.
THE MATCH/MISMATCH IN PERCEPTIONS OF SUCCESSFUL AGING AMONG OLDER BURUNDIAN REFUGEES IN THE US
Authors: Owino Jonix , Fuller Heather
Published: December 2023

Perceptions of successful aging may be impacted by unique lived experiences such as migration, adaptation, and traumatic life experiences. While there exist studies on successful aging among immigrant communities, research studies on successful aging among older refugees, who flee due to life threatening situations, are sparse. The present qualitative study aimed to shed light on the match or mismatch that may exist between older refugees’ perceptions of successful aging and their perceptions of their lived experiences, as well as sex variations in those perceptions. Twenty-one Burundian refugees, aged 50+, were recruited from an upper Midwest community to participate in in-depth interviews. The qualitative interviews were analyzed using thematic content analysis. Themes denoting a match in aging refugees’ perceptions of success aging and lived experience included: wisdom/ability to give advice (i.e., guidance especially to younger individuals), experiencing peace and security, and fostering family relationships. A mismatch was highlighted in themes related to work experiences (i.e., the challenge of engaging in jobs not related to their prior skills), lack of social connections, and communication difficulties. Gender differences were apparent in that women emphasized shifts in work-related gender roles while men emphasized shifts in dependency-related gender roles. In many ways, aging refugees’ unique backgrounds and experiences seemed influential for their match/mismatch in successful aging perceptions and experiences. These findings highlight the importance for host communities to better understanding how refugees perceive and experience successful aging to best inform the implementation of effective interventions for aging refugees.
HOW AN INTERGENERATIONAL TECHNOLOGY INTERNSHIP MODEL BUILDS CAREER READINESS AND AGE FRIENDLINESS
Authors: Leedahl Skye , Souza Kristin , Pascuzzi Emma
Published: December 2023

This presentation will describe the key elements of the University of Rhode Island (URI) Engaging Generations Cyber-Seniors Program internship and discuss results from an assessment study that examined post-survey data related to student experiences. Past research has shown that this program is successful in reducing ageism in student participants. In this study, we examined questions from two scales about youth empowerment and participation in planning that corresponded to the Career Readiness Competencies employers seek in graduates today as determined by the National Association of Colleges & Employers (NACE) and measures for building age-friendliness. Survey findings (n=112) showed that the areas in which students stated the most impact were: effort, problem solving, identity exploration, goal setting, and time management. This corresponds to improvements in the NACE Career Readiness Competencies of career & self-development, professionalism, equity & inclusion, and leadership. Related to age-friendliness, scores were particularly high for questions about students speaking out and educating people about older adulthood, telling people about how older people can be digitally included, feeling confident about teaching older adults to use technology, and having ideas about how to improve digital support for older people. The key takeaway from this presentation will be for educators to identify a way in which student experiences can be assessed for growth in career readiness and building age-friendliness.
MOVEMENT AND HEALTH: NOVEL INSIGHTS INTO PHYSICAL ACTIVITY, ENERGY EXPENDITURE, AND MOTOR FUNCTION
Authors: Schrack Jennifer , Wanigatunga Amal , Glynn Nancy
Published: December 2023

Physical activity, energy expenditure, and motor function are well-established predictors of health and longevity with aging. Traditionally, most research using these measures has focused on speed of movement and intensity of activity. More recently, interest has grown in ways to refine these movement-related measures—and the methods used to analyze them—to improve predictive and discriminatory power for older adult health outcomes. This symposium will focus on measures derived from traditional in-lab assessments of motor function as well as free-living accelerometry, and their novel application across a variety of large U.S. cohort studies. Ms. Marino will present analyses on the links among heart rate variability, physical activity, and cognitive health in the Atherosclerosis Risk in Communities (ARIC) study. Dr. Dougherty will present the association of fine and gross motor function with MRI-derived brain volumes in the Baltimore Longitudinal Study of Aging (BLSA). Dr. Davoudi will present evidence on the link between physical activity quantities and variability with dementia in the National Health and Aging Trends Study (NHATS). Dr. Schumacher will compare measures of absolute and relative physical activity intensity with incident cardiovascular outcomes and all-cause mortality in the Objective Physical Activity and Cardiovascular Health (OPACH) Study. Finally, Dr. Wanigatunga will describe objectively measured physical activity quantities and patterns by self-reported fatigue levels and HIV status in the Multicenter AIDS Cohort Study (MACS). Collectively, these presentations will highlight novel ways to utilize motor function, energy expenditure, and physical activity data to advance prevention science and promote healthy aging. \ This is an Epidemiology of Aging Interest Group Sponsored Symposium.
FREE-LIVING HEART RATE VARIABILITY/PHYSICAL ACTIVITY AND COGNITIVE FUNCTION AND DEMENTIA IN ARIC
Authors: Marino Francesca , Wu Hau-Tieng , Rooney Mary , Soliman Elsayed , Deal Jennifer , Wanigatunga Amal , Schrack Jennifer , Chen Lin Yee
Published: December 2023

Low heart rate variability (HRV) and physical activity (PA) are associated with cognitive dysfunction in clinical settings. Yet, associations with these measures among older adults in the free-living environment remain unexplored. We hypothesize higher free-living HRV and PA are associated with higher cognitive test scores and less likelihood of mild cognitive impairment (MCI)/dementia. This study includes 1,590 ARIC participants aged 72-94 years who wore the Zio XT Patch for 14-days to simultaneously capture ECG and accelerometry, from which we derived HRV as the standard deviation (SDNN) or root mean squared successive difference (rMSSD) of normal RR intervals and PA as total mean amplitude deviation (TMAD; higher values represent more movement). Linear or ordinal regression models were fitted to estimate cross-sectional associations between log transformed HRV or PA with latent-variable derived global and domain-specific cognitive factor scores or adjudicated MCI/dementia, respectively. Participants were on average 79 years, 57% female, and 32% Black. There were no significant associations between either HRV measure and cognition. After adjusting for demographic and medical covariates, 1-unit higher in log TMAD was associated with a 0.30-point higher global factor score (95% CI: 0.16-0.44), 0.38-point higher executive function factor score (95% CI: 0.22-0.53), 62% lower odds of MCI (95% CI: 0.22-0.67) and 75% lower odds of dementia compared to normal cognition (95% CI: 0.08-0.74). In summary, free-living PA, but not HRV of RR intervals, is associated with cognitive and dementia status. Further investigation of other objective HRV measures and directionality of associations between PA and cognition is needed.
SHARED AND DISTINCT ASSOCIATIONS OF MANUAL DEXTERITY AND GROSS MOTOR FUNCTION WITH BRAIN ATROPHY
Authors: Dougherty Ryan , Wang Hang , Gross Alden , Schrack Jennifer , Agrawal Yuri , Simonsick Eleanor , Resnick Susan , Tian Qu
Published: December 2023

Poor motor function is associated with brain volume and cognitive impairment. Less is known about the associations among motor domains and brain atrophy and whether associations are affected by cerebrovascular burden and/or physical activity. We analyzed data from 726 Baltimore Longitudinal Study of Aging participants (mean age 70.6±10.1 years, 56%women, 27%Black), 525 of whom had repeat MRI scans over 5.0±2.1 years. Two motor domains were operationalized as latent variables. Manual dexterity using the Purdue Pegboard and gross motor function using grip strength and comprehensive physical performance testing. Associations between the latent variables and cortical and subcortical brain volumes of interest were examined using latent growth curve modeling, adjusted for demographics, white matter hyperintensities, and physical activity. Both higher manual dexterity and gross motor function were cross-sectionally associated with smaller ventricular volume and greater white matter volumes in the frontal, parietal, and temporal lobes (all p<.05). Higher manual dexterity was also cross-sectionally associated with greater parietal gray matter ( =0.14;95%CI:0.05,0.23), hippocampal ( =0.10;95%CI:0.01,0.20), postcentral gyrus ( =0.11;95%CI:0.01,0.20), and occipital white matter ( =0.10;95%CI:0.01,0.21) volumes, and better gross motor function with greater temporal gray matter volume ( =0.16;95%CI:0.05,0.26). Longitudinally, higher manual dexterity and gross motor function were associated with lower temporal white matter and occipital gray matter atrophy (all p<0.05). Greater manual dexterity was also associated with a slower rate of ventricular enlargement ( =-0.17;95%CI:-0.29,-0.05) and less atrophy of occipital white matter ( =0.39;95%CI:0.04,0.71). Among cognitively normal middle- and older-aged adults, manual dexterity and gross motor function exhibited shared as well as distinct associations with brain atrophy over time.