bluuebunny/crossref_metadata_2025 huggingface dataset:
COGNITIVE INTERFERENCE ACROSS THE LIFESPAN
Authors: Cole Rachel , Espinoza Arturo , Yeager Brooke , Narayanan Nandakumar
Published: December 2022

Mental processes that facilitate goal-directed behavior can be negatively affected by age-related biological and physiological changes. Such cognitive changes impact daily activities like driving and using the computer, which can in turn influence social relationships and capacity to work. Previous research has shown that older adults are more affected by interference than young adults. It is critical to understand how cognition changes across the adult lifespan, as cognition during middle age may be predictive of cognitive decline in older age. We evaluated performance on the MultiSource Interference Task (MSIT). The MSIT draws on Stroop, Flanker, and Simon-type tasks; it taxes interference resolution and typically results in interference-related slowing. We studied 60 individuals (32 adults 18–39 years old, 17 adults 40–59 years old, and 11 adults 60–99 years old). As expected, age had a significant effect on accuracy interference (difference in errors between interference and control trials). Surprisingly, however, young adults demonstrated the highest (worst) accuracy interference cost, while middle-aged and older adults had similar interference cost. Replicating previous findings, age group did not have an effect on reaction time interference cost (slowing of response between interference and control trials). It is notable that, in this study, older adults did not fare worse than middle-aged adults. These surprising findings challenge long-held theories that age negatively impacts interference resolution. Understanding differences (and similarities) between cognition in middle-age and older age will be critical for promoting healthy cognition throughout the lifespan, which benefits daily activities and quality of life.
ASSOCIATION OF COGNITION AND SMARTPHONE SURVEY ATTRIBUTES IN THE ELECTRONIC FRAMINGHAM HEART STUDY
Authors: Pathiravasan Chathurangi , Beiser Alexa , Seshadri Sudha , Satizabal Claudia , Zhang Yuankai , Wang Xuzhi , Liu Chunyu , Murabito Joanne
Published: December 2022

Mobile technology offers a remote method to monitor health in older adults and it may provide a platform for early detection of cognitive decline. We aimed to examine attributes of smartphone survey use in the electronic Framingham Heart Study (eFHS) cohort in relation to cognitive testing performed at the time of enrollment. eFHS participants who returned smartphone surveys and underwent cognitive testing were considered in the study (n=1810). The CERAD recall score, Victoria Stroop test interference score, and dichotomous AD8 and MOCA (MOCA score ≤ 19, AD8 score ≥2) were considered as primary exposures. App-based survey adherence was defined as a dichotomous outcome based on whether at least one survey was completed at each 3-month period from baseline to 12 months. Several time attributes were considered including survey return time, touch time, step time, and question completion time. Linear mixed models (LMM for time attributes outcomes and generalized LMM for adherence outcome) were fitted for each cognitive score as the predictor adjusting for age, sex, race/ethnicity, and education level. Results suggest that higher CERAD recall scores were associated with higher odds of completing surveys. There was a significant association between all cognitive exposures and survey time attributes. Participants with poorer cognitive function (lower CERAD, higher stroop interference, MOCA score ≤ 19, AD8 score ≥2) had delayed survey return times, higher touch time, higher step time and higher question completion time. This study contributes to the growing body of evidence that smartphones may be an important tool to identify cognitive decline.
DEPRESSIVE SYMPTOMS AND SUBJECTIVE MEMORY AMONG MIDDLE-AGED AND OLDER MIDWESTERN COUPLES
Authors: Thrane Lisa , Russell Dan , Turner Rachael , Rendell Peter , Savla Jyoti , Reese-Melancon Celinda , Margrett Jennifer
Published: December 2022

Older adults face unique challenges with the COVID-19 pandemic and its effects on mental health and cognition (Lebrasseur et al., 2021). Across the age spectrum, depression is associated with self-reported forgetfulness (Loprinzi, 2018; Ronnlund et al., 2011), and this trend is consistent among older adults with mild cognitive impairment (Ryu et al., 2016). There is some suggestion of gender differences in prospective and retrospective memory ratings among couples (Smith et al., 2000). However, little is known about how depression relates to perceptions of everyday memory performance among couples. In the current study, 47 married or cohabiting couples completed a baseline survey. The mean age of both women and men was 62 years. An Actor-Partner Interdependence Model with latent variables was employed to examine depressive symptoms with an adapted version of the Center for Epidemiological Studies-Depression scale (CES-D; Radloff, 1977) and responses to the Prospective and Retrospective Memory Questionnaire (PRMQ; Smith et al., 2000). Both constructs were parceled separately by gender and summed prior to the analysis. For women, preliminary findings revealed that higher levels of depressive symptoms were related to a negative perception of their own memory (β = .28). Conversely, men’s memory abilities were not associated with their depressive symptoms. Lastly, higher levels of depressive symptoms in men were associated with an increase in women’s self-reported forgetfulness (β = .24). These findings are suggestive of a “couple-oriented” effect (Kenny et. al., 2006), whereas there was not a statistically significant relationship between women’s depressive symptomology and men’s cognitive functioning.
ADDRESSING SOCIAL ISOLATION IN NURSING HOMES DURING COVID-19 – QUALITATIVE DATA FROM A NATIONAL SURVEY
Authors: McPhillips Emily , Dube Catherine , Nielsen Natalia , Hargraves J Lee , Cosenza Carol , Lim Emily , Barooah Adrita , Lapane Kate
Published: December 2022

The COVID-19 pandemic had dramatic, sometimes devastating impacts on nursing homes, residents, and staff. Rapid deployment of innovative approaches to resident care was required even while under sustained distress. We collected textual responses to open-ended questions about COVID-19 experiences through a national nursing home survey of Directors of Nursing/Administrators in February-May 2022. We employed a stratified (by size and quality ratings) sample of 1,669 nursing homes. Response rate was 30%, and 51% of responders answered > 1 open-ended question. We conducted an iterative thematic qualitative analysis yielding 10 themes. Respondents described addressing social isolation using new technology; enlisting staff from across the nursing home [beyond-the-call effort, gifting of voluntary time], and new ways for residents to safely connect with family. Respondents felt severely limited by COVID regulations that seemed to ignore residents’ mental health needs. The majority of respondents felt significant professional and personal impact of the pandemic experience: “The pandemic was the most stressful situation I have encountered in 26 years of nursing” – “What a toll it took on all us emotionally, physically, and mentality” – “Every day was a challenge and I felt hopeless” – Some respondents plan to quit: “I am now seeking other employment. It has been too much for too long and has directly affected my mental health.” Nursing homes reported extraordinary efforts put forth by administration and staff to meet the needs of residents. Efforts to retain nursing staff are needed given profound impacts of the pandemic on their personal and professional lives.
THE COVID-19 PANDEMICS’ IMPACTS ON OLDER ADULTS’ MENTAL HEALTH: THE BUFFERING EFFECTS OF NEIGHBORHOOD COHESION
Authors: Ding Kedong
Published: December 2022

Background

During the COVID-19 pandemic, many older adults reported less frequency of having in-person contact due to the worries of COVID -19, which raises concerns about their mental health. The past research suggests neighborhood cohesion can facilitate social participation and have positive effects on mental health. This study aims to examine the impact of the decreased social contacts due to COVID on older adults’ depressive symptoms, and whether the relationship is moderated by neighborhood cohesion. Method: Data were from the 2020 waves of the Health and Retirement Study (HRS) (n=2,732). Participants included community-dwelling adults aged 65 years or older. The independent variable is the perceived changing amount of in-person contact due to the pandemic. Neighborhood cohesion was measured by four-item sales that assess the extent to which respondents feel about the neighborhoods and neighbors’ trust. The depressive symptoms were measured by the 8-item CES-D scale. All models were controlled for sociodemographic characteristics and health status. Multivariate regression models were used to and an interaction term was created to examine the moderating effects of neighborhood cohesion.

Results

The results from the multivariate regression model show that perceived neighborhood cohesion was associated with fewer depressive symptoms (β=-.16, p < 0.001). Not having enough in-person contact since the pandemic is associated with more depressive symptoms (β=.24, p < 0.001). High perceived neighborhood cohesion attenuates the relationship between not having enough in-person contact and depressive symptoms.

Conclusion

This study demonstrates the buffering effects of neighborhood cohesion on Covid-19 impacts on older adults’ in-person contact and mental health outcomes.
RACE AND AGE DIFFERENCES IN DEPRESSION AND ANXIETY DURING COVID-19: A LONGITUDINAL STUDY
Authors: Wang Xiaochuan , Xu Mengyu , Gryglewicz Kim , Beltran Susanny
Published: December 2022

The COVID-19 pandemic has negatively affected the physical and mental health of many. It remains unclear whether such impacts differ across diverse races or age groups, or along the course of the pandemic. This study assessed trends in levels of depression and anxiety symptoms among U.S. adults during COVID-19 and whether differences emerged across race and age. Data were drawn from the Understanding America Study (UAS) COVID-19 survey, a longitudinal panel survey of a nationally representative sample of over 6,000 individuals. A mixed effect linear model was conducted to assess the influence of race and age on the level of depression and anxiety over time during the pandemic, controlling for covariates such as marital status, employment status, and household income. Results indicate that greater age was associated with lower levels of depression and anxiety. Additionally, trends in levels of depression and anxiety vary across races (e.g., minority populations generally reported lower or comparable levels of depression and anxiety comparing to the White). Findings further suggest significant interactions between age and race, especially among minoritized adults. Study findings underscore the importance of future research and tailored strategies to improve culturally sensitive and age-appropriate mental health services targeting diverse populations.
IMPACT OF COVID-19 PANDEMIC ON MENTAL HEALTH IN OLDER ADULTS: COMPARISON BETWEEN 2020 AND 2022
Authors: Kiu Dara , Leung Yi , Liu Tianyin , Zhang Wen , Kwok Wai-wai , Sze Lesley , Wong Gloria H Y , Lum Terry
Published: December 2022

The COVID-19 pandemic had a major impact on older adults’ mental health, but less is known about its longer-term effect. We examined changes in depressive and anxiety symptoms among older adults between the onset and two years into the pandemic. Data were drawn from two cross-sectional telephone surveys conducted with older adults aged ≥ 60 years in Hong Kong in 2020 and 2022. Respondents were screened for depression and anxiety using Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorders-2 (GAD-2) and, if screened positive (i.e. scoring ≥ 3 in PHQ-2 or GAD-2), evaluated with PHQ-9 and GAD-7 for symptom severity. After case-control matching baseline age, gender, living districts, and pre-existing mental health conditions based on the respondent ratio between the two surveys (i.e. 2:1 ratio), 4095 and 2099 respondents from the 2020 and 2022 surveys were included in the analysis. Respondents’ average baseline age was 75 years old, 77% were female, and 13% had a pre-existing mental health condition. There were significant increases in the proportion of older adults screened positive for depression (8.3% to 13.5%) and anxiety (6.9% to 11.4%) and a significant increase in depressive symptom severity (4.63 to 7.72) between 2020 and 2022 (p < .001). Logistic regression suggested that, over two years, older adults with pre-existing mental health conditions were 1.59 times more likely to screen positive for depression than those without such conditions. Linear regression suggested that males were associated with increased depressive (B=-2.42, p=.004) and anxiety (B=-2.49, p=.021) symptom severity than females over the years.
COVID-19 RELATED MEDICAL CARE DELAYS IN UNDERSERVED AFRICAN AMERICAN OLDER ADULTS WITH COMORBIDITIES
Authors: Adinkrah Edward , Cobb Sharon , Kibe Lucy , Vargas Roberto , Bazargan Mohsen
Published: December 2022

Health seeking behaviors have been negatively impacted during the COVID-19 pandemic particularly among minority older adults. There is a paucity of data concerning African American older adults who delayed, reduced, or stopped visits to primary and specialty providers. To outline the magnitude of this health disparity, this study examines the patterns and correlates of seeking preventive and specialized healthcare within this population. One-hundred and fifty (150) underserved African Americans older adults took part in this health advisor-led cross-sectional study. They completed a survey that inquired about seeking medical, dental, emergency room, and/or specialty care. We employed descriptive analyses to assess patterns of healthcare and multinomial logistic regression to document correlates of healthcare utilization. Almost one-third of participants (32%) delayed or did not get at least one type of care because of COVID-19. Dental care was the most frequent healthcare service that was missed (23%), followed by primary care (10%) and specialty care (7%). A higher level of depressive symptoms, lower level of educational attainment, and higher number of chronic conditions were associated with a higher number of delayed or cancelled medical care. Almost one-third of participants had never used any type of telehealth. Additionally, access and use of telehealth had no impact on healthcare utilization. One-year post pandemic, while vaccines are widely available, COVID-19 is disproportionately worsening healthcare disparities that exist even among African American older adults in underserved and under-resourced communities with access to healthcare. Interventional studies are urgently needed.
ASSOCIATIONS BETWEEN COVID-19 RELATED STRESS, COVID-19 EXPERIENCES, AND MENTAL HEALTH RISKS IN OLDER PEOPLE
Authors: Liu Tianyin , Kiu Dara , Leung Yi , Zhang Wen , Kwok Wai-wai , Sze Lesley , Wong Edwin , Wong Gloria H Y , Lum Terry
Published: December 2022

There is increasing recognition of the need to understand the mechanism of psychological impact brought by COVID-19. The present research used the Delphi technique to develop a COVID-19-Related Stress Scale for older people in Hong Kong (CSS-old) (study one) and examined its associations with COVID-19 experiences and mental health risks (study two). In study one, 17 helping professionals and 20 service users co-developed an 8-item CSS-old through four rounds of Delphi. In study two, a cross-sectional telephone survey was conducted between April and June 2022 among 4,921 older people (age≥60) recruited through community centres. Respondents were assessed using Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder 2-item (GAD-2), and CSS-old; their experiences with COVID-19 (infection, close friend/family infection) and demographical information were collected. A three-factor solution of CSS-old was identified after dropping one item (X2(df) = 83.53(11), CFI=0.996, TLI=0.993, RMSEA=0.037): (1) disruption to routines; (2) fear of infecting families/friends; and (3) concern for the community’s health. Structural equation modelling analyses revealed that being female (B=0.45), having close friend/family infected (B=1.10) and having a pre-existing mental health condition (B=1.87) were positively associated with COVID-19-related stress. Infection of COVID-19 (BPHQ=0.22; BGAD=0.24) and a pre-existing mental health condition (BPHQ=0.71; BGAD=0.59) had direct associations with depressive and anxiety symptoms; COVID-19-related stress mediated the relationship between close friend/family infection with depressive (B=0.20) and anxiety symptoms (B=0.21, all p < 0.05). These results suggest that older people’s COVID-19-related stress is beyond infection of the disease, and different experiences with COVID-19 may increase depression and anxiety risks through different pathways.
COMPARING INFORMANT BASED MEASURES OF COGNITIVE FUNCTIONING BETWEEN THE US AND MEXICO
Authors: Zhang Yuan , Cantu Phillip , Saenz Joseph
Published: December 2022

Informant reports are important for understanding cognitive impairment and dementia in older populations. Recently, several population-based aging studies have included harmonized direct and informant assessments to assess the prevalence of dementia globally as part of the international Harmonized Cognitive Assessment Protocol (HCAP). However, the social and cultural contexts of nations, sociodemographic characteristics of informants, and the subject-informant relationship may affect the meaning and accuracy of informant reports of cognitive decline and functioning. This study examines the extent to which informant characteristics and the informant-respondent relationships are associated with informant-reported cognitive function in the United States and Mexico. Data are from the 2016 US Health and Retirement Study (HRS) HCAP (Nf 2,918) and the Ancillary Study of Cognitive Aging in Mexico (Mex-Cog) (Nf 1,750). Informant-reported cognitive function was measured by the informant Community Screening Instrument for Dementia (CSI-D). Linear regression is used to assess the association of informant characteristics and the information-participant relationship with the total CSI-D score. We find older Americans have worse informant-reported cognitive functioning but higher directly-assessed cognitive functioning than Mexicans. Nearly 80% of informants lived with the subject in Mexico, compared to less than half in the US. In both countries, older informants, children and other family members (compared to spouse) report less cognitive impairment. In Mexico, female informants reported more impairment. In the US, coresident informants reported more impairment. This research shows how social environments influence informant reporting. Understanding heterogeneity in informants is vital when examining informant measures of cognitive function in cross-countries studies.
BUILDING BRIDGES POST-LICENSURE: DEVELOPING GEROPSYCHOLOGY CONSULTATION SERVICES
Authors: Emery-Tiburcio Erin , Kube Erin , Poon Cecilia , Steffen Ann
Published: December 2022

More than one third of psychologists report frequently treating older adults, while only 1% consider themselves geropsychologists. Continuing education opportunities in geropsychology have historically been scant, with even fewer opportunities for expert case consultation in work with older adults. To identify interest in geropsychology consultation, the Building Bridges Post-Licensure (BBPL) group conducted an informal survey of licensed psychologists via listservs. Results among 80 respondents indicated strong interest in group consultation regarding foundational knowledge, assessment, and intervention. This presentation will describe the BBPL group's efforts to examine effective models of consultation, develop a consultation model for geropsychology, and partner with both professional and community-based organizations to develop the infrastructure for geropsychology consultation.
THE INFLUENCE OF MARRIAGE AND COHABITATION ON PHYSICAL ACTIVITY AMONG MIDDLE-AGED AND OLDER PEOPLE
Authors: Yuan Shuhan , Elam Kit , Johnston Jeanne , Chow Angela
Published: December 2022

The Behavioral Risk Factor Surveillance System (2020) indicates that 30.6% of middle-aged and older adults were physically inactive. Whereas marital status is linked to physical activity (PA), it is increasingly common for couples to cohabitate, making it important to capture these relationships. The stress/social support theory(Burman & Margolin, 1992) highlights the importance of relationship quality in long-term relationships, but this hasn’t been cohesively examined relative to PA. This study investigated whether partnered living status (married/cohabitating) and partnered living quality (support/strain from partner, partner disagreements) were associated with PA in middle-aged/older adults. Data were from a nationally representative longitudinal study, Midlife in the United States(waves 1–3; Nf1113; aged 49–93). Subjects were categorized into four groups based on partnered living status over the three waves: partnered living at all waves (57.9%), non-partnered living (separated, divorced, widowed, or never married) at all waves (17.6%), change from partnered living to non-partnered living (20.8%), and change from non-partnered living to partnered living (3.8%). Regressions were conducted to test the effect of partnered living status and relationship quality on the frequency of moderate and vigorous PA at wave 3. Subjects who changed from non-partnered to partnered living had the highest moderate and vigorous PA levels. Partner support was positively associated with moderate PA (β=0.50, p < 0.01), and partner disagreements was negatively associated with vigorous PA (β=-0.27, p < 0.01). Results suggest that relationship status and quality can influence PA among the aging population. Public health educators should provide additional social support to older adults to promote PA.
BUILDING BRIDGES TO FUTURE LEADERS: A CAREER PATHWAYS WEBINAR
Authors: McDarby Meghan
Published: December 2022

Educational webinars can improve attitudes toward careers in aging. We developed a 6-session webinar series about careers in geropsychology, detailing unique career pathways (e.g., academic, private practice, VA). Our evaluation of the series included trainees from graduate programs and postdoctoral fellowships. Participants rated their attitudes toward each career pathway at pre- and post-session. At post-session, participants reported significantly increased interest in careers in aging (t(83) = 4.72, p < .00). They also reported significantly increased understanding of the type of training required for careers in aging (t(77) = 8.10, p < .00). Importantly, at post-session, participants reported stronger beliefs that they could be successful in a career in aging (t(84) = 3.86, p < .00) and that they would have good work-life balance (t(87) = 9.34, p < .00). Results suggest that a webinar series may increase student interest in and understanding of unique career pathways in geropsychology.
TRAJECTORIES OF HEALTH RECOVERY AFTER HIP FRACTURE IN OLDER ADULTS: A SCOPING REVIEW
Authors: Xue Tingzhong (Michelle) , Cao Jiepin , Ledbetter Leila , Graton Margaret , Zhan Yan , Wang Dingyue (Demy) , Lee Youran , McConnell Eleanor
Published: December 2022

Hip fracture recovery outcomes in older adults are characterized by high mortality, lowered functional status, and feelings of being disrupted from a normal life. Studying recovery trajectories through the lens of resilience can provide novel perspectives for developing interventions targeting to promote recovery. However, the lack of knowledge of recovery trajectories and their variations in hip fracture patients impedes such efforts. This review aims to synthesize current evidence on how multiple health domains change longitudinally after hip fracture in older adults. The Joanna Briggs Institute scoping review methodology was followed, and seven databases were searched including Medline (PubMed), EMBASE, Web of Science Core Collection, CINAHL, Proquest Dissertations and Theses, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. No date limits were applied, and the final search resulted in 7,515 articles. Articles in English with participants aged 60 years and above who experienced a low-energy, nonpharmacological hip fracture in any health setting were selected. Results regarding multiple domains of health outcomes will be synthesized, including physical health (e.g. functional status, pain, nutrition, and mobility/physical performance), cognition, psychosocial health (e.g. depression, anxiety, social isolation, loneliness, and behavioral and psychological symptoms of dementia when individuals with dementia were included), and multidimensional outcomes such as health-related quality of life. Methodological challenges and limitations will be discussed. This review has important implications for clinicians and researchers to improve individualized treatment plans and research methodologies by providing a comprehensive, critical review of knowledge regarding health trajectories in older adults after hip fracture.
THE EFFECTS OF LOSING A SECURE JOB ON HEALTH BEHAVIORS ACROSS THE LIFE COURSE
Authors: Song Qian , Lim Emily , Zhang Jackie
Published: December 2022

Involuntary, no-fault job loss from a relatively secure position has become more common among workers. However, it is not clear how displaced workers cope with the stress induced by the job loss and change their health behaviors due to work precarity, especially in the long-term. To address these gaps, we take advantage of the case of policy-driven layoffs from the State-Owned Enterprises in transitional China (1990s – mid-2000s), which resembles a quasi-experimental design, and examine effects of losing a secure job on dietary diversity, drinking, and smoking behaviors. We use the China Health and Nutrition Survey (1989–2015) and fixed effects models for controlling individual confounders. The results show that job loss decreases displaced workers’ dietary diversity (β=-.18, p < .05); however, the decline bounced back after three years after job loss. The career stage in which job loss occurred made a difference. The reduction of dietary diversity only applies to early-career job loss (aged 35 or younger, β=-.24, p < .1), and mid-career job loss (aged 36 – 45, β=-.37, p < .01). Job loss increases probability of drinking (OR=1.36, p < .1), but the effect is only statistically significant for late-career job loss (aged 45+, OR=1.60, p < .1). Risks of heavy drinking are only increased for early-career job losers (OR=2.09, p < .05). Risks of smoking are not impacted by job loss. The findings highlight how health behaviors serve as coping strategies for job loss, how the effects vary by the timing of job loss, and how health promotions could be helpful to address the potential risks of work displacement.
IMPACT OF RECEIVING HOME-BASED PRIMARY CARE FOR PERSONS LIVING WITH DEMENTIA: PATIENT AND CAREGIVER PERSPECTIVES
Authors: Mattos Meghan , Bernacchi Veronica , Duffy Karen , Jepson Laura , Gonzalez Stephanie , Mutter Justin
Published: December 2022

Homebound persons living with dementia (PWD) require healthcare services that proliferate with physical and cognitive changes over time. PWD often experience fragmented care that results in poor health outcomes and delayed healthcare access. The objective of the Virginia at Home Program (VaH), a recently initiated home-based primary care (HBPC) program, is to promote long-term sustainability and proliferation of HBPC. The study purpose was to examine the impact of VaH on the overall care and outcomes of homebound PWD and their families. We used quantitative and qualitative methods to describe the impact of VaH on patient care and outcomes over six months. We compared clinical outcomes (e.g., activities of daily living, frailty, behavioral symptoms) at baseline and six months using paired t-tests. We also conducted semi-structured phone interviews at baseline and six months with PWD-caregiver dyads. Thirty PWD-caregiver dyads enrolled. Of the 17 dyads that completed both visits, PWD’s physical function and caregiver’s burden decreased significantly over time (ps < .05). There was a significant improvement in PWD’s behavioral symptoms over the six-month period (p=.03). Three preliminary themes emerged from qualitative data: 1) participants established trusting relationships with the VaH team, 2) VaH supported caregivers in their caregiving responsibilities, and 3) participants met their pre-program goals through increased healthcare access. Findings suggest that the HBPC intervention improved care satisfaction and healthcare access and alleviated caregiver burden. Future studies should consider introducing HBPC programs in this hard-to-reach population to decrease acute care utilization and health care costs while improving care satisfaction and quality.
THEMES FROM CONVERSATIONS WITH MEDICAL TRAINEES ON LGBTQ OLDER ADULTS
Authors: Sandhu Shobhana , Kim Mackenzi , Wilson Lynn , Biery Nyann , Infante Kimberly
Published: December 2022

Approximately 6–12% of the US population 65 or older self-identifies as LGBTQ. This population faces immense barriers when accessing care, including the bias from healthcare professionals. Efforts to combat this bias through formal education are minimal. Using a mixed methods study with one-group pretest-posttest design and focus groups, medical learners were included in sessions involving a showing of Gen Silent and a post-viewing discussion. Themes from discussion were extracted by two independent reviewers. Medical learners (Nf15) included residents and faculty of psychiatric and emergency medicine at Lehigh Valley Health Network. Themes included: recognition of the social isolation faced by LGBTQ older adults, recognition of barriers to care including stigma and bias, challenges supporting patients and enabling patients’ openness, a need for a community resource repository, opportunities for EMR optimization, and physicians as advocates. These results highlight the need for additional training for medical trainees as well as the efficacy of using a tool like Gen Silent to accomplish this.
IMPACT OF COVID-19 ON THE MENTAL HEALTH OF OLDER SEXUAL MINORITY CANADIANS: A LONGITUDINAL ANALYSIS
Authors: Grady Alexandra , Stinchcombe Arne
Published: December 2022

The COVID-19 pandemic and related restrictions have had negative impacts on mental health. Sexual minorities (i.e., lesbian, gay, and bisexual; LGB people) have been shown to exhibit mental health disparities stemming from minority stress experiences. The purpose of this study was to examine the mental health trajectories of older sexual minority Canadians in comparison to heterosexual Canadians before and during the pandemic. We used data from the Canadian Longitudinal Study on Aging (CLSA), where data were collected from participants at baseline (2011–2015), first follow-up (2015–2018), and two time points during the COVID-19 pandemic (April-December 2020). General Estimating Equations (GEE) were used to model changes in depression symptoms (CESD-10; n=47,728) and loneliness (UCLA 3-item loneliness scale; n=41,698), adjusting for covariates (i.e., age, sex, income, race, education). Results showed that LGB participants reported more symptoms of depression (β=.595, p < .001) and loneliness (β=.313, p < .001) in comparison to heterosexual participants. Mental health outcomes worsened over time for all participants. These findings highlight the impacts of the pandemic on mental health and the need for tailored interventions for older lesbian, gay, and bisexual individuals.
LIFECOURSE DETERMINANTS OF DEPRESSION AMONG OLDER MEXICAN ADULTS
Authors: Downer Paige , Prochaska John , Wong Rebeca
Published: December 2022

Older adults’ exposure to poverty, poor health, and negative life events over their lifetime creates cumulative adversity, increasing their risk of depressive symptoms. We hypothesize that those with disadvantaged sociodemographic characteristics like household poverty, chronic health conditions, and negative lifecourse exposures will be more likely to report a high number of depressive symptoms in old age. Three sequential multivariable logistic regression models were estimated using Wave 3 (2012) of the Mexican Health and Aging Study (MHAS). The final sample included 5,610 respondents aged 50 and older, of which 34.3% reported depression measured by a modified 9-item CES-D scale. The sample was mostly female (63.3%) with a mean age of 69. Present-day conditions were measured by quality of the home, consumer durables, chronic health conditions, and health insurance. Early-life conditions were measured by the respondent’s mother’s education and exposure to poverty and illness during childhood. In 2012, older Mexican adults living in homes built with poor construction materials or homes that lack access to water and sanitation (OR=1.24) were more likely to experience high depressive symptoms. In addition, those living in homes without consumer durable goods (OR=1.23) were at increased risk. Older Mexican adults who experienced poverty (OR=1.16) or illness during childhood (OR=1.21) were more likely to report a high number of depressive symptoms in old age. In conclusion, we find evidence of a “long-arm” of childhood, whereas older Mexican adults’ exposure to poverty and illness in childhood increases their likelihood of poor mental health outcomes, regardless of their present-day conditions.
GENDER DIFFERENCES IN RURAL-URBAN MIGRATION AND ITS IMPACT ON MENTAL HEALTH IN LATER LIFE
Authors: Zhang Jingwen , Nazroo James , Zhang Nan
Published: December 2022

Although rural-to-urban migration has been well researched, how gender shapes processes and outcomes, including later life health outcomes, has not been thoroughly investigated. Guided by a life course perspective, this study explores gender differences in rural-urban migration patterns and its association with mental health in later life among Chinese older adults. Exploiting rich life history data from the China Health and Retirement Longitudinal Study, we employ sequence analysis to identify the typical migration trajectories of Chinese older adults. Moderated mediation analysis is then used to examine gender-specific health pathways linking migration trajectories and later-life mental health. The results indicate that: men and women follow different migration trajectories across the life course. Men are more likely to migrate between rural and urban areas, and to migrate multiple times. Rural migrants who settled in urban regions have better mental health in later life than return migrants or rural non-migrants; the gender gap in mental health is marginally smaller among early urban settlers than rural non-migrants. Household income and Hukou conversion mediate the relationship between migration trajectories and later-life mental health among older people of rural origin. Household income in later life has stronger mediation effects for migrant men than for migrant women. The study suggests that a life course perspective and awareness of gender dynamics should be incorporated in policymaking to reduce the rural-urban divide and gender-based inequality in mental health.
LOVE AMONG OLDER AFRICAN AMERICAN COUPLES: AN ACTOR PARTNER INTERDEPENDENCE MODEL ANALYSIS
Authors: Mussa Kadija , Bryant Chalandra
Published: December 2022

Older women are often described as being asexual and uninterested in sex or intimacy (McHugh & Interligi, 2015). Thus, most research examining older couples describes those couples as primarily enjoying companionate or compassionate love – a type of love reflecting care and concern for another person (Allen et al., 2018). Unlike companionate or compassionate love, passionate love refers to a “state of intense longing for union with another” (Hatfield & Rapson, 1993, p. 67). Relatively little is known about passionate love and older couples (Hatfield & Rapson, 1993); moreover, far less is known about passionate love among African American older couples. Using data collected from African American couples (332 couples aged 20 to 39 and 90 couples aged 40 to 79), Actor-Partner Interdependence Models were used. For both age groups, 20 to 39 and 40 to 79, husbands’ and wives’ reports of marital quality were significantly associated with each other at Time 1. Husbands’ and wives’ reports of passionate love (assessed at Time 2) were not significantly associated with each other – for either age group under study. Cross paths (partner effects) were not significant for either of the two age groups; wives’ marital quality (Time 1) did not significantly predict husbands’ passionate love (Time 2), nor did husbands’ marital quality (Time 1) predict wives passionate love (Time 2). It is important to note that the older and younger age groups exhibited a similar pattern of results, suggesting that passion and physical intimacy may operate in similar ways for both.
THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM: NEW DATA ON OLDER ASIAN WORKERS
Authors: Ho Patrick , Lai Lam , Halvorsen Cal
Published: December 2022

The Senior Community Service Employment Program (SCSEP) is the only federal employment program for people aged 55 and older. While 6% of the approximately 60,000 participants are Asian and federal funds are set aside to serve Asian workers, little is known about their personal characteristics and experiences in SCSEP. Using novel data from an online and paper-based Massachusetts survey of SCSEP participants from April to August 2022 offered in multiple languages, this study aimed to describe Asian participants’ characteristics and experiences in SCSEP. Respondents (Nf39) ranged in age from 58 to 73. Almost all spoke a language other than English at home, and all respondents were born outside of the U.S. Nearly half reported a high school degree or less, and none reported “excellent” health. One-third reported feeling lonely occasionally or in specific situations. While two-thirds have made recent tradeoffs in paying for important goods and services (e.g., food and health care), most reported that their personal finances, social engagement, family life, and self-confidence have improved due to SCSEP. Further, 9 in 10 agreed that their supervisors understood the goals of SCSEP and were supportive. A quarter said separately that it was very likely they would search for a paid job or volunteer role after exiting SCSEP. These results contribute to the small amount of literature on older Asian American workers while informing the work of organizations that serve older Asian workers who have experienced multiple barriers to employment relating to nativity status, language abilities, and anti-Asian discrimination.
MOTIVATING PATIENTS WITH PARKINSON’S DISEASE AND THEIR FAMILIES TO DISCUSS PREPARATION FOR END-OF-LIFE CARE
Authors: Xu Jiayun , Hickman Susan , Huber Jessica , Sudore Rebecca , Shields Cleveland , Moonesinghe Dilhara , Parr Aubrey , Kong Taylor
Published: December 2022

Parkinson’s disease is the second most common neurological illness among older adults. Although most patients with Parkinson’s face communication challenges in advanced illness, few talk about care preferences and are unprepared for worsening illness as a result. Thus, the purpose of the study was to explore the experience of making end-of-life decisions or the preparation of making end-of-life decisions among patients with Parkinson’s, their family caregivers, and clinicians. The long-term goal of this study is to develop a medical decision-making resource for patients and families to better prepare for the end of life. We conducted one-hour semi-structured interviews with nine patients, 12 caregivers, and 12 clinicians to explore perceptions of whether end-of-life discussions may be difficult, the preferred timing of end-of-life information, and how to best motivate patients and their families to prepare. Descriptive thematic qualitative analysis methods were used to analyze the transcribed interviews. Participants were on average 59.7±15.3 years of age, 69.7% female, and 69.7% married. The predominant reasons for delaying end-of-life discussions were the unpredictability of Parkinson’s disease, limited illness and prognostic awareness, and clinicians not initiating the discussion earlier in the disease course. There was a mismatch in preferences for timing of end-of-life information, with patients and family wanting end-of-life information presented earlier in the illness than clinicians. All participants desired a resource to help patients and caregivers cope emotionally, to guide future decisions, and to help prompt conversations. Findings indicate that despite provider concerns, patients and their families want early information about end-of-life issues.
ENGAGING METHOD AND ANALYSIS TO DISCOVER AND REIMAGINE POSSIBILITIES FOR INDIVIDUALS AGING WITH AND INTO DISABILITY
Authors: Munly Kelly , Ng Ted , van Heumen Lieke
Published: December 2022

This symposium engages diverse methods and analyses to discover and reimagine possibilities for individuals aging with and into disability. The presentations advance an understanding of the diversity of service/care needs as well as of social capital, with exploration into assistive technologies, educational attainment, and assessment of successful aging. In the first presentation, the authors delineate key informant interview data identifying capacity-building needs in professional skills, organizational operations, service/care models, and public policies to effectively serve older adults aging with and into disability. The second presentation offers a content analysis of how researchers conceptualize, measure, and apply social capital to developmental disability throughout the life course, reviewing peer-reviewed articles from 5 disciplines, across more than 20 years. In the third presentation, using National Health and Aging Trends Study data, the authors investigate the longitudinal associations between disabilities, assistive technologies, and subjective well-being among older adults. In the fourth presentation, the author uses multivariate regression analysis to analyze National Health Interview Survey (NHIS) data, building on prior research analyzing the association between educational attainment and the perceived need for future help with activities of daily living (ADLs), often measuring disability in the literature. In the fifth and final presentation, the authors use the National Health & Aging Trends Study data to understand successful aging from the perspectives of those who experience disability, integrating subjective components of self-rated health and well-being, and providing insights on subjective perceptions on successful aging among older adults with disabilities.
INCREASING SOCIAL CARE CAPACITY TO MEET THE NEEDS OF PERSONS AGING WITH DISABILITY
Authors: Putnam Michelle , van Heumen Lieke , Odgen Lydia , Coyle Caitlyn , Morgan Kerri
Published: December 2022

This national study presents key informant interview data (N=28) collected 2017-2018 identifying capacity building needs in professional skills, organizational operations, service/care models, and public policies to effectively serve older adults with long-term serious mental illness, intellectual/developmental disabilities, physical and sensory disabilities. A multi-university, interdisciplinary team collected data through phone interviews, coded, and analyzed transcripts thematically and using content analysis. Key informants worked in national affinity organizations, state-level organizations, academia, and social care organizations. Findings are broad in scope, highlighting variances in rural/urban areas, state government dispositions, workforce characteristics, social and health care infrastructure, beliefs about disability and chronic conditions, and other factors. Findings will informed the development of a larger survey study aiming to articulate an agenda for building capacity to meet the needs of aging with disability populations.
THE IMPACT OF TECHNOLOGY USE ON CUSTODIAL GRANDPARENTS’ DEPRESSION
Authors: Pace Sarah , Xu Yanfeng , Harrison Theresa
Published: December 2022

During COVID-19, custodial grandparents experienced symptoms of depression due to social isolation, and technology use may reduce depression. This study examines the association between level of comfort of using technology and depression among custodial grandparents. Cross-sectional survey data (N = 287) were collected via multiple sources, including state agencies, local non-profit organizations serving kinship families, foster parent associations, schools, and Qualtrics Panels between March 2021 and March 2022. The average age of grandparents was 55 years. Over half were female (71.43%), had some college education (68.75%), and were White (55.12%). Depression was measured using the CES-D 10 scale. This variable was dummy coded using 8 as the cutoff score (Andresen et al., 1994). The level of comfort using technology was measured by combining four survey questions. Grandparent age, race, gender, marital status, home ownership, geographic area, disability, employment, education, physical health, telehealth, and telemental health were controlled. The logistic regression model revealed that those who had a higher comfort level with technology had significantly lower odds of having depression (OR = .543, p = < .001). Those with physical health had significantly lower odds of having depression (OR = .727, p = .044). Grandparents who needed telehealth (OR = 2.81, p =.005) and telemental health services (OR = 2.93, p =.003) had significantly higher odds of having depression. This research implies that custodial grandparents’ use of technology, particularly their comfort levels with technology may reduce depression among grandparents. This will inform practice and policy for those who work with custodial grandparents.
STUDENT CARE PARTNERING AMONG STUDENTS AT A HBCU: EXPLORING THE POTENTIAL IMPACT ON STUDENT PERSISTENCE
Authors: Thorne Claudia
Published: December 2022

The number of students enrolled in higher education who are taking care of older adults, many of whom may be suffering from an illness, is expanding. The numerous factors in care partnering can compromise student success and persistence towards graduation. While most care partners experience challenges, the care partnering experience of Black students is magnified because Historically Black Colleges and Universities (HBCUs) have a higher enrollment of nontraditional and first-generation college students. Students may be primary care partners who provide most of the care, or they may provide supportive care as secondary, tertiary, and auxiliary care partners within an extended family or kinship network. Aging in place, within the context of family and community, emerges from African culture and tradition deeply grounded in filial loyalty. Care partnering is nuanced in the interaction of race, ethnicity, gender, family relationships, and student status; however, little is known about the lived experience of Black student care partners and how to support them to facilitate their persistence towards graduation. This poster describes initial efforts to understand Black student experiences in care partnering in the context of a Mid-Atlantic HBCU and suggests the next steps in a multi-year research program.