bluuebunny/crossref_metadata_2025 huggingface dataset:
THE BLUES AND OLDER MINORITY MUSICIANS: MORE THAN JUST MUSIC XXIX
Authors: Migliaccio John
Published: December 2022

The Blues and Older Minority Musicians: More Than Just Music XXIXThe “ ’Bo Diddley’ Track”; GSA, 2022 Indianapolis, INLecture/Interview/ Performance: TBAIndianapolis has been described as “The Crossroads of America,” with a long history of fostering the music and entrepreneurial spirit of Black Americans. Starting in 1915 with Mrs. C.J. Walker, America’s first female millionaire and her cosmetic enterprise, and the Starr Piano Company and its Gennett Records studio – identified as “The Cradle of Recorded Jazz” in the 1920s and 30s – both were instrumental in national distribution of the works of the earliest blues, jazz, country, and gospel artists including Louis Armstrong, King Oliver, Alberta Hunter, and Charlie Patton among others.Indianapolis continues to host a thriving Blues music community, and will host the 29th consecutive year of GSA’s “Bo Diddley Track” with local older minority musicians, one of GSA’s most popular and fun events. This year will feature a lecture, interview, and mini-performance with leading local blues musicians, followed by a typically raucous live blues performance that evening at a local blues hotspot, with prizes for the first 50 GSA attendees. This has been going on for 29 years for a reason folks---don’t miss it!
AN EXAMINATION OF MEDICATION UTILIZATION DURING MEDICARE HOSPICE ELECTION: A NATIONAL STUDY
Authors: Christian Thomas , Plotzke Michael
Published: December 2022

In addition to drugs received through the Medicare hospice benefit, each year Medicare hospice beneficiaries receive nearly $700 million in medications through Medicare Part D. Little is known about the nature of these medications. To explore this issue, we identified all beneficiaries who were enrolled in Part D and elected hospice during Calendar Year (CY) 2020. We cross-walked hospice dates of service to Part D medication fill dates. We also collected information on drugs hospices themselves provided and voluntarily reported on hospice claims. Nationally, 1.2 million out of 1.8 million beneficiaries had some drugs provided, through hospice alone (406,423), Part D alone (412,810), and also from both sources (348,659). Medications from Part D tended to be more expensive, upwards of $40 per fill, compared to medications from hospices, which were about $15 per fill or less. Moreover, we found that 98,561 of beneficiaries (8.4%) received the exact same drug from both sources. Across diagnoses, the daily rates of pre-hospice Part D utilization were nearly identical to Part D utilization after electing hospice, and there was no relation to prior Part D use and hospice election duration. Categorically, the greatest amount of Part D expenditures during hospice are for diabetic therapies ($100.2 million), followed by anticoagulants ($97.8 million) and bronchodilators ($57.2 million). CMS should continue to monitor the provision of medications during hospice to maintain the integrity of the benefit and to ensure beneficiaries receive adequate care.
CHALLENGES ASSOCIATED WITH AND LESSONS LEARNED FROM AGGREGATING MEDICAL AID IN DYING DATA IN THE UNITED STATES
Authors: Nowels Molly , Kozlov Elissa
Published: December 2022

Nine U.S. jurisdictions have legal Medical Aid in Dying (MAID) and produce publicly available data on the use of MAID. We performed a retrospective observational cohort study of MAID data from Oregon, Washington, California, Colorado, Washington DC, Vermont, Hawaii, New Jersey, and Maine. We investigated the total number of deaths from self-administered lethal medications, number of prescriptions for MAID written, characteristics of MAID users and requesters, and challenges of aggregating these data. Over the last 22 years of publicly available data from all states or jurisdictions that have legalized MAID, demographics data was collected for 1,949 people who died by MAID. Persons using MAID were more likely to be non-Hispanic white (95.6%), have some college education (72.2% vs. 26.2%) and a cancer diagnosis (74.0% cancer, 10.9% neurological illness, 15.1% other). Patients who died from MAID prescription ingestion were more likely to have insurance (88.9% insured vs 11.1% uninsured or unknown). Aggregating data came with multiple challenges including states collecting data on different populations (deaths vs prescriptions), with different variable categories, and for different time intervals for reports. More research is needed to better understand why MAID is currently being accessed by an overwhelmingly white, educated, and insured population. This research also highlighted the need for a national research agenda on Medical Aid in Dying. As more states plan to adopt MAID legislation, having standardized data collection elements will help to elucidate how these policies are being implemented and accessed.
CARING FOR OLDER ADULTS ACROSS THE CARE CONTINUUM: EXPERIENCES OF OLDER ADULTS AND FORMAL CAREGIVERS
Authors: DiMaria-Ghalili Rose Ann , DiMaria-Ghalili Rose Ann
Published: December 2022

As individuals age, they are at risk of experiencing health challenges that can contribute to poorer health outcomes and increase health care costs. During acute care crises and through the continuum of dealing with chronic diseases, older adults rely on formal caregivers to provide care and support. Formal caregivers’ delivery of care can be challenged during difficult patient cases (e.g., providing wound care to a person exhibiting behavioral and psychological symptoms of dementia) and during high stress times, such as working through a pandemic. However, during difficult times, resilience among formal caregivers can have a positive affect on care delivery. This symposium identifies some of the health challenges experienced by aging adults, challenging experiences of nurses, levels of resilience among formal caregivers, and discusses the implications for nursing care and future research. Ms. Coates examines trends in adverse drug admissions among older adults in the United States using the 2018 Healthcare Cost and Utilization Project’s National Inpatient Sample. Dr. Hwang explores the relationship between nutrition, inflammation, and physical and mental health in aging adults with chronic leg wounds. Dr. Sefcik discusses nurses’ experiences caring for community-dwelling persons living with dementia and chronic wounds. Mr. Hathaway examines factors that contribute to resilience in staff of a continuing care retirement community during the late stage of the COVID-19 pandemic. Dr. DiMaria-Ghalili, discussant, will synthesize these findings and offer insights on designing interventions to address health challenges and recommendations for supporting formal caregivers.
TRENDS IN ADVERSE DRUG EVENT ADMISSIONS AMONG OLDER ADULTS IN THE UNITED STATES
Authors: Coates Martha , Shewokis Patricia , DiMaria-Ghalili Rose Ann
Published: December 2022

Older adults experience adverse drug events (ADEs) putting them at risk for increased morbidity and mortality. Utilizing the 2018 Healthcare Cost and Utilization Project’s National Inpatient Sample, we identified the prevalence of ADE admissions among adults 65 and older and examined the differences in characteristics and discharge outcomes in those with and without a primary diagnosis of an ADE (n=2,647,673). ADEs accounted for 7.4% of discharges and had higher odds of needing post-discharge care including transfer to a skilled nursing facility (OR=1.08, 95% CI [1.07, 1.09]) and home-health care (OR=1.1, 95% CI [1.09,1.1]). In the ADE group, hospital charges were higher ($39,609 vs. $38,649, p< .01) and length of stay (6+ days) longer (OR=1.53, 95% CI [1.52,1.55]). Opiates, diabetic agents, benzodiazepines and narcotics were frequently associated with ADEs. Older adults discharged after an ADE have increased healthcare utilization. Education on medication self-management is needed to prevent ADEs in older adults.
HOSPICE UTILIZATION AMONG MEDICAID-ONLY AND DUALLY ELIGIBLE DECEDENTS IN CONNECTICUT
Authors: Robison Julie , Migneault Deborah , Shugrue Noreen , Charles Doreek , Richards Bradley , Wakefield Dorothy , Dillon Ellis , Lambert Dawn
Published: December 2022

Individuals with Medicaid as their health care payer source may be either “Medicaid-only,” or “dually eligible,” i.e., qualifying for both Medicaid and Medicare. Medicare included hospice as a full Medicare benefit in 1982; Hospice is an optional Medicaid benefit for states; Connecticut added the Medicaid hospice benefit in 2010. This study explores hospice use in Connecticut’s Medicaid program by comparing hospice use and length of hospice enrollment by Medicaid-only vs. dually eligible and by diagnosis for decedents who died between 2017 and 2020 and had a hospice-appropriate diagnosis. This analysis of 2,990 Medicaid-only and 24,881 dually eligible decedents finds that dually eligible decedents had a significantly (p<.001) higher rate of hospice use (48.1%) compared to Medicaid-only decedents (29.9%). Medicaid-only decedents received hospice for a median of 12 days vs. 13 days for the dually eligible (p=.12). Dually eligible decedents consistently received hospice more often than Medicaid-only decedents across all diagnoses (cancer (p<.05) circulatory (p<.001), dementia (p<.001), respiratory (p<.001) and stroke (p<.001)). Dually eligible decedents had significantly more days of hospice than Medicaid-only decedents for subgroups with a circulatory (p<.05) or stroke (p<.05) diagnosis, but Medicaid-only decedents with a dementia diagnosis had more days of hospice than their dually-eligible counterparts. Additional multi-variate analysis will demonstrate how other factors, like age, may account for differences. Recommendations include encouraging physician use of hospice screening tools and developing education interventions with physicians and patients to increase understanding of the availability and benefits of hospice with particular focus on Medicaid-only patients.
NURSES' EXPERIENCES CARING FOR PERSONS LIVING WITH DEMENTIA AND CHRONIC LEG WOUNDS IN THE COMMUNITY
Authors: Sefcik Justine , Hernandez Olivia , Stoll Isabella , Hathaway Zachary , Bass Ellen , DiMaria-Ghalili Rose Ann
Published: December 2022

A gap exists with understanding the care required for community-dwelling persons living with dementia (PLWD) who have chronic wounds. As one step to address this gap we explored the experiences of nurses who care for community-dwelling PLWD that have chronic diabetic foot and venous leg ulcers. A qualitative descriptive approach with a conventional content analysis was undertaken. We conducted 5 focus groups with Home Health Nurses (n = 13) and nurses holding specialty certifications (e.g., wound care) (n = 3); 87.5% female, 69% White, non-Hispanic, mean age = 52 (range 32-67), mean years of experience as a nurse = 23.8. The main themes identified were 1) the challenges with dementia (e.g., confusion, taking dressings off), 2) concerns about the person (e.g., medical issues, financial considerations), and 3) adjusting interventions (for wounds and behavioral symptoms). Study findings can inform the develop of future novel interventions for PLWD and chronic wounds.
COVID-19 PANDEMIC AND RESILIENCE IN STAFF OF A CONTINUING CARE RETIREMENT COMMUNITY
Authors: Hathaway Zachary , Fisher Kathleen , Coates Martha , Hufnal Shelby , Stoll Isabella , Sefcik Justine , DiMaria-Ghalili Rose Ann
Published: December 2022

Residents and staff of continuing care retirement communities (CCRC) experienced many challenges during the COVID-19 pandemic including loss, social isolation, and staff turnover. This study examined factors that contribute to resilience in staff during the late stage of the pandemic using the Connor-Davidson Resilience Scale. Resilience scores ranged from 0 (low) to 100 (high). A total of 96 staff (76% female) were enrolled, and average age was 48.41 years (SD = 16.16). Average resilience in staff was 75.16 (SD = 11.81). Those under 35 years of age reported lower resilience scores (M = 67.38) compared to those 35-49 years of age (M = 76.65), 50-64 (M = 75.83), and 65 years and older (M = 82.71), p <.05. Staff who were married scored higher than those who were not (M = 76.63 vs 69.05), p < .05. Findings can inform professional development programs aimed at increasing coping skills in staff.
EMERGENCY DEPARTMENT AND INPATIENT HOSPITAL HEALTHCARE UTILIZATION IN THE YEARS PRECEDING INCIDENT DEMENTIA
Authors: Kumar Raj , Ornstein Katherine , Bollens-Lund Evan , Li Jing , Covinsky Ken , Kelley Amy
Published: December 2022

There is evidence health utilization increases after incident dementia, particularly toward the end of life. However, less is known about utilization in the years before dementia. Our study objectives were to compare outpatient emergency department (ED) and inpatient hospital utilization in the six years preceding incident dementia compared to a reference group without dementia. We obtained data on n=5,547 Beneficiaries from the Health and Retirement Study-Medicare linked sample, and defined dementia using a validated algorithm. Those with (n=1,241) and without (n=4,306) dementia were balanced on confounders using inverse probability weighting applied to longitudinal Generalized Estimating Equation models. We found persons with dementia had greater odds of ED (OR=1.46, 95% CI: 1.21, 1.77) and inpatient hospital (OR=1.35, 95% CI: 1.12, 1.63) usage in the years preceding dementia compared to those without dementia across a comparable timespan. This study provides evidence to suggest greater healthcare burden may exist before manifestation of dementia.
CAN VIRTUAL EXERCISE PROMOTE PHYSICAL RESILIENCE DURING THE COVID-19 PANDEMIC AMONG ACTIVE OLDER ADULTS?
Authors: Manning Kenneth , Jennings Stephen , Pearson Megan , Sloane Richard , Hall Katherine , Bourassa Kyle , Morey Miriam
Published: December 2022

Background

Gerofit is a facility-based exercise and health promotion program for older Veterans that transitioned to virtual delivery in March 2020. Little is known about how virtual exercise would promote resilience in the physical function of individuals previously participating in-person.

Methods

Preliminary data from 1 of 14 sites was gathered 72 Veterans returning to facility-based exercise after COVID mandated shutdowns. 39 individuals chose not to participate virtually, and 33 actively participated virtually for over 1 year. Re-entry data were then compared to the patients’ most recent test. Assessment means were compared within groups.

Results

Change scores from T1 to T2 were: -1.19 versus +2.4 repetitions for 30-second arm curls; +1.57 repetitions for 30-second chair stands; and -113.87 versus -77.3 yards for six-minute walk distance for non-virtual versus virtual groups. Implications: Participation in virtual exercise interventions may promote resilience and resistance to functional decline in previously active individuals during enforced isolation.
VIRTUAL NUTRITION EDUCATION AND PRODUCE DELIVERY INCREASES DIETARY QUALITY AMONG OLDER VETERANS
Authors: Parker Elizabeth , Cassatt Sarah , Giffuni Jamie , Katzel Leslie , Ortmeyer Heidi , Addison Odessa
Published: December 2022

This project assessed the impact of a 14-week virtual group nutrition education plus produce delivery on diet quality of Baltimore GEROFIT participants. RD led classes focused on healthy aging content. Participants could receive an optional bag of local produce. Dietary intake assessed via a 24-hour recall was used to calculate healthy eating index (HEI-2015; higher scores=higher diet quality). Twelve participants enrolled in the program. Two participants discontinued produce delivery due to physical/environmental limitations prohibiting preparation; seven completed recalls at pre/post and received produce (86% male; 71% Caucasian; age=73 years; BMI=33 kg/m2). There were no changes in overall diet. However, among participants who received >80% of produce (n=4), HEI scores increased (+5.4 points). Daily F&V increased by 1.9 servings. Daily protein intake decreased (-25g). This study highlights areas for program improvement including a stronger emphasis on protein intake and incorporating physical/environmental adaptations that may increase participation among older Veterans with disabilities.
AFFECTIVE REACTIVITY TO DAILY STRESSORS AND IMMUNE GENE EXPRESSION IN THE MIDUS STUDY
Authors: Apsley Abner , Lee Sun Ah , Bhat Aarti , Almeida David , Shalev Idan
Published: December 2022

Past research indicates that an individual’s affective reactivity to daily stressors is associated with elevated levels of inflammatory biomarkers such as interleukin-6 and C-reactive protein. Here, we assessed individuals’ positive and negative affective reactivity to daily stressors, and their association with expression levels of genes in the conserved transcriptional response to adversity (CTRA; proinflammatory and type-1 interferon antiviral genes). We hypothesize that gene expression levels of CTRA genes are a possible explanatory mechanistic link between higher levels of affective reactivity and inflammatory markers. Our study included 199 individuals from the Midlife in the United States Refresher study (ages 26-71, 52.8% female, and 17.9% non-white) who participated in the Gene Expression and Daily Diary Projects. Individuals provided whole blood for gene expression analysis and completed an 8-day telephone interview to assess daily experiences. Positive and negative affective reactivity scores were used to indicate magnitude of an individual’s changes in daily affect on stressor-days versus non-stressor-days, and were computed using multilevel modeling. Three CTRA gene expression scores were created for each individual, representing the average expression of proinflammatory, type-1 interferon, and a combination of both. Preliminary findings suggest a negative association between the CTRA composite score and negative affective reactivity to daily stressors (β = -0.963, p = 0.034), controlling for covariates. Further analyses will use affective reactivity to predict individual CTRA genes, correcting for multiple testing. This study will be the first to examine the relationship between daily assessments of emotions and gene expression levels in a representative U.S. cohort.
DEPRESSION, INFLAMMATION, AND THE MODERATING ROLE OF METFORMIN: RESULTS FROM THE MIDUS STUDY
Authors: Syed Sumaiyah , Yang Iris , Wilson Stephanie
Published: December 2022

There is a well-established link between depression and aging-related inflammation, where depression can spur inflammation and affect physical health. Previous animal trials have shown compelling evidence that the use of metformin, the first line of treatment for diabetes, can offset inflammation. These findings have not yet been extended to human samples. This study examined the association between depression and inflammation, specifically the moderating role of metformin usage in middle-aged and older adults. We predicted that metformin would attenuate the link between depression and inflammation. Participants in Project 4 of the Midlife in the United States (MIDUS) Study (n=1255, Mage = 57) provided data on medication use, depressive symptoms, and inflammatory cytokines interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP). Controlling for age, sex, body mass index (BMI), and comorbidity burden, metformin use moderated the association of depressive symptoms with IL-6 and CRP, but not TNF-α. Higher levels of depressive symptoms were significantly associated with higher interleukin 6 (IL-6) (p <.001) and C-reactive protein (CRP) (p = .033) among those not using metformin. However, this effect was not significant among those using metformin, suggesting that metformin usage may attenuate the relationship between depression and inflammation. These findings support the potential of metformin in mitigating the link between depression, a well-known behavioral risk factor, and inflammation, a key source of biological aging. Metformin, an accessible and commonly prescribed drug, may have a hidden anti-aging role that may protect against the inflammatory effects of depression.
STRUCTURAL INEQUITIES IN OUTCOMES FOR DUAL-ELIGIBLE RESIDENTS IN ASSISTED LIVING
Authors: Cornell Portia , Hua Cassandra , Rahman Momotazur , Gadkari Gauri , Thomas Kali
Published: December 2022

We examined the association of AL residents’ dual-eligibility and the concentration of dually eligible residents in AL communities with residents’ risk of hospitalization and long-term nursing home admission. The exposure was dual status interacted with AL concentration: no-duals, minority-duals [<=50%] (reference group), and majority-duals [>50%]. We found that duals in AL have higher risk of hospitalization and nursing home admission than non-duals. For both duals and non-duals, moving to an AL with a high concentration of duals conferred excess risk of hospitalization. Among duals, however, lower concentration of duals in ALs increases risk of long-term nursing home admission for duals, whereas it is protective for non-duals. The association of higher hospitalization with concentration of duals suggests that quality may be a concern in communities that specialize in care for duals. However, majority-duals ALs may be better equipped to provide more comprehensive care as an alternative to nursing homes.
ADULTS' VIEWS OF AGING AS AN UNDERESTIMATED RISK FACTOR FOR HEALTH, WELL-BEING, AND LONGEVITY
Authors: Diehl Manfred , Wurm Susanne , Levy Becca
Published: December 2022

Worldwide population aging has greatly increased the diversity of the “aging enterprise.” Research has established a solid portfolio of evidence showing that positive and negative views of aging represent independent resilience or risk factors for health, well-being, and longevity. Indeed, the effects of views of aging remain significant beyond the effects of other risk factors for health and mortality. This raises the following questions: What do we currently know about the effect of self-perceptions of aging (SPA) and subjective age (SA) on health, well-being, and longevity? What are recent advancements and perspectives? Which research questions should be addressed to stimulate further, sustainable developments in research and practice? This symposium addresses these questions with a diverse set of presentations and from different perspectives. Wahl and colleagues will discuss the role of SPA in the clinical context, namely in a sample of older adults with terminal cancer comparing them to older adults without a terminal illness. Based on a population-based sample, Wurm and Schaefer will report findings on the impact of different gain- and loss-related SPA and SA on mortality over a 23-year period. Building on an earlier meta-analysis, Westerberg and colleagues evaluated data from over 100 studies and will present the findings of a systematic review on the role of SPA and SA for health and longevity. Finally, Nehrkorn-Bailey et al. will present findings from a clinical trial that addressed views of aging as a mechanism to promote physical activity. Dr. Becca Levy will serve as the discussant.
ASSESSING DEMENTIA CLASSIFICATION IN THE NATIONAL CORE INDICATORS AGING AND DISABILITY SURVEY
Authors: Mulcahy John , Bucy Taylor , Shippee Tetyana , Jutkowitz Eric
Published: December 2022

Improving the quality of long-term care services for older adults is a national priority. The National Core Indicators Aging and Disability (NCI-AD) collects data from multiple states to evaluate long-term care recipients’ service satisfaction and needs. Many analysts are interested in exploring the service environments of people living with dementia. However, dementia measurement and reporting varies in NCI-AD between states. Dementia status may be obtained from administrative records or self-reported during the survey. We explored the measurement of dementia in NCI-AD and the implications of relying on administrative or self-reported dementia status. We analyzed NCI-AD data from 2015-2018 representing 24,569 respondents age 65+, of which 5,502 (22.4%) were identified as having dementia. 42.9% of respondents had dementia status determined administratively and 57.1% had it determined during the survey. To assess dementia accuracy by data source, we fit separate LASSO models for both the administrative and survey subpopulations predicting dementia status using demographic and functional predictors. We then used each model to predict dementia status in the subpopulation with discordant dementia data source. Using the administrative model to predict survey reported status resulted in a higher sensitivity than using the survey model to predict administrative status (44.6% vs 32.2%). The diminished predictive accuracy of the survey model suggests administrative records may capture cases of dementia diagnosis that would be missed by self-report. These findings highlight analytical caveats for researchers interested study long-term care quality for people with dementia using NCI-AD, and emphasize the importance of moving towards more standardized dementia reporting.
FINDING THE MINDS OF OUR ELDERS: TESTING THE MINORITY STRESS AND COGNITION MODEL WITH INDIGENOUS OLDER ADULTS
Authors: Whetung Cliff
Published: December 2022

This study used data from the Health and Retirement Study (HRS) data to investigate how an understudied group of Indigenous Older Adults (IOAs) in the United States fared over a 14-year period (2006-2020) in the domain of global cognitive function. The number of IOAs, defined here as Native American and Alaska Natives, will more than double in the next 30 years. Concurrently, the number of IOAs living with cognitive impairments will also increase. Guided by the Minority Stress and Cognition Model, we tested the hypothesis that discriminatory stress increases the risk of cognitive impairment in later life. Using a robust set of psychosocial (e.g. educational quality, perceived everyday discrimination experiences), behavioral (e.g. substance use, exercise), and physiological (e.g. diabetes, hypertension, obesity) risk factors, we modeled the cognition trajectories 186 IOAs using mixed growth curves. We found that one third of these IOAs reported experiencing everyday discrimination at least once per month, the highest of any ethnic group. They also reported high rates of other risk factors for cognitive impairment like low education, SES, and physical activity, and high rates of depression and chronic health conditions. Our analysis found that everyday discrimination was negatively associated with total cognition among IOAs but that this relationship was mediated by allostatic loads. On average, the total cognition scores of IOAs declined significantly faster than those of Whites. This study has important implications for the integration of stress as a mechanism for cognitive decline and the health equity of Indigenous older adults.
RACIAL/ETHNIC DISPARITIES IN THE EFFECTS OF RECEIVING A DIAGNOSIS OF DEMENTIA ON SOCIAL RELATIONSHIPS
Authors: Amano Takashi , Reynolds Addam , Scher Clara , Jia Yuane
Published: December 2022

Although early diagnosis has been recognized as a key strategy to improve outcomes for those with dementia, receiving a diagnosis may negatively influence social relationships. Absent from the literature are considerations of how race/ethnicity may alter these associations. This study examines racial/ethnic variation in the effects of receiving a diagnosis of dementia on social relationships of older adults. Data from the three waves of the Health and Retirement Study were utilized as part of this study. This study examined whether receiving a new diagnosis of dementia changed subsequent social relationships (social networks, social engagement, social support). Regression analyses with inverse probability weighting were performed to estimate the impact of receiving a dementia diagnosis on changes in social relationships. Receiving a new diagnosis of dementia reduced both informal (b = -0.476, p = 0.011, 95% CI = [-0.842, -0.110]) and formal (IRR = 0.688, p = 0.034, 95% CI = [0.487, 0.971]) social engagements. The negative impact of receiving a diagnosis on formal social engagement was stronger among non-Hispanic Blacks (IRR = 0.047, p = 0.007, 95% CI = [0.005, 0.432]). We found no statistically significant impacts of receiving a diagnosis of dementia on social networks and social support. Results suggest that receiving a new diagnosis of dementia may have unintended negative consequences on social engagement and may be more salient for racial/ethnic minorities, such as non-Hispanic Blacks. Practitioners and policymakers should be aware of these consequences and should identify strategies to alleviate the negative implications of receiving a diagnosis.
PROMOTING HEALTHY AGING THROUGH LGBTQ+ AFFIRMING CARE
Authors: Barbee Harry , McKay Tara , Tran Nathaniel , Min Judy
Published: December 2022

This study examines variation in health service utilization and aging outcomes among older LGBTQ+ adults by access to an LGBTQ+ affirming health care provider. Primary survey data (n=1128) come from the Vanderbilt University Social Networks, Aging, and Policy Study, a panel study of older LGBTQ+ adults residing Alabama, Georgia, North Carolina, and Tennessee. Respondents with an LGBTQ+ affirming health care provider were more likely to seek preventative care, including routine checkups, colorectal screenings, flu shots, and HIV tests. Respondents with an LGBTQ+ affirming health care provider also reported higher control over their mental health and lower levels of cognitive decline. Overall, this study suggests that increasing access to LGBTQ+ affirming care could reduce health disparities among aging LGBTQ+ populations.
LONG-TERM GENDERED PATHWAYS OF RELIGIOUS INVOLVEMENT POST WIDOWHOOD
Authors: Hawes Frances , Tavares Jane
Published: December 2022

Widowhood is associated with decreased emotional well-being, particularly increased depression. Prior research suggests that religiosity may help improve mental health among widowed individuals. However, longitudinal studies exploring the role of religiosity on emotional well-being among widowed older adults is lacking, as are studies which examine different dimensions of religiosity. This longitudinal study analyzed data from the 2006-2018 waves of the nationally representative Health and Retirement Study (HRS). Ordinary least squares (OLS) regression analysis was used to examine the relationship between widowhood and depression as well as the role of religiosity as a moderator of this association. Analysis was stratified by gender to further explore these interactions. Results show that men and women show similar levels of depression at widowhood, but men are far less likely to be depressed prior to widowhood. Women also show a better recovery pattern over time post-widowhood. Furthermore, religiosity (particularly attending church) is an effective way of coping with widowhood and mitigating depression for both genders. However, men are significantly less religious than women. This study highlights the long-term effects of widowhood on depressive symptomology among older adults. Practical implications of this study include intervention development around increased screening and treatment for depression for widowed older adults (in particular, for widowers) as well as connecting this vulnerable population with resources. These findings may also inform program outreach (such as hospice bereavement services) that aim to facilitate healthy grieving among widowed older adults.
LONELINESS IN COMMUNITY-DWELLING US OLDER LATINX ADULTS
Authors: Camacho David , Pacheco Kelly , Becker Todd , Reid Cary , Wethington Elaine
Published: December 2022

Loneliness is a critical public health problem yet little is known about older Latinx’s experiences with loneliness. We conducted narrative interviews (Cultural Formulation Interview), with 17 Spanish-speaking Latinx (60 years+) living with loneliness (based on 3-item Loneliness scale) in New York or Los Angeles. Interviewers were bilingual (English/Spanish) gerontological social workers with training in qualitative methods, culturally-sensitive clinical research and elicitation of “sensitive data”. Our thematic analysis was informed by Biopsychosocial and Minority Stress Models, and our gerontological clinical experience with Latinx groups. Most participants immigrated from Mexico, Dominican Republic, Ecuador or Uruguay and lived in the US for more than 20 years. Interviews ranged from 60 to 120 minutes. Most participants described comorbid depression or pain. A substantial majority (82%) had never discussed feelings of loneliness with family or friends. No participant reported seeking professional help to address loneliness. Other identified themes demonstrated how cultural and contextual factors shape loneliness: 1) Descriptions and interpretations rooted in familism and views of aging (“it seems I no longer matter to my children”); 2) perceived causes e.g. discrimination, family conflict, bereavements, immigrant stress, violence; 3) religious and cognitive coping to mitigate loneliness (“I pray that God gives me strength, “I befriend loneliness”); and 4) psychosocial functioning impact ( “there is no reason to live”). Our findings support development of culturally congruent loneliness prevention and treatment practices for older Latinx adults. Future quantitative research should explore the association of cultural and minority stress factors related to loneliness in diverse samples of older Latinx.
UNMET NEEDS AND PERCEIVED BARRIERS TO ACCESSING HCBS AMONG CAREGIVERS OF VETERANS OF ALL ERAS
Authors: Trivedi Ranak , Ngo Victoria , Lee Trevor , Humber Marika , Risbud Rashmi , Desai Shreya , Jacobs Josephine , Gallagher-Thompson Dolores
Published: December 2022

VA has several HCBS to offset caregiver burden, facilitate caregiving, and enhance Veterans’ home-based care, but they remain underutilized. We aimed to describe: the unmet psychosocial and HCBS needs of caregivers, barriers to accessing services, and gaps in available programs. Twenty-three caregivers participated in a 1-hr semi-structured interview (62.9□13.5y; 74.0% women; 47.8% White; 17.4% Hispanic; 65.2% spouses). Caregivers provided 7.3 hrs of daily care (SD=5.5 hrs, Range=1-24); most had provided care for 1+ year. Barriers to accessing HCBS included: a) disagreement with Veterans regarding service preferences and needs; b) lack of awareness of VA and non-VA programs; c) delays in obtaining services; and d) emotional toll of caregiving on personal health and relationship with the Veteran. The VA may need to invest in advertising existing services, develop strategies to match caregivers with available services when needed, and enhancing mental health and relationship quality for Veterans and caregivers.
“DEMENTIA-FRIENDLY”: WHAT DOES IT MEAN TO UNDERGRADUATE STUDENTS?
Authors: Sadeq Nasreen
Published: December 2022

Experiential learning assignments may be a potential method of educating undergraduate students about relevant issues in gerontology. Experiential learning involves applying knowledge learned in the classroom to real-world situations and requires students to engage in reflection. The current study explores undergraduate students’ perspectives on what it means to be “dementia-friendly” through an activity completed outside of the classroom. Students enrolled in an Alzheimer’s Disease Management course completed a module about quality of life, which included information about dementia-friendly communities. Then, students visited a location of their choice that is often frequented by older adults. Based on what they learned in class, they explored the location and documented observations about its dementia-friendly characteristics, or lack thereof. Following their visit, students wrote a reflection on their experience and suggested ways to improve dementia-friendliness. Consensual qualitative methods were used to explore themes in student responses. Among students (N=56), the majority visited grocery or big-box stores, followed by retail shops and restaurants. The three most common themes that emerged about essential dementia-friendly characteristics were 1) availability of helpful people, 2) easy to read signs, and 3) easy to navigate with few fall hazards. Themes from students’ suggestions for improving dementia-friendliness included 1) items with larger font sizes, 2) providing staff with dementia training, and 3) more amenities (e.g., store maps, personal shoppers). Student reflections suggested that the assignment also increased awareness and empathy about challenges faced by older adults who wish to age in place.
DISMANTLING AGEISM: EXPLORING PERSONAL AND SOCIETAL ATTITUDES ABOUT AGING IN UNDERGRADUATE CLASS ACTIVITIES
Authors: Srinivasan Erica
Published: December 2022

Ageism and fear of aging are influenced by both personal and societal attitudes about aging. Ageist beliefs reflected in society or in individuals can impact both our own aging process and how we treat others (Cooney et al, 2020). Thus, it is imperative to explore personal and societal attitudes about aging. In this poster, themes will be presented from a study on two class activities that explore ageism and attitudes about aging, as well as directions for these activities. Students (n=34) in an undergraduate college class were asked to describe their thoughts on aging in 6 words. They were next prompted, with no word limit, to describe fears and what they look forward to about aging. Content analysis of responses revealed themes including the complexity of aging, fears about dementia, physical changes, and the unknown nature of life, and positive interest in career and family goals. In a second activity, based off the AARP social experiment in which millennials were asked “what do you consider to be old?,” students asked peers “what image comes to mind when I say “old person?” and “what three words come to mind when I say old person?” Content analysis of responses included themes relating primarily to negative stereotypes, such as “confused and nursing home,” with some positive associations, such as “grandparents or wisdom.” Both activities prompted rich discussion about the connection between fears of aging and ageism, the importance of addressing ageism and of exploring both positive and challenging aspects of personal aging.
BREATHING LIFE INTO CONVERSATIONS ON DEATH: USING A DEATH CAFÉ MODEL IN A SERVICE-LEARNING PROJECT
Authors: Getz Marjorie
Published: December 2022

This poster presentation describes a project from an upper-level course on death and dying (part of a gerontology program at a small Midwest college). The course derives from the work of Phillipe Ariès’s book, The Hour of Our Death. Ariès traced five patterns across time and showed why death had become an uncomfortable truth for those of us living now. In essence, death has been banished from our daily lives. Other research suggests that younger healthcare professionals are particularly uncomfortable interacting with dying clients and may withdraw from them at this important life juncture. Finally, frustration with textbook development of cultural approaches to dying and death (often varied cultural groups, e.g., Asian Americans, are lumped together as if all Asian-Americans share death related practices) led to design of this unique service-learning project. Students, and community members who are experts on various faith/cultural practices take part in a modified death café. Students from an OLLI program are invited to participate, too. We report on qualitative data taken from student reflections. Content analyses of reflective essays identified these themes: (a) new insights/questions about death encounters/attitudes/practices in America (b) willingness to assimilate and accommodate various aspects of other cultural approaches to death into one’s own philosophy; (c) feelings of accomplishment/awareness of new skills in providing community-based support to people isolated during the pandemic; (d) understandings related to the importance/value of community service and civic engagement; and (e) new found comfort in openly discussing death concepts in this supportive environment.
CREATING AN AGE-FRIENDLY UNIVERSITY: THE CASE OF ST. CLOUD STATE UNIVERSITY (SCSU)
Authors: Greenberg Phyllis , Karasik Rona , VanderWerf Jessica , Zuniga Claudia Burgos , Kroeber Maria
Published: December 2022

As universities seek ways to address decreasing enrollments and enhance Diversity, Equity, and Inclusion (DEI) initiatives, the concept of Age-Friendly Universities (AFU) has gained momentum. The AFU Global Movement is a way to situate a university to explore means to increase student enrollments, and expand DEI Initiatives to include age. This poster details the steps taken by St. Cloud State University, a comprehensive Minnesota State university, to become designated as an AFU, as well as the unique challenges encountered. Actions taken both before and after being designated as an Age Friendly University (December, 2021) are discussed. Pre-designation steps included evaluating the campus’ current age friendliness, gathering university and community support at all levels, participating as a “champion” in the UMass-Boston & LaSalle University’s Age-Friendly University Inventory and Campus Climate survey, and piggy-backing on Minnesota’s Age-Friendly State and the local community’s Age-Friendly initiatives. The SCSU Gerontology program was awarded a grant from the MinnState Innovation Fund to explore ways of “Creating an Age-Friendly SCSU.” The grantors saw this as a potential template for other universities in the system who were seeking to expand their student base. Post benefits, challenges, strategies and next steps working towards meeting the 10 Principles of an Age-Friendly University are also discussed.
EXOME-WIDE STUDY IDENTIFIED 12 PLEIOTROPIC LOCI ASSOCIATED WITH ALZHEIMER’S AND CARDIOVASCULAR DISEASE RISKS
Authors: Loika Yury , Loiko Elena , Arbeev Konstantin , Stallard Eric , Yashin Anatoliy , Culminskaya Irina , Kulminski Alexander
Published: December 2022

Health of brain, heart and blood vessels are closely connected, which means that Alzheimer’s (AD) and cardiovascular (CVD) diseases may have overlapping etiologies including genetic component. Most of previous genetic association studies considered different traits (AD, CVD, and their risk factors) separately. The analysis of pleiotropic predisposition to these traits may shed light on the trait-specific mechanisms in protection against AD. We carried out pair-wise pleiotropic exome-wide association study (~250K common genetic variants) in predisposition to AD and each of 17 traits in a sample of 118K individuals from UK biobank. The analysis included seven qualitative traits (CVD, coronary-heart disease, type 2 diabetes, stroke, myocardial infarction, heart failure and hypertension), as well as their 10 risk factors (blood glucose, body-mass index, height, weight, 4 lipid traits, systolic and diastolic blood pressure). Fisher’s method and omnibus test were used in pleiotropic analyses. In addition to the APOE-TOMM40 locus, the analysis identified 12 genetic loci in which genetic polymorphisms demonstrated significant associations with AD at p≤5×10-4 and pleiotropic associations at genome-wide level, p≤5×10-8. The identified genes are involved in processes of phosphorylation; regulation of cell growth, differentiation, and brain development; signal transduction and neurotransmission; mitochondrial and cytoskeleton organization; regulation of gene expression, apoptotic processes, and adaptive immune response. Our results provide novel evidence supporting the hypothesis of complex pleiotropic mechanisms contributing to the development and progression of AD and provide more insights into understanding of underlying biological functions and regulatory mechanisms behind these effects.
REGULATION OF NEURONAL MITOCHONDRIAL BIOENERGETICS BY LIPID METABOLITES UPREGULATED IN DEMENTIA
Authors: Heimler Stephanie , Amick K Allison , Bergstrom Jaclyn , Jain Mohit , Molina Anthony
Published: December 2022

Mitochondrial dysfunction occurs early in Alzheimer’s disease (AD) progression and is evident in the Central Nervous System (CNS) and peripheral circulating cells. While there is evidence indicating that bioenergetic decline can drive the early pathogenesis of AD, little is known about the extracellular factors that alter neuronal bioenergetic capacity. We hypothesized that circulating metabolites contribute to neuronal bioenergetic decline associated with AD. Using a cohort comprised of participants with normal cognition, mild cognitive impairment, and dementia, we show that human serum harbors circulating, non-cellular factors capable of mediating neuronal bioenergetic differences according to the cognitive status of the serum donor. We developed a novel screening-based approach to identify candidate “mito-active” lipid metabolites in human serum that could mediate differences in bioenergetic capacity. Among these, Nervonic Acid and 15-epi-PGA1 were predicted to be mitochondrial inhibitors upregulated in participants with dementia. Neurons exposed to physiologically-relevant ranges of these molecules in-vitro exhibited a dose-dependent reduction in maximal mitochondrial respiration. We found that 500ug/mL of Nervonic Acid and 9ug/mL of 15-epi-PGA1 reduced maximal mitochondrial respiration by 62.3% and 63.3%, respectively, thereby validating our screening and prediction approach. Future experiments may be directed towards investigating if and how these and other mito-active metabolites of interest cross the blood-brain barrier to meaningfully affect AD. Furthermore, identified mito-active molecules can be investigated in other clinical cohorts to examine their role/s in multiple age-related or neurological conditions. This work expands our mechanistic understanding of how extrinsic factors associated with age and cognitive status contribute to neuronal bioenergetic decline.
CONVERGENT CELL NONAUTONOMOUS PATHWAYS REWIRE METABOLISM TO SLOW AGING
Authors: Leiser Scott , Huang Shijiao , Miller Hillary , Beydoun Safa , Dean Elizabeth , Choi Hyo , Bhat Ajay , Howington Marshall
Published: December 2022

An organism’s ability to perceive and respond to changes in its environment is crucial for its health and survival. Our approach to identify molecular mechanisms of aging is to focus on common mechanisms downstream of multiple pathways. This approach led to our discovery of a gene, flavin-containing monooxygenase (fmo)-2, that is both necessary and sufficient to increase lifespan and healthspan downstream of several longevity interventions, including dietary restriction and hypoxia. Surprisingly, we also find that in both hypoxia and dietary restriction models, fmo-2 is induced by cell non-autonomous signaling pathways, consistent with the worms’ perceiving the stress (e.g. low oxygen, lack of food) and changing physiology as a result. Our current work focuses on 1) the signaling networks that regulate stress perception and integrate multiple signals to change physiology, and 2) the mechanism of FMO-2-mediated longevity. Our new data suggest that these cell non autonomous networks pathways utilize both overlapping and distinct signaling mechanisms to converge on upregulation of the same gene. They also suggest that these pathways can be manipulated by small molecule drugs to increase lifespan by “tricking” the organism into activating stress response networks. We further find that FMO enzyme expression has a drastic effect on endogenous metabolism, primarily through tryptophan and one carbon metabolism. Ultimately, we aim to leverage our results in a translational framework to identify key signals, genes, and mechanisms where organisms respond to the perception of environmental stress to improve health and slow aging.