bluuebunny/crossref_metadata_2025 huggingface dataset:
ARE LIFE ACCOMPLISHMENTS RELATED TO WELL-BEING: FINDINGS FROM THE HEALTH AND RETIREMENT STUDY (HRS)?
Authors: Larkina Marina , Smith Jacqui
Published: January 2025

Butler (1963) proposed that engaging in a whole life review is especially beneficial for older adults because it promotes a sense of self-worth. Previous research highlights links between reminiscing and psychological well-being, however, life review narratives are rarely collected in the context of large, population-based aging studies. This study uses data from the HRS Life History Mail Survey (2017, 2019) to 1) examine factors that predict older adults (N=12,815; Mage= 68 years; range 50-101) willingness to share their life’s most important accomplishments (up to three); and 2) establish relations between content and complexity (content variety) of reported accomplishments and participants’ well-being. Participants who reported their accomplishments (59%), compared to those who didn’t, were more likely to be better educated, currently married, wealthier, have better memory and fewer depressive symptoms. Importantly, they also were more likely to perceive their life-as-a-whole as either completely or very satisfied (OR=1.315, CI=1.214-1.425, p<.001). Multinomial analysis of content and complexity of reported accomplishments revealed that people with higher life satisfaction were more likely to report relationship-related accomplishments (47%; family, friendship, or caring for others) compared to those who were most proud of their societal achievement (35%; education, work, military services), adjusted RRR=1.207, CI=1.061-1.372, p<.005. People, who wrote about personal qualities (e.g., their faith, health) did not differ from other two groups. The complexity of reported accomplishments was not associated with life satisfaction but was related to respondents’ education and memory. Our findings support the proposal that reviewing one’s life accomplishments enhances well-being in later life.
INTERGENERATIONAL QUALITY OF LIFE: SIMILARITIES AND DIFFERENCES AMONG MUSICIANS
Authors: Nesser Whitney , Snyder Scott
Published: January 2025

Music has been shown to improve Quality of Life (QoL) for various populations. However, few studies have studied older musicians’ QoL or QoL in an intergenerational sample of musicians. To address this gap this study assessed four QoL domains (physical, psychological, social, and environmental) in a nationally representative intergenerational sample of musicians using the WHOQOL-BREF scale. Data were obtained via a survey of professional and amateur musicians (N=407) across the United States (US). Results demonstrated that while the oldest subgroup of musicians had the highest mean scores for environmental, psychological and social QoL, there were no significant differences between age groups for any of the QoL domains. Rating scale responses for all QoL items were independent of age group except for “How often do you have negative feelings” (p=.01). Examination of standardized residual showed that significant effect was due to the older musicians responding “never” more frequently than expected. The Spearman correlations of environmental QoL with psychological, and social QoL were significantly lower (p <.05) in the older musicians (r=.442, r=.494) than in the aggregate of other age groups (r=.715, r=.733). Furthermore, there was a significantly lower Spearman correlation between “enjoyment of being a musician” and “impact of being a musician on QoL” for older respondents (r=.384) compared to younger respondents (r=.678). Future research is needed to establish normative QoL data for the US on all age groups as measured by the WHOQOL-BREF and to examine the role of music as a mediator of QoL across the lifespan.
TWO-LEVEL CONFIRMATORY FACTOR ANALYSIS OF THE POSITIVE AND NEGATIVE AFFECT SCHEDULE (PANAS) IN MID- AND LATE LIFE
Authors: Nichols Madeline , Geldhof John
Published: January 2025

The Positive and Negative Affect Schedule (PANAS; Watson et al., 1988) is widely used in the study of well-being; however, its factor structure continues to be a source of debate (Wedderhoff et al., 2021). The present study examined the factor structure of the PANAS using data from the third wave of the National Study of Daily Experiences (NSDE; N=1176, Mage=62.48, SD=10.20, Range=43-91, %Female=57.38) in which participants indicated how much of the time they felt positive and negative emotions each day for eight days. We conducted two-level confirmatory factor analyses in MPlus informed by the 45-degree rotation hypothesis (Yik et al., 1999) that classifies emotion words by both valence (negative or positive) and activation (high or low). Results revealed that a five-factor structure at both the within and between levels exhibited good fit (χ2(188) = 989.76; p <.001; RMSEA = 0.02; CFI = 0.960; TLI = 0.949). These factors were: high activation negative (upset, angry, frustrated); negative (worthless, sad, hopeless, lonely); high activation positive (enthusiastic, attentive, proud, active, confident); positive (happy, cheerful); and low activation positive (calm, satisfied). Latent correlations indicated factor separation at both the within- and between-person levels (median absolute correlations of.44 and.60, respectively). These results emphasize the importance of considering both valence and activation in the study of daily affective well-being. The authors recommend that researchers using the PANAS consider the implications of valence and activation when examining associations between affect and health-related outcomes.
CONCEPT ANALYSIS: SLEEP QUALITY IN OLDER ADULTS
Authors: Park Suah , Byun Eeeseung
Published: January 2025

Sleep quality is crucial in determining one’s overall quality of life, particularly among older adults disproportionately affected by poor sleep. Despite its significance, there exists a gap in the analysis of the concept of sleep quality in older adults. This concept analysis was guided by Walker and Avant’s method to conceptualize sleep quality in older adults comprehensively. A systematic search of studies published between 2018 and 2023 was conducted across databases, including CINAHL, EMBASE, PubMed, and Web of Science. Inclusion criteria encompassed quantitative and qualitative studies exploring sleep quality in older adults. The analysis identified key elements, such as defining attributes, antecedents, and consequences of sleep quality in older adults, based on the content of the articles. Fifty articles provided data for sleep quality in older adult conceptualization. Six defining attributes were identified: (a) number of awakenings, (b) sleep duration, (c) sleep disturbance, (d) sleep efficiency, (e) sleep latency, and (f) sleep satisfaction. Antecedents encompassed factors such as Diet, Physical activity, Circadian rhythm, Perceived health, Chronic disease, Psychosocial factors, Sociodemographic factors, and Environmental factors. Consequences included Fall, Daytime dysfunction, Physical health, Mental health, Mortality, and Quality of life. The bidirectional relationships between consequences and sleep quality indicated that some antecedents could be part of consequences and vice versa. This concept analysis presents a conceptual model of sleep quality in older adults based on defining attributes, antecedents, and consequences. The model provides a foundation for further testing and developing measures and interventions for addressing poor sleep quality in older adults.
EDUCATION AS A MODERATOR IN THE ASSOCIATION OF SLEEP DURATION AND DEPRESSIVE SYMPTOMS
Authors: Dong Wuyi , Su Yan-Jhu , Liang ChangPu , Hong Dongfang
Published: January 2025

Optimal sleep duration is critical for older adults’ health and either too long or too short sleep duration potentially leads to mental disorders such as depression, anxiety, and distress. This study explores the association between sleep duration and depression among older adults, with a focus on whether education achievement buffers the association. To create a pooled cross-sectional dataset, we combined data from the National Health and Nutrition Examination Survey (NHANES) of two consecutive waves (2015-16 and 2017-18). Our analysis includes a weighted sample of individuals aged 60 and older without missing responses (n=9,254). We measured sleep duration for three categories based on weekday reports: short sleep (< 7 hours), optimal sleep (7 to 9 hours), and long sleep (>=9 hours). Depression was evaluated using total scores from a 9-item Patient Health Questionnaire (PHQ; range: 0-27). Through multiple linear regression models—adjusting for demographics characteristics, self-reported health, health behaviors, and living arrangements, we found either people with short sleep duration or long sleep duration is associated with higher depression symptoms (β=1.28, p<.001 and β=1.24, p<.001, respectively), compared to optimal sleep duration individuals. The interaction effect showed that higher education levels (college or above) significantly decrease depression associated with longer sleep (β=-1.66, p<.05). These findings suggest that both insufficient sleep and excessive sleep increase the depression risks among older adults, while higher education may have protective effects against mental health challenges related to non-optimal sleep durations.
LAYPERSON’S UNDERSTANDING OF GEROTRANSCENDENCE
Authors: Ribeiro Oscar , Abreu Taiane , Teixeira Laetitia , Araujo Lia
Published: January 2025

Gerotranscendence is an adaptive theory of aging that posits a mindset shift across three dimensions: cosmic, coherence, and solitude. Despite its consolidation in recent years, the theory’s depth continues to evolve, stimulating a need for broader perspectives to enhance its practical comprehension. This study aimed to explore laypersons’ perceptions regarding gerotranscendence’s aspects. Three focus groups were conducted with a total of 18 participants, ranging in age from 58 to 98 years old (mean=79.5). Open-ended questions were used to collect information regarding what gerotranscendence and its dimensions meant to them; thoughts on the components of the theory after a brief explanation were also obtained. Transcripts from recorded sessions underwent content analysis and organized under two overarching themes: general assumptions and personal perceptions. The latter theme encompassed two sub-themes highlighting participants’ identification of personal experiences, as well as their diverse and complementary interpretations of the theory. Initially, participants encountered challenges grasping the theory’s terminology. Subsequent clarification facilitated their recognition and resonance with gerotranscendence’s components. Further discussions exposed associations between concepts of gerotranscendence and other theoretical frameworks of successful aging, notably the life cycle theory and socio-emotional selectivity theory. This interconnection highlights the theory’s relevance within broader aging frameworks. Engaging lay individuals in gerotranscendence discussions yields profound insights into both its fundamental principles and culturally embedded nuances. By associating theoretical concepts with lived experiences, such dialogues enrich the understanding of aging paradigms, paving the way for more holistic approaches to aging research and practice.
THE MULTIDIMENSIONAL SUCCESSFUL AGING SCALE: A LONGITUDINAL VALIDATION STUDY
Authors: Chung Edwin Ka Hung , Yeung Dannii Y
Published: January 2025

The diversified measurement tools of successful aging have restricted comparison of findings between studies and hindering development of this field advancement (Cosco et al., 2014). This study thereby aimed to validate the 25-item Multidimensional Successful Aging Scale (MSAS) through examining its overall structure, measurement invariance, and predictive validity. Four hundred and fourteen community-dwelling older Chinese adults (Mage=68.92 years, SD=6.64, range=60–91; 59.9% females) were assessed on the MSAS in conjunction with demographic, physical and psychological measures at baseline (Time 1) and at 6 months (Time 2). The results of confirmatory factor analysis first revealed a good model fit of the 9-factor model of the MSAS in the two assessments, and indicated that the 9-factor model fitted the data better than other higher-order factor models. In addition to the metric invariance across age and gender groups as well as strict invariance across groups of individuals with and without chronic illness, a strict form of longitudinal invariance was shown at the 6-month interval. Furthermore, the overall results of hierarchical linear regression analyses indicated that, among all dimensions of MSAS in Time 1, positive attitudes and perceived constraints were more predictive of depressive symptoms, functional ability, and pain in Time 2. Overall, the present study advances the previously established psychometric properties of MSAS (Chung & Yeung, 2021; 2022) by demonstrating its temporal stability and predictive value. Findings also support the multidimensional nature of successful aging, and provide health care practitioners and policymakers a more holistic understanding of what is important to older adults.
POLICIES FOR SUPPORTING CAREGIVERS OF OLDER ADULTS WITH LONG-TERM CARE NEEDS: A MIXED-METHODS SYSTEMATIC REVIEW
Authors: Albertini Marco , Bei Eva , Toth Federico
Published: January 2025

Background

In an era marked by the imperative to restrain costs within health and social care services throughout Europe, informal caregivers of older adults assume a pivotal role as primary providers of long-term care. Nevertheless, there remains a shortage in mapping the various social policies pertaining to both direct and indirect support for informal carers across the various EU member states. Objective: This mixed-method systematic review synthesizes data on care policies related to diverse support forms implemented across EU countries to assist caregivers.

Methods

A comprehensive search strategy was conducted in three electronic databases and grey literature to minimise publication bias.

Results

Preliminary findings of studies published between 2010 and 2023 indicate that various forms and levels of support have been introduced or reformed over the past 13 years across EU countries to support caregivers. Despite the challenges posed by population ageing, there is significant policy development disparity among EU members, with some countries to have established mechanisms aside financial assistance to support carers, while others to only now starting to express interest in developing such services. Financial support, primarily through cash-for-care schemes, emerges as the predominant form of assistance, followed by respite care, while other policies in terms of training and mental health services exhibit a notably lower level of development within the EU social policy landscape.

Conclusion

The review is expected to provide significant implications for policymaking, thoroughly mapping the implementation of diverse social care policies across Europe to ensure the sustainability of informal care.
THE ROLE OF PSYCHOLOGICAL CAPITAL IN MODULATING CAREER ADAPTABILITY AND TURNOVER AMONG NURSING ASSISTANTS
Authors: Sun Changxian , Xing Yurong
Published: January 2025

Background

High turnover intention of nursing assistants was detrimental to the sustainability of long-term care. Career adaptability is an important determinant in reducing turnover intention, but little research has explored the mechanism from the perspective of psychological capital. The aim of this study was to analyze the association between career adaptability and turnover intention and to examine the mediating role of psychological capital between career adaptability and turnover intention among nursing assistants in mainland China.

Methods

A cross-sectional online study was conducted among 276 nursing assistants from eight nursing homes in Nanjing, China. The participants’ career adaptability, psychological capital, and turnover intention were obtained. SPSS 26.0 and Amos 24.0 software were employed for statistical analysis.

Results

Career adaptability was positively related to psychological capital and negatively linked to turnover intention (P < 0.01). Psychological capital played a fully mediating role (β = -0.085, P < 0.05) in the relationship between career adaptability and turnover intention, and the largest indirect effect was generated through the curiosity dimension. Conclusions: The management of long-term care facilities should focus on assessing the level of career adaptability of nursing assistants. The overall improvement of career adaptability and psychological capital is conducive in reducing turnover intention. Targeted interventions are recommended to improve career adaptability and reduce turnover intentions by increasing career curiosity. Online career adaptability programs can be developed for nursing assistant students to improve their psychological capital and facilitate career transitions.
ASSOCIATIONS OF PHYSICAL ACTIVITY ENGAGEMENT WITH CEREBRAL AB AND TAU PET FROM MIDLIFE
Authors: Gonzales Mitzi , Kojis Daniel , Spartano Nicole , Thibault Emma , DeCarli Charles , Johnson Keith , Beiser Alexa , Seshadri Sudha
Published: January 2025

Higher midlife physical activity engagement has been associated with lower dementia risk in late life. However, the underlying mechanisms contributing to the protective effect remain unclear. The goal of the current study was to evaluate the associations of physical activity with cerebral amyloid beta (Aβ) and tau in a predominately middle-aged community-based cohort, as well as to explore whether the associations differ by age or sex. Participants from the Framingham Heart Study underwent 11C-Pittsburgh Compound B amyloid and 18F-Flortaucipir tau positron emission tomography (PET) imaging. Total physical activity levels were evaluated by self-report using the Physical Activity Index (PAI). Cross-sectional associations between total PAI with regional Aβ and tau PET retention were evaluated using linear regression models adjusted for demographic and cardiovascular risk factors. Interactions with sex and age group were examined and stratified analyses were performed when significant. The sample included 354 participants (mean age 53±8 years, 51% female). Higher total PAI scores were associated with lower entorhinal cortex (β(SE)=-0.021(0.008), p=0.013), inferior temporal lobe (β(SE)=-0.017(0.008), p=0.040), and rhinal cortex (β(SE)=-0.018(0.008), p=0.030) tau PET binding. There were significant interactions with sex with only males displaying inverse associations between total PAI with entorhinal cortex, inferior temporal lobe. and rhinal cortex tau. The results suggest that higher midlife physical activity may confer resistance against tau pathology in regions susceptible to early neuropathological changes. However, the effects may vary based on sex, highlighting the importance of better understanding and tailoring lifestyle interventions to address sex disparities.
EARLY CLINICAL UTILITY DATA OF A MULTI-ANALYTE BLOOD BIOMARKER TEST FOR EVALUATING COGNITIVE IMPAIRMENT
Authors: Monane Mark , Merrill David , Johnson Kim , Gitelman Darren , Maraganore Demetrius , Jacobs Leslie , Jiang Yan , Braunstein Joel
Published: January 2025

There is an important unmet need for timely, noninvasive, low-burden diagnostic tools to aid in Alzheimer’s disease evaluation. The AAA-BBM2 (PrecivityAD2™) blood test combines plasma amyloid beta (AB)42/40 Ratio and phosphorylated-tau217/non-phosphorylated-tau217 Ratio (%p-tau217) into a clinically-validated algorithm. The test result, the Amyloid Probability Score 2 (APS2), determines the likelihood of brain amyloid, the pathological hallmark of Alzheimer’s disease, on amyloid PET scan: the test result has previously demonstrated 88% sensitivity and 89% specificity. The objective of the QUIP II Study (NCT06025877) is to evaluate the clinical utility of this blood biomarker test with APS2 result among cognitively symptomatic patients presenting to memory specialists. To date, 52 symptomatic patients (median age 75, 65% female, 77% white) from 7 memory centers received the AAA-BBM2 test. Concordance with intended use of the test was 100% (52/52). Positive APS2 results were noted in 26 patients (50%). From pre- to post-test, clinician-reported probability of AD decreased from 48% to 16% among negative APS2 patients (p< 0.0001), and increased from 71% to 93% among positive APS2 patients (p< 0.0001). The composite endpoint of change in AD diagnostic certainty, drug therapy, or brain amyloid evaluation pre- and post-AAA-BBM2 testing was 79% (p < 0.0001 versus a pre-specified threshold of 20% clinically meaningful change). We believe that the AAA-BBM2 test showed clinical utility in its association with changes in clinicians’ diagnostic certainty and clinical management among patients presenting with cognitive impairment. This blood biomarker test may allow memory specialists to guide patients to anti-AD therapies and facilitate other diagnostic considerations.
BUILDING AN ELEPHANT BRAIN DATABASE: ADVANCING INSIGHTS INTO COGNITIVE AGING IN ELEPHANTS
Authors: Chusyd Daniella , Hof Patrick , Risacher Shannon , Cheng Hu , Sherwood Chet
Published: January 2025

Cognitive aging is a complex phenomenon, and a comparative approach leverages the strengths of various species to identify conserved and divergent mechanisms associated with cognitive health. Elephants are an informative species for cognitive aging research because they are analogous to humans in that they live to comparable ages, display complex cognition, have strong long-term memory, and rely on social bonds. They differ, however, in their evolutionary path to arrive at these same outcomes. Studying elephants can potentially reveal different trajectories for cognitive performance maintenance and impairment compared to humans, and provide information on brain aging in elephants, contributing missing knowledge on aspects of well-being in a long-lived species. We initiated the Elephant Brain Database to enhance the use of elephants as a comparative species to further understand the structure, function, and evolution of the brain, and to increase the availability of elephant postmortem brain tissue, MRI scans, and related datasets for investigators. This repository is for postmortem fixed and frozen brain specimens and when possible, postmortem structural MRI scans and diffusion tensor images. In collaboration with North American zoos and partners in Zambia, we obtained fixed or frozen brain specimens from 23 individuals (age: stillborn to 75 years). Of those, 12 are from Asian elephants (Elephas maximus; 8 females, 4 males) and 11 are from African savanna elephants (Loxodonta africana; 4 females, 7 males). A structural MRI scan was conducted on one left hemisphere from a 52-year-old female Asian elephant. This collection represents the largest consolidation of elephant brain resources.
PERCEIVED DISCRIMINATION ON DEPRESSION IN OLDER ADULTS: MODERATING EFFECT OF GEOGRAPHIC ACCESS TO SOCIAL SERVICES
Authors: Choi Seo-Yun , Chung Soondool
Published: January 2025

Age discrimination against older adults represents a significant issue in South Korea, with notable implications for their mental health and well-being. Addressing ageism is critical as it limits resources for detecting and treating depression in older adults, affecting their health behaviors and willingness to seek help. On the other hand, despite a high prevalence of depression among this population, only 2.2% utilize mental health services. This study examined how geographic accessibility to social services for diagnosing and treating depression can improve mental health service utilization among older adults experiencing age discrimination. About 9,920 individuals 65 and above from the National Survey of Older Persons were included. It explored the moderating effect of geographic accessibility on the relationship between perceived age discrimination and depression. Correlation and moderating effect analyses using SPSS PROCESS Macro Model 1 were computed, and the results demonstrated that perceived ageism is positively associated with depression (r=.220, p<.01). More importantly, geographic access to social services significantly moderated this relationship (B=-.180, p<.05), reducing the impact of perceived ageism on depression. These findings underscore the importance of enhancing geographic access to social services to mitigate the effects of ageism on depression among older adults. The study recommends direct measures, such as expanding social service infrastructure in rural areas, and indirect measures, like improving public transportation connectivity and introducing age-friendly technology. Further research will be necessary to understand regional characteristics better and enhance access to adequate social services.
PERSONALITY TRAITS, SCREEN TIME, AND MOBILE PHONE DEPENDENCE ACROSS THE LIFESPAN
Authors: Washburn Stephanie , Andrews Hailey , Roque Nelson
Published: January 2025

Digital technologies have become integral to daily life worldwide, with many individuals increasingly dependent on mobile devices like smartphones and tablets. The widespread growth of technology use worldwide highlights the need to understand how individual traits contribute to mobile device dependence and its potential impacts on mental health, paving the way for interventions to mitigate these effects. This study examined the association between self-reported screen time, mobile phone dependence (Nomophobia Questionnaire), and personality traits (Ten Item Personality Inventory), across the lifespan. Data were collected from 550 adults (Mage=39yrs, Rangeage=19-77; 54% female; 59% non-Hispanic White) through an online survey, delivered on Prolific. Linear regression models, adjusted for age and gender, assessed the relationship between personality traits and two outcomes: self-reported screen time and mobile phone dependence. For screen time (N = 299), significant predictors were age (β = -0.06, p =.001), conscientiousness (β = -0.44, p =.013), and agreeableness (β = -0.47, p =.014). For mobile phone dependence (N = 550), significant predictors were age (β = -0.33, p =.001), emotional stability (β = -5.07, p <.001), and agreeableness (β = 2.59, p =.021). These results suggest that three of the Big Five personality traits influence screen time and mobile phone dependence. Understanding these factors may guide interventions to reduce dependency and its mental health effects. Future longitudinal studies are needed to explore these relationships over time and establish causality.
STRESS AND IDENTITY FOR LGBTQ+ HEALTH: MODELING RISK AND RESILIENCE
Authors: Clancy Erin , Guest M Aaron , Dhawan Aanika , Koffer Rachel
Published: January 2025

Marginalized communities, including lesbian and gay populations, may experience unique experiences and expectations associated with growing older. The present study aimed to provide a preliminary model of how lesbian and gay adults view their own aging and identify psychosocial risk and resilience factors specific to this community. Data are from a pilot study of social perceptions of aging in lesbian and gay middle-aged and older adults, in which 45 gay and 46 lesbian adults participants (ages = 55-87, 70% white) completed questionnaires on their health, perceptions of aging, community engagement and identity congruence, and stressful experiences. Self-perceptions of aging were measured with an 8 item scale ranging from 1 to 6, where higher scores indicate greater agreement with positive perceptions of aging (e.g., “So far, I am satisfied with the way that I am aging.”). In a regression model accounting for self-rated health, subjective socioeconomic status, and race/ethnicity, lesbian women reported better self-perceptions of aging than gay men (b = 0.50, SE = 0.16, p <.01). Further, greater outness was associated with better self-perceptions of aging (b = 0.04, SE = 0.01, p <.01), LGBTQ+ community engagement did not relate to self-perceptions of aging (b = -0.10, SE = 0.12, p =.40), and more stressful experiences in daily life were associated with worse self-perceptions of aging (b = -0.15, SE = 0.05, p <.01). Results will be discussed in the context of a model of risk and resilience for “accelerated social aging” among LGBTQ+ populations.
TRANSITION INTO RECEIVING CARE AND DEPRESSIVE SYMPTOMS AMONG KOREAN OLDER ADULTS
Authors: Yoo Haeun , Kim Kyungmin
Published: January 2025

Although transitioning into receiving care in late life is common, its psychological impact remains underexplored. Adaptation theory suggests that depressive symptoms may peak when individuals start receiving care but diminish over time as they adapt. On the other hand, they may become more depressed over time as their health conditions decline. Furthermore, the availability of a larger care resource network, including formal and informal caregivers, may buffer the negative impact of receiving care on depressive symptoms. This study aims to examine how transitioning into receiving care is associated with changes in depressive symptoms, and how the association varies by perceived care resources. Utilizing panel data from the Korean Longitudinal Study of Ageing (biennial surveys; 2008–2022), we compared two groups of older adults (aged 65–105; observation N = 3,739), based on care status at two consecutive waves: (a) received care at both waves and (b) newly received care at later wave. We found that older adults who transitioned into receiving care showed greater increases in depressive symptoms than those who continued receiving care, adjusting for participants’ sociodemographic/health characteristics as well as depressive symptoms at prior wave. Moreover, the association between transitioning into receiving care and changes in depressive symptoms differed depending on perceived care resources; thus, the negative psychological impact of transitioning into receiving care was significant only for participants with fewer perceived care resources at prior wave. The findings highlight the importance of a well-established support network in the context of disability.
TRANSNATIONAL PARENT-CARE AND FILIAL PIETY: THE PARADOX OF IDEALIZED TRADITIONAL IMMIGRANT VALUES
Authors: Yoon Joonsik
Published: January 2025

For families from highly filial societies, such as those from East Asian countries, providing care to parents in later life has long been considered an important value and duty. However, providing parent-care to older adults in modern societies can present many practical challenges for families. When adult children emigrate abroad while the parents stay, the physical distance separating the transnational families presents additional difficulties in meeting filial expectations and providing practical care. In this qualitative ethnographic study, ten first-generation Korean Americans were interviewed in depth using an open-ended, semi-structured protocol. These interviews focused on respondents’ experiences and concerns surrounding transnational parent-caregiving for parents living back in South Korea. A grounded theory approach was used to adapt the research focus to accommodate emerging thematic elements as the interviews progressed. Most respondents expressed a strong preference for idealized and traditional models of filial piety. They not only felt a strong obligation to support and care for their parents as they aged, but many even stated that they wanted to co-reside with their parents. This is notable since the practice is not only outdated in the West, but it has rapidly fallen out of favor and use in Korea. This preference for seemingly outdated traditional filial values stood in stark contrast to the respondents’ acknowledgement that there were significant obstacles in achieving their preferred care goals. I conclude with a discussion of the respondents’ preferences for seemingly outdated and unachievable filial ideals.
UNDERSTANDING THE ROLE OF CULTURE IN SHAPING ATTITUDES AND BELIEFS ON URINARY INCONTINENCE: A SCOPING REVIEW
Authors: Panesar Simran , Rajabali Saima , Wagg Adrian
Published: January 2025

Urinary incontinence (UI) is a common condition among older adults with diverse consequences for health and well-being. Shame, stigma, and cultural perspectives can prevent treatment-seeking behaviour. There is a scarcity of literature that explores the role that culture, beyond stigma, plays in shaping attitudes to, beliefs about, and management practices of UI. This review investigates and describes what is known about the role of culture in shaping the attitudes and beliefs on UI to identify gaps in the literature and direct future research. Following the Joanna Briggs Institute (JBI) method for scoping reviews, the MEDLINE, EMBASE, PsychINFO, CINAHL, EBSCOhost, and SCOPUS databases were searched, without any restriction on language and publication date. A full extraction was conducted of seventeen articles that met the inclusion criteria. Key themes revealed were the stress of managing UI and devout cleanliness for religious activities among Muslim women, a norm of secrecy/silence around UI for Latina women, the potent role of caste discrimination on pelvic health-seeking behaviours in parts of India, and the intersection of UI with cultural belief systems like Confucianism, which prioritize maintaining respectability, challenged by the taboo condition of UI. Although several studies emphasized the surface-level stigma of UI, there is a dearth of literature exploring culture and UI. Further research is needed to inform health promotion efforts regarding UI, which consider the severe emotional toll of UI stemming from the isolation it can create, segregating those that experience it from full participation in society.
WHAT MAKES YOU FEEL AFRAID OF DYING: A SYSTEMATIC REVIEW OF DEATH ANXIETY AMONG KOREAN OLDER ADULTS
Authors: Kim Haeun , Lee Yeonjung
Published: January 2025

Death anxiety (DA) refers to negative emotional responses such as anxiety, fear, and denial toward death that result from the inevitability of death. Studies have suggested that older adults experience higher levels of DA than other age groups in Korea, and DA is related negatively with suicidality. Given that the suicide rate among Korean older adults is extremely high as about 39.9 suicides per 100,000 people aged 65 and older as of 2022, DA and related studies need to be appraised and synthesized. This study aims to examine recent research and provide a theoretical basis for various intervention programs by conducting a systematic literature review on factors influencing DA among Korean older people. The three key electronic databases in Korea (e-Article, KCI, and RISS) were extensively searched using the selected keywords. Among the peer-reviewed articles written in Korean since 2015, a total of 21 eligible articles were included for analysis after excluding qualitative studies, dissertations, overlapping studies, and gray literature. Findings show that the factors influencing DA can be classified as followings: sociodemographic, psychological, and medical factors, intervention programs, attitudes toward death, and preparation for death. Among the psychological factors, depression was found to relate significantly and positively with DA. Regarding the DA interventions, some programs implemented at the community such as positive psychology improvement program, dance sports, music and physical activities have a significant effect on reducing DA. Findings provide a theoretical basis for developing the intervention programs and practical strategies and thus, alleviating DA among older adults.
A CLIENT-CENTERED HOME TRAINING APP OF MUSIC-BASED THERAPY FOR UPPER EXTREMITY FUNCTIONS IN OLDER ADULTS WITH STROKE
Authors: Chen Yi-An , Johnstone Sara Lynn , Solomon Annie , Norgaard Martin , Weinberg Gil , Pargai Dhruv , Szypulski Evan , Sanford Jon
Published: January 2025

Music-based therapy (MBT) has been shown to be effective in improving upper extremity (UE) functions for older adults with stroke in clinical settings. To expand the MBT benefits to home, we designed a client-centered, stroke-specific MBT app and examined the app feasibility with stroke survivors in this study. During the 2-week pilot home testing, the participants (n=5, mild to moderate UE motor impairments) actively used the app for rehab exercises around 71% of the time, which equals 26.6 ± 16.7 min per day, 5 days per week, over 2 weeks. Motor outcomes portrayed a positive trend from pre- to post-intervention. Participants’ average Fugl-Meyer Assessment scores increased from 53 to 57, and Nine-Hole Pegboard Test time decreased from 38 seconds to 32 seconds. Additionally, participants provided generally positive feedback, commenting on the app user-friendliness (e.g., easy to navigate, clear exercise instructions, convenience) and motivational music feature (e.g., engaging and a new way to experience therapy). They also enjoyed the flexibility of training scheduling – participants could do rehab exercises at any time they wanted. Based on the positive findings, we anticipate that the app will serve as a feasible tool for older adults with stroke to engage in a personalized program to improve UE functions at home. This will minimize the burden of travel and wait times to healthcare clinics and increase rehab access for older adults. We are currently continuing the data collection and app refinement to optimize the app to support stroke recovery in older adults.
ALZHEIMER’S DISEASE AND DISPARITY: A RURAL UNDERCOUNTING
Authors: Brenman Noah , Cheng Mengyuan , Ferdows Nasim
Published: January 2025

Rising life expectancy has led to an increasing prevalence of age-related diseases, particularly Alzheimer’s disease and related dementia. The more rapid increase of the older population in rural areas, combined with a higher prevalence of dementia risk factors, and limited access to healthcare services, may lead to higher rates of dementia in these communities. This project examines the differences in dementia mortality rates between rural and urban areas over a three-year period. We used county-level data on age-adjusted mortality rates from the CDC Wonder Database, merging it with County Health Rankings from 2018-2020. Using Rural-Urban Commuting Area (RUCA) we defined the level of rurality as: Urban, rural-adjacent to an urban area, and rural non-adjacent to an urban area. We found that rural areas had higher dementia age-adjusted death rates compared to urban areas, even after accounting for select county characteristics. The percent difference between rural and urban dementia mortality ranged between 7.1 to 9.8%, showing a persistent widening gap in rural-urban dementia mortality rates.
ARE WE WAREHOUSING PEOPLE WITH SERIOUS MENTAL ILLNESS? EXPLORING US NURSING HOMES IN 2000 AND 2021
Authors: Hadson Kim , Bergh Marissa , Travers Jasmine
Published: January 2025

The 1999 Supreme Court Olmstead decision reaffirmed people with serious mental illness (SMI) have the right to care integrated into community settings. The growth of SMI in nursing homes (NHs) suggests care has instead shifted to NHs. Insufficient attention has been given to the facility characteristics and state environments to understand if individuals with SMI in NHs are receiving high quality, equitable care. We used cross-sectional LTCFocus data from 2000 and 2021 to identify NHs with high volumes of SMI (more than 50% of residents with a diagnosis of schizophrenia or bipolar) and compared them to those below this cutoff. High volume NHs grew from 1.00% (161) of all NHs in 2000 to 3.10% (461) in 2021. While most states gained one or fewer high volume NHs, California gained 54, Illinois 44, Missouri 42, and Ohio 35, suggesting state policies play a role. High volume facilities were fundamentally different from other facilities. Wilcoxon rank sum tests and Pearson’s Chi-squared test of the 2021 data showed significantly (p< 0.001) lower acuity and higher restraint use, 13 year lower average resident age, 0.21, 0.13, and 0.29 fewer registered nurse, licensed practical nurse, and certified nursing assistant hours per resident day respectively, 20% fewer female residents, 16% fewer White residents, 7% fewer residents with dementia, 22% more residents on Medicaid and 22% more facilities being for-profit. More investigation is needed to determine if high volume NHs offer appropriate care for people with SMI, or if they are warehouses for inappropriate segregation from community living.
OLDER PEDESTRIANS’ PERSPECTIVES ON WALKING SAFETY IN KAMPALA: A QUALITATIVE INQUIRY INTO THE BUILT ENVIRONMENT
Authors: Namukasa Juliet , Mulkey Heather
Published: January 2025

Safe, accessible, and inclusive urban environments are important elements in walking as a means of transport. Limited studies are focusing on the walking safety of older people especially in African cities. This study explored the older pedestrians’ perceptions and experiences about walking safety in the built environment of Kampala. A qualitative design was used where purposive and convenience sampling methods were used to recruit fifteen participants from the streets of Kampala and its neighbourhood. Findings showed that older pedestrians had negative perceptions and experiences of walkability and safety in Kampala and its neighbourhoods citing inadequate pedestrian facilities e.g. the lack of sidewalks on most roads, insufficient lighting, uncovered drainage systems, and uneven surfaces. Additionally, the general lack of respect for pedestrians and traffic rules, including speed driving affects the older pedestrians’ sense of safety. Despite these challenges, older pedestrians valued safe mobility within their neighbourhoods for accessing services and sustaining social connections similar to other community members. The study concludes that enhancing the safety of older pedestrians is essential for promoting equitable road access for all members of the community, it urges city policymakers to prioritize improvements in pedestrian infrastructure. Keywords: older pedestrians, walking safety, Kampala City, built environment, perceptions, experiences, qualitative study, equitable road access.
POPULATION AGING AND INCREASING CHRONIC DISEASE BURDEN AMONG UNAUTHORIZED AGRICULTURAL WORKERS
Authors: Bishop Nicholas , Campos Baltazar , Martinez Daniel , Yahirun Jenjira
Published: January 2025

The US and Mexico are experiencing rapid population aging and increased chronic disease burden. We hypothesize these dynamics are magnified among undocumented farmworkers who work in challenging conditions and have limited access to healthcare. We used data from the National Agricultural Workers Survey (2001–2018) to examine whether 1) the age of undocumented farmworkers has increased over time (n=19,434), and 2) chronic disease burden has increased among undocumented workers aged 50+ (n=1,463). Multiple regression was used to examine the association between respondent age and survey year, and Poisson regression was used to estimate the association between number of doctor-diagnosed conditions (asthma, diabetes, hypertension, and heart disease) and survey year among respondents aged 50+. Models were adjusted for covariates (sex, migrant type, health service use, region, and age (in the chronic disease model)), and person weights. The mean age of the sample in survey years 2001–2002 was 28 (SD=9.7), which increased to 39 (SD=11.0) by 2017–2018. After adjusting for covariates and weights, there was a monotonic positive increase in age across survey years (e.g., respondents surveyed in 2017–2018 were on average 8.36 years older (95% CI:7.61–9.12, p<.001) than those surveyed in 2001–2002). Among undocumented agricultural workers aged 50+, respondents in the 2017–2018 survey waves had an expected condition count 202% greater than respondents in the 2001–2002 waves (IRR=3.02, 95% CI:1.45–6.29, p=0.003). An aging population of undocumented farmworkers with increasing chronic disease burden represents a significant health equity issue and strain on US agricultural output.
PROFESSIONAL CAREGIVER SATISFACTION AND BURNOUT IN ASSISTED LIVING
Authors: Morton Elizabeth , Zimmerman Sheryl , Efird-Green Lea , Davis Scott
Published: January 2025

Professional caregivers (direct care workers) perform most of the care for residents in assisted living (AL) and have consistently high turnover rates. Because high turnover is associated with low job satisfaction and decreased quality of care, understanding professional caregiver satisfaction can inform approaches to improve the well-being of both staff and residents. This study obtained information from 559 professional caregivers from 69 AL communities to explore job satisfaction, burnout, and how satisfaction varies based on professional caregiver and AL characteristics (e.g., resident-case mix, staffing ratio). It also established the validity of the Direct Care Worker Job Satisfaction Scale (scored 1-4) as applied to this population through a principal components analysis. Principal components analysis produced a single-factor solution with an eigenvalue of 10.8, the only eigenvalue above 1. All scale items loaded at least 0.70 on the single factor. Overall, professional caregivers had an average satisfaction of 3.05 (“satisfied”), and 18.5% were burned out; satisfaction and burnout were negatively correlated (-0.46, p< 0.0001; adjusted -0.43, p< 0.0001). Satisfaction was positively correlated with the percent of residents with dementia (0.19, p< 0.0001) and provision of special/memory care at their AL community (0.17, p< 0.0001); it was negatively correlated with the professional caregiver-to-resident staffing ratio (-0.18, p< 0.0001) and presence of licensed nursing staff (-0.27, p< 0.0001). Results suggest that caring for individuals with dementia is particularly rewarding for professional caregivers, while being responsible for more residents and working alongside licensed nursing staff may lessen satisfaction.
REFINING CARE NETWORK MEASURES FOR DIVERSE DEMENTIA CAREGIVERS USING CROSS-CULTURAL COGNITIVE INTERVIEWING
Authors: Howe Melissa , Tiburcio Alan Rodriguez , Pudelek Kelly , Zhong Selena , Compernolle Nell , Piedra Lissette
Published: January 2025

It is often assumed that American English speakers universally understand validated instruments and survey items used in previous research. However, comprehension can vary widely due to differences in dialect, education background, and other factors, impacting both survey data quality and respondent burden. To address this, we used cross-cultural cognitive interviewing methods to: (1) facilitate the inclusion of caregivers from diverse cultural and linguistic groups and (2) ensure that survey items elicit comparable data across these groups for accurate analysis. We conducted ~60-minute interviews with 20 informal caregivers to test new and existing survey questions designed to characterize the care networks and caregiving experiences of adults who regularly assist a family member or friend living with dementia. We assessed their ease or difficulty when answering survey questions with close-coded response options and probed into their understandings of key terms. Initially, we interviewed ten caregivers purposefully selected to represent diverse ethnoracial and gender identities, education backgrounds, and geographic locations (urban/rural). After analyzing the transcripts to identify and remedy problematic wording, we conducted ten additional cognitive interviews with new respondents, focusing on Latinx caregivers who primarily speak American English. This iterative process informed specific changes, such as refining the description of “caregiver” in a question designed to be maximally inclusive and replacing misunderstood words such as “dominant” and “primary” with more familiar words. Variations in participant comprehension underscore the importance of rigorously pre-testing research materials. Post-survey development, our data and findings will provide valuable context for interpreting survey results.