bluuebunny/crossref_metadata_2025 huggingface dataset:
CHILDHOOD TRAUMA AMONG US VETERANS AND THEIR NEGATIVE HEALTH AND RISKY BEHAVIORS IN LATER LIFE
Authors: Dayrit Jessika , Salom-Bail Shirley , Islaya Cesz , Castro Eunice
Published: December 2023

Background

Behavioral and health outcomes of childhood traumas are public health issues. Research on adverse childhood experiences (ACEs) have been explored among the general population; however, ACEs among persons with history of military service remains unknown.

Methods

Current study used secondary dataset obtained from CDC Behavioral Risk Factor Surveillance System (BRFSS) 2011. Study’s total sample size was 7,112. Data was weighted to account for the complex sampling design and nonresponse. Logistic regression was used to explore ACEs among US Veterans, and how early trauma correlates to long-term health problems, while controlling for their socioeconomic status.

Results

Our analyses suggested that compared to participants with 0 ACEs, those who reported 1 ACE (OR=1.38; CI=1.10-1.73), 2 ACEs (OR=2.30; CI=1.80-2.95), 3 ACEs (OR=2.81; CI=2.11-3.73), and 4+ ACEs (OR=4.04; CI=3.20-5.09) were more likely to report depression. Participants who reported for having 4+ ACEs were 4.16 times more likely to report in risky sexual behaviors (OR=4.16; CI= 1.83-9.46). Individuals with 4+ ACEs scores were 30% more likely to report binge drinking (OR=1.30; CI=1.02-1.67), 94% at risk for being a smoker (OR=1.94; CI=1.54-2.45) and had higher odds of developing poor health status (OR=1.67; CI=1.32-2.10).

Conclusion

Our research suggests that more ACEs score associates to a higher risk of developing health issues in later life. Research on ACEs has traditionally focused on health outcomes using secondary datasets among the general population. More research should be explored in longitudinal studies on ACEs, particularly with persons who have served in the military.
DIABETES OCCURRENCE, RISK FACTORS, AND LIFESTYLE PATTERNS IN OLDER ADULTS ATTENDING SENIOR CENTERS
Authors: Ruggiero Laurie , Orsega-Smith Elizabeth , Kayatta Sophia
Published: December 2023

Diabetes risk and rates increase across age with prevalence rates of diagnosed diabetes of 24% and estimated pre-diabetes rates of 49% in adults 65 or older (2017-2020; CDC, 2020) underscoring the importance of understanding diabetes risk factors and lifestyle behaviors in older adults. Senior centers offer a unique opportunity to reach older adults to deliver health promotion interventions. The study purpose was to examine diabetes/pre-diabetes occurrence, risk factors, lifestyle behaviors, and preferences for promoting healthy lifestyles to reduce diabetes risk in older adults (>60). An anonymous cross-sectional self-report survey was administered in senior centers. It included questions regarding occurrence of diabetes, diabetes risk factors, and hypertension; self-reported health status; lifestyle behavior patterns; cognitive function; and social engagement. Open-ended questions obtained information on diabetes risk awareness and preferences for healthy lifestyle interventions delivered in senior centers. The sample included 159 adults: average age of 76 years (range: 60-96), 77% female, 83% White, and 14% African American. Reported health related patterns include: 89% rated health as good-excellent; 74% were at high risk for pre-diabetes; 64% had hypertension; and 20% were told by provider of diabetes and 32% pre-diabetes. Reported lifestyle patterns included: 73% get regular physical activity, 53% eat 5 daily fruits/vegetables, 7% smoke, and average 7 hours of sleep/night. The large proportion at high risk for pre-diabetes underscores the importance of focusing on diabetes prevention in older adults and potential for delivering healthy lifestyle interventions in senior centers. Presentation will describe the quantitative and qualitative results and implications for lifestyle interventions.
DIFFERENTIAL PAIN SENSATION AND GUT MICROBIOME BETWEEN YOUNG AND OLDER ADULTS
Authors: Chen Jie , Wang Zequan , Starkweather Angela , Chen Ming-Hui , Miao Hongyu , Ahn Hyochol , Cong Xiaomei
Published: December 2023

This study aimed to investigate the differences in pain sensation and gut microbiota between young and older adults. Twenty-one healthy young adults (YAs) and sixteen healthy older adults (OAs) were recruited. Quantitative sensory testing data, and stool samples were collected. The 16S rRNA V4 gene region of stool samples were sequenced and processed by using the Mothur 1.42.3 pipeline. The mean ages of YAs and OAs were 20.14 (SD = 1.39) and 63.19 (SD = 8.00), respectively. Eleven of the YAs and 12 of the OAs were female, and 8 of the YAs and 3 of the OAs reported pain. OAs had significantly higher heat pain threshold (HPT), higher pressure pain threshold (PPT), lower cold detection threshold (CDT), and lower cold pain threshold (CPT) than YAs (all p < 0.05). OAs had significantly different a-diversity indices including higher species of observed (Sobs), Chao index and Shannon index, and lower coverage, and significantly different beta diversity indices (Bray-Curtis, Jaccard, and Theta YC) than YAs. The significantly abundant taxa in YAs included Bacteroidaceae, Veillonellaceae, and Alcaligenaceae. Coriobacteriaceae, Streptococcaceae, Lachnospiraceae, Erysipelotrichaceae, and Verrucomicrobiaceae were significantly enriched in OAs. The Spearman correlation analysis showed that the CDT, CPT, and HPT were significantly associated with gut microbiota Sobs, Chao index, Shannon index, and coverage (all p < 0.05). But the directions and coefficients of correlations varied. OAs had distinguished peripheral sensation and gut microbiota profiles than YAs. The changed peripheral sensation and gut microbiota profiles among OAs may be biomarkers of aging-related pain processing.
DEMENTIA CAREGIVER RE-ENTRY INITIATIVE: FINDING NEW DIRECTION AND PURPOSE AFTER CAREGIVING ENDS
Authors: Wolfe Warren , Fairbanks Sheryl
Published: December 2023

Many former dementia caregivers struggle to find a “new normal” when the long and exhausting caregiving journey ends. Grieving eases, the estate is settled, and now what? Who am I after caregiving ends? Following 12 years of intense care for their parents, two with dementia, Sheryl Fairbanks and Warren Wolfe searched nationally for a program that might help them restart their lives. They found none. In 2016, they launched the Former Dementia Caregiver Re-Entry Initiative, which has served more than sixty people. At a kick-off meeting, former caregivers said their deepest needs were reestablishing relationships with family and friends and finding new life purpose. Typically, six to eight former caregivers meet twice a month – online since the COVID pandemic - and focus on moving forward. They share that these meetings give them a renewed purpose, deeper social connections, increased energy and a new sense of self-esteem. “My kids care. My friends care,” one member explained. “But nobody who hasn’t lived it really knows how hard that time was, and how hard it is to find a new path.” Four similar programs have started in Minnesota, The couple has written a book to encourage more. In 2022, Ms. Fairbanks and Mr. Wolfe became Community Leads in a University of Minnesota research project to see if Black former dementia caregivers have unmet needs and whether this model might help. Preliminary findings will be presented at the Addressing the Needs of African American Bereaved Dementia Caregivers symposium at this GSA annual meeting.
EFFECTS OF BEING FORGOTTEN ON ADULT CHILDREN OF MOTHERS WITH DEMENTIA
Authors: Wood Kristie , Suizzo Marie-Anne
Published: December 2023

Mothers with dementia sometimes do not recognize their adult children. Yet, research on the effects of being forgotten by a mother with dementia is scarce. Object relations theorists posit that healthy development of a child’s sense of self is linked to being remembered by a primary caretaker. Further, being held in mind by a primary caregiver allows the child to form a cohesive identity. It is unclear how adult children’s identities are impacted by being forgotten by their mothers. To investigate this phenomenon, this qualitative study explored the effects of being forgotten on adult children in the context of dementia. The aims were: 1) to develop an in-depth understanding of what it means for adults to be forgotten by their mothers with dementia, and 2) to gain insight on the effect of being forgotten on adults’ identities. Data were gathered through 12 interviews. Data was analyzed following an interpretative phenomenological analysis approach. Preliminary findings suggest adult children of mothers with dementia experience being forgotten as both a threat to their identity and forewarning of continued poor disease outcomes. The following themes illustrate this: 1) The sense that one’s existence was not important enough to be remembered, 2) Feelings of failure due to the inability to spark recognition of themselves in their mother’s mind, and 3) Dread for the disease progression. While research regarding adult children of parents with dementia largely focuses on practical aspects of caregiving, clinical implications of these findings suggest that this population suffers silently from being forgotten.
A SCOPING REVIEW OF SYSTEMS-LEVEL INTERVENTIONS FOR FALL PREVENTION IN LONG-TERM CARE
Authors: Ustach Andrew , Wi Dahee , Thompson Hilaire
Published: December 2023

Older adults residing in long-term care facilities (LTCFs) are at high risk for falls. In addition to individual resident-level interventions to prevent falls and fall-related injury (FRI), system-focused interventions are also necessary to adequately address fall prevention. Relatively little attention has been given to research involving systems-focused interventions. We aimed to synthesize studies on the effects of system-focused interventions for fall and FRI prevention in LTCFs with the goal of identifying promising strategies and gaps. We searched Medline, CINAHL, and EMBASE databases from 2017 to 2022 following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline. We conducted a narrative synthesis to summarize included studies. In the initial review, 301 studies were identified and underwent title and abstract screening resulting in 98 articles were retrieved for full-text review. Fifteen studies were included in data extraction. Fall prevention interventions evaluated in LTCF settings include: (1) multicomponent fall prevention programs, (2) staff education programs, (3) training in safe handling/transfers, (4) environmental adaptations, (5) electronic health record algorithms and prompts, (6) local culture change, (7) video analysis of falls to change local interventions, and (8) facility-level physical activity programs. About half of reported studies reported significant effects of system-focused interventions to reduce fall and FRI in LTCFs. Multicomponent fall prevention programs and physical activity interventions are the most effective systems-level interventions, while electronic health record interventions were the least effective. Overall, little attention has been given in the literature to evaluation of environmental adaptations at the systems level.
DISPARITIES IN MOCA AND MMSE SCORES AMONG DIVERSE OLDER ADULTS: A CASE ANALYSIS OF CREOLE-SPEAKING PARTICIPANTS
Authors: Adonis-Rizzo Marie , Tappen Ruth , Rosselli Monica , Newman David , Panday Somi , Conniff Joshua
Published: December 2023

Almost 11% of older adults in the US have Alzheimer’s or related dementia. Most studies suggest that those who are Black or Hispanic are at higher risk. A culturally diverse sample, including Haitian older adults, was recruited from South Florida communities to participate in a longitudinal study, “In-Vehicle Sensors to Detect Change in Cognition of Older Drivers.” An extensive cognitive battery was administered for comparison with driving behaviors. No validated translations in Creole were available, so three Haitian-born examiners translated and back-translated test items into Creole. Two additional bilingual examiners verified the results. An analysis of variance (ANCOVA) comparing Haitian participants (N=12) and European Americans (N=135) on the MoCA controlling for age and education indicated the European American group scored higher (M = 25.78, SD = 2.57) than the Haitian Group (M =24.17, SD = 3.01), a significant difference in test performance, F (1, 124) = 6.11, P= .015. Results on four subscales of the MoCA evidenced significantly higher scores for the European American group: Visual EX Total, F (1, 124) = 22.52, p < .001; Serial-7, F (1, 124) = 12.09, p <.001; Attention Total, F (1, 124) = 5.10, p <.001; Letter Score F (1, 124) = 13.09, p <.001. No differences in language, abstract, delayed recall, or orientation were found. These preliminary results suggest cultural influences may account for differences in test performance. Further investigation with a larger sample of Haitian older adults is needed to explain differences in performance on this widely used test.
BUILDING AN AGE-FRIENDLY ECOSYSTEM THROUGH NEIGHBORHOODS, HEALTH SYSTEMS, AND CAMPUSES
Authors: Greer Valerie , Fulmer Terry , Cadiz Ashley , Hernandez Christopher , Edelman Linda
Published: December 2023

The age-friendly movement grew from an idea into a social movement recognizing the importance of adapting multiple facets of society to meet the needs of older adults. The movement integrates multidisciplinary work in research, policy, planning and design to build age-friendly ecosystems. Age-friendly ecosystems comprised of communities, health systems and campuses can become platforms for equity, health, and wellness for older adults. We designed a virtual symposium to examine age friendliness from a place-based approach by examining neighborhoods, campuses and health environments as sites uniquely positioned to catalyze equity in aging. The symposium was convened by national experts and regional aging stakeholders to consider how age friendly environments can address urgent social, environmental and health challenges, and create measurable outcomes that promote aging well for all. Knowledge was generated through lectures, panel discussions, a world café, focus group discussions, and a student-ideas competition. There were 113 attendees, including 27 health professions students; 78% of attendees indicated their work focused on aging/older adults and 52% reported specialized training in geriatrics/gerontology. Attendees reported increased familiarity with age-friendly concepts post-symposium. Key findings indicated the benefits of shared language and metrics across place-types that can collectively transform the social, physical, and economic landscape of aging. Symposium outcomes include a website, graphic facilitation, a collaboration resource guide, and a forthcoming book. Outcomes are serving as a foundation to radically re-imagine cross-sector collaborations between communities, health systems and campuses to create an ecosystem that embraces longevity as an asset and advances equity in aging.
PROMOTING INTERGENERATIONAL EXCHANGES WITHIN RURAL AGE-FRIENDLY COMMUNITIES: A CBPR APPROACH
Authors: Pumilio Victoria , Steinman Bernard
Published: December 2023

The World Health Organization (WHO) Global Age-Friendly Cities (AFC) guide identifies eight interconnected domains for promoting the well-being, engagement, and participation of older adults in community activities and events. It defines an inclusive society as one that actively encourages older adults to participate in their community’s social, civic, and economic life. Research often prioritizes addressing the physical challenges many older adults face, frequently overlooking societal engagement aspects that promote active aging and inclusion. This research outlines how a Community-Based Participatory Research (CBPR) approach was used to uncover and address the societal stigmas and counterproductive attitudes experienced by older adults in a rural age-friendly designated community. Our CBPR approach is characterized as a process encountered in three stages: (i) conducting a multigenerational survey on age-friendliness, (ii) engaging community members in planning intergenerational opportunities, and (iii) implementing intergenerational engagement activities identified in earlier stages. By participating in methodologies from both CBPR and grounded theory approaches, older adults acquired agency and voice in the research process, thus directly impacting age-friendly outcomes in their communities. Our findings detail the importance of utilizing a CBPR approach when researching core AFC fundamentals that are instrumental in creating inclusive policies and promoting healthful, mutually beneficial intergenerational opportunities.
A DYADIC ASSESSMENT OF COGNITIVE RESOURCES AND COGNITIVE FUNCTION AMONG OLDER KOREAN AMERICAN COUPLES
Authors: Park Nan , Jang Yuri , Kim Kyungmin , Chung Soondool , Haley William , Chiriboga David , Kim Miyong
Published: December 2023

Individuals’ health and well-being are often shaped by significant others in their lives in that spousal relationships are particularly important. In dyadic studies among older couples, few studies have examined cognitive health as an outcome variable. Considering the lack of couple research on cognition especially among older immigrant population, the purpose of this study was to examine the cognitive function of community-dwelling older Korean American couples in the U.S. Data were drawn from a survey with older Korean Americans aged 60 and older, collected during 2017−2018 in multiple locations. Using a subset of 252 couples of the survey (individual N = 504), we examined the extent to which one’s cognitive function was associated with the cognitive resources (education, acculturation, friend network, and activity participation) of their own and of their spouse. The analyses with the Actor-Partner Interdependence Model showed the differences in the actor- and partner-effects between spouses. For husbands, acculturation was the only significant actor-level predictor to cognitive function. Wives’ cognitive function was associated with a wider array of their own cognitive resources, including education, friend network, and activity participation. The partner effect was only observed in education for husbands, indicating that wives’ higher education was beneficial for their husbands’ cognitive function. Further, the cognitive benefit of higher education was found to be maximized for husbands who also had greater levels of acculturation or activity participation. For practice implications, cognitive resources both in individual and spousal levels could help promote the cognitive health and well-being of older married couples.
ASSOCIATIVE AND EXECUTIVE INFLUENCES ON MEMORY FOR EVENTS AS REVEALED BY AGING AND DISTRACTION
Authors: Kersten Alan , Earles Julie , Smithwick Megan , Angus Carlos Vaca
Published: December 2023

Diagnostic tests of memory functioning typically employ verbal material, potentially encouraging mnemonic strategies ranging from rehearsal to visual imagery. Poor performance could thus reflect either impairments in basic associative mechanisms or impairments in executive functions underlying strategy deployment. Kersten et al. (2018) developed a more ecologically valid test of episodic memory, the Person-Action Conjunction (PAC) Test, involving memory for who did what in events. They found that when many different actors performed the actions, memory for who performed each action was related to tests of associative functioning, whereas when only two actors performed all the actions, memory performance was related to executive functioning. The present research tested the ensuing prediction that manipulating the availability of executive resources through distraction should only impact performance when a small number of actors perform the actions. The PAC Test was administered to 207 young adults (M age = 20.39) and 163 healthy older adults (M age = 70.80), either with no distraction or while performing a tone counting distractor task. Young adults performed better than older adults at remembering who did what, consistent with an age-related associative deficit. When two actors performed all the actions, distraction impacted both age groups’ memory for which actor performed each action. When many different actors performed the actions, distraction had no specific impact on memory for who did what. Implications will be discussed for the development of diagnostic tests to differentiate impairments in basic memory mechanisms (e.g., early-stage Alzheimer’s disease) from impairments of executive functioning (e.g., vascular dementia).
EXPLORING LINKS BETWEEN COGNITIVE AGING AND FEATURES OF WORKING MEMORY VIA COMPUTATIONAL MODELING
Authors: Kim Sharon H , Li Yanling , Harrington Karra , Hakun Jonathan , Elbich Daniel , Sliwinski Martin , Oravecz Zita
Published: December 2023

With an aging population, understanding cognitive aging is essential for developing interventions to support independence and well-being. Additionally, there is a need for sensitive measures that can differentiate subtle cognitive decline related to neurodegenerative disease from age-related changes. In particular, Alzheimer’s Disease and Related Dementia (ADRD) increases in prevalence with age and involves progressive cognitive decline. The Color Shapes task (CST) is a visual working memory task that has been shown to be sensitive to early indicators for ADRD. CST involves feature binding (e.g., mental representation of features into a unified whole) that is impaired in people with ADRD. In an experiment, we manipulated different CST properties to study whether drift diffusion modeling (DDM) can account for individual differences in latent decision-making processes generating manifest CST performance scores. DDM allows us to quantify theoretically meaningful cognitive parameters that underlie task performance captured in reaction times and accuracies. 68 U.S. community-residing adults (28-80 years) completed daily smartphone assessments across 8 days with experimentally manipulated versions of the CST. We implemented a single-step Bayesian estimation of experimental conditions contrasts, latent DDM parameters, and their associations. We show how individual differences in experimental contrasts were related to age in terms of cognitive (drift rate), non-cognitive (non-decision time), and meta-cognitive (boundary separation) parameters. The results highlight the benefits of using cognitive process models with optimized cognitive tasks to delineate features of cognitive aging for ADRD research.
FACTORS INFLUENCING COGNITIVE FUNCTION AMONG THE US OLDEST-OLDER ADULTS
Authors: Son Jung Yoen , Larson Janet
Published: December 2023

Previous studies have identified factors that influence cognition in older adults (aged ≥ 65); however, the findings cannot be generalized to the oldest-old adults (aged ≥ 80), who face different physical and functional challenges. This study aimed to examine the association between potential influencing factors and cognitive function in community-dwelling oldest-older adults using the National Health Aging Trends Study (NHATS) dataset, a nationally representative sample from 2015. We conducted linear multilevel modeling (MLM) to examine the association between participation in physical activity (PA) and social activity, everyday technology use, mental health, and self-reported health with cognitive function (immediate and delayed word recall), adjusting for five sociodemographic characteristics (age, sex, race/ethnicity, and education). A total of 2779 community-dwelling oldest-old adults from the NHATS were included. Most of study participants were 80-84 years old (47%), female (61%), Non-Hispanic White (70%), not married (63%), and did not obtain a college degree (75%). In the MLM, participating in physical and social activities, using technology, and poorer mental health were significantly associated with higher word-recall scores (better cognitive function). Self-reported health was not associated with word recall. Results from our study suggest that interventions aimed at promoting physical and social activities and improving mental health may help maintain cognitive function among the oldest-old population. Our findings also suggest the potential positive impact of technology use on cognition, although further study is needed to support the evidence.
SELF-PERCEIVED COGNITIVE CHANGES IN OLDER BLACK ADULTS DURING COVID-19
Authors: Martens Nancy , Hanna Sophie , Adams Hannah , DiCerbo Loraine , Giordani Bruno , Kavcic Voyko
Published: December 2023

The COVID-19 pandemic has had myriad effects on health and well-being. Contracting the COVID-19 virus and concerns of social and physical consequences during pandemic-related restrictions have been proven to negatively impact health. To better understand possible effects of COVID-19 on Black community-dwelling older adults’ perceived cognitive changes, we conducted a pilot study with 48 community-dwelling African Americans with measures obtained over 24 months from 10/2020 to 10/2022. Participants were recruited from the Wayne State University Institute of Gerontology Healthier Black Elders Center, and Michigan Alzheimer’s Disease Research Center, and the general Detroit Area (Mage=73.07, Range=65-87 years). The Cognitive Change Index (CCI) was used as a self-report measure of perceived change over the last five years. The COVID Impact Survey (CIS) was used to assess the burden of COVID-19 on daily living. To evaluate emotional-being, the Perceived Stress Scale (PSS responses referred to the last month) and the Geriatric Depression Scale (GDS, within the last week) were administered. Stepwise regression models showed CIS outcome measures did not predict CCI. GDS outcome measures predicted CCI to some degree (R2adj = .15, p = .008), whereas PSS was the strongest predictor (R2adj = .50, p < .001). Results suggest that for older community-dwelling African Americans, past COVID-19 pandemic experiences did not affect their self-evaluated cognitive changes. Higher levels of self-perceived stress within the last month best predicted their subjective cognitive decline. Future research should involve interventions focused on stress reduction, and clinicians should consider stress level when diagnosing cognitive status in older adults.
SEMANTIC RETRIEVAL PATTERNS IN COGNITIVELY HEALTHY OLDER ADULTS
Authors: Phatak Vaishali , Vlock Elizabeth , Im Yunju , Merickel Jennifer , Aflagah Erica , Murman Daniel , Chang Jun Ha , Rizzo Matthew
Published: December 2023

Word finding difficulties can be a normative change in aging. The purpose of this descriptive study is to establish metrics of word retrieval patterns in older adults using a semantic fluency task. Forty-five healthy aging, primary English speakers (mean age 75.0; 69% female, mean MoCA = 26.5) participated. Participants were asked “I want you to tell me all the animals you can think of in one minute.” The responses were scored using two novel normalized coefficients. (1) Archetypal Coefficient (AC): frequency proportional to the 60-second frequency. (2) Seeding Coefficient (SC): frequency proportional to both the 60-second frequency and the first-word frequency. Cluster coefficients (CC) also measured adjacency of responses. Participants generated mean of 19.9 words with a low correlation to MoCA (r=0.32). A total of 204 unique animal names including developmental stages (e.g., puppy), sex differences (e.g., rooster), and nicknames (e.g., bunny) were produced. In descending order, the most frequent responses were cat (AC=1.00), dog (AC=0.99), elephant (AC=0.89), horse (AC=0.83), and lion (AC=0.78). SC showed high ranking for archetypal animals (e.g., dog (SC=1.00), cat (SC=0.72)) and animals beginning with the letter “a” (e.g., anteater (SC=0.18), aardvark (SC=0.17)). CC showed greater adjacency for semantic subcategories such as pets (cat-dog) or farm animals (cow-horse), closely related species (mouse-rat) and superordinate labels (bird-fish). Our novel indices and CC revealed semantic retrieval in healthy aging occurs in an organized fashion that includes linguistic (i.e., alphabetical, word frequency) and semantic characteristics of animals, which adds to the current literature on semantic networks.
THE RELATIONSHIP OF COGNITIVE CONTROL BELIEFS TO 10 YEAR CHANGES IN COGNITIVE PERFORMANCE
Authors: Schiloski Kylie , Lachman Margie
Published: December 2023

Past work has shown that older adults who believe they have control over their cognitive performance (i.e., higher cognitive control beliefs) have better cognitive performance than those with lower cognitive control beliefs. However, it is unclear whether cognitive control beliefs are related to individual differences in cognitive change among middle-aged and older adults. The current study examined longitudinal associations between cognitive control beliefs and 10-year cognitive changes using data from waves 2 and 3 of the Midlife in the United States study (MIDUS; N=2,509, Ages 33 to 83 at wave 2). We predicted that higher baseline cognitive control beliefs would be related to greater maintenance of episodic memory and executive functioning over 10 years. Age was tested as a moderator of these relationships and each analysis controlled for baseline performance, age, sex, education, and self-rated physical health. Multiple linear regression models revealed that higher baseline control beliefs were related to less decline in episodic memory (p<.001) and executive functioning (p<.05); however, age did not moderate these relationships. Taken together, these results suggest that across age, cognitive control beliefs are associated with greater maintenance of episodic memory and executive functioning over 10 years in middle-aged and older adults. As such, cognitive control beliefs may represent a promising modifiable mechanism to help minimize cognitive declines starting in midlife.
WHAT’S ON THE CALENDAR THIS WEEK? EVERYDAY COLLABORATIVE STRATEGY USE AMONG MIDDLE-AGED AND OLDER COUPLES
Authors: Reese-Melancon Celinda , Turner Rachael , Wyatt Riley , Harrington Erin , Savla Tina , Rendell Peter , Margrett Jennifer
Published: December 2023

Mnemonic strategies support individual memory performance in a variety of domains, including school, work, and home. Less is known about how people collaborate to remember information in their daily lives. We asked married and/or cohabitating middle-aged and older adults (118 individuals, M age = 62 years, Range = 40-88 years, 50% female) about their individual strategy use and whether they engaged in any collaborative behaviors to support their everyday memory success. We employed a mixed methods approach to data analysis. We found that, as a group, husbands did not statistically differ from wives in their reports of individual internal, external, or technology-based strategy use. Most participants did report collaborating with their partner to remember the things they need to do in a given week. Themes regarding collaborative strategy use included weekly or daily calendar planning, making joint To-Do lists or making such a list for one’s partner, conferring about upcoming events and appointments, and providing reminders to partners. These findings lay the groundwork for future work examining how partners may support each other cognitively as they age and whether these supports change over time.
INDECISIVENESS ABOUT LONG-TERM CARE AMONG OLDER ADULTS
Authors: Schierer Allie , Miller-Winder Amber , Relerford Raven , Olvera Charles , Ramirez-Zohfeld Vanessa , Murawski Alaine , Lindquist Lee A
Published: December 2023

As cognition and function worsen, older adults often make decisions about living in long term care (LTC) or accepting support in the home. We are longitudinally studying LTC decision-making among a cohort of older adults (65+), who have viewed PlanYourLifespan.org (PYL), a proven-effective LTC planning tool. Subjects were surveyed at baseline (BL), administered PYL, then followed with surveys every 6 months. Participants were asked about LTC decisions in the event of worsening cognition and to describe those decisions. Responses were analyzed using a mixed-methods approach with open-ended responses coded using constant comparative analysis. Of the 293 subjects, mean age was 73 years, 72.7% (213) female, 40.4% (118) under-represented minority. Between baseline-18 months, 66.5% of subjects changed their LTC plans (28.7% one change, 24.23% two changes, 9.2% three changes) At 1 and 6 mos., the proportion of respondents who changed their decision from their prior timepoint was 44%. By 12 mos., this proportion has declined to 39%, and by 18 mos., the proportion further decreased to 34%. Higher indecision (Yes-No-Yes-No) was seen with changes in family caregivers, timing around COVID-19, and personal health. Decision permanence increased at 12-and 18-month time points. LTC decision-making fluctuates; however, over time, the decision-making progresses from circling to more permanence. Understanding LTC decision making is longitudinally important to understand and should be revisited every 6-12 months in clinical practice.
READ TO SUCCEED: HOW BOOK CLUBS CAN IMPROVE INTERGENERATIONAL RELATIONS AND FOSTER AGE FRIENDLINESS IN COMMUNITIES
Authors: Frey Katelyn , Sublett Jennifer , Kravljaca Nikolina , Stanley Jennifer
Published: December 2023

Intergenerational programming is recommended to improve age friendliness in communities, but there is little empirical research to support its effectiveness (Canedo-García et al., 2017). This project examined whether a multimodal intergenerational book club challenged age stereotypes and reduced ageism among participants (N=41). Twenty-one older adults (61-82) and 20 younger adults (18-22) read A Man Called Ove and met three times to introduce themselves (Time 1) and discuss the book (Time 2 and 3). Before the first meeting and after subsequent meetings, participants completed a survey to assess ageist beliefs and stereotypes. We expected ageist beliefs and stereotypes to decrease across time during the book club program. There was a statistically significant interaction between age group and time on benevolent ageism F(2, 52)= 5.23, p= .009 , partial η2= .167, such that benevolent ageism was more endorsed in younger adults (M=6.64, SE= 2.48, p= .011) compared to older adults at Time 1. This difference was not observed at Time 2 or Time 3 due to younger adults’ decreased overall endorsement. For positive generational stereotypes about older adults, there was a statistically significant main effect of time, F(2, 52)=7.095, p=.002, partial η2= .214, such that both younger and older adults increased their endorsement of these stereotypes from Time 1 to Time 3; similar findings occurred for positive stereotypes about younger adults F(2, 46)=4.53, p=.016, partial η2= .165. Results indicate intergenerational book clubs are an effective means to improve intergenerational relations and reduce ageist attitudes in younger adults.
SPOUSAL CAREGIVING AND PARALLEL COGNITIVE TRAJECTORIES AMONG OLDER ADULT CAREGIVERS AND RECIPIENTS IN CHINA
Authors: Yu Guo , Zhang Zhenmei , Jiang Quanbao
Published: December 2023

Prior studies have paid much attention to the physical and mental health outcomes of spouse caregivers. However, few have looked at the cognitive trajectory of caregivers and how it was associated with the characteristics of caregivers and care recipients. Based on four waves (2011, 2013, 2015, and 2018) of the Chinese Health and Retirement Longitudinal Survey (CHARLS) (N=3137 dyad couples aged 45 and above), cognitive function was measured by Mini-Mental State Examination (MMSE). A parallel process growth model was conducted to explore the association between spouse caregiving and the joint trajectories of caregivers and their recipients’ cognitive decline during the eight years. Preliminary results show that 1) couples’ trajectories are significantly related to each other, although men had a higher initial level of cognitive function than women, their cognitive function declined at a faster rate than women did; 2) The relationship between caregiving and cognitive trajectory varies by gender. Specifically, providing care is positively correlated with slower cognitive decline in men, but not in women. Whereas receiving the care was associated with a faster cognitive decline for both gender. These findings emphasize the need of paying attention to both family caregivers and recipients and the need for more targeted intervention strategies based on the nature of care.
A LATENT VARIABLE APPROACH TO ASSESS DEMENTIA IN MEXICO AND THE UNITED STATES: MEASUREMENT INVARIANCE AND VALIDATION
Authors: Saenz Joseph , Beam Christopher , Mejía-Arango Silvia
Published: December 2023

Latent dementia indices (LDI) use cognitive and functional data to approximate dementia. Few evaluate the LDI’s utility in cross-national work. This study tests metric measurement invariance of an LDI in the United States and Mexico and evaluates its validity in Mexico. Data included the United States Harmonized Cognitive Assessment Protocol (HCAP, n=3,267), MexCog (n=2,042), and a Mexican clinical validation sample with diagnosed cognitive status (51 cognitively normal, 49 mild cognitive impairment (MCI), and 50 dementia) who received the MexCog battery. The LDI was measured using highly comparable items (13 cognitive and 10 functional). We tested metric measurement invariance of the LDI in MexCog/HCAP samples and evaluated validity by regressing cognitive status on LDI factor scores in the Mexican validation sample using multinomial regression and evaluating how model-implied cognitive status aligned with diagnosis. Full metric invariance of the LDI in the MexCog and HCAP was supported, suggesting that the LDI may be used in cross-national work to validly compare dementia risk factors in the studies. In the Mexican validation sample, LDI factor scores significantly predicted MCI (β=-2.62, p< 0.001) and dementia (β=-5.93, p< 0.001) versus cognitively normal in multinomial regressions. LDI model-implied cognitive status showed moderately high dementia (84.0%) and MCI (88.9%) sensitivity and moderately high dementia (92.0%) and MCI (88.2%) specificity. The LDI may be used to cross-nationally compare risk/protective factors for dementia in MexCog/HCAP studies. Alignment between the LDI and diagnosed cognitive status in the Mexican validation sample supports its validity as a proxy for dementia in Mexico.
DEMENTIA FRIENDS AWARENESS BUSINESS TRAINING PROGRAM: MAKING A POSITIVE IMPACT IN SMALL ARKANSAS BUSINESSES
Authors: Spradley Laura , Thomasson Whitney , McAtee Robin
Published: December 2023

The Arkansas Geriatric Education Collaborative, a HRSA-funded Geriatric Workforce Enhancement Program grant, and a Dementia Friends USA sub-licensee, provides a program to businesses called Dementia Friends at Work. This program utilizes the tenants of the “Become a Dementia Friend” program created by Dementia Friendly America©, a multi-sector movement that aims to foster “dementia friendly communities”. A one-hour training was conducted for 222 business employees, focusing on recognizing the signs of dementia, challenging the stigma about dementia, how to best communicate with individuals with dementia and their caregivers, and practical tips to make themselves and their environment more Dementia-Friendly. During the program, management and staff were asked to self-assess the physical business environment for “dementia friendliness” and review possible changes toward improvement. Pre-program and post-program evaluations were completed. The results showed that 100% of participants agreed the training program made an impact on their business or job and 75% claimed to use the knowledge gained from the program. Qualitative data gathered 90-days post training supported these results with themes emerging such as staff using new ways to navigate conversations with those expected to have dementia, being more aware of the signs of dementia, and utilization of skills learned to more effectively interact with these customers. Findings suggest that many employees were unaware of the common signs of dementia or how to recognize behaviors of those with dementia. They had also not considered learning about or using proven techniques to assist with interactions and conversations; therefore, this training was well-received and effective.
DEVELOPING AND TESTING A TWO-PART INTERVENTION: ENHANCING DEMENTIA INSTRUCTION AND TOOL IN HOME HOSPICE CARE
Authors: Geisser Sophia , Aamponsah Abigail , Vasquez Felix , Luth Elizabeth
Published: December 2023

Family care partners of persons living with dementia provide extensive care and experience significant stress and strain, particularly near the person living with dementia’s end of life. Hospice nurses and social workers (clinicians) are positioned to support family care partners, but seldom receive training to do so. This article describes the approach to developing and pilot testing a two-part intervention, Enhancing Dementia Instruction and Tool in Home Hospice Care (EDITH-HC). This intervention provides 1) educational videos for hospice nurses and social workers about dementia-specific end-of-life care and 2) a worksheet for clinicians to use as part of their clinical practice to use with family care partners to identify and address their stressors and concerns. EDITH-HC development involved: (1) a systematic review of literature and analysis of interview data from 58 family care partners (n=40) of home hospice patients living with dementia and clinicians (physicians, nurses, and social workers, n=18); (2) analysis of primary data collected from two rounds of structured, key stakeholder input from 19 family care partners, hospice clinicians, and research/content experts; and (3) single-arm pilot of the intervention to test initial feasibility and acceptability. The intervention development will lead to a randomized pilot study to determine the feasibility and acceptability of implementing the training and worksheet in clinical practice compared to usual care.
INITIAL FINDINGS ON THE BENEFITS OF THE TOVERTAFEL: REDUCING BEHAVIORS IN PERSONS WITH DEMENTIA
Authors: Steiner Victoria , Perion Jennifer , Hartzog Meggan , Ibrahim Safa , Lopez Alexa , Martinez Beanna , Saltzman Barbara , Kinney Jennifer
Published: December 2023

Technologies have been developed to reduce behaviors in persons with dementia by addressing unmet needs through activities that stimulate multiple senses. The Tovertafel (“magic table”) is a novel device from the Netherlands that enables purposeful play using interactive games designed to promote social, physical, and cognitive engagement in people with dementia. This study is investigating whether an intervention using the Tovertafel improves quality of life for residents with moderate to severe dementia living in long-term care communities in the Midwest. Twelve white women with an average BIM score of 6 completed the study at the initial facility. The 4-week intervention consisted of 30-minute game sessions with 2 to 6 individuals each weekday. Participants attended 2.5 sessions per week on average and displayed increased engagement during the games per facilitator reports. Direct care staff completed the Revised Memory and Behavior Problems Checklist–Nursing Home and the Apathy Evaluation Scale–10 for all participants. Data collected eight times over six consecutive weeks during the control (2 weeks) and intervention (4 weeks) periods were analyzed. After checking assumptions, paired-sample t-tests were conducted that indicated significantly fewer memory-related behaviors (p=.047) (e.g., repetitive behaviors and questions) and instances of apathy (p=.027), during the intervention period than the control. Despite reductions in depressive and disruptive behaviors, no statistically significant differences were found. Initial findings suggest that the Tovertafel could offer innovative ways to provide activities to people with moderate to severe dementia in long-term care settings, increase their quality of life, and improve interactions with staff.
RE-IMAGINING DEMENTIA FAMILY CAREGIVER ENGAGEMENT FOR POST–ACUTE CARE TRANSITIONS: LESSONS LEARNED FROM COVID-19
Authors: Tadesse Ruth , Lyons Karen , McKenzie Glenise , Hart Sara , Ellington Lee , Cloyes Kristin
Published: December 2023

Family caregivers of persons with dementia (PwD) experience three-times more post-acute care transitions (PACT) to skilled nursing facilities than other caregivers. During Covid-19, visitation policies drastically changed, limiting family caregiver engagement in the skilled nursing facility. This was a widespread experience; yet, few studies have examined dementia family caregivers’ perceptions of PACT engagement during Covid-19 restrictions. This qualitative study focused on the findings and lessons learned about the meaning of engagement, barriers, facilitators, and support needs during Covid-19 using an interpretive descriptive approach. Participants (n=15) were mostly female (n=13), adult children (n=8), and the majority (n=9) had a PACT experience during the Covid-19 pandemic. Family caregivers reported improved engagement with the PwD and healthcare team in the acute care setting, because hospital policies on Covid-19 allowed one visitor which gave family caregivers the option to be physically present and advocate for the PwD. However, after the PACT, only essential workers were allowed at the skilled nursing facility making it impossible for family caregivers to visit the PwD and communicate with professional caregivers. Lack of perceived support negatively affected family caregivers’ ability to communicate, share knowledge, advocate, and participate in critical decision making. These Covid-19 challenges highlight the importance of being physically present as a necessary component to engagement which was a form of communication compensation that improves outcomes for the PwD. Future practice policies should view family caregivers as essential to the healthcare team and develop innovative solutions to connect family caregivers to the PwD during Covid-19 or future pandemics.
DYNAMIC BENEFITS OF FINDING THE SILVER LINING: COUPLED CHANGES IN SECONDARY CONTROL AND WELL-BEING DURING COVID-19
Authors: Pierce Matthew , Hamm Jeremy , Duggan Katherine , Garcia Odalis
Published: December 2023

Secondary control beliefs (e.g., “negative experiences can be blessings in disguise”) reflect a psychological resource that can protect well-being for individuals who encounter uncontrollable life circumstances. However, previous research has focused on between-person differences in secondary control; little is known about the role of dynamic, within-person shifts in secondary control during major life stressors such as the COVID-19 pandemic. Our study examined whether within-person changes in secondary control beliefs were associated with corresponding within-person shifts in mental health and well-being during the pandemic. We analyzed 1-year data from the NDSU National COVID Study which contains 4 waves of data from a nationally representative sample of U.S. adults aged 18-80 (n = 293). Multilevel models assessed the extent to which within-person shifts in secondary control predicted corresponding changes in mental health (perceived stress, depressive symptoms), hedonic well-being (positive and negative affect, life satisfaction), and eudemonic well-being (personal growth, meaning and purpose). All models controlled for age, sex, education, income, and between-person differences in secondary control. Within-person changes in secondary control predicted corresponding shifts in mental health and well-being outcomes (bs = |.10-.25|, p < .005) except life satisfaction (b = .10, p = .061). In other words, participants reported increased mental health and well-being on occasions during the pandemic when they experienced increased secondary control. Findings advance the literature by documenting that secondary control exhibits dynamic shifts during a major life stressor. Additionally, these findings point to the adaptive role of such shifts (within-person increases) in supporting well-being during the pandemic.