bluuebunny/crossref_metadata_2025 huggingface dataset:
TWO SIDES OF THE SAME COIN: OPIOIDS AND CANNABIS FOR PAIN MANAGEMENT IN AFRICAN AMERICAN OLDER ADULTS
Authors: Jackson Simone , Booker Staja
Published: December 2023

Approximately 50 million U.S. adults live with chronic pain. Example treatments for chronic pain include opioids and the re-emerging cannabinoid pain management (CPM). However, older African Americans (AAs) are more likely to use pain treatments that are considered safe, affordable, and socially acceptable. We examined the perception of opioid and cannabis use for pain management in AA older adults by conducting: (1) secondary data analyses from two studies to quantify patterns of opioid and cannabis use, (2) a concept analysis to delineate the concept of CPM, and (3) developing data-driven model cases for CPM. Study 1 was a cross-sectional survey with 110 AA adults (age 50 and older) in Louisiana, and study 2 was observational with 72 AA adults (age 55 and older) in Florida with self-reported osteoarthritis. Both samples were primarily women, 79-81% respectively. Only 33% and 1.3% reported using opioid analgesics, while less than 4% in both studies reported using medical or recreational cannabis. Using Walker and Avant’s concept analysis approach, the (A) attributes of CPM include lower side effect profile and social acceptability; (B) antecedents include chronic pain, motivation to seek alternative treatment, access to cannabis dispensaries, family and professional support, and health literacy; and (C) the consequences are pain relief, lower mortality, self-efficacy, reduced anxiety, and empowerment. Lastly, based on our quantitative and qualitative data, we developed two model cases demonstrating support for and against CPM. These results illuminate the need to further understand the barriers and facilitators to using opioids and CPM in older AAs.
ASSESSING FRAILTY USING THE FIT-FRAILTY APP IN A NONGERIATRIC PRACTICE: A FEASIBILITY STUDY
Authors: Kouroukis Alexa , Tariq Suleman , Adachi Jonathan , Ioannidis George , Kennedy Courtney , Leckie Carolyn , Papaioannou Alexandra , Rodrigues Isabel
Published: December 2023

Frailty is a common medical condition with a prevalence of 24% in adults ≥50 years when using the Frailty Index. Thus, assessing frailty is a priority. The Fit-Frailty Application (App) is a user-friendly and validated measure that incorporates disease-related, physical, cognitive, psychosocial, and functional aspects of frailty. The purpose of this study was to determine the feasibility of using the App in a non-geriatric clinic. We conducted a cross-sectional study in a rheumatology clinic in Hamilton, Ontario. We included participants ≥50 years with osteoporosis who understood English or attended with a caregiver. Our primary outcome was feasibility defined by recruitment rate (criteria for success 90%), length of time to complete the App by a non-healthcare professional (≤15 minutes), and safety/challenges of using the App. Our secondary outcome was to conduct an exploratory analysis between osteoporosis management (osteoporosis medication, vitamin D and calcium) and total Fit-Frailty score. Thirty participants were approached during a routine clinic visit and 25 agreed to participate (mean age 72.2±11.2; 88% female; 44% had higher education). The mean Fit-Frailty score was 0.24±0.14; scores ≥0.25 indicate frailty. Five chose not to participate citing other time commitments. The mean time to complete the App was 15.48±6.6 minutes with no adverse events. Challenges included the need for a private room and space to perform the gait assessment. We found no association between osteoporosis management and Fit-Frailty score (p>0.05). Despite not meeting our feasibility criterion for recruitment, the App was a feasible tool to measure frailty in a non-geriatric clinic.
COMPAS: AN APP TO PROMOTE PERSON-CENTERED COMMUNICATION BETWEEN PEOPLE LIVING WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Delacourt Barbara , le Masson-Trottier Michè , Dubuc Jade , Dubé Catherine , Ansaldo Ana Inés
Published: December 2023

Introduction

People living with dementia (PWD) experience communication deficits as soon as the early stages of the diseases, deficits which significantly increase over time. In the last stages, constant communication breakdowns lead to reduced exchanges with caregivers, resulting in the isolation of both communication partners. These difficulties have negative impacts on the quality of life of PWD and their caregivers, who themselves face increasing burden. While communication difficulties in PWD are a core issue in care, few interventions to address this issue have been developed. Aims: The present study focused on COMPAs, an app designed to sustain communication between PWD and their caregivers. COMPAS has been shown to trigger emotional communication during the short co-viewing of personalized audiovisual material. Method: This was a pre-post intervention study with COMPAs in 2 long-term care centers. Seventeen caregivers used COMPAs in the context of daily routines over eight weeks with seventeen PWD. Data collection included specific questionnaires and semi-structured interviews to measure effects on communication and caregiver burden. Data analyses combined quantitative and qualitative approaches.

Results

In caregivers, there was a significant improvement in personal achievement at work. Semi-structured interviews showed an improvement in communication in the dyad and a more empathetic approach to caregiving.

Discussion

These results indicate that the communication triggered by COMPAs breaks down communication barriers, by creating positive exchanges through personalized emotionally driven exchanges, while stimulating empathy and personalized interventions. Caregivers see COMPAs as an ecological tool to address communication barriers, while facilitating an empathetic caregiving relationship.
DATA ANALYTICS FOR HEALTH-RELEVANT EVENTS DETECTION BASED UPON LONGITUDINAL FITBIT HEART RATE DATA
Authors: Dharangutte Prathamesh , Gao Jie , Schoenfeld Elinor , Xie Zongxing , Hua Yindong , Ye Fan
Published: December 2023

The increasing prevalence of wearable devices enables low-cost, long-term collection of health relevant data such as heart rate, exercise, and sleep signals. Currently these data are used to monitor short term changes with limited interpretation of their relevance to health. These data provide an untapped resource to monitor daily and long-term activity patterns. Changes and trends identified from such data can provide insights and guidance to the management of many chronic conditions that change over time. In this study we conducted a machine learning based analysis of longitudinal heart rate data collected over multiple years from Fitbit devices. We built a multi-resolutional pipeline for time series analysis, using model-free clustering methods inspired by statistical conformal prediction framework. With this method, we were able to detect health relevant events, their interesting patterns (e.g., daily routines, seasonal differences, and anomalies), and correlations to acute and chronic changes in health conditions. We present the results, lessons, and insights learned, and how to address the challenge of lack of labels. The study confirms the value of long-term heart rate data for health monitoring and surveillance, as complementary to extensive yet intermittent examinations by health care providers.
FEASIBILITY AND VALIDITY OF WEARABLE TECHNOLOGY FOR ASSESSING MOBILITY AMONG HOSPITALIZED OLDER ADULTS
Authors: Nascimento Paulo Roberto Carvalho do , Kirkwood Renata , Duong Mylinh , Griffith Lauren , Beauchamp Marla
Published: December 2023

The need for strategies to promote mobility during acute care hospital stays among older adults is increasingly recognized. Wearable technologies show great potential for this purpose. The objective of this study was to determine the most accurate wearable sensor device and location for capturing in-hospital mobility in older patients. Twenty-five older adults (79.6±8.1 years) admitted to a hospital medical care unit volunteered to test the feasibility and concurrent validity of the ActiGraph wGT3X-BT, Mox1, MetaMotionC and Fitbit Versa. All 25 enrolled patients wore the devices simultaneously on the wrist, hip, and ankle while undertaking a mobility activity protocol consisting of supine lying, sitting, and standing tasks. Participants also performed the Timed Up and Go (TUG) and 10-meter walk test (10MWT) wearing the devices. A trained physiotherapist supervised the performance of the tasks. Most participants (58%) preferred to wear the device on the ankle. Overall, the ActiGraph and Mox1 were the easiest to set up and download. The ActiGraph was the most reliable device, retrieving 100% of the collected data. Regarding body posture, the thigh-worn ActiGraph algorithm accurately classified 78% of sitting and lying postures, as well as 84% of standing postures, indicating high overall accuracy. After implementing the recommended low-frequency filter extension for slower gait speeds, the ankle-worn ActiGraph showed the narrowest limits of agreement and observations closer to zero for step count during the TUG and the 10MWT. These findings lay the foundation for subsequent work to validate wearable devices for monitoring “free-living” mobility in this population.
DUAL SENSORY LOSS AND COGNITIVE TEST PERFORMANCE IN OLDER ADULTS IN INDIA
Authors: Wang Ethan , Deal Jennifer
Published: December 2023

Dementia is rising in the global population, especially in low- and middle-income countries like India. Hearing and vision loss are risk factors for cognitive decline/dementia, but studies have primarily been in high income countries. This study aims to investigate the association between dual sensory loss and cognitive function with specific domains among the older Indian population. Data was from the 2017-2019 Wave 1 of the population-based Longitudinal Aging Study in India. The analysis sample consists of 27,975 individuals aged 60 years and older in 35 states and union territories. Dual sensory loss was determined by respondents’ self-reported, perceived difficulty regarding hearing and vision function. Linear regression was used to model associations of dual sensory loss with global cognitive performance, summarized as a z-score, and in the domains of memory, orientation, arithmetic, and executive function, adjusted for demographics and health characteristics. Overall, 5.9% had hearing loss, 24.1% had vision loss, and 3.4% had both. In fully adjusted models, hearing loss only, vision loss only, and dual sensory loss were associated with a change of -0.08 (95%CI: -0.1, -0.04), -0.11 (95%CI: -0.12, -0.09), and -0.22 (95%CI: -0.27, -0.18) standard deviations, respectively. Associations were also observed for all domains. Poor hearing and/or vision loss is associated with lower cognitive performance across various cognitive domains in older adults in India. The association was strongest for those with dual sensory loss. Rehabilitative interventions for hearing and vision may be an additional resource in reducing dementia risk in India.
PREVALENCE OF DEMENTIA AND COGNITIVE IMPAIRMENT IN PUBLIC SENIOR HOUSINGS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Park Soobin , Amano Takashi , Park Sojung , Kim BoRin
Published: December 2023

Older residents in public housing represent a particularly vulnerable population at risk for cognitive decline due to their disadvantaged socioeconomic and health-related characteristics which are well-known risk factors of dementia. This study aims to synthesize available evidence regarding the prevalence of dementia and cognitive impairment among public senior housing residents. We conducted a literature search for studies published in English in the following databases: PsychInfo, PubMed, MEDLINE, CINAHL, and The Cochrane Library. We focused on observational studies about residents of public senior housings that reported prevalence and/or incidence of dementia and/or cognitive impairment screened by assessment tools for detecting dementia equivalent cognitive impairment. A total of ten studies were included for a meta-analysis to estimate the overall prevalence of cognitive impairment and dementia. Seven of ten studies utilized screening tools to detect dementia equivalent cognitive impairment. Overall pooled prevalence of cognitive impairment or dementia was 20.4% (95%CI: 14.1-27.5). The subgroup analyses revealed the pooled prevalence of cognitive impairment among residents of public senior housing was 25.5% (95%CI: 22.0-29.1) and pooled prevalence of dementia was 13.5% (95%CI: 8.3-19.7). The subgroup findings suggest the prevalence of dementia may be higher among residents of public senior housing compared to their peers in non-public housing. Also, this population may be particularly susceptible to an unrecognized or delayed diagnosis of dementia due to the lack of formal detection strategies in public senior housing. More resources should be allocated for detection to ensure better support the residents.
FAMILY CAREGIVERS AT WORK: THE RELATIONSHIP BETWEEN WORK PRODUCTIVITY LOSS AND WORKPLACE SUPPORTIVE MEASURES
Authors: Milnamow Mary , Bakk Louanne
Published: December 2023

Background

Employment and economic security remain elusive for the majority of working family caregivers, especially for caregivers for older adults with complex health problems. Family paid leave remains unattainable in the United States requiring caregivers to work while providing critical support to older adults making them vulnerable for unemployment and financial hardships. While caregivers experience higher rates of absenteeism and presenteeism at work compared to their non-caregiving counterparts, research pertaining to the impact of supportive measures in the workplace is relatively unknown.

Methods

This exploratory, cross-sectional study examined 1) the relationship between supportive workplace measures (i.e., employment stability, flexible work schedules), and productivity loss, absenteeism and presenteeism; and 2) the relationship between caregiver characteristics (i.e., traditional versus non-traditional) and supportive workplace measures, productivity loss, absenteeism, and presenteeism. Data from 2017 (n=2,652) and 2020 (n=1,938) waves of the National Survey of Caregivers (NSOC) were analyzed using the validated WPAI-CG measure.

Results

Bivariate findings suggest an association between workplace flexibility and productivity loss (p<.001), absenteeism (p<.001), and presenteeism (p<.001); caregivers with flexible hours had greater productivity loss, absenteeism, and presenteeism compared to caregivers without flexible hours. Additionally, caregivers in traditional dyads reported higher work productivity loss (p<.001) and presenteeism (p<.001) compared to non-traditional dyads.

Conclusions

Findings suggest flexible hours may not adequately address workplace issues experienced by family caregivers for older adults. As the number of older adults increases over the next decade, greater understanding of the best way to decrease work challenges for diverse caregivers is critical.
INFORMAL CAREGIVING EXPERIENCES: CHALLENGES AND OPPORTUNITIES FOR AN AGE-FRIENDLY UNIVERSITY
Authors: Cannon Melissa , Johnson C J , Winters Emily
Published: December 2023

The growing Age-Friendly University (AFU) global network has been helping its members assess their institutions and identify action items for increasing age-friendliness. This research investigates one of the issues identified through previous assessment of an AFU as a weakness and area of opportunity, which is the lack of resources and information for campus community members who identify as informal or unpaid family caregivers. Data from N = 70 campus members (26% faculty, 18% staff, 56% students; 84% female, 16% male) were collected in early 2023 through a campus-wide online survey and analyzed by a team of researchers using quantitative analysis for responses to Likert-type items and thematic analysis for open-ended responses. Issues around physical demands, time demands, financial stress, and social and emotional health while caregiving were assessed. Results indicated that respondents are experiencing different types of stress and need additional support and resources as caregivers, particularly related to respite care, mental health services, financial support, and assistance with physical tasks such as housework and transportation. The findings from this research will be used to develop and share resources around caregiving broadly across the university campus, and to ensure that resources are culturally inclusive, particularly as nearly 25% of the enrollment of undergraduate full-time equivalent students is composed of students from a Hispanic/Latinx background. Findings will also be used to establish community partnerships to harness resources from outside the university, and ultimately to help support the campus community moving forward and to achieve a piece of the university’s AFU vision.
THE ROLE OF TRUST FOR DEMOGRAPHIC VARIABILITY IN VACCINE HESITANCY AND BEHAVIORS AMONG OLDER ADULTS
Authors: Huseth-Zosel Andrea , Fuller Heather , Hajdar Melisa , Kinkade Emily , Carson Paul
Published: December 2023

Because of increased risks of infectious disease, understanding older adults’ decisions related to trust and reception of vaccines is important. This study examines the associations between demographic characteristics, vaccine hesitancy, compliance, and the potential mediating role of uncertainty of who to trust. Seven hundred and thirty-nine older adults in North Dakota, oversampled from rural and lower vaccinated regions, completed a mailed survey about vaccine beliefs and behaviors. Participants reported demographic characteristics (age, gender, years of education, rurality, political ideology, and self-perceived physical health) and answered a 7-item scale of vaccine hesitancy. Vaccination behaviors were measured with an assessment of overall vaccine compliance, as well as measures of uptake for influenza, shingles, pneumonia, and SARS-CoV-2 immunizations. Uncertainty who to trust was assessed with the single-item “I am not sure who to trust when it comes to information about vaccines”, which was rated from Strongly Agree (4) to Strongly Disagree (1) and used as a mediator. Bootstrapping analyses indicated uncertainty of who to trust partially or fully mediated associations of rurality, education level, and political leaning with vaccine hesitancy. Further, trust partially or fully mediated associations of education level, health, and political leaning with vaccine behaviors; however, trust did not account for the association between vaccine hesitancy and behaviors. Findings highlight demographic variations in older adults’ vaccine beliefs and behaviors that may be partially explained due to uncertainty who to trust, indicating that practitioners should implement education and trust-building interventions, especially with rural-dwelling, conservative-leaning, and lower-educated older adults.
AN UNEQUAL WORK ENVIRONMENT: NURSING HOME STAFF PERCEPTIONS OF UNIT ORGANIZATIONAL CONTEXT
Authors: Iaconi Alba , Tate Kaitlyn , Penconek Tatiana , Duan Yinfei , Saeidzadeh Seyedehtanaz , Cummings Greta , Norton Peter , Estabrooks Carole
Published: December 2023

The organizational context in nursing homes is associated with quality of care and residents’ quality of life. Our objective was to examine nursing home staff perceptions of unit organizational context. We conducted a secondary analysis of cross-sectional data. Participants were 3765 unregulated (health care aides (HCAs)) and 1130 regulated staff (managers, registered nurses, registered psychiatric nurses (RN/RPNs) and licensed practical nurses (LPNs)) from 91 nursing homes in Western Canada. We measured nursing home staff’s perceptions of organizational context via the Alberta Context Tool (ACT), comprised of ten concepts: leadership, culture, evaluation, social capital, formal interactions, informal interactions, organizational slack (staff, space, time). Differences between groups were examined via one-way ANOVA. Managers reported significantly higher organizational context scores compared to all other staff members in care homes, followed by RN/RPNs. LPNs and HCAs reported the lowest scores. Specifically, LPNs reported the lowest scores on all organizational context measures except for structural resources and organizational slack space, for which HCAs reported the lowest scores. HCAs reported higher scores than LPNs on unit leadership, culture, evaluation, social capital. When compared with managers and RN/RPNs in the nursing home, LPNs reported the lowest SF-8 mental health scores (49.30 (10.05)) and HCAs reported the lowest physical health scores (48.53 (8.16)). Our work demonstrates the need for improvement of staffing and time for staff in nursing homes. Specific attention is needed to focus on modifiable organizational unit context factors for LPNs and HCAs, who are responsible for providing the majority of the direct care for residents.
FACTORS ASSOCIATED WITH SERVICE UTILIZATION AMONG OLDER ADULTS WITH FUNCTIONAL OR COGNITIVE IMPAIRMENT
Authors: Choi Yeon Jin , Aranda Maria , Ailshire Jennifer
Published: December 2023

Social services (e.g., senior centers, adult day care centers) and home health services (e.g., in-home personal care, visiting nurses) have been found to provide numerous benefits, such as opportunities for social interaction, physical activity, cognitive stimulation, as well as personal care and regular medical check-ups for older adults. These services may have greater positive impacts among older adults with disabilities or impairments given their limited mobility and reduced capacities to perform daily tasks. However, as most previous studies have focused on the general population, our understanding of factors associated with service utilization among those with disabilities or impairments is limited. This study examined individual characteristics associated with social and home health service utilization among older adults with functional limitations or cognitive impairments using data from the Health and Retirement Study. Results from logistic regression models suggest that older age and being not married were positively associated with utilization of both social and home health services, while being foreign-born was negatively associated with the outcomes, adjusting for sociodemographic characteristics. Respondents with higher educational attainment tend to use social services more and are less likely to use home health services than those with less than a high school education. Rural residence was negatively associated with the utilization of social services, but not with home health services. Providing information on available services and enhancing access by increasing the number of service providers, transportation options, and financial assistance would promote utilization of supportive services among older adults with functional limitations and cognitive impairments.
IDENTIFYING EFFORTS AND CHALLENGES OF MARKETING THE DEPARTMENT OF VETERANS AFFAIRS MEDICAL FOSTER HOME PROGRAM
Authors: Haverhals Leah , Manheim Chelsea , Nunnery Mary , Levy Cari
Published: December 2023

The United States (US) Department of Veterans Affairs (VA) Medical Foster Home (MFH) program is a long-term care (LTC) option for Veterans needing nursing home-level care. In the MFH program, Veterans live in the home of a community-based caregiver who has been recruited and screened by VA staff. Since 2016, VA Offices of Rural Health and Geriatrics and Extended Care has expanded the program, and by 2026 the VA plans to have programs at every VA Medical Center. To describe current efforts to market the MFH program, we conducted a national survey of MFH staff between Dec. 2, 2021-Jan. 6, 2022. We sent invitations via email, including a website link to the survey. N=94 completed the survey. Three team members analyzed open-ended data, using an inductive and deductive approach to thematic analysis. Findings revealed that external marketing strategies primarily focused on recruiting appropriate caregivers. Efforts included in-person presentations to community groups, utilizing local media outlets, manning booths at local health and job fairs, and providing written materials about the program. Internal marketing efforts included approaching many different VA departments including inpatient social workers, case managers, and discharge planners to identify Veterans for the program, and holding in-service presentations. Challenges included MFH coordinators having minimal time to market the program and receiving inconsistent support from the VA Public Affairs Office depending on location. Findings will inform expansion of the MFH program, which is paramount as the demand for LTC increases concurrently with the aging Veteran population.
PROMOTING CO-WORKER RELATIONSHIPS IN LONG-TERM CARE FACILITIES: A SYSTEMATIC REVIEW OF THE LITERATURE
Authors: Haunch Kirsty
Published: December 2023

Introduction

Co-worker relationships in long-term care settings are important. The work is physically and emotionally demanding. A largely unregistered workforce with variable preparation and training are expected to provide complex care to the most vulnerable members of society, with little external support. Often staff only have each other to rely on. Current evidence lacks insight into how co-worker relationships are established and what influences them. The aim of the review was to synthesise what is known about co-worker relationships more widely and its applicability to long-term care.

Methods

A systematic review identified, evaluated, and synthesised published evidence associated with co-worker relationships in health and social care settings. PRISMA guidelines were followed. The COM-B model was used to identify key behaviours and associated triggers of co-worker relationships.

Results

37 papers were included. The majority of studies were conducted in the US (n=23), used descriptive study designs (n=30) and were in a hospital setting (n=29). Interdependent organisational and individual factors suggest co-worker relationships occur when staff are ‘able’ (have the social skills), are ‘willing’ (have the right values) and are ‘supported’ (effective leadership).

Discussion

To date the focus has been on the ‘willingness’ of people and the ‘support’ they receive. Paying attention, the ‘ability’ (the social skills), which can be taught, is of equal, if not more importance. Social skills enable staff to navigate difficult and complex situations that arise, which preserves, and in some cases strengthens relationships. Social skills are particularly important when leadership is poor.
SEEKING ANSWERS FOR UNCERTAINTIES: GATHERING AND ORGANIZING CARE HOME UNCERTAINTIES: THE SEARCH U STUDY
Authors: Devi Reena , Haunch Kirsty , Graham Liz , Spilsbury Karen , Forster Anne , Griffiths Alys , Thompson Carl
Published: December 2023

Introduction and method

Staff providing care to residents must manage uncertainties whilst using their judgement and making decisions about care. Residents and their relatives may also have questions and ideas about how care could be improved. It is important to capture uncertainties/questions and work on addressing these. We gathered uncertainties/questions from residents, relatives and staff before, and during COVID-19 through interviews, analysis of a COVID-19 WhatsApp discussion group for long-term-care (LTC), and a systematic literature review.

Results

Questions and uncertainties gathered were categorised into 21 themes: 1. Direct care (personal care, sleep, care planning, medication management, nutrition) 2. Physical environment (safety, mobility, infection risk) 3. Mental health/well-being (relationships, socialising and meaningful activities, spirituality) 4. Resident individuality and dignity 5. End-of-life 6. Quality of work for care staff (reward and recognition, training and career opportunities, well-being, shift flexibility, workload) 7. Staff shortages 8. Promoting staff diversity 9. Care home interaction with wider healthcare services 10. Use of technology 11. Family engagement and communication with staff 12. COVID-19-related anxiety 13. Financial support with care home costs 14. Care homes and climate change and future sustainability 15. Valuing the contribution of care homes 16. Infection prevention control 17. Visiting care homes during COVID-19 18. COVID-19 safety for residents and staff 19. COVID-19 and the individual (symptoms and treatment) 20. Organisational impact of COVID-19 21. Information sharing and learning from COVID-19.

Discussion

With LTC staff, residents and relatives the identified uncertainties/questions will be shortlisted; the prioritised list will direct future research.
>ADVOCATING FOR ENGINEERING SOLUTIONS TO IMPROVE OLDER ADULT DRIVING LONGEVITY
Authors: Dickerson Anne
Published: December 2023

To age-in-place, older adults need to access their community. As most older adults live in suburban/rural areas, driving is the primary and preferred means of mobility. While recent research has shown that drivers in the seventies have fewer crashes than middle-aged drivers, it is likely due to less exposure. However, it demonstrates that driving decisions need to be based on function, not age. Moreover, with the aging population and increase numbers of older adults with cognitive impairment and/or slowed processing speed, other strategies are needed to preserve and lengthen the driving lifetime. While efforts for developing alternative transportation options are working in some places, rural areas lack the infrastructure and potential for public transportation or volunteer programs beyond medical necessity. This presentation will present some roadway engineering proven countermeasures and community strategies that can protect and benefit aging drivers so they can drive longer while reducing crash risk. Stepping outside the typical gerontological community, this presenter became a contributing member of their state’s highway safety five-year plan. As an older driver advocate, I was successful in achieving older adults as an “emphasis” area in the present plan. For the next five-year plan, researching engineering solutions was deemed essential to advocate for specific strategies that protect both aging drivers and pedestrians. Since every state is required have a five-year plan for highway safety to receive federal funding, the presenter will outline successful strategies to participate in innovative ways for improving safety such as influencing engineering and department of motor vehicles partners.
PERSPECTIVES ON TECHNOLOGY ADOPTION AMONG SPANISH-SPEAKING HISPANIC ADULTS AGE 60+
Authors: Navarro Sheila Salinas , Lomeli Sindy , Estenson Lilly , Wilber Kathleen
Published: December 2023

By 2060, Hispanics aged 65+ are projected to be 21% (19.9 million) of the total US age 65+ population. Despite the benefits of technology use, such as facilitating social engagement and access to health services, few studies have explored attitudes of older Spanish-Speaking Hispanic adults toward technology adoption. In this secondary analysis of a larger diverse study of attitudes toward technology, we reviewed audio recordings and transcripts of Spanish-language interviews and focus groups with adults ages 63-89. Participants (n=21) self-identified as Hispanic, 67% had less than a high school education, and almost half (n=10) lived alone. Connecting with family members abroad was the primary motivator and a “necessity” for using technology; excess use of a device was negative. As one participant stated: “Technology brings you closer to those far away and pushes you away from those near you.” Those without relatives living with or near them reported greater difficulty using technology and identified living alone as a barrier to adoption. Finally, although the sample had low levels of English proficiency and low educational attainment, characteristics associated with lower use and knowledge of technology, findings challenge stereotypes that these older adults lack the capacity or interest to adopt the technology. Rather, the study identified multiple social factors that may hinder adoption. Understanding these cultural and linguistic barriers is important to promote digital inclusion; overcoming the digital divide will involve more than providing free tablets or classes. It will also require addressing barriers with adequate, culturally competent understanding, training and support.
A LIFESPAN DEVELOPMENTAL ANALYSIS OF RECIPROCAL RELATIONS BETWEEN HEAVY DRINKING AND SLEEP PROBLEMS
Authors: Bowlby Douglas
Published: December 2023

In recent years, numerous studies have begun to explore the ways in which problem drinking behavior is affected by different lifespan developmental changes. However, while there currently exists a plethora of research on adolescence and young adulthood, there is far less research with midlife and older adults examining lifespan developmental changes and problem drinking. As part of larger NIAAA-funded project investigating aging, health, and alcohol use, the current study investigated cross-sectional and longitudinal associations among heavy drinking and sleep problems in a sample of midlife and older adults. One particularly noteworthy analysis used path analysis in Mplus to test a longitudinal moderated mediation model involving sleep problems, sleep-related motives for drinking, and heavy drinking. Results showed an interaction between sleep problems and sleep-related drinking motives. Interestingly, sleep problems appear to significantly reduce the risk for heavy drinking among most participants. However, when combined with high sleep-related drinking motives, sleep problems appear to significantly increase risk for heavy drinking. This phenomenon may help explain the occasionally contradictory results found in previous studies examining the impact of sleep disturbances on drinking behavior and may prove to be an area worth investigating in future studies. From a lifespan-developmental perspective, these findings highlight how there are likely important differences across stages of adulthood in the most relevant factors that affect heavy drinking. Health-related factors including sleep problems, coupled with motives to use alcohol to cope with such problems, appear to be a pathway to heavy drinking that increases in importance across the adult lifespan.
ELDER ABUSE, ANXIETY, AND SOCIAL SUPPORT: DOES GENDER MATTER?
Authors: Yoon Sukyung
Published: December 2023

Elder abuse is a serious social justice violation and a public health concern that impacts victims’ mental and physical health worldwide. In the U.S., about 11.7% of older adults have reported elder abuse each year, but the rate is underestimated due to underreporting (Dong, 2015). To date, research on elder abuse has focused mostly on risk factors rather than protective factors (Storey, 2020). Some risk factors are beyond one’s control, such as physical and cognitive dysfunctions, but identifying both risk and protective factors will help healthcare professionals intervene more effectively (Yoon & Cummings, 2019). The research aims were to investigate 1) the impact of elder abuse on anxiety among community-dwelling older adults who experienced elder abuse, 2) the effects of social support on anxiety among older adults, and 3) the differences in the impact of elder abuse, anxiety, and social support between older men and women. This study used data from the Wisconsin Longitudinal Study (WLS), Wave 3. Structured equation modeling was used for the analysis. The independent variable was the experience of elder abuse, the dependent variable was anxiety, and the intervening variable was social support. The control variables were income, physical health, and marital status. The experience of elder abuse had a positive association with anxiety, however; social support had a negative association with anxiety. Multi-group analysis was conducted to investigate gender differences. Measurement invariance was examined by comparing unconstrained and fully constrained models. Both models were good fits. Gender differences were identified. Implications will be discussed.
INTERGENERATIONAL REMINISCENCE PROGRAM IN IMPROVING GENERATION CONNECTIONS: A RADAR ANALYSIS
Authors: Xu Ling , Raval Minjaal
Published: December 2023

Objectives

Intergenerational solidarity between grandparents and grandchildren has been highlighted in Asian Families and it is beneficial for the health of grandparents. An intergenerational reminiscence program was developed to improve the well-being of Asian American older adults as well as generational bonding. This paper qualitatively reported the weekly reflection from grandchild participants of this program.

Methods

Older grandparents received 6 sessions of life-review with their grandchildren remotely or in person for approximately 1 hour each week for 6 weeks. Each grandchild (n = 12) provided written reflection each week after talking with grandparent. The qualitative data were organized and analyzed using the five phases of the Rigorous and Accelerated Data Reduction (RADaR) technique.

Results

Results showed three categories with themes. Category 1: Positive experience. The grandchildren expressed: (1) more connection with grandparent, (2) learn more about grandparent’s past life experience, and (3) have more engagement. Category 2: Strategy to lead the discussion. The grandchildren thought the following good ways in facilitating their weekly conversation with grandparents: (1) taking notes, (2) using guiding question in the manual; (3) use translators, (4) spending time together. Category 3: Challenging experience. The grandchildren felt challenges regarding: (1) over explaining things, (2) language or vocabulary barriers, (3) broad topic.

Discussion

The reflection pages from grandchild participants showed that intergenerational reminiscence program is promising in bonding the grandparent-grandchild relationship and connection. They also gained knowledge and experienced challenges when talking with their grandparents during the program.
MEDICARE ADVANTAGE (MA) PLAN CHARACTERISTICS ON PHYSICAL AND MENTAL HEALTH OUTCOMES OF MA BENEFICIARIES
Authors: Basu Rashmita
Published: December 2023

With growing demands for better and cost-effective care delivery by Medicare Advantage (MA) plans, comparison of self-reported health outcomes is more important because those outcomes capture patients’ experiences and perspectives. The purpose of the study is to examine the characteristics of MA plans on Medicare beneficiaries’ physical and mental health status.

Methods: I used the Medicare Health Outcomes (HOS) survey, a random sample of Medicare beneficiaries surveyed from each MA plan with a minimum of 500 enrollees conducted by the CMS. The current study included 3 baseline cohorts from 2015 (n=195,800), 2016 (n=178,973), and 2017 (n=172,047). I used physical component summary (PCS) and mental component summary (MCS) scores as two outcomes which include various domains of physical (exercise, pain, activity limitation) and mental health (social functioning, emotional status, depression) status. Plan characteristics include plan ownership status (for-profit (FP) vs. not-for-profit (NFP), plan types (PPO vs. HMO/cost contract), and the number of plan members. I used the linear regression method with clustering at the plan contract level due to the correlation of multiple beneficiaries within the same plan.

Results: Adjusted for beneficiary level characteristics, beneficiaries in PPO plans experienced greater physical and mental health scores than HMO or cost contract plans. MA plan with less than 5k beneficiaries is associated with a lower physical health score than plans with more than 100k beneficiaries. For-profit ownership was significantly associated with lower mental health scores.

Discussion: The characteristics of MA plan insurers are important factors for beneficiaries’ enrollment decisions and quality improvement efforts.
RELATIONSHIP BETWEEN SOCIAL PROBLEM-SOLVING SKILLS AND CAREGIVER BURDEN AMONG DEMENTIA CARE PARTNERS
Authors: Kew Chung Lin (Novelle) , Smith Matthew , Han Gang , Wright Brittany , Holland Alexandra , Khera Alka , Wilmoth Kristin , Juengst Shannon
Published: December 2023

Background

This study examined the extent to which social problem-solving abilities, care situations, and depressive symptomatology were associated with caregiver burden among care partners of adults with Alzheimer’s Disease and Related Dementias (ADRD).

Methods

Baseline survey data were analyzed from care partners of ADRD who participated in a larger state-funded study. We used validated measures to assess social problem-solving abilities, care situation, positive aspects of caregiving, depressive symptomatology, and caregiver burden. Multivariate regression analysis with backward stepwise entry was used to identify factors associated with caregiver burden.

Results

Care partners were, on average, age 60.4 (±12.4) and most were female (82.5%) and lived with their care recipient (69.1%). Care partners who reported high caregiver burden were more likely to be male (p< 0.0001) and have a positive problem-solving orientation (p=0.0002), but less likely to have a negative problem-solving orientation (p=0.0376). Higher caregiver burden was also associated with more resentment for caregiving role (p< 0.0001), more anger towards care recipients (p< 0.0001), more depressive symptomology (p< 0.0001), and higher positive aspects of caregiving (p=0.0010). Care partners who reported high caregiver burden also reported less social support (p=0.0076) and less family conflict (p=0.0159).

Discussion

Findings suggest that factors thought to be protective against caregiver burden may not sufficiently reduce caregiver burden when considering their feelings of resentment and anger towards their care recipient, limited perceived social support, and high depressive symptomology. Interventions to reduce caregiver burden must consider care partners’ internal conflict as a caregiver and the relationship between the care partner and their care recipient.
THE IMPACT OF CLOSING MEDICARE PART D COVERAGE GAP ON MENTAL HEALTH OF OLDER ADULTS
Authors: Gai Junjie , Arora Kanika
Published: December 2023

The ACA mandated the gradual elimination of the Medicare prescription drug coverage gap (also called the “Doughnut Hole”) beginning in 2011. This policy change can impact mental health through mechanisms such as reduction in out-of-pocket (OOP) expenses and increased access to prescription medication. However, no previous study has examined its impact on mental health outcomes of older adults on Medicare. Employing data from the Medical Expenditure Panel Survey (from 2006 to 2016), compare the mental health of Medicare beneficiaries (66-70 years; N=7,664) with that of non-Medicare beneficiaries (60-64 years; N=8,079) before versus after policy implementation. We find that the 2011 phasing out of Medicare drug coverage gap was associated with 0.86-point (p< 0.05) improvement in the Mental Component score of the Short-Form 12 Health Survey among beneficiaries. Our analysis was robust to using alternate measures of mental health outcomes (Kessler Index and PHQ-2) as well as to an alternate construction of treatment and control groups (comparing individuals aged 60-70 years on Medicare and private insurance). We find no detectable differences in the mental health of Medicare beneficiaries who already receive subsidies for costs associated with the coverage gap through the Low Income Subsidy (LIS) program. Further, we find that elimination of the doughnut hole reduced OOP expenses by $32.65 among Medicare beneficiaries in our sample. Overall, our results for mental health and OOP expenses are mainly attributable to women. This evidence highlights indirect effects of drug coverage gap elimination on mental health outcomes among Medicare beneficiaries.
THE POTENTIAL BENEFITS OF COMPANION ROBOTIC PETS ON THE QUALITY OF LIFE AMONG COMMUNITY-DWELLING OLDER WOMEN
Authors: Kang Suk-Young , Kim Jeungkun , Poplawski Antonina
Published: December 2023

This project explores whether companion robotic pets improve mental well-being of community-dwelling older women with depression. Depression is a major mental health issue disproportionately impacting women due to lifelong experiences of sexism and limitations in education and employment. Aging exacerbates an already undervalued status, and feelings of powerlessness increase. Women thus experience double jeopardy from discrimination on both gender and age (Hooyman et al., 2017). This project will investigate the efficacy of companion robotic pets and will recommend plans to the local Office for Aging (OFA). Recruitment was done in collaboration with the local OFA, with mail-survey data collected from community-dwelling women over the age of 65. 38 participants were provided with a robotic pet after an initial screening. Following a one-group pretest posttest design, data from 31 participants were used to determine the impact of a robotic pet intervention on older women’s quality of life. Paired samples t-tests were used to compare means of the 15-item Geriatric Depression Scale (GDS), 10-item Geriatric Anxiety Scale (GAS), 6-item De Jong Loneliness Scale, and one physical health status question completed by 30 women. There was a significant average difference between before- and after-companion pet scores for depression (t29 = 6.597, p < 0.001), anxiety (t29 = 6.728, p < 0.001), loneliness (t29 = 6.462, p < 0.001) and physical health (t29 = - 3.496, p = 0.002). Results confirmed companion robotic pets improve mental health in older women with depression and anxiety. Moreover, they are helpful in improving loneliness and physical health.
VOLUNTEERING, DISCRIMINATION, AND DEPRESSION IN OLD AGE: DOES THE FORM OF DISCRIMINATION PLAY A ROLE?
Authors: Shen Huei-wern
Published: December 2023

Older adults experiencing discrimination have an increased risk of poor mental health, such as depression. Discrimination could happen based on age, race, gender, sexual orientation, or other factors but the effects of experiencing different forms of discrimination on depression are unknown. Given the evidence that volunteering in old age promotes mental health, this study explores the relationship between volunteering and depressive symptoms among older adults who experience discrimination, and investigates whether such a relationship differs between those experiencing ageism and those experiencing other forms of discrimination. Using a subsample of respondents 65-96 years of age from the 2016 Health and Retirement Study, 1881 older adults who reported experiencing everyday discrimination were included. Discrimination was measured by the six-item Everyday Discrimination Scale. Among them, 955 respondents named age as the reason behind the discrimination experiences, and 926 named other forms (e.g. race). Controlling for health-related variables (e.g., ADLs/IADLs), SES (e.g., income), and sociodemographics (e.g., gender), findings from the weighted OLS regression models showed that volunteering (doing unpaid work for religious, educational, health-related, or other charitable organizations) related to lower depressive symptoms (8-item CES-D, P<.05). When looking at the groups who experienced different forms of discrimination, volunteering continued to have a negative relationship with depressive symptoms for older adults who experienced ageism (p<.01); however, such a relationship disappeared for the group experiencing other forms of discrimination. Discussions will target the importance of understanding the complicated relationships that may exist in volunteering, mental health, and the forms of discrimination that older adults experience.