bluuebunny/crossref_metadata_2025 huggingface dataset:
Cohort Differences and Similarities in Women's Attitudes About Self and Aging
Authors: Sherman Aurora , Bookwala Jamila
Published: December 2021

This panel focuses on four complementing and international views of women’s aging, with a special emphasis on cohort comparisons and using three different studies of women, with contrasting methodological frameworks. In so doing, we present evidence related to trends in social percepetions of aging, attitudes about aging and identity, and ideas about control and objectification. Dr. Newton presents data on older Canadian women showing the connection between physical aging and identity maintenance, using both qualitative and quantitative data and using the lifecourse perspective. Dr. Ryan, using data from the Health and Retirement Study to compare cohorts of women from the 2008 and 2018 HRS waves, reports cohort differences in negative self-perceptions of aging, and that both cohort and negative self-perfections are associated with life satisfaction, using the life course developmental framework. Ms. Tran compares younger and older cohorts of women on a measure of self-objectification, finding that the older cohort reported lower objectification, consistent with a selection, optimization, and compensation (SOC) model. Finally, Dr. Sherman, using the same data set as Ms. Tran, shows that control beliefs are associated with objectification, regardless of cohort, consistent with objectification theory predictions of consistency over time regarding the impact of objectification experiences. Dr. Jamila Bookwala will provide discussion of this group of papers.
Types of Late-Life Challenges to Aging in Place
Authors: Kim Kyeongmo
Published: December 2021

Many older adults prefer to live within their community because they have built strong relationships with their neighbors and neighborhood. Although housing-related factors promote aging in place, findings on the relationships of late-life challenges to aging in place (e.g., cost of living, autonomy) and relocation are mixed. Less is known about the types of challenges to aging in place and about the relationship between the types of challenges and relocation. Using data from the AARP 2015 Age-Friendly Community Surveys (N=3,190 adults aged 65 and older), this study examined the intersection of challenges to aging in place (e.g., home size, cost, safety, independence, family, transportation) and relocation (i.e., move to a different home outside of their community). Using latent class analysis (LCA), we identified five subgroups of late-life challenges to aging in place: multifaceted challenges, cost of living, independence, social connection, no concern. Findings from LCA with a distal outcome showed that older adults with multifaceted challenges (b=0.77, p<.001), were more likely to move out of their community, compared to those with lower levels of challenges, even after adjusting for age, sex, education, income, and chronic diseases. Also, those with challenges regarding the cost of living (b=0.84, p<.001), independence (b=0.64, p<.001), and family connection (b=0.45, p<.001) were more likely to expect to move out of their community. The findings highlight that older adults have different types of challenges to aging in place. Practitioners and policymakers should provide more individualized supportive services, considering the types of challenges to promote aging in place.
Ambulatory Assessment of Socio-Affective and Cognitive Aging: Zooming Into Daily Processes
Authors: Meier Tabea , Horn Andrea , Roecke Christina
Published: December 2021

Ambulatory assessment methods offer new possibilities to study cognitive, emotional, and social processes in the setting in which they naturally occur, namely in the daily life of individuals and couples. This allows to zoom into processes with great relevance for healthy aging and well-being over the lifespan. Research on daily psychological processes opens the door for investigating the interplay with contextual (daily stress, social resources) and stable factors (relationship quality status, accumulated discrimination) that are known to shape these dynamic processes. This symposium will present and discuss innovative contributions investigating daily emotional and cognitive functioning and their interplay with social and individual characteristics over the adult lifespan. The first study by Haas and colleagues will present experience sampling data on daily prospective memory performance in couples. Haas et al. will offer a dyadic perspective on cognitive functioning by examining how prospective memory performance is co-regulated in the daily lives of younger and older couples. Meier et al. will present another study from the same couples project; here the focus is on age differences in couples’ “we-ness” and its relationship with daily positive emotional experiences and how they are shared with the partner. The series of talks will be completed by Zavala et al. who examined associations between stress and emotional health in daily life and its interplay with prior discrimination experiences of an age-diverse sample of BIPOC adults. After these individual contributions, Christina Roecke will discuss the presented studies and provide her reflections on the results and their implications.
Age Differences in Personality Structure
Authors: Jackson Joshua , Condon David , Beck Emorie
Published: December 2021

Most investigations in the structure of personality traits do not adequately address age, as few studies look at the structure of personality traits a-theoretically, instead presupposing a theoretical structure e.g., Big Five. As a result, the relationship among indicators within a trait (coherence) are often highlighted but relationships across traits (differentiation) are not thoroughly examined. Using a large-scale sample of 369,151 individuals ranging in age from 14 to 90, the present study examines whether personality indicators show differential relationships as a function of age. Results indicate that coherence shows few changes across the lifespan, while differentiation weakens across adulthood into old age. These finding suggest that Big Five indicators only parallel the Big Five structure among young but not older adults. Thus, using standard Big Five personality trait assessments in older adults may, at best, not reflect reality and, at worse, undermine the predictive utility of personality traits.
COVID-19 Response In U.S. Assisted Living Settings: Key Stakeholder Perspectives
Authors: Dys Sarah , Winfree Jaclyn , Carder Paula , Zimmerman Sheryl , Thomas Kali
Published: December 2021

Unique regulatory requirements and scope of services within assisted living (AL) pose distinctive challenges to COVID-19 response. To identify COVID-19 issues specific to AL, we recruited stakeholders with expertise in AL operations, policy, practice, and research (n=42) to participate in remote interviews between July and September 2020. Using thematic analysis, we derived the following overarching themes: 1) Policymakers lack an understanding of the AL context; 2) AL administrators were left to coordinate guidelines with little support; 3) AL organizations faced limited knowledge of and disparate access to resources; 4) State-level regulatory requirements conflicted with COVID-19 guidelines resulting in confusion; and 5) AL operators struggled to balance public health priorities with promoting their residents’ wellbeing. To develop evidence-informed policy and avoid unintended consequences, AL operators, direct care workers, residents, and clinicians practicing in these settings should have opportunities to provide feedback through the policy development process, both state and national.
Building Friendships Through Volunteering in Late Life: Does Gender Moderate the Relationship?
Authors: Lim Emily , Peng Changmin , Burr Jeffrey
Published: December 2021

Friendship plays a crucial role in maintaining social connectedness in late life. Volunteering helps older adults to stay socially engaged and often times provides the opportunity to meet and make new friends. A small literature suggests that volunteering may be associated with friendship, but many studies are limited by reliance on small, non-probability samples and simplistic analytic approaches. The literature is also unclear on how volunteering behaviors relate to specific characteristics of friendships and whether there are gender differences that condition these relationships. Using the 2014 and 2018 waves of the Health and Retirement Study (N=1,638 ), we investigate whether volunteer status and hours volunteered in 2014 are associated with friendship characteristics in 2018 (i.e., number of close friends, friendship quality, and contact frequency) among community-dwelling adults aged 50 years and above (M=65.60 years old, SD=8.31). We also examine whether gender moderated these relationships. Volunteer status and hours in 2014 were positively associated with the number of close friends and contact frequency in 2018. Only those who volunteered 200 hours or more in 2014 were positively associated with friendship quality in 2018. Regarding gender differences, men who volunteered 200 hours or more in 2014 had higher friendship quality in 2018 than women, while women who volunteered 100-199 hours in 2014 had greater contact frequency in 2018 than men. Hence, our results suggest volunteering is integral in shaping late-life friendships and volunteering might be more critical for understanding friendship characteristics among older men and women.
Examining the Risk of Potentially Preventable Hospitalization in Adults With Congenital and Acquired Disabilities
Authors: Mahmoudi Elham , Lin Paul , Khan Anam , Kamdar Neil
Published: December 2021

Introduction: Adults with congenital (cerebral palsy/spina bifida (CP/SB)) or acquired disabilities (spinal cord injury (SCI) or multiple sclerosis (MS)) are more likely than those without disability to develop medical complications. Little is known about potentially preventable hospitalizations (PPH) among adults with disabilities. PPHs are preventable if a patient had timely access to care. Our objective was to estimate PPH risk for each of the aforementioned disabilities. Methods: We used private payer claims data from 2007-2017 to identify adults (18+) with diagnoses of CP/SB (n=10,617), SCI (n=5,173), and MS (n=6,198). Adults without these disabilities were included as controls. We propensity score matched individuals for age and sex. Logistic regression models with repeated measures were subsequently applied, adjusting for age, sex, race/ethnicity, health indicators, U.S. census divisions, and socioeconomic variables. Odd ratios (OR) were compared over 4-years of follow up. Results: Adults with CP/SB, SCI, and MS had higher odds of any PPH compared with adults without disability [CP/SB: (OR=4.10; 95% CI: 2.31-7.31); SCI: (OR=1.67; 95% CI: 1.21-2.32); and MS: (OR=1.48; 95% CI: 1.00-2.25)]. Use of preventative services reduced the PPH risk. For example, wellness visit reduced the odds of PPH by almost half [CP/SB: (OR=0.52; 95% CI: 0.41-0.67); SCI: (OR=0.57; 95% CI: 0.45-0.71); and MS: (OR=0.53; 95% CI: 0.40-0.66)]. Conclusions: Adults with disabilities are at greater odds of PPH compared to adults without disabilities. Clinical guidelines for use of preventative care for adults living with disabilities need to be accordingly updated.
How Does Aging in Place Help Us Understand Loneliness During the COVID-19 Pandemic?
Authors: Phillips Judith Robertson , Ford Cassandra , Prohaska Thomas
Published: December 2021

Co-sponsored by the Disasters and Older Adults, Loneliness and Social Isolation, and Rural Aging Interest Groups, five presenters will highlight multiple circumstances regarding the intersection of social isolation or loneliness and the impact of COVID-19. Haverhals and colleagues interviewed veterans and their caregivers to identify the impact of changes in care delivery and social isolation as a result of the pandemic. Findings indicated differences in feelings of isolation among individuals living in their own home or assisted living facilities. Hua et al. examined whether individuals in long-term care communities were lonelier than individuals in the community during the pandemic using data from the NHATS COVID-19 module with higher levels of loneliness reported from individuals living in more restricted communities. Henning-Smith and colleagues explored differences in social activities among rural and urban participants in the COVID-19 Coping Study. Their study provides awareness into the ways rural and urban older adults stayed connected during the pandemic. Peterson et al. examined the effect of COVID-19 on care in Florida nursing homes and assisted living communities and on residents’ anxiety with higher levels of anxiety reported by residents in nursing homes. Using the Coping with Loneliness, Isolation and COVID19 Global Survey, O’Sullivan and colleagues utilized the lens of ‘place’ to examine factors associated with those experiencing loneliness and/or social isolation during the pandemic with insights from a public health perspective. Collectively, these presenters will provide evidence of the challenges associated with older adults’ social isolation and loneliness throughout the COVID-19 pandemic.
Does Place Matter When Understanding Loneliness and Social Isolation?
Authors: O'Sullivan Roger , Burns Annette , Victor Christina , Prohaska Thomas , Lawlor Brian , Leavey Gerry
Published: December 2021

Physical distancing and restriction of movements as measures to prevent the spread of Covid-19 required people to change their work, home and social lives. Loneliness and social isolation have emerged as key public health issues during the pandemic. Traditionally when considering loneliness the focus is often on individual factors rather than within the context of structural and environmental dimensions. This paper will utilise data from the Coping with Loneliness, Isolation and Covid-19 global online survey which had over 20, 000 global responses from people aged 18+ in 2020. Analysis will use the lens of ‘place’ and the 5-item UCLA scale and 6-item Lubben social network scale to understand the social and demographic characteristics and structural and environmental factors associated with those experiencing loneliness and/or social isolation in rural and urban areas both before and during the pandemic. The paper will conclude with key messages from a public health perspective.
Innovative Gerontology in Higher Education: Transformative Effects of the Pandemic
Authors: Saunders Pamela , Kim Yoon Chung , Dobbs Debra
Published: December 2021

Gerontology in higher education is experiencing an exciting inflection point rising from the COVID pandemic pushing us to adapt our teaching modalities. Many educators have developed innovative learning experiences making use of creativity, virtual reality, online discussion boards, virtual tours, Jam Boards, videos, and breakout rooms. This symposium will bring together gerontologists and educators to discuss their educational innovations. Dr. Saunders will discuss the use of virtual reality in a Geriatrics clerkship experience to enhance knowledge, empathy, and attitudes towards older adults. Dr. Hanna and Ms. Kim will present the use of a virtual avatar to explore aging identity. Professor Barsness will discuss the participation of older adults from the community as subject matter experts. Ms. Redlich will share her virtual internship experience of exploring the intellectual and social benefits of adult study abroad. Although the pandemic was challenging to gerontological education, substantial transformations have been accomplished. The innovations described in this session broadened engagement of students with older adults to identify their strengths and challenges to flourish in the "New Normal."
Older Adults as Virtual Subject Matter Experts in COVID Graduate Education
Authors: Barsness Sonya
Published: December 2021

COVID-19 has further illuminated the need for educational approaches in gerontology that are person-centered and experiential. Ideally, this includes in-person experiences with students and older adults. Through their classroom participation as subject matter experts in aging, older adults share their personal experiences, and react to gerontological theories and ideas. Shared learning offers a platform for exploration of shared humanity, so that older adults are not seen as the “other”, but “us”. This prepares a generation of gerontologists to identify and reject ongoing ageism, again highlighted by the pandemic. COVID-19 has also challenged educators to offer these experiential opportunities. In this presentation we will outline how older adults from a Continuing Care Retirement Community participated virtually in a graduate course. We will discuss how their virtual involvement was structured, how their real-time COVID experiences were integrated, and share feedback from older adult participants and students on their shared learning experiences.
Discovering Modality of Cognitive Function Using Clustering Analysis
Authors: Xiang Qingyan , Anderson Stacy , Perls Thomas , Nygaard Marianne , Sebastiani Paola
Published: December 2021

In this study with Long Life Family Study (LLFS) participants, we aimed to identify patterns of performance on cognitive function assessments as specific cognitive signatures. We hypothesize that such signatures can be correlated with biomarkers and clinical outcomes. More than 4,700 LLFS participants were administered, at enrollment, a series of neuropsychological tests that measure various cognitive domains. We performed a cluster analysis to group LLFS subjects into clusters characterized by combinations of six neuropsychological test scores. The analysis resulted in 10 clusters of varying size with different cognitive signatures that (1) significantly correlated with physical and pulmonary function, and 31 blood biomarkers and (2) predicted mortality and incident medical events such as dementia, cardiovascular diseases, etc. We conclude that cluster analysis of multiple neuropsychological tests discovers cognitive signatures that are more specific than individual cognitive domains and that these can be correlated with blood biomarkers, incident medical outcomes and mortality.
Rejection of Care in Hospitalized Persons Living With Dementia: The Impact of Nurse Communication
Authors: Shaw Clarissa , Ward Caitlin , Gordon Jean , Williams Kristine , Herr Keela
Published: December 2021

Rejection of care (RoC) by persons living with dementia (PLWD) has yet to be measured in the hospital setting. Elderspeak communication (i.e., baby talk or infantilization) is an established antecedent to RoC in nursing home dementia care. The purpose of this study was to determine the impact of elderspeak communication by nursing staff on RoC by hospitalized PLWD. Eighty-eight care encounters between 16 PLWD and 53 nursing staff were observed for RoC using the Resistiveness to Care scale in one Midwestern hospital. Audio-recordings of the care encounters were transcribed verbatim and coded for semantic, pragmatic, and prosodic features of elderspeak. Over one-quarter (28.7%) of the duration of nursing staff speech towards PLWD constituted elderspeak and nearly all (96.6%) of the 88 care encounters included some elderspeak. Almost half of the observations (48.9%) included RoC behaviors by PLWD. Rejection of care was modeled as present or absent using a GEE method. Characteristics of the PLWD (e.g., pain, delirium) and the observation (e.g., environmental simulation) were evaluated as potential covariates. After adjusting for pain, length of stay, and gender, a 15-percentage point decrease in the proportion of elderspeak communication by nursing staff reduced the odds of RoC by 62% (OR=0.38, 95% CI=0.21-0.71, p=.002,) and a one unit decrease in pain reduced the odds of RoC by 63% (OR=0.37, 95% CI=0.22-0.63, p<.001). This study identified that pain and elderspeak are two modifiable factors of RoC. Person-centered interventions are needed that address communication practices and approaches to pain management for hospitalized PLWD.
Utilizing Peer Cohort Networks to Disseminate Information and to Prevent and Mitigate COVID-19 in Nursing Homes
Authors: Moone Rajean
Published: December 2021

The COVID-19 pandemic disproportionately impacted residents, families, and staff of nursing homes and senior care communities. Even with federally mandated emergency planning, the pandemic highlighted the lack of preparation to meet the daily challenges faced in senior care. In response, the federal CARES Act including funding for a nationwide network of nursing home cohorts led by academic health centers to disseminate clinical guidance in infection control and pandemic mitigation strategies. We present a case study of a successful diffusion model as implemented in Minnesota with seven cohorts comprised of 242 nursing homes and 544 employees. Experts in geriatric care, long term care regulatory management, and public health led ninety-minute sessions held over the span of sixteen weeks. The session format included foundational evidence-based practices in pandemic management (including infection control, social isolation, leadership, and other topics), individual case studies, peer to peer knowledge diffusion, and expert guidance.
Qualitative Research With LGBTQ Older Adults and Older Adults Living With HIV/AIDS During COVID-19
Authors: Bybee Sara , Oswald Austin
Published: December 2021

In this symposium, researchers will discuss conceptual and practical challenges to conducting qualitative research with older LGBTQ+ adults and older adults living with HIV/AIDS during the COVID-19 pandemic. Researchers who conduct studies with LGBTQ+ populations and with older adults living with HIV/AIDS already face challenges in recruiting and retaining large enough sample sizes. Social distancing guidelines during the pandemic prohibited many researchers from conducting in-person studies. Conducting health and social science research entirely online may have its challenges when working with these older adult populations, but it may also present new opportunities for reaching hidden or hard-to-reach groups. Presenters draw on their recent experiences conducting semi-structured interviews, online surveys, and qualitative analyses of public records to illuminate the complex considerations of conducting research remotely with LGBTQ+ older adults and older adults living with HIV/AIDS. Presenters also discuss how conducting remote research with these populations may require methodological changes in study design in order to collect the most meaningful and reliable data from research participants. Ultimately, COVID-19 has required researchers to alter or change their methods of conducting research. As the internet becomes more heavily relied upon for conducting research, it is imperative that scholars in LGBTQ+ aging and HIV/AIDS consider the potential challenges and opportunities that online research presents for their studies, and for research participants who are living with HIV/AIDS or who identify as LGBTQ+.
Transcending the Corporeal in Later Old Age?
Authors: Higgs Paul
Published: December 2021

This symposium addresses the older body and later life. It focusses on the cultural and social implications of the corporeality of the ageing body. Specifically it seeks to explore the degree to which it is possible to transcend the constraints brought about by the body in later old age. Drawing the distinction between the third and fourth ages for understanding contemporary ageing the papers address three important dimensions of later old age. The first presentation by Gilleard directly addresses the corporeality of late old age noting its seeming undesirability and limitation. Gilleard posits that not only does the ageing body impact on the lived experiences of those in later old age but also acts as a cultural reference point for the representation of this period of the life course. Eliopoulos presents preliminary results from her qualitative study on social exclusion of individuals aged over 80 living in remote island environments of the Pacific Northwest. The research considers how such environments might, even in the absence of high levels of health and social care resources, mitigate some of the constraints associated with the ageing body. The chair, Paul Higgs will discuss the issue of ageism and how it is abstractly inscribed on the ageing body; often with little reference to the lived experiences of older people themselves. He will call for a more reflexive approach to ageism. Overall, the symposium seeks to draw gerontological attention to the complexities and possibilities surrounding the ageing body at later ages.
Motoric Cognitive Risk Syndrome: Prevalence and Cognitive Performance
Authors: Garcia-Cifuentes Elkin , Marquez Isabela , Cano Carlos
Published: December 2021

Cognitive decline and dementia have a significant impact older adult. Motor Cognitive Risk Syndrome (MCRS) is a pre-dementia stage where slow gait speed and subjective memory complaints are present. MCRS increases the risk of frailty, dementia, disability, falls and overall mortality. We used data from the SABE Colombia study (Health, Well-Being, and Aging) conducted in 2015 in adults aged 60 years and older. After adjusting for confounding variables MCRS was associated with MMSE (OR 0.90, CI 0.82-0.99), pre-frail (OR 9.1, CI 3.26-25.47) and frail (OR 21.38, CI 6.30-72.57). This study found a prevalence of 5.45% of MCRS in Colombian older adults. We found an associations between cognitive performance (MMSE), frailty and MCRS. Our results increase the awareness of a pre-dementia stages different to Mild Cognitive Impairment (MCI), as these individuals are at greater risk than those with MCI to develop dementia.
65 & Thrive: Improving Patient Length of Stay, Readmission, and Quality of Care by Becoming an Age-Friendly Hospital
Authors: Vien Tracey , Bobroff Stella , De Ocampo Ricardo
Published: December 2021

Data indicates that older persons will increase in numbers along with having an increase of life expectancy in the United States. Kaiser Permanente Los Angeles Medical Center’s Utilization Department developed “65 & Thrive”—an age-specialized initiative to provide holistic care that preserves independence, quality of life, prevents functional and cognitive decline, and promotes both patients and their families to continue thriving. The initiative’s focus is guided by the 5 M’s model on mobility, medication, mentation, multi-morbidity, and what matters. Case management staff were given age-sensitivity trainings, improved workflows and made assessments that identified, addressed, and secured resources for patients throughout their hospitalization. Silver Angel volunteers were specially trained to prevent physical and mental decline and focused on activities to prevent delirium, depression and falls. The volunteers visited with patients daily for these interactions. The initiative was piloted in April 2020 on a stroke telemetry unit and since then the hospital has seen a significant decrease in the overall annual readmission rates by 3.1% when compared to 2019. The average length of stay for older adult patients; however, increased from 4.05 to 4.83 days unfortunately due to COVID-19. This initiative demonstrates the necessity to expand “65 & Thrive” throughout the hospital and ultimately to other Kaiser Permanente medical centers to best provide holistic care to older adults.
Changes in Functional Status Among Clusters of Older Adults After Hospitalization for Pneumonia
Authors: Park Chan Mi , Rhim Hye Chang , Lee Eun Sik , Kim Wonsock , Kim Jong Hun , Kim Dae Hyun
Published: December 2021

Little is known about how social determinants, comorbidity, and disability status are associated with functional recovery after an acute illness. A prospective cohort study was conducted between 2019-2020 at a university hospital in Korea, to investigate functional recovery after hospitalization for pneumonia in older adults with different degrees of social deprivation, disabilities, and comorbidities. K-means cluster analysis was used to identify groups of patients based on social deprivation score, activities of daily living, instrumental activities of daily living, physical limitation score, and Gagne comorbidity index. Four groups were identified: Group A: non-disabled group with limited social support (n=61 [30.3%]); Group B: multimorbid but non-disabled group with social support (n=45 [22.4%]); Group C: multimorbid and disabled group with social support (n=38 [18.9%]); Group D: multimorbid and disabled group with limited social support (n=57 [28.4%]). Functional status, defined as ability to perform 21 activities and physical tasks independently, was measured via telephone interviews at 1, 3, and 6 months after discharge. Group-based trajectory model identified four functional status trajectories: excellent (n=29 [14.4%]), good (n=51 [25.4%]), fair (n=58 [28.9%]) and poor (n=63 [31.3%]). The most common functional trajectory by four groups was good trajectory (59%) in Group A, excellent trajectory (48.9%) in Group B, fair (50%) and poor trajectory (50%) in Group C, and poor trajectory (77.2%) in Group D. Our results suggest that most patients without disability recover functional status after pneumonia, despite multimorbidity or limited social support. Social support seems to be more important for those with multimorbidity and disability.
LinkAGES Colorado: Evaluation of Intergenerational Programs to Improve Connections Across All Ages
Authors: De Fries Carson , Hasche Leslie , Cohen Rachel , Steward Andrew , Schilz Matthew
Published: December 2021

LinkAGES: Colorado is a collaborative group of multi-sector organizations (e.g., libraries, non-profit service organizations, nursing homes) that uses a capacity-building approach to support the offering of intergenerational programs and evaluation of outcomes over time and across programs. Since 2018, LinkAGES has implemented 20 intergenerational programs involving various activities (e.g., music and art therapy, sharing cultural traditions), across settings, and across modalities (in-person and online). Ages of program participants ranged from 5 months to 96 years old. This study evaluated change in connectedness between generations over time. Participants (n=118) completed pre- and post-program ratings on social connection (i.e., level of intergenerational engagement, self-perception of extent of feeling connected, and self-perception of impact on someone from another generation) on a 4-point Likert scale. Paired sample t-test results indicated that programs significantly improved engagement and perceived impact. Using multiple regression analyses, we tested change over time for each outcome controlling for participant age group, program host setting, and program modality. A greater positive change in level of engagement occurred for older adults and in-person programs. Additionally, feelings of connection and perceived impact significantly improved over time when controlling for age group, program modality, and program host setting, with age group as a significant covariate. This study demonstrates the impact of intergenerational programs on social connectedness across a wider network of organizations than much of the extant literature. While the positive outcomes are promising and consistent across LinkAGES programs and existing literature, further exploration of age group differences should be considered.
Ageism Predicts Prioritizing COVID-19 Vaccines for Older Adults and LTC Residents
Authors: Pullen Carly , Steele Jenessa , Patrick Julie Hicks
Published: December 2021

Ageism and ageistic stereotypes regarding older adults have become widespread and influence many policies and practices. Benevolent ageism includes attitudes or behaviors that appear overtly positive but are actually patronizing (Cary et al., 2017). Hostile ageism, usually expressed through negative stereotypes, highlights older adults' poor physical and mental functioning (Cary et al., 2017). The aim of the current study was to examine the role of benevolent and hostile ageism on perceptions of vaccination priority during the COVID-19 pandemic. As part of a larger longitudinal study on perceptions of aging, measures of benevolent and hostile ageism were collected in January 2020, before the pandemic began in the US. In March 2021, the same participants were asked to identify top vaccine priorities by ranking groups (e.g., adults 65 and older, school teachers, etc.). Participants who put older adults in the lowest priority group expressed more benevolent ageism before the pandemic than those who put older adults in the top priority group, F(2, 88) = 3.93, p < .05. Participants who put older adults in the lowest priority group expressed more hostile ageism prior to the pandemic, compared to those who put older adults in the top priority group, F(2, 88) = -3.34, p < .05. Similar to Vale and colleague (2020) findings, our results suggest that ageism influences people's ideas about triage for the vaccine. Notably, neither form of ageism related to prioritization for other high-risk groups, including members of racial/ethnic minority groups or health care workers.
Development and validation of multimorbidity index predicting mortality among Chinese older adults
Authors: Luo Yan , Huang Zi-Ting , Xu Hui-wen , Chen zi-shuo , Su He-Xuan , Liu Hui , Xu Beibei
Published: December 2021

This study aimed to construct a multimorbidity index among Chinese older adults. Participants aged 65-84 years (n=11,757) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Fourteen self-reported chronic conditions were assessed at baseline. Outcome was all-cause mortality within five-year follow-up. We used restrictive association rules mining to identify the patterns of multiple chronic conditions associated with mortality. The weights of conditions and disease combinations were assigned using logistic regression adjusted by age and sex in training set. Multimorbidity index (MI) with individual diseases and multimorbidity index incorporating disease combinations (MIDC) were developed. We compared the performance of MI and MIDC with condition count and XGBoost algorithm in the validation set. There were no significant differences of c-statistics between condition count (0.687) and MI (0.692) or MIDC (0.689). The c-statistic of XGBoost algorithm (0.675) was the lowest among all models. The Integrated Discrimination Improvement (IDI) and categorical Net Reclassification Index (NRI) for MI (IDI: 0.01, P < 0.001; NRI: 0.01, P = 0.127), MIDC (IDI: 0.004, p = 0.002; NRI: 0.02, P = 0.033), and XGBoost model (IDI: 0.02, P < 0.001; NRI: 0.03, P = 0.004) were significantly positive compared with condition count. However, no significant differences for IDI and NRI were observed between MI and MIDC. Among Chinese older adults, weighted multimorbidity index with individual disease can better predict five-year mortality risk over condition count. There was little improvement in the predictive performance of the index after considering the joint effects of disease combinations.
Markers Of Glucose Metabolism And Muscle Strength Decline Among The Offspring Of Long-Lived Individuals
Authors: Miljkovic Iva , Cvejkus Ryan , Santanasto Adam , Feitosa Mary , Schwander Karen , Wojczynski Mary , Thyagarajan Bharat , Zmuda Joseph
Published: December 2021

Diabetes has been linked to accelerated muscle strength decline with aging. However, the association between glucose metabolism and muscle strength decline among individuals without diabetes is less clear. We tested whether fasting plasma markers of glucose and insulin metabolism (glucose, insulin, hemoglobin A1c, and soluble receptor for advanced glycation end products (sRAGE)) are associated with grip strength decline among 1415 non-diabetic offspring of exceptionally long-lived individuals who have a low diabetes risk (age range 36-88; mean age ± SD = 60 ± 8 years; mean BMI ± SD = 27 ± 4.7 kg/m2; 57% women). Grip strength was assessed using a hand-held dynamometer at two clinic visits over an average of 7.9 years. Multiple linear mixed models were adjusted for age, sex, field center, lifestyle, comorbidities, body weight, height, weight change, and family relatedness. Each standard deviation higher fasting insulin (7.3 mIU/L) was related to greater grip strength decline (-0.38 ± 0.16 kg; p=0.016), while each standard deviation higher fasting sRAGE (430 pg/mL) was related to slower grip strength decline (0.36 ± 0.18 kg; p=0.04). Our findings suggest that even among non-diabetic individuals from families with a clustering of “healthier” metabolic profiles - insulin metabolism and advanced glycation end products may be important biomarkers of muscle strength decline with aging. Potential mechanisms, including genetic and metabolic mediators underlying the observed associations, warrant further investigation.
Opportunities and Barriers to Medication Safety in Community-Dwelling Older Adults
Authors: Jallow Fatoumata , Stehling Elisa , Sajwani Zara , Daniel Kathryn , Xiao Yan
Published: December 2021

Community-dwelling multi-morbid older adults are a vulnerable population for medication safety-related threats. We interviewed a sample of these older adults recruited from local retirement communities and from primary care practices to learn their perceptions of barriers and enablers for their medication safety. The present study is part of the Partnership in Resilience for Medication Safety (PROMIS) study. One of the aims of this project is to identify barriers and opportunities to improve older adults' medication safety. These interviews were conducted during COVID-19 pandemic conditions. Results from this qualitative study suggest that trust between these older adults and their healthcare providers is an essential component of medication safety. Overarching themes include disruptions in medication management, caregivers caring for each other, patient safety practices or habits, and medication management literacy. Participants also shared strain due to lack of skills to navigate telemedicine visits, trust in Primary Care Providers (PCPs) and pharmacists to prescribe and dispense safely for them, reliance on PCPs and pharmacists to give essential information about medications without having to be asked. Our interviews illustrated large variations in older adults’ perceived role in medication safety, with some developing expertise in understanding how medications work for them and how long-term medications should be periodically reviewed. The types of information needs and supports from PCPs were likely different. Understanding these barriers and enablers for safe medication management can help us develop medication safety improvements for this vulnerable population.
The Impact of Tooth Retention on Health and Quality of Life in Older Adults
Authors: Atanda Adejare (Jay) , Livinski Alicia , Weatherspoon Darien , Fontelo Paul , Boroumand Shahdokht
Published: December 2021

America is aging rapidly, and older adults (age ≥65 y) are retaining more of their natural teeth, a trend expected to continue. Although much is known about the impact of complete tooth loss on overall health and well-being, less is known about the effect of partial tooth loss. We conducted a systematic review to advance our understanding of the impact of retaining ≥20 teeth on health and quality of life (QoL) in older adults using two tooth retention concepts – shortened dental arch (SDA) and functional dentition (FD). We searched seven scientific databases from 1981–2019 for publications on tooth retention and outcomes and impact on health and QoL. Ninety-six studies were included in this review. Most were assessed with low risk of bias (n=74) and of good quality (n=73) using the revised Cochrane Risk of Bias tool and Newcastle-Ottawa Scale. Tooth retention was defined as FD in 82 studies, SDA in 10 studies, and four studies used both. Most were cross-sectional and only seven were from the US. We found an increasing trend among published studies in using FD and SDA to describe natural dentition retention (50 articles in 2015-19 vs one in 1995-99). In general, having <20 teeth was associated with increased likelihood for functional dependence, onset of disability, declines in higher-level functioning, and lower QoL. New information is needed to facilitate clinical decision-making, care-giving, and to help health providers better meet the future oral health needs of an aging US population.
Characteristics and Prognoses of Long-Term Home Care Patients
Authors: Yamanaka Takashi , Mizuki Maiko , Kidana Kiwami , Yamaga Ryonosuke
Published: December 2021

With demographic aging, many older adults require home medical care. Although home-based primary care is promoted in the United States and Japan, there is insufficient evidence about it. We aimed to study the characteristics and prognoses of long-term home care patients. We prospectively registered 151 patients, estimated to receive physician home visits for more than six months, in a clinic in Chiba, Japan, in 2020. The mean (±SD) age was 83.9±10.0 years and ranged from 31 to 102 years. Most patients were men (60.3%) and aged 65 years or above (95.3%). We investigated clinical information, the Edmonton Symptom Assessment System Revised Japanese version (ESAS-r-J), Dementia Assessment Sheet in Community-based Integrated Care System 21 items (DASC-21), EuroQOL 5 dimensions 5-level (EQ-5D-5L) every six months, and the incidence of hospital admission, death, and patient transportation by ambulance. The most frequent diagnoses were dementia (31.1%), bone and articular diseases (17.2%), cerebrovascular diseases (11.9%), organ failure (9.3%), and neurological diseases (9.3%). Most patients (78.2%) showed more than 30 points on the DASC-21, suggesting cognitive impairment. Worse wellbeing, drowsiness, tiredness, anxiety, depression, and pain were the most prevalent symptoms. EQ-5D-5L index values were distributed around–0-0.2 and 0.4-0.7. During the first three months of physician home visits, 21.9% of patients had hospital admissions, 12.5% of them died, and 11.7% required hospital transportation by an ambulance. In this study, most long-term home care patients suffered from cognitive impairment. In addition to receiving care for daily life, these patients require intensive medical management.
Obesity and Multimorbidity in the USA: National Health and Nutrition Examination Surveys 2005-2014
Authors: Lynch David , Petersen Curtis , Spangler Hillary , Kahkoska Anna , Batsis John
Published: December 2021

Declining mortality rates and an aging population have contributed to increasing rates of multimorbidity (≥2 chronic conditions) in the United States. Obesity is an important risk factor for the development of chronic diseases. We evaluated the association between obesity and multimorbidity, and how the prevalence of concomitant obesity has changed over time. We used data from 8,883 individuals aged ≥60 years with data on body mass index (BMI) and self-reported comorbidities from the National Health and Nutrition Examination Surveys 2005-2014. Logistic regression was used to quantify the association between BMI categories (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m2) and multimorbidity (yes/no). Change in proportions of obesity coexisting with multimorbidity by year was tested through linear regression. All analysis used NHANES survey design and weighting to be representative of the US population. The overall proportion of individuals with concomitant multimorbidity and obesity was 75%. As compared to a normal BMI (18.5-24.9 kg/m2), older adults with obesity (BMI ≥30 kg/m2) had higher odds of multimorbidity (OR 1.78, 95% CI 1.49,2.12). Persons with obesity had higher odds of decline in physical (1.41 [1.06,1.88]), basic (1.56 [1.13,2.15]), and instrumental activities of daily living (OR 1.58 [1.03,2.40]). The proportion of individuals with obesity and multimorbidity increased over time, but did not reach significance (β = 0.008, p=0.051). These results emphasize the role of obesity as a contributing factor to the burden of multimorbidity among older adults and underscore the importance of identifying and addressing obesity and multimorbidity via interventions to decrease obesity prevalence.
Impact of Virtual Reality on Healthcare Provider Empathy for Older Adults With Sensory Impairment
Authors: Dutton Suzanne
Published: December 2021

Virtual reality (VR) is an innovative technology that can simulate dual sensory impairment so that healthcare providers and others can experience this affliction common in older adults. This study investigated whether VR simulation could increase empathy among healthcare workers. Healthcare providers experienced a 7-minute scenario from the viewpoint of “Alfred”, a 74-year-old with macular degeneration and high frequency hearing loss on a commercial VR headset (Oculus Rift). Using a one-group pre/post-test study design, we measured knowledge, changes in empathy, and assessed participants’ self-reported behavior change. Results showed that participants increased their knowledge and that 9 of 14 empathy items had statistically significant increases. Additionally, 97% of participants agreed or strongly agreed that they would utilize the information learned in their work with patients. In conclusion, evidence suggests VR is an effective intervention to increase empathy and positively change behavior to support persons with sensory impairment.
Disparities in Basic Housing Needs as a Predictor of Psychological Well-Being Among Older Adults
Authors: Custis Meghan , Lee Jeongeun , Peterson Natasha
Published: December 2021

Adequate housing and safe environments are among older adults’ foundational needs. Prior research suggests minority older adults face significant barriers to accessing affordable and appropriate housing. However, the effects of this environmental press on their psychological well-being are rarely addressed. This project examined racial disparities between minority and white older adults’ housing and environment conditions and the differential impact on their psychological well-being. Using nationally representative data from the National Health & Aging Trends Study (NHATS), older adults' reported rating of the quality of housing conditions, financial security, neighborhood security, and the interviewer’s rating of the home environment were analyzed. A total of 4,048 community-dwelling older adults aged 65 and over were selected for analysis. The sample demographics are predominantly white (77.5%), female (61.4%), and residing in the community (82%). Results found minority older adults reported poorer housing conditions, fewer home modifications, and lower financial and neighborhood security, compared to white counterparts. The impact of housing quality was more detrimental to minority older adults’ psychological well-being, compared to white counterparts. These findings suggest a significant negative impact of home conditions on the psychological well-being of minority older adults. Home modifications are a viable option to increase or preserve functional status in the home, which could lessen the deleterious effects of environmental press on older adults’ psychological outcomes, especially minorities. This study’s findings provide information that bolsters our knowledge of housing and environment conditions, which are critical in efforts to reduce health disparities in late life.