bluuebunny/crossref_metadata_2025 huggingface dataset:
AGE-FRIENDLY CITIES AND COMMUNITIES: RESEARCH ON LOCAL PRACTICE TO STRENGTHEN THE MOVEMENT’S FUTURE
Authors: Greenfield Emily , Pope Natalie , Pestine-Stevens Althea
Published: December 2023

The age-friendly cities and communities (AFCC) movement has accelerated a major paradigmatic shift for the field of aging in the 21st century. Launched and spurred by high-profile government agencies and organizations across the globe, this ambitious movement highlights the transformative potential of deliberate, cross-sectoral efforts to improve built, social, and service environments of localities in response to population aging. This presentation will provide a brief overview of the development of a global program of policy and practice on AFCCs, with an emphasis on its emergence in the United States. It will then present insights regarding challenges and opportunities for the future based on findings from an ongoing, longitudinal study of a regional network of AFCC initiatives. The study, designed as a developmental evaluation, explores the perspectives of on-the-ground AFCC leaders on their practice as part of a private philanthropic grantmaking initiative to spur AFCCs in New Jersey. Reflecting on our years of engaged research with this network, the presentation will highlight issues concerning multi-level systems alignment, the promises and pitfalls of public sector leadership, the need for additional practice theories, and greater incorporation of considerations of aging equity and racial justice. The presentation will demonstrate the importance of continuing to leverage the strengths of community-engaged research to better ensure the movement’s relevance, reach, and equitable impact across diverse community, organizational, and broader systems contexts.
VISION LOSS AND FOOD INSECURITY IN THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Almidani Louay , Lee Moon , Swenor Bonnielin , Samuel Laura , Varadaraj Varshini
Published: December 2023

Adults with vision impairment (VI) may be at a greater risk of experiencing food insecurity due to economic hardships and difficulty with daily activities. However, the relationship is not well understood. We examined the cross-sectional associations between VI and food insecurity in older community-dwelling US adults among 2,815 National Health and Aging Trends Study participants. VI was measured on categorical (distance acuity VI [> 20/40], near acuity VI [> 20/40], contrast sensitivity impairment [CSI] [<1.55], and any VI (distance, near, or CSI)) and continuous scales (distance and near acuity [per 0.1 logMAR], and contrast sensitivity [per 0.1 logCS units]). Food insecurity was classified based on functional limitations, lack of social support, and/or financial limitations. Overall, older adults with any VI had higher prevalence rates of food insecurity than adults without VI (4.56% vs. 1.90%). In fully-adjusted models, older adults with any VI had double the odds of food insecurity than their peers (OR=2.13, 95% CI: 1.25–3.62). Although no associations were found when assessing other vision measures categorically, continuous scales showed strong associations; worse distance (OR=5.00, 95% CI: 1.85–13.48) and near acuity (OR=2.56, 95% CI: 1.05–6.21, per 0.1 logMAR), and worse CS (OR=2.57, 95% CI: 1.11–5.94, per 0.1 logCS units) were associated with higher odds of food insecurity. These results suggest that older Americans with VI have a higher likelihood of food insecurity, and highlight a need to examine strategies, such as more disability-inclusive policies impacting food access, to improve accessibility and reduce these inequities.
ADVANCING RESEARCH ACROSS THE ADRD CONTINUUM IN UNDERREPRESENTED POPULATIONS
Authors: Zahodne Laura , Ajrouch Kristine , Elliott Cerise
Published: December 2023

This symposium highlights innovative work advancing ADRD research with African Americans, Latinos, and Arab Americans. Included papers address critical issues along the ADRD spectrum from life course risk factors, through mild cognitive impairment (MCI), to dementia caregiving. Investigating links between the early-life environment and later-life ADRD risk, Dr. Tsotsoros examines cognitive correlates of adverse childhood experiences (ACEs) in two disparate samples, demonstrating the need to characterize risk pathways among older Latina women, who are at increased risk of both ACEs and ADRD. Using nationally representative data, Dr. Esiaka focuses on adult risk factors for ADRD among Black men. She shows that neighborhood physical disorder and poor sleep quality represent key risk factors for worse cognitive health in this critically understudied population. Moving along the ADRD continuum, Dr. Darwish focuses on another severely underrepresented group: Arab American immigrants with MCI. Based on in-depth work with older adults in Lebanon, she details cultural adaptations made in the development of a combined cognitive-behavioral and cognitive rehabilitation intervention for this group. Next, Dr. Bouldin uses nationally representative data on African American, Latino, and non-Latino White older adults with dementia to quantify racial/ethnic differences in the prevalence and correlates of caregiver support service use. Findings highlight both risk and resilience among dementia caregivers from minoritized racial/ethnic groups. Finally, Cerise Elliott from the National Institute on Aging (NIA) will offer perspectives on how disaggregating population subgroups through between- and within-group research designs can advance NIA’s goal of understanding and eliminating racial/ethnic inequalities across the ADRD continuum. This is an Alzheimer’s Disease and Related Dementias Interest Group Sponsored Symposium.
STRESSOR CHARACTERIZATION IN STUDIES OF PHYSICAL RESILIENCE
Authors: Bandeen-Roche Karen , Xue Qianli , Liu Fangyu , Varadhan Ravi , Buta Brian , Brown IV Charles , Walston Jeremy , Sieber Frederick
Published: December 2023

Physical resilience may be considered as rebounding well from physical stressors. Early gerontological consensus has emphasized that resilience properly should be referred to as “resiliencies”—each, specific to a given stressor type and magnitude. Specificities include that one may be resilient to a minor stressor but not a more severe one as well as that one’s physiologic state and constellation relevant to determining resilience capacity (“PRC”) may better accommodate certain types of stressors than others. Yet, the literature on resilience in older adults has devoted little attention to stressor characterization. In this talk, a conceptual framework for considering the role of stressor variation in studies of resiliency and a process to elicit expert opinion on sources of variation in stressor experience are presented. Both are applied both within the RESiliency in TOtal knee REplacement (RESTORE) study. The conceptual framework distinguishes “exogenous” (potentially randomizable) and “endogenous” (connected to one’s PRC) variation in stressor magnitude and type. Elicitation identified anesthesia aspects and surgical technique elements among exogenous features, and perioperative vital indicators, bleeding and pain amelioration among endogenous features. Stressor feature variation was analyzed: this was found to be highest for perioperative vasopressor use, body temperature and postoperative opioid requirements. Analyses describing feature associations with resilience outcomes also will be presented: These examine the validation hypothesis that more severe stressors are associated with worse outcomes. This work is producing measures of stressor magnitude and type suitable for testing the primary RESTORE hypothesis that fitter PRC blunts adverse stressor effects on outcomes.
PHYSICAL RESERVE MEASURES AS PREDICTORS OF RESILIENCE IN OLDER ADULTS UNDERGOING TOTAL KNEE REPLACEMENT
Authors: Sison Maria , Sloane Richard , Colon-Emeric Cathleen , Whitson Heather
Published: December 2023

Measures of physical reserve have been shown to predict resilience following surgery in older adults. The objective of this study was to evaluate the utility of gait speed, hand grip strength, and 3-minute walk distance to predict resilience in older adults scheduled for total knee arthroplasty (TKA), in whom preoperative gait and mobility may be limited by pain or reduced range of motion. We conducted an interim analysis of data from PRIME-KNEE, an ongoing prospective study following participants age ≥60 years undergoing TKA recruited from Duke hospitals. We determined the change in self-reported Lower Extremity Physical Activities of Daily Living (LE PADL) score from pre-surgery baseline to 4 months following TKA in 133 participants (mean age = 72, 59% female). Gait speed, hand grip, and 3-minute walk were collected at baseline. A total of 110 (83%) participants exhibited “resilience,” defined dichotomously as any improvement in LE PADL score (occurred in 38 participants) or return to a non-disabled state (occurred in 72 participants). Logistic regression analysis adjusted for age and sex revealed that 3-minute walk distance was significantly associated with resilience at 4 months (OR=1.012 [CI 1.002-1.022]) with an area under the curve of 0.634. The presentation will review the implications of these results and present findings with an updated sample, as well as discuss the need for other predictive measures, such as provocative tests (i.e., tests that measure response to an experimental stressor) and biomarkers.
CAPABLE: APPLYING AN EVIDENCE-BASED MODEL OF CARE FOR OLDER ADULTS WITH HIV
Authors: Smith Jamie , Farley Jason , Lowensen Kelly , McDaniel Kennedy , Szanton Sarah , Ornstein Katherine
Published: December 2023

In the United States, more than half of people living with HIV (OWH) are at least 50 years. Older PWH experience increased comorbidities, earlier onset of geriatric syndromes, and functional decline. These health consequences intersect with complex social and environmental factors, further complicating aging with HIV. Yet initiatives focused on successful aging do not consider the unique needs of older PHWs. Models of care tailored to the individual that addresses both intrinsic (e.g., chronic infections, stress, and nutrition) and extrinsic (socioeconomic status, housing instability, food insecurity, and threats to safety) factors unique to older PWH are needed to improve health and functional outcomes. Community Aging in Place, Advancing Better Living for Elders (CAPABLE), an internationally recognized model of care, is a person-directed program that has been successful in supporting aging in place by reducing functional decline and disability among older adults. Over several months, the participant, occupational therapist, registered nurse, and handy worker collaborate on solutions to improve the participant’s bio-psych-functional capacity to function at home. In multiple trials, CAPABLE has demonstrated improvements in independence, safety, self-efficacy, and depression. CAPABLE is associated with healthcare cost reductions, including over $30,000 in Medicare and Medicaid savings. CAPABLE has not been adapted to older PWH, despite being well-positioned to address intrinsic and extrinsic factors affecting adherence, viral suppression, and other health outcomes. This presentation will discuss the first-ever translation of CAPABLE to a cohort of older PWH using human-centered design strategies and discuss initial feasibility trial of older PWH at Johns Hopkins.
A CRITICAL REFLECTION ON AGING IN PLACE: INCLUDING END OF LIFE IN AGE-FRIENDLY POLICY
Authors: Doran Patty
Published: December 2023

By taking a critical perspective on the policy objective of ageing in place, this theoretical paper asks where are the end-of-life discussions in age-friendly policies? People do not like to think about “growing old”, even less so, perhaps, do they like to talk about end of life and dying. To overcome this, ageing policies have successively been focused on active, successful and healthy ageing. However, there have been increasing calls to examine ageing, and to support ageing in place, from a perspective that acknowledges the heterogeneity of the older population and the challenges faced by diverse groups of older people. The places in which we age, and our experiences of ageing, living and dying, are all influenced by social and political determinants. While separately there is increasing research highlighting inequity in both the ability of older adults to age in place and their experience at end-of-life, there is little literature that suggests how policy that supports ageing in place can also enable better experiences at end-of-life. By adopting a spatial justice lens to the concept of ageing in place, this paper first presents a critical reflection of the places in which we live and age. Second, the paper suggests there are overlapping challenges and opportunities in relation to supporting both ageing in place and end-of-life, therefore there is a need to include greater discussion of end-of-life and dying in age-friendly policy.
RELATIONSHIPS MATTERS: INTERGENERATIONAL CONFLICT PREDICTS STRESS AND DEPRESSION IN GRANDPARENT CAREGIVERS
Authors: Yancura Loriena
Published: December 2023

Literature from both research and applied perspectives suggest that studies consider aspects of grandparent involvement beyond residence and custodial status to examine predictors and correlates of grandparent well-being. These suggestions are supported by a multigenerational family life course framework, which considers lifelong linkages among family and notes that interactions among family members are critically important for well-being. Objective: This study hypothesized that stress and burden in caregiving grandparents (G1) would be predicted by relationship quality with the grandchildrens’ parents (G2) when other variables are controlled. Method: Data for these analyses were collected online via Qualtrics Panel Service. Surveys were completed by 312 grandparents who provided care to their grandchildren for at least 20 hours per week.

Results: After controlling for grandchild age and grandparent household status (non-resident, skipped generation, multigeneration), stress (R2=.21) and depression (R2= .34) were positively predicted by non-White race, lower income, and grandparent age. Adding grandchild behavior and grandparent relationship with G2 significantly increased predictive power (p<.001) for both stress (R2=.51) and ( R2=.41) depression.

Discussion: These findings suggest that variables beyond residence status are important in understanding the effect of providing care to grandchildren on grandparents’ well-being.
IDENTIFYING DYAD-LEVEL PARENTING PRACTICES AMONG US CUSTODIAL GRANDPARENTS: A LATENT PROFILE ANALYSIS
Authors: Ye Minzhi
Published: December 2023

Although half of US custodial grand families contain married grandparents, little is known about the parenting practices of custodial grandfathers (CGF). Based on the Family Stress model and the latent profile analyses, we identified typologies of dyad-level parenting practices among 193 married custodial grandparents (CGP) couples recruited nationally through convenience-based and population-based strategies. Grandmothers (CGM) and CGF were interviewed separately, and four types of parenting practices profiles emerged: (1) Ideal CGM&CGF; (2) Inadequate CGM & Ideal CGF; (3) Ambivalent CGM & High-effective CGF; and (4) High-effective CGM & Inadequate CGF. After controlling for socio-demographics, these profiles related differentially to the psychological well-being of CGF and CGM, as well as to the behavioral and emotional outcomes of grandchildren (CGC). CGF in Profile four reported significantly lower positive affect than those in Profiles one and three, but there were no profile differences regarding CGF depressive symptoms. While CGM in Profile two reported fewer depressive symptoms than the other profiles, there were no differences regarding GM’s positive affect. A pattern also occurred whereby CGC from Profile one had significantly fewer externalizing and internalizing difficulties than other profiles. It is essential for future researchers and practitioners to recognize the contribution of CGF to the parenting dynamics in families with married CGP.
ASSOCIATIONS BETWEEN HEARING LOSS AND HEALTH CARE UTILIZATION: EVIDENCE FROM NHATS
Authors: Garcia Emmanuel , Reed Nicholas
Published: December 2023

We investigated the association between self-reported hearing loss and healthcare utilization among community dwelling older Medicare beneficiaries (age ≥65) who were enrolled in the 2011 cycle of the National Health and Aging Trends Study (NHATS). Participants’ survey data were linked to fee-for-service Medicare claims data during the 2011-2016 period. Hearing loss was ascertained using based on participants’ hearing aid use, and difficulty hearing in various noisy situations. Those who reported any difficulty hearing or reported hearing aid use were categorized as having hearing loss. Healthcare utilization included: (1) number of inpatient hospitalizations, (2) number of Emergency Department visits, and (3) total number of days spent during hospitalizations per calendar year. Each participant with hearing loss was matched to a participant without hearing loss using a one-to-one propensity score matching to minimize confounding bias. Using generalized estimating equations, we found that among our matched sample those with hearing loss had 21% (Incidence Rate [IR]=1.21; 95% Confidence Interval [CI]= 1.06,1.37) higher rates of emergency department visits, and 48% (IR = 1.48; 95% CI: 1.20,1.82) higher number of days spent in a hospital over the 6-year period from 2011-2016. No association was found between hearing loss and the number of hospitalizations. These finding suggest that older adults with hearing loss may be at risk for increased healthcare utilization. Interventions for hearing loss, such as the use of hearing aids, might reduce healthcare utilization and associated expenditures among older adults in the U.S. Medicare program.
PROMOTING ELDER JUSTICE IN THE VETERANS HEALTH ADMINISTRATION VIA INTER- AND EXTRADEPARTMENTAL COLLABORATIONS
Authors: Makaroun Lena , Smith Kathrine , Boris Lisa , Halaszynski Jaime
Published: December 2023

The Veterans Health Administration (VHA), the largest integrated health system in the country, provides comprehensive, high-quality care to nearly 19 million Veterans, over half of whom are age ≥60. Older Veterans receiving care in VHA have a high prevalence of most known elder abuse (EA) risk factors, many stemming from their military service. The VHA is a leader in advancing knowledge and care for complex geriatric syndromes, and now leaders in both VHA research and social work are spearheading interdisciplinary collaborations to do the same for EA. In this symposium, we present practical experiences, empirical data and lessons learned from four VHA led collaborations, including: 1) development of the VHA National Social Work Elder Abuse Tiger Team that has worked with VHA researchers to develop and lead a national strategy around EA response; 2) a partnership with the Veterans Benefits Administration to conduct novel research on financial exploitation among Veterans; 3) an education and training collaboration with the National Adult Protective Services Association to demystify the processes and procedures of each organization that has thus far led to 7 presentations to >2,500 attendees; and 4) a relationship with the National Collaboratory to Address Elder Mistreatment to adapt and pilot an EA screening tool for use in VHA emergency departments. Highlighting how the VHA has built bridges both within and outside its organization and the impact this has had on advancing EA research and response will generate ideas for other healthcare systems and those interested in future collaborations with VHA.
LIFE COURSE EXPOSURE TO RISKY WORK ENVIRONMENTS AND EARLY RETIREMENT DUE TO DISABILITY
Authors: Sonnega Amanda , Carr Dawn , Chen Qize , Carpenter Rebekah , Cao Katy (Qiuchang)
Published: December 2023

Jobs that are physically demanding, stressful, and dangerous are typically associated with earlier onset of physical health decline and may be associated with increased risk of early retirement due to disability. Occupations reflect differentiation by race and ethnicity due to structural racism in the educational and judicial systems, and the labor market, with Blacks and Hispanics more likely to occupy jobs that are more physically demanding and dangerous. If such jobs lead to earlier retirement, they may exacerbate wealth disparities. We use new data from the Health and Retirement Study’ Life History Mail Survey linked to rich job characteristic data from O*NET to characterize lifetime exposure to risky work environments based on levels of physiological and psychological stress. We evaluate differences by race/ethnicity in exposure to a wide range of risky work environments, explore whether they relate to disability retirement, and explore whether these associations differ by race. We show that there are large racial and ethnic differences in both the likelihood of disability retirement and lifetime exposure to risky work environments. Probit regressions controlling for education and cohort suggest that racial and ethnic differences in disability retirement are partly explained by lifetime exposure to risky work. Our findings may inform modifications to work environments that could improve the lives of workers in “bad jobs” and potentially reduce disparities in disability retirement.
JOURNAL OF GERONTOLOGY SOCIAL SCIENCES: FEATURED 2022 EDITOR’S CHOICE ARTICLES
Authors: Kelley Jessica
Published: December 2023

Social science inquiry on age, aging, and the life course spans many topics and methodologies. This symposium highlights papers that were selected as Editor’s Choice articles in the Journal of Gerontology Social Sciences in 2022. These papers highlight methodological innovations, important advancements in our state of knowledge in an area, or emerging issues in the study of aging and older adults. Moen et al. trace the divergence in later-adulthood work trajectories at the intersection of race, gender, and class. Hamler et al. discuss the impact of skin tone on mental health among older Black Americans. Waselmann et al. present an innovation of counting number of days one attended school and whether one lived in the Jim Crow South to help explain Black-White disparities in later-life cognitive function. Falzarano et al. explore cultural differences in orientation toward familialism and its impact on caregiver outcomes. Zimmer et al. examine the linkage between war exposure and later-life frailty among Vietnamese older adults.
INFORMAL SUPPORT NETWORKS AND LONELINESS IN OLDER WOMEN LIVING WITH HIV
Authors: Manalel Jasmine , Brennan-Ing Mark
Published: December 2023

Older adults with HIV are at increased risk for social isolation and poor well-being. Although older women living with HIV (WLWH) are more likely to be embedded in supportive networks than men, they often report inadequate support in meeting their needs. The function of older WLWH’s informal networks, their effectiveness in meeting care needs, and links to well-being are major gaps in the literature. Using a subsample of heterosexual WLWH from The Research on Older Adults with HIV 2.0 Study aged 50 to 77 (Mage = 59; n = 210), we assessed sources of social support, interpersonal strain, and support adequacy, in relation to loneliness. About half the sample reported having ever (i.e., currently or in the past) needed regular assistance due to HIV or other illness, disability, or frailty whereas the rest reported never needed regular assistance. Preliminary regression analyses controlled for age, race, ADLs, partnership, and formal care status. Findings revealed that neither support from family or from friends was associated with loneliness. However, strain from both sources was significantly associated with greater loneliness. In terms of support adequacy, having someone to count on for emotional support was associated with lower loneliness, and needing more emotional support was associated with greater loneliness. Instrumental support (i.e., help with tasks was not significantly associated with loneliness. These findings highlight the importance of considering positive and negative social relations, as well as different dimensions and sources of support. Interventions to improve emotional support resources could help mitigate loneliness among older WLWH.
TESTING AN INTERVENTION TO PREVENT CARETAKER NEGLECT: CHALLENGES IN RECRUITING STUDY PARTICIPANTS
Authors: Ejaz Farida , Tuft Samantha , Reynolds Courtney , Bibbo Jessica
Published: December 2023

Researchers collaborated with Utah Adult Protective Services (APS) to develop a telephone-based case management intervention to follow-up with both alleged victims and perpetrators of caretaker neglect after their case was determined to be inconclusive and closed by APS. We focused on this group because APS administrative data suggested that reoccurrence of caretaker neglect was common among this cohort. We hypothesized that linking both victims and caretakers with needed community-based services could prevent reoccurrence of caretaker neglect reports over time. In this presentation, we will describe the challenges we faced with recruiting alleged victims and perpetrators of caretaker neglect. In the piloting phase, we approached 87 potential participants; 18 did not meet study criteria, and 35 did not answer or had incorrect or non-working phone numbers. Of the remaining 34, 9 (26%) agreed to participate and one withdrew later during the follow-up phase. Interviewers reported that refusals were related to reading a 6-minute-long consent form over the phone and conducting an hour-long interview that included the research questionnaire and case-management intervention. The feedback led investigators to simplify the study design/protocols and to shorten the questionnaire to focus on critical data elements and the service needs of participants. Data collection is expected to continue across Utah until spring 2024. We will have a clearer sense of whether such adaptations increased response rates. In addition, we learned that research and practice/intervention goals are likely to be different but negotiating trade-offs, and establishing contracts and data-use agreements early on are important for successful partnerships.
CAREGIVERS WITH MODIFIABLE RISK FACTORS FOR DEMENTIA: LEVERAGING EXISTING PUBLIC HEALTH STRATEGIES
Authors: Gore Janelle , Omura John , Patel Roshni , Olivari Benjamin , McGuire Lisa
Published: December 2023

Caregivers are more likely to self-report subjective cognitive decline, an early indicator of possible future Alzheimer’s disease and related dementias (ADRD), than non-caregivers. Research has identified potential modifiable risk factors for ADRD. To estimate the prevalence of eight modifiable risk factors for ADRD (i.e., high blood pressure, physical inactivity, obesity, type 2 diabetes, depression, current smoking, hearing loss, and binge drinking) among caregivers and non-caregivers, this study analyzed 2021 BRFSS data from 40 jurisdictions that conducted the caregiver module. Among respondents aged ≥18 years (n=232,772), we estimated prevalence of risk factors among caregivers and non-caregivers by selected demographic and health characteristics and the distribution of these characteristics by caregiving status and health condition of care recipient. Significant differences were assessed using t-tests (p< 0.05). Overall, caregivers reported significantly higher prevalence of six out of eight modifiable risk factors for ADRD examined (i.e., high blood pressure, obesity, diabetes, depression, current cigarette smoking, hearing loss) compared with non-caregivers, including high blood pressure (38.8% versus 32.6%), depression (25.1% versus 18.4%), and cigarette smoking (17.2% versus 12.1%). Caregivers of persons living with ADRD reported high blood pressure, diabetes, depression, and hearing loss more often than other types of caregivers. These findings suggest caregivers, especially caregivers of persons living with ADRD, can benefit from existing state-based public health strategies to reduce chronic conditions, such as heart health education and programming. The management of chronic diseases is also beneficial to the brain health of caregivers.
SUPPORT FOR FAMILY CAREGIVERS: WORK STRAIN AND THE IMPACTS OF FORMAL AND INFORMAL SUPPORT
Authors: Svec Joseph , Nemmers Natasha , Lee Jeong Eun
Published: December 2023

In the US, caregiver burnout has significant mental and physical ramifications for an estimated 40 million unpaid caregivers. In addition to higher risks of depression, fatigue, and anxiety, caregivers are often squeezed in the already tenuous balance between work and life. This study seeks to assess whether and to what extent the mental health consequences of caregiver work strain is ameliorated by the presence of additional (informal) family caregivers and formal service use. This study utilizes data provided by the National Study of Caregiving (NSOC) data which is linked with care-recipient information from Health and Aging Trends Study (NHATS) data. We analyze mental health outcomes for caregivers who were present in years 2015 and 2017 (N = 281) using lagged linear regression techniques. We estimate associations of work-strain with mental health issues as well as the moderating effects of informal support (the number of additional caregivers) and utilization of formal support (such as paid service support, formal training, and Medicare funding). Preliminary analyses indicate that the additional informal support mitigates the effect of work strain on mental health. However, formal support corresponds with positive mental health outcomes in the absence of work strain and poorer mental health outcomes when the caregiver experiences work strain. One possible explanation is that formal support is more likely to be used when caregiver burden and isolation is higher, highlighting the importance of timing in service utilization as well as the importance of social and informal resources for employed caregivers.
COMPARING IN-PERSON ONLY, TELEMEDICINE ONLY, AND HYBRID HEALTH CARE VISITS AMONG OLDER ADULTS IN SAFETY-NET CLINICS
Authors: Adepoju Omolola , Dang Patrick , Singh Maya , Chavez Arlette
Published: December 2023

Introduction

Older adults face challenges in seeking healthcare. This study examined factors associated with in-person only versus telemedicine only versus hybrid healthcare visits among adults 65+ in safety-net clinics.

Methods

Data was obtained from a large Texas-based Federally Qualified Health Center (FQHC) network. The dataset included 12,279 appointments for 3,914 unique older adults between March and November 2020. The outcome of interest was a 3-level indicator of telemedicine visits: in-person visits only, telemedicine visits only, and hybrid (In person + Telemedicine) visits during the study period. We used a multinomial logit model adjusting for patient-level characteristics to assess the strength of the relationships.

Results

Compared to their white counterparts, Black and Hispanic older adults were significantly likely to have telemedicine only visits vs in-person only visits (Black RR: 0.59, 95% CI 0.41-0.86; Hispanic RR: 0.46, 95% CI 0.36-0.60). However, there were no significant racial and ethnic differences in hybrid utilization (Black RR: 0.91, 95% CI 0.67-1.23; Hispanic RR: 0.86, 95% CI 0.70-1.07).

Discussion

Our findings suggest that hybrid opportunities may bridge racial and ethnic disparities in access to care. Clinics should consider building capacity for both in-person and telemedicine opportunities as complementary strategies.
SOCIAL NETWORKS AND COGNITIVE HEALTH IN RACIAL/ETHNIC CONTEXT
Authors: Ajrouch Kristine , Antonucci Toni , Brauer Simon , Zahodne Laura
Published: December 2023

Social networks provide tangible resources for older adults and their families. Yet, their formation and characteristics may vary across diverse aging contexts. Friedman and colleagues examine multiple dimensions of caregivers’ networks using a nationally representative sample (N=2,176). Latent profile analysis identified three classes of caregiving networks: (1) Large, sparse networks with relatively few kin and only some people who assist with caregiving tasks for care recipients; (2) Moderately-sized, somewhat dense, kin-based networks; (3) Small, very dense family networks where caregiving is shared across network members, all of which uniquely influence caregiver well-being. Hu and colleagues evaluate measurement invariance of objective and subjective social isolation between US-born and foreign-born older adults using a regionally representative sample (N=611). Findings show indicators of social network structure and perceived relationship quality may be useful for examining social isolation among older immigrants. Ajrouch and colleagues show distinct dimensions of networks differentially influence older adult’s cognitive function. Larger networks and higher proportion of family are positively related while higher contact frequency is negatively related to cognitive function. Using data from the Detroit-based Social Relations Study, Webster and Chin show the extent of similarity in health-related behaviors between older adults and their closest social network members. Analysis of 247 dyads illustrate associations between multiple social network factors (homophily, structure, and relationship quality) and similarity in these behaviors. Together, these papers advance theoretical and methodological approaches to the ways in which social networks serve as a resource across diverse aging contexts.
SOCIAL NETWORK STRUCTURE AND THE WELL-BEING OF FAMILY CAREGIVERS TO OLDER ADULTS
Authors: Friedman Esther , Murphy James , Kennedy David
Published: December 2023

Personal networks provide social support to both older adults and the family members who care for them, yet we know very little about the different structures of caregiver networks and which are most protective of caregiver well-being. Using a new nationally representative survey of 2,176 individuals who report providing care to a family member or friend age 50 or older with a health condition during the height of the Covid-19 pandemic and give detailed information on their personal networks, we examine caregivers’ networks in terms of size, density, proportion kin, and how care is allocated among network members. We also examine the implications of network structure for caregiver well-being including anxiety, depression, and hopefulness. We use latent profile analysis to identify three classes of caregiving networks: (1) Large, sparse networks with relatively few kin and only some people assisting with caregiving tasks for care recipients; (2) Moderately-sized, somewhat dense, kin-based networks; (3) Small, very dense kin networks where caregiving is shared across network members. Caregivers who are male, highly-educated, and providing care for someone with dementia are disproportionately in Class 1. Being in Class 3 is significantly associated with lower caregiver anxiety compared to being in the other two groups, even after controlling for sociodemographic factors, but not with depression and hopefulness. This work has implications for the optimal network structure for facilitating the well-being of family caregivers, and provides a baseline for examining network change and the implications thereof as the impact of the pandemic wanes.
MEASURING SOCIAL ISOLATION AMONG US-BORN AND FOREIGN-BORN OLDER ADULTS
Authors: Hu Rita , Webster Noah , Ajrouch Kristine , Antonucci Toni
Published: December 2023

While older immigrants are at increased risk of social isolation, little research has examined if established measures are equivalent across nativity groups. This study evaluates the measurement invariance of objective and subjective social isolation between US-born and foreign-born older adults. Data are from the Detroit Area Wellness Network (DAWN) study and were collected via a telephone survey from three groups prominent in metro-Detroit: African Americans, Middle Eastern/Arab Americans, and Non-Hispanic White Americans (N=611; Mage = 72.7 [64-98]). The sample was comprised of 29% immigrants. Objective social isolation was measured by network size, household size, and contact frequency with network members. Subjective social isolation was measured by feeling lonely, relationship quality, frequency of arguing, and frequency of conflict. Confirmatory Factor Analysis (CFA) was used to evaluate the dimensional structure, and multiple-group CFA was used to test for measurement variance by immigrant status. The measurement invariance models of objective social isolation showed a good fit after allowing the intercepts of both network and household size to vary in the scalar model. The measurement invariance models of subjective social isolation showed a good fit after allowing the estimate and intercept of loneliness and the intercept of argument to vary in the scalar model. Establishing measurement invariance in both objective and subjective social isolation is essential for valid interpretation of group differences among US- and foreign-born adults in aspects of social isolation. Findings show indicators of social network structure and perceived relationship quality may be useful to examine social isolation among older immigrants.
GLOBAL POPULATION AGING AND HEAT EXPOSURE IN THE 21ST CENTURY: IMPLICATIONS FOR LATE-LIFE WELL-BEING AND POLICY
Authors: Carr Deborah , Falchetta Giacomo , Wing Ian Sue , DeCian Enrica
Published: December 2023

Climate change has profound consequences for older adults’ well-being. Global increases in the frequency, intensity and duration of extreme heat spells pose the most direct threats, given older adults’ underlying health conditions and reduced capacity to thermoregulate. Individual-level consequences of heat exposure are well-documented, yet gerontological research has paid less attention to older adults’ heat exposure at the population level. World regions with both increasing concentrations of older adults and high temperature extremes are potential hotspots where growing aged populations are at risk of heat-related health threats. We estimate older adults’ current and future heat exposure in six global regions (Africa, Asia, Europe, North America, Oceania, South America). Analyses use NASA NEX Global Daily Downscaled Product climate data and country-level projections for the size and distribution of the age 65+ population. We focus on measures of cumulative heat exposure (cooling degree days) and acute exposure to heat extremes (95th percentile of daily maximum temperatures). We project that by 2050, populations aged 65+ globally exposed to >1200 cooling degree days will double. We also project that one-quarter of the aged population worldwide (roughly 340 million) will be living in climates with 95th percentile TMax95 > 99.5 F◦, a critical exposure threshold for health. The drivers of this population-level exposure vary by region. Population aging will drive exposure in historically hot regions in Africa and Asia, whereas climate change will drive heat exposure in historically older regions in Europe and North America. These results can inform public policy and local decision-making.
EXPOSURE TO NATURE IS RELATED TO GENERATIVITY, ESPECIALLY AMONG ADULTS WITH LIMITED FUTURE TIME PERSPECTIVE
Authors: Nikitin Jana , Rupprecht Fiona
Published: December 2023

Theory and research suggest that connection with nature may promote prosocial and environmentally sustainable behaviors. The first objective of the present study was to replicate this finding in an age-heterogeneous sample of N = 115 participants (Mage = 38, SDage = 17, age range 18-85) who reported their exposure to nature up to eight times a day for seven days. We examined the relationship between nature exposure and participants’ generativity, i.e., the extent to which they care about future generations and are politically, socially, and environmentally engaged. The second goal of the study was to show that this relationship is particularly pronounced among individuals with a shorter future time perspective that is related to remaining lifetime and associated with the choice of more emotionally significant goals that focus on generativity. We therefore hypothesized that nature experiences would be more strongly associated with generativity among adults whose future time perspective is limited. We found that people who were more exposed to nature in their daily lives also reported higher levels of generativity. This relationship was moderated by future time perspective. As hypothesized, the association was stronger among adults with a limited future time perspective. Contrary to the widely held stereotype that it is primarily younger adults who are concerned about climate and the future of humanity, we showed the opposite: People who perceived their remaining lifetime as limited were the ones for whom nature experiences were more strongly associated with concern for the environment and future generations.
EXAMINING DIFFERENCES IN SLEEP QUALITY AMONG CAREGIVERS FOR PERSONS LIVING WITH AND WITHOUT DEMENTIA
Authors: Petrovsky Darina , Geisser Sophia , Luth Elizabeth
Published: December 2023

Sleep disturbances among caregivers are linked to increased burden and worse mental health outcomes. Caregivers for persons living with dementia experience more sleep disturbances than non-caregivers. Few studies examine whether sleep quality differs between dementia and non-dementia caregivers. This study analyzes whether dementia caregivers experience worse sleep quality than non-dementia caregivers. Using 2017 National Study of Caregiving, National Health and Aging Trends Study, and time diary interview data, we examined the relationship between caregiver sleep quality (“excellent/very good” versus “good/fair/poor” the previous night) and care recipient’s dementia status (“probable” versus “no”) for 1,374 caregivers in a series of nested multi-variable logistic regression models, controlling for the caregiver and care recipient sociodemographic characteristics, relationship quality, and other controls. Caregivers’ mean age was 62.3 years old (SD=14) and about two-thirds were women (68%), non-Hispanic White (69.4%), and married (66%) Thirty-eight percent cared for persons living with dementia. In the bivariate model, being a caregiver for someone living with dementia was associated with significantly lower odds of reporting “excellent/very good” sleep quality (OR: 0.78, 95%CI: 0.62-0.97, p=0.02). This relationship persisted independent of caregiver and care recipient demographic characteristics. However, caregiver perceptions of the quality of their relationship with the care recipient and the benefits of their caregiving role explained the relationship between care recipient dementia status and caregiver sleep quality ratings (AOR: 0.80, 95%CI: 0.63-1.02, p=0.08). Addressing caregiver burden and relationship quality may help improve sleep quality among dementia caregivers and reduce disparities in sleep quality between dementia and non-dementia caregivers.
CONTRIBUTIONS OF HBCUS TO THE GERONTOLOGY FIELD: DISCUSSIONS OF RELIGION, HEALTH DETERMINANTS, AND BLACK AGING
Authors: Baker Tamara , Washington Tiffany
Published: December 2023

Health advancements have allowed older adults to a better quality of life. This however, is not equitably translated to the well-being of older Black adults. To bypass this narrative, actions are need to focus on restructuring fragmented systems that perpetuate health inequities and social injustices. This however cannot be the responsibility of one person, community, or institution, but rather a collective obligation of those willing to service the needs of all older adults. This allows us to not only acknowledge the scholarly work aimed at bettering the lives of our aging communities, but also recognizes the contributions of scholars affiliated with Historically Black Colleges and Universities (HBCUs), through research, policy, community interventions, and scholarly practices. To address this progressive movement, this collection of papers not only acknowledges the contributions of HBCUs to the gerontology discipline, but also to the scientific advancement focusing on the health and well-being of older Black adults. Speaker one will discuss the biopsychosocial determinants of cognitive function of older Black adults. Our second speaker will focus on religious coping and COVID-19 vaccine hesitancy among older Black individuals. Speaker three will highlight SDoH among older adults within Caribbean societies. The final speaker will discuss the impact and contributions of HBCU’s on an ’aging’ society through data analysis of demographic patterns and historical factors from an Afrocentric and Black perspectives. The discussant will tie together these themes and provide recommendations related to education, scholarly research ventures, particularly as it relates to health outcomes, equity, and collaborating with HBCUs. This is a HBCU Collaborative Interest Group Sponsored Symposium.
CURRENT AND FUTURE SERVICE USE, SATISFACTION, AND NEED FOR SERVICES AS DEFINED BY RURAL AND FRONTIER OLDER ADULTS
Authors: Karlin Nancy
Published: December 2023

This study focused on differences for current service utilization and satisfaction, along with perceived future service use and need for rural versus frontier residing older adults. A sample of older adults (age 65+), stratified using United States government and State of Wyoming definitions for rural (n=70) and frontier (n=72) counties, were interviewed. Frontier respondents reported less education F (1, 141) = 10.19, p = .002, η2 = .068, monthly income F (1, 141) = 17.03, p = .001, η2 = .108 with fewer financial resources F (1, 141) = 10.32, p = .002, η2 = .069, experience with technology F (1, 140) = 4.53, p = .035, η2 = .032, and potential for telehealth F (1, 140) = 19.27, p < .001, η2 = .112, along with fewer computers F (1, 141) = 11.08, p < .001, η2 = .084, and less access to the internet F (1, 141) = 10.19, p = .001, η2 = .073. Differences were evident for recent use of senior nutrition programs and meal sites, dental care, and senior centers along with future use of senior nutrition programs and meal site location, food related services, hearing and vision clinics, and housing needs. Policy concerns have been identified for the funding of future senior housing, medical care, transportation, and food support in frontier and rural areas.
MAINTAINING BRAIN HEALTH VIA TELEHEALTH-BASED CHAIR YOGA FOR RURAL UNDERSERVED OLDER ADULTS
Authors: Park JuYoung , Wiese Lisa Ann , Holt Janet
Published: December 2023

We conducted a randomized control pilot trial in an underserved, racially/ethnically diverse community, to examine the efficacy of (1) computer literacy training provided by high school students meeting rural older adults in their homes, followed by 2) telehealth-based online chair yoga (OCY) or computer brain games (CBG). First, high school students engaged in a “train the trainer” computer skills course using a previously-tested curriculum designed for the target population. Students mentored the older adults in learning computer skills and to access either the OCY (n = 15) or CBG (n=15), which were randomly assigned. Outcomes measured at pre, post, and three months following the 12-week intervention included computer proficiency, cognitive function, pain levels, and psychosocial well-being. In a linear mixed growth model with random intercepts, there was a significant linear trend in computer-based competency, t(50, 19) = 2.56, p = .013. Computer proficiency (computer basics, Internet and email use, communication, and calendaring) increased significantly in both the OCY and CBG groups. Importantly, there was a significant linear change in pain by group, controlling for age and living alone, F(1, 14) = 6.64, p = .022, η2 = .32 (large effect size). Chronic pain in the OCY group decreased significantly from baseline to 3-month follow-up (18.89 to 11.35) but increased in the CBG group (14.27 to 17.28). Increases in cognitive function increased pre/post t(29) = -2.98, p = .003 (one-tailed). These results are promising for older adults with limited exercise opportunities, who also face cognitive risk exacerbated by elevated pain levels.